Distress and Diabetes Treatment Adherence: A Mediating Role for Perceived Control

PubMed Central

Gonzalez, Jeffrey S.; Shreck, Erica; Psaros, Christina; Safren, Steven A.

2014-01-01

Objective To understand independent pathways linking emotional distress, medication adherence and glycemic control in adults with type 2 diabetes, as well as the potential mediating effects of perceived control over illness and self-efficacy. Methods Adults with type 2 diabetes (N = 142) were recruited for an intervention study evaluating cognitive behavioral therapy for adherence and depression. Depressive symptom severity was assessed via semi-structured interview. Validated self-reports assessed diabetes-related distress, perceived control over diabetes (perceived control), self-efficacy for diabetes self-management and medication adherence. Glycemic control was evaluated by hemoglobin A1c (A1C). Only baseline data were included in correlational and linear regression analyses. Results Perceived control was an important mediator for both medication adherence and A1C outcomes. Specifically, regression analyses demonstrated that diabetes distress, but not depression severity, was significantly related to medication adherence and A1C. Self-efficacy and perceived control were also independently associated with medication adherence and A1C. Mediation analyses demonstrated a significant indirect effect for diabetes distress and medication adherence, through perceived control and self-efficacy. The relationship between distress and A1C was accounted for by an indirect effect through perceived control. Conclusion Results demonstrate that diabetes-related emotional distress is associated with poorer treatment adherence and glycemic control among adults with type 2 diabetes; these relationships were partially mediated through perceived control over diabetes. Perceptions of one’s personal ability to influence diabetes may be important in understanding the pathway between emotional distress and poor diabetes treatment outcomes. PMID:25110840

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study

PubMed Central

2012-01-01

Background Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Methods Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. Results 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. Conclusions There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis. PMID:22873682

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study.

PubMed

Waters, Lauren; George, Alexis S; Chey, Tien; Bauman, Adrian

2012-08-08

Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis.

Effect of motivational interviewing on rates of early childhood caries: a randomized trial.

PubMed

Harrison, Rosamund; Benton, Tonya; Everson-Stewart, Siobhan; Weinstein, Phil

2007-01-01

The purposes of this randomized controlled trial were to: (1) test motivational interviewing (MI) to prevent early childhood caries; and (2) use Poisson regression for data analysis. A total of 240 South Asian children 6 to 18 months old were enrolled and randomly assigned to either the MI or control condition. Children had a dental exam, and their mothers completed pretested instruments at baseline and 1 and 2 years postintervention. Other covariates that might explain outcomes over and above treatment differences were modeled using Poisson regression. Hazard ratios were produced. Analyses included all participants whenever possible. Poisson regression supported a protective effect of MI (hazard ratio [HR]=0.54 (95%CI=035-0.84)-that is, the M/ group had about a 46% lower rate of dmfs at 2 years than did control children. Similar treatment effect estimates were obtained from models that included, as alternative outcomes, ds, dms, and dmfs, including "white spot lesions." Exploratory analyses revealed that rates of dmfs were higher in children whose mothers had: (1) prechewed their food; (2) been raised in a rural environment; and (3) a higher family income (P<.05). A motivational interviewing-style intervention shows promise to promote preventive behaviors in mothers of young children at high risk for caries.

Sleep problems and suicide attempts among adolescents: a case-control study.

PubMed

Koyawala, Neel; Stevens, Jack; McBee-Strayer, Sandra M; Cannon, Elizabeth A; Bridge, Jeffrey A

2015-01-01

This study used a case-control design to compare sleep disturbances in 40 adolescents who attempted suicide with 40 never-suicidal adolescents. Using hierarchical logistic regression analyses, we found that self-reported nighttime awakenings were significantly associated with attempted suicide, after controlling for antidepressant use, antipsychotic use, affective problems, and being bullied. In a separate regression analysis, the parent-reported total sleep problems score also predicted suicide attempt status, controlling for key covariates. No associations were found between suicide attempts and other distinct sleep problems, including falling asleep at bedtime, sleeping a lot during the day, trouble waking up in the morning, sleep duration, and parent-reported nightmares. Clinicians should be aware of sleep problems as potential risk factors for suicide attempts for adolescents.

How is the weather? Forecasting inpatient glycemic control

PubMed Central

Saulnier, George E; Castro, Janna C; Cook, Curtiss B; Thompson, Bithika M

2017-01-01

Aim: Apply methods of damped trend analysis to forecast inpatient glycemic control. Method: Observed and calculated point-of-care blood glucose data trends were determined over 62 weeks. Mean absolute percent error was used to calculate differences between observed and forecasted values. Comparisons were drawn between model results and linear regression forecasting. Results: The forecasted mean glucose trends observed during the first 24 and 48 weeks of projections compared favorably to the results provided by linear regression forecasting. However, in some scenarios, the damped trend method changed inferences compared with linear regression. In all scenarios, mean absolute percent error values remained below the 10% accepted by demand industries. Conclusion: Results indicate that forecasting methods historically applied within demand industries can project future inpatient glycemic control. Additional study is needed to determine if forecasting is useful in the analyses of other glucometric parameters and, if so, how to apply the techniques to quality improvement. PMID:29134125

Two studies on participation in decision-making and equity among FAA personnel.

DOT National Transportation Integrated Search

1991-07-01

Study 1 Moderated multiple regression analyses on data collected from 2,177 FAA air traffic controller specialists indicated that equity perceptions moderated the relationship between participation in decision-making and level of job satisfaction. Sp...

Teacher Personality and Pupil Control Ideology: Associations with Response to Relational Aggression in the Classroom

ERIC Educational Resources Information Center

Gyllborg, Amy B.

2015-01-01

The current study investigated the associations between teacher personality and pupil control ideology and the way in which these variables impact the methods used by Midwestern teachers (n = 123) to respond to and intervene in hypothetical instances of relational aggression, presented via vignette. Regression analyses indicated that aspects of…

Parental Perceptions of Aggressive Behavior in Preschoolers: Inhibitory Control Moderates the Association with Negative Emotionality

ERIC Educational Resources Information Center

Suurland, Jill; van der Heijden, Kristiaan B.; Huijbregts, Stephan C. J.; Smaling, Hanneke J. A.; de Sonneville, Leo M. J.; Van Goozen, Stephanie H. M.; Swaab, Hanna

2016-01-01

Inhibitory control (IC) and negative emotionality (NE) are both linked to aggressive behavior, but their interplay has not yet been clarified. This study examines different NE × IC interaction models in relation to aggressive behavior in 855 preschoolers (aged 2-5 years) using parental questionnaires. Hierarchical regression analyses revealed that…

Modeling and Analysis of Process Parameters for Evaluating Shrinkage Problems During Plastic Injection Molding of a DVD-ROM Cover

NASA Astrophysics Data System (ADS)

Öktem, H.

2012-01-01

Plastic injection molding plays a key role in the production of high-quality plastic parts. Shrinkage is one of the most significant problems of a plastic part in terms of quality in the plastic injection molding. This article focuses on the study of the modeling and analysis of the effects of process parameters on the shrinkage by evaluating the quality of the plastic part of a DVD-ROM cover made with Acrylonitrile Butadiene Styrene (ABS) polymer material. An effective regression model was developed to determine the mathematical relationship between the process parameters (mold temperature, melt temperature, injection pressure, injection time, and cooling time) and the volumetric shrinkage by utilizing the analysis data. Finite element (FE) analyses designed by Taguchi (L27) orthogonal arrays were run in the Moldflow simulation program. Analysis of variance (ANOVA) was then performed to check the adequacy of the regression model and to determine the effect of the process parameters on the shrinkage. Experiments were conducted to control the accuracy of the regression model with the FE analyses obtained from Moldflow. The results show that the regression model agrees very well with the FE analyses and the experiments. From this, it can be concluded that this study succeeded in modeling the shrinkage problem in our application.

Visual field progression with frequency-doubling matrix perimetry and standard automated perimetry in patients with glaucoma and in healthy controls.

PubMed

Redmond, Tony; O'Leary, Neil; Hutchison, Donna M; Nicolela, Marcelo T; Artes, Paul H; Chauhan, Balwantray C

2013-12-01

A new analysis method called permutation of pointwise linear regression measures the significance of deterioration over time at each visual field location, combines the significance values into an overall statistic, and then determines the likelihood of change in the visual field. Because the outcome is a single P value, individualized to that specific visual field and independent of the scale of the original measurement, the method is well suited for comparing techniques with different stimuli and scales. To test the hypothesis that frequency-doubling matrix perimetry (FDT2) is more sensitive than standard automated perimetry (SAP) in identifying visual field progression in glaucoma. Patients with open-angle glaucoma and healthy controls were examined by FDT2 and SAP, both with the 24-2 test pattern, on the same day at 6-month intervals in a longitudinal prospective study conducted in a hospital-based setting. Only participants with at least 5 examinations were included. Data were analyzed with permutation of pointwise linear regression. Permutation of pointwise linear regression is individualized to each participant, in contrast to current analyses in which the statistical significance is inferred from population-based approaches. Analyses were performed with both total deviation and pattern deviation. Sixty-four patients and 36 controls were included in the study. The median age, SAP mean deviation, and follow-up period were 65 years, -2.6 dB, and 5.4 years, respectively, in patients and 62 years, +0.4 dB, and 5.2 years, respectively, in controls. Using total deviation analyses, statistically significant deterioration was identified in 17% of patients with FDT2, in 34% of patients with SAP, and in 14% of patients with both techniques; in controls these percentages were 8% with FDT2, 31% with SAP, and 8% with both. Using pattern deviation analyses, statistically significant deterioration was identified in 16% of patients with FDT2, in 17% of patients with SAP, and in 3% of patients with both techniques; in controls these values were 3% with FDT2 and none with SAP. No evidence was found that FDT2 is more sensitive than SAP in identifying visual field deterioration. In about one-third of healthy controls, age-related deterioration with SAP reached statistical significance.

Application of logistic regression to case-control association studies involving two causative loci.

PubMed

North, Bernard V; Curtis, David; Sham, Pak C

2005-01-01

Models in which two susceptibility loci jointly influence the risk of developing disease can be explored using logistic regression analysis. Comparison of likelihoods of models incorporating different sets of disease model parameters allows inferences to be drawn regarding the nature of the joint effect of the loci. We have simulated case-control samples generated assuming different two-locus models and then analysed them using logistic regression. We show that this method is practicable and that, for the models we have used, it can be expected to allow useful inferences to be drawn from sample sizes consisting of hundreds of subjects. Interactions between loci can be explored, but interactive effects do not exactly correspond with classical definitions of epistasis. We have particularly examined the issue of the extent to which it is helpful to utilise information from a previously identified locus when investigating a second, unknown locus. We show that for some models conditional analysis can have substantially greater power while for others unconditional analysis can be more powerful. Hence we conclude that in general both conditional and unconditional analyses should be performed when searching for additional loci.

Risk factors for highly pathogenic avian influenza in commercial layer chicken farms in bangladesh during 2011.

PubMed

Osmani, M G; Thornton, R N; Dhand, N K; Hoque, M A; Milon, Sk M A; Kalam, M A; Hossain, M; Yamage, M

2014-12-01

A case-control study conducted during 2011 involved 90 randomly selected commercial layer farms infected with highly pathogenic avian influenza type A subtype H5N1 (HPAI) and 175 control farms randomly selected from within 5 km of infected farms. A questionnaire was designed to obtain information about potential risk factors for contracting HPAI and was administered to farm owners or managers. Logistic regression analyses were conducted to identify significant risk factors. A total of 20 of 43 risk factors for contracting HPAI were identified after univariable logistic regression analysis. A multivariable logistic regression model was derived by forward stepwise selection. Both unmatched and matched analyses were performed. The key risk factors identified were numbers of staff, frequency of veterinary visits, presence of village chickens roaming on the farm and staff trading birds. Aggregating these findings with those from other studies resulted in a list of 16 key risk factors identified in Bangladesh. Most of these related to biosecurity. It is considered feasible for Bangladesh to achieve a very low incidence of HPAI. Using the cumulative list of risk factors to enhance biosecurity pertaining to commercial farms would facilitate this objective. © 2013 Blackwell Verlag GmbH.

Fetal Growth and Childhood Acute Lymphoblastic Leukemia: Findings from the Childhood Leukemia International Consortium (CLIC)

PubMed Central

Milne, Elizabeth; Greenop, Kathryn R.; Metayer, Catherine; Schüz, Joachim; Petridou, Eleni; Pombo-de-Oliveira, Maria S.; Infante-Rivard, Claire; Roman, Eve; Dockerty, John D.; Spector, Logan G.; Koifman, Sérgio; Orsi, Laurent; Rudant, Jérémie; Dessypris, Nick; Simpson, Jill; Lightfoot, Tracy; Kaatsch, Peter; Baka, Margarita; Faro, Alessandra; Armstrong, Bruce K.; Clavel, Jacqueline; Buffler, Patricia A.

2013-01-01

Positive associations have been reported between measures of accelerated fetal growth and risk of childhood acute lymphoblastic leukemia (ALL). We investigated this association by pooling individual-level data from 12 case-control studies participating in the Childhood Leukemia International Consortium. Two measures of fetal growth – weight-for-gestational-age and proportion of optimal birth weight (POBW) – were analysed. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, and combined in fixed effects meta-analyses. Pooled analyses of all data were also undertaken using multivariable logistic regression. Subgroup analyses were undertaken when possible. Data on weight for gestational age were available for 7,348 cases and 12,489 controls from all 12 studies and POBW data were available for 1,680 cases and 3,139 controls from three studies. The summary ORs from the meta-analyses were 1.24 (95% CI 1.13, 1.36) for children who were large for gestational age relative to appropriate for gestational age, and 1.16 (95% CI: 1.09, 1.24) for a one standard deviation increase in POBW. The pooled analyses produced similar results. The summary and pooled ORs for small-for-gestational-age children were 0.83 (95% CI: 0.75, 0.92) and 0.86 (95% CI 0.77, 0.95) respectively. Results were consistent across subgroups defined by sex, ethnicity and immunophenotype, and when the analysis was restricted to children who did not have high birth weight. The evidence that accelerated fetal growth is associated with a modest increased risk of childhood ALL is strong and consistent with known biological mechanisms involving insulin like growth factors. PMID:23754574

An empirical study using permutation-based resampling in meta-regression

PubMed Central

2012-01-01

Background In meta-regression, as the number of trials in the analyses decreases, the risk of false positives or false negatives increases. This is partly due to the assumption of normality that may not hold in small samples. Creation of a distribution from the observed trials using permutation methods to calculate P values may allow for less spurious findings. Permutation has not been empirically tested in meta-regression. The objective of this study was to perform an empirical investigation to explore the differences in results for meta-analyses on a small number of trials using standard large sample approaches verses permutation-based methods for meta-regression. Methods We isolated a sample of randomized controlled clinical trials (RCTs) for interventions that have a small number of trials (herbal medicine trials). Trials were then grouped by herbal species and condition and assessed for methodological quality using the Jadad scale, and data were extracted for each outcome. Finally, we performed meta-analyses on the primary outcome of each group of trials and meta-regression for methodological quality subgroups within each meta-analysis. We used large sample methods and permutation methods in our meta-regression modeling. We then compared final models and final P values between methods. Results We collected 110 trials across 5 intervention/outcome pairings and 5 to 10 trials per covariate. When applying large sample methods and permutation-based methods in our backwards stepwise regression the covariates in the final models were identical in all cases. The P values for the covariates in the final model were larger in 78% (7/9) of the cases for permutation and identical for 22% (2/9) of the cases. Conclusions We present empirical evidence that permutation-based resampling may not change final models when using backwards stepwise regression, but may increase P values in meta-regression of multiple covariates for relatively small amount of trials. PMID:22587815

Parathyroid Hormone Levels and Cognition

NASA Technical Reports Server (NTRS)

Burnett, J.; Smith, S.M.; Aung, K.; Dyer, C.

2009-01-01

Hyperparathyroidism is a well-recognized cause of impaired cognition due to hypercalcemia. However, recent studies have suggested that perhaps parathyroid hormone itself plays a role in cognition, especially executive dysfunction. The purpose of this study was to explore the relationship of parathyroid hormone levels in a study cohort of elders with impaied cognition. Methods: Sixty community-living adults, 65 years of age and older, reported to Adult Protective Services for self-neglect and 55 controls matched (on age, ethnicity, gender and socio-economic status) consented and participated in this study. The research team conducted in-home comprehensive geriatric assessments which included the Mini-mental state exam (MMSE), the 15-item geriatric depression scale (GDS) , the Wolf-Klein clock test and a comprehensive nutritional panel, which included parathyroid hormone and ionized calcium. Students t tests and linear regression analyses were performed to assess for bivariate associations. Results: Self-neglecters (M = 73.73, sd=48.4) had significantly higher PTH levels compared to controls (M =47.59, sd=28.7; t=3.59, df=98.94, p<.01). There was no significant group difference in ionized calcium levels. Overall, PTH was correlated with the MMSE (r=-.323, p=.001). Individual regression analyses revealed a statistically significant correlation between PTH and MMSE in the self-neglect group (r=-.298, p=.024) and this remained significant after controlling for ionized calcium levels in the regression. No significant associations were revealed in the control group or among any of the other cognitive measures. Conclusion: Parathyroid hormone may be associated with cognitive performance.

Teacher psychological needs, locus of control and engagement.

PubMed

Betoret, Fernando Doménech

2013-01-01

This study examines the relationships among psychological needs, locus of control and engagement in a sample of 282 Spanish secondary school teachers. Nine teacher needs were identified based on the study of Bess (1977) and on the Self-Determination Theory (Deci & Ryan, 1985, 2000, 2002). Self-report questionnaires were used to measure the construct selected for this study and their interrelationships were examined by conducting hierarchical regression analyses. An analysis of teacher responses using hierarchical regression reveals that psychological needs have significant positive effects on the three engagement dimensions (vigor, dedication and absorption). Furthermore, the results show the moderator role played by locus of control in the relationship between teacher psychological needs and the so-called core of engagement (vigor and dedication). Finally, practical implications are discussed.

Power and sample size for multivariate logistic modeling of unmatched case-control studies.

PubMed

Gail, Mitchell H; Haneuse, Sebastien

2017-01-01

Sample size calculations are needed to design and assess the feasibility of case-control studies. Although such calculations are readily available for simple case-control designs and univariate analyses, there is limited theory and software for multivariate unconditional logistic analysis of case-control data. Here we outline the theory needed to detect scalar exposure effects or scalar interactions while controlling for other covariates in logistic regression. Both analytical and simulation methods are presented, together with links to the corresponding software.

Race-based job discrimination, disparities in job control, and their joint effects on health.

PubMed

Meyer, John D

2014-05-01

To examine disparities between job control scores in Black and White subjects and attempt to discern whether self-rated low job control in Blacks may arise from structural segregation into different jobs, or represents individual responses to race-based discrimination in hiring or promotion. Data from the National Survey of Midlife in the United States (MIDUS) were analyzed by mixed-effects linear regression and variance regression to determine the effects of grouping by occupation, and racial discrimination in hiring or promotion, on control scores from the Job Content Questionnaire in Black and White subjects. Path analyses were constructed to determine the mediating effect of discrimination on pathways from education and job control to self-rated health. Black subjects exhibited lower mean job control scores compared to Whites (mean score difference 2.26, P < 0.001) adjusted for age, sex, education, and income. This difference narrowed to 1.86 when adjusted for clustering by occupation, and was greatly reduced by conditioning on race-based discrimination (score difference 1.03, P = 0.12). Path analyses showed greater reported discrimination in Blacks with increasing education, and a stronger effect of job control on health in Black subjects. Individual racially-based discrimination appears a stronger determinant than structural segregation in reduced job control in Black workers, and may contribute to health disparities consequent on work. © 2013 Wiley Periodicals, Inc.

Parental Practices and the Development of Maladaptive Schemas

ERIC Educational Resources Information Center

Gunty, Amy L.; Buri, John R.

2008-01-01

The relationship between Young's (1999) Early Maladaptive Schemas (EMSs) and several parental variables was investigated. The parental variables of interest were: (a) Nurturance, (b) Authority, (c) Intrusiveness, (d) Psychological Control, (e) Overprotection, and (f) Parentification. Regression analyses revealed that these parental practices…

Assessment of Weighted Quantile Sum Regression for Modeling Chemical Mixtures and Cancer Risk

PubMed Central

Czarnota, Jenna; Gennings, Chris; Wheeler, David C

2015-01-01

In evaluation of cancer risk related to environmental chemical exposures, the effect of many chemicals on disease is ultimately of interest. However, because of potentially strong correlations among chemicals that occur together, traditional regression methods suffer from collinearity effects, including regression coefficient sign reversal and variance inflation. In addition, penalized regression methods designed to remediate collinearity may have limitations in selecting the truly bad actors among many correlated components. The recently proposed method of weighted quantile sum (WQS) regression attempts to overcome these problems by estimating a body burden index, which identifies important chemicals in a mixture of correlated environmental chemicals. Our focus was on assessing through simulation studies the accuracy of WQS regression in detecting subsets of chemicals associated with health outcomes (binary and continuous) in site-specific analyses and in non-site-specific analyses. We also evaluated the performance of the penalized regression methods of lasso, adaptive lasso, and elastic net in correctly classifying chemicals as bad actors or unrelated to the outcome. We based the simulation study on data from the National Cancer Institute Surveillance Epidemiology and End Results Program (NCI-SEER) case–control study of non-Hodgkin lymphoma (NHL) to achieve realistic exposure situations. Our results showed that WQS regression had good sensitivity and specificity across a variety of conditions considered in this study. The shrinkage methods had a tendency to incorrectly identify a large number of components, especially in the case of strong association with the outcome. PMID:26005323

Assessment of weighted quantile sum regression for modeling chemical mixtures and cancer risk.

PubMed

Czarnota, Jenna; Gennings, Chris; Wheeler, David C

2015-01-01

In evaluation of cancer risk related to environmental chemical exposures, the effect of many chemicals on disease is ultimately of interest. However, because of potentially strong correlations among chemicals that occur together, traditional regression methods suffer from collinearity effects, including regression coefficient sign reversal and variance inflation. In addition, penalized regression methods designed to remediate collinearity may have limitations in selecting the truly bad actors among many correlated components. The recently proposed method of weighted quantile sum (WQS) regression attempts to overcome these problems by estimating a body burden index, which identifies important chemicals in a mixture of correlated environmental chemicals. Our focus was on assessing through simulation studies the accuracy of WQS regression in detecting subsets of chemicals associated with health outcomes (binary and continuous) in site-specific analyses and in non-site-specific analyses. We also evaluated the performance of the penalized regression methods of lasso, adaptive lasso, and elastic net in correctly classifying chemicals as bad actors or unrelated to the outcome. We based the simulation study on data from the National Cancer Institute Surveillance Epidemiology and End Results Program (NCI-SEER) case-control study of non-Hodgkin lymphoma (NHL) to achieve realistic exposure situations. Our results showed that WQS regression had good sensitivity and specificity across a variety of conditions considered in this study. The shrinkage methods had a tendency to incorrectly identify a large number of components, especially in the case of strong association with the outcome.

Childhood Leukemia and 50 Hz Magnetic Fields: Findings from the Italian SETIL Case-Control Study

PubMed Central

Salvan, Alberto; Ranucci, Alessandra; Lagorio, Susanna; Magnani, Corrado

2015-01-01

We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. PMID:25689995

Work stress and patient safety: observer-rated work stressors as predictors of characteristics of safety-related events reported by young nurses.

PubMed

Elfering, A; Semmer, N K; Grebner, S

This study investigates the link between workplace stress and the 'non-singularity' of patient safety-related incidents in the hospital setting. Over a period of 2 working weeks 23 young nurses from 19 hospitals in Switzerland documented 314 daily stressful events using a self-observation method (pocket diaries); 62 events were related to patient safety. Familiarity of safety-related events and probability of recurrence, as indicators of non-singularity, were the dependent variables in multilevel regression analyses. Predictor variables were both situational (self-reported situational control, safety compliance) and chronic variables (job stressors such as time pressure, or concentration demands and job control). Chronic work characteristics were rated by trained observers. The most frequent safety-related stressful events included incomplete or incorrect documentation (40.3%), medication errors (near misses 21%), delays in delivery of patient care (9.7%), and violent patients (9.7%). Familiarity of events and probability of recurrence were significantly predicted by chronic job stressors and low job control in multilevel regression analyses. Job stressors and low job control were shown to be risk factors for patient safety. The results suggest that job redesign to enhance job control and decrease job stressors may be an important intervention to increase patient safety.

Death Anxiety as a Function of Aging Anxiety

ERIC Educational Resources Information Center

Benton, Jeremy P.; Christopher, Andrew N.; Walter, Mark I.

2007-01-01

To assess how different facets of aging anxiety contributed to the prediction of tangible and existential death anxiety, 167 Americans of various Christian denominations completed a battery of questionnaires. Multiple regression analyses, controlling for demographic variables and previously demonstrated predictors of death anxiety, revealed that…

Encouraging Community Service through Service Learning.

ERIC Educational Resources Information Center

McCarthy, Anne M.; Tucker, Mary L.

2002-01-01

Using a modified Solomon four-group design, 437 business students were divided into 6 treatment and 2 control groups. Treatments included service-learning lectures, service-learning projects, or lecture and project with and/or without pre and posttests. Hierarchical regression analyses indicated service learning treatments significantly affected…

Relationship between body composition and postural control in prepubertal overweight/obese children: A cross-sectional study.

PubMed

Villarrasa-Sapiña, Israel; Álvarez-Pitti, Julio; Cabeza-Ruiz, Ruth; Redón, Pau; Lurbe, Empar; García-Massó, Xavier

2018-02-01

Excess body weight during childhood causes reduced motor functionality and problems in postural control, a negative influence which has been reported in the literature. Nevertheless, no information regarding the effect of body composition on the postural control of overweight and obese children is available. The objective of this study was therefore to establish these relationships. A cross-sectional design was used to establish relationships between body composition and postural control variables obtained in bipedal eyes-open and eyes-closed conditions in twenty-two children. Centre of pressure signals were analysed in the temporal and frequency domains. Pearson correlations were applied to establish relationships between variables. Principal component analysis was applied to the body composition variables to avoid potential multicollinearity in the regression models. These principal components were used to perform a multiple linear regression analysis, from which regression models were obtained to predict postural control. Height and leg mass were the body composition variables that showed the highest correlation with postural control. Multiple regression models were also obtained and several of these models showed a higher correlation coefficient in predicting postural control than simple correlations. These models revealed that leg and trunk mass were good predictors of postural control. More equations were found in the eyes-open than eyes-closed condition. Body weight and height are negatively correlated with postural control. However, leg and trunk mass are better postural control predictors than arm or body mass. Finally, body composition variables are more useful in predicting postural control when the eyes are open. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials.

PubMed

Dong, Jia-Yi; Tong, Xing; Wu, Zhi-Wei; Xun, Peng-Cheng; He, Ka; Qin, Li-Qiang

2011-08-01

Observational studies have indicated that soya food consumption is inversely associated with blood pressure (BP). Evidence from randomised controlled trials (RCT) on the BP-lowering effects of soya protein intake is inconclusive. We aimed to evaluate the effectiveness of soya protein intake in lowering BP. The PubMed database was searched for published RCT in the English language through to April 2010, which compared a soya protein diet with a control diet. We conducted a random-effects meta-analysis to examine the effects of soya protein on BP. Subgroup and meta-regression analyses were performed to explore possible explanations for heterogeneity among trials. Meta-analyses of twenty-seven RCT showed a mean decrease of 2·21 mmHg (95 % CI - 4·10, - 0·33; P = 0·021) for systolic BP (SBP) and 1·44 mmHg (95 % CI - 2·56, - 0·31; P = 0·012) for diastolic BP (DBP), comparing the participants in the soya protein group with those in the control group. Soya protein consumption significantly reduced SBP and DBP in both hypertensive and normotensive subjects, and the reductions were markedly greater in hypertensive subjects. Significant and greater BP reductions were also observed in trials using carbohydrate, but not milk products, as the control diet. Meta-regression analyses further revealed a significantly inverse association between pre-treatment BP and the level of BP reductions. In conclusion, soya protein intake, compared with a control diet, significantly reduces both SBP and DBP, but the BP reductions are related to pre-treatment BP levels of subjects and the type of control diet used as comparison.

Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders.

PubMed

Jalilianhasanpour, Rozita; Williams, Benjamin; Gilman, Isabelle; Burke, Matthew J; Glass, Sean; Fricchione, Gregory L; Keshavan, Matcheri S; LaFrance, W Curt; Perez, David L

2018-04-01

Reduced resilience, a construct associated with maladaptive stress coping and a predisposing vulnerability for Functional Neurological Disorders (FND), has been under-studied compared to other neuropsychiatric factors in FND. This prospective case-control study investigated self-reported resilience in patients with FND compared to controls and examined relationships between resilience and affective symptoms, personality traits, alexithymia, health status and adverse life event burden. 50 individuals with motor FND and 47 healthy controls participated. A univariate test followed by a logistic regression analysis investigated group-level differences in Connor-Davidson Resilience Scale (CD-RISC) scores. For within-group analyses performed separately in patients with FND and controls, univariate screening tests followed by multivariate linear regression analyses examined factors associated with self-reported resilience. Adjusting for age, gender, education status, ethnicity and lifetime adverse event burden, patients with FND reported reduced resilience compared to controls. Within-group analyses in patients with FND showed that individual-differences in mental health, extraversion, conscientiousness, and openness positively correlated with CD-RISC scores; post-traumatic stress disorder symptom severity, depression, anxiety, alexithymia and neuroticism scores negatively correlated with CD-RISC scores. Extraversion independently predicted resilience scores in patients with FND. In control subjects, univariate associations were appreciated between CD-RISC scores and gender, personality traits, anxiety, alexithymia and physical health; conscientiousness independently predicted resilience in controls. Patients with FND reported reduced resilience, and CD-RISC scores covaried with other important predisposing vulnerabilities for the development of FND. Future research should investigate if the CD-RISC is predictive of clinical outcomes in patients with FND. Copyright © 2018 Elsevier Inc. All rights reserved.

Meta-analyses of the 5-HTTLPR polymorphisms and post-traumatic stress disorder.

PubMed

Navarro-Mateu, Fernando; Escámez, Teresa; Koenen, Karestan C; Alonso, Jordi; Sánchez-Meca, Julio

2013-01-01

To conduct a meta-analysis of all published genetic association studies of 5-HTTLPR polymorphisms performed in PTSD cases. Potential studies were identified through PubMed/MEDLINE, EMBASE, Web of Science databases (Web of Knowledge, WoK), PsychINFO, PsychArticles and HuGeNet (Human Genome Epidemiology Network) up until December 2011. Published observational studies reporting genotype or allele frequencies of this genetic factor in PTSD cases and in non-PTSD controls were all considered eligible for inclusion in this systematic review. Two reviewers selected studies for possible inclusion and extracted data independently following a standardized protocol. A biallelic and a triallelic meta-analysis, including the total S and S' frequencies, the dominant (S+/LL and S'+/L'L') and the recessive model (SS/L+ and S'S'/L'+), was performed with a random-effect model to calculate the pooled OR and its corresponding 95% CI. Forest plots and Cochran's Q-Statistic and I(2) index were calculated to check for heterogeneity. Subgroup analyses and meta-regression were carried out to analyze potential moderators. Publication bias and quality of reporting were also analyzed. 13 studies met our inclusion criteria, providing a total sample of 1874 patients with PTSD and 7785 controls in the biallelic meta-analyses and 627 and 3524, respectively, in the triallelic. None of the meta-analyses showed evidence of an association between 5-HTTLPR and PTSD but several characteristics (exposure to the same principal stressor for PTSD cases and controls, adjustment for potential confounding variables, blind assessment, study design, type of PTSD, ethnic distribution and Total Quality Score) influenced the results in subgroup analyses and meta-regression. There was no evidence of potential publication bias. Current evidence does not support a direct effect of 5-HTTLPR polymorphisms on PTSD. Further analyses of gene-environment interactions, epigenetic modulation and new studies with large samples and/or meta-analyses are required.

The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders.

PubMed

Gearing, Robin E; Schwalbe, Craig S J; Lee, RaeHyuck; Hoagwood, Kimberly E

2013-09-01

To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions). Electronic databases were searched for CBT interventions for youth with mood and anxiety disorders. Fifty-three (k = 53) studies investigating 1,937 youth met criteria for inclusion. Booster sessions were examined using two case-controlled effect sizes: pre-post and pre-follow-up (6 months) effect sizes and employing weighted least squares (WLSs) regressions. Meta-analyses found pre-post studies with booster sessions had a larger effect size r = .58 (k = 15; 95% CI = 0.52-0.65; P < .01) than those without booster sessions r = .45 (k = 38; 95% CI = 0.41-0.49; P < .001). In the WLS regression analyses, controlling for demographic factors, primary diagnosis, and intervention characteristics, studies with booster sessions showed larger pre-post effect sizes than those without booster sessions (B = 0.13, P < .10). Similarly, pre-follow-up studies with booster sessions showed a larger effect size r = .64 (k = 10; 95% CI = 0.57-0.70; P < .10) than those without booster sessions r = .48 (k = 20; 95% CI = 0.42-0.53; P < .01). Also, in the WLS regression analyses, pre-follow-up studies showed larger effect sizes than those without booster sessions (B = 0.08, P < .01) after accounting for all control variables. Result suggests that CBT interventions with booster sessions are more effective and the effect is more sustainable for youth managing mood or anxiety disorders than CBT interventions without booster sessions. © 2013 Wiley Periodicals, Inc.

Abnormal dynamics of language in schizophrenia.

PubMed

Stephane, Massoud; Kuskowski, Michael; Gundel, Jeanette

2014-05-30

Language could be conceptualized as a dynamic system that includes multiple interactive levels (sub-lexical, lexical, sentence, and discourse) and components (phonology, semantics, and syntax). In schizophrenia, abnormalities are observed at all language elements (levels and components) but the dynamic between these elements remains unclear. We hypothesize that the dynamics between language elements in schizophrenia is abnormal and explore how this dynamic is altered. We, first, investigated language elements with comparable procedures in patients and healthy controls. Second, using measures of reaction time, we performed multiple linear regression analyses to evaluate the inter-relationships among language elements and the effect of group on these relationships. Patients significantly differed from controls with respect to sub-lexical/lexical, lexical/sentence, and sentence/discourse regression coefficients. The intercepts of the regression slopes increased in the same order above (from lower to higher levels) in patients but not in controls. Regression coefficients between syntax and both sentence level and discourse level semantics did not differentiate patients from controls. This study indicates that the dynamics between language elements is abnormal in schizophrenia. In patients, top-down flow of linguistic information might be reduced, and the relationship between phonology and semantics but not between syntax and semantics appears to be altered. Published by Elsevier Ireland Ltd.

Adolescent Violence: The Protective Effects of Youth Assets

ERIC Educational Resources Information Center

Aspy, Cheryl B.; Oman, Roy F.; Vesely, Sara K.; McLeroy, Kenneth; Rodine, Sharon; Marshall, LaDonna

2004-01-01

The authors explored adolescent physical fighting and weapon carrying, using in-home interviews with 1,098 middle-high school students and their parents. Logistic regression analyses examined the relationship between youth assets and the risk behaviors while controlling for demographic information. Both demographic factors and assets were…

Violence Breeds Violence: Childhood Exposure and Adolescent Conduct Problems

ERIC Educational Resources Information Center

Weaver, Chelsea M.; Borkowski, John G.; Whitman, Thomas L.

2008-01-01

The relationships between childhood exposure to violence and adolescent conduct problems were investigated in a sample of 88 primiparous adolescent mothers and their children. Regression analyses revealed that witnessing violence and victimization prior to age 10 predicted delinquency and violent behaviors, even after controlling for prenatal…

Influence of Family Structure on Health among Youths with Diabetes.

ERIC Educational Resources Information Center

Thompson, Sanna J.; Auslander, Wendy F.; White, Neil H.

2001-01-01

Discusses the extent to which family structure is significantly associated with health in youth with Type 1 diabetes. Multiple regression analyses demonstrated that family structure remains a significant predictor of youth's health when statistically controlling for race, child's age, family socioeconomic status, and adherence. (BF)

Effect of Risk of Bias on the Effect Size of Meta-Analytic Estimates in Randomized Controlled Trials in Periodontology and Implant Dentistry.

PubMed

Faggion, Clovis Mariano; Wu, Yun-Chun; Scheidgen, Moritz; Tu, Yu-Kang

2015-01-01

Risk of bias (ROB) may threaten the internal validity of a clinical trial by distorting the magnitude of treatment effect estimates, although some conflicting information on this assumption exists. The objective of this study was evaluate the effect of ROB on the magnitude of treatment effect estimates in randomized controlled trials (RCTs) in periodontology and implant dentistry. A search for Cochrane systematic reviews (SRs), including meta-analyses of RCTs published in periodontology and implant dentistry fields, was performed in the Cochrane Library in September 2014. Random-effect meta-analyses were performed by grouping RCTs with different levels of ROBs in three domains (sequence generation, allocation concealment, and blinding of outcome assessment). To increase power and precision, only SRs with meta-analyses including at least 10 RCTs were included. Meta-regression was performed to investigate the association between ROB characteristics and the magnitudes of intervention effects in the meta-analyses. Of the 24 initially screened SRs, 21 SRs were excluded because they did not include at least 10 RCTs in the meta-analyses. Three SRs (two from periodontology field) generated information for conducting 27 meta-analyses. Meta-regression did not reveal significant differences in the relationship of the ROB level with the size of treatment effect estimates, although a trend for inflated estimates was observed in domains with unclear ROBs. In this sample of RCTs, high and (mainly) unclear risks of selection and detection biases did not seem to influence the size of treatment effect estimates, although several confounders might have influenced the strength of the association.

Associations of parental feeding styles with child snacking behaviour and weight in the context of general parenting.

PubMed

Rodenburg, Gerda; Kremers, Stef P J; Oenema, Anke; van de Mheen, Dike

2014-05-01

To examine cross-sectional and longitudinal (one-year follow-up) associations of parental feeding styles with child snacking behaviour and weight in the context of general parenting, taking into account the multidimensionality of the controlling feeding style. Linear regression analyses were performed. Parents completed a questionnaire to measure five feeding style dimensions (Instrumental Feeding, Emotional Feeding, Encouragement, Overt Control and Covert Control) and children's fruit, energy-dense snack and sugar-sweetened beverage (SSB) intakes. Children's height and weight were measured to calculate their BMI Z-scores. Moderation by parenting style was tested by adding interaction terms to the regression analyses. Observational study in the Netherlands. Parent-child dyads (n 1275) participating in the INPACT (IVO Nutrition and Physical Activity Child cohorT) study; children were (on average) 9 years of age. Instrumental Feeding and Emotional Feeding were negatively related to child fruit intake one year later and positively to (changes in) child energy-dense snack intake. Encouragement was negatively related to child energy-dense snacking and SSB intake one year later. Overt Control was cross-sectionally and prospectively related to (changes in) child energy-dense snacking and SSB intake in a negative direction. Covert Control showed similar associations with child energy-dense snacking and SSB intake as Overt Control. Although Covert Control was also positively related to child fruit intake and (changes in) child BMI Z-score, bootstrapping analyses revealed only a differential effect of Overt Control and Covert Control on child BMI Z-score one year later, with Covert Control displaying a stronger, positive association. Moderation analyses showed that some significant associations between parental feeding styles and outcome measures were dependent on the degree of psychological control and behavioural control. Instrumental Feeding and Emotional Feeding may have a detrimental impact on children's snacking behaviour, while Encouragement, Overt Control and Covert Control may lead to less energy-dense snacking and less SSB intake. Overt Control and Covert Control have differential effects on child BMI Z-score one year later, which supports the idea that they should be treated as separate constructs. Prospective studies with a longer follow-up may elucidate the causal pathways between the various feeding styles and children's snacking behaviour and weight, as well as the moderating influences of psychological and behavioural control.

An examination of the misuse of prescription stimulants among college students using the theory of planned behavior.

PubMed

Gallucci, Andrew; Martin, Ryan; Beaujean, Alex; Usdan, Stuart

2015-01-01

The misuse of prescription stimulants (MPS) is an emergent adverse health behavior among undergraduate college students. However, current research on MPS is largely atheoretical. The purpose of this study was to validate a survey to assess MPS-related theory of planned behavior (TPB) constructs (i.e. attitudes, subjective norms, and perceived behavioral control) and determine the relationship between these constructs, MPS-related risk factors (e.g. gender and class status), and current MPS (i.e. past 30 days use) among college students. Participants (N = 978, 67.8% female and 82.9% Caucasian) at a large public university in the southeastern USA completed a survey assessing MPS and MPS-related TPB constructs during fall 2010. To examine the relationship between MPS-related TPB constructs and current MPS, we conducted (1) confirmatory factor analyses to validate that our survey items assessed MPS-related TPB constructs and (2) a series of regression analyses to examine associations between MPS-related TPB constructs, potential MPS-related risk factors, and MPS in this sample. Our factor analyses indicated that the survey items assessed MPS-related TPB constructs and our multivariate logistic regression analysis indicated that perceived behavioral control was significantly associated with current MPS. In addition, analyses found that having a prescription stimulant was a protective factor against MPS when the model included MPS-related TPB variables.

Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.

PubMed

Faul, Franz; Erdfelder, Edgar; Buchner, Axel; Lang, Albert-Georg

2009-11-01

G*Power is a free power analysis program for a variety of statistical tests. We present extensions and improvements of the version introduced by Faul, Erdfelder, Lang, and Buchner (2007) in the domain of correlation and regression analyses. In the new version, we have added procedures to analyze the power of tests based on (1) single-sample tetrachoric correlations, (2) comparisons of dependent correlations, (3) bivariate linear regression, (4) multiple linear regression based on the random predictor model, (5) logistic regression, and (6) Poisson regression. We describe these new features and provide a brief introduction to their scope and handling.

Good Self-Control as a Buffering Agent for Adolescent Substance Use

PubMed Central

Wills, Thomas A.; Ainette, Michael G.

2008-01-01

We tested the prediction that self-control will have buffering effects for adolescent substance use (tobacco, alcohol, and marijuana) with regard to three risk factors: family life events, adolescent life events, and peer substance use. Participants were a sample of public school students (N = 1,767) who were surveyed at four yearly intervals between 6th grade and 9th grade. Good self-control was assessed with multiple indicators including planning and problem solving. Results showed that the impact of all three risk factors on substance use was reduced among persons with higher scores on good self-control. Buffering was found in cross-sectional analyses with multiple regression and in longitudinal analyses in a latent growth model with time-varying covariates. Implications for addressing self-control in prevention programs are discussed. PMID:19071971

Coaches' Feedback and Changes in Children's Perceptions of Their Physical Competence.

ERIC Educational Resources Information Center

Horn, Thelma Sternberg

1985-01-01

This study examined the relationship between five softball coaches' feedback and changes in their female athletes' self-perceptions of competence; performance control; and expectancy for success. Multivariate regression analyses showed players' psychosocial growth was a function of both players' skill and the coaches' response to player…

The Role of Parental Influences on Young Adolescents' Career Development

ERIC Educational Resources Information Center

Keller, Briana K.; Whiston, Susan C.

2008-01-01

The relationship between specific parental behaviors and the career development of young adolescents was assessed. Regression analyses revealed that parental behaviors did relate to the career development of middle school students, after controlling for student grade level and gender. Parental behaviors tended to relate more to career…

Clinical Utility of Cancellation on the WISC-IV

ERIC Educational Resources Information Center

Zhu, Jianjun; Chen, Hsinyi

2013-01-01

This study examined empirical evidence for clinical utility of the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV) cancellation subtest by comparing data from 597 clinical and 597 matched control children. The results of dependent t and sequential logistic regression analyses demonstrated that (a) children with intellectual…

Conditional Poisson models: a flexible alternative to conditional logistic case cross-over analysis.

PubMed

Armstrong, Ben G; Gasparrini, Antonio; Tobias, Aurelio

2014-11-24

The time stratified case cross-over approach is a popular alternative to conventional time series regression for analysing associations between time series of environmental exposures (air pollution, weather) and counts of health outcomes. These are almost always analyzed using conditional logistic regression on data expanded to case-control (case crossover) format, but this has some limitations. In particular adjusting for overdispersion and auto-correlation in the counts is not possible. It has been established that a Poisson model for counts with stratum indicators gives identical estimates to those from conditional logistic regression and does not have these limitations, but it is little used, probably because of the overheads in estimating many stratum parameters. The conditional Poisson model avoids estimating stratum parameters by conditioning on the total event count in each stratum, thus simplifying the computing and increasing the number of strata for which fitting is feasible compared with the standard unconditional Poisson model. Unlike the conditional logistic model, the conditional Poisson model does not require expanding the data, and can adjust for overdispersion and auto-correlation. It is available in Stata, R, and other packages. By applying to some real data and using simulations, we demonstrate that conditional Poisson models were simpler to code and shorter to run than are conditional logistic analyses and can be fitted to larger data sets than possible with standard Poisson models. Allowing for overdispersion or autocorrelation was possible with the conditional Poisson model but when not required this model gave identical estimates to those from conditional logistic regression. Conditional Poisson regression models provide an alternative to case crossover analysis of stratified time series data with some advantages. The conditional Poisson model can also be used in other contexts in which primary control for confounding is by fine stratification.

Rigid and flexible control of eating behavior in a college population.

PubMed

Timko, C Alix; Perone, Julie

2005-02-01

The objective of this study was to explore the relationship between rigid control (RC) and flexible control (FC) of eating behavior and their relationship to traditional weight, eating, and affective measurements in a large heterogeneous population. Participants were 639 underweight to obese male and female college students. Multiple regression analyses (MRA) revealed that high RC was associated with high Body Mass Index (BMI) and high Disinhibition (DIS), and high FC was associated with low BMI and low DIS in women. In men, high RC was associated with high BMI and high DIS, whereas FC was not related to BMI or DIS. Multiple regression analyses of BMI on RC and FC in the female subsample revealed that the control variables interact in such a way that the relationship between RC and BMI is stronger when FC is lower. In men, there was no interaction between these variables. This study is the first full replication of Westenhoefer's Gezugeltes Essen und Storbarkeit des Ebetaverhaltens: 2. Auflage. Gottingen: Verlag fur Psychologie () findings regarding RC and FC and their relationship to weight (BMI) and Disinhibition (DIS) in women. This is also the only second study to use the expanded, more reliable versions of the RC and FC scales. Overall, high RC in women and men was associated with greater eating and affective pathology.

Does tip-of-the-tongue for proper names discriminate amnestic mild cognitive impairment?

PubMed

Juncos-Rabadán, Onésimo; Facal, David; Lojo-Seoane, Cristina; Pereiro, Arturo X

2013-04-01

Difficulty in retrieving people's names is very common in the early stages of Alzheimer's disease and mild cognitive impairment. Such difficulty is often observed as the tip-of-the-tongue (TOT) phenomenon. The main aim of this study was to explore whether a famous people's naming task that elicited the TOT state can be used to discriminate between amnestic mild cognitive impairment (aMCI) patients and normal controls. Eighty-four patients with aMCI and 106 normal controls aged over 50 years performed a task involving naming 50 famous people shown in pictures. Univariate and multivariate regression analyses were used to study the relationships between aMCI and semantic and phonological measures in the TOT paradigm. Univariate regression analyses revealed that all TOT measures significantly predicted aMCI. Multivariate analysis of all these measures correctly classified 70% of controls (specificity) and 71.6% of aMCI patients (sensitivity), with an AUC (area under curve ROC) value of 0.74, but only the phonological measure remained significant. This classification value was similar to that obtained with the Semantic verbal fluency test. TOTs for proper names may effectively discriminate aMCI patients from normal controls through measures that represent one of the naming processes affected, that is, phonological access.

Women's work stress and cortisol levels: a longitudinal study of the association between the psychosocial work environment and serum cortisol.

PubMed

Evolahti, Annika; Hultcrantz, Malou; Collins, Aila

2006-11-01

The aim of the present study was to investigate whether there is an association between serum cortisol and work-related stress, as defined by the demand-control model in a longitudinal design. One hundred ten women aged 47-53 years completed a health questionnaire, including the Swedish version of the Job Content Scale, and participated in a psychological interview at baseline and in a follow-up session 2 years later. Morning blood samples were drawn for analyses of cortisol. Multiple stepwise regression analyses and logistic regression analyses showed that work demands and lack of social support were significantly associated with cortisol. The results of this study showed that negative work characteristics in terms of high demands and low social support contributed significantly to the biological stress levels in middle-aged women. Participation in the study may have served as an intervention, increasing the women's awareness and thus improving their health profiles on follow-up.

Linear regression metamodeling as a tool to summarize and present simulation model results.

PubMed

Jalal, Hawre; Dowd, Bryan; Sainfort, François; Kuntz, Karen M

2013-10-01

Modelers lack a tool to systematically and clearly present complex model results, including those from sensitivity analyses. The objective was to propose linear regression metamodeling as a tool to increase transparency of decision analytic models and better communicate their results. We used a simplified cancer cure model to demonstrate our approach. The model computed the lifetime cost and benefit of 3 treatment options for cancer patients. We simulated 10,000 cohorts in a probabilistic sensitivity analysis (PSA) and regressed the model outcomes on the standardized input parameter values in a set of regression analyses. We used the regression coefficients to describe measures of sensitivity analyses, including threshold and parameter sensitivity analyses. We also compared the results of the PSA to deterministic full-factorial and one-factor-at-a-time designs. The regression intercept represented the estimated base-case outcome, and the other coefficients described the relative parameter uncertainty in the model. We defined simple relationships that compute the average and incremental net benefit of each intervention. Metamodeling produced outputs similar to traditional deterministic 1-way or 2-way sensitivity analyses but was more reliable since it used all parameter values. Linear regression metamodeling is a simple, yet powerful, tool that can assist modelers in communicating model characteristics and sensitivity analyses.

Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

PubMed Central

Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L.; Morris, Michael D. S.; Robinson, Lara R.; Myers, Sonya S.; Aucoin, Katherine J.; Keyes, Angela W.; Terranova, Andrew

2013-01-01

This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children’s effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children’s effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children’s effortful control primarily account for variation in children’s academic adjustment. The associations between children’s effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children’s internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed. PMID:24163572

Separation in Logistic Regression: Causes, Consequences, and Control.

PubMed

Mansournia, Mohammad Ali; Geroldinger, Angelika; Greenland, Sander; Heinze, Georg

2018-04-01

Separation is encountered in regression models with a discrete outcome (such as logistic regression) where the covariates perfectly predict the outcome. It is most frequent under the same conditions that lead to small-sample and sparse-data bias, such as presence of a rare outcome, rare exposures, highly correlated covariates, or covariates with strong effects. In theory, separation will produce infinite estimates for some coefficients. In practice, however, separation may be unnoticed or mishandled because of software limits in recognizing and handling the problem and in notifying the user. We discuss causes of separation in logistic regression and describe how common software packages deal with it. We then describe methods that remove separation, focusing on the same penalized-likelihood techniques used to address more general sparse-data problems. These methods improve accuracy, avoid software problems, and allow interpretation as Bayesian analyses with weakly informative priors. We discuss likelihood penalties, including some that can be implemented easily with any software package, and their relative advantages and disadvantages. We provide an illustration of ideas and methods using data from a case-control study of contraceptive practices and urinary tract infection.

Chronotype Is Independently Associated With Glycemic Control in Type 2 Diabetes

PubMed Central

Reutrakul, Sirimon; Hood, Megan M.; Crowley, Stephanie J.; Morgan, Mary K.; Teodori, Marsha; Knutson, Kristen L.; Van Cauter, Eve

2013-01-01

OBJECTIVE To examine whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes had a structured interview and completed questionnaires to collect information on diabetes history and habitual sleep duration, quality, and timing. Shift workers were excluded. A recently validated construct derived from mid-sleep time on weekends was used as an indicator of chronotype. One-day food recall was used to compute the temporal distribution of caloric intake. Hierarchical linear regression analyses controlling for demographic and sleep variables were computed to determine whether chronotype was associated with HbA1c values and whether this association was mediated by a higher proportion of caloric intake at dinner. RESULTS We analyzed 194 completed questionnaires. Multiple regression analyses adjusting for age, sex, race, BMI, insulin use, depressed mood, diabetes complications, and perceived sleep debt found that chronotype was significantly associated with glycemic control (P = 0.001). This association was partially mediated by a greater percentage of total daily calories consumed at dinner. CONCLUSIONS Later chronotype and larger dinner were associated with poorer glycemic control in patients with type 2 diabetes independently of sleep disturbances. These results suggest that chronotype may be predictive of disease outcomes and lend further support to the role of the circadian system in metabolic regulation. PMID:23637357

Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study.

PubMed

Yank, Veronica; Rennie, Drummond; Bero, Lisa A

2007-12-08

To determine whether financial ties to one drug company are associated with favourable results or conclusions in meta-analyses on antihypertensive drugs. Retrospective cohort study. Meta-analyses published up to December 2004 that were not duplicates and evaluated the effects of antihypertensive drugs compared with any comparator on clinical end points in adults. Financial ties were categorised as one drug company compared with all others. The main outcomes were the results and conclusions of meta-analyses, with both outcomes separately categorised as being favourable or not favourable towards the study drug. We also collected data on characteristics of meta-analyses that the literature suggested might be associated with favourable results or conclusions. 124 meta-analyses were included in the study, 49 (40%) of which had financial ties to one drug company. On univariate logistic regression analyses, meta-analyses of better methodological quality were more likely to have favourable results (odds ratio 1.16, 95% confidence interval 1.07 to 1.27). Although financial ties to one drug company were not associated with favourable results, such ties constituted the only characteristic significantly associated with favourable conclusions (4.09, 1.30 to 12.83). When controlling for other characteristics of meta-analyses in multiple logistic regression analyses, meta-analyses that had financial ties to one drug company remained more likely to report favourable conclusions (5.11, 1.54 to 16.92). Meta-analyses on antihypertensive drugs and with financial ties to one drug company are not associated with favourable results but are associated with favourable conclusions.

Do job demands and job control affect problem-solving?

PubMed

Bergman, Peter N; Ahlberg, Gunnel; Johansson, Gun; Stoetzer, Ulrich; Aborg, Carl; Hallsten, Lennart; Lundberg, Ingvar

2012-01-01

The Job Demand Control model presents combinations of working conditions that may facilitate learning, the active learning hypothesis, or have detrimental effects on health, the strain hypothesis. To test the active learning hypothesis, this study analysed the effects of job demands and job control on general problem-solving strategies. A population-based sample of 4,636 individuals (55% women, 45% men) with the same job characteristics measured at two times with a three year time lag was used. Main effects of demands, skill discretion, task authority and control, and the combined effects of demands and control were analysed in logistic regressions, on four outcomes representing general problem-solving strategies. Those reporting high on skill discretion, task authority and control, as well as those reporting high demand/high control and low demand/high control job characteristics were more likely to state using problem solving strategies. Results suggest that working conditions including high levels of control may affect how individuals cope with problems and that workplace characteristics may affect behaviour in the non-work domain.

How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms.

PubMed

Pots, Wendy T M; Trompetter, Hester R; Schreurs, Karlein M G; Bohlmeijer, Ernst T

2016-05-23

Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention. Data from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web-based ACT (n = 82) or one of two control conditions (web-based Expressive Writing (EW; n = 67) and a waiting list (n = 87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre- to post- and follow-up treatment change of depressive symptoms. The treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web-based ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow-up. The findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web-based ACT intervention. The results indicate that there are no restrictions to the allocation of web-based ACT intervention and that web-based ACT can work for different subpopulations. Netherlands Trial Register NTR2736 . Registered 6 February 2011.

Effect of Risk of Bias on the Effect Size of Meta-Analytic Estimates in Randomized Controlled Trials in Periodontology and Implant Dentistry

PubMed Central

Faggion, Clovis Mariano; Wu, Yun-Chun; Scheidgen, Moritz; Tu, Yu-Kang

2015-01-01

Background Risk of bias (ROB) may threaten the internal validity of a clinical trial by distorting the magnitude of treatment effect estimates, although some conflicting information on this assumption exists. Objective The objective of this study was evaluate the effect of ROB on the magnitude of treatment effect estimates in randomized controlled trials (RCTs) in periodontology and implant dentistry. Methods A search for Cochrane systematic reviews (SRs), including meta-analyses of RCTs published in periodontology and implant dentistry fields, was performed in the Cochrane Library in September 2014. Random-effect meta-analyses were performed by grouping RCTs with different levels of ROBs in three domains (sequence generation, allocation concealment, and blinding of outcome assessment). To increase power and precision, only SRs with meta-analyses including at least 10 RCTs were included. Meta-regression was performed to investigate the association between ROB characteristics and the magnitudes of intervention effects in the meta-analyses. Results Of the 24 initially screened SRs, 21 SRs were excluded because they did not include at least 10 RCTs in the meta-analyses. Three SRs (two from periodontology field) generated information for conducting 27 meta-analyses. Meta-regression did not reveal significant differences in the relationship of the ROB level with the size of treatment effect estimates, although a trend for inflated estimates was observed in domains with unclear ROBs. Conclusion In this sample of RCTs, high and (mainly) unclear risks of selection and detection biases did not seem to influence the size of treatment effect estimates, although several confounders might have influenced the strength of the association. PMID:26422698

An Improved Framework for Confound Regression and Filtering for Control of Motion Artifact in the Preprocessing of Resting-State Functional Connectivity Data

PubMed Central

Satterthwaite, Theodore D.; Elliott, Mark A.; Gerraty, Raphael T.; Ruparel, Kosha; Loughead, James; Calkins, Monica E.; Eickhoff, Simon B.; Hakonarson, Hakon; Gur, Ruben C.; Gur, Raquel E.; Wolf, Daniel H.

2013-01-01

Several recent reports in large, independent samples have demonstrated the influence of motion artifact on resting-state functional connectivity MRI (rsfc-MRI). Standard rsfc-MRI preprocessing typically includes regression of confounding signals and band-pass filtering. However, substantial heterogeneity exists in how these techniques are implemented across studies, and no prior study has examined the effect of differing approaches for the control of motion-induced artifacts. To better understand how in-scanner head motion affects rsfc-MRI data, we describe the spatial, temporal, and spectral characteristics of motion artifacts in a sample of 348 adolescents. Analyses utilize a novel approach for describing head motion on a voxelwise basis. Next, we systematically evaluate the efficacy of a range of confound regression and filtering techniques for the control of motion-induced artifacts. Results reveal that the effectiveness of preprocessing procedures on the control of motion is heterogeneous, and that improved preprocessing provides a substantial benefit beyond typical procedures. These results demonstrate that the effect of motion on rsfc-MRI can be substantially attenuated through improved preprocessing procedures, but not completely removed. PMID:22926292

Cognitive Processing Therapy for Veterans with Military-Related Posttraumatic Stress Disorder

ERIC Educational Resources Information Center

Monson, Candice M.; Schnurr, Paula P.; Resick, Patricia A.; Friedman, Matthew J.; Young-Xu, Yinong; Stevens, Susan P.

2006-01-01

Sixty veterans (54 men, 6 women) with chronic military-related posttraumatic stress disorder (PTSD) participated in a wait-list controlled trial of cognitive processing therapy (CPT). The overall dropout rate was 16.6% (20% from CPT, 13% from waiting list). Random regression analyses of the intention-to-treat sample revealed significant…

School Climate: The Controllable and the Uncontrollable

ERIC Educational Resources Information Center

Sulak, Tracey N.

2018-01-01

A positive school climate impacts students by promoting positive relations among students, staff and faculty of the school. The current study used latent class analysis and multinomial regression with R3STEP to analyse patterns of negative behaviours in schools and test the association of these patterns with structural variables like school size,…

Emotional Self-Efficacy and Alcohol and Tobacco Use in Adolescents

ERIC Educational Resources Information Center

Zullig, Keith J.; Teoli, Dac A.; Valois, Robert F.

2014-01-01

This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n?=?2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by…

The Relationship between Cognate Awareness and English Comprehension among Spanish-English Bilingual Fourth Grade Students

ERIC Educational Resources Information Center

Proctor, C. Patrick; Mo, Elaine

2009-01-01

This study was designed to investigate the effect of English reading comprehension on cognate knowledge among a sample of Spanish-speaking bilinguals alongside their monolingual English-speaking counterparts. In order to understand this developmental relationship, the effects of English reading comprehension were controlled in regression analyses,…

Parental Youth Assets and Sexual Activity: Differences by Race/Ethnicity

ERIC Educational Resources Information Center

Tolma, Eleni L.; Oman, Roy F.; Vesely, Sara K.; Aspy, Cheryl B.; Beebe, Laura; Fluhr, Janene

2011-01-01

Objectives: To examine how the relationship between parental-related youth assets and youth sexual activity differed by race/ethnicity. Methods: A random sample of 976 youth and their parents living in a Midwestern city participated in the study. Multivariate logistic regression analyses were conducted for 3 major ethnic groups controlling for the…

Mediators of the Risk for Problem Behavior in Children with Language Learning Disabilities.

ERIC Educational Resources Information Center

Vallance, Denise D.; Cummings, Richard L.; Humphries, Tom

1998-01-01

The independent and relative influences of social discourse and social skills on problem behaviors were examined in 50 children with language learning disabilities (LLD) and 50 control children. Hierarchical regression analyses revealed that both impaired social discourse skills and poor social skills accounted for the negative effects of LLD on…

Good self-control as a buffering agent for adolescent substance use: an investigation in early adolescence with time-varying covariates.

PubMed

Wills, Thomas A; Ainette, Michael G; Stoolmiller, Mike; Gibbons, Frederick X; Shinar, Ori

2008-12-01

This study tested the prediction that self-control would have buffering effects for adolescent substance use (tobacco, alcohol, and marijuana) with regard to 3 risk factors: family life events, adolescent life events, and peer substance use. Participants were a sample of public school students (N = 1,767) who were surveyed at 4 yearly intervals between 6th grade and 9th grade. Good self-control was assessed with multiple indicators (e.g., planning and problem solving). Results showed that the impact of all 3 risk factors on substance use was reduced among persons with higher scores on good self-control. Buffering was found in cross-sectional analyses with multiple regression and in longitudinal analyses in a latent growth model with time-varying covariates. Implications for addressing self-control in prevention programs are discussed. 2008 APA, all rights reserved

Robustness of meta-analyses in finding gene × environment interactions

PubMed Central

Shi, Gang; Nehorai, Arye

2017-01-01

Meta-analyses that synthesize statistical evidence across studies have become important analytical tools for genetic studies. Inspired by the success of genome-wide association studies of the genetic main effect, researchers are searching for gene × environment interactions. Confounders are routinely included in the genome-wide gene × environment interaction analysis as covariates; however, this does not control for any confounding effects on the results if covariate × environment interactions are present. We carried out simulation studies to evaluate the robustness to the covariate × environment confounder for meta-regression and joint meta-analysis, which are two commonly used meta-analysis methods for testing the gene × environment interaction or the genetic main effect and interaction jointly. Here we show that meta-regression is robust to the covariate × environment confounder while joint meta-analysis is subject to the confounding effect with inflated type I error rates. Given vast sample sizes employed in genome-wide gene × environment interaction studies, non-significant covariate × environment interactions at the study level could substantially elevate the type I error rate at the consortium level. When covariate × environment confounders are present, type I errors can be controlled in joint meta-analysis by including the covariate × environment terms in the analysis at the study level. Alternatively, meta-regression can be applied, which is robust to potential covariate × environment confounders. PMID:28362796

Mortality rates in OECD countries converged during the period 1990-2010.

PubMed

Bremberg, Sven G

2017-06-01

Since the scientific revolution of the 18th century, human health has gradually improved, but there is no unifying theory that explains this improvement in health. Studies of macrodeterminants have produced conflicting results. Most studies have analysed health at a given point in time as the outcome; however, the rate of improvement in health might be a more appropriate outcome. Twenty-eight OECD member countries were selected for analysis in the period 1990-2010. The main outcomes studied, in six age groups, were the national rates of decrease in mortality in the period 1990-2010. The effects of seven potential determinants on the rates of decrease in mortality were analysed in linear multiple regression models using least squares, controlling for country-specific history constants, which represent the mortality rate in 1990. The multiple regression analyses started with models that only included mortality rates in 1990 as determinants. These models explained 87% of the intercountry variation in the children aged 1-4 years and 51% in adults aged 55-74 years. When added to the regression equations, the seven determinants did not seem to significantly increase the explanatory power of the equations. The analyses indicated a decrease in mortality in all nations and in all age groups. The development of mortality rates in the different nations demonstrated significant catch-up effects. Therefore an important objective of the national public health sector seems to be to reduce the delay between international research findings and the universal implementation of relevant innovations.

The moderating role of emotional competence in suicidal ideation among Chinese university students.

PubMed

Kwok, Sylvia Y C L

2014-04-01

To explore the relationship among perceived family functioning, emotional competence and suicidal ideation and to examine the moderating role of emotional competence in suicidal ideation. Previous studies have highlighted that poor family relationships and emotional symptoms are significant predictors of suicidal ideation. However, the roles of perceived family functioning and emotional competence in predicting suicidal ideation have not been given adequate attention. A cross-sectional survey using convenience sampling. A questionnaire was administered to 302 university students from February-April in 2011 in Hong Kong. The means, standard deviations and Cronbach's alphas of the variables were computed. Pearson correlation analyses and hierarchical regression analyses were performed. Hierarchical regression analyses showed that perceived high family functioning and emotional competence were significant negative predictors of suicidal ideation. Further analyses showed that parental concern, parental control and creative use of emotions were significant predictors of suicidal ideation. Emotional competence, specifically creative use of emotions, was found to moderate the relationship between perceived family functioning and suicidal ideation. The findings support the family ecological framework and provide evidence for emotional competence as a resilience factor that buffers low family functioning on suicidal ideation. Suggested measures to decrease suicidal ideation include enhancing parental concern, lessening parental control, developing students' awareness, regulation and management of their own emotions, fostering empathy towards others' emotional expression, enhancing social skills in sharing and influencing others' emotions and increasing the positive use of emotions for the evaluation and generation of new ideas. © 2013 John Wiley & Sons Ltd.

Learning climate and feedback as predictors of dental students' self-determined motivation: The mediating role of basic psychological needs satisfaction.

PubMed

Orsini, C; Binnie, V; Wilson, S; Villegas, M J

2018-05-01

The aim of this study was to test the mediating role of the satisfaction of dental students' basic psychological needs of autonomy, competence and relatedness on the association between learning climate, feedback and student motivation. The latter was based on the self-determination theory's concepts of differentiation of autonomous motivation, controlled motivation and amotivation. A cross-sectional correlational study was conducted where 924 students completed self-reported questionnaires measuring motivation, perception of the learning climate, feedback and basic psychological needs satisfaction. Descriptive statistics, Cronbach's alpha scores and bivariate correlations were computed. Mediation of basic needs on each predictor-outcome association was tested based on a series of regression analyses. Finally, all variables were integrated into one structural equation model, controlling for the effects of age, gender and year of study. Cronbach's alpha scores were acceptable (.655 to .905). Correlation analyses showed positive and significant associations between both an autonomy-supportive learning climate and the quantity and quality of feedback received, and students' autonomous motivation, which decreased and became negative when correlated with controlled motivation and amotivation, respectively. Regression analyses revealed that these associations were indirect and mediated by how these predictors satisfied students' basic psychological needs. These results were corroborated by the structural equation analysis, in which data fit the model well and regression paths were in the expected direction. An autonomy-supportive learning climate and the quantity and quality of feedback were positive predictors of students' autonomous motivation and negative predictors of amotivation. However, this was an indirect association mediated by the satisfaction of students' basic psychological needs. Consequently, supporting students' needs of autonomy, competence and relatedness might lead to optimal types of motivation, which has an important influence on dental education. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of socio-cultural factors on spontaneous abortion in Burdur, Turkey: A population based case-control study.

PubMed

Catak, Binali; Oner, Can; Sutlu, Sevinc; Kilinc, Selcuk

2016-01-01

To determine the sociocultural factors that have effect on spontaneous abortion in Burdur, Turkey. Study was designed as case-control study. The case group consist of 257 women whose pregnancies ended with spontaneous abortion. The control group consisted of 514 women whose pregnancy continued since 22 weeks and more during the study. Chi-square, and backward LR logistic regression were utilized in analyses. In multifactorial-analyses it was determined that four factors (educational status of women, employment status of women, exposure to physical violence and non-receipt of ANC) created independent risk on spontaneous abortions. Pregnant women with these risk factors should be followed up more frequently and in a more qualified way in primary and secondary and tertiary health institutions.

Estimates of Flow Duration, Mean Flow, and Peak-Discharge Frequency Values for Kansas Stream Locations

USGS Publications Warehouse

Perry, Charles A.; Wolock, David M.; Artman, Joshua C.

2004-01-01

Streamflow statistics of flow duration and peak-discharge frequency were estimated for 4,771 individual locations on streams listed on the 1999 Kansas Surface Water Register. These statistics included the flow-duration values of 90, 75, 50, 25, and 10 percent, as well as the mean flow value. Peak-discharge frequency values were estimated for the 2-, 5-, 10-, 25-, 50-, and 100-year floods. Least-squares multiple regression techniques were used, along with Tobit analyses, to develop equations for estimating flow-duration values of 90, 75, 50, 25, and 10 percent and the mean flow for uncontrolled flow stream locations. The contributing-drainage areas of 149 U.S. Geological Survey streamflow-gaging stations in Kansas and parts of surrounding States that had flow uncontrolled by Federal reservoirs and used in the regression analyses ranged from 2.06 to 12,004 square miles. Logarithmic transformations of climatic and basin data were performed to yield the best linear relation for developing equations to compute flow durations and mean flow. In the regression analyses, the significant climatic and basin characteristics, in order of importance, were contributing-drainage area, mean annual precipitation, mean basin permeability, and mean basin slope. The analyses yielded a model standard error of prediction range of 0.43 logarithmic units for the 90-percent duration analysis to 0.15 logarithmic units for the 10-percent duration analysis. The model standard error of prediction was 0.14 logarithmic units for the mean flow. Regression equations used to estimate peak-discharge frequency values were obtained from a previous report, and estimates for the 2-, 5-, 10-, 25-, 50-, and 100-year floods were determined for this report. The regression equations and an interpolation procedure were used to compute flow durations, mean flow, and estimates of peak-discharge frequency for locations along uncontrolled flow streams on the 1999 Kansas Surface Water Register. Flow durations, mean flow, and peak-discharge frequency values determined at available gaging stations were used to interpolate the regression-estimated flows for the stream locations where available. Streamflow statistics for locations that had uncontrolled flow were interpolated using data from gaging stations weighted according to the drainage area and the bias between the regression-estimated and gaged flow information. On controlled reaches of Kansas streams, the streamflow statistics were interpolated between gaging stations using only gaged data weighted by drainage area.

A reanalysis of cluster randomized trials showed interrupted time-series studies were valuable in health system evaluation.

PubMed

Fretheim, Atle; Zhang, Fang; Ross-Degnan, Dennis; Oxman, Andrew D; Cheyne, Helen; Foy, Robbie; Goodacre, Steve; Herrin, Jeph; Kerse, Ngaire; McKinlay, R James; Wright, Adam; Soumerai, Stephen B

2015-03-01

There is often substantial uncertainty about the impacts of health system and policy interventions. Despite that, randomized controlled trials (RCTs) are uncommon in this field, partly because experiments can be difficult to carry out. An alternative method for impact evaluation is the interrupted time-series (ITS) design. Little is known, however, about how results from the two methods compare. Our aim was to explore whether ITS studies yield results that differ from those of randomized trials. We conducted single-arm ITS analyses (segmented regression) based on data from the intervention arm of cluster randomized trials (C-RCTs), that is, discarding control arm data. Secondarily, we included the control group data in the analyses, by subtracting control group data points from intervention group data points, thereby constructing a time series representing the difference between the intervention and control groups. We compared the results from the single-arm and controlled ITS analyses with results based on conventional aggregated analyses of trial data. The findings were largely concordant, yielding effect estimates with overlapping 95% confidence intervals (CI) across different analytical methods. However, our analyses revealed the importance of a concurrent control group and of taking baseline and follow-up trends into account in the analysis of C-RCTs. The ITS design is valuable for evaluation of health systems interventions, both when RCTs are not feasible and in the analysis and interpretation of data from C-RCTs. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The influence of training characteristics on the effect of exercise training in patients with coronary artery disease: Systematic review and meta-regression analysis.

PubMed

Kraal, Jos J; Vromen, Tom; Spee, Ruud; Kemps, Hareld M C; Peek, Niels

2017-10-15

Although exercise-based cardiac rehabilitation improves exercise capacity of coronary artery disease patients, it is unclear which training characteristic determines this improvement. Total energy expenditure and its constituent training characteristics (training intensity, session frequency, session duration and programme length) vary considerably among clinical trials, making it hard to compare studies directly. Therefore, we performed a systematic review and meta-regression analysis to assess the effect of total energy expenditure and its constituent training characteristics on exercise capacity. We identified randomised controlled trials comparing continuous aerobic exercise training with usual care for patients with coronary artery disease. Studies were included when training intensity, session frequency, session duration and programme length was described, and exercise capacity was reported in peakVO 2 . Energy expenditure was calculated from the four training characteristics. The effect of training characteristics on exercise capacity was determined using mixed effects linear regression analyses. The analyses were performed with and without total energy expenditure as covariate. Twenty studies were included in the analyses. The mean difference in peakVO 2 between the intervention group and control group was 3.97ml·min -1 ·kg -1 (p<0.01, 95% CI 2.86 to 5.07). Total energy expenditure was significantly related to improvement of exercise capacity (effect size 0.91ml·min -1 ·kg -1 per 100J·kg, p<0.01, 95% CI 0.77 to 1.06), no effect was found for its constituent training characteristics after adjustment for total energy expenditure. We conclude that the design of an exercise programme should primarily be aimed at optimising total energy expenditure rather than on one specific training characteristic. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

An approach to checking case-crossover analyses based on equivalence with time-series methods.

PubMed

Lu, Yun; Symons, James Morel; Geyh, Alison S; Zeger, Scott L

2008-03-01

The case-crossover design has been increasingly applied to epidemiologic investigations of acute adverse health effects associated with ambient air pollution. The correspondence of the design to that of matched case-control studies makes it inferentially appealing for epidemiologic studies. Case-crossover analyses generally use conditional logistic regression modeling. This technique is equivalent to time-series log-linear regression models when there is a common exposure across individuals, as in air pollution studies. Previous methods for obtaining unbiased estimates for case-crossover analyses have assumed that time-varying risk factors are constant within reference windows. In this paper, we rely on the connection between case-crossover and time-series methods to illustrate model-checking procedures from log-linear model diagnostics for time-stratified case-crossover analyses. Additionally, we compare the relative performance of the time-stratified case-crossover approach to time-series methods under 3 simulated scenarios representing different temporal patterns of daily mortality associated with air pollution in Chicago, Illinois, during 1995 and 1996. Whenever a model-be it time-series or case-crossover-fails to account appropriately for fluctuations in time that confound the exposure, the effect estimate will be biased. It is therefore important to perform model-checking in time-stratified case-crossover analyses rather than assume the estimator is unbiased.

Multidrug-resistant pulmonary tuberculosis in Los Altos, Selva and Norte regions, Chiapas, Mexico.

PubMed

Sánchez-Pérez, H J; Díaz-Vázquez, A; Nájera-Ortiz, J C; Balandrano, S; Martín-Mateo, M

2010-01-01

To analyse the proportion of multidrug-resistant tuberculosis (MDR-TB) in cultures performed during the period 2000-2002 in Los Altos, Selva and Norte regions, Chiapas, Mexico, and to analyse MDR-TB in terms of clinical and sociodemographic indicators. Cross-sectional study of patients with pulmonary tuberculosis (PTB) from the above regions. Drug susceptibility testing results from two research projects were analysed, as were those of routine sputum samples sent in by health personnel for processing (n = 114). MDR-TB was analysed in terms of the various variables of interest using bivariate tests of association and logistic regression. The proportion of primary MDR-TB was 4.6% (2 of 43), that of secondary MDR-TB was 29.2% (7/24), while among those whose history of treatment was unknown the proportion was 14.3% (3/21). According to the logistic regression model, the variables most highly associated with MDR-TB were as follows: having received anti-tuberculosis treatment previously, cough of >3 years' duration and not being indigenous. The high proportion of MDR cases found in the regions studied shows that it is necessary to significantly improve the control and surveillance of PTB.

Atomoxetine-Related Change in Sluggish Cognitive Tempo Is Partially Independent of Change in Attention-Deficit/Hyperactivity Disorder Inattentive Symptoms.

PubMed

McBurnett, Keith; Clemow, David; Williams, David; Villodas, Miguel; Wietecha, Linda; Barkley, Russell

2017-02-01

To evaluate effects of atomoxetine versus placebo on sluggish cognitive tempo (SCT) and determine factors affecting improvement of SCT in children with attention-deficit/hyperactivity disorder (ADHD) with dyslexia (ADHD+D) or dyslexia only. This is a post hoc analysis of a 16-week placebo-controlled, double-blind randomized phase of a previously reported atomoxetine study in children aged 10-16 years with ADHD+D, Dyslexia-only, or ADHD-only (no placebo arm). Least squares mean changes from baseline to endpoint for atomoxetine versus placebo on the Kiddie-Sluggish Cognitive Tempo Interview (K-SCT) (Parent, Teacher, and Youth) were analyzed using analysis of covariance and multiple regression (partial R 2 ) analyses to test contributions of ADHD and dyslexia to improvements in K-SCT scores. Results were examined for the three informants within the three diagnostic groups (nine outcomes). Atomoxetine treatment was associated with significant reductions from baseline in seven of the nine outcomes using the p = 0.05 significance level, appropriate for exploratory analysis. When change in ADHD symptom severity was controlled, all of the seven SCT outcomes remained significant; changes in effect sizes were minimal. Regression analyses using SCT change as the criterion found a significant contribution by inattention change only for parent report, whereas, baseline SCT severity was a significant predictor in the randomized groups with the exception of teacher report in the Dyslexia-only group. Given that controlling for change in ADHD symptoms had little effect on change in SCT scores, findings suggest that change in SCT is substantially independent of change in ADHD. By inference, SCT and its response to treatment is a partially distinct phenomenon from ADHD response. Regression analyses did not reveal global effects of inattention change on SCT change; instead, baseline SCT severity was the strongest predictor of placebo-controlled treatment effect on SCT. Atomoxetine effects on SCT appear to be best predicted by how much room for improvement exists for SCT rather than by severity or improvement in inattention. NCT00607919, www.clinicaltrials.gov.

Early miscarriage rate in lean polycystic ovary syndrome women after euploid embryo transfer - a matched-pair study.

PubMed

Luo, Lu; Gu, Fang; Jie, Huying; Ding, Chenhui; Zhao, Qiang; Wang, Qiong; Zhou, Canquan

2017-11-01

The early miscarriage rate is reported to be higher in patients with polycystic ovary syndrome (PCOS) compared with non-PCOS patients. However, whether PCOS is an independent risk factor for early miscarriage is still controversial; to what extent embryonic aneuploidy accounts for miscarriages of PCOS is still unknown. In this 1:3 matched-pair study, 67 lean PCOS patients and 201 controls matched for age, body mass index (BMI) and embryo scores undergoing a single euploid blastocyst transfer in vitrified-warmed cycles were analysed. Clinical pregnancy, early miscarriage and live birth rates were compared. Logistic regression analysis was performed to further evaluate the factors associated with early miscarriage and live birth. Clinical pregnancy rates were 50.7% in PCOS and 55.2% in control groups. Early miscarriage rate was significantly (P = 0.029) increased in the PCOS group compared with controls; non-PCOS patients had a significantly higher live birth rate than PCOS patients, P < 0.001. Further regression analyses showed that PCOS was significantly associated with a higher risk of early miscarriage and decreased chance of live birth. In conclusion, PCOS in women undergoing pre-implantation genetic diagnosis may, independently from BMI and karyotype, increase the risk of miscarriage. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Keeping children safe at home: protocol for three matched case–control studies of modifiable risk factors for falls

PubMed Central

Kendrick, Denise; Stewart, Jane; Clacy, Rose; Coffey, Frank; Cooper, Nicola; Coupland, Carol; Hayes, Mike; McColl, Elaine; Reading, Richard; Sutton, Alex; M L Towner, Elizabeth; Craig Watson, Michael

2012-01-01

Background Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children. Objectives To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity. Design Three multicentre case–control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0–4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences. Main outcome measures Falls on stairs, on one level and from furniture. Discussion As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children. PMID:22628151

Consideration of "g" as a Common Antecedent for Cognitive Ability Test Performance, Test Motivation, and Perceived Fairness

ERIC Educational Resources Information Center

Reeve, Charlie L.; Lam, Holly

2007-01-01

Several different analyses were used to test the hypothesis that test-taking motivation, perceived test fairness, and actual test performance are correlated only because they share a common antecedent. First, hierarchical regressions reveal that initial test performance has a unique influence on non-ability factors even after controlling for…

Relationship between Type of Trauma Exposure and Posttraumatic Stress Disorder among Urban Children and Adolescents

ERIC Educational Resources Information Center

Luthra, Rohini; Abramovitz, Robert; Greenberg, Rick; Schoor, Alan; Newcorn, Jeffrey; Schmeidler, James; Levine, Paul; Nomura, Yoko; Chemtob, Claude M.

2009-01-01

This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender,…

Posttraumatic Symptoms and Thought Control Strategies among Aging Hidden Jewish Children

ERIC Educational Resources Information Center

Fohn, Adeline; Grynberg, Delphine; Luminet, Olivier

2012-01-01

This study examined the severity of posttraumatic stress disorder (PTSD) symptoms and the coping strategies of 51 aging hidden children (28 women and 23 men) 65 years after the Holocaust. Results indicated a positive relation between age and PTSD symptoms that was fully mediated by sense of danger and education. Regression analyses showed that…

Personality and attention: Levels of neuroticism and extraversion can predict attentional performance during a change detection task.

PubMed

Hahn, Sowon; Buttaccio, Daniel R; Hahn, Jungwon; Lee, Taehun

2015-01-01

The present study demonstrates that levels of extraversion and neuroticism can predict attentional performance during a change detection task. After completing a change detection task built on the flicker paradigm, participants were assessed for personality traits using the Revised Eysenck Personality Questionnaire (EPQ-R). Multiple regression analyses revealed that higher levels of extraversion predict increased change detection accuracies, while higher levels of neuroticism predict decreased change detection accuracies. In addition, neurotic individuals exhibited decreased sensitivity A' and increased fixation dwell times. Hierarchical regression analyses further revealed that eye movement measures mediate the relationship between neuroticism and change detection accuracies. Based on the current results, we propose that neuroticism is associated with decreased attentional control over the visual field, presumably due to decreased attentional disengagement. Extraversion can predict increased attentional performance, but the effect is smaller than the relationship between neuroticism and attention.

Nutrition Risk in Critically Ill Versus the Nutritional Risk Screening 2002: Are They Comparable for Assessing Risk of Malnutrition in Critically Ill Patients?

PubMed

Canales, Cecilia; Elsayes, Ali; Yeh, D Dante; Belcher, Donna; Nakayama, Anna; McCarthy, Caitlin M; Chokengarmwong, Nalin; Quraishi, Sadeq A

2018-05-30

Malnutrition influences clinical outcomes. Although various screening tools are available to assess nutrition status, their use in the intensive care unit (ICU) has not been rigorously studied. Our goal was to compare the Nutrition Risk in Critically Ill (NUTRIC) to the Nutritional Risk Screening (NRS) 2002 in terms of their associations with macronutrient deficit in ICU patients. We performed a retrospective analysis to investigate the relationship between NUTRIC vs NRS 2002 and macronutrient deficit (protein and calories) in critically ill patients. We performed linear regression analyses, controlling for age, sex, race, body mass index, and ICU length of stay. We then dichotomized our primary exposures and outcomes to perform logistic regression analyses, controlling for the same covariates. The analytic cohort included 312 adults. Mean NUTRIC and NRS 2002 scores were 4 ± 2 and 4 ± 1, respectively. Linear regression demonstrated that each increment in NUTRIC score was associated with a 49 g higher protein deficit (β = 48.70: 95% confidence interval [CI] 29.23-68.17) and a 752 kcal higher caloric deficit (β = 751.95; 95% CI 447.80-1056.09). Logistic regression demonstrated that NUTRIC scores >4 had over twice the odds of protein deficits ≥300 g (odds ratio [OR] 2.35; 95% CI 1.43-3.85) and caloric deficits ≥6000 kcal (OR 2.73; 95% CI 1.66-4.50) compared with NUTRIC scores ≤4. We did not observe an association of NRS 2002 scores with macronutrient deficit. Our data suggest that NUTRIC is superior to NRS 2002 for assessing malnutrition risk in ICU patients. Randomized, controlled studies are needed to determine whether nutrition interventions, stratified by NUTRIC score, can improve patient outcomes. © 2018 American Society for Parenteral and Enteral Nutrition.

Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials.

PubMed

Binia, Aristea; Jaeger, Jonathan; Hu, Youyou; Singh, Anurag; Zimmermann, Diane

2015-08-01

To evaluate the efficacy of daily potassium intake on decreasing blood pressure in non-medicated normotensive or hypertensive patients, and to determine the relationship between potassium intake, sodium-to-potassium ratio and reduction in blood pressure. Mixed-effect meta-analyses and meta-regression models. Medline and the references of previous meta-analyses. Randomized controlled trials with potassium supplementation, with blood pressure as the primary outcome, in non-medicated patients. Fifteen randomized controlled trials of potassium supplementation in patients without antihypertensive medication were selected for the meta-analyses (917 patients). Potassium supplementation resulted in reduction of SBP by 4.7 mmHg [95% confidence interval (CI) 2.4-7.0] and DBP by 3.5 mmHg (95% CI 1.3-5.7) in all patients. The effect was found to be greater in hypertensive patients, with a reduction of SBP by 6.8 mmHg (95% CI 4.3-9.3) and DBP by 4.6 mmHg (95% CI 1.8-7.5). Meta-regression analysis showed that both increased daily potassium excretion and decreased sodium-to-potassium ratio were associated with blood pressure reduction (P < 0.05). Increased total daily potassium urinary excretion from 60 to 100 mmol/day and decrease of sodium-to-potassium ratio were shown to be necessary to explain the estimated effect. Potassium supplementation is associated with reduction of blood pressure in patients who are not on antihypertensive medication, and the effect is significant in hypertensive patients. The reduction in blood pressure significantly correlates with decreased daily urinary sodium-to-potassium ratio and increased urinary potassium. Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or decreased sodium intake.

Family-centered prevention ameliorates the association between adverse childhood experiences and prediabetes status in young black adults.

PubMed

Brody, Gene H; Yu, Tianyi; Chen, Edith; Miller, Gregory E

2017-07-01

Individuals exposed to adverse childhood experiences (ACEs) are vulnerable to various health problems later in life. This study was designed to determine whether participation in an efficacious program to enhance supportive parenting would ameliorate the association between ACEs and prediabetes status at age 25. Rural African American parents and their 11-year-old children (N=390) participated in the Strong African American Families (SAAF) program or a control condition. Each youth at age 25 provided a total ACEs score and a blood sample from which overnight fasting glucose was assayed. Logistic regression equations were used to test the hypotheses. The logistic regression analyses revealed a significant interaction between total ACEs and random assignment to SAAF or control, OR=0.56, 95% CI [0.36, 0.88]. Follow-up analyses indicated that, for participants in the control condition, a 1-point increase in ACEs was associated with a 37.3% increase in risk of having prediabetes. ACEs were not associated with the likelihood of having prediabetes among participants in the SAAF condition. Control participants with high total ACEs scores were 3.54 times more likely to have prediabetes than were SAAF participants with similar scores. This study indicated that participation at age 11 in a randomized controlled trial designed to enhance supportive parenting ameliorated the association of ACEs with prediabetes at age 25. If substantiated, these findings may provide a strategy for preventing negative health consequences of ACEs. Copyright © 2017 Elsevier Inc. All rights reserved.

Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design.

PubMed

Bekkhus, Mona; Lee, Yunsung; Nordhagen, Rannveig; Magnus, Per; Samuelsen, Sven O; Borge, Anne I H

2018-02-01

Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors. Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample. In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same. Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Cognitive predictors of a common multitasking ability: Contributions from working memory, attention control, and fluid intelligence.

PubMed

Redick, Thomas S; Shipstead, Zach; Meier, Matthew E; Montroy, Janelle J; Hicks, Kenny L; Unsworth, Nash; Kane, Michael J; Hambrick, D Zachary; Engle, Randall W

2016-11-01

Previous research has identified several cognitive abilities that are important for multitasking, but few studies have attempted to measure a general multitasking ability using a diverse set of multitasks. In the final dataset, 534 young adult subjects completed measures of working memory (WM), attention control, fluid intelligence, and multitasking. Correlations, hierarchical regression analyses, confirmatory factor analyses, structural equation models, and relative weight analyses revealed several key findings. First, although the complex tasks used to assess multitasking differed greatly in their task characteristics and demands, a coherent construct specific to multitasking ability was identified. Second, the cognitive ability predictors accounted for substantial variance in the general multitasking construct, with WM and fluid intelligence accounting for the most multitasking variance compared to attention control. Third, the magnitude of the relationships among the cognitive abilities and multitasking varied as a function of the complexity and structure of the various multitasks assessed. Finally, structural equation models based on a multifaceted model of WM indicated that attention control and capacity fully mediated the WM and multitasking relationship. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The acute effects of grape polyphenols supplementation on endothelial function in adults: meta-analyses of controlled trials.

PubMed

Li, Shao-Hua; Tian, Hong-Bo; Zhao, Hong-Jin; Chen, Liang-Hua; Cui, Lian-Qun

2013-01-01

The acute effects of grape polyphenols on endothelial function in adults are inconsistent. Here, we performed meta-analyses to determine these acute effects as measured by flow-mediated dilation (FMD). Trials were searched in PubMed, Embase and the Cochrane Library database. Summary estimates of weighted mean differences (WMDs) and 95% CIs were obtained by using random-effects models. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity. The protocol details of our meta-analysis have been submitted to the PROSPERO register and our registration number is CRD42013004157. Nine studies were included in the present meta-analyses. The results showed that the FMD level was significantly increased in the initial 120 min after intake of grape polyphenols as compared with controls. Meta-regression and subgroup analyses were performed and showed that a health status was the main effect modifier of the significant heterogeneity. Subgroups indicated that intake of grape polyphenols could significantly increase FMD in healthy subjects, and the increased FMD appeared to be more obviously in subjects with high cardiovascular risk factors. Moreover, the peak effect of grape polyphenols on FMD in healthy subjects was found 30 min after ingestion, which was different from the effect in subjects with high cardiovascular risk factors, in whom the peak effect was found 60 min after ingestion. Endothelial function can be significantly improved in healthy adults in the initial 2 h after intake of grape polyphenols. The acute effect of grape polyphenols on endothelial function may be more significant but the peak effect is delayed in subjects with a smoking history or coronary heart disease as compared with the healthy subjects.

The Acute Effects of Grape Polyphenols Supplementation on Endothelial Function in Adults: Meta-Analyses of Controlled Trials

PubMed Central

Li, Shao-Hua; Tian, Hong-Bo; Zhao, Hong-Jin; Chen, Liang-Hua; Cui, Lian-Qun

2013-01-01

Background The acute effects of grape polyphenols on endothelial function in adults are inconsistent. Here, we performed meta-analyses to determine these acute effects as measured by flow-mediated dilation (FMD). Methods Trials were searched in PubMed, Embase and the Cochrane Library database. Summary estimates of weighted mean differences (WMDs) and 95% CIs were obtained by using random-effects models. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity. The protocol details of our meta-analysis have been submitted to the PROSPERO register and our registration number is CRD42013004157. Results Nine studies were included in the present meta-analyses. The results showed that the FMD level was significantly increased in the initial 120 min after intake of grape polyphenols as compared with controls. Meta-regression and subgroup analyses were performed and showed that a health status was the main effect modifier of the significant heterogeneity. Subgroups indicated that intake of grape polyphenols could significantly increase FMD in healthy subjects, and the increased FMD appeared to be more obviously in subjects with high cardiovascular risk factors. Moreover, the peak effect of grape polyphenols on FMD in healthy subjects was found 30 min after ingestion, which was different from the effect in subjects with high cardiovascular risk factors, in whom the peak effect was found 60 min after ingestion. Conclusions Endothelial function can be significantly improved in healthy adults in the initial 2 h after intake of grape polyphenols. The acute effect of grape polyphenols on endothelial function may be more significant but the peak effect is delayed in subjects with a smoking history or coronary heart disease as compared with the healthy subjects. PMID:23894543

Association between Use of Exogenous Testosterone Therapy and Risk of Venous Thrombotic Events among Exogenous Testosterone Treated and Untreated Men with Hypogonadism.

PubMed

Li, Hu; Benoit, Karin; Wang, Wei; Motsko, Stephen

2016-04-01

Limited information exists about whether exogenous testosterone therapy is associated with a risk of venous thrombotic events. We investigated via cohort and nested case-control analyses whether exogenous testosterone therapy is associated with the risk of venous thrombotic events in men with hypogonadism. Databases were reviewed to identify men prescribed exogenous testosterone therapy and/or men with a hypogonadism diagnosis. Propensity score 1:1 matching was used to select patients for cohort analysis. Cases (men with venous thrombotic events) were matched 1:4 with controls (men without venous thrombotic events) for the nested case-control analysis. Primary outcome was defined as incident idiopathic venous thrombotic events. Cox regression and conditional logistic regression were used to assess HRs and ORs, respectively. Sensitivity analyses were also performed. A total of 102,650 exogenous testosterone treated and 102,650 untreated patients were included in cohort analysis after matching, and 2,785 cases and 11,119 controls were included in case-control analysis. Cohort analysis revealed a HR of 1.08 for all testosterone treated patients (95% CI 0.91, 1.27, p = 0.378). Case-control analysis resulted in an OR of 1.02 (95% CI 0.92, 1.13, p = 0.702) for current exogenous testosterone therapy exposure and an OR of 0.92 (95% CI 0.82, 1.03, p = 0.145) for past exogenous testosterone therapy exposure. These results remained nonstatistically significant after stratifying by exogenous testosterone therapy administration route and age category. Most sensitivity analyses yielded consistent results. No significant association was found between exogenous testosterone therapy and incidents of idiopathic or overall venous thrombotic events in men with hypogonadism. However, some discrepant findings exist for the association between injectable formulations and the risk of overall venous thrombotic events. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Work stress, asthma control and asthma-specific quality of life: Initial evidence from a cross-sectional study.

PubMed

Hartmann, Bettina; Leucht, Verena; Loerbroks, Adrian

2017-03-01

Research has suggested that psychological stress is positively associated with asthma morbidity. One major source of stress in adulthood is one's occupation. However, to date, potential links of work stress with asthma control or asthma-specific quality of life have not been examined. We aimed to address this knowledge gap. In 2014/2015, we conducted a cross-sectional study among adults with asthma in Germany (n = 362). For the current analyses that sample was restricted to participants in employment and reporting to have never been diagnosed with chronic obstructive pulmonary disease (n = 94). Work stress was operationalized by the 16-item effort-reward-imbalance (ERI) questionnaire, which measures the subcomponents "effort", "reward" and "overcommitment." Participants further completed the Asthma Control Test and the Asthma Quality of Life Questionnaire-Sydney. Multivariable associations were quantified by linear regression and logistic regression. Effort, reward and their ratio (i.e. ERI ratio) did not show meaningful associations with asthma morbidity. By contrast, increasing levels of overcommitment were associated with poorer asthma control and worse quality of life in both linear regression (ß = -0.26, p = 0.01 and ß = 0.44, p < 0.01, respectively) and logistic regression (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.14-3.07 and OR = 2.34, 95% CI = 1.32-4.15, respectively). The present study provides initial evidence of a positive relationship of work-related overcommitment with asthma control and asthma-specific quality of life. Longitudinal studies with larger samples are needed to confirm our findings and to disentangle the potential causality of associations.

Patterns of medicinal plant use: an examination of the Ecuadorian Shuar medicinal flora using contingency table and binomial analyses.

PubMed

Bennett, Bradley C; Husby, Chad E

2008-03-28

Botanical pharmacopoeias are non-random subsets of floras, with some taxonomic groups over- or under-represented. Moerman [Moerman, D.E., 1979. Symbols and selectivity: a statistical analysis of Native American medical ethnobotany, Journal of Ethnopharmacology 1, 111-119] introduced linear regression/residual analysis to examine these patterns. However, regression, the commonly-employed analysis, suffers from several statistical flaws. We use contingency table and binomial analyses to examine patterns of Shuar medicinal plant use (from Amazonian Ecuador). We first analyzed the Shuar data using Moerman's approach, modified to better meet requirements of linear regression analysis. Second, we assessed the exact randomization contingency table test for goodness of fit. Third, we developed a binomial model to test for non-random selection of plants in individual families. Modified regression models (which accommodated assumptions of linear regression) reduced R(2) to from 0.59 to 0.38, but did not eliminate all problems associated with regression analyses. Contingency table analyses revealed that the entire flora departs from the null model of equal proportions of medicinal plants in all families. In the binomial analysis, only 10 angiosperm families (of 115) differed significantly from the null model. These 10 families are largely responsible for patterns seen at higher taxonomic levels. Contingency table and binomial analyses offer an easy and statistically valid alternative to the regression approach.

Epidemiological analysis of factors influencing rate of progress in Echinococcus granulosus control in New Zealand.

PubMed Central

Burridge, M. J.; Schwabe, C. W.

1977-01-01

The factors influencing the rate of progress in Echinococcus granulosus control in New Zealand were analysed by hydatid control area using stepwise multiple regression techniques. The results indicated that the rate of progress was related positively to initial E. granulosus prevalence in dogs and the efficiency with which local authorities implemented national control policy, and negatively to the Maori proportion in the local population and the number of dogs per owner. Problems in analysis of the New Zealand data are discussed and improved methods of monitoring progress in hydatid disease control programmes are described. Images Fig. 1 PMID:265340

Estimates of Median Flows for Streams on the 1999 Kansas Surface Water Register

USGS Publications Warehouse

Perry, Charles A.; Wolock, David M.; Artman, Joshua C.

2004-01-01

The Kansas State Legislature, by enacting Kansas Statute KSA 82a?2001 et. seq., mandated the criteria for determining which Kansas stream segments would be subject to classification by the State. One criterion for the selection as a classified stream segment is based on the statistic of median flow being equal to or greater than 1 cubic foot per second. As specified by KSA 82a?2001 et. seq., median flows were determined from U.S. Geological Survey streamflow-gaging-station data by using the most-recent 10 years of gaged data (KSA) for each streamflow-gaging station. Median flows also were determined by using gaged data from the entire period of record (all-available hydrology, AAH). Least-squares multiple regression techniques were used, along with Tobit analyses, to develop equations for estimating median flows for uncontrolled stream segments. The drainage area of the gaging stations on uncontrolled stream segments used in the regression analyses ranged from 2.06 to 12,004 square miles. A logarithmic transformation of the data was needed to develop the best linear relation for computing median flows. In the regression analyses, the significant climatic and basin characteristics, in order of importance, were drainage area, mean annual precipitation, mean basin permeability, and mean basin slope. Tobit analyses of KSA data yielded a model standard error of prediction of 0.285 logarithmic units, and the best equations using Tobit analyses of AAH data had a model standard error of prediction of 0.250 logarithmic units. These regression equations and an interpolation procedure were used to compute median flows for the uncontrolled stream segments on the 1999 Kansas Surface Water Register. Measured median flows from gaging stations were incorporated into the regression-estimated median flows along the stream segments where available. The segments that were uncontrolled were interpolated using gaged data weighted according to the drainage area and the bias between the regression-estimated and gaged flow information. On controlled segments of Kansas streams, the median flow information was interpolated between gaging stations using only gaged data weighted by drainage area. Of the 2,232 total stream segments on the Kansas Surface Water Register, 34.5 percent of the segments had an estimated median streamflow of less than 1 cubic foot per second when the KSA analysis was used. When the AAH analysis was used, 36.2 percent of the segments had an estimated median streamflow of less than 1 cubic foot per second. This report supercedes U.S. Geological Survey Water-Resources Investigations Report 02?4292.

Food and Drug Administration tobacco regulation and product judgments.

PubMed

Kaufman, Annette R; Finney Rutten, Lila J; Parascandola, Mark; Blake, Kelly D; Augustson, Erik M

2015-04-01

The Family Smoking Prevention and Tobacco Control Act granted the Food and Drug Administration (FDA) the authority to regulate tobacco products in the U.S. However, little is known about how regulation may be related to judgments about tobacco product-related risks. To understand how FDA tobacco regulation beliefs are associated with judgments about tobacco product-related risks. The Health Information National Trends Survey is a national survey of the U.S. adult population. Data used in this analysis were collected from October 2012 through January 2013 (N=3,630) by mailed questionnaire and analyzed in 2013. Weighted bivariate chi-square analyses were used to assess associations among FDA regulation belief, tobacco harm judgments, sociodemographics, and smoking status. A weighted multinomial logistic regression was conducted where FDA regulation belief was regressed on tobacco product judgments, controlling for sociodemographic variables and smoking status. About 41% believed that the FDA regulates tobacco products in the U.S., 23.6% reported the FDA does not, and 35.3% did not know. Chi-square analyses showed that smoking status was significantly related to harm judgments about electronic cigarettes (p<0.0001). The multinomial logistic regression revealed that uncertainty about FDA regulation was associated with tobacco product harm judgment uncertainty. Tobacco product harm perceptions are associated with beliefs about tobacco product regulation by the FDA. These findings suggest the need for increased public awareness and understanding of the role of tobacco product regulation in protecting public health. Copyright © 2015. Published by Elsevier Inc.

Predictors of Global Self-Worth and Academic Performance among Regular Education, Learning Disabled, and Continuation High School Students.

ERIC Educational Resources Information Center

Wiest, Dudley J.; Wong, Eugene H.; Kreil, Dennis A.

1998-01-01

The ability of measures of perceived competence, control, and autonomy support to predict self-worth and academic performance was studied across groups of high school students. Stepwise regression analyses indicate these variables in model predict self-worth and grade point average. In addition, levels of school status and depression predict…

Optimization of large animal MI models; a systematic analysis of control groups from preclinical studies.

PubMed

Zwetsloot, P P; Kouwenberg, L H J A; Sena, E S; Eding, J E; den Ruijter, H M; Sluijter, J P G; Pasterkamp, G; Doevendans, P A; Hoefer, I E; Chamuleau, S A J; van Hout, G P J; Jansen Of Lorkeers, S J

2017-10-27

Large animal models are essential for the development of novel therapeutics for myocardial infarction. To optimize translation, we need to assess the effect of experimental design on disease outcome and model experimental design to resemble the clinical course of MI. The aim of this study is therefore to systematically investigate how experimental decisions affect outcome measurements in large animal MI models. We used control animal-data from two independent meta-analyses of large animal MI models. All variables of interest were pre-defined. We performed univariable and multivariable meta-regression to analyze whether these variables influenced infarct size and ejection fraction. Our analyses incorporated 246 relevant studies. Multivariable meta-regression revealed that infarct size and cardiac function were influenced independently by choice of species, sex, co-medication, occlusion type, occluded vessel, quantification method, ischemia duration and follow-up duration. We provide strong systematic evidence that commonly used endpoints significantly depend on study design and biological variation. This makes direct comparison of different study-results difficult and calls for standardized models. Researchers should take this into account when designing large animal studies to most closely mimic the clinical course of MI and enable translational success.

An association between dietary habits and traffic accidents in patients with chronic liver disease: A data-mining analysis

PubMed Central

KAWAGUCHI, TAKUMI; SUETSUGU, TAKURO; OGATA, SHYOU; IMANAGA, MINAMI; ISHII, KUMIKO; ESAKI, NAO; SUGIMOTO, MASAKO; OTSUYAMA, JYURI; NAGAMATSU, AYU; TANIGUCHI, EITARO; ITOU, MINORU; ORIISHI, TETSUHARU; IWASAKI, SHOKO; MIURA, HIROKO; TORIMURA, TAKUJI

2016-01-01

The incidence of traffic accidents in patients with chronic liver disease (CLD) is high in the USA. However, the characteristics of patients, including dietary habits, differ between Japan and the USA. The present study investigated the incidence of traffic accidents in CLD patients and the clinical profiles associated with traffic accidents in Japan using a data-mining analysis. A cross-sectional study was performed and 256 subjects [148 CLD patients (CLD group) and 106 patients with other digestive diseases (disease control group)] were enrolled; 2 patients were excluded. The incidence of traffic accidents was compared between the two groups. Independent factors for traffic accidents were analyzed using logistic regression and decision-tree analyses. The incidence of traffic accidents did not differ between the CLD and disease control groups (8.8 vs. 11.3%). The results of the logistic regression analysis showed that yoghurt consumption was the only independent risk factor for traffic accidents (odds ratio, 0.37; 95% confidence interval, 0.16–0.85; P=0.0197). Similarly, the results of the decision-tree analysis showed that yoghurt consumption was the initial divergence variable. In patients who consumed yoghurt habitually, the incidence of traffic accidents was 6.6%, while that in patients who did not consume yoghurt was 16.0%. CLD was not identified as an independent factor in the logistic regression and decision-tree analyses. In conclusion, the difference in the incidence of traffic accidents in Japan between the CLD and disease control groups was insignificant. Furthermore, yoghurt consumption was an independent negative risk factor for traffic accidents in patients with digestive diseases, including CLD. PMID:27123257

An association between dietary habits and traffic accidents in patients with chronic liver disease: A data-mining analysis.

PubMed

Kawaguchi, Takumi; Suetsugu, Takuro; Ogata, Shyou; Imanaga, Minami; Ishii, Kumiko; Esaki, Nao; Sugimoto, Masako; Otsuyama, Jyuri; Nagamatsu, Ayu; Taniguchi, Eitaro; Itou, Minoru; Oriishi, Tetsuharu; Iwasaki, Shoko; Miura, Hiroko; Torimura, Takuji

2016-05-01

The incidence of traffic accidents in patients with chronic liver disease (CLD) is high in the USA. However, the characteristics of patients, including dietary habits, differ between Japan and the USA. The present study investigated the incidence of traffic accidents in CLD patients and the clinical profiles associated with traffic accidents in Japan using a data-mining analysis. A cross-sectional study was performed and 256 subjects [148 CLD patients (CLD group) and 106 patients with other digestive diseases (disease control group)] were enrolled; 2 patients were excluded. The incidence of traffic accidents was compared between the two groups. Independent factors for traffic accidents were analyzed using logistic regression and decision-tree analyses. The incidence of traffic accidents did not differ between the CLD and disease control groups (8.8 vs. 11.3%). The results of the logistic regression analysis showed that yoghurt consumption was the only independent risk factor for traffic accidents (odds ratio, 0.37; 95% confidence interval, 0.16-0.85; P=0.0197). Similarly, the results of the decision-tree analysis showed that yoghurt consumption was the initial divergence variable. In patients who consumed yoghurt habitually, the incidence of traffic accidents was 6.6%, while that in patients who did not consume yoghurt was 16.0%. CLD was not identified as an independent factor in the logistic regression and decision-tree analyses. In conclusion, the difference in the incidence of traffic accidents in Japan between the CLD and disease control groups was insignificant. Furthermore, yoghurt consumption was an independent negative risk factor for traffic accidents in patients with digestive diseases, including CLD.

Users manual for flight control design programs

NASA Technical Reports Server (NTRS)

Nalbandian, J. Y.

1975-01-01

Computer programs for the design of analog and digital flight control systems are documented. The program DIGADAPT uses linear-quadratic-gaussian synthesis algorithms in the design of command response controllers and state estimators, and it applies covariance propagation analysis to the selection of sampling intervals for digital systems. Program SCHED executes correlation and regression analyses for the development of gain and trim schedules to be used in open-loop explicit-adaptive control laws. A linear-time-varying simulation of aircraft motions is provided by the program TVHIS, which includes guidance and control logic, as well as models for control actuator dynamics. The programs are coded in FORTRAN and are compiled and executed on both IBM and CDC computers.

Estimating parasitic sea lamprey abundance in Lake Huron from heterogenous data sources

USGS Publications Warehouse

Young, Robert J.; Jones, Michael L.; Bence, James R.; McDonald, Rodney B.; Mullett, Katherine M.; Bergstedt, Roger A.

2003-01-01

The Great Lakes Fishery Commission uses time series of transformer, parasitic, and spawning population estimates to evaluate the effectiveness of its sea lamprey (Petromyzon marinus) control program. This study used an inverse variance weighting method to integrate Lake Huron sea lamprey population estimates derived from two estimation procedures: 1) prediction of the lake-wide spawning population from a regression model based on stream size and, 2) whole-lake mark and recapture estimates. In addition, we used a re-sampling procedure to evaluate the effect of trading off sampling effort between the regression and mark-recapture models. Population estimates derived from the regression model ranged from 132,000 to 377,000 while mark-recapture estimates of marked recently metamorphosed juveniles and parasitic sea lampreys ranged from 536,000 to 634,000 and 484,000 to 1,608,000, respectively. The precision of the estimates varied greatly among estimation procedures and years. The integrated estimate of the mark-recapture and spawner regression procedures ranged from 252,000 to 702,000 transformers. The re-sampling procedure indicated that the regression model is more sensitive to reduction in sampling effort than the mark-recapture model. Reliance on either the regression or mark-recapture model alone could produce misleading estimates of abundance of sea lampreys and the effect of the control program on sea lamprey abundance. These analyses indicate that the precision of the lakewide population estimate can be maximized by re-allocating sampling effort from marking sea lampreys to trapping additional streams.

Processing speed and working memory span: their differential role in superficial and deep memory processes in schizophrenia.

PubMed

Brébion, Gildas; Bressan, Rodrigo A; Pilowsky, Lyn S; David, Anthony S

2011-05-01

Previous work has suggested that decrement in both processing speed and working memory span plays a role in the memory impairment observed in patients with schizophrenia. We undertook a study to examine simultaneously the effect of these two factors. A sample of 49 patients with schizophrenia and 43 healthy controls underwent a battery of verbal and visual memory tasks. Superficial and deep encoding memory measures were tallied. We conducted regression analyses on the various memory measures, using processing speed and working memory span as independent variables. In the patient group, processing speed was a significant predictor of superficial and deep memory measures in verbal and visual memory. Working memory span was an additional significant predictor of the deep memory measures only. Regression analyses involving all participants revealed that the effect of diagnosis on all the deep encoding memory measures was reduced to non-significance when processing speed was entered in the regression. Decreased processing speed is involved in verbal and visual memory deficit in patients, whether the task require superficial or deep encoding. Working memory is involved only insofar as the task requires a certain amount of effort.

Use of Multiple Regression and Use-Availability Analyses in Determining Habitat Selection by Gray Squirrels (Sciurus Carolinensis)

Treesearch

John W. Edwards; Susan C. Loeb; David C. Guynn

1994-01-01

Multiple regression and use-availability analyses are two methods for examining habitat selection. Use-availability analysis is commonly used to evaluate macrohabitat selection whereas multiple regression analysis can be used to determine microhabitat selection. We compared these techniques using behavioral observations (n = 5534) and telemetry locations (n = 2089) of...

Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression

PubMed Central

Robinson, Jo; Spittal, Matthew J; Carter, Greg

2016-01-01

Objective To examine the efficacy of psychological and psychosocial interventions for reductions in repeated self-harm. Design We conducted a systematic review, meta-analysis and meta-regression to examine the efficacy of psychological and psychosocial interventions to reduce repeat self-harm in adults. We included a sensitivity analysis of studies with a low risk of bias for the meta-analysis. For the meta-regression, we examined whether the type, intensity (primary analyses) and other components of intervention or methodology (secondary analyses) modified the overall intervention effect. Data sources A comprehensive search of MEDLINE, PsycInfo and EMBASE (from 1999 to June 2016) was performed. Eligibility criteria for selecting studies Randomised controlled trials of psychological and psychosocial interventions for adult self-harm patients. Results Forty-five trials were included with data available from 36 (7354 participants) for the primary analysis. Meta-analysis showed a significant benefit of all psychological and psychosocial interventions combined (risk ratio 0.84; 95% CI 0.74 to 0.96; number needed to treat=33); however, sensitivity analyses showed that this benefit was non-significant when restricted to a limited number of high-quality studies. Meta-regression showed that the type of intervention did not modify the treatment effects. Conclusions Consideration of a psychological or psychosocial intervention over and above treatment as usual is worthwhile; with the public health benefits of ensuring that this practice is widely adopted potentially worth the investment. However, the specific type and nature of the intervention that should be delivered is not yet clear. Cognitive–behavioural therapy or interventions with an interpersonal focus and targeted on the precipitants to self-harm may be the best candidates on the current evidence. Further research is required. PMID:27660314

Sexual possibility situations and sexual behaviors among young adolescents: the moderating role of protective factors.

PubMed

DiLorio, Colleen; Dudley, William N; Soet, Johanna E; McCarty, Frances

2004-12-01

To examine sexual possibility situations (SPS) and protective practices associated with involvement in intimate sexual behaviors and the initiation of sexual intercourse among young adolescents and to determine if protective factors moderate the relationship between SPS and sexual behaviors. Data for these analyses were obtained from the baseline assessment for adolescents conducted as part of an HIV prevention study called "Keepin' it R.E.A.L.!" The study was conducted with a community-based organization (CBO) in an urban area serving a predominantly African-American population. In addition to items assessing SPS, intimate sexual behaviors, and initiation of sexual intercourse, adolescents provided information on the following protective factors: educational goals, self-concept, future time perspective, orientation to health, self-efficacy, outcome expectations, parenting, communication, values, and prosocial activities. Background personal information, including age and gender, was also collected. The analyses were conducted on data from 491 predominantly African-American adolescents, 61% of whom were boys. Variables were combined to form SPS and protective indices that were used in the first set of regression analyses. In a second set of analyses, the indices were unbundled and individual variables were entered into regression analyses. Both SPS and protective indices explained significant portions of variance in intimate sexual behaviors, and the SPS index explained a significant portion of variance in the initiation of sexual intercourse. The regression analysis using the unbundled SPS and protective factors revealed the following statistically significant predictors for intimate sexual behaviors: age, gender, time alone with groups of peers, time alone with a member of the opposite sex, behavior self-concept, popularity self-concept, self-efficacy for abstinence, outcome expectations for abstinence, parental control, personal values, and parental values. A similar regression analysis revealed that age, time alone with a member of the opposite sex, and personal values were significant predictors of initiation of sexual intercourse. These results provide evidence for the important role of protective factors in explaining early involvement in sexual behaviors and show that protective factors extend beyond personal characteristics to include both familial and peer factors.

A comparative study of entrepreneurs and managers: stress, burnout, locus of control, and social support.

PubMed

Rahim, M A

1995-01-01

This study investigated the relationships of job stress to job burnout, of locus of control and social support to stress and burnout, and the moderating effects of locus of control and social support on the stress-burnout relationship. These relationships were tested with questionnaire data collected from a random sample of entrepreneurs (N = 238) and managers (N = 288). Results showed that entrepreneurs reported that they had higher internal locus of control, received less social support, and had less job burnout than managers. Hierarchical regression analyses found support for eight of the ten main effects and one of the four moderating effects.

Prosthesis rejection in acquired major upper-limb amputees: a population-based survey.

PubMed

Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

2012-07-01

To estimate the rates of primary and secondary prosthesis rejection in acquired major upper-limb amputees (ULAs), to describe the most frequently reported reasons for rejection and to estimate the influence of background factors on the risk of rejection. Cross-sectional study analysing population-based questionnaire data (n = 224). Effects were analysed by logistic regression analyses and Cox regression analyses. Primary prosthesis rejection was found in 4.5% whereas 13.4% had discontinued prosthesis use. The main reasons reported for primary non-wear were a perceived lack of need and discrepancies between perceived need and the prostheses available. The main reasons reported for secondary prosthesis rejection were dissatisfaction with prosthetic comfort, function and control. Primary prosthesis rejection was more likely in ULAs amputated at high age and in ULAs with proximal amputations. Secondary prosthesis rejection was more likely in proximal ULAs and in women. Clinicians should be aware of the increased risk of rejection in proximal ULAs, elderly ULAs and in women. Emphasising individual needs will probably facilitate successful prosthetic fitting. Improved prosthesis quality and individualised prosthetic training may increase long-term prosthesis use. Further studies of the effect of prosthetic training and of the reasons for rejection of different prosthetic types are suggested.

The association between metacognitions and the impact of Fibromyalgia in a German sample.

PubMed

Kollmann, Josianne; Gollwitzer, Mario; Spada, Marcantonio M; Fernie, Bruce A

2016-04-01

Fibromyalgia is a chronic condition of unknown aetiology, characterised by widespread pain, sleep disturbances, and fatigue. In this paper we examined the relationship metacognitions and the impact of Fibromyalgia in a German sample, detailing the translation and validation of a self-report metacognitive instrument. The Metacognitions about Symptoms Control Scale (MaSCS) was translated into German using the back-forward translation process. A total of 348 patients (316 female and 26 male) with Fibromyalgia contributed data to the study to test the structure and psychometric properties of the MaSCS. Confirmatory factor analyses, informed by modification indices, resulted in a 16-item scale consisting of two factors pertaining to positive and negative metacognitions about symptoms control. Further analyses revealed that both factors had good internal consistency. Correlation analyses established convergent validity, indicating that both factors were significantly associated with: (1) established positive and negative metacognitions scales; and (2) with symptoms severity in Fibromyalgia. Regression analyses revealed that positive metacognitions about symptoms control significantly predicted impairment in physical functioning while negative metacognitions about symptoms control significantly predicted the overall Fibromyalgia impact value, when controlling for stress, anxiety, and depression and a general metacognitions. The findings support the potential relevance of metacognitions, and utility of the German version of MaSCS, in examining the role of metacognitions in Fibromyalgia and other chronic health conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

An epidemiologic study of index and family infectious mononucleosis and adult Hodgkin's disease (HD): evidence for a specific association with EBV+ve HD in young adults.

PubMed

Alexander, Freda E; Lawrence, Davia J; Freeland, June; Krajewski, Andrew S; Angus, Brian; Taylor, G Malcolm; Jarrett, Ruth F

2003-11-01

Infectious mononucleosis (IM) is an established risk factor for Hodgkin's disease (HD). A substantial minority (33%) of cases of HD have Epstein-Barr virus (EBV) DNA within the malignant cells (are EBV+ve). It is unclear whether risk after IM applies specifically to EBV+ve HD. We report the results of a population-based case-control study of HD in adults (n = 408 cases of classical HD, 513 controls) aged 16-74 years; the case series included 113 EBV+ve and 243 EBV+ve HD. Analyses compared total HD, EBV+ve HD and EBV-ve HD with the controls and EBV+ve HD with EBV-ve HD cases using, mainly, logistic regression. Regression analyses were adjusted for gender, age-group and socioeconomic status, and were performed for the whole age range and separately for young (< 35 years) and old adults (> or = 35 years); formal tests of effect modification by age were included. For the young adults, reported IM in index or relative was strongly and significantly associated with EBV+ve HD when compared to controls (odds ratio [OR] = 2.94, 95% confidence interval [CI]: 1.08-7.98 and OR = 5.22, 95% CI: 2.15-12.68, respectively). These results may be interpreted as indications that late first exposure to EBV increases risk of HD, especially in young adults; this applies primarily to EBV+ve HD. Copyright 2003 Wiley-Liss, Inc.

Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database.

PubMed

Koo, Malcolm; Chen, Jin-Cherng; Hwang, Juen-Haur

2016-01-01

Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities.

Theory of mind and executive function: working-memory capacity and inhibitory control as predictors of false-belief task performance.

PubMed

Mutter, Brigitte; Alcorn, Mark B; Welsh, Marilyn

2006-06-01

This study of the relationship between theory of mind and executive function examined whether on the false-belief task age differences between 3 and 5 ears of age are related to development of working-memory capacity and inhibitory processes. 72 children completed tasks measuring false belief, working memory, and inhibition. Significant age effects were observed for false-belief and working-memory performance, as well as for the false-alarm and perseveration measures of inhibition. A simultaneous multiple linear regression specified the contribution of age, inhibition, and working memory to the prediction of false-belief performance. This model was significant, explaining a total of 36% of the variance. To examine the independent contributions of the working-memory and inhibition variables, after controlling for age, two hierarchical multiple linear regressions were conducted. These multiple regression analyses indicate that working memory and inhibition make small, overlapping contributions to false-belief performance after accounting for age, but that working memory, as measured in this study, is a somewhat better predictor of false-belief understanding than is inhibition.

Tree-ring variation in western larch (Larix occidentalis Nutt. ) exposed to sulfur dioxide emissions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fox, C.A.; Kincaid, W.B.; Nash, T.H. III

1984-12-01

Tree-ring analysis of western larch (Larix occidentialis Nutt) demonstrated both direct and indirect affects of sulfur dioxide emissions from the lead/zinc smelter at Trail, B.C. Tree cores were collected from 5 stands known to have been polluted and from 3 control stands. Age effects were removed by fitting theoretical growth curves, and macrocliate was modeled using the average of the controls and two laged values thereof. Separate analyses were performed for years before and after installation of two tall stacks, for drought and nondrought years, and for years prior to initiation of smelting. Regression analyses revealed a negative effect onmore » annual growth that diminished with increasing distance from the smelter and during drought years. Furthermore, chronology statistics suggested an increase in sensitivity to climate that persisted decades beyond implementation of pollution controls, which reduced emissions 10-fold. 38 references, 6 figures, 3 tables.« less

Domain or not domain? That is the question: longitudinal semantic deterioration in Alzheimer's disease.

PubMed

Moreno-Martínez, F Javier; Goñi-Imízcoz, Miguel; Spitznagel, Mary Beth

2011-10-01

Category specific semantic impairment (e.g. living versus nonliving things) has been reported in association with various pathologies, including herpes simplex encephalitis and semantic dementia. However, evidence is inconsistent regarding whether this effect exists in diseases progressively impacting diverse cortical regions, such as Alzheimer's disease (AD). Ceiling effects producing non-Gaussian distributions and poor control for confounds such as nuisance variables (e.g. familiarity) may contribute to this discrepancy. Fourteen AD patients were longitudinally studied examining category effects on three semantic tasks (picture naming, naming to description and word to picture matching) matched across domain on all known nuisance variables (NV). To address non-Gaussian distributions, we run bootstrap analyses to determine whether NV, semantic domain or control performance best predicted AD patient performance. Multiple hierarchical regression analyses revealed that, whilst NV accounted for most of the explained variance in patients in the three tasks, the influence of semantic domain was substantially lower. Individual logistic regression demonstrated a significant category effect in only a few patients and healthy controls. No significant qualitative changes were observed in patients over time. Our results confirm the importance of NVs as predictors of AD patient performance, suggesting that the role of semantic domain is not a useful predictor of the progressive deterioration in AD. Copyright © 2011 Elsevier Inc. All rights reserved.

Anisodamine accelerates spontaneous passage of single symptomatic bile duct stones ≤ 10 mm

PubMed Central

Gao, Jun; Ding, Xue-Mei; Ke, Shan; Zhou, Yi-Ming; Qian, Xiao-Jun; Ma, Rui-Liang; Ning, Chun-Min; Xin, Zong-Hai; Sun, Wen-Bing

2013-01-01

AIM: To investigate the rate of spontaneous passage of single and symptomatic common bile duct (CBD) stones ≤ 10 mm in diameter in 4 wk with or without a 2-wk course of anisodamine. METHODS: A multicenter, randomized, placebo-controlled trial was undertaken. A total of 197 patients who met the inclusion criteria were enrolled. Ninety-seven patients were assigned randomly to the control group and the other 100 to the anisodamine group. The anisodamine group received intravenous infusions of anisodamine (10 mg every 8 h) for 2 wk. The control group received the same volume of 0.9% isotonic saline for 2 wk. Patients underwent imaging studies and liver-function tests every week for 4 wk. The rate of spontaneous passage of CBD stones was analyzed. RESULTS: The rate of spontaneous passage of CBD stones was significantly higher in the anisodamine group than that in the control group (47.0% vs 22.7%). Most (87.2%, 41/47) stone passages in the anisodamine group occurred in the first 2 wk, and passages in the control group occurred at a comparable rate each week. Factors significantly increasing the possibility of spontaneous passage by univariate logistic regression analyses were stone diameter (< 5 mm vs ≥ 5 mm and ≤ 10 mm) and anisodamine therapy. Multivariate logistic regression analyses revealed that these two factors were significantly associated with spontaneous passage. CONCLUSION: Two weeks of anisodamine administration can safely accelerate spontaneous passage of single and symptomatic CBD stones ≤ 10 mm in diameter, especially for stones < 5 mm. PMID:24151390

Does the perception that God controls health outcomes matter for health behaviors?

PubMed

Karvinen, Kristina H; Carr, Lucas J

2014-04-01

The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.

The Relationship Between Gratitude and Loneliness: The Potential Benefits of Gratitude for Promoting Social Bonds.

PubMed

Caputo, Andrea

2015-05-01

This paper explores the potential role of gratitude on the reduction of loneliness feelings, even controlling for several variables related to social desirability, well-being (subjective happiness and life satisfaction) and socio-demographic characteristics. Through a web-based survey a convenience sample of 197 participants completed an online questionnaire including these measures. Correlation analyses and four-step hierarchical multiple regression analyses were conducted. The results show a negative correlation between gratitude and loneliness; specifically, gratitude succeeds in accounting for up to almost one-fifth of the total variability of loneliness even controlling for further variables. Being female, not having a stable and consolidated relationship and not participating in the labor force represent some risk factors affecting loneliness which should be taken into account in further research.

The Relationship Between Gratitude and Loneliness: The Potential Benefits of Gratitude for Promoting Social Bonds

PubMed Central

Caputo, Andrea

2015-01-01

This paper explores the potential role of gratitude on the reduction of loneliness feelings, even controlling for several variables related to social desirability, well-being (subjective happiness and life satisfaction) and socio-demographic characteristics. Through a web-based survey a convenience sample of 197 participants completed an online questionnaire including these measures. Correlation analyses and four-step hierarchical multiple regression analyses were conducted. The results show a negative correlation between gratitude and loneliness; specifically, gratitude succeeds in accounting for up to almost one-fifth of the total variability of loneliness even controlling for further variables. Being female, not having a stable and consolidated relationship and not participating in the labor force represent some risk factors affecting loneliness which should be taken into account in further research. PMID:27247660

Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

PubMed

Gaskin, Cadeyrn J; Happell, Brenda

2014-05-01

To (a) assess the statistical power of nursing research to detect small, medium, and large effect sizes; (b) estimate the experiment-wise Type I error rate in these studies; and (c) assess the extent to which (i) a priori power analyses, (ii) effect sizes (and interpretations thereof), and (iii) confidence intervals were reported. Statistical review. Papers published in the 2011 volumes of the 10 highest ranked nursing journals, based on their 5-year impact factors. Papers were assessed for statistical power, control of experiment-wise Type I error, reporting of a priori power analyses, reporting and interpretation of effect sizes, and reporting of confidence intervals. The analyses were based on 333 papers, from which 10,337 inferential statistics were identified. The median power to detect small, medium, and large effect sizes was .40 (interquartile range [IQR]=.24-.71), .98 (IQR=.85-1.00), and 1.00 (IQR=1.00-1.00), respectively. The median experiment-wise Type I error rate was .54 (IQR=.26-.80). A priori power analyses were reported in 28% of papers. Effect sizes were routinely reported for Spearman's rank correlations (100% of papers in which this test was used), Poisson regressions (100%), odds ratios (100%), Kendall's tau correlations (100%), Pearson's correlations (99%), logistic regressions (98%), structural equation modelling/confirmatory factor analyses/path analyses (97%), and linear regressions (83%), but were reported less often for two-proportion z tests (50%), analyses of variance/analyses of covariance/multivariate analyses of variance (18%), t tests (8%), Wilcoxon's tests (8%), Chi-squared tests (8%), and Fisher's exact tests (7%), and not reported for sign tests, Friedman's tests, McNemar's tests, multi-level models, and Kruskal-Wallis tests. Effect sizes were infrequently interpreted. Confidence intervals were reported in 28% of papers. The use, reporting, and interpretation of inferential statistics in nursing research need substantial improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

[Association of XRCC1 genetic polymorphism with susceptibility to non-Hodgkin's lymphoma].

PubMed

Li, Su-Xia; Zhu, Hong-Li; Guo, Bo; Yang, Yang; Wang, Hong-Yan; Sun, Jing-Fen; Cao, Yong-Bin

2014-08-01

The purpose of this study was to explore the association between X-ray repair cross-complementing group 1 (XRCC1)gene polymorphism and non-Hodgkin's lymphoma risk. A total of 282 non-Hodgkin's lymphoma (NHL) patients and 231 normal controls were used to investigate the effect of three XRCC1 gene polymorphisms (rs25487, rs25489, rs1799782) on susceptibility to non-Hodgkin's lymphoma. Genotyping was performed by using SNaPshot method. All statistical analyses were done with R software. Genotype and allele frequencies of XRCC1 were compared between the patients and controls by using the chi-square test. Crude and adjusted odd ratios and 95% confidence intervals were calculated by using logistic regression on the basis of genetic different models. For four kinds of NHL, subgroup analyses were also conducted. Combined genotype analyses of the three XRCC1 polymorphisms were also done by using logistic regression. The results showed that the variant genotype frequency was not significantly different between the controls and NHL or NHL subtype cases. Combined genotype analyses of XRCC1 399-280-194 results showed that the combined genotype was not associated with risk of NHL overall, but the VT-WT-WT combined genotype was associated with the decreased risk of T-NHL (OR: 0.21; 95%CI (0.06-0.8); P = 0.022), and the WT-VT-WT combined genotype was associated with the increased risk of FL(OR:15.23; 95%CI (1.69-137.39); P = 0.015). It is concluded that any studied polymorphism (rs25487, rs25489, rs1799782) alone was not shown to be rela-ted with the risk of NHL or each histologic subtype of NHL. The combined genotype with mutation of three SNP of XRCC1 was not related to the risk of NHL. However, further large-scale studies would be needed to confirm the association of decreased or increased risk for T-NHL and FL with the risk 3 combined SNP mutants of XRCC1 polymorphism.

Predictors of asthma control in children from different ethnic origins living in Amsterdam.

PubMed

van Dellen, Q M; Stronks, K; Bindels, P J E; Ory, F G; Bruil, J; van Aalderen, W M C

2007-04-01

To identify factors associated with asthma control in a multi-ethnic paediatric population. We interviewed 278 children with paediatrician diagnosed asthma (aged 7-17 years) and one of their parents. Asthma control was assessed with the Asthma Control Questionnaire (ACQ). Detailed information about sociodemographic variables, asthma medication, knowledge of asthma, inhalation technique and environmental factors were collected. Turkish and Moroccan parents were interviewed in their language of choice. Logistic regression analyses were used to identify correlates of asthma control. Of the 278 children, 85 (30.6%) were Dutch, 84 (30.2%) were Moroccan, 58 (20.9%) were Turkish and 51 (18.3%) were Surinamese. Overall, almost 60% had a status of well-controlled asthma, as indicated by the ACQ. Only 51 of the 142 (35.9%) Moroccan and Turkish parents had a good comprehension of the Dutch language. In logistic regression analyses the risk of having uncontrolled asthma was significantly higher among Surinamese children (OR 2.3; 95% CI 1.06-4.83), respondents with insufficient comprehension of the Dutch language (OR 2.3; 95% CI 1.08-4.78), children using woollen blankets (OR 9.8; 95% CI 1.52-63.42), and significantly lower among male (OR 0.5; 95% CI 0.31-0.91) and non-daily users of inhaled corticosteroids (OR 0.6; 95% CI 0.38-1.07). In conclusion, ethnicity as well as insufficient comprehension of the Dutch language appeared to be independent risk factors for uncontrolled asthma. Special attention should be given to children from immigrants groups for example by calling in an interpreter by physicians when comprehension is insufficient.

Serum 25-hydroxyvitamin D3 and body composition in an elderly cohort from Germany: a cross-sectional study

PubMed Central

2012-01-01

Background Emerging evidence indicates that there is an association between vitamin D and obesity. The aim of this study was to investigate whether the level of serum 25-hydroxyvitamin D3 [25(OH)D3] in the elderly is influenced by parameters of anthropometry and body composition independent of potential confounding lifestyle factors and the level of serum intact parathyroid hormone (iPTH). Methods Cross-sectional data of 131 independently living participants (90 women, 41 men; aged 66–96 years) of the longitudinal study on nutrition and health status in senior citizens of Giessen, Germany were analysed. Concentrations of 25(OH)D3 and iPTH were ascertained by an electrochemiluminescence immunoassay. Body composition was measured by a bioelectrical impedance analysis. We performed univariate and multiple regression analyses to examine the influence of body composition on 25(OH)D3 with adjustments for age, iPTH and lifestyle factors. Results In univariate regression analyses, 25(OH)D3 was associated with body mass index (BMI), hip circumference and total body fat (TBF) in women, but not in men. Using multiple regression analyses, TBF was shown to be a negative predictor of 25(OH)D3 levels in women even after controlling for age, lifestyle and iPTH (ß = −0.247; P = 0.016), whereas the associations between BMI, hip circumference and 25(OH)D3 lost statistical significance after adjusting for iPTH. In men, 25(OH)D3 was not affected by anthropometric or body composition variables. Conclusions The results indicate that 25(OH)D3 levels are affected by TBF, especially in elderly women, independent of lifestyle factors and iPTH. PMID:22607088

Marine aerosol source regions to Prince of Wales Icefield, Ellesmere Island, and influence from the tropical Pacific, 1979-2001

NASA Astrophysics Data System (ADS)

Criscitiello, Alison S.; Marshall, Shawn J.; Evans, Matthew J.; Kinnard, Christophe; Norman, Ann-Lise; Sharp, Martin J.

2016-08-01

Using a coastal ice core collected from Prince of Wales (POW) Icefield on Ellesmere Island, we investigate source regions of sea ice-modulated chemical species (methanesulfonic acid (MSA) and chloride (Cl-)) to POW Icefield and the influence of large-scale atmospheric variability on the transport of these marine aerosols (1979-2001). Our key findings are (1) MSA in the POW Icefield core is derived primarily from productivity in the sea ice zone of Baffin Bay and the Labrador Sea, with influence from waters within the North Water (NOW) polynya, (2) sea ice formation processes within the NOW polynya may be a significant source of sea-salt aerosols to the POW core site, in addition to offshore open water source regions primarily in Hudson Bay, and (3) the tropical Pacific influences the source and transport of marine aerosols to POW Icefield through its remote control on regional winds and sea ice variability. Regression analyses during times of MSA deposition reveal sea level pressure (SLP) anomalies favorable for opening of the NOW polynya and subsequent oceanic dimethyl sulfide production. Regression analyses during times of Cl- deposition reveal SLP anomalies that indicate a broader oceanic region of sea-salt sources to the core site. These results are supported by Scanning Multichannel Microwave Radiometer- and Special Sensor Microwave/Imager-based sea ice reconstructions and air mass transport density analyses and suggest that the marine biogenic record may capture local polynya variability, while sea-salt transport to the site from larger offshore source regions in Baffin Bay is likely. Regression analyses show a link to tropical dynamics via an atmospheric Rossby wave.

The use of segmented regression in analysing interrupted time series studies: an example in pre-hospital ambulance care.

PubMed

Taljaard, Monica; McKenzie, Joanne E; Ramsay, Craig R; Grimshaw, Jeremy M

2014-06-19

An interrupted time series design is a powerful quasi-experimental approach for evaluating effects of interventions introduced at a specific point in time. To utilize the strength of this design, a modification to standard regression analysis, such as segmented regression, is required. In segmented regression analysis, the change in intercept and/or slope from pre- to post-intervention is estimated and used to test causal hypotheses about the intervention. We illustrate segmented regression using data from a previously published study that evaluated the effectiveness of a collaborative intervention to improve quality in pre-hospital ambulance care for acute myocardial infarction (AMI) and stroke. In the original analysis, a standard regression model was used with time as a continuous variable. We contrast the results from this standard regression analysis with those from segmented regression analysis. We discuss the limitations of the former and advantages of the latter, as well as the challenges of using segmented regression in analysing complex quality improvement interventions. Based on the estimated change in intercept and slope from pre- to post-intervention using segmented regression, we found insufficient evidence of a statistically significant effect on quality of care for stroke, although potential clinically important effects for AMI cannot be ruled out. Segmented regression analysis is the recommended approach for analysing data from an interrupted time series study. Several modifications to the basic segmented regression analysis approach are available to deal with challenges arising in the evaluation of complex quality improvement interventions.

Using Spatial Multiple Regression to Identify Intrinsic Connectivity Networks Involved in Working Memory Performance

PubMed Central

Gordon, Evan M.; Stollstorff, Melanie; Vaidya, Chandan J.

2012-01-01

Many researchers have noted that the functional architecture of the human brain is relatively invariant during task performance and the resting state. Indeed, intrinsic connectivity networks (ICNs) revealed by resting-state functional connectivity analyses are spatially similar to regions activated during cognitive tasks. This suggests that patterns of task-related activation in individual subjects may result from the engagement of one or more of these ICNs; however, this has not been tested. We used a novel analysis, spatial multiple regression, to test whether the patterns of activation during an N-back working memory task could be well described by a linear combination of ICNs delineated using Independent Components Analysis at rest. We found that across subjects, the cingulo-opercular Set Maintenance ICN, as well as right and left Frontoparietal Control ICNs, were reliably activated during working memory, while Default Mode and Visual ICNs were reliably deactivated. Further, involvement of Set Maintenance, Frontoparietal Control, and Dorsal Attention ICNs was sensitive to varying working memory load. Finally, the degree of left Frontoparietal Control network activation predicted response speed, while activation in both left Frontoparietal Control and Dorsal Attention networks predicted task accuracy. These results suggest that a close relationship between resting-state networks and task-evoked activation is functionally relevant for behavior, and that spatial multiple regression analysis is a suitable method for revealing that relationship. PMID:21761505

Effects of Psychological and Social Work Factors on Self-Reported Sleep Disturbance and Difficulties Initiating Sleep.

PubMed

Vleeshouwers, Jolien; Knardahl, Stein; Christensen, Jan Olav

2016-04-01

This prospective cohort study examined previously underexplored relations between psychological/social work factors and troubled sleep in order to provide practical information about specific, modifiable factors at work. A comprehensive evaluation of a range of psychological/social work factors was obtained by several designs; i.e., cross-sectional analyses at baseline and follow-up, prospective analyses with baseline predictors (T1), prospective analyses with average exposure across waves as predictor ([T1 + T2] / 2), and prospective analyses with change in exposure from baseline to follow-up as predictor. Participants consisted of a sample of Norwegian employees from a broad spectrum of occupations, who completed a questionnaire at two points in time, approximately two years apart. Cross-sectional analyses at T1 comprised 7,459 participants, cross-sectional analyses at T2 included 6,688 participants. Prospective analyses comprised a sample 5,070 of participants who responded at both T1 and T2. Univariable and multivariable ordinal logistic regressions were performed. Thirteen psychological/social work factors and two aspects of troubled sleep, namely difficulties initiating sleep and disturbed sleep, were studied. Ordinal logistic regressions revealed statistically significant associations for all psychological and social work factors in at least one of the analyses. Psychological and social work factors predicted sleep problems in the short term as well as the long term. All work factors investigated showed statistically significant associations with both sleep items, however quantitative job demands, decision control, role conflict, and support from superior were the most robust predictors and may therefore be suitable targets of interventions aimed at improving employee sleep. © 2016 Associated Professional Sleep Societies, LLC.

Desistance from intimate partner violence: the role of legal cynicism, collective efficacy, and social disorganization in Chicago neighborhoods.

PubMed

Emery, Clifton R; Jolley, Jennifer M; Wu, Shali

2011-12-01

This paper examined the relationship between reported Intimate Partner Violence (IPV) desistance and neighborhood concentrated disadvantage, ethnic heterogeneity, residential instability, collective efficacy and legal cynicism. Data from the Project on Human Development in Chicago Neighborhoods (PHDCN) Longitudinal survey were used to identify 599 cases of IPV in Wave 1 eligible for reported desistance in Wave 2. A Generalized Boosting Model was used to determine the best proximal predictors of IPV desistance from the longitudinal data. Controlling for these predictors, logistic regression of neighborhood characteristics from the PHDCN community survey was used to predict reported IPV desistance in Wave 2. The paper finds that participants living in neighborhoods high in legal cynicism have lower odds of reporting IPV desistance, controlling for other variables in the logistic regression model. Analyses did not find that IPV desistance was related to neighborhood concentrated disadvantage, ethnic heterogeneity, residential instability and collective efficacy.

Health Care Expenditures for University and Academic Medical Center Employees Enrolled in a Pilot Workplace Health Partner Intervention.

PubMed

Johnston, Kenton J; Hockenberry, Jason M; Rask, Kimberly J; Cunningham, Lynn; Brigham, Kenneth L; Martin, Greg S

2015-08-01

To evaluate the impact of a pilot workplace health partner intervention delivered by a predictive health institute to university and academic medical center employees on per-member, per-month health care expenditures. We analyzed the health care claims of participants versus nonparticipants, with a 12-month baseline and 24-month intervention period. Total per-member, per-month expenditures were analyzed using two-part regression models that controlled for sex, age, health benefit plan type, medical member months, and active employment months. Our regression results found no statistical differences in total expenditures at baseline and intervention. Further sensitivity analyses controlling for high cost outliers, comorbidities, and propensity to be in the intervention group confirmed these findings. We find no difference in health care expenditures attributable to the health partner intervention. The intervention does not seem to have raised expenditures in the short term.

Reprint of: Relationship between cataract severity and socioeconomic status.

PubMed

Wesolosky, Jason D; Rudnisky, Christopher J

2015-06-01

To determine the relationship between cataract severity and socioeconomic status (SES). Retrospective, observational case series. A total of 1350 eyes underwent phacoemulsification cataract extraction by a single surgeon using an Alcon Infiniti system. Cataract severity was measured using phaco time in seconds. SES was measured using area-level aggregate census data: median income, education, proportion of common-law couples, and employment rate. Preoperative best corrected visual acuity was obtained and converted to logarithm of the minimum angle of resolution values. For patients undergoing bilateral surgery, the generalized estimating equation was used to account for the correlation between eyes. Univariate analyses were performed using simple regression, and multivariate analyses were performed to account for variables with significant relationships (p < 0.05) on univariate testing. Sensitivity analyses were performed to assess the effect of including patient age in the controlled analyses. Multivariate analyses demonstrated that cataracts were more severe when the median income was lower (p = 0.001) and the proportion of common-law couples living in a patient's community (p = 0.012) and the unemployment rate (p = 0.002) were higher. These associations persisted even when controlling for patient age. Patients of lower SES have more severe cataracts. Copyright © 2015. Published by Elsevier Inc.

Low trait self-control predicts self-handicapping.

PubMed

Uysal, Ahmet; Knee, C Raymond

2012-02-01

Past research has shown that self-handicapping stems from uncertainty about one's ability and self-presentational concerns. The present studies suggest that low dispositional self-control is also associated with self-handicapping. In 3 studies (N = 289), the association between self-control and self-handicapping was tested. Self-control was operationalized as trait self-control, whereas self-handicapping was operationalized as trait self-handicapping in Study 1 (N = 160), self-reported self-handicapping in Study 2 (N = 74), and behavioral self-handicapping in Study 3 (N = 55). In all 3 studies, hierarchical regression analyses revealed that low self-control predicts self-handicapping, independent of self-esteem, self-doubt, social desirability, and gender. © 2012 The Authors. Journal of Personality © 2012, Wiley Periodicals, Inc.

Bias from historical control groups used in orthodontic research: a meta-epidemiological study.

PubMed

Papageorgiou, Spyridon N; Koretsi, Vasiliki; Jäger, Andreas

2017-02-01

The validity of meta-analysis is dependent upon the quality of included studies. Here, we investigated whether the design of untreated control groups (i.e. source and timing of data collection) influences the results of clinical trials in orthodontic research. This meta-epidemiological study used unrestricted literature searching for meta-analyses in orthodontics including clinical trials with untreated control groups. Differences in standardized mean differences (ΔSMD) and their 95% confidence intervals (CIs) were calculated according to the untreated control group through multivariable random-effects meta-regression controlling for nature of the interventional group and study sample size. Effects were pooled with random-effects synthesis, followed by mixed-effect subgroup and sensitivity analyses. Studies with historical control groups reported deflated treatment effects compared to studies with concurrent control groups (13 meta-analyses; ΔSMD = -0.31; 95% CI = -0.53, -0.10; P = 0.004). Significant differences were found according to the type of historical control group (based either on growth study or clinical archive; 11 meta-analyses; ΔSMD = 0.40; 95% CI = 0.21, 0.59; P < 0.001). The use of historical control groups in orthodontic clinical research was associated with deflation of treatment effects, which was independent from whether the interventional group was prospective or retrospective and from the study's sample size. Caution is warranted when interpreting clinical studies with historical untreated control groups or when interpreting systematic reviews that include such studies. PROSPERO (CRD42015024179). None. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Gender Gaps in Mathematics, Science and Reading Achievements in Muslim Countries: Evidence from Quantile Regression Analyses

ERIC Educational Resources Information Center

Shafiq, M. Najeeb

2011-01-01

Using quantile regression analyses, this study examines gender gaps in mathematics, science, and reading in Azerbaijan, Indonesia, Jordan, the Kyrgyz Republic, Qatar, Tunisia, and Turkey among 15 year-old students. The analyses show that girls in Azerbaijan achieve as well as boys in mathematics and science and overachieve in reading. In Jordan,…

Association between coagulation function and patients with primary angle closure glaucoma: a 5-year retrospective case-control study.

PubMed

Li, Shengjie; Gao, Yanting; Shao, Mingxi; Tang, Binghua; Cao, Wenjun; Sun, Xinghuai

2017-11-04

To evaluate the association between coagulation function and patients with primary angle closure glaucoma (PACG). A retrospective, hospital-based, case-control study. Shanghai, China. A total of 1778 subjects were recruited from the Eye & ENT Hospital of Fudan University from January 2010 to December 2015, including patients with PACG (male=296; female=569) and control subjects (male=290; female=623). Sociodemographic data and clinical data were collected. The one-way analysis of variance test was used to compare the levels of laboratory parameters among the mild, moderate and severe PACG groups. Multivariate logistic regression analyses were performed to identify the independent risk factors for PACG. The nomogram was constructed based on the logistic regression model using the R project for statistical computing (R V.3.3.2). The activated partial thromboplastin time (APTT) of the PACG group was approximately 4% shorter (p<0.001) than that of the control group. The prothrombin time (PT) was approximately 2.40% shorter (p<0.001) in patients with PACG compared with the control group. The thrombin time was also approximately 2.14% shorter (p<0.001) in patients with PACG compared with the control group. The level of D-dimer was significantly higher (p=0.042) in patients with PACG. Moreover, the mean platelet volume (MPV) of the PACG group was significantly higher (p=0.013) than that of the control group. A similar trend was observed when coagulation parameters were compared between the PACG and control groups with respect to gender and/or age. Multiple logistic regression analyses revealed that APTT (OR=1.032, 95% CI 1.000 to 1.026), PT (OR=1.249, 95% CI 1.071 to 1.457) and MPV (OR=1.185, 95% CI 1.081 to 1.299) were independently associated with PACG. Patients with PACG had a shorter coagulation time. Our results suggest that coagulation function is significantly associated with patients with PACG and may play an important role in the onset and development of PACG. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A general framework for the use of logistic regression models in meta-analysis.

PubMed

Simmonds, Mark C; Higgins, Julian Pt

2016-12-01

Where individual participant data are available for every randomised trial in a meta-analysis of dichotomous event outcomes, "one-stage" random-effects logistic regression models have been proposed as a way to analyse these data. Such models can also be used even when individual participant data are not available and we have only summary contingency table data. One benefit of this one-stage regression model over conventional meta-analysis methods is that it maximises the correct binomial likelihood for the data and so does not require the common assumption that effect estimates are normally distributed. A second benefit of using this model is that it may be applied, with only minor modification, in a range of meta-analytic scenarios, including meta-regression, network meta-analyses and meta-analyses of diagnostic test accuracy. This single model can potentially replace the variety of often complex methods used in these areas. This paper considers, with a range of meta-analysis examples, how random-effects logistic regression models may be used in a number of different types of meta-analyses. This one-stage approach is compared with widely used meta-analysis methods including Bayesian network meta-analysis and the bivariate and hierarchical summary receiver operating characteristic (ROC) models for meta-analyses of diagnostic test accuracy. © The Author(s) 2014.

Evaluation of risk factors for perforated peptic ulcer.

PubMed

Yamamoto, Kazuki; Takahashi, Osamu; Arioka, Hiroko; Kobayashi, Daiki

2018-02-15

The aim of this study was to evaluate the prediction factors for perforated peptic ulcer (PPU). At St. Luke's International Hospital in Tokyo, Japan, a case control study was performed between August 2004 and March 2016. All patients diagnosed with PPU were included. As control subjects, patients with age, sex and date of CT scan corresponding to those of the PPU subjects were included in the study at a proportion of 2 controls for every PPU subject. All data such as past medical histories, physical findings, and laboratory data were collected through chart reviews. Univariate analyses and multivariate analyses with logistic regression were conducted, and receiver operating characteristic curves (ROCs) were calculated to show validity. Sensitivity analyses were performed to confirm results using a stepwise method and conditional logistic regression. A total of 408 patients were included in this study; 136 were a group of patients with PPU, and 272 were a control group. Univariate analysis showed statistical significance in many categories. Four different models of multivariate analyses were conducted, and significant differences were found for muscular defense and a history of peptic ulcer disease (PUD) in all models. The conditional forced-entry analysis of muscular defense showed an odds ratio (OR) of 23.8 (95% confidence interval [CI]: 5.70-100.0), and the analysis of PUD history showed an OR of 6.40 (95% CI: 1.13-36.2). The sensitivity analysis showed consistent results, with an OR of 23.8-366.2 for muscular defense and an OR of 3.67-7.81 for PUD history. The area under the curve (AUC) of all models was high enough to confirm the results. However, anticoagulants, known risk factors for PUD, did not increase the risk for PPU in our study. The conditional forced-entry analysis of anticoagulant use showed an OR of 0.85 (95% CI: 0.03-22.3). The evaluation of prediction factors and development of a prediction rule for PPU may help our decision making in performing a CT scan for patients with acute abdominal pain.

The Persistence of the Gender Gap in Introductory Physics

NASA Astrophysics Data System (ADS)

Kost, Lauren E.; Pollock, Steven J.; Finkelstein, Noah D.

2008-10-01

We previously showed[l] that despite teaching with interactive engagement techniques, the gap in performance between males and females on conceptual learning surveys persisted from pre- to posttest, at our institution. Such findings were counter to previously published work[2]. Our current work analyzes factors that may influence the observed gender gap in our courses. Posttest conceptual assessment data are modeled using both multiple regression and logistic regression analyses to estimate the gender gap in posttest scores after controlling for background factors that vary by gender. We find that at our institution the gender gap persists in interactive physics classes, but is largely due to differences in physics and math preparation and incoming attitudes and beliefs.

What We Have Learned from the Recent Meta-analyses on Diagnostic Methods for Atherosclerotic Plaque Regression.

PubMed

Biondi-Zoccai, Giuseppe; Mastrangeli, Simona; Romagnoli, Enrico; Peruzzi, Mariangela; Frati, Giacomo; Roever, Leonardo; Giordano, Arturo

2018-01-17

Atherosclerosis has major morbidity and mortality implications globally. While it has often been considered an irreversible degenerative process, recent evidence provides compelling proof that atherosclerosis can be reversed. Plaque regression is however difficult to appraise and quantify, with competing diagnostic methods available. Given the potential of evidence synthesis to provide clinical guidance, we aimed to review recent meta-analyses on diagnostic methods for atherosclerotic plaque regression. We identified 8 meta-analyses published between 2015 and 2017, including 79 studies and 14,442 patients, followed for a median of 12 months. They reported on atherosclerotic plaque regression appraised with carotid duplex ultrasound, coronary computed tomography, carotid magnetic resonance, coronary intravascular ultrasound, and coronary optical coherence tomography. Overall, all meta-analyses showed significant atherosclerotic plaque regression with lipid-lowering therapy, with the most notable effects on echogenicity, lipid-rich necrotic core volume, wall/plaque volume, dense calcium volume, and fibrous cap thickness. Significant interactions were found with concomitant changes in low density lipoprotein cholesterol, high density lipoprotein cholesterol, and C-reactive protein levels, and with ethnicity. Atherosclerotic plaque regression and conversion to a stable phenotype is possible with intensive medical therapy and can be demonstrated in patients using a variety of non-invasive and invasive imaging modalities.

Effectiveness of a low-intensity telephone counselling intervention on an untreated metabolic syndrome detected by national population screening in Korea: a non-randomised study using regression discontinuity design.

PubMed

Yi, Sang-Wook; Shin, Soon-Ae; Lee, Youn-Jung

2015-07-10

Whether low-intensity telephone-counselling interventions can improve cardiometabolic risk factors in screen-detected people with metabolic syndrome (MetS) is unclear. The aim of this study was to evaluate the effectiveness of a low-intensity, telephone-counselling programme on MetS implemented by the National Health Insurance Service (NHIS) of Korea using regression discontinuity design. A nationwide non-randomised intervention study with a regression discontinuity design. A retrospective analysis using data from NHIS. NHIS, Korea from January 2011 to June 2013. 5,378,558 beneficiaries with one or more MetS components by NHIS criteria detected by population screening were enrolled in the NHIS MetS Management Programme in 2012. Of these, 1,147,695 underwent annual follow-up examinations until June 2013 ('control group' which received control intervention, n=855,870; 'eligible group' which was eligible for counselling, n=291,825; 'intervention group' which participated in telephone counselling among eligible groups, n=23,968). Absolute changes in MetS components, weight and body mass index (BMI) were analysed. Multiple regression analyses were applied using the analysis of covariance model (baseline measurements as covariates). Low-intensity telephone counselling was associated with decreased systolic BP (-0.85 mm Hg, 95% CI -1.02 to -0.68), decreased diastolic BP (-0.63 mm Hg, -95% CI -0.75 to -0.50), decreased triglyceride (-1.57 mg/dL, 95% CI -2.89 to -0.25), reduced waist circumference (-0.09 cm, 95% CI -0.16 to -0.02), reduced weight (-0.19 kg, 95% CI -0.24 to -0.15) and reduced BMI (-0.07 kg/m(2), 95% CI -0.09 to -0.05), when comparing the intervention and control groups. When individuals with low high-density lipoprotein cholesterol were analysed, the intervention was also associated with increased HDL cholesterol (0.90 mg/dL, 95% CI 0.51 to 1.29). Low-intensity telephone counselling programmes could yield improvements in the following year on blood pressure, lipid profiles, weight and body mass index in untreated patients detected at the population screening. However, the improvements may be very modest and the clinical relevance of these small improvements may be limited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effectiveness of a low-intensity telephone counselling intervention on an untreated metabolic syndrome detected by national population screening in Korea: a non-randomised study using regression discontinuity design

PubMed Central

Yi, Sang-Wook; Shin, Soon-Ae; Lee, Youn-Jung

2015-01-01

Objective Whether low-intensity telephone-counselling interventions can improve cardiometabolic risk factors in screen-detected people with metabolic syndrome (MetS) is unclear. The aim of this study was to evaluate the effectiveness of a low-intensity, telephone-counselling programme on MetS implemented by the National Health Insurance Service (NHIS) of Korea using regression discontinuity design. Design A nationwide non-randomised intervention study with a regression discontinuity design. A retrospective analysis using data from NHIS. Setting NHIS, Korea from January 2011 to June 2013. Participants 5 378 558 beneficiaries with one or more MetS components by NHIS criteria detected by population screening were enrolled in the NHIS MetS Management Programme in 2012. Of these, 1 147 695 underwent annual follow-up examinations until June 2013 (‘control group’ which received control intervention, n=855 870; ‘eligible group’ which was eligible for counselling, n=291 825; ‘intervention group’ which participated in telephone counselling among eligible groups, n=23 968). Main outcome measures Absolute changes in MetS components, weight and body mass index (BMI) were analysed. Multiple regression analyses were applied using the analysis of covariance model (baseline measurements as covariates). Results Low-intensity telephone counselling was associated with decreased systolic BP (−0.85 mm Hg, 95% CI −1.02 to −0.68), decreased diastolic BP (−0.63 mm Hg, −95% CI −0.75 to −0.50), decreased triglyceride (−1.57 mg/dL, 95% CI −2.89 to −0.25), reduced waist circumference (−0.09 cm, 95% CI −0.16 to −0.02), reduced weight (−0.19 kg, 95% CI −0.24 to −0.15) and reduced BMI (−0.07 kg/m2, 95% CI −0.09 to −0.05), when comparing the intervention and control groups. When individuals with low high-density lipoprotein cholesterol were analysed, the intervention was also associated with increased HDL cholesterol (0.90 mg/dL, 95% CI 0.51 to 1.29). Conclusions Low-intensity telephone counselling programmes could yield improvements in the following year on blood pressure, lipid profiles, weight and body mass index in untreated patients detected at the population screening. However, the improvements may be very modest and the clinical relevance of these small improvements may be limited. PMID:26163030

Modelling of capital asset pricing by considering the lagged effects

NASA Astrophysics Data System (ADS)

Sukono; Hidayat, Y.; Bon, A. Talib bin; Supian, S.

2017-01-01

In this paper the problem of modelling the Capital Asset Pricing Model (CAPM) with the effect of the lagged is discussed. It is assumed that asset returns are analysed influenced by the market return and the return of risk-free assets. To analyse the relationship between asset returns, the market return, and the return of risk-free assets, it is conducted by using a regression equation of CAPM, and regression equation of lagged distributed CAPM. Associated with the regression equation lagged CAPM distributed, this paper also developed a regression equation of Koyck transformation CAPM. Results of development show that the regression equation of Koyck transformation CAPM has advantages, namely simple as it only requires three parameters, compared with regression equation of lagged distributed CAPM.

Effects of Coaching on Standardized Admission Examinations. Revised Statistical Analyses of Data Gathered By Boston Regional Office of the Federal Trade Commission.

ERIC Educational Resources Information Center

Federal Trade Commission, Washington, DC. Bureau of Consumer Protection.

The effect of commercial coaching on Scholastic Aptitude Test (SAT) scores was analyzed, using 1974-1977 test results of 2,500 non-coached students and 1,568 enrollees in two coaching schools. (The Stanley H. Kaplan Educational Center, Inc., and the Test Preparation Center, Inc.). Multiple regression analysis was used to control for student…

Executive dysfunction predicts social cognition impairment in amyotrophic lateral sclerosis.

PubMed

Watermeyer, Tamlyn J; Brown, Richard G; Sidle, Katie C L; Oliver, David J; Allen, Christopher; Karlsson, Joanna; Ellis, Catherine M; Shaw, Christopher E; Al-Chalabi, Ammar; Goldstein, Laura H

2015-07-01

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder of the motor system with recognised extra-motor and cognitive involvement. This cross-sectional study examined ALS patients' performance on measures requiring social inference, and determined the relationship between such changes and variations in mood, behaviour, personality, empathy and executive function. Fifty-five ALS patients and 49 healthy controls were compared on tasks measuring social cognition and executive function. ALS patients also completed measures examining mood, behaviour and personality. Regression analyses explored the contribution of executive function, mood, behaviour and personality to social cognition scores within the ALS sample. A between-group MANOVA revealed that, the ALS group was impaired relative to controls on two composite scores for social cognition and executive function. Patients also performed worse on individual tests of executive function measuring cognitive flexibility, response inhibition and concept formation, and on individual aspects of social cognition assessing the attribution of emotional and mental states. Regression analyses indicated that ALS-related executive dysfunction was the main predictor of social cognition performance, above and beyond demographic variables, behaviour, mood and personality. On at least some aspects of social cognition, impaired performance in ALS appears to be secondary to executive dysfunction. The profile of cognitive impairment in ALS supports a cognitive continuum between ALS and frontotemporal dementia.

Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population.

PubMed

Söderberg, Mia; Härenstam, Annika; Rosengren, Annika; Schiöler, Linus; Olin, Anna-Carin; Lissner, Lauren; Waern, Margda; Torén, Kjell

2014-06-14

Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. Participants were working men and women (n = 940; 54.3% women), aged 24-60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility.

Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals.

PubMed

Jansson, Bruce S; Nyamathi, Adeline; Heidemann, Gretchen; Duan, Lei; Kaplan, Charles

2015-01-01

Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed.

Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis.

PubMed

Pan, Yuanqing; Yang, Kehu; Wang, Yuliang; Zhang, Laiping; Liang, Haiqing

2017-04-01

To determine if yoga as a complementary and alternative therapy was associated with enhanced health and treatment-related side effects in patients with breast cancer. This systematic review examines whether yoga practice provides any measurable benefit, both physically and psychologically, for women with breast cancer. PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) throughout June 2013. We evaluated the quality of the included studies by the Cochrane Handbook 5.2 standards and analyzed the data using the Stata software, version 10.0. Meta-regression and subgroup analysis were also performed to identify additional predictors of outcome and to assess heterogeneity. Sixteen RCTs with a total of 930 participants were included. Comparing yoga groups to control groups, there was a statistically significant difference in overall health-related quality of life, depression, anxiety and gastrointestinal symptoms. Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity. Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practiced for longer than 3 months. Only the wait-list control group showed an effect of yoga on physical well-being. The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer. In future clinical studies, clinicians should consider the patient's wishes along with the current best evidence of the effects of yoga practice in their clinical decision-making. © 2015 Wiley Publishing Asia Pty Ltd.

Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database

PubMed Central

Hwang, Juen-Haur

2016-01-01

Background Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. Methods We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Results Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. Conclusions A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities. PMID:27631630

Authoritative school climate and high school dropout rates.

PubMed

Jia, Yuane; Konold, Timothy R; Cornell, Dewey

2016-06-01

This study tested the association between school-wide measures of an authoritative school climate and high school dropout rates in a statewide sample of 315 high schools. Regression models at the school level of analysis used teacher and student measures of disciplinary structure, student support, and academic expectations to predict overall high school dropout rates. Analyses controlled for school demographics of school enrollment size, percentage of low-income students, percentage of minority students, and urbanicity. Consistent with authoritative school climate theory, moderation analyses found that when students perceive their teachers as supportive, high academic expectations are associated with lower dropout rates. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Use of principal-component, correlation, and stepwise multiple-regression analyses to investigate selected physical and hydraulic properties of carbonate-rock aquifers

USGS Publications Warehouse

Brown, C. Erwin

1993-01-01

Correlation analysis in conjunction with principal-component and multiple-regression analyses were applied to laboratory chemical and petrographic data to assess the usefulness of these techniques in evaluating selected physical and hydraulic properties of carbonate-rock aquifers in central Pennsylvania. Correlation and principal-component analyses were used to establish relations and associations among variables, to determine dimensions of property variation of samples, and to filter the variables containing similar information. Principal-component and correlation analyses showed that porosity is related to other measured variables and that permeability is most related to porosity and grain size. Four principal components are found to be significant in explaining the variance of data. Stepwise multiple-regression analysis was used to see how well the measured variables could predict porosity and (or) permeability for this suite of rocks. The variation in permeability and porosity is not totally predicted by the other variables, but the regression is significant at the 5% significance level. ?? 1993.

Gender differences in health-related quality of life of adolescents with cystic fibrosis

PubMed Central

Arrington-Sanders, Renata; Yi, Michael S; Tsevat, Joel; Wilmott, Robert W; Mrus, Joseph M; Britto, Maria T

2006-01-01

Background Female patients with cystic fibrosis (CF) have consistently poorer survival rates than males across all ages. To determine if gender differences exist in health-related quality of life (HRQOL) of adolescent patients with CF, we performed a cross-section analysis of CF patients recruited from 2 medical centers in 2 cities during 1997–2001. Methods We used the 87-item child self-report form of the Child Health Questionnaire to measure 12 health domains. Data was also collected on age and forced expiratory volume in 1 second (FEV1). We analyzed data from 98 subjects and performed univariate analyses and linear regression or ordinal logistic regression for multivariable analyses. Results The mean (SD) age was 14.6 (2.5) years; 50 (51.0%) were female; and mean FEV1 was 71.6% (25.6%) of predicted. There were no statistically significant gender differences in age or FEV1. In univariate analyses, females reported significantly poorer HRQOL in 5 of the 12 domains. In multivariable analyses controlling for FEV1 and age, we found that female gender was associated with significantly lower global health (p < 0.05), mental health (p < 0.01), and general health perceptions (p < 0.05) scores. Conclusion Further research will need to focus on the causes of these differences in HRQOL and on potential interventions to improve HRQOL of adolescent patients with CF. PMID:16433917

Risk of acute liver injury associated with use of antibiotics. Comparative cohort and nested case-control studies using two primary care databases in Europe.

PubMed

Brauer, Ruth; Douglas, Ian; Garcia Rodriguez, Luis Alberto; Downey, Gerald; Huerta, Consuelo; de Abajo, Francisco; Bate, Andrew; Feudjo Tepie, Maurille; de Groot, Mark C H; Schlienger, Raymond; Reynolds, Robert; Smeeth, Liam; Klungel, Olaf; Ruigómez, Ana

2016-03-01

To assess the impact of varying study designs, exposure and outcome definitions on the risk of acute liver injury (ALI) associated with antibiotic use. The source population comprised of patients registered in two primary care databases, in the UK and in Spain. We identified a cohort consisting of new users of antibiotics during the study period (2004-2009) and non-users during the study period or in the previous year. Cases with ALI were identified within this cohort and classified as definite or probable, based on recorded medical information. The relative risk (RR) of ALI associated with antibiotic use was computed using Poisson regression. For the nested case-control analyses, up to five controls were matched to each case by age, sex, date and practice (in CPRD) and odds ratios (OR) were computed with conditional logistic regression. The age, sex and year adjusted RRs of definite ALI in the current antibiotic use periods was 10.04 (95% CI: 6.97-14.47) in CPRD and 5.76 (95% CI: 3.46-9.59) in BIFAP. In the case-control analyses adjusting for life-style, comorbidities and use of medications, the OR of ALI for current users of antibiotics was and 5.7 (95% CI: 3.46-9.36) in CPRD and 2.6 (95% CI: 1.26-5.37) in BIFAP. Guided by a common protocol, both cohort and case-control study designs found an increased risk of ALI associated with the use of antibiotics in both databases, independent of the exposure and case definitions used. However, the magnitude of the risk was higher in CPRD compared to BIFAP. Copyright © 2016 John Wiley & Sons, Ltd.

The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes.

PubMed

Reutrakul, Sirimon; Hood, Megan M; Crowley, Stephanie J; Morgan, Mary K; Teodori, Marsha; Knutson, Kristen L

2014-02-01

Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients. We collected sleep timing and 24-h dietary recall from 194 non-shift-working type 2 diabetes patients who were being followed in outpatient clinics. Mid-sleep time on free days (MSF) was used as an indicator of chronotype. Hemoglobin A1C (HbA1C) values were obtained from medical records. Hierarchical linear regression analyses controlling for demographic, sleep, and dietary variables were computed to determine whether breakfast skipping was associated with HbA1C. Additional regression analyses were performed to test if this association was mediated by chronotype. There were 22 participants (11.3%) who self-reported missing breakfast. Breakfast skippers had significantly higher HbA1C levels, higher body mass indices (BMI), and later MSF than breakfast eaters. Breakfast skipping was significantly associated with higher HbA1C values (B = 0.108, p = 0.01), even after adjusting for age, sex, race, BMI, number of diabetes complications, insulin use, depressive symptoms, perceived sleep debt, and percentage of daily caloric intake at dinner. The relationship between breakfast skipping and HbA1C was partially mediated by chronotype. In summary, breakfast skipping is associated with a later chronotype. Later chronotype and breakfast skipping both contribute to poorer glycemic control, as indicated by higher HbA1C levels. Future studies are needed to confirm these findings and determine whether behavioral interventions targeting breakfast eating or sleep timing may improve glycemic control in patients with type 2 diabetes.

Comorbidity and its relevance on general hospital based mortality in major depressive disorder: a naturalistic 12-year follow-up in general hospital admissions.

PubMed

Schoepf, Dieter; Uppal, Hardeep; Potluri, Rahul; Chandran, Suresh; Heun, Reinhard

2014-05-01

Major depressive disorder (MDD) is associated with physical comorbidity, but the risk factors of general hospital-based mortality are unclear. Consequently, we investigated whether the burden of comorbidity and its relevance on in-hospital death differs between patients with and without MDD in a 12-year follow-up in general hospital admissions. During 1 January 2000 and 30 June 2012, 9604 MDD patients were admitted to three General Manchester Hospitals. All comorbidities with a prevalence ≥1% were compared with those of 96,040 age-gender matched hospital controls. Risk factors of in-hospital death were identified using multivariate logistic regression analyses. Crude hospital-based mortality rates within the period under observation were 997/9604 (10.4%) in MDD patients and 8495/96,040 (8.8%) in controls. MDD patients compared to controls had a substantial higher burden of comorbidity. The highest comorbidities included hypertension, asthma, and anxiety disorders. Subsequently, twenty-six other diseases were disproportionally increased, many of them linked to chronic lung diseases and to diabetes. In deceased MDD patients, chronic obstructive pulmonary disease and type-2 diabetes mellitus were the most common comorbidities, contributing to 18.6% and 17.1% of deaths. Furthermore, fifteen physical diseases contributed to in-hospital death in the MDD population. However, there were no significant differences in their impact on mortality compared to controls in multivariate logistic regression analyses. Thus in one of the largest samples of MDD patients in general hospitals, MDD patients have a substantial higher burden of comorbidity compared to controls, but they succumb to the same physical diseases as their age-gender matched peers without MDD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Physiological and Psychological Predictors of Short-Term Disability in Workers with a History of Low Back Pain: A Longitudinal Study

PubMed Central

Dubois, Jean-Daniel; Cantin, Vincent; Piché, Mathieu; Descarreaux, Martin

2016-01-01

Despite an elusive pathophysiology, common characteristics are often observed in individuals with chronic low back pain (LBP). These include psychological symptoms, altered pain perception, altered pain modulation and altered muscle activation. These factors have been explored as possible determinants of disability, either separately or in cross-sectional studies, but were never assessed in a single longitudinal study. Therefore, the objective was to determine the relative contribution of psychological and neurophysiological factors to future disability in individuals with past LBP. The study included two experimental sessions (baseline and six months later) to assess cutaneous heat pain and pain tolerance thresholds, pain inhibition, as well as trunk muscle activation. Both sessions included the completion of validated questionnaires to determine clinical pain, disability, pain catastrophizing, fear-avoidance beliefs and pain vigilance. One hundred workers with a history of LBP and 19 healthy individuals took part in the first experimental session. The second experimental session was exclusively conducted on workers with a history of LBP (77/100). Correlation analyses between initial measures and disability at six months were conducted, and measures significantly associated with disability were used in multiple regression analyses. A first regression analysis showed that psychological symptoms contributed unique variance to future disability (R2 = 0.093, p = .009). To control for the fluctuating nature of LBP, a hierarchical regression was conducted while controlling for clinical pain at six months (R2 = 0.213, p < .001) where pain inhibition contributed unique variance in the second step of the regression (R2 change = 0.094, p = .005). These results indicate that pain inhibition processes may constitute potential targets for treatment to alleviate future disability in individuals with past or present LBP. Then again, the link between psychological symptoms and pain inhibition needs to be clarified as both of these factors are linked together and influence disability in their own way. PMID:27783666

Building information for systematic improvement of the prevention of hospital-acquired pressure ulcers with statistical process control charts and regression.

PubMed

Padula, William V; Mishra, Manish K; Weaver, Christopher D; Yilmaz, Taygan; Splaine, Mark E

2012-06-01

To demonstrate complementary results of regression and statistical process control (SPC) chart analyses for hospital-acquired pressure ulcers (HAPUs), and identify possible links between changes and opportunities for improvement between hospital microsystems and macrosystems. Ordinary least squares and panel data regression of retrospective hospital billing data, and SPC charts of prospective patient records for a US tertiary-care facility (2004-2007). A prospective cohort of hospital inpatients at risk for HAPUs was the study population. There were 337 HAPU incidences hospital wide among 43 844 inpatients. A probit regression model predicted the correlation of age, gender and length of stay on HAPU incidence (pseudo R(2)=0.096). Panel data analysis determined that for each additional day in the hospital, there was a 0.28% increase in the likelihood of HAPU incidence. A p-chart of HAPU incidence showed a mean incidence rate of 1.17% remaining in statistical control. A t-chart showed the average time between events for the last 25 HAPUs was 13.25 days. There was one 57-day period between two incidences during the observation period. A p-chart addressing Braden scale assessments showed that 40.5% of all patients were risk stratified for HAPUs upon admission. SPC charts complement standard regression analysis. SPC amplifies patient outcomes at the microsystem level and is useful for guiding quality improvement. Macrosystems should monitor effective quality improvement initiatives in microsystems and aid the spread of successful initiatives to other microsystems, followed by system-wide analysis with regression. Although HAPU incidence in this study is below the national mean, there is still room to improve HAPU incidence in this hospital setting since 0% incidence is theoretically achievable. Further assessment of pressure ulcer incidence could illustrate improvement in the quality of care and prevent HAPUs.

Visual field progression in glaucoma: estimating the overall significance of deterioration with permutation analyses of pointwise linear regression (PoPLR).

PubMed

O'Leary, Neil; Chauhan, Balwantray C; Artes, Paul H

2012-10-01

To establish a method for estimating the overall statistical significance of visual field deterioration from an individual patient's data, and to compare its performance to pointwise linear regression. The Truncated Product Method was used to calculate a statistic S that combines evidence of deterioration from individual test locations in the visual field. The overall statistical significance (P value) of visual field deterioration was inferred by comparing S with its permutation distribution, derived from repeated reordering of the visual field series. Permutation of pointwise linear regression (PoPLR) and pointwise linear regression were evaluated in data from patients with glaucoma (944 eyes, median mean deviation -2.9 dB, interquartile range: -6.3, -1.2 dB) followed for more than 4 years (median 10 examinations over 8 years). False-positive rates were estimated from randomly reordered series of this dataset, and hit rates (proportion of eyes with significant deterioration) were estimated from the original series. The false-positive rates of PoPLR were indistinguishable from the corresponding nominal significance levels and were independent of baseline visual field damage and length of follow-up. At P < 0.05, the hit rates of PoPLR were 12, 29, and 42%, at the fifth, eighth, and final examinations, respectively, and at matching specificities they were consistently higher than those of pointwise linear regression. In contrast to population-based progression analyses, PoPLR provides a continuous estimate of statistical significance for visual field deterioration individualized to a particular patient's data. This allows close control over specificity, essential for monitoring patients in clinical practice and in clinical trials.

Maternal impulse control disability and developmental disorder traits are risk factors for child maltreatment.

PubMed

Tachibana, Yoshiyuki; Takehara, Kenji; Kakee, Naoko; Mikami, Masashi; Inoue, Eisuke; Mori, Rintaro; Ota, Erika; Koizumi, Tomoe; Okuyama, Makiko; Kubo, Takahiko

2017-11-14

Previous work has suggested that maternal developmental disorder traits related to autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are significantly associated with child maltreatment. However, there may be other important maternal characteristics that contribute to child maltreatment. We hypothesized that maternal impulse control disability may also affect child maltreatment in addition to maternal developmental disorder traits. We aimed to test this hypothesis via a cohort study performed in Tokyo (n = 1,260). Linear regression analyses using the Behavioural Inhibition/Behavioural Activation Scales, the self-administered short version of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the short form of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and the Child Maltreatment Scale, revealed that excessive inhibition of behaviour and affect, which is impulse control disability, is significantly associated with child maltreatment (b = 0.031, p = 0.018) in addition to maternal developmental disorder traits (ASD: b = 0.052, p = 0.004; ADHD: b = 0.178, p < 0.001). Logistic regression analyses revealed that ASD (adjusted odds ratio [AOR] = 1.083, p = 0.014) and high behavioural inhibition (AOR = 1.068, p = 0.016) were significantly associated with moderate child maltreatment, while ADHD was associated (AOR = 1.034, p = 0.022) with severe child maltreatment. These maternal characteristics may inform the best means for prevention and management of child maltreatment cases.

Relationship of early-life stress and resilience to military adjustment in a young adulthood population.

PubMed

Choi, Kang; Im, Hyoungjune; Kim, Joohan; Choi, Kwang H; Jon, Duk-In; Hong, Hyunju; Hong, Narei; Lee, Eunjung; Seok, Jeong-Ho

2013-11-01

Early-life stress (ELS) may mediate adjustment problems while resilience may protect individuals against adjustment problems during military service. We investigated the relationship of ELS and resilience with adjustment problem factor scores in the Korea Military Personality Test (KMPT) in candidates for the military service. Four hundred and sixty-one candidates participated in this study. Vulnerability traits for military adjustment, ELS, and resilience were assessed using the KMPT, the Korean Early-Life Abuse Experience Questionnaire, and the Resilience Quotient Test, respectively. Data were analyzed using multiple linear regression analyses. The final model of the multiple linear regression analyses explained 30.2 % of the total variances of the sum of the adjustment problem factor scores of the KMPT. Neglect and exposure to domestic violence had a positive association with the total adjustment problem factor scores of the KMPT, but emotion control, impulse control, and optimism factor scores as well as education and occupational status were inversely associated with the total military adjustment problem score. ELS and resilience are important modulating factors in adjusting to military service. We suggest that neglect and exposure to domestic violence during early life may increase problem with adjustment, but capacity to control emotion and impulse as well as optimistic attitude may play protective roles in adjustment to military life. The screening procedures for ELS and the development of psychological interventions may be helpful for young adults to adjust to military service.

Facial measurement differences between patients with schizophrenia and non-psychiatric controls.

PubMed

Compton, Michael T; Brudno, Jennifer; Kryda, Aimee D; Bollini, Annie M; Walker, Elaine F

2007-07-01

Several previous reports suggest that facial measurements in patients with schizophrenia differ from those of non-psychiatric controls. Because the face and brain develop in concert from the same ectodermal tissue, the study of quantitative craniofacial abnormalities may give clues to genetic and/or environmental factors predisposing to schizophrenia. Using a predominantly African American sample, the present research question was two-fold: (1) Do patients differ from controls in terms of a number of specific facial measurements?, and (2) Does cluster analysis based on these facial measurements reveal distinct facial morphologies that significantly discriminate patients from controls? Facial dimensions were measured in 73 patients with schizophrenia and related psychotic disorders (42 males and 31 females) and 69 non-psychiatric controls (35 males and 34 females) using a 25-cm head and neck caliper. Due to differences in facial dimensions by gender, separate independent samples Student's t-tests and logistic regression analyses were employed to discern differences in facial measures between the patient and control groups in women and men. Findings were further explored using cluster analysis. Given an association between age and some facial dimensions, the effect of age was controlled. In unadjusted bivariate tests, female patients differed from female controls on several facial dimensions, though male patients did not differ significantly from male controls for any facial measure. Controlling for age using logistic regression, female patients had a greater mid-facial depth (tragus-subnasale) compared to female controls; male patients had lesser upper facial (trichion-glabella) and lower facial (subnasale-gnathion) heights compared to male controls. Among females, cluster analysis revealed two facial morphologies that significantly discriminated patients from controls, though this finding was not evident when employing further cluster analyses using secondary distance measures. When the sample was restricted to African Americans, results were similar and consistent. These findings indicate that, in a predominantly African American sample, some facial measurements differ between patients with schizophrenia and non-psychiatric controls, and these differences appear to be gender-specific. Further research on gender-specific quantitative craniofacial measurement differences between cases and controls could suggest gender-specific differences in embryologic/fetal neurodevelopmental processes underpinning schizophrenia.

Are your covariates under control? How normalization can re-introduce covariate effects.

PubMed

Pain, Oliver; Dudbridge, Frank; Ronald, Angelica

2018-04-30

Many statistical tests rely on the assumption that the residuals of a model are normally distributed. Rank-based inverse normal transformation (INT) of the dependent variable is one of the most popular approaches to satisfy the normality assumption. When covariates are included in the analysis, a common approach is to first adjust for the covariates and then normalize the residuals. This study investigated the effect of regressing covariates against the dependent variable and then applying rank-based INT to the residuals. The correlation between the dependent variable and covariates at each stage of processing was assessed. An alternative approach was tested in which rank-based INT was applied to the dependent variable before regressing covariates. Analyses based on both simulated and real data examples demonstrated that applying rank-based INT to the dependent variable residuals after regressing out covariates re-introduces a linear correlation between the dependent variable and covariates, increasing type-I errors and reducing power. On the other hand, when rank-based INT was applied prior to controlling for covariate effects, residuals were normally distributed and linearly uncorrelated with covariates. This latter approach is therefore recommended in situations were normality of the dependent variable is required.

The base rates and factors associated with reported access to firearms in psychiatric inpatients.

PubMed

Kolla, Bhanu Prakash; O'Connor, Stephen S; Lineberry, Timothy W

2011-01-01

The aim of this study was to define whether specific patient demographic groups, diagnoses or other factors are associated with psychiatric inpatients reporting firearms access. A retrospective medical records review study was conducted using information on access to firearms from electronic medical records for all patients 16 years and older admitted between July 2007 and May 2008 at the Mayo Clinic Psychiatric Hospital in Rochester, MN. Data were obtained only on patients providing authorization for record review. Data were analyzed using univariate and multivariate logistic regression analyses accounting for gender, diagnostic groups, comorbid substance use, history of suicide attempts and family history of suicide/suicide attempts. Seventy-four percent (1169/1580) of patients provided research authorization. The ratio of men to women was identical in both research and nonresearch authorization groups. There were 14.6% of inpatients who reported firearms access. In univariate analysis, men were more likely (P<.0001) to report access than women, and a history of previous suicide attempt(s) was associated with decreased access (P=.02). Multiple logistic regression analyses controlling for other factors found females and patients with history of previous suicide attempt(s) less likely to report access, while patients with a family history of suicide or suicide attempts reported increased firearms access. Diagnostic groups were not associated with access on univariate or multiple logistic regression analyses. Men and inpatients with a family history of suicide/suicide attempts were more likely to report firearms access. Clinicians should develop standardized systems of identification of firearms access and provide guidance on removal. Copyright © 2011 Elsevier Inc. All rights reserved.

High correlations between MRI brain volume measurements based on NeuroQuant® and FreeSurfer.

PubMed

Ross, David E; Ochs, Alfred L; Tate, David F; Tokac, Umit; Seabaugh, John; Abildskov, Tracy J; Bigler, Erin D

2018-05-30

NeuroQuant ® (NQ) and FreeSurfer (FS) are commonly used computer-automated programs for measuring MRI brain volume. Previously they were reported to have high intermethod reliabilities but often large intermethod effect size differences. We hypothesized that linear transformations could be used to reduce the large effect sizes. This study was an extension of our previously reported study. We performed NQ and FS brain volume measurements on 60 subjects (including normal controls, patients with traumatic brain injury, and patients with Alzheimer's disease). We used two statistical approaches in parallel to develop methods for transforming FS volumes into NQ volumes: traditional linear regression, and Bayesian linear regression. For both methods, we used regression analyses to develop linear transformations of the FS volumes to make them more similar to the NQ volumes. The FS-to-NQ transformations based on traditional linear regression resulted in effect sizes which were small to moderate. The transformations based on Bayesian linear regression resulted in all effect sizes being trivially small. To our knowledge, this is the first report describing a method for transforming FS to NQ data so as to achieve high reliability and low effect size differences. Machine learning methods like Bayesian regression may be more useful than traditional methods. Copyright © 2018 Elsevier B.V. All rights reserved.

Multicomponent analysis of a digital Trail Making Test.

PubMed

Fellows, Robert P; Dahmen, Jessamyn; Cook, Diane; Schmitter-Edgecombe, Maureen

2017-01-01

The purpose of the current study was to use a newly developed digital tablet-based variant of the TMT to isolate component cognitive processes underlying TMT performance. Similar to the paper-based trail making test, this digital variant consists of two conditions, Part A and Part B. However, this digital version automatically collects additional data to create component subtest scores to isolate cognitive abilities. Specifically, in addition to the total time to completion and number of errors, the digital Trail Making Test (dTMT) records several unique components including the number of pauses, pause duration, lifts, lift duration, time inside each circle, and time between circles. Participants were community-dwelling older adults who completed a neuropsychological evaluation including measures of processing speed, inhibitory control, visual working memory/sequencing, and set-switching. The abilities underlying TMT performance were assessed through regression analyses of component scores from the dTMT with traditional neuropsychological measures. Results revealed significant correlations between paper and digital variants of Part A (r s  = .541, p < .001) and paper and digital versions of Part B (r s  = .799, p < .001). Regression analyses with traditional neuropsychological measures revealed that Part A components were best predicted by speeded processing, while inhibitory control and visual/spatial sequencing were predictors of specific components of Part B. Exploratory analyses revealed that specific dTMT-B components were associated with a performance-based medication management task. Taken together, these results elucidate specific cognitive abilities underlying TMT performance, as well as the utility of isolating digital components.

Characterizing mammographic images by using generic texture features

PubMed Central

2012-01-01

Introduction Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. Methods A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Results Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Conclusions Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy. PMID:22490545

Shrinkage regression-based methods for microarray missing value imputation.

PubMed

Wang, Hsiuying; Chiu, Chia-Chun; Wu, Yi-Ching; Wu, Wei-Sheng

2013-01-01

Missing values commonly occur in the microarray data, which usually contain more than 5% missing values with up to 90% of genes affected. Inaccurate missing value estimation results in reducing the power of downstream microarray data analyses. Many types of methods have been developed to estimate missing values. Among them, the regression-based methods are very popular and have been shown to perform better than the other types of methods in many testing microarray datasets. To further improve the performances of the regression-based methods, we propose shrinkage regression-based methods. Our methods take the advantage of the correlation structure in the microarray data and select similar genes for the target gene by Pearson correlation coefficients. Besides, our methods incorporate the least squares principle, utilize a shrinkage estimation approach to adjust the coefficients of the regression model, and then use the new coefficients to estimate missing values. Simulation results show that the proposed methods provide more accurate missing value estimation in six testing microarray datasets than the existing regression-based methods do. Imputation of missing values is a very important aspect of microarray data analyses because most of the downstream analyses require a complete dataset. Therefore, exploring accurate and efficient methods for estimating missing values has become an essential issue. Since our proposed shrinkage regression-based methods can provide accurate missing value estimation, they are competitive alternatives to the existing regression-based methods.

Using an innovative multiple regression procedure in a cancer population (Part 1): detecting and probing relationships of common interacting symptoms (pain, fatigue/weakness, sleep problems) as a strategy to discover influential symptom pairs and clusters

PubMed Central

Francoeur, Richard B

2015-01-01

Background The majority of patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. Improved methods are needed to detect and interpret interactions among symptoms or diesease markers to reveal influential pairs or clusters. In prior work, I developed and validated sequential residual centering (SRC), a method that improves the sensitivity of multiple regression to detect interactions among predictors, by conditioning for multicollinearity (shared variation) among interactions and component predictors. Materials and methods Using a hypothetical three-way interaction among pain, fatigue, and sleep to predict depressive affect, I derive and explain SRC multiple regression. Subsequently, I estimate raw and SRC multiple regressions using real data for these symptoms from 268 palliative radiation outpatients. Results Unlike raw regression, SRC reveals that the three-way interaction (pain × fatigue/weakness × sleep problems) is statistically significant. In follow-up analyses, the relationship between pain and depressive affect is aggravated (magnified) within two partial ranges: 1) complete-to-some control over fatigue/weakness when there is complete control over sleep problems (ie, a subset of the pain–fatigue/weakness symptom pair), and 2) no control over fatigue/weakness when there is some-to-no control over sleep problems (ie, a subset of the pain–fatigue/weakness–sleep problems symptom cluster). Otherwise, the relationship weakens (buffering) as control over fatigue/weakness or sleep problems diminishes. Conclusion By reducing the standard error, SRC unmasks a three-way interaction comprising a symptom pair and cluster. Low-to-moderate levels of the moderator variable for fatigue/weakness magnify the relationship between pain and depressive affect. However, when the comoderator variable for sleep problems accompanies fatigue/weakness, only frequent or unrelenting levels of both symptoms magnify the relationship. These findings suggest that a countervailing mechanism involving depressive affect could account for the effectiveness of a cognitive behavioral intervention to reduce the severity of a pain, fatigue, and sleep disturbance cluster in a previous randomized trial. PMID:25565865

Using an innovative multiple regression procedure in a cancer population (Part 1): detecting and probing relationships of common interacting symptoms (pain, fatigue/weakness, sleep problems) as a strategy to discover influential symptom pairs and clusters.

PubMed

Francoeur, Richard B

2015-01-01

The majority of patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. Improved methods are needed to detect and interpret interactions among symptoms or diesease markers to reveal influential pairs or clusters. In prior work, I developed and validated sequential residual centering (SRC), a method that improves the sensitivity of multiple regression to detect interactions among predictors, by conditioning for multicollinearity (shared variation) among interactions and component predictors. Using a hypothetical three-way interaction among pain, fatigue, and sleep to predict depressive affect, I derive and explain SRC multiple regression. Subsequently, I estimate raw and SRC multiple regressions using real data for these symptoms from 268 palliative radiation outpatients. Unlike raw regression, SRC reveals that the three-way interaction (pain × fatigue/weakness × sleep problems) is statistically significant. In follow-up analyses, the relationship between pain and depressive affect is aggravated (magnified) within two partial ranges: 1) complete-to-some control over fatigue/weakness when there is complete control over sleep problems (ie, a subset of the pain-fatigue/weakness symptom pair), and 2) no control over fatigue/weakness when there is some-to-no control over sleep problems (ie, a subset of the pain-fatigue/weakness-sleep problems symptom cluster). Otherwise, the relationship weakens (buffering) as control over fatigue/weakness or sleep problems diminishes. By reducing the standard error, SRC unmasks a three-way interaction comprising a symptom pair and cluster. Low-to-moderate levels of the moderator variable for fatigue/weakness magnify the relationship between pain and depressive affect. However, when the comoderator variable for sleep problems accompanies fatigue/weakness, only frequent or unrelenting levels of both symptoms magnify the relationship. These findings suggest that a countervailing mechanism involving depressive affect could account for the effectiveness of a cognitive behavioral intervention to reduce the severity of a pain, fatigue, and sleep disturbance cluster in a previous randomized trial.

Using Dual Regression to Investigate Network Shape and Amplitude in Functional Connectivity Analyses

PubMed Central

Nickerson, Lisa D.; Smith, Stephen M.; Öngür, Döst; Beckmann, Christian F.

2017-01-01

Independent Component Analysis (ICA) is one of the most popular techniques for the analysis of resting state FMRI data because it has several advantageous properties when compared with other techniques. Most notably, in contrast to a conventional seed-based correlation analysis, it is model-free and multivariate, thus switching the focus from evaluating the functional connectivity of single brain regions identified a priori to evaluating brain connectivity in terms of all brain resting state networks (RSNs) that simultaneously engage in oscillatory activity. Furthermore, typical seed-based analysis characterizes RSNs in terms of spatially distributed patterns of correlation (typically by means of simple Pearson's coefficients) and thereby confounds together amplitude information of oscillatory activity and noise. ICA and other regression techniques, on the other hand, retain magnitude information and therefore can be sensitive to both changes in the spatially distributed nature of correlations (differences in the spatial pattern or “shape”) as well as the amplitude of the network activity. Furthermore, motion can mimic amplitude effects so it is crucial to use a technique that retains such information to ensure that connectivity differences are accurately localized. In this work, we investigate the dual regression approach that is frequently applied with group ICA to assess group differences in resting state functional connectivity of brain networks. We show how ignoring amplitude effects and how excessive motion corrupts connectivity maps and results in spurious connectivity differences. We also show how to implement the dual regression to retain amplitude information and how to use dual regression outputs to identify potential motion effects. Two key findings are that using a technique that retains magnitude information, e.g., dual regression, and using strict motion criteria are crucial for controlling both network amplitude and motion-related amplitude effects, respectively, in resting state connectivity analyses. We illustrate these concepts using realistic simulated resting state FMRI data and in vivo data acquired in healthy subjects and patients with bipolar disorder and schizophrenia. PMID:28348512

Long-term sickness absence during pregnancy and the gender balance of workplaces.

PubMed

Melsom, Anne M

2014-11-01

This study addresses how the gender composition of workplaces affects pregnant women's sickness absence. It also assesses whether an observed association may be explaine by differential selection to female- or male-dominated workplaces. The analyses are based on Norwegian registry data from 2003-2011. Using Poisson regressions with detailed control for occupational categories, I examine whether the number of absence days are associated with the proportion of females at the workplace. I address possible selection effects by Poisson regressions with fixed individual effects using only within-individual variation on women with two or more pregnancies during the time window. The analyses indicate a positive and significant relationship between the female proportion in workplaces and sickness absence rates during pregnancy. Analyses limited to within-individual variation also show positive and significant effects of similar strength, indicating that the observed relationship is not due to differential selection of absence-prone pregnant workers to female-dominated workplaces. The proportion of female individuals at workplaces is positively associated with sickness absence rates during pregnancy this association is not likely explained by occupational nor individual characteristics the results are consistent with absence culture theory and more lenient norms concerning sickness absence during pregnancy at female-dominated workplaces. © 2014 the Nordic Societies of Public Health.

Self-identity and the theory of planned behaviour: between- and within-participants analyses.

PubMed

Hagger, Martin S; Chatzisarantis, Nikos L D

2006-12-01

Two studies addressed the hypothesis that a minority of people are more oriented towards their self-identity when forming intentions to act than the traditional antecedents of intentional action; attitudes, subjective norms and perceived behavioural control (PBC). In Study 1, participants (N=241) completed measures of an augmented version of theory of planned behaviour (TPB) that included self-identity for 30 behaviours. Using within-participants multiple regression analyses, the sample was classified into self-identity-oriented (SI-oriented) and TPB-oriented groups. Between-participants multiple regression analyses revealed that self-identity was a significantly stronger predictor of intentions and accounted for significantly more incremental variance in intentions in the SI-oriented sample compared with the TPB-oriented sample across the 30 behaviours. In Study 2, participants (N=250) completed the same TPB and self-identity measures used in Study 1 as well as measures of generalized self-concept and social physique anxiety for dieting behaviour. Results indicated that self-identity was significantly associated with the generalized self-related measures, and self-concept and social physique anxiety moderated the self-identity-intention relationship. This investigation provides some preliminary evidence to support the effect of individual differences in self-identity on the formation of intentions to act.

Emotional exhaustion and cognitive performance in apparently healthy teachers: a longitudinal multi-source study.

PubMed

Feuerhahn, Nicolas; Stamov-Roßnagel, Christian; Wolfram, Maren; Bellingrath, Silja; Kudielka, Brigitte M

2013-10-01

We investigate how emotional exhaustion (EE), the core component of burnout, relates to cognitive performance, job performance and health. Cognitive performance was assessed by self-rated cognitive stress symptoms, self-rated and peer-rated cognitive impairments in everyday tasks and a neuropsychological test of learning and memory (LGT-3); job performance and physical health were gauged by self-reports. Cross-sectional linear regression analyses in a sample of 100 teachers confirm that EE is negatively related to cognitive performance as assessed by self-rating and peer-rating as well as neuropsychological testing (all p < .05). Longitudinal linear regression analyses confirm similar trends (p < .10) for self-rated and peer-rated cognitive performance. Executive control deficits might explain impaired cognitive performance in EE. In longitudinal analyses, EE also significantly predicts physical health. Contrary to our expectations, EE does not affect job performance. When reversed causation is tested, none of the outcome variables at Time 1 predict EE at Time 2. This speaks against cognitive dysfunctioning serving as a vulnerability factor for exhaustion. In sum, results underpin the negative consequences of EE for cognitive performance and health, which are relevant for individuals and organizations alike. In this way, findings might contribute to the understanding of the burnout syndrome. Copyright © 2012 John Wiley & Sons, Ltd.

Relationship between cataract severity and socioeconomic status.

PubMed

Wesolosky, Jason D; Rudnisky, Christopher J

2013-12-01

To determine the relationship between cataract severity and socioeconomic status (SES). Retrospective, observational case series. A total of 1350 eyes underwent phacoemulsification cataract extraction by a single surgeon using an Alcon Infiniti system. Cataract severity was measured using phaco time in seconds. SES was measured using area-level aggregate census data: median income, education, proportion of common-law couples, and employment rate. Preoperative best corrected visual acuity was obtained and converted to logarithm of the minimum angle of resolution values. For patients undergoing bilateral surgery, the generalized estimating equation was used to account for the correlation between eyes. Univariate analyses were performed using simple regression, and multivariate analyses were performed to account for variables with significant relationships (p < 0.05) on univariate testing. Sensitivity analyses were performed to assess the effect of including patient age in the controlled analyses. Multivariate analyses demonstrated that cataracts were more severe when the median income was lower (p = 0.001) and the proportion of common-law couples living in a patient's community (p = 0.012) and the unemployment rate (p = 0.002) were higher. These associations persisted even when controlling for patient age. Patients of lower SES have more severe cataracts. Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

A Two-Phase Case-Control Study of Autism Risk Among Children Born From the Late 1990s Through the Early 2000s in the United States.

PubMed

Geier, David A; Kern, Janet K; Geier, Mark R

2016-12-29

BACKGROUND This study evaluated the hypothesis that the 1999 recommendation by the American Academy of Pediatrics (AAP) and US Public Health Service (PHS) to reduce exposure to mercury (Hg) from Thimerosal in US vaccines would be associated with a reduction in the long-term risk of being diagnosed with autism. MATERIAL AND METHODS A two-phase assessment utilizing a case (n=73) -control (n=11,783) study in the Vaccine Adverse Event Reporting System (VAERS) database (for hypothesis generating) and a more rigorous, independent matched case (n=40) -control (n=40) study (hypothesis testing) was undertaken. RESULTS Analysis of the VAERS database using logistic regression revealed that the odds ratio (OR) for being an autism case in the VAERS database significantly decreased with a more recent year of vaccination in comparison to controls (OR=0.65) from 1998 to 2003. Sex-separated analyses revealed similar significant effects for males (OR=0.62) and females (OR=0.71). Analyses of the matched case-control data revealed, using the t-test statistic, that the mean date of birth among cases diagnosed with an autism spectrum disorder (ASD) (2000.5±1.2) was significantly more in the past than in controls (2001.1±1.3). Logistic regression also revealed that the OR for being diagnosed with ASD significantly decreased with a more recent date of birth in comparison to controls (OR=0.67) from 1998-2003. CONCLUSIONS This study reveals that the risk of autism during from the late1990s to early 2000s in the US significantly decreased with reductions in Hg exposure from Thimerosal-containing childhood vaccines, but future studies should examine this phenomenon in other US populations. Vaccine programs have significantly reduced the morbidity and mortality associated with infectious disease, but Thimerosal should be removed from all vaccines.

Genomic investigation of porcine periweaning failure to thrive syndrome (PFTS).

PubMed

Bertolini, Francesca; Yang, Tianfu; Huang, Yanyun; Harding, John C S; Plastow, Graham S; Rothschild, Max F

2018-04-25

Porcine periweaning failure to thrive syndrome (PFTS) can be defined by anorexia, lethargy, progressive debilitation and compulsive behaviours that occur in seemingly healthy pigs within two to threeweeks of weaning in the absence of any known infectious, nutritional, management or environmental factors. A genetic component has been hypothesised for this syndrome. In the present study, 119 commercial pigs (80 cases and 39 controls) were genotyped with the porcine 80K single nucleotide polymorphism-chip and were analysed with logistic regression and two Fixation Index-based approaches. The analyses revealed several regions on chromosomes 1, 3, 6 and 11 with moderate divergence between cases and controls, particularly three haplotypes on SSC3 and 11. The gene-based analyses of the candidate regions revealed the presence of genes that have been reported to be associated with phenotypes like PFST including depression ( PDE10A ) and intestinal villous atrophy ( CUL4A ). It is important to increase the effort of collecting more samples to improve the power of these analyses. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Job characteristics in nursing and cognitive failure at work.

PubMed

Elfering, Achim; Grebner, Simone; Dudan, Anna

2011-06-01

Stressors in nursing put high demands on cognitive control and, therefore, may increase the risk of cognitive failures that put patients at risk. Task-related stressors were expected to be positively associated with cognitive failure at work and job control was expected to be negatively associated with cognitive failure at work. Ninety-six registered nurses from 11 Swiss hospitals were investigated (89 women, 7 men, mean age = 36 years, standard deviation = 12 years, 80% supervisors, response rate 48%). A new German version of the Workplace Cognitive Failure Scale (WCFS) was employed to assess failure in memory function, failure in attention regulation, and failure in action exertion. In linear regression analyses, WCFS was related to work characteristics, neuroticism, and conscientiousness. The German WCFS was valid and reliable. The factorial structure of the original WCF could be replicated. Multilevel regression task-related stressors and conscientiousness were significantly related to attention control and action exertion. The study sheds light on the association between job characteristics and work-related cognitive failure. These associations were unique, i.e. associations were shown even when individual differences in conscientiousness and neuroticism were controlled for. A job redesign in nursing should address task stressors.

Air quality and ventilation fan control based on aerosol measurement in the bi-directional undersea Bømlafjord tunnel.

PubMed

Indrehus, Oddny; Aralt, Tor Tybring

2005-04-01

Aerosol, NO and CO concentration, temperature, air humidity, air flow and number of running ventilation fans were measured by continuous analysers every minute for a whole week for six different one-week periods spread over ten months in 2001 and 2002 at measuring stations in the 7860 m long tunnel. The ventilation control system was mainly based on aerosol measurements taken by optical scatter sensors. The ventilation turned out to be satisfactory according to Norwegian air quality standards for road tunnels; however, there was some uncertainty concerning the NO2 levels. The air humidity and temperature inside the tunnel were highly influenced by the outside metrological conditions. Statistical models for NO concentration were developed and tested; correlations between predicted and measured NO were 0.81 for a partial least squares regression (PLS1) model based on CO and aerosol, and 0.77 for a linear regression model based only on aerosol. Hence, the ventilation control system should not solely be based on aerosol measurements. Since NO2 is the hazardous polluter, modelling NO2 concentration rather than NO should be preferred in any further optimising of the ventilation control.

Covariate Imbalance and Adjustment for Logistic Regression Analysis of Clinical Trial Data

PubMed Central

Ciolino, Jody D.; Martin, Reneé H.; Zhao, Wenle; Jauch, Edward C.; Hill, Michael D.; Palesch, Yuko Y.

2014-01-01

In logistic regression analysis for binary clinical trial data, adjusted treatment effect estimates are often not equivalent to unadjusted estimates in the presence of influential covariates. This paper uses simulation to quantify the benefit of covariate adjustment in logistic regression. However, International Conference on Harmonization guidelines suggest that covariate adjustment be pre-specified. Unplanned adjusted analyses should be considered secondary. Results suggest that that if adjustment is not possible or unplanned in a logistic setting, balance in continuous covariates can alleviate some (but never all) of the shortcomings of unadjusted analyses. The case of log binomial regression is also explored. PMID:24138438

Age differences in coping and locus of control: a study of managerial stress in Hong Kong.

PubMed

Siu, O; Cooper, C L; Spector, P E; Donald, I

2001-12-01

The present study involved data collection from 3 samples of Hong Kong managers to examine mechanisms by which age would relate to work well-being. A total of 634 managers was drawn by random sampling and purposive sampling methods. The results showed that age was positively related to well-being (job satisfaction and mental well-being). Furthermore, older managers reported fewer sources of stress, better coping, and a more internal locus of control. Multiple regression analyses suggested that the relations of age with 2 well-being indicators can be attributed to various combinations of coping, work locus of control, sources of stress, managerial level, and organizational tenure.

An Empirical Study of Eight Nonparametric Tests in Hierarchical Regression.

ERIC Educational Resources Information Center

Harwell, Michael; Serlin, Ronald C.

When normality does not hold, nonparametric tests represent an important data-analytic alternative to parametric tests. However, the use of nonparametric tests in educational research has been limited by the absence of easily performed tests for complex experimental designs and analyses, such as factorial designs and multiple regression analyses,…

How Many Subjects Does It Take to Do a Regression Analysis?

ERIC Educational Resources Information Center

Green, Samuel B.

1991-01-01

An evaluation of the rules-of-thumb used to determine the minimum number of subjects required to conduct multiple regression analyses suggests that researchers who use a rule of thumb rather than power analyses trade simplicity of use for accuracy and specificity of response. Insufficient power is likely to result. (SLD)

Hydrology and trout populations of cold-water rivers of Michigan and Wisconsin

USGS Publications Warehouse

Hendrickson, G.E.; Knutilla, R.L.

1974-01-01

Statistical multiple-regression analyses showed significant relationships between trout populations and hydrologic parameters. Parameters showing the higher levels of significance were temperature, hardness of water, percentage of gravel bottom, percentage of bottom vegetation, variability of streamflow, and discharge per unit drainage area. Trout populations increase with lower levels of annual maximum water temperatures, with increase in water hardness, and with increase in percentage of gravel and bottom vegetation. Trout populations also increase with decrease in variability of streamflow, and with increase in discharge per unit drainage area. Most hydrologic parameters were significant when evaluated collectively, but no parameter, by itself, showed a high degree of correlation with trout populations in regression analyses that included all the streams sampled. Regression analyses of stream segments that were restricted to certain limits of hardness, temperature, or percentage of gravel bottom showed improvements in correlation. Analyses of trout populations, in pounds per acre and pounds per mile and hydrologic parameters resulted in regression equations from which trout populations could be estimated with standard errors of 89 and 84 per cent, respectively.

The influence of family stability on self-control and adjustment.

PubMed

Malatras, Jennifer Weil; Israel, Allen C

2013-07-01

The aim of the present study was to replicate previous evidence for a model in which self-control mediates the relationship between family stability and internalizing symptoms, and to evaluate a similar model with regard to externalizing problems. Participants were 155 female and 134 male undergraduates--mean age of 19.03 years. Participants completed measures of stability in the family of origin (Stability of Activities in the Family Environment), self-control (Self-Control scale), current externalizing (Adult Self-Report), and internalizing problems (Beck Depression Inventory II and Beck Anxiety Inventory). Multiple regression analyses largely support the proposed model for both the externalizing and internalizing domains. Family stability may foster the development of self-control and, in turn, lead to positive adjustment. © 2012 Wiley Periodicals, Inc.

What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.

PubMed

Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine

2015-05-09

Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified Poisson regression models will compare groups on dichotomous outcome measures. Analyses will be pre-planned, conducted while masked to group allocation and will use an intention-to-treat approach. This trial will address a key gap in evidence regarding physical activity and fall prevention for older people and will evaluate a program that could be directly implemented within Australian health services. ACTRN12614000016639, 7/01/2014.

One-year symptom trajectories in patients with stable schizophrenia maintained on antipsychotics versus placebo: meta-analysis.

PubMed

Takeuchi, Hiroyoshi; Kantor, Navot; Sanches, Marcos; Fervaha, Gagan; Agid, Ofer; Remington, Gary

2017-09-01

Background As definitions of relapse differ substantially between studies, in investigations involving data aggregation, total scores on clinical rating scales provide a more generalisable outcome. Aims To compare total symptom trajectories for antipsychotic versus placebo treatment over a 1-year period of maintenance treatment in schizophrenia. Method Randomised controlled trials with antipsychotic and placebo treatment arms in patients with stable schizophrenia that reported Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale total scores at more than one time point were included. Meta-regression analyses were employed using a mixed model. Results A total of 11 studies involving 2826 patients were included. Meta-regression analyses revealed significant interactions between group and time ( PS <0.0001); both standardised total scores and per cent score changes remained almost unchanged in patients continuing antipsychotic treatment, whereas symptoms continuously worsened over time in those switching to placebo treatment. Conclusions When considering long-term antipsychotic treatment of schizophrenia, clinicians must balance symptomatic and functional outcomes. © The Royal College of Psychiatrists 2017.

The association between short interpregnancy interval and preterm birth in Louisiana: a comparison of methods.

PubMed

Howard, Elizabeth J; Harville, Emily; Kissinger, Patricia; Xiong, Xu

2013-07-01

There is growing interest in the application of propensity scores (PS) in epidemiologic studies, especially within the field of reproductive epidemiology. This retrospective cohort study assesses the impact of a short interpregnancy interval (IPI) on preterm birth and compares the results of the conventional logistic regression analysis with analyses utilizing a PS. The study included 96,378 singleton infants from Louisiana birth certificate data (1995-2007). Five regression models designed for methods comparison are presented. Ten percent (10.17 %) of all births were preterm; 26.83 % of births were from a short IPI. The PS-adjusted model produced a more conservative estimate of the exposure variable compared to the conventional logistic regression method (β-coefficient: 0.21 vs. 0.43), as well as a smaller standard error (0.024 vs. 0.028), odds ratio and 95 % confidence intervals [1.15 (1.09, 1.20) vs. 1.23 (1.17, 1.30)]. The inclusion of more covariate and interaction terms in the PS did not change the estimates of the exposure variable. This analysis indicates that PS-adjusted regression may be appropriate for validation of conventional methods in a large dataset with a fairly common outcome. PS's may be beneficial in producing more precise estimates, especially for models with many confounders and effect modifiers and where conventional adjustment with logistic regression is unsatisfactory. Short intervals between pregnancies are associated with preterm birth in this population, according to either technique. Birth spacing is an issue that women have some control over. Educational interventions, including birth control, should be applied during prenatal visits and following delivery.

Evaluation of Cox's model and logistic regression for matched case-control data with time-dependent covariates: a simulation study.

PubMed

Leffondré, Karen; Abrahamowicz, Michal; Siemiatycki, Jack

2003-12-30

Case-control studies are typically analysed using the conventional logistic model, which does not directly account for changes in the covariate values over time. Yet, many exposures may vary over time. The most natural alternative to handle such exposures would be to use the Cox model with time-dependent covariates. However, its application to case-control data opens the question of how to manipulate the risk sets. Through a simulation study, we investigate how the accuracy of the estimates of Cox's model depends on the operational definition of risk sets and/or on some aspects of the time-varying exposure. We also assess the estimates obtained from conventional logistic regression. The lifetime experience of a hypothetical population is first generated, and a matched case-control study is then simulated from this population. We control the frequency, the age at initiation, and the total duration of exposure, as well as the strengths of their effects. All models considered include a fixed-in-time covariate and one or two time-dependent covariate(s): the indicator of current exposure and/or the exposure duration. Simulation results show that none of the models always performs well. The discrepancies between the odds ratios yielded by logistic regression and the 'true' hazard ratio depend on both the type of the covariate and the strength of its effect. In addition, it seems that logistic regression has difficulty separating the effects of inter-correlated time-dependent covariates. By contrast, each of the two versions of Cox's model systematically induces either a serious under-estimation or a moderate over-estimation bias. The magnitude of the latter bias is proportional to the true effect, suggesting that an improved manipulation of the risk sets may eliminate, or at least reduce, the bias. Copyright 2003 JohnWiley & Sons, Ltd.

Bayesian regression analyses of radiation modality effects on pericardial and pleural effusion and survival in esophageal cancer.

PubMed

He, Liru; Chapple, Andrew; Liao, Zhongxing; Komaki, Ritsuko; Thall, Peter F; Lin, Steven H

2016-10-01

To evaluate radiation modality effects on pericardial effusion (PCE), pleural effusion (PE) and survival in esophageal cancer (EC) patients. We analyzed data from 470 EC patients treated with definitive concurrent chemoradiotherapy (CRT). Bayesian semi-competing risks (SCR) regression models were fit to assess effects of radiation modality and prognostic covariates on the risks of PCE and PE, and death either with or without these preceding events. Bayesian piecewise exponential regression models were fit for overall survival, the time to PCE or death, and the time to PE or death. All models included propensity score as a covariate to correct for potential selection bias. Median times to onset of PCE and PE after RT were 7.1 and 6.1months for IMRT, and 6.5 and 5.4months for 3DCRT, respectively. Compared to 3DCRT, the IMRT group had significantly lower risks of PE, PCE, and death. The respective probabilities of a patient being alive without either PCE or PE at 3-years and 5-years were 0.29 and 0.21 for IMRT compared to 0.13 and 0.08 for 3DCRT. In the SCR regression analyses, IMRT was associated with significantly lower risks of PCE (HR=0.26) and PE (HR=0.49), and greater overall survival (probability of beneficial effect (pbe)>0.99), after controlling for known clinical prognostic factors. IMRT reduces the incidence and postpones the onset of PCE and PE, and increases survival probability, compared to 3DCRT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Spiritual therapy to improve the spiritual well-being of Iranian women with breast cancer: a randomized controlled trial.

PubMed

Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir; Jafari, Nooshin

2013-01-01

Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL) of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT) recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n = 34) or control group (n = 31). Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL) were assessed using Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12) and cancer quality-of-life questionnaire (QLQ-C30), respectively. t-test, Paired t-test, pearson's correlation, and hierarchical regression analyses were used for analysis using Predictive Analytic software (PASW, version 18) for Windows. Results. After six spiritual therapy sessions, the mean spiritual well-being score from 29.76 (SD = 6.63) to 37.24 (SD = 3.52) in the intervention group (P < 0.001). There was a significant difference between arms of study (F = 22.91, P < 0.001). A significant positive correlation was detected between meaning and peace with all subscales of functional subscales on European Organization for Research and Treatment of Cancer quality of Life (EORTC QLQ-C30) (P < 0.05). Hierarchical regression analyses of participants indicated that the study arm, pain, and financial impact were significant predictors of spiritual well-being and overall QOL. Social functioning was another significant predictor of spiritual well-being. Conclusion. The results of this randomized controlled trial study suggest that participation in spiritual therapy program is associated with improvements in spiritual well-being and QOL. Targeted interventions to acknowledge and incorporate spiritual needs into conventional treatment should be considered in caring of Iranian patients with breast cancer.

Contemporary meta-analysis of short-term probiotic consumption on gastrointestinal transit.

PubMed

Miller, Larry E; Zimmermann, Angela K; Ouwehand, Arthur C

2016-06-07

To determine the efficacy of probiotic supplementation on intestinal transit time (ITT) in adults and to identify factors that influence these outcomes. We conducted a systematic review of randomized controlled trials of probiotic supplementation that measured ITT in adults. Study quality was assessed using the Jadad scale. A random effects meta-analysis was performed with standardized mean difference (SMD) of ITT between probiotic and control groups as the primary outcome. Meta-regression and subgroup analyses examined the impact of moderator variables on SMD of ITT. A total of 15 clinical trials with 17 treatment effects representing 675 subjects were included in this analysis. Probiotic supplementation was moderately efficacious in decreasing ITT compared to control, with an SMD of 0.38 (95%CI: 0.23-0.53, P < 0.001). Subgroup analyses demonstrated statistically greater reductions in ITT with probiotics in subjects with vs without constipation (SMD: 0.57 vs 0.22, P < 0.01) and in studies with high vs low study quality (SMD: 0.45 vs 0.00, P = 0.01). Constipation (R (2) = 38%, P < 0.01), higher study quality (R (2) = 31%, P = 0.01), older age (R (2) = 27%, P = 0.02), higher percentage of female subjects (R (2) = 26%, P = 0.02), and fewer probiotic strains (R (2) = 20%, P < 0.05) were predictive of decreased ITT with probiotics in meta-regression. Medium to large treatment effects were identified with B. lactis HN019 (SMD: 0.67, P < 0.001) and B. lactis DN-173 010 (SMD: 0.54, P < 0.01) while other probiotic strains yielded negligible reductions in ITT relative to control. Probiotic supplementation is moderately efficacious for reducing ITT in adults. Probiotics were most efficacious in constipated subjects, when evaluated in high-quality studies, and with certain probiotic strains.

Antibiotic use from conception to diagnosis of child leukaemia as compared to the background population: A nested case-control study.

PubMed

Gradel, Kim Oren; Kaerlev, Linda

2015-07-01

The role of infection in the aetiology of childhood leukaemia is unknown. We used prescriptions of antibiotics from Danish pharmacies as a proxy measure for the occurrence of infections. We investigated the association between exposure to antibiotics, from conception to leukaemia diagnosis, and the risk of leukaemia. Incident cases of leukaemia among children in Denmark, 1995-2008, with mothers having their earliest conception date in 1995, were individually matched to population controls by age, sex and municipality. Conditional logistic regression analyses assessed antibiotic redemptions in different time periods from conception up to 6 months before the diagnoses of all leukaemia types, acute lymphoblastic leukaemia [ALL] and ALL in 2- to 5-year-old children, adjusting for several potential confounders. A total of 120/360 (33.3%) leukaemia mothers and 1,081/3,509 (30.8%) control mothers redeemed antibiotics during pregnancy (P = 0.32). For children, the equivalent numbers were 276 (76.7%) and 2,665 (75.9%) (P = 0.76). Histograms of antibiotic redemptions showed no temporal differences between leukaemia mothers/children and controls, which was confirmed in adjusted regression analyses (OR [95% CI]: 1.02 [0.75-1.38]). Only antibiotics redeemed during the first year after birth differed from this (OR [95% CI] for ALL diagnosed in 2- to 5-year-old children: 0.46 [0.31-0.66]). In this hypothesis generating study, the similar amount and pattern of antibiotic redemptions in children with and without leukaemia indicate that infections play a minor role in the aetiology of childhood leukaemia. However, less antibiotic redemptions during the first year of life conform to Greaves' 'delayed infection hypothesis'. © 2015 Wiley Periodicals, Inc.

The impact of moderate-to-severe Crohn's Disease on employees' salary growth.

PubMed

Loftus, Edward V; Skup, Martha; Ozbay, Ahmet Burak; Wu, Eric; Guérin, Annie; Chao, Jingdong; Mulani, Parvez

2014-10-01

Moderate-to-severe Crohn's Disease (CD) has been shown to reduce daily activities; however, little is known of the impact on employees' salary growth. Employment and health care benefit data were extracted from the OptumHealth Reporting and Insights database, aggregating data from 23 self-insured U.S. companies with approximately 2.5 million covered beneficiaries. Employees diagnosed with moderate-to-severe CD (i.e., ≥1 prescription fill for systemic corticosteroids, immunosuppressive drugs, methotrexate or cyclosporine, or biologic agents within 6 months after the first observed CD diagnosis) between January 1999 and December 2006 were retrospectively matched with controls without CD based on year of birth, sex, industry, and geographic region. Employees' salaries and salary growth rates were estimated and compared between cohorts. Both descriptive comparison and multivariate regression analyses controlling for baseline characteristics and differences in comorbidities were performed. A total of 918 employees with moderate-to-severe CD were matched to 2154 CD-free controls. The 2 cohorts did not differ in their annual salary in the first year of observation. However, regression analyses revealed that the 2 groups had significantly different adjusted annualized salary growth rates (0.69% versus 1.01%, P < 0.001), and employees with CD had a 31% lower salary increase rate than controls. A total income loss of $3195 per person was estimated for employees with CD compared with their CD-free peers over a cumulative 5 years after the first calendar year. In the United States, employees with moderate-to-severe CD had a substantially lower salary growth rate than their peers without CD, suggesting an impaired career progression.

Dientamoeba fragilis colonization is not associated with gastrointestinal symptoms in children at primary care level.

PubMed

Holtman, Gea A; Kranenberg, Justin J; Blanker, Marco H; Ott, Alewijn; Lisman-van Leeuwen, Yvonne; Berger, Marjolein Y

2017-02-01

Dientamoeba fragilis is commonly identified in children in primary care and is suspected to cause gastrointestinal disease. To determine the association between D. fragilis colonization and gastrointestinal symptoms in children. We performed a cross-sectional study with children who presented in primary care with gastrointestinal symptoms. The associations between D. fragilis colonization and specific symptoms were explored by means of logistic regression analyses. Asymptomatic siblings of these cases were invited as control subjects for a case-control analysis, where we explored the association between D. fragilis and gastrointestinal symptoms with conditional logistic regression analysis. In the cross-sectional study, 107 children were included. Their median age was 9 years (interquartile range = 6-12) and 38 (35.5%) were boys. Colonization of D. fragilis was present in 59 children (55.1%). The absence of D. fragilis was associated with soft to watery stool [odds ratio (OR) = 0.29; 95% confidence interval (CI) = 0.10-0.85], chronic diarrhoea (OR = 0.42; 95% CI = 0.18-0.97) and fatigue (OR = 0.45; 95% CI = 0.20-0.99). The case-control analyses included 44 children in each group. Dientamoeba fragilis colonization was not observed more often in cases than in controls after adjustment for age and sex (OR = 1.02; 95% CI = 0.28-3.65). Dientamoeba fragilis is a common parasite in children with and without gastrointestinal symptoms. The anomalous finding of the association between the absence of D. fragilis with soft to watery stools, chronic diarrhoea and fatigue are inexplicable. Our study suggests that D. fragilis colonization does not increase the risk for gastrointestinal symptoms. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes.

PubMed

Konnopka, Alexander; König, Hans-Helmut; Kaufmann, Claudia; Egger, Nina; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schaefert, Rainer

2016-11-01

Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves. Using intention-to-treat analysis, total costs during the 12-month study period were 5777EUR in the intervention, and 6858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+0.017; p=0.019) and an insignificant cost saving resulting from a cost-increase in the control group (-10.5%; p=0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15≥15). CGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity. Copyright © 2016 Elsevier Inc. All rights reserved.

Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: How do they relate?

PubMed Central

Hughes, Sheryl O.; Power, Thomas G.; O’Connor, Teresia M.; Fisher, Jennifer Orlet

2016-01-01

The purpose of the present study was to examine relationships between child eating self-regulation, child non-eating self-regulation, and child BMIz in a low-income sample of Hispanic families with preschoolers. The eating in the absence of hunger task as well as parent-report of child satiety responsiveness and food responsiveness were used to assess child eating self-regulation. Two laboratory tasks assessing executive functioning, a parent questionnaire assessing child effortful control (a temperament dimension related to executive functioning), and the delay of gratification and gift delay tasks assessing child emotion regulation were used to assess child non-eating self-regulation. Bivariate correlations were run among all variables in the study. Hierarchical linear regression analyses assessed: 1) child eating self-regulation associations with the demographic, executive functioning, effortful control, and emotion regulation measures; and 2) child BMI z-scores associations with executive functioning, effortful control, emotion regulation measures, and eating self-regulation measures. Within child eating self-regulation, only the two parent-report measures were related. Low to moderate positive correlations were found between measures of executive functioning, effortful control, and emotion regulation. Only three relationships were found between child eating self-regulation and other forms of child self-regulation: eating in the absence of hunger was positively associated with delay of gratification, and poor regulation on the gift delay task was associated positively with maternal reports of food responsiveness and negatively with parent-reports of satiety responsiveness. Regression analyses showed that child eating self-regulation was associated with child BMIz but other forms of child self-regulation were not. Implications for understanding the role of self-regulation in the development of child obesity are discussed. PMID:25596501

The association of lifetime physical inactivity with bladder and renal cancer risk: A hospital-based case-control analysis.

PubMed

Cannioto, Rikki; Etter, John Lewis; Guterman, Lauren Beryl; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; LaMonte, Michael J; Nagy, Ryan; Minlikeeva, Albina; Szender, James Brian; Moysich, Kirsten B

2017-08-01

Recreational physical inactivity has been gaining recognition as an independent epidemiological exposure of interest in relation to cancer endpoints due to evidence suggesting that it may associate with cancer independent of obesity. In the current analyses, we examined the associations of lifetime recreational physical inactivity with renal and bladder cancer risk. In this hospital-based case-control study, we identified N=160 renal cancer patients, N=208 bladder cancer patients, and N=766 age frequency-matched controls without cancer. Participants self-reporting never participating in any regular/weekly recreational physical activity throughout their lifetime were classified as physically inactive. Utilizing unconditional multivariable logistic regression analyses, we estimated odds ratios and 95% confidence intervals to represent the associations between lifetime physical inactivity and renal and bladder cancer risk. In multivariable logistic regression models, we observed significant positive associations between lifetime recreational physical inactivity and renal cancer and bladder cancer risk: odds ratio=1.77 (95% CI: 1.10-2.85) and odds ratio=1.73 (95% CI: 1.13-2.63), respectively. Similar associations also persisted among individuals who were not obese for both renal and bladder cancer: odds ratio=1.75 (95% CI: 1.03-2.98) and odds ratio=1.70 (95% CI: 1.08-2.69), respectively. In this case-control study, we observed evidence of a positive association between renal and bladder cancer with lifetime recreational physical inactivity. These data add to the growing body of evidence suggesting that physical inactivity may be an important independent risk factor for cancer. However, additional studies using a larger sample and prospectively collected data are needed to substantiate the current findings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: how do they relate?

PubMed

Hughes, Sheryl O; Power, Thomas G; O'Connor, Teresia M; Orlet Fisher, Jennifer

2015-06-01

The purpose of the present study was to examine relationships between child eating self-regulation, child non-eating self-regulation, and child BMIz in a low-income sample of Hispanic families with preschoolers. The eating in the absence of hunger task as well as parent-report of child satiety responsiveness and food responsiveness were used to assess child eating self-regulation. Two laboratory tasks assessing executive functioning, a parent questionnaire assessing child effortful control (a temperament dimension related to executive functioning), and the delay of gratification and gift delay tasks assessing child emotion regulation were used to assess child non-eating self-regulation. Bivariate correlations were run among all variables in the study. Hierarchical linear regression analyses assessed: (1) child eating self-regulation associations with the demographic, executive functioning, effortful control, and emotion regulation measures; and (2) child BMI z-score associations with executive functioning, effortful control, emotion regulation measures, and eating self-regulation measures. Within child eating self-regulation, only the two parent-report measures were related. Low to moderate positive correlations were found between measures of executive functioning, effortful control, and emotion regulation. Only three relationships were found between child eating self-regulation and other forms of child self-regulation: eating in the absence of hunger was positively associated with delay of gratification, and poor regulation on the gift delay task was associated positively with maternal reports of food responsiveness and negatively with parent-reports of satiety responsiveness. Regression analyses showed that child eating self-regulation was associated with child BMIz but other forms of child self-regulation were not. Implications for understanding the role of self-regulation in the development of child obesity are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

BAYESIAN LARGE-SCALE MULTIPLE REGRESSION WITH SUMMARY STATISTICS FROM GENOME-WIDE ASSOCIATION STUDIES1

PubMed Central

Zhu, Xiang; Stephens, Matthew

2017-01-01

Bayesian methods for large-scale multiple regression provide attractive approaches to the analysis of genome-wide association studies (GWAS). For example, they can estimate heritability of complex traits, allowing for both polygenic and sparse models; and by incorporating external genomic data into the priors, they can increase power and yield new biological insights. However, these methods require access to individual genotypes and phenotypes, which are often not easily available. Here we provide a framework for performing these analyses without individual-level data. Specifically, we introduce a “Regression with Summary Statistics” (RSS) likelihood, which relates the multiple regression coefficients to univariate regression results that are often easily available. The RSS likelihood requires estimates of correlations among covariates (SNPs), which also can be obtained from public databases. We perform Bayesian multiple regression analysis by combining the RSS likelihood with previously proposed prior distributions, sampling posteriors by Markov chain Monte Carlo. In a wide range of simulations RSS performs similarly to analyses using the individual data, both for estimating heritability and detecting associations. We apply RSS to a GWAS of human height that contains 253,288 individuals typed at 1.06 million SNPs, for which analyses of individual-level data are practically impossible. Estimates of heritability (52%) are consistent with, but more precise, than previous results using subsets of these data. We also identify many previously unreported loci that show evidence for association with height in our analyses. Software is available at https://github.com/stephenslab/rss. PMID:29399241

Bayesian Unimodal Density Regression for Causal Inference

ERIC Educational Resources Information Center

Karabatsos, George; Walker, Stephen G.

2011-01-01

Karabatsos and Walker (2011) introduced a new Bayesian nonparametric (BNP) regression model. Through analyses of real and simulated data, they showed that the BNP regression model outperforms other parametric and nonparametric regression models of common use, in terms of predictive accuracy of the outcome (dependent) variable. The other,…

An assessment of the association between asset ownership and intimate partner violence in Pakistan.

PubMed

Murshid, N S

2017-09-01

This study assessed the association between women's reports of asset ownership (home and land) and experience of three types of intimate partner violence (IPV): physical violence, emotional violence, and husbands' controlling behaviors. Population-based secondary analysis. This cross-sectional study used data from a sub-sample of 658 women from the nationally representative Pakistan Demographic and Health Survey 2012-13. Logistic regression analyses were used to estimate the association between asset ownership and IPV. Results from logistic regressions indicated that when women owned assets their husbands were 2.3 times more likely to use controlling tactics (P < 0.001) which was mitigated only when women had a say in household decisions. Physical or emotional violence, however, was not significantly associated with women's asset ownership. The study findings highlight the importance of culture and context in policy implementation. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Lower back pain in nurses working in home care: linked to work-family conflict, emotional dissonance, and appreciation?

PubMed

Elfering, Achim; Häfliger, Evelyne; Celik, Zehra; Grebner, Simone

2018-07-01

In industrial countries home care services for elderly people living in the community are growing rapidly. Home care nursing is intensive and the nurses often suffer from musculoskeletal pain. Time pressure and job control are job-related factors linked to the risk of experiencing lower back pain (LBP) and LBP-related work impairment. This survey investigated whether work-family conflict (WFC), emotional dissonance and being appreciated at work have incremental predictive value. Responses were obtained from 125 home care nurses (63% response rate). Multiple linear regression showed that emotional dissonance and being appreciated at work predicted LBP intensity and LBP-related disability independently of time pressure and job control. WFC was not a predictor of LBP-related disability in multiple regression analyses despite a zero-order correlation with it. Redesigning the working pattern of home care nurses to reduce the emotional demands and improve appreciation of their work might reduce the incidence of LBP in this group.

Patterns and Controls of Erosion along the Elson Lagoon Coastline, Barrow, Alaska (2003-2016)

NASA Astrophysics Data System (ADS)

Tweedie, C. E.; Escarzaga, S. M.; Cody, R. P.; Manley, W. F.; Gaylord, A. G.; Aiken, Q.; Lopez, A. F.; Aguirre, A.; George, C.; Nelson, L.; Brown, J.

2016-12-01

With arctic warming and the combined effect of decreased summer sea ice extent, longer fetch for wave propagation, warmer sea surface and ground temperature, and longer periods of open water; the propensity for increased arctic coastal erosion rates and land-ocean sediment inputs to increase has been recognized for some time. In this study, we report on coastal erosion trends along a 11km stretch of coastline adjacent to the Barrow Environmental Observatory (BEO) where the position of the 2-4 meter high coastal bluff has been monitored annually with survey grade differential GPS (dGPS). Modern and historic erosion trends can be viewed through interactive web mapping applications at http://barrowmapped.org/. Rates of aerial and volumetric erosion losses averaged 0.7-2.8 meters and 0.8-3.5 cubic meters per meter of coast per year from 2003-2015 for each of the four coastal sections monitored. These losses equate to losses to the atmosphere and/or inputs to lagoon waters 53-220kgC per meter of coast per year. Such aerial losses are lower than from other areas of the Beaufort Sea coast that lack protective barrier islands, but 25-30% higher than historic decadal-scale change rates estimated for this section of coastline. However, regression analyses indicate no significant change to the rate of erosion during the past 13 years. Historic hotspots of erosion remained modern hotspots of erosion, and increases in modern erosion rates were greatest for sections of coast where historically high rates of erosion have been recorded. Regionally, the Elson Lagoon study area shows some of the highest rates of erosion for the Barrow Peninsula, which are generally 2-3 times mean annual erosion rates recorded for the Chukchi Sea Coastline near Barrow. Regression tree analysis used to isolate the relative importance of different biophysical controls of erosion differ between analyses run for aerial and volumetric losses along the Elson Lagoon Coast. These analyses also highlight key differences in controls between sampling periods with high/low wind-wave activity. In particular, analyses show the important influence of wave energy, land cover type, and landscape geomorphic history on modern coastal erosion dynamics.

Marital status, social capital and health locus of control: a population-based study.

PubMed

Lindström, M; Rosvall, M

2012-09-01

To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. Cross-sectional study. The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Association of salivary levels of the bone remodelling regulators sRANKL and OPG with periodontal clinical status.

PubMed

Tobón-Arroyave, Sergio I; Isaza-Guzmán, Diana M; Restrepo-Cadavid, Eliana M; Zapata-Molina, Sandra M; Martínez-Pabón, María C

2012-12-01

To determine the variations in salivary concentrations of sRANKL, osteoprotegerin (OPG) and its ratio, regarding the periodontal status. Ninety-seven chronic periodontitis (CP) subjects and 43 healthy controls were selected. Periodontal status was assessed based on full-mouth clinical periodontal measurements. sRANKL and OPG salivary levels were analysed by ELISA. The association between these analytes and its ratio with CP was analysed individually and adjusted for confounding using a binary logistic regression model. sRANKL and sRANKL/OPG ratio were increased, whereas OPG was decreased in CP compared with healthy controls subjects. Although univariate analysis revealed a positive association of sRANKL salivary levels ≥6 pg/ml, OPG salivary levels ≤131 pg/ml and sRANKL/OPG ratio ≥0.062 with CP, after logistic regression analysis only the latter parameter was strongly and independently associated with disease status. Confounding and interaction effects of ageing and smoking habit on sRANKL and OPG levels could be noted. Although salivary concentrations of sRANKL, OPG and its ratio may act as indicators of the amount/extent of periodontal breakdown, the mutual confounding and synergistic biological interactive effects related to ageing and smoking habit of the susceptible host may also promote the tissue destruction in CP. © 2012 John Wiley & Sons A/S.

Adjuvant radiotherapy after breast conserving surgery - a comparative effectiveness research study.

PubMed

Corradini, Stefanie; Niyazi, Maximilian; Niemoeller, Olivier M; Li, Minglun; Roeder, Falk; Eckel, Renate; Schubert-Fritschle, Gabriele; Scheithauer, Heike R; Harbeck, Nadia; Engel, Jutta; Belka, Claus

2015-01-01

The purpose of this retrospective outcome study was to validate the effectiveness of postoperative radiotherapy in breast conserving therapy (BCT) and to evaluate possible causes for omission of radiotherapy after breast conserving surgery (BCS) in a non-trial population. Data were provided by the population-based Munich Cancer Registry. The study included epidemiological data of 30.811 patients diagnosed with breast cancer from 1998 to 2012. The effect of omitting radiotherapy was analysed using Kaplan-Meier-estimates and Cox proportional hazard regression. Variables predicting omission of radiotherapy were analysed using multivariate logistic regression. Use of postoperative radiotherapy after BCS was associated with significant improvements in local control and survival. 10-year loco-regional recurrence-free-survival was 90.8% with postoperative radiotherapy vs. 77.6% with surgery alone (p<0.001). 10-year overall survival rates were 55.2% with surgery alone vs. 82.2% following postoperative radiotherapy (p<0.001). Variables predicting omission of postoperative radiotherapy included advanced age (women ⩾80 years; OR: 0.082; 95% CI: 0.071-0.094, p<0.001). This study shows a decrease in local control and a survival disadvantage if postoperative radiotherapy after breast conserving surgery is omitted in an unselected cohort of primary breast cancer patients. Due to its epidemiological nature, it cannot answer the question in whom postoperative radiotherapy can be safely omitted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Family Medicine or Primary Care Residency Selection: Effects of Family Medicine Interest Groups, MD/MPH Dual Degrees, and Rural Medical Education.

PubMed

Wei McIntosh, Elizabeth; Morley, Christopher P

2016-05-01

If medical schools are to produce primary care physicians (family medicine, pediatrics, or general internal medicine), they must provide educational experiences that enable medical students to maintain existing or form new interests in such careers. This study examined three mechanisms for doing so, at one medical school: participation as an officer in a family medicine interest group (FMIG), completion of a dual medical/public health (MD/MPH) degree program, and participation in a rural medical education (RMED) clinical track. Specialty Match data for students who graduated from the study institution between 2006 and 2015 were included as dependent variables in bivariate analysis (c2) and logistic regression models, examining FMIG, MD/MPH, and RMED participation as independent predictors of specialty choice (family medicine yes/no, or any primary care (PC) yes/no), controlling for student demographic data. In bivariate c2 analyses, FMIG officership did not significantly predict matching with family medicine or any PC; RMED and MD/MPH education were significant predictors of both family medicine and PC. Binary logistic regression analyses replicated the bivariate findings, controlling for student demographics. Dual MD/MPH and rural medical education had stronger effects in producing primary care physicians than participation in a FMIG as an officer, at one institution. Further study at multiple institutions is warranted.

Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V).

PubMed

Park, Ji-Hye; Lee, Young-Eun

2015-11-01

[Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90 years. Statistical analyses included χ(2) tests, multiple linear regression, and logistic regression. [Results] Factors found to be significantly related to glycemic control included income level, physical activity based on intensity of aerobic exercise, use of diabetes medicine, presence of hypertension, duration of diabetes, and waist circumference. In addition, engaging in combined low- and moderate-intensity aerobic exercise when adjusted for resistance exercise was found to lower the risk of glycemic control failure. [Conclusion] Patients with type 2 diabetes mellitus in Korea should engage in combined low- and moderate-intensity aerobic exercise such as walking for 30 minutes or more five times a week. Physical activity is likely to improve glycemic control and thus prevent the acute and chronic complications of diabetes mellitus.

Controlled pattern imputation for sensitivity analysis of longitudinal binary and ordinal outcomes with nonignorable dropout.

PubMed

Tang, Yongqiang

2018-04-30

The controlled imputation method refers to a class of pattern mixture models that have been commonly used as sensitivity analyses of longitudinal clinical trials with nonignorable dropout in recent years. These pattern mixture models assume that participants in the experimental arm after dropout have similar response profiles to the control participants or have worse outcomes than otherwise similar participants who remain on the experimental treatment. In spite of its popularity, the controlled imputation has not been formally developed for longitudinal binary and ordinal outcomes partially due to the lack of a natural multivariate distribution for such endpoints. In this paper, we propose 2 approaches for implementing the controlled imputation for binary and ordinal data based respectively on the sequential logistic regression and the multivariate probit model. Efficient Markov chain Monte Carlo algorithms are developed for missing data imputation by using the monotone data augmentation technique for the sequential logistic regression and a parameter-expanded monotone data augmentation scheme for the multivariate probit model. We assess the performance of the proposed procedures by simulation and the analysis of a schizophrenia clinical trial and compare them with the fully conditional specification, last observation carried forward, and baseline observation carried forward imputation methods. Copyright © 2018 John Wiley & Sons, Ltd.

The use of modelling to evaluate and adapt strategies for animal disease control.

PubMed

Saegerman, C; Porter, S R; Humblet, M F

2011-08-01

Disease is often associated with debilitating clinical signs, disorders or production losses in animals and/or humans, leading to severe socio-economic repercussions. This explains the high priority that national health authorities and international organisations give to selecting control strategies for and the eradication of specific diseases. When a control strategy is selected and implemented, an effective method of evaluating its efficacy is through modelling. To illustrate the usefulness of models in evaluating control strategies, the authors describe several examples in detail, including three examples of classification and regression tree modelling to evaluate and improve the early detection of disease: West Nile fever in equids, bovine spongiform encephalopathy (BSE) and multifactorial diseases, such as colony collapse disorder (CCD) in the United States. Also examined are regression modelling to evaluate skin test practices and the efficacy of an awareness campaign for bovine tuberculosis (bTB); mechanistic modelling to monitor the progress of a control strategy for BSE; and statistical nationwide modelling to analyse the spatio-temporal dynamics of bTB and search for potential risk factors that could be used to target surveillance measures more effectively. In the accurate application of models, an interdisciplinary rather than a multidisciplinary approach is required, with the fewest assumptions possible.

The association between financial literacy and Problematic Internet Shopping in a multinational sample.

PubMed

Lam, Lawrence T; Lam, Mary K

2017-12-01

To examine the association between financial literacy and Problematic Internet Shopping in adults. This cross-sectional online survey recruited participants, aged between 18 and 60 years, through an online research facility. The sample consisted of multinational participants from mainly three continents including Europe, North America, and Asia. Problematic Internet Shopping was assessed using the Bergen Shopping Addiction Scale (BSAS). Financial Literacy was measured by the Financial Literacy subscale of the Financial Wellbeing Questionnaire. Multiple linear regression analyses were conducted to elucidate the relationship between the study and outcome variables with adjustment for other potential risk factors. Of the total of 997 respondents with an average age of 30.9 (s.d. = 8.8), 135 (13.8%) could be classified as having a high risk of being Problematic Internet Shoppers. Results from the multiple regression analyses suggested a significant and negative relationship between financial literacy and Problematic Internet Shopping with a regression coefficient of - 0.13, after controlling for the effects of potential risk factors such as age, region of birth, employment, income, shopping frequency, self-regulation and anxiety (t = - 6.42, p < 0.001). The clinical management of PIS should include a financial counselling as a component of the treatment regime. Enhancement of financial literacy in the general population, particularly among young people, will likely have a positive effect on the occurrence of PIS.

Effects of Psychological and Social Work Factors on Self-Reported Sleep Disturbance and Difficulties Initiating Sleep

PubMed Central

Vleeshouwers, Jolien; Knardahl, Stein; Christensen, Jan Olav

2016-01-01

Study Objectives: This prospective cohort study examined previously underexplored relations between psychological/social work factors and troubled sleep in order to provide practical information about specific, modifiable factors at work. Methods: A comprehensive evaluation of a range of psychological/social work factors was obtained by several designs; i.e., cross-sectional analyses at baseline and follow-up, prospective analyses with baseline predictors (T1), prospective analyses with average exposure across waves as predictor ([T1 + T2] / 2), and prospective analyses with change in exposure from baseline to follow-up as predictor. Participants consisted of a sample of Norwegian employees from a broad spectrum of occupations, who completed a questionnaire at two points in time, approximately two years apart. Cross-sectional analyses at T1 comprised 7,459 participants, cross-sectional analyses at T2 included 6,688 participants. Prospective analyses comprised a sample 5,070 of participants who responded at both T1 and T2. Univariable and multivariable ordinal logistic regressions were performed. Results: Thirteen psychological/social work factors and two aspects of troubled sleep, namely difficulties initiating sleep and disturbed sleep, were studied. Ordinal logistic regressions revealed statistically significant associations for all psychological and social work factors in at least one of the analyses. Psychological and social work factors predicted sleep problems in the short term as well as the long term. Conclusions: All work factors investigated showed statistically significant associations with both sleep items, however quantitative job demands, decision control, role conflict, and support from superior were the most robust predictors and may therefore be suitable targets of interventions aimed at improving employee sleep. Citation: Vleeshouwers J, Knardahl S, Christensen JO. Effects of psychological and social work factors on self-reported sleep disturbance and difficulties initiating sleep. SLEEP 2016;39(4):833–846. PMID:26446114

Perceived Emotion Control Moderates the Relationship between Neuroticism and Generalized Anxiety Disorder

PubMed Central

Bourgeois, Michelle L.; Brown, Timothy A.

2015-01-01

The relationships between neuroticism, perceived emotion control, and generalized anxiety disorder (GAD) severity were examined in 293 individuals diagnosed with GAD at a specialty anxiety disorders clinic. Hierarchical regression analyses performed within a structural equation modeling framework revealed that (1) neuroticism and perceived emotion control both predicted a latent variable of GAD in the expected direction, and (2) perceived emotion control moderated the relationship between neuroticism and GAD severity, such that lower levels of perceived emotion control were associated with a stronger relationship between neuroticism and GAD severity. The other dimensions of perceived control (i.e., stress and threat control) did not moderate the effect of neuroticism on GAD severity. The findings are discussed with regard to their implications to conceptual models of the psychopathology of GAD, and theory-based differential relationships between dimensions of vulnerability, perceived control, and anxiety disorders. PMID:26236059

Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis.

PubMed

Mazza, Mario Gennaro; Lucchi, Sara; Tringali, Agnese Grazia Maria; Rossetti, Aurora; Botti, Eugenia Rossana; Clerici, Massimo

2018-06-08

The immune and inflammatory system is involved in the etiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR and PLR in mood disorder. We identified 11 studies according to our inclusion criteria from the main Electronic Databases. Meta-analyses were carried out generating pooled standardized mean differences (SMDs) between index and healthy controls (HC). Heterogeneity was estimated. Relevant sensitivity and meta-regression analyses were conducted. Subjects with bipolar disorder (BD) had higher NLR and PLR as compared with HC (respectively SMD = 0.672; p < 0.001; I 2  = 82.4% and SMD = 0.425; p = 0.048; I 2  = 86.53%). Heterogeneity-based sensitivity analyses confirmed these findings. Subgroup analysis evidenced an influence of bipolar phase on the overall estimate whit studies including subjects in manic and any bipolar phase showing a significantly higher NLR and PLR as compared with HC whereas the effect was not significant among studies including only euthymic bipolar subjects. Meta-regression showed that age and sex influenced the relationship between BD and NLR but not the relationship between BD and PLR. Meta-analysis was not carried out for MLR because our search identified only one study when comparing BD to HC, and only one study when comparing MDD to HC. Subjects with major depressive disorder (MDD) had higher NLR as compared with HC (SMD = 0.670; p = 0.028; I 2  = 89.931%). Heterogeneity-based sensitivity analyses and meta-regression confirmed these findings. Our meta-analysis supports the hypothesis that an inflammatory activation occurs in mood disorders and NLR and PLR may be useful to detect this activation. More researches including comparison of NLR, PLR and MLR between different bipolar phases and between BD and MDD are needed. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of a Web-Based Computer-Tailored Game to Reduce Binge Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial

PubMed Central

Crutzen, Rik; Mercken, Liesbeth; Candel, Math; de Vries, Hein

2016-01-01

Background Binge drinking among Dutch adolescents is among the highest in Europe. Few interventions so far have focused on adolescents aged 15 to 19 years. Because binge drinking increases significantly during those years, it is important to develop binge drinking prevention programs for this group. Web-based computer-tailored interventions can be an effective tool for reducing this behavior in adolescents. Embedding the computer-tailored intervention in a serious game may make it more attractive to adolescents. Objective The aim was to assess whether a Web-based computer-tailored intervention is effective in reducing binge drinking in Dutch adolescents aged 15 to 19 years. Secondary outcomes were reduction in excessive drinking and overall consumption during the previous week. Personal characteristics associated with program adherence were also investigated. Methods A cluster randomized controlled trial was conducted among 34 Dutch schools. Each school was randomized into either an experimental (n=1622) or a control (n=1027) condition. Baseline assessment took place in January and February 2014. At baseline, demographic variables and alcohol use were assessed. Follow-up assessment of alcohol use took place 4 months later (May and June 2014). After the baseline assessment, participants in the experimental condition started with the intervention consisting of a game about alcohol in which computer-tailored feedback regarding motivational characteristics was embedded. Participants in the control condition only received the baseline questionnaire. Both groups received the 4-month follow-up questionnaire. Effects of the intervention were assessed using logistic regression mixed models analyses for binge and excessive drinking and linear regression mixed models analyses for weekly consumption. Factors associated with intervention adherence in the experimental condition were explored by means of a linear regression model. Results In total, 2649 adolescents participated in the baseline assessment. At follow-up, 824 (31.11%) adolescents returned. The intervention was effective in reducing binge drinking among adolescents aged 15 years (P=.03) and those aged 16 years when they participated in at least 2 intervention sessions (P=.04). Interaction effects between excessive drinking and educational level (P=.08) and between weekly consumption and age (P=.09) were found; however, in-depth analyses revealed no significant subgroup effects for both interaction effects. Additional analyses revealed that prolonged use of the intervention was associated with stronger effects for binge drinking. Yet, overall adherence to the intervention was low. Analyses revealed that being Protestant, female, younger, a nonbinge drinker, and having a higher educational background were associated with adherence. Conclusions The intervention was effective for adolescents aged 15 and 16 years concerning binge drinking. Prevention messages may be more effective for those at the start of their drinking career, whereas other methods may be needed for those with a longer history of alcohol consumption. Despite using game elements, intervention completion was low. Trial Registration Dutch Trial Register: NTR4048; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4048 (Archived by WebCite® at http://www.webcitation.org/6eSJD3FiY) PMID:26842694

Effects of a Web-Based Computer-Tailored Game to Reduce Binge Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial.

PubMed

Jander, Astrid; Crutzen, Rik; Mercken, Liesbeth; Candel, Math; de Vries, Hein

2016-02-03

Binge drinking among Dutch adolescents is among the highest in Europe. Few interventions so far have focused on adolescents aged 15 to 19 years. Because binge drinking increases significantly during those years, it is important to develop binge drinking prevention programs for this group. Web-based computer-tailored interventions can be an effective tool for reducing this behavior in adolescents. Embedding the computer-tailored intervention in a serious game may make it more attractive to adolescents. The aim was to assess whether a Web-based computer-tailored intervention is effective in reducing binge drinking in Dutch adolescents aged 15 to 19 years. Secondary outcomes were reduction in excessive drinking and overall consumption during the previous week. Personal characteristics associated with program adherence were also investigated. A cluster randomized controlled trial was conducted among 34 Dutch schools. Each school was randomized into either an experimental (n=1622) or a control (n=1027) condition. Baseline assessment took place in January and February 2014. At baseline, demographic variables and alcohol use were assessed. Follow-up assessment of alcohol use took place 4 months later (May and June 2014). After the baseline assessment, participants in the experimental condition started with the intervention consisting of a game about alcohol in which computer-tailored feedback regarding motivational characteristics was embedded. Participants in the control condition only received the baseline questionnaire. Both groups received the 4-month follow-up questionnaire. Effects of the intervention were assessed using logistic regression mixed models analyses for binge and excessive drinking and linear regression mixed models analyses for weekly consumption. Factors associated with intervention adherence in the experimental condition were explored by means of a linear regression model. In total, 2649 adolescents participated in the baseline assessment. At follow-up, 824 (31.11%) adolescents returned. The intervention was effective in reducing binge drinking among adolescents aged 15 years (P=.03) and those aged 16 years when they participated in at least 2 intervention sessions (P=.04). Interaction effects between excessive drinking and educational level (P=.08) and between weekly consumption and age (P=.09) were found; however, in-depth analyses revealed no significant subgroup effects for both interaction effects. Additional analyses revealed that prolonged use of the intervention was associated with stronger effects for binge drinking. Yet, overall adherence to the intervention was low. Analyses revealed that being Protestant, female, younger, a nonbinge drinker, and having a higher educational background were associated with adherence. The intervention was effective for adolescents aged 15 and 16 years concerning binge drinking. Prevention messages may be more effective for those at the start of their drinking career, whereas other methods may be needed for those with a longer history of alcohol consumption. Despite using game elements, intervention completion was low. Dutch Trial Register: NTR4048; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4048 (Archived by WebCite® at http://www.webcitation.org/6eSJD3FiY).

Anxiety and depression are more prevalent in patients with graves' disease than in patients with nodular goitre.

PubMed

Bové, Kira Bang; Watt, Torquil; Vogel, Asmus; Hegedüs, Laszlo; Bjoerner, Jakob Bue; Groenvold, Mogens; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla

2014-09-01

Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease. 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable 'anxiety'/probable 'depression'. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression. In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms. Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.

Release from bats: genetic distance and sensoribehavioural regression in the Pacific field cricket, Teleogryllus oceanicus

NASA Astrophysics Data System (ADS)

Fullard, James H.; Ter Hofstede, Hannah M.; Ratcliffe, John M.; Pollack, Gerald S.; Brigidi, Gian S.; Tinghitella, Robin M.; Zuk, Marlene

2010-01-01

The auditory thresholds of the AN2 interneuron and the behavioural thresholds of the anti-bat flight-steering responses that this cell evokes are less sensitive in female Pacific field crickets that live where bats have never existed (Moorea) compared with individuals subjected to intense levels of bat predation (Australia). In contrast, the sensitivity of the auditory interneuron, ON1 which participates in the processing of both social signals and bat calls, and the thresholds for flight orientation to a model of the calling song of male crickets show few differences between the two populations. Genetic analyses confirm that the two populations are significantly distinct, and we conclude that the absence of bats has caused partial regression in the nervous control of a defensive behaviour in this insect. This study represents the first examination of natural evolutionary regression in the neural basis of a behaviour along a selection gradient within a single species.

Revisiting the relationship between managed care and hospital consolidation.

PubMed

Town, Robert J; Wholey, Douglas; Feldman, Roger; Burns, Lawton R

2007-02-01

This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration. We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000. We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity. All data are from secondary sources merged at the level of the Health Care Services Area. In 1990, the mean population-weighted hospital Herfindahl-Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications.

Revisiting the Relationship between Managed Care and Hospital Consolidation

PubMed Central

Town, Robert J; Wholey, Douglas; Feldman, Roger; Burns, Lawton R

2007-01-01

Objective This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration. Data Sources We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000. Study Design We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity. Data Collection All data are from secondary sources merged at the level of the Health Care Services Area. Principle Findings In 1990, the mean population-weighted hospital Herfindahl–Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications. PMID:17355590

Associations of circulating plasma microRNAs with age, body mass index and sex in a population-based study.

PubMed

Ameling, Sabine; Kacprowski, Tim; Chilukoti, Ravi Kumar; Malsch, Carolin; Liebscher, Volkmar; Suhre, Karsten; Pietzner, Maik; Friedrich, Nele; Homuth, Georg; Hammer, Elke; Völker, Uwe

2015-10-14

Non-cellular blood circulating microRNAs (plasma miRNAs) represent a promising source for the development of prognostic and diagnostic tools owing to their minimally invasive sampling, high stability, and simple quantification by standard techniques such as RT-qPCR. So far, the majority of association studies involving plasma miRNAs were disease-specific case-control analyses. In contrast, in the present study, plasma miRNAs were analysed in a sample of 372 individuals from a population-based cohort study, the Study of Health in Pomerania (SHIP). Quantification of miRNA levels was performed by RT-qPCR using the Exiqon Serum/Plasma Focus microRNA PCR Panel V3.M covering 179 different miRNAs. Of these, 155 were included in our analyses after quality-control. Associations between plasma miRNAs and the phenotypes age, body mass index (BMI), and sex were assessed via a two-step linear regression approach per miRNA. The first step regressed out the technical parameters and the second step determined the remaining associations between the respective plasma miRNA and the phenotypes of interest. After regressing out technical parameters and adjusting for the respective other two phenotypes, 7, 15, and 35 plasma miRNAs were significantly (q < 0.05) associated with age, BMI, and sex, respectively. Additional adjustment for the blood cell parameters identified 12 and 19 miRNAs to be significantly associated with age and BMI, respectively. Most of the BMI-associated miRNAs likely originate from liver. Sex-associated differences in miRNA levels were largely determined by differences in blood cell parameters. Thus, only 7 as compared to originally 35 sex-associated miRNAs displayed sex-specific differences after adjustment for blood cell parameters. These findings emphasize that circulating miRNAs are strongly impacted by age, BMI, and sex. Hence, these parameters should be considered as covariates in association studies based on plasma miRNA levels. The established experimental and computational workflow can now be used in future screening studies to determine associations of plasma miRNAs with defined disease phenotypes.

Effects of the X:IT smoking intervention: a school-based cluster randomized trial.

PubMed

Andersen, Anette; Krølner, Rikker; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille

2015-12-01

Uptake of smoking in adolescence is still of major public health concern. Evaluations of school-based programmes for smoking prevention show mixed results. The aim of this study was to examine the effect of X:IT, a multi-component school-based programme to prevent adolescent smoking. Data from a Danish cluster randomized trial included 4041 year-7 students (mean age: 12.5) from 51 intervention and 43 control schools. Outcome measure 'current smoking' was dichotomized into smoking daily, weekly, monthly or more seldom vs do not smoke. Analyses were adjusted for baseline covariates: sex, family socioeconomic position (SEP), best friend's smoking and parental smoking. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. At baseline, 4.7% and 6.8% of the students at the intervention and the control schools smoked, respectively. After 1 year of the intervention, the prevalence was 7.9% and 10.7%, respectively. At follow-up, 553 students (13.7%) did not answer the question on smoking. Available case analyses: crude odds ratios (OR) for smoking at intervention schools compared with control schools: 0.65 (0.48-0.88) and adjusted: 0.70 (0.47-1.04). ITT analyses: crude OR for smoking at intervention schools compared with control schools: 0.67 (0.50-0.89) and adjusted: 0.61 (0.45-0.82). Students at intervention schools had a lower risk of smoking after a year of intervention in year 7. This multi-component intervention involving educational, parental and context-related intervention components seems to be efficient in lowering or postponing smoking uptake in Danish adolescents. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

The association of health-related fitness with indicators of academic performance in Texas schools.

PubMed

Welk, Gregory J; Jackson, Allen W; Morrow, James R; Haskell, William H; Meredith, Marilu D; Cooper, Kenneth H

2010-09-01

This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school grades. Mixed-model regression analyses revealed modest associations between fitness and academic achievement after controlling for potentially confounding variables. The effects of fitness on academic achievement were positive but small. A separate logistic regression analysis indicated that higher fitness rates increased the odds of schools achieving exemplary/recognized school status within the state. School fitness attainment is an indicator of higher performing schools. Direction of causality cannot be inferred due to the cross-sectional nature of the data.

The geography of crime and violence surrounding tobacco shops, medical marijuana dispensaries, and off-sale alcohol outlets in a large, urban low-income community of color.

PubMed

Subica, Andrew M; Douglas, Jason A; Kepple, Nancy J; Villanueva, Sandra; Grills, Cheryl T

2018-03-01

Tobacco shops, medical marijuana dispensaries (MMD), and off-sale alcohol outlets are legal and prevalent in South Los Angeles, California-a high-crime, low-income urban community of color. This research is the first to explore the geographic associations between these three legal drug outlets with surrounding crime and violence in a large low-income urban community of color. First, spatial buffer analyses were performed using point-location and publically accessible January-December 2014 crime data to examine the geography of all felony property and violent crimes occurring within 100, 200, 500, and 1000-foot buffers of these three legal drug outlet types across South Los Angeles. Next, spatial regression analyses explored the geographic associations between density of these outlets and property and violent crimes at the census tract level. Results indicated that mean property and violent crime rates within 100-foot buffers of tobacco shops and alcohol outlets-but not MMDs-substantially exceeded community-wide mean crime rates and rates around grocery/convenience stores (i.e., comparison properties licensed to sell both alcohol and tobacco). Spatial regression analyses confirmed that tobacco shops significantly positively associated with property and violent crimes after controlling for key neighborhood factors (poverty, renters, resident mobility, ethnic/racial heterogeneity). Thus, study findings provide the first empirical evidence that tobacco shops may constitute public health threats that associate with crime and violence in U.S. low-income urban communities of color. Implementing and enforcing control policies that regulate and monitor tobacco shops in these communities may promote community health by improving public safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Randomized trial of parent training to prevent adolescent problem behaviors during the high school transition.

PubMed

Mason, W Alex; Fleming, Charles B; Gross, Thomas J; Thompson, Ronald W; Parra, Gilbert R; Haggerty, Kevin P; Snyder, James J

2016-12-01

This randomized controlled trial tested a widely used general parent training program, Common Sense Parenting (CSP), with low-income 8th graders and their families to support a positive transition to high school. The program was tested in its original 6-session format and in a modified format (CSP-Plus), which added 2 sessions that included adolescents. Over 2 annual cohorts, 321 families were enrolled and randomly assigned to either the CSP, CSP-Plus, or minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey data on parenting as well as youth school bonding, social skills, and problem behaviors were collected from parents and youth (94% retention). Extending prior examinations of posttest outcomes, intent-to-treat regression analyses tested for intervention effects at the 2 follow-up assessments, and growth curve analyses examined experimental condition differences in yearly change across time. Separate exploratory tests of moderation by youth gender, youth conduct problems, and family economic hardship also were conducted. Out of 52 regression models predicting 1- and 2-year follow-up outcomes, only 2 out of 104 possible intervention effects were statistically significant. No statistically significant intervention effects were found in the growth curve analyses. Tests of moderation also showed few statistically significant effects. Because CSP already is in widespread use, findings have direct implications for practice. Specifically, findings suggest that the program may not be efficacious with parents of adolescents in a selective prevention context and may reveal the limits of brief, general parent training for achieving outcomes with parents of adolescents. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Associations between strain in domestic work and self-rated health: a study of employed women in Sweden.

PubMed

Staland-Nyman, Carin; Alexanderson, Kristina; Hensing, Gunnel

2008-01-01

The aim of this study was to analyse the association between strain in domestic work and self-rated health among employed women in Sweden, using two different methods of measuring strain in domestic work. Questionnaire data were collected on health and living conditions in paid and unpaid work for employed women (n=1,417), aged 17-64 years. "Domestic job strain'' was an application of the demand-control model developed by Karasek and Theorell, and "Domestic work equity and marital satisfaction'' was measured by questions on the division of and responsibility for domestic work and relationship with spouse/cohabiter. Self-rated health was measured using the SF-36 Health Survey. Associations were analysed by bivariate and multivariate linear regression analyses, and reported as standardized regression coefficients. Higher strain in domestic work was associated with lower self-rated health, also after controlling for potential confounders and according to both strain measures. "Domestic work equity and marital satisfaction'' showed for example negative associations with mental health beta -0.211 (p<0.001), vitality beta -0.195 (p<0.001), social function -0.132 (p<0.01) and physical role beta -0.115 (p<0.01). The highest associations between "Domestic job strain'' and SF-36 were found for vitality beta -0.156 (p<0.001), mental health beta -0.123 (p<0.001). Strain in domestic work, including perceived inequity in the relationship and lack of a satisfactory relationship with a spouse/cohabiter, was associated with lower self-rated health in this cross-sectional study. Future research needs to address the specific importance of strain in domestic work as a contributory factor to women's ill-health.

Service climate as a mediator of organizational empowerment in customer-service employees.

PubMed

Mendoza-Sierra, Maria Isabel; Orgambídez-Ramos, Alejandro; Carrasco-González, Ana María; León-Jariego, José Carlos

2014-01-01

The aim of this study is to examine the mediating role of the service climate between organizational empowerment (i.e., dynamic structural framework, control of workplace decisions, fluidity in information sharing) and service quality (functional and relational). 428 contact employees from 46 hotels participated in the survey. Correlations demonstrated that dynamic structural framework, control decisions, and fluidity in information sharing are related to both functional and relational service quality. Regression analyses and Sobel tests revealed that service climate totally mediated the relationship between all three dimensions of organizational empowerment and relational service quality. Implications for practice and future research are discussed.

Population dynamics of pond zooplankton, I. Diaptomus pallidus Herrick

USGS Publications Warehouse

Armitage, K.B.; Saxena, B.; Angino, E.E.

1973-01-01

The simultaneous and lag relationships between 27 environmental variables and seven population components of a perennial calanoid copepod were examined by simple and partial correlations and stepwise regression. The analyses consistently explained more than 70% of the variation of a population component. The multiple correlation coefficient (R) usually was highest in no lag or in 3-week or 4-week lag except for clutch size in which R was highest in 1-week lag. Population control, egg-bearing, and clutch size were affected primarily by environmental components categorized as weather; food apparently was relatively minor in affecting population control or reproduction. ?? 1973 Dr. W. Junk B.V. Publishers.

Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials.

PubMed

Sun, Xin; Briel, Matthias; Busse, Jason W; Akl, Elie A; You, John J; Mejza, Filip; Bala, Malgorzata; Diaz-Granados, Natalia; Bassler, Dirk; Mertz, Dominik; Srinathan, Sadeesh K; Vandvik, Per Olav; Malaga, German; Alshurafa, Mohamed; Dahm, Philipp; Alonso-Coello, Pablo; Heels-Ansdell, Diane M; Bhatnagar, Neera; Johnston, Bradley C; Wang, Li; Walter, Stephen D; Altman, Douglas G; Guyatt, Gordon H

2009-11-09

Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of subgroup analyses, and claim and interpretation of subgroup effects in randomized trials.

Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials

PubMed Central

Sun, Xin; Briel, Matthias; Busse, Jason W; Akl, Elie A; You, John J; Mejza, Filip; Bala, Malgorzata; Diaz-Granados, Natalia; Bassler, Dirk; Mertz, Dominik; Srinathan, Sadeesh K; Vandvik, Per Olav; Malaga, German; Alshurafa, Mohamed; Dahm, Philipp; Alonso-Coello, Pablo; Heels-Ansdell, Diane M; Bhatnagar, Neera; Johnston, Bradley C; Wang, Li; Walter, Stephen D; Altman, Douglas G; Guyatt, Gordon H

2009-01-01

Background Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. Methods We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. Discussion A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of subgroup analyses, and claim and interpretation of subgroup effects in randomized trials. PMID:19900273

Physical health, self-reliance, and emotional control as moderators of the relationship between locus of control and mental health among men treated for prostate cancer.

PubMed

Burns, Shaun Michael; Mahalik, James R

2006-12-01

This investigation examined the moderating effects of physical health and scripts for masculinity (i.e., self-reliance and emotional control) on the relationship between powerful other people locus of control and mental health for 230 men treated for prostate cancer. Regression analyses indicated that physical health and masculine gender scripts moderated the association between powerful other people locus of control and mental health. Specifically, men with poor physical health evinced negative mental health when they endorsed masculine gender scripts and believed powerful other people (i.e., family, friends, or peers) were influential in controlling their cancer. By comparison, men reporting poor physical health, strong beliefs that powerful other people controlled their cancer, and less adherence to masculine scripts experienced positive mental health. The authors discuss future research directions and potential mental health implications for men treated for prostate cancer.

Cultivating Conformists or Raising Rebels? Connecting Parental Control and Autonomy Support to Adolescent Delinquency.

PubMed

Brauer, Jonathan R

2017-06-01

This study investigates short-term and long-term associations between parenting in early adolescence and delinquency throughout adolescence using data from the National Longitudinal Surveys. Multilevel longitudinal Poisson regressions show that behavioral control, psychological control, and decision-making autonomy in early adolescence (ages 10-11) are associated with delinquency trajectories throughout adolescence (ages 10-17). Path analyses reveal support for three mediation hypotheses. Parental monitoring (behavioral control) is negatively associated with delinquency in the short term and operates partly through changes in self-control. Parental pressure (psychological control) shows immediate and long-lasting associations with delinquency through changes in self-control and delinquent peer pressures. Decision-making autonomy is negatively associated with delinquency in the long term, yet may exacerbate delinquency in early adolescence by increasing exposure to delinquent peers. © 2016 The Author. Journal of Research on Adolescence © 2016 Society for Research on Adolescence.

The Management Standards Indicator Tool and evaluation of burnout.

PubMed

Ravalier, J M; McVicar, A; Munn-Giddings, C

2013-03-01

Psychosocial hazards in the workplace can impact upon employee health. The UK Health and Safety Executive's (HSE) Management Standards Indicator Tool (MSIT) appears to have utility in relation to health impacts but we were unable to find studies relating it to burnout. To explore the utility of the MSIT in evaluating risk of burnout assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). This was a cross-sectional survey of 128 borough council employees. MSIT data were analysed according to MSIT and MBI-GS threshold scores and by using multivariate linear regression with MBI-GS factors as dependent variables. MSIT factor scores were gradated according to categories of risk of burnout according to published MBI-GS thresholds, and identified priority workplace concerns as demands, relationships, role and change. These factors also featured as significant independent variables, with control, in outcomes of the regression analysis. Exhaustion was associated with demands and control (adjusted R (2) = 0.331); cynicism was associated with change, role and demands (adjusted R (2) =0.429); and professional efficacy was associated with managerial support, role, control and demands (adjusted R (2) = 0.413). MSIT analysis generally has congruence with MBI-GS assessment of burnout. The identification of control within regression models but not as a priority concern in the MSIT analysis could suggest an issue of the setting of the MSIT thresholds for this factor, but verification requires a much larger study. Incorporation of relationship, role and change into the MSIT, missing from other conventional tools, appeared to add to its validity.

Differential involvement of knowledge representation and executive control in episodic memory performance in young and older adults.

PubMed

Bouazzaoui, Badiâa; Fay, Séverine; Taconnat, Laurence; Angel, Lucie; Vanneste, Sandrine; Isingrini, Michel

2013-06-01

Craik and Bialystok (2006, 2008) postulated that examining the evolution of knowledge representation and control processes across the life span could help in understanding age-related cognitive changes. The present study explored the hypothesis that knowledge representation and control processes are differentially involved in the episodic memory performance of young and older adults. Young and older adults were administered a cued-recall task and tests of crystallized knowledge and executive functioning to measure representation and control processes, respectively. Results replicate the classic finding that executive and cued-recall performance decline with age, but crystallized-knowledge performance does not. Factor analysis confirmed the independence of representation and control. Correlation analyses showed that the memory performance of younger adults was correlated with representation but not with control measures, whereas the memory performance of older adults was correlated with both representation and control measures. Regression analyses indicated that the control factor was the main predictor of episodic-memory performance for older adults, with the representation factor adding an independent contribution, but the representation factor was the sole predictor for young adults. This finding supports the view that factors sustaining episodic memory vary from young adulthood to old age; representation was shown to be important throughout adulthood, and control was also important for older adults. The results also indicated that control and representation modulate age-group-related variance in episodic memory.

Factors associated with interest in novel interfaces for upper limb prosthesis control

PubMed Central

Engdahl, Susannah M.; Chestek, Cynthia A.; Kelly, Brian; Davis, Alicia

2017-01-01

Background Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual’s decision to try one. Methods We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. Results While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Conclusions Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant’s opinions on the interfaces, so additional exploration is warranted. PMID:28767716

Factors associated with interest in novel interfaces for upper limb prosthesis control.

PubMed

Engdahl, Susannah M; Chestek, Cynthia A; Kelly, Brian; Davis, Alicia; Gates, Deanna H

2017-01-01

Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one. We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface. While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ≤ 0.001, odds ratio ≥ 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ≤ 0.959) and had acquired limb loss (p ≤ 0.012, odds ratio ≥ 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958). Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant's opinions on the interfaces, so additional exploration is warranted.

Job strain and resting heart rate: a cross-sectional study in a Swedish random working sample.

PubMed

Eriksson, Peter; Schiöler, Linus; Söderberg, Mia; Rosengren, Annika; Torén, Kjell

2016-03-05

Numerous studies have reported an association between stressing work conditions and cardiovascular disease. However, more evidence is needed, and the etiological mechanisms are unknown. Elevated resting heart rate has emerged as a possible risk factor for cardiovascular disease, but little is known about the relation to work-related stress. This study therefore investigated the association between job strain, job control, and job demands and resting heart rate. We conducted a cross-sectional survey of randomly selected men and women in Västra Götalandsregionen, Sweden (West county of Sweden) (n = 1552). Information about job strain, job demands, job control, heart rate and covariates was collected during the period 2001-2004 as part of the INTERGENE/ADONIX research project. Six different linear regression models were used with adjustments for gender, age, BMI, smoking, education, and physical activity in the fully adjusted model. Job strain was operationalized as the log-transformed ratio of job demands over job control in the statistical analyses. No associations were seen between resting heart rate and job demands. Job strain was associated with elevated resting heart rate in the unadjusted model (linear regression coefficient 1.26, 95 % CI 0.14 to 2.38), but not in any of the extended models. Low job control was associated with elevated resting heart rate after adjustments for gender, age, BMI, and smoking (linear regression coefficient -0.18, 95 % CI -0.30 to -0.02). However, there were no significant associations in the fully adjusted model. Low job control and job strain, but not job demands, were associated with elevated resting heart rate. However, the observed associations were modest and may be explained by confounding effects.

Occupational asphalt is not associated with head and neck cancer

PubMed Central

Fogleman, E. V.; Eliot, M.; Michaud, D. S.; Nelson, H. H.; McClean, M. D.

2015-01-01

Background Epidemiologic studies that evaluate the relationship between occupational asphalt exposure and head and neck cancer have had a limited ability to control for known risk factors such as smoking, alcohol and human papillomavirus (HPV). Aims To better elucidate this relationship by including known risk factors in a large case–control study of head and neck squamous cell carcinoma (HNSCC) from the greater Boston area. Methods We analysed the relationship between occupational asphalt exposure and HNSCC among men in the Greater Boston area of Massachusetts. Analyses were conducted using unconditional multivariable logistic regression, performed with adjustments for age, race, education, smoking, alcohol consumption and HPV serology. Results There were 753 cases and 913 controls. No associations between HNSCC and occupational asphalt exposure (neither among ever-exposed nor by occupational duration) were observed for exposures in any occupation or those restricted to the construction industry. We also observed no associations in subgroup analyses of never-smokers and ever-smokers. Adjusting for known risk factors further reduced the estimated effect of asphalt exposure on HNSCC risk. Conclusions We found no evidence for an association between occupational asphalt exposure and HNSCC. The null findings from this well-controlled analysis could suggest that the risk estimates stemming from occupational cohort studies may be overestimated due to uncontrolled confounding and enhance the literature available for weighing cancer risk from occupational exposure to bitumen. PMID:26272381

Do state characteristics matter? State level factors related to tobacco cessation quitlines

PubMed Central

Keller, Paula A; Koss, Kalsea J; Baker, Timothy B; Bailey, Linda A; Fiore, Michael C

2007-01-01

Background Quitline services are an effective population‐wide tobacco cessation strategy adopted widely in the United States as part of state comprehensive tobacco control efforts. Despite widespread evidence supporting quitlines' effectiveness, many states lack sufficient financial resources to adequately fund and promote this service. Efforts to augment state tobacco control efforts might be fostered by greater knowledge of state level factors associated with the funding and implementation of those efforts. Methods We analysed data from the 2004 North American Quitline Consortium survey and from publicly available sources to identify state level factors related to quitline implementation and funding. Factors included in the analyses were state demographic characteristics, tobacco use variables, state tobacco control spending, and economic and political climate variables. Univariate and multivariate regression analyses were conducted. Results The best fitting multivariate model that significantly predicted the presence or absence of a state quitline included only cigarette excise tax rate (p = 0.020). In terms of funding levels, states with high rates of cigarette consumption (p = 0.047) and with higher per capita expenditures for tobacco control programmes (p = 0 .0.004) were most likely to spend more on per capita operations budget for quitlines. Conclusion State level factors appear to play a part in whether states had established quitlines by mid‐2004 and the amount of per capita quitline funding. PMID:18048637

Progranulin gene variation affects serum progranulin levels differently in Danish bipolar individuals compared with healthy controls.

PubMed

Buttenschøn, Henriette N; Nielsen, Marit N; Thotakura, Gangadaar; Lee, Chris W; Nykjær, Anders; Mors, Ole; Glerup, Simon

2017-06-01

The identification of peripheral biomarkers for bipolar disorder is of great importance and has the potential to improve diagnosis, treatment and prognosis. Recent studies have reported lower plasma progranulin levels in bipolar individuals compared with controls and association with single nucleotide polymorphisms (SNPs) within the progranulin gene (GRN). In the present study, we investigated the effect of GRN and sortilin (SORT1) gene variation on serum progranulin levels in bipolar individuals and controls. In a Danish cohort of individuals with bipolar disorder and controls, we analysed the serum progranulin level (nbipolar=80, ncontrols=76) and five SNPs located within GRN and two SNPs near the SORT1 gene encoding sortilin, a progranulin scavenger receptor known to affect circulating progranulin levels (nbipolar=166, ncontrols=186). We observed no significant difference in the serum progranulin level between cases and controls and none of the analysed SNPs located within GRN or close to SORT1 were associated with bipolar disorder. Crude and adjusted (adjusted for case-control status, sex and age) linear regression analyses showed no effect of any SNPs on the serum progranulin level. However, we observed that the mean serum progranulin level in cases and controls is affected differently depending on the genotypes of two SNPs within GRN (rs2879096 and rs4792938). The sample size is relatively small and detailed information on medication and polarity of the disorder is not available. No correction for multiple testing was performed. Our study suggests that the potential of progranulin as a biomarker for bipolar disorder is genotype dependent.

Gender Gaps in Mathematics, Science and Reading Achievements in Muslim Countries: A Quantile Regression Approach

ERIC Educational Resources Information Center

Shafiq, M. Najeeb

2013-01-01

Using quantile regression analyses, this study examines gender gaps in mathematics, science, and reading in Azerbaijan, Indonesia, Jordan, the Kyrgyz Republic, Qatar, Tunisia, and Turkey among 15-year-old students. The analyses show that girls in Azerbaijan achieve as well as boys in mathematics and science and overachieve in reading. In Jordan,…

The impact of global signal regression on resting state correlations: Are anti-correlated networks introduced?

PubMed Central

Murphy, Kevin; Birn, Rasmus M.; Handwerker, Daniel A.; Jones, Tyler B.; Bandettini, Peter A.

2009-01-01

Low-frequency fluctuations in fMRI signal have been used to map several consistent resting state networks in the brain. Using the posterior cingulate cortex as a seed region, functional connectivity analyses have found not only positive correlations in the default mode network but negative correlations in another resting state network related to attentional processes. The interpretation is that the human brain is intrinsically organized into dynamic, anti-correlated functional networks. Global variations of the BOLD signal are often considered nuisance effects and are commonly removed using a general linear model (GLM) technique. This global signal regression method has been shown to introduce negative activation measures in standard fMRI analyses. The topic of this paper is whether such a correction technique could be the cause of anti-correlated resting state networks in functional connectivity analyses. Here we show that, after global signal regression, correlation values to a seed voxel must sum to a negative value. Simulations also show that small phase differences between regions can lead to spurious negative correlation values. A combination breath holding and visual task demonstrates that the relative phase of global and local signals can affect connectivity measures and that, experimentally, global signal regression leads to bell-shaped correlation value distributions, centred on zero. Finally, analyses of negatively correlated networks in resting state data show that global signal regression is most likely the cause of anti-correlations. These results call into question the interpretation of negatively correlated regions in the brain when using global signal regression as an initial processing step. PMID:18976716

The impact of global signal regression on resting state correlations: are anti-correlated networks introduced?

PubMed

Murphy, Kevin; Birn, Rasmus M; Handwerker, Daniel A; Jones, Tyler B; Bandettini, Peter A

2009-02-01

Low-frequency fluctuations in fMRI signal have been used to map several consistent resting state networks in the brain. Using the posterior cingulate cortex as a seed region, functional connectivity analyses have found not only positive correlations in the default mode network but negative correlations in another resting state network related to attentional processes. The interpretation is that the human brain is intrinsically organized into dynamic, anti-correlated functional networks. Global variations of the BOLD signal are often considered nuisance effects and are commonly removed using a general linear model (GLM) technique. This global signal regression method has been shown to introduce negative activation measures in standard fMRI analyses. The topic of this paper is whether such a correction technique could be the cause of anti-correlated resting state networks in functional connectivity analyses. Here we show that, after global signal regression, correlation values to a seed voxel must sum to a negative value. Simulations also show that small phase differences between regions can lead to spurious negative correlation values. A combination breath holding and visual task demonstrates that the relative phase of global and local signals can affect connectivity measures and that, experimentally, global signal regression leads to bell-shaped correlation value distributions, centred on zero. Finally, analyses of negatively correlated networks in resting state data show that global signal regression is most likely the cause of anti-correlations. These results call into question the interpretation of negatively correlated regions in the brain when using global signal regression as an initial processing step.

Relationship between postural control and fine motor skills in preterm infants at 6 and 12 months adjusted age.

PubMed

Wang, Tien-Ni; Howe, Tsu-Hsin; Hinojosa, Jim; Weinberg, Sharon L

2011-01-01

We examined the relationship between postural control and fine motor skills of preterm infants at 6 and 12 mo adjusted age. The Alberta Infant Motor Scale was used to measure postural control, and the Peabody Developmental Motor Scales II was used to measure fine motor skills. The data analyzed were taken from 105 medical records from a preterm infant follow-up clinic at an urban academic medical center in south Taiwan. Using multiple regression analyses, we found that the development of postural control is related to the development of fine motor skills, especially in the group of preterm infants with delayed postural control. This finding supports the theoretical assumption of proximal-distal development used by many occupational therapists to guide intervention. Further research is suggested to corroborate findings.

Analysis of Palm Oil Production, Export, and Government Consumption to Gross Domestic Product of Five Districts in West Kalimantan by Panel Regression

NASA Astrophysics Data System (ADS)

Sulistianingsih, E.; Kiftiah, M.; Rosadi, D.; Wahyuni, H.

2017-04-01

Gross Domestic Product (GDP) is an indicator of economic growth in a region. GDP is a panel data, which consists of cross-section and time series data. Meanwhile, panel regression is a tool which can be utilised to analyse panel data. There are three models in panel regression, namely Common Effect Model (CEM), Fixed Effect Model (FEM) and Random Effect Model (REM). The models will be chosen based on results of Chow Test, Hausman Test and Lagrange Multiplier Test. This research analyses palm oil about production, export, and government consumption to five district GDP are in West Kalimantan, namely Sanggau, Sintang, Sambas, Ketapang and Bengkayang by panel regression. Based on the results of analyses, it concluded that REM, which adjusted-determination-coefficient is 0,823, is the best model in this case. Also, according to the result, only Export and Government Consumption that influence GDP of the districts.

Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population

PubMed Central

2014-01-01

Background Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. Method Participants were working men and women (n = 940; 54.3% women), aged 24–60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. Results Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). Conclusions The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility. PMID:24927628

Quantifying cross-border movements and migrations for guiding the strategic planning of malaria control and elimination

PubMed Central

2014-01-01

Background Identifying human and malaria parasite movements is important for control planning across all transmission intensities. Imported infections can reintroduce infections into areas previously free of infection, maintain ‘hotspots’ of transmission and import drug resistant strains, challenging national control programmes at a variety of temporal and spatial scales. Recent analyses based on mobile phone usage data have provided valuable insights into population and likely parasite movements within countries, but these data are restricted to sub-national analyses, leaving important cross-border movements neglected. Methods National census data were used to analyse and model cross-border migration and movement, using East Africa as an example. ‘Hotspots’ of origin-specific immigrants from neighbouring countries were identified for Kenya, Tanzania and Uganda. Populations of origin-specific migrants were compared to distance from origin country borders and population size at destination, and regression models were developed to quantify and compare differences in migration patterns. Migration data were then combined with existing spatially-referenced malaria data to compare the relative propensity for cross-border malaria movement in the region. Results The spatial patterns and processes for immigration were different between each origin and destination country pair. Hotspots of immigration, for example, were concentrated close to origin country borders for most immigrants to Tanzania, but for Kenya, a similar pattern was only seen for Tanzanian and Ugandan immigrants. Regression model fits also differed between specific migrant groups, with some migration patterns more dependent on population size at destination and distance travelled than others. With these differences between immigration patterns and processes, and heterogeneous transmission risk in East Africa and the surrounding region, propensities to import malaria infections also likely show substantial variations. Conclusion This was a first attempt to quantify and model cross-border movements relevant to malaria transmission and control. With national census available worldwide, this approach can be translated to construct a cross-border human and malaria movement evidence base for other malaria endemic countries. The outcomes of this study will feed into wider efforts to quantify and model human and malaria movements in endemic regions to facilitate improved intervention planning, resource allocation and collaborative policy decisions. PMID:24886389

Quasi-experimental study designs series-paper 10: synthesizing evidence for effects collected from quasi-experimental studies presents surmountable challenges.

PubMed

Becker, Betsy Jane; Aloe, Ariel M; Duvendack, Maren; Stanley, T D; Valentine, Jeffrey C; Fretheim, Atle; Tugwell, Peter

2017-09-01

To outline issues of importance to analytic approaches to the synthesis of quasi-experiments (QEs) and to provide a statistical model for use in analysis. We drew on studies of statistics, epidemiology, and social-science methodology to outline methods for synthesis of QE studies. The design and conduct of QEs, effect sizes from QEs, and moderator variables for the analysis of those effect sizes were discussed. Biases, confounding, design complexities, and comparisons across designs offer serious challenges to syntheses of QEs. Key components of meta-analyses of QEs were identified, including the aspects of QE study design to be coded and analyzed. Of utmost importance are the design and statistical controls implemented in the QEs. Such controls and any potential sources of bias and confounding must be modeled in analyses, along with aspects of the interventions and populations studied. Because of such controls, effect sizes from QEs are more complex than those from randomized experiments. A statistical meta-regression model that incorporates important features of the QEs under review was presented. Meta-analyses of QEs provide particular challenges, but thorough coding of intervention characteristics and study methods, along with careful analysis, should allow for sound inferences. Copyright © 2017 Elsevier Inc. All rights reserved.

Acute myeloid and chronic lymphoid leukaemias and exposure to low-level benzene among petroleum workers

PubMed Central

Rushton, L; Schnatter, A R; Tang, G; Glass, D C

2014-01-01

Background: High benzene exposure causes acute myeloid leukaemia (AML). Three petroleum case–control studies identified 60 cases (241 matched controls) for AML and 80 cases (345 matched controls) for chronic lymphoid leukaemia (CLL). Methods: Cases were classified and scored regarding uncertainty by two haematologists using available diagnostic information. Blinded quantitative benzene exposure assessment used work histories and exposure measurements adjusted for era-specific circumstances. Statistical analyses included conditional logistic regression and penalised smoothing splines. Results: Benzene exposures were much lower than previous studies. Categorical analyses showed increased ORs for AML with several exposure metrics, although patterns were unclear; neither continuous exposure metrics nor spline analyses gave increased risks. ORs were highest in terminal workers, particularly for Tanker Drivers. No relationship was found between benzene exposure and risk of CLL, although the Australian study showed increased risks in refinery workers. Conclusion: Overall, this study does not persuasively demonstrate a risk between benzene and AML. A previously reported strong relationship between myelodysplastic syndrome (MDS) (potentially previously reported as AML) at our study's low benzene levels suggests that MDS may be the more relevant health risk for lower exposure. Higher CLL risks in refinery workers may be due to more diverse exposures than benzene alone. PMID:24357793

The Efficacy of Non-Pharmacological Interventions on Brain-Derived Neurotrophic Factor in Schizophrenia: A Systematic Review and Meta-Analysis.

PubMed

Sanada, Kenji; Zorrilla, Iñaki; Iwata, Yusuke; Bermúdez-Ampudia, Cristina; Graff-Guerrero, Ariel; Martínez-Cengotitabengoa, Mónica; González-Pinto, Ana

2016-10-24

Several studies have investigated the relationship between non-pharmacological interventions (NPIs) and peripheral brain-derived neurotrophic factor (BDNF) in schizophrenia patients. We conducted a systematic review and meta-analysis to review the efficacy of NPIs on peripheral serum and plasma BDNF in subjects with schizophrenia (including schizoaffective disorder). Meta-analyses were conducted to examine the effects of NPIs on blood BDNF levels by using the standardized mean differences (SMDs) between the intervention groups and controls. In total, six randomized controlled trials with 289 participants were included. Of them, five studies used exercise, physical training or diet products. One study used cognitive training. Overall, the BDNF levels in the NPI group increased significantly compared with the control groups (SMD = 0.95, 95% confidence interval (CI) = 0.07 to 1.83, p = 0.03). Subgroup analyses indicated beneficial effects of a non-exercise intervention on peripheral BDNF levels (SMD = 0.41, 95% CI = 0.08 to 0.74, p = 0.01). Meta-regression analyses showed that the completion rate influenced the variation in SMD ( p = 0.01). Despite insufficient evidence to draw a conclusion, our results suggest that use of NPIs as adjunctive treatments, specifically non-exercise interventions, may affect positively serum or plasma BDNF in patients with schizophrenia.

No Association of Coronary Artery Disease with X-Chromosomal Variants in Comprehensive International Meta-Analysis.

PubMed

Loley, Christina; Alver, Maris; Assimes, Themistocles L; Bjonnes, Andrew; Goel, Anuj; Gustafsson, Stefan; Hernesniemi, Jussi; Hopewell, Jemma C; Kanoni, Stavroula; Kleber, Marcus E; Lau, King Wai; Lu, Yingchang; Lyytikäinen, Leo-Pekka; Nelson, Christopher P; Nikpay, Majid; Qu, Liming; Salfati, Elias; Scholz, Markus; Tukiainen, Taru; Willenborg, Christina; Won, Hong-Hee; Zeng, Lingyao; Zhang, Weihua; Anand, Sonia S; Beutner, Frank; Bottinger, Erwin P; Clarke, Robert; Dedoussis, George; Do, Ron; Esko, Tõnu; Eskola, Markku; Farrall, Martin; Gauguier, Dominique; Giedraitis, Vilmantas; Granger, Christopher B; Hall, Alistair S; Hamsten, Anders; Hazen, Stanley L; Huang, Jie; Kähönen, Mika; Kyriakou, Theodosios; Laaksonen, Reijo; Lind, Lars; Lindgren, Cecilia; Magnusson, Patrik K E; Marouli, Eirini; Mihailov, Evelin; Morris, Andrew P; Nikus, Kjell; Pedersen, Nancy; Rallidis, Loukianos; Salomaa, Veikko; Shah, Svati H; Stewart, Alexandre F R; Thompson, John R; Zalloua, Pierre A; Chambers, John C; Collins, Rory; Ingelsson, Erik; Iribarren, Carlos; Karhunen, Pekka J; Kooner, Jaspal S; Lehtimäki, Terho; Loos, Ruth J F; März, Winfried; McPherson, Ruth; Metspalu, Andres; Reilly, Muredach P; Ripatti, Samuli; Sanghera, Dharambir K; Thiery, Joachim; Watkins, Hugh; Deloukas, Panos; Kathiresan, Sekar; Samani, Nilesh J; Schunkert, Heribert; Erdmann, Jeanette; König, Inke R

2016-10-12

In recent years, genome-wide association studies have identified 58 independent risk loci for coronary artery disease (CAD) on the autosome. However, due to the sex-specific data structure of the X chromosome, it has been excluded from most of these analyses. While females have 2 copies of chromosome X, males have only one. Also, one of the female X chromosomes may be inactivated. Therefore, special test statistics and quality control procedures are required. Thus, little is known about the role of X-chromosomal variants in CAD. To fill this gap, we conducted a comprehensive X-chromosome-wide meta-analysis including more than 43,000 CAD cases and 58,000 controls from 35 international study cohorts. For quality control, sex-specific filters were used to adequately take the special structure of X-chromosomal data into account. For single study analyses, several logistic regression models were calculated allowing for inactivation of one female X-chromosome, adjusting for sex and investigating interactions between sex and genetic variants. Then, meta-analyses including all 35 studies were conducted using random effects models. None of the investigated models revealed genome-wide significant associations for any variant. Although we analyzed the largest-to-date sample, currently available methods were not able to detect any associations of X-chromosomal variants with CAD.

Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding

PubMed Central

Malisoux, Laurent; Chambon, Nicolas; Delattre, Nicolas; Gueguen, Nils; Urhausen, Axel; Theisen, Daniel

2016-01-01

Background/aim This randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology. Methods Recreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet. Results The overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22). Conclusions The overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type. PMID:26746907

Standardized Regression Coefficients as Indices of Effect Sizes in Meta-Analysis

ERIC Educational Resources Information Center

Kim, Rae Seon

2011-01-01

When conducting a meta-analysis, it is common to find many collected studies that report regression analyses, because multiple regression analysis is widely used in many fields. Meta-analysis uses effect sizes drawn from individual studies as a means of synthesizing a collection of results. However, indices of effect size from regression analyses…

Ultrasound analysis of mental artery flow in elderly patients: a case-control study.

PubMed

Baladi, Marina G; Tucunduva Neto, Raul R C M; Cortes, Arthur R G; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

2015-01-01

Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. This case-control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86-15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height.

Self-efficacy and health locus of control: relationship to occupational disability among workers with back pain.

PubMed

Richard, Sylvie; Dionne, Clermont E; Nouwen, Arie

2011-09-01

Although self-efficacy and health locus of control (HLC) have been extensively studied in health research, little is known about their contribution to occupational disability among workers with back pain. This 2 year prospective study examined the association between these control belief constructs and "return to work in good health" (RWGH), a four-category, composite index of back pain outcome. The participants (n = 1,007, participation = 68.4%, follow-up = 86%) were workers with occupational disruptions who sought a medical consultation for non specific back pain in primary care and emergency settings in the Quebec City area, Canada. Information about self-efficacy for return to work (SERW) and HLC, as well as potential confounders, was collected during a telephone interview about 3 weeks after the baseline medical consultation. Polytomous logistic regression was used to assess the relationship between the baseline control variables and RWGH at 2 year. Odds ratios (OR) and their 95% confidence intervals were used to quantify the strength of associations. For all analyses, the "success" category was considered the reference group. Although bivariate analyses showed a significant association between external HLC and RWGH at 2 year, this relationship was not significant in multivariate analyses. Higher scores on the self-efficacy questionnaire were however protective of "failure to return to work after attempt(s)" (OR: 0.28; 95% CI: 0.14-0.57) and of "failure to return to work" (OR: 0.19; 95% CI: 0.07-0.48) in multivariate analyses. Self-efficacy is an important determinant of the occupational outcome of back pain.

Random regression analyses using B-splines to model growth of Australian Angus cattle

PubMed Central

Meyer, Karin

2005-01-01

Regression on the basis function of B-splines has been advocated as an alternative to orthogonal polynomials in random regression analyses. Basic theory of splines in mixed model analyses is reviewed, and estimates from analyses of weights of Australian Angus cattle from birth to 820 days of age are presented. Data comprised 84 533 records on 20 731 animals in 43 herds, with a high proportion of animals with 4 or more weights recorded. Changes in weights with age were modelled through B-splines of age at recording. A total of thirteen analyses, considering different combinations of linear, quadratic and cubic B-splines and up to six knots, were carried out. Results showed good agreement for all ages with many records, but fluctuated where data were sparse. On the whole, analyses using B-splines appeared more robust against "end-of-range" problems and yielded more consistent and accurate estimates of the first eigenfunctions than previous, polynomial analyses. A model fitting quadratic B-splines, with knots at 0, 200, 400, 600 and 821 days and a total of 91 covariance components, appeared to be a good compromise between detailedness of the model, number of parameters to be estimated, plausibility of results, and fit, measured as residual mean square error. PMID:16093011

Refining cost-effectiveness analyses using the net benefit approach and econometric methods: an example from a trial of anti-depressant treatment.

PubMed

Sabes-Figuera, Ramon; McCrone, Paul; Kendricks, Antony

2013-04-01

Economic evaluation analyses can be enhanced by employing regression methods, allowing for the identification of important sub-groups and to adjust for imperfect randomisation in clinical trials or to analyse non-randomised data. To explore the benefits of combining regression techniques and the standard Bayesian approach to refine cost-effectiveness analyses using data from randomised clinical trials. Data from a randomised trial of anti-depressant treatment were analysed and a regression model was used to explore the factors that have an impact on the net benefit (NB) statistic with the aim of using these findings to adjust the cost-effectiveness acceptability curves. Exploratory sub-samples' analyses were carried out to explore possible differences in cost-effectiveness. Results The analysis found that having suffered a previous similar depression is strongly correlated with a lower NB, independent of the outcome measure or follow-up point. In patients with previous similar depression, adding an selective serotonin reuptake inhibitors (SSRI) to supportive care for mild-to-moderate depression is probably cost-effective at the level used by the English National Institute for Health and Clinical Excellence to make recommendations. This analysis highlights the need for incorporation of econometric methods into cost-effectiveness analyses using the NB approach.

A comparison of Cox and logistic regression for use in genome-wide association studies of cohort and case-cohort design.

PubMed

Staley, James R; Jones, Edmund; Kaptoge, Stephen; Butterworth, Adam S; Sweeting, Michael J; Wood, Angela M; Howson, Joanna M M

2017-06-01

Logistic regression is often used instead of Cox regression to analyse genome-wide association studies (GWAS) of single-nucleotide polymorphisms (SNPs) and disease outcomes with cohort and case-cohort designs, as it is less computationally expensive. Although Cox and logistic regression models have been compared previously in cohort studies, this work does not completely cover the GWAS setting nor extend to the case-cohort study design. Here, we evaluated Cox and logistic regression applied to cohort and case-cohort genetic association studies using simulated data and genetic data from the EPIC-CVD study. In the cohort setting, there was a modest improvement in power to detect SNP-disease associations using Cox regression compared with logistic regression, which increased as the disease incidence increased. In contrast, logistic regression had more power than (Prentice weighted) Cox regression in the case-cohort setting. Logistic regression yielded inflated effect estimates (assuming the hazard ratio is the underlying measure of association) for both study designs, especially for SNPs with greater effect on disease. Given logistic regression is substantially more computationally efficient than Cox regression in both settings, we propose a two-step approach to GWAS in cohort and case-cohort studies. First to analyse all SNPs with logistic regression to identify associated variants below a pre-defined P-value threshold, and second to fit Cox regression (appropriately weighted in case-cohort studies) to those identified SNPs to ensure accurate estimation of association with disease.

Beliefs about meditating among university students, faculty, and staff: a theory-based salient belief elicitation.

PubMed

Lederer, Alyssa M; Middlestadt, Susan E

2014-01-01

Stress impacts college students, faculty, and staff alike. Although meditation has been found to decrease stress, it is an underutilized strategy. This study used the Reasoned Action Approach (RAA) to identify beliefs underlying university constituents' decision to meditate. N=96 students, faculty, and staff at a large midwestern university during spring 2012. A survey measured the RAA global constructs and elicited the beliefs underlying intention to meditate. Thematic and frequency analyses and multiple regression were performed. Quantitative analyses showed that intention to meditate was significantly predicted (R2=.632) by attitude, perceived norm, and perceived behavioral control. Qualitative analyses revealed advantages (eg, reduced stress; feeling calmer), disadvantages (eg, takes time; will not work), and facilitating circumstances (eg, having more time; having quiet space) of meditating. Results of this theory-based research suggest how college health professionals can encourage meditation practice through individual, interpersonal, and environmental interventions.

Regression and multivariate models for predicting particulate matter concentration level.

PubMed

Nazif, Amina; Mohammed, Nurul Izma; Malakahmad, Amirhossein; Abualqumboz, Motasem S

2018-01-01

The devastating health effects of particulate matter (PM 10 ) exposure by susceptible populace has made it necessary to evaluate PM 10 pollution. Meteorological parameters and seasonal variation increases PM 10 concentration levels, especially in areas that have multiple anthropogenic activities. Hence, stepwise regression (SR), multiple linear regression (MLR) and principal component regression (PCR) analyses were used to analyse daily average PM 10 concentration levels. The analyses were carried out using daily average PM 10 concentration, temperature, humidity, wind speed and wind direction data from 2006 to 2010. The data was from an industrial air quality monitoring station in Malaysia. The SR analysis established that meteorological parameters had less influence on PM 10 concentration levels having coefficient of determination (R 2 ) result from 23 to 29% based on seasoned and unseasoned analysis. While, the result of the prediction analysis showed that PCR models had a better R 2 result than MLR methods. The results for the analyses based on both seasoned and unseasoned data established that MLR models had R 2 result from 0.50 to 0.60. While, PCR models had R 2 result from 0.66 to 0.89. In addition, the validation analysis using 2016 data also recognised that the PCR model outperformed the MLR model, with the PCR model for the seasoned analysis having the best result. These analyses will aid in achieving sustainable air quality management strategies.

Cigarette smoking and cutaneous damage in systemic lupus erythematosus.

PubMed

Turchin, Irina; Bernatsky, Sasha; Clarke, Ann E; St-Pierre, Yvan; Pineau, Christian A

2009-12-01

To evaluate the association between cigarette smoking and cutaneous damage in systemic lupus erythematosus (SLE). Our study was performed in SLE clinic registry cohort patients, all of whom fulfilled revised American College of Rheumatology criteria for SLE; patients are followed prospectively with annual assessments that include collection of demographic variables, smoking history, disease activity (SLE Disease Activity Index version 2000, SLEDAI-2K), medications, and damage scores (Systemic Lupus International Collaborating Clinics/ACR Damage Index). Cumulative cutaneous damage scores were used for the primary analyses. Logistic and logit regression models were performed to examine potential associations between current smoking and cutaneous damage, controlling for age, sex, race, lupus disease duration, antimalarial or immunosuppressant use, and anti-DNA and anti-SSA antibody status. Of our sample (N = 276), 92% were women and 73.7% were Caucasian; the mean age was 45.1 years, mean disease duration 13.5 years, and 17.5% were current smokers. In the regression analyses, current cigarette smoking was associated with total cutaneous damage (OR 2.73, 95% CI 1.10, 6.81) and with scarring (OR 4.70, 95 CI 1.04, 21.2). In additional analyses, current smoking was also associated with active lupus rash (OR 6.18, 95% CI 1.63, 23.3). Current cigarette smoking may be associated with cutaneous damage and active lupus rash in SLE, suggesting another reason to emphasize smoking cessation in patients with SLE.

Religion and BMI in Australia.

PubMed

Kortt, Michael A; Dollery, Brian

2014-02-01

We estimated the relationship between religion and body mass index (BMI) for a general and representative sample of the Australia population. Data from the Household Income Labour Dynamics survey were analysed for 9,408 adults aged 18 and older. OLS regression analyses revealed that religious denomination was significantly related to higher BMI, after controlling for socio-demographic, health behaviours, and psychosocial variables. 'Baptist' men had, on average, a 1.3 higher BMI compared to those reporting no religious affiliation. Among women, 'Non-Christians' had, on average, a 1 unit lower BMI compared to those reporting no religious affiliation while 'Other Christian' women reported, on average, a 1 unit higher BMI. Our results also indicate that there was a negative relationship between religious importance and BMI among Australian women.

Antibiotic Resistances in Livestock: A Comparative Approach to Identify an Appropriate Regression Model for Count Data

PubMed Central

Hüls, Anke; Frömke, Cornelia; Ickstadt, Katja; Hille, Katja; Hering, Johanna; von Münchhausen, Christiane; Hartmann, Maria; Kreienbrock, Lothar

2017-01-01

Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i) to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model) and (ii) to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate model. PMID:28620609

Self-control, self-regulation, and doping in sport: a test of the strength-energy model.

PubMed

Chan, Derwin K; Lentillon-Kaestner, Vanessa; Dimmock, James A; Donovan, Robert J; Keatley, David A; Hardcastle, Sarah J; Hagger, Martin S

2015-04-01

We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes' behavioral responses to taking illegal performance-enhancing substances, or "doping." Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a "lollipop" decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the "lollipop" protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.

Socioeconomic factors affecting infant sleep-related deaths in St. Louis.

PubMed

Hogan, Cathy

2014-01-01

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. Though researchers have analyzed and described various sociodemographic characteristics of SIDS and infant deaths by unintentional suffocation in St. Louis, they have not simultaneously controlled for contributory risk factors to racial disparity such as race, poverty, maternal education, and number of children born to each mother (parity). To determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death. This quantitative case-control study used secondary data collected by the Missouri Department of Health and Senior Services between 2005 and 2009. The sample includes matched birth/death certificates and living birth certificates of infants who were born/died within time frame. Descriptive analysis, Chi-square, and logistic regression. The controls were birth records of infants who lived more than 1 year. Chi-square and logistic regression analyses confirmed that race and poverty have significant relationships with infant sleep-related deaths. The social significance of this study is that the results may lead to population-specific modifications of prevention messages that will reduce infant sleep-related deaths. © 2013 Wiley Periodicals, Inc.

Evaluation of Female Breast Cancer Risk Among the Betel Quid Chewer: A Bio-Statistical Assessment in Assam, India.

PubMed

Rajbongshi, Nijara; Mahanta, Lipi B; Nath, Dilip C

2015-06-01

Breast cancer is the most commonly diagnosed cancer among the female population of Assam, India. Chewing of betel quid with or without tobacco is common practice among female population of this region. Moreoverthe method of preparing the betel quid is different from other parts of the country.So matched case control study is conducted to analyse whetherbetel quid chewing plays a significant role in the high incidence of breast cancer occurrences in Assam. Here, controls are matched to the cases by age at diagnosis (±5 years), family income and place of residence with matching ratio 1:1. Conditional logistic regression models and odd ratios (OR) was used to draw conclusions. It is observed that cases are more habituated to chewing habits than the controls.Further the conditional logistic regression analysis reveals that betel quid chewer faces 2.353 times more risk having breast cancer than the non-chewer with p value 0.0003 (95% CI 1.334-4.150). Though the female population in Assam usually does not smoke, the addictive habits typical to this region have equal effect on the occurrence of breast cancer.

Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women.

PubMed

Bountress, Kaitlin E; Metzger, Isha W; Maples-Keller, Jessica L; Gilmore, Amanda K

2017-01-01

Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy. The current study ( n = 160) examined the effect of a brief, web-based alcohol intervention ( n = 53) for college women on reducing SRBs compared to an assessment only control ( n = 107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up. Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories. These findings suggest that alcohol interventions may impact college women's beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors.

Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women

PubMed Central

Bountress, Kaitlin E.; Metzger, Isha W.; Maples-Keller, Jessica L.; Gilmore, Amanda K.

2017-01-01

Background Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy. Methods The current study (n = 160) examined the effect of a brief, web-based alcohol intervention (n = 53) for college women on reducing SRBs compared to an assessment only control (n = 107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up. Results Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories. Conclusions These findings suggest that alcohol interventions may impact college women’s beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors. PMID:28428737

Cooperative Genome-Wide Analysis Shows Increased Homozygosity in Early Onset Parkinson's Disease

PubMed Central

Nalls, Michael A.; Martinez, Maria; Schulte, Claudia; Holmans, Peter; Gasser, Thomas; Hardy, John; Singleton, Andrew B.; Wood, Nicholas W.; Brice, Alexis; Heutink, Peter; Williams, Nigel; Morris, Huw R.

2012-01-01

Parkinson's disease (PD) occurs in both familial and sporadic forms, and both monogenic and complex genetic factors have been identified. Early onset PD (EOPD) is particularly associated with autosomal recessive (AR) mutations, and three genes, PARK2, PARK7 and PINK1, have been found to carry mutations leading to AR disease. Since mutations in these genes account for less than 10% of EOPD patients, we hypothesized that further recessive genetic factors are involved in this disorder, which may appear in extended runs of homozygosity. We carried out genome wide SNP genotyping to look for extended runs of homozygosity (ROHs) in 1,445 EOPD cases and 6,987 controls. Logistic regression analyses showed an increased level of genomic homozygosity in EOPD cases compared to controls. These differences are larger for ROH of 9 Mb and above, where there is a more than three-fold increase in the proportion of cases carrying a ROH. These differences are not explained by occult recessive mutations at existing loci. Controlling for genome wide homozygosity in logistic regression analyses increased the differences between cases and controls, indicating that in EOPD cases ROHs do not simply relate to genome wide measures of inbreeding. Homozygosity at a locus on chromosome19p13.3 was identified as being more common in EOPD cases as compared to controls. Sequencing analysis of genes and predicted transcripts within this locus failed to identify a novel mutation causing EOPD in our cohort. There is an increased rate of genome wide homozygosity in EOPD, as measured by an increase in ROHs. These ROHs are a signature of inbreeding and do not necessarily harbour disease-causing genetic variants. Although there might be other regions of interest apart from chromosome 19p13.3, we lack the power to detect them with this analysis. PMID:22427796

Sleep Pattern, Duration and Quality in Relation with Glycemic Control in People with Type 2 Diabetes Mellitus.

PubMed

Gozashti, Mohammad Hossein; Eslami, Nazanin; Radfar, Mohammad Hadi; Pakmanesh, Hamid

2016-11-01

Sleep disturbances have been shown to be associated with diabetes control, but the relation between planned wakings or napping with glycemic indices has not been evaluated yet. This study evaluated the relation between sleep quality, duration, and pattern, including daytime napping of people with diabetes and their glycemic control. A cross-sectional correlation research design was used for this study. We enrolled 118 people with type 2 diabetes receiving oral agents without major complications at the Shahid Bahonar Center, Kerman. The age, weight, height, serum HbA1c, as well as other glycemic indices and lipid profile were measured. BMI was also calculated. All participants were requested to fill in the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep quality. In addition, they were inquired about their sleep schedule during day and night. Pearson correlation and multiple regression analyses were conducted to examine the correlation between HbA1c and sleep pattern variables. The variables were also compared between participants with or without napping using t-test. All analyses were performed with the SPSS version 19 (SPSS, Chicago, IL, USA). The mean age was 58±11 years and mean HbA1c (%) was 7.8±11 (62±13 mmol/mol). Sleep duration and the number of sleep segments significantly predicted HbA1c (F (2,114)=5.232, P=0.007, R2=0.084). A one-hour increment in sleep duration was associated with a 0.174% (1.4 mmol/mol) decrement in HbA1c. PSQI score did not contribute to the regression model. Moreover, participants who napped (66%) had a lower HbA1c (7.6±1) compared to others (8.1±1.3) (P=0.04). We concluded that napping and segmented sleep are associated with a better glycemic control in type 2 diabetes and there is a linear correlation between sleep duration and better glycemic control.

Disentangling the Correlates of Drug Use in a Clinic and Community Sample: A Regression Analysis of the Associations between Drug Use, Years-of-School, Impulsivity, IQ, Working Memory, and Psychiatric Symptoms.

PubMed

Heyman, Gene M; Dunn, Brian J; Mignone, Jason

2014-01-01

Years-of-school is negatively correlated with illicit drug use. However, educational attainment is positively correlated with IQ and negatively correlated with impulsivity, two traits that are also correlated with drug use. Thus, the negative correlation between education and drug use may reflect the correlates of schooling, not schooling itself. To help disentangle these relations we obtained measures of working memory, simple memory, IQ, disposition (impulsivity and psychiatric status), years-of-school and frequency of illicit and licit drug use in methadone clinic and community drug users. We found strong zero-order correlations between all measures, including IQ, impulsivity, years-of-school, psychiatric symptoms, and drug use. However, multiple regression analyses revealed a different picture. The significant predictors of illicit drug use were gender, involvement in a methadone clinic, and years-of-school. That is, psychiatric symptoms, impulsivity, cognition, and IQ no longer predicted illicit drug use in the multiple regression analyses. Moreover, high risk subjects (low IQ and/or high impulsivity) who spent 14 or more years in school used stimulants and opiates less than did low risk subjects who had spent <14 years in school. Smoking and drinking had a different correlational structure. IQ and years-of-school predicted whether someone ever became a smoker, whereas impulsivity predicted the frequency of drinking bouts, but years-of-school did not. Many subjects reported no use of one or more drugs, resulting in a large number of "zeroes" in the data sets. Cragg's Double-Hurdle regression method proved the best approach for dealing with this problem. To our knowledge, this is the first report to show that years-of-school predicts lower levels of illicit drug use after controlling for IQ and impulsivity. This paper also highlights the advantages of Double-Hurdle regression methods for analyzing the correlates of drug use in community samples.

Creative thinking in schizophrenia: the role of executive dysfunction and symptom severity.

PubMed

Abraham, Anna; Windmann, Sabine; McKenna, Peter; Güntürkün, Onur

2007-05-01

This study examines the notion of enhanced creative thinking in schizophrenia and determines the mediating role of executive dysfunction and symptom severity in this relationship. Patients with chronic schizophrenia (n=28) were assessed on varied facets of creative cognition and standard tests of executive control relative to matched healthy control participants (n=18). Multivariate analyses revealed poorer performance by the patient group across almost all creative and executive function measures, except in the ability to be unconstrained by the influence of restrictive examples. Symptom-based contrasts using partial correlations revealed that differences were most extensive in the presence of thought disorder. Using hierarchical regression analyses, performance on the executive function tasks was found to play a mediatory role on specific aspects of creative cognition. Results are at odds with the popular notion of enhanced creative thinking in schizophrenia, but elucidate complex interactions between executive control and certain facets of creative thinking. In particular, performance of the schizophrenia group on measures that tap creativity elements of fluency and relevance were either partially or fully mediated by their performance on the executive control tasks, but this was not true of measures of originality.

A serum protein-based algorithm for the detection of Alzheimer disease.

PubMed

O'Bryant, Sid E; Xiao, Guanghua; Barber, Robert; Reisch, Joan; Doody, Rachelle; Fairchild, Thomas; Adams, Perrie; Waring, Steven; Diaz-Arrastia, Ramon

2010-09-01

To develop an algorithm that separates patients with Alzheimer disease (AD) from controls. Longitudinal case-control study. The Texas Alzheimer's Research Consortium project. Patients  We analyzed serum protein-based multiplex biomarker data from 197 patients diagnosed with AD and 203 controls. Main Outcome Measure  The total sample was randomized equally into training and test sets and random forest methods were applied to the training set to create a biomarker risk score. The biomarker risk score had a sensitivity and specificity of 0.80 and 0.91, respectively, and an area under the curve of 0.91 in detecting AD. When age, sex, education, and APOE status were added to the algorithm, the sensitivity, specificity, and area under the curve were 0.94, 0.84, and 0.95, respectively. These initial data suggest that serum protein-based biomarkers can be combined with clinical information to accurately classify AD. A disproportionate number of inflammatory and vascular markers were weighted most heavily in the analyses. Additionally, these markers consistently distinguished cases from controls in significant analysis of microarray, logistic regression, and Wilcoxon analyses, suggesting the existence of an inflammatory-related endophenotype of AD that may provide targeted therapeutic opportunities for this subset of patients.

Vitamin D Status at Birth and Future Risk of Attention Deficit/Hyperactivity Disorder (ADHD).

PubMed

Gustafsson, Peik; Rylander, Lars; Lindh, Christian H; Jönsson, Bo A G; Ode, Amanda; Olofsson, Per; Ivarsson, Sten A; Rignell-Hydbom, Anna; Haglund, Nils; Källén, Karin

2015-01-01

To investigate whether children with Attention Deficit/Hyperactivity Disorder have lower levels of Vitamin D3 at birth than matched controls. Umbilical cord blood samples collected at birth from 202 children later diagnosed with Attention Deficit/Hyperactivity Disorder were analysed for vitamin D content and compared with 202 matched controls. 25-OH vitamin D3 was analysed by liquid chromatography tandem mass spectrometry. No differences in cord blood vitamin D concentration were found between children with Attention Deficit/Hyperactivity Disorder (median 13.0 ng/ml) and controls (median 13.5 ng/ml) (p = 0.43). In a logistic regression analysis, Attention Deficit/Hyperactivity Disorder showed a significant association with maternal age (odds ratio: 0.96, 95% confidence interval: 0.92-0.99) but not with vitamin D levels (odds ratio: 0.99, 95% confidence interval: 0.97-1.02). We found no difference in intrauterine vitamin D levels between children later developing Attention Deficit/Hyperactivity Disorder and matched control children. However, the statistical power of the study was too weak to detect an eventual small to medium size association between vitamin D levels and Attention Deficit/Hyperactivity Disorder.

PARAMETRIC AND NON PARAMETRIC (MARS: MULTIVARIATE ADDITIVE REGRESSION SPLINES) LOGISTIC REGRESSIONS FOR PREDICTION OF A DICHOTOMOUS RESPONSE VARIABLE WITH AN EXAMPLE FOR PRESENCE/ABSENCE OF AMPHIBIANS

EPA Science Inventory

The purpose of this report is to provide a reference manual that could be used by investigators for making informed use of logistic regression using two methods (standard logistic regression and MARS). The details for analyses of relationships between a dependent binary response ...

A Simulation Investigation of Principal Component Regression.

ERIC Educational Resources Information Center

Allen, David E.

Regression analysis is one of the more common analytic tools used by researchers. However, multicollinearity between the predictor variables can cause problems in using the results of regression analyses. Problems associated with multicollinearity include entanglement of relative influences of variables due to reduced precision of estimation,…

Area-level poverty, race/ethnicity & dialysis star ratings.

PubMed

Kshirsagar, Abhijit V; Manickam, Raj N; Mu, Yi; Flythe, Jennifer E; Chin, Andrew I; Bang, Heejung

2017-01-01

The Centers for Medicare and Medicaid Services recently released a five star rating system as part of 'Dialysis Facility Compare' to help patients identify and choose high performing clinics in the US. Eight dialysis-related measures determine ratings. Little is known about the association between surrounding community sociodemographic characteristics and star ratings. Using data from the U.S. Census and over 6000 dialysis clinics across the country, we examined the association between dialysis clinic star ratings and characteristics of the local population: 1) proportion of population below the federal poverty level (FPL); 2) proportion of black individuals; and 3) proportion of Hispanic individuals, by correlation and regression analyses. Secondary analyses with Quality Incentive Program (QIP) scores and population characteristics were also performed. We observed a negligible correlation between star ratings and the proportion of local individuals below FPL; Spearman coefficient, R = -0.09 (p<0.0001), and a stronger correlation between star ratings and the proportion of black individuals; R = -0.21 (p<0.0001). Ordered logistic regression analyses yielded adjusted odds ratio of 0.91 (95% confidence interval [0.80-1.30], p = 0.12) and 0.55 ([0.48-0.63], p<0.0001) for high vs. low level of proportion below FPL and proportion of black individuals, respectively. In contrast, a near-zero correlation was observed between star ratings and the proportion of Hispanic individuals. Correlations varied substantially by country region, clinic profit status and clinic size. Analyses using clinic QIP scores provided similar results. Sociodemographic characteristics of the surrounding community, factors typically outside of providers' direct control, have varying levels of association with clinic dialysis star ratings.

Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels.

PubMed

Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki

2015-09-01

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

Artificial Neural Network for the Prediction of Chromosomal Abnormalities in Azoospermic Males.

PubMed

Akinsal, Emre Can; Haznedar, Bulent; Baydilli, Numan; Kalinli, Adem; Ozturk, Ahmet; Ekmekçioğlu, Oğuz

2018-02-04

To evaluate whether an artifical neural network helps to diagnose any chromosomal abnormalities in azoospermic males. The data of azoospermic males attending to a tertiary academic referral center were evaluated retrospectively. Height, total testicular volume, follicle stimulating hormone, luteinising hormone, total testosterone and ejaculate volume of the patients were used for the analyses. In artificial neural network, the data of 310 azoospermics were used as the education and 115 as the test set. Logistic regression analyses and discriminant analyses were performed for statistical analyses. The tests were re-analysed with a neural network. Both logistic regression analyses and artificial neural network predicted the presence or absence of chromosomal abnormalities with more than 95% accuracy. The use of artificial neural network model has yielded satisfactory results in terms of distinguishing patients whether they have any chromosomal abnormality or not.

A cross-sectional study to estimate associations between education level and osteoporosis in a Chinese postmenopausal women sample.

PubMed

Piao, Hui-Hong; He, Jiajia; Zhang, Keqin; Tang, Zihui

2015-01-01

Our research aims to investigate the associations between education level and osteoporosis (OP) in Chinese postmenopausal women. A large-scale, community-based, cross-sectional study was conducted to examine the associations between education level and OP. A self-reported questionnaire was used to access the demographical information and medical history of the participants. A total of 1905 postmenopausal women were available for data analysis in this study. Multiple regression models controlling for confounding factors to include education level were performed to investigate the relationship with OP. The prevalence of OP was 28.29% in our study sample. Multivariate linear regression analyses adjusted for relevant potential confounding factors detected significant associations between education level and T-score (β = 0.025, P-value = 0.095, 95% CI: -0.004-0.055 for model 1; and β = 0.092, P-value = 0.032, 95% CI: 0.008-0.175 for model 2). Multivariate logistic regression analyses detected significant associations between education level and OP in model 1 (P-value = 0.070 for model 1, Table 5), while no significant associations was reported in model 2 (P value = 0.131). In participants with high education levels, the OR for OP was 0.914 (95% CI: 0.830-1.007). The findings indicated that education level was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese postmenopausal women with low educational status.

Improved Dietary Guidelines for Vitamin D: Application of Individual Participant Data (IPD)-Level Meta-Regression Analyses

PubMed Central

Cashman, Kevin D.; Ritz, Christian; Kiely, Mairead

2017-01-01

Dietary Reference Values (DRVs) for vitamin D have a key role in the prevention of vitamin D deficiency. However, despite adopting similar risk assessment protocols, estimates from authoritative agencies over the last 6 years have been diverse. This may have arisen from diverse approaches to data analysis. Modelling strategies for pooling of individual subject data from cognate vitamin D randomized controlled trials (RCTs) are likely to provide the most appropriate DRV estimates. Thus, the objective of the present work was to undertake the first-ever individual participant data (IPD)-level meta-regression, which is increasingly recognized as best practice, from seven winter-based RCTs (with 882 participants ranging in age from 4 to 90 years) of the vitamin D intake–serum 25-hydroxyvitamin D (25(OH)D) dose-response. Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of 25(OH)D concentrations >25, 30, and 50 nmol/L across the population are 10, 13, and 26 µg/day, respectively. In contrast, standard meta-regression analyses with aggregate data (as used by several agencies in recent years) from the same RCTs estimated that a vitamin D intake requirement of 14 µg/day would maintain 97.5% of 25(OH)D >50 nmol/L. These first IPD-derived estimates offer improved dietary recommendations for vitamin D because the underpinning modeling captures the between-person variability in response of serum 25(OH)D to vitamin D intake. PMID:28481259

The relationship between job stressors, hardy personality, coping resources and burnout in a sample of nurses: a correlational study at two time points.

PubMed

Garrosa, Eva; Rainho, Conceição; Moreno-Jiménez, Bernardo; Monteiro, Maria João

2010-02-01

Nursing is considered as a risk profession with high levels of stress and burnout, and these levels are probably increasing. This study assessed temporal and cross-sectional relationships between job stressors, hardy personality and coping resources on burnout dimensions among nurses. Temporal and cross-sectional effects were evaluated. A sample of 98 nurses from Portugal completed the Nursing Burnout Scale at two time points. The data were analysed using descriptive statistics, Pearson correlations, and hierarchical linear regression analyses regressing Wave 2 burnout dimensions. The study confirmed the specific contribution of control and challenged hardy personality dimensions as the explanation of burnout. However, commitment did not show any effects in this study. Social support and active coping were also relevant predictors of burnout dimensions. Specifically, active coping had an inverse temporal effect on depersonalisation and lack of personal accomplishment. In relation to the burnout process, depersonalisation appeared as an antecedent of lack of personal accomplishment. The present study is an initial step to comprehend the link between job stressors, hardy personality, coping resources and diminishing burnout. Copyright 2009 Elsevier Ltd. All rights reserved.

Robust Machine Learning Variable Importance Analyses of Medical Conditions for Health Care Spending.

PubMed

Rose, Sherri

2018-03-11

To propose nonparametric double robust machine learning in variable importance analyses of medical conditions for health spending. 2011-2012 Truven MarketScan database. I evaluate how much more, on average, commercially insured enrollees with each of 26 of the most prevalent medical conditions cost per year after controlling for demographics and other medical conditions. This is accomplished within the nonparametric targeted learning framework, which incorporates ensemble machine learning. Previous literature studying the impact of medical conditions on health care spending has almost exclusively focused on parametric risk adjustment; thus, I compare my approach to parametric regression. My results demonstrate that multiple sclerosis, congestive heart failure, severe cancers, major depression and bipolar disorders, and chronic hepatitis are the most costly medical conditions on average per individual. These findings differed from those obtained using parametric regression. The literature may be underestimating the spending contributions of several medical conditions, which is a potentially critical oversight. If current methods are not capturing the true incremental effect of medical conditions, undesirable incentives related to care may remain. Further work is needed to directly study these issues in the context of federal formulas. © Health Research and Educational Trust.

The relationship between coping styles and benefit finding of Chinese cancer patients: The mediating role of distress.

PubMed

Liu, Zhunzhun; Zhang, Lanfeng; Cao, Yuerong; Xia, Wenkai; Zhang, Liying

2018-06-01

To identify the relationship of medical coping styles and benefit finding in Chinese early-stage cancer patients by preliminary pilot study. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University medical college and the Nantong Tumor Hospital in this study. Measurements were Chinese Benefit Finding Scale, Medical Coping Modes Questionnaire- Chinese version and Distress Thermometer. Regression analysis and pathway analysis were employed to identify the correlation of medical coping styles and benefit finding, and the mediating role of distress. Hierarchical regression analyses showed that confrontation coping style explained 24% of the variance in benefit finding, controlling for demographics and medical variables. While confrontation and resignation coping styles explained 10% and 6% of variance in distress separately. Pathway analyses implied that distress was found to mediate the effect of confrontation coping style on benefit finding in our study. Our study suggested an indirect association between medical coping styles and benefit finding, and a negative correlation of distress to medical coping styles and benefit finding. These results indicated that medical coping styles could influence benefit finding through distress. Copyright © 2018. Published by Elsevier Ltd.

Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults.

PubMed

Foong, Hui Foh; Hamid, Tengku Aizan; Ibrahim, Rahimah; Haron, Sharifah Azizah

2018-04-01

Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

Optimism, well-being, depressive symptoms, and perceived physical health: a study among Stroke survivors.

PubMed

Shifren, Kim; Anzaldi, Kristen

2018-01-01

The investigation of the relation of positive personality characteristics to mental and physical health among Stroke survivors has been a neglected area of research. The purpose of this study was to examine the relationship between optimism, well-being, depressive symptoms, and perceived physical health among Stroke survivors. It was hypothesized that Stroke survivors' optimism would explain variance in their physical health above and beyond the variance explained by demographic variables, diagnostic variables, and mental health. One hundred seventy-six Stroke survivors (97 females, 79 males) completed the Revised Life Orientation Test, the Center for Epidemiological Studies Depression Scale, two items on perceived physical health from the 36-item Short Form of the Medical Outcomes study, and the Identity scale of the Illness Perception Questionnaire. Pearson correlations, hierarchical regression analyses, and the PROCESS approach to determining mediators were used to assess hypothesized relations between variables. Stroke survivors' level of optimism explained additional variance in overall health in regression models controlling for demographic and diagnostic variables, and mental health. Analyses revealed that optimism played a partial mediator role between mental health (well-being, depressive symptoms and total score on CES-D) variables and overall health.

Experience with a Multinational, Secondary School Education Module with a Focus on Prevention of Virus Infections

PubMed Central

Doornekamp, Laura; Stegers-Jager, Karen M.; Vlek, Odette M.; Klop, Tanja; Goeijenbier, Marco; van Gorp, Eric C. M.

2017-01-01

Abstract. Worldwide, virus infections are responsible for many diseases in terms of morbidity and mortality. Vaccinations and therapies are only available for relatively few virus infections and not always where they are needed. However, knowledge of transmission routes can prevent virus infection. In the context of this study, we measured the effects of a secondary school education module, named Viruskenner, on knowledge, attitude, and risk behavior as these relate to virus infections. A nonrandomized intervention study was conducted between April and August 2015 to assess the effect of this 2-month education module on knowledge, attitude, and behavior of 684 secondary school students in the Netherlands, Suriname, and Indonesia. For the Netherlands, a control group of a further 184 students was added. Factor analysis was performed on questions pertaining to attitude and behavior. Comparative analyses between pre- and posttest per country were done using multiple linear regression, independent sample T-tests, and one-way analysis of variance. These showed a significant increase in knowledge about virus infections and the prevention of infectious diseases among the Dutch and Surinamese groups, whereas a trend of increased knowledge was evident among the Indonesian participants. The Dutch control group showed an overall decrease in knowledge. Regression analyses showed that there was a significant interaction effect between participation and time on knowledge, attitude, and awareness and behavior and risk infection. Attitudes improved significantly in the intervention group. Pearson correlation coefficients between knowledge, attitude, and behavior were found to be positive. PMID:28719318

Meat-Related Compounds and Colorectal Cancer Risk by Anatomical Subsite

PubMed Central

Miller, Paige E.; Lazarus, Philip; Lesko, Samuel M.; Cross, Amanda J.; Sinha, Rashmi; Laio, Jason; Zhu, Jay; Harper, Gregory; Muscat, Joshua E.; Hartman, Terryl J.

2012-01-01

Since meat may be involved in the etiology of colorectal cancer, associations between meat-related compounds were examined to elucidate underlying mechanisms in a population-based case-control study. Participants (989 cases/1,033 healthy controls) completed a food frequency questionnaire with a meat-specific module. Multivariable logistic regression was used to examine associations between meat variables and colorectal cancer; polytomous logistic regression was used for subsite-specific analyses. The following significant positive associations were observed for meat-related compounds: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and colorectal, distal colon, and rectal tumors; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and colorectal and colon cancer tumors; nitrites/nitrates and proximal colon cancer; 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and rectal cancer; and benzo[a]pyrene and rectal cancer (P-trends < 0.05 ). For analyses by meat type, cooking method, and doneness preference, positive associations between red processed meat and proximal colon cancer and pan-fried red meat and colorectal cancer were found (P-trends < 0.05). Inverse associations were observed between unprocessed poultry and colorectal, colon, proximal colon, and rectal tumors; grilled/barbequed poultry and proximal colon cancer; and well-done/charred poultry and colorectal, colon, and proximal colon tumors (P-trends < 0.05). HCAs, PAHs, nitrites, and nitrates may be involved in colorectal cancer etiology. Further examination into the unexpected inverse associations between poultry and colorectal cancer is warranted. PMID:23441608

Meat-related compounds and colorectal cancer risk by anatomical subsite.

PubMed

Miller, Paige E; Lazarus, Philip; Lesko, Samuel M; Cross, Amanda J; Sinha, Rashmi; Laio, Jason; Zhu, Jay; Harper, Gregory; Muscat, Joshua E; Hartman, Terryl J

2013-01-01

Since meat may be involved in the etiology of colorectal cancer, associations between meat-related compounds were examined to elucidate underlying mechanisms in a population-based case-control study. Participants (989 cases/1,033 healthy controls) completed a food frequency questionnaire with a meat-specific module. Multivariable logistic regression was used to examine associations between meat variables and colorectal cancer; polytomous logistic regression was used for subsite-specific analyses. The following significant positive associations were observed for meat-related compounds: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and colorectal, distal colon, and rectal tumors; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and colorectal and colon cancer tumors; nitrites/nitrates and proximal colon cancer; 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) and rectal cancer; and benzo[a]pyrene and rectal cancer (P-trends < 0.05). For analyses by meat type, cooking method, and doneness preference, positive associations between red processed meat and proximal colon cancer and pan-fried red meat and colorectal cancer were found (P-trends < 0.05). Inverse associations were observed between unprocessed poultry and colorectal, colon, proximal colon, and rectal tumors; grilled/barbequed poultry and proximal colon cancer; and well-done/charred poultry and colorectal, colon, and proximal colon tumors (P-trends < 0.05). HCAs, PAHs, nitrites, and nitrates may be involved in colorectal cancer etiology. Further examination into the unexpected inverse associations between poultry and colorectal cancer is warranted.

Experience with a Multinational, Secondary School Education Module with a Focus on Prevention of Virus Infections.

PubMed

Doornekamp, Laura; Stegers-Jager, Karen M; Vlek, Odette M; Klop, Tanja; Goeijenbier, Marco; van Gorp, Eric C M

2017-07-01

Worldwide, virus infections are responsible for many diseases in terms of morbidity and mortality. Vaccinations and therapies are only available for relatively few virus infections and not always where they are needed. However, knowledge of transmission routes can prevent virus infection. In the context of this study, we measured the effects of a secondary school education module, named Viruskenner, on knowledge, attitude, and risk behavior as these relate to virus infections. A nonrandomized intervention study was conducted between April and August 2015 to assess the effect of this 2-month education module on knowledge, attitude, and behavior of 684 secondary school students in the Netherlands, Suriname, and Indonesia. For the Netherlands, a control group of a further 184 students was added. Factor analysis was performed on questions pertaining to attitude and behavior. Comparative analyses between pre- and posttest per country were done using multiple linear regression, independent sample T-tests, and one-way analysis of variance. These showed a significant increase in knowledge about virus infections and the prevention of infectious diseases among the Dutch and Surinamese groups, whereas a trend of increased knowledge was evident among the Indonesian participants. The Dutch control group showed an overall decrease in knowledge. Regression analyses showed that there was a significant interaction effect between participation and time on knowledge, attitude, and awareness and behavior and risk infection. Attitudes improved significantly in the intervention group. Pearson correlation coefficients between knowledge, attitude, and behavior were found to be positive.

Short- and long-term theory-based predictors of physical activity in women who participated in a weight-management program.

PubMed

Wasserkampf, A; Silva, M N; Santos, I C; Carraça, E V; Meis, J J M; Kremers, S P J; Teixeira, P J

2014-12-01

This study analyzed psychosocial predictors of the Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) and evaluated their associations with short- and long-term moderate plus vigorous physical activity (MVPA) and lifestyle physical activity (PA) outcomes in women who underwent a weight-management program. 221 participants (age 37.6 ± 7.02 years) completed a 12-month SDT-based lifestyle intervention and were followed-up for 24 months. Multiple linear regression analyses tested associations between psychosocial variables and self-reported short- and long-term PA outcomes. Regression analyses showed that control constructs of both theories were significant determinants of short- and long-term MVPA, whereas affective and self-determination variables were strong predictors of short- and long-term lifestyle PA. Regarding short-term prediction models, TPB constructs were stronger in predicting MVPA, whereas SDT was more effective in predicting lifestyle PA. For long-term models, both forms of PA were better predicted by SDT in comparison to TPB. These results highlight the importance of comparing health behavior theories to identify the mechanisms involved in the behavior change process. Control and competence constructs are crucial during early adoption of structured PA behaviors, whereas affective and intrinsic sources of motivation are more involved in incidental types of PA, particularly in relation to behavioral maintenance. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Birth Outcomes Among U.S. Women With Hearing Loss.

PubMed

Mitra, Monika; Akobirshoev, Ilhom; McKee, Michael M; Iezzoni, Lisa I

2016-12-01

The purpose of this study is to estimate the national occurrence of deliveries in women with hearing loss and to compare their birth outcomes to women without hearing loss. This study examined the 2008-2011 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project in 2015 to compare birth outcomes in women with hearing loss and without. Birth outcomes included preterm birth and low birth weight. Multivariate regression analyses compared birth outcomes between women with and without hearing loss, controlling for maternal age, racial and ethnic identity, type of health insurance, comorbidity, region of hospital, location and teaching status of the hospital, ownership of the hospital, and median household income for mother's ZIP code. Of an estimated 17.9 million deliveries, 10,462 occurred in women with hearing loss. In adjusted regression analyses controlling for demographic characteristics, women with hearing loss were significantly more likely than those without hearing loss to have preterm birth (OR=1.28, 95% CI=1.08, 1.52, p<0.001) and low birth weight (OR=1.43, 95% CI=1.09, 1.90, p<0.05). This study provides a first examination of the pregnancy outcomes among women with hearing loss in the U.S. This analysis demonstrates significant disparities in birth outcomes between women with and without hearing loss. Understanding and addressing the causes of these disparities is critical to improving pregnancy outcomes among women with hearing loss. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Methods for analyzing matched designs with double controls: excess risk is easily estimated and misinterpreted when evaluating traffic deaths.

PubMed

Redelmeier, Donald A; Tibshirani, Robert J

2018-06-01

To demonstrate analytic approaches for matched studies where two controls are linked to each case and events are accumulating counts rather than binary outcomes. A secondary intent is to clarify the distinction between total risk and excess risk (unmatched vs. matched perspectives). We review past research testing whether elections can lead to increased traffic risks. The results are reinterpreted by analyzing both the total count of individuals in fatal crashes and the excess count of individuals in fatal crashes, each time accounting for the matched double controls. Overall, 1,546 individuals were in fatal crashes on the 10 election days (average = 155/d), and 2,593 individuals were in fatal crashes on the 20 control days (average = 130/d). Poisson regression of total counts yielded a relative risk of 1.19 (95% confidence interval: 1.12-1.27). Poisson regression of excess counts yielded a relative risk of 3.22 (95% confidence interval: 2.72-3.80). The discrepancy between analyses of total counts and excess counts replicated with alternative statistical models and was visualized in graphical displays. Available approaches provide methods for analyzing count data in matched designs with double controls and help clarify the distinction between increases in total risk and increases in excess risk. Copyright © 2018 Elsevier Inc. All rights reserved.

[Risk factors for surgical site infections in patients undergoing craniotomy].

PubMed

Cha, Kyeong-Sook; Cho, Ok-Hee; Yoo, So-Yeon

2010-04-01

The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, X(2)-test and logistic regression analyses were used for data analysis. The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (< or = 7 days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (< or = 7 scores) (OR=4.71, 95% CI=1.64-13.50). The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

Sperm Retrieval in Patients with Klinefelter Syndrome: A Skewed Regression Model Analysis.

PubMed

Chehrazi, Mohammad; Rahimiforoushani, Abbas; Sabbaghian, Marjan; Nourijelyani, Keramat; Sadighi Gilani, Mohammad Ali; Hoseini, Mostafa; Vesali, Samira; Yaseri, Mehdi; Alizadeh, Ahad; Mohammad, Kazem; Samani, Reza Omani

2017-01-01

The most common chromosomal abnormality due to non-obstructive azoospermia (NOA) is Klinefelter syndrome (KS) which occurs in 1-1.72 out of 500-1000 male infants. The probability of retrieving sperm as the outcome could be asymmetrically different between patients with and without KS, therefore logistic regression analysis is not a well-qualified test for this type of data. This study has been designed to evaluate skewed regression model analysis for data collected from microsurgical testicular sperm extraction (micro-TESE) among azoospermic patients with and without non-mosaic KS syndrome. This cohort study compared the micro-TESE outcome between 134 men with classic KS and 537 men with NOA and normal karyotype who were referred to Royan Institute between 2009 and 2011. In addition to our main outcome, which was sperm retrieval, we also used logistic and skewed regression analyses to compare the following demographic and hormonal factors: age, level of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone between the two groups. A comparison of the micro-TESE between the KS and control groups showed a success rate of 28.4% (38/134) for the KS group and 22.2% (119/537) for the control group. In the KS group, a significantly difference (P<0.001) existed between testosterone levels for the successful sperm retrieval group (3.4 ± 0.48 mg/mL) compared to the unsuccessful sperm retrieval group (2.33 ± 0.23 mg/mL). The index for quasi Akaike information criterion (QAIC) had a goodness of fit of 74 for the skewed model which was lower than logistic regression (QAIC=85). According to the results, skewed regression is more efficient in estimating sperm retrieval success when the data from patients with KS are analyzed. This finding should be investigated by conducting additional studies with different data structures.

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

PubMed

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Identification of an Interaction between VWF rs7965413 and Platelet Count as a Novel Risk Marker for Metabolic Syndrome: An Extensive Search of Candidate Polymorphisms in a Case-Control Study

PubMed Central

Nakatochi, Masahiro; Ushida, Yasunori; Yasuda, Yoshinari; Yoshida, Yasuko; Kawai, Shun; Kato, Ryuji; Nakashima, Toru; Iwata, Masamitsu; Kuwatsuka, Yachiyo; Ando, Masahiko; Hamajima, Nobuyuki; Kondo, Takaaki; Oda, Hiroaki; Hayashi, Mutsuharu; Kato, Sawako; Yamaguchi, Makoto; Maruyama, Shoichi; Matsuo, Seiichi; Honda, Hiroyuki

2015-01-01

Although many single nucleotide polymorphisms (SNPs) have been identified to be associated with metabolic syndrome (MetS), there was only a slight improvement in the ability to predict future MetS by the simply addition of SNPs to clinical risk markers. To improve the ability to predict future MetS, combinational effects, such as SNP—SNP interaction, SNP—environment interaction, and SNP—clinical parameter (SNP × CP) interaction should be also considered. We performed a case-control study to explore novel SNP × CP interactions as risk markers for MetS based on health check-up data of Japanese male employees. We selected 99 SNPs that were previously reported to be associated with MetS and components of MetS; subsequently, we genotyped these SNPs from 360 cases and 1983 control subjects. First, we performed logistic regression analyses to assess the association of each SNP with MetS. Of these SNPs, five SNPs were significantly associated with MetS (P < 0.05): LRP2 rs2544390, rs1800592 between UCP1 and TBC1D9, APOA5 rs662799, VWF rs7965413, and rs1411766 between MYO16 and IRS2. Furthermore, we performed multiple logistic regression analyses, including an SNP term, a CP term, and an SNP × CP interaction term for each CP and SNP that was significantly associated with MetS. We identified a novel SNP × CP interaction between rs7965413 and platelet count that was significantly associated with MetS [SNP term: odds ratio (OR) = 0.78, P = 0.004; SNP × CP interaction term: OR = 1.33, P = 0.001]. This association of the SNP × CP interaction with MetS remained nominally significant in multiple logistic regression analysis after adjustment for either the number of MetS components or MetS components excluding obesity. Our results reveal new insight into platelet count as a risk marker for MetS. PMID:25646961

Identification of an interaction between VWF rs7965413 and platelet count as a novel risk marker for metabolic syndrome: an extensive search of candidate polymorphisms in a case-control study.

PubMed

Nakatochi, Masahiro; Ushida, Yasunori; Yasuda, Yoshinari; Yoshida, Yasuko; Kawai, Shun; Kato, Ryuji; Nakashima, Toru; Iwata, Masamitsu; Kuwatsuka, Yachiyo; Ando, Masahiko; Hamajima, Nobuyuki; Kondo, Takaaki; Oda, Hiroaki; Hayashi, Mutsuharu; Kato, Sawako; Yamaguchi, Makoto; Maruyama, Shoichi; Matsuo, Seiichi; Honda, Hiroyuki

2015-01-01

Although many single nucleotide polymorphisms (SNPs) have been identified to be associated with metabolic syndrome (MetS), there was only a slight improvement in the ability to predict future MetS by the simply addition of SNPs to clinical risk markers. To improve the ability to predict future MetS, combinational effects, such as SNP-SNP interaction, SNP-environment interaction, and SNP-clinical parameter (SNP × CP) interaction should be also considered. We performed a case-control study to explore novel SNP × CP interactions as risk markers for MetS based on health check-up data of Japanese male employees. We selected 99 SNPs that were previously reported to be associated with MetS and components of MetS; subsequently, we genotyped these SNPs from 360 cases and 1983 control subjects. First, we performed logistic regression analyses to assess the association of each SNP with MetS. Of these SNPs, five SNPs were significantly associated with MetS (P < 0.05): LRP2 rs2544390, rs1800592 between UCP1 and TBC1D9, APOA5 rs662799, VWF rs7965413, and rs1411766 between MYO16 and IRS2. Furthermore, we performed multiple logistic regression analyses, including an SNP term, a CP term, and an SNP × CP interaction term for each CP and SNP that was significantly associated with MetS. We identified a novel SNP × CP interaction between rs7965413 and platelet count that was significantly associated with MetS [SNP term: odds ratio (OR) = 0.78, P = 0.004; SNP × CP interaction term: OR = 1.33, P = 0.001]. This association of the SNP × CP interaction with MetS remained nominally significant in multiple logistic regression analysis after adjustment for either the number of MetS components or MetS components excluding obesity. Our results reveal new insight into platelet count as a risk marker for MetS.

Did Groundwater Processes Shape the Saharan Landscape during the Previous Wet Periods? a Remote Sensing and Geostatistical Approach

NASA Astrophysics Data System (ADS)

Farag, A. Z. A.; Sultan, M.; Elkadiri, R.; Abdelhalim, A.

2014-12-01

An integrated approach using remote sensing, landscape analysis and statistical methods was conducted to assess the role of groundwater sapping in shaping the Saharan landscape. A GIS-based logistic regression model was constructed to automatically delineate the spatial distribution of the sapping features over areas occupied by the Nubian Sandstone Aquifer System (NSAS): (1) an inventory was compiled of known locations of sapping features identified either in the field or from satellite datasets (e.g. Orbview-3 and Google Earth Digital Globe imagery); (2) spatial analyses were conducted in a GIS environment and seven geomorphological and geological predisposing factors (i.e. slope, stream density, cross-sectional and profile curvature, minimum and maximum curvature, and lithology) were identified; (3) a binary logistic regression model was constructed, optimized and validated to describe the relationship between the sapping locations and the set of controlling factors and (4) the generated model (prediction accuracy: 90.1%) was used to produce a regional sapping map over the NSAS. Model outputs indicate: (1) groundwater discharge and structural control played an important role in excavating the Saharan natural depressions as evidenced by the wide distribution of sapping features (areal extent: 1180 km2) along the fault-controlled escarpments of the Libyan Plateau; (2) proximity of mapped sapping features to reported paleolake and tufa deposits suggesting a causal effect. Our preliminary observations (from satellite imagery) and statistical analyses together with previous studies in the North Western Sahara Aquifer System (North Africa), Sinai Peninsula, Negev Desert, and The Plateau of Najd (Saudi Arabia) indicate extensive occurrence of sapping features along the escarpments bordering the northern margins of the Saharan-Arabian Desert; these areas share similar hydrologic settings with the NSAS domains and they too witnessed wet climatic periods in the Mid-Late Quaternary.

Anxiety and Depression Are More Prevalent in Patients with Graves' Disease than in Patients with Nodular Goitre

PubMed Central

Bové, Kira Bang; Watt, Torquil; Vogel, Asmus; Hegedüs, Laszlo; Bjoerner, Jakob Bue; Groenvold, Mogens; Bonnema, Steen Joop; Rasmussen, Åse Krogh; Feldt-Rasmussen, Ulla

2014-01-01

Background and Objective Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves' disease compared to patients with another chronic thyroid disease, nodular goitre, and to investigate determinants of anxiety and depression in Graves' disease. Methods 157 cross-sectionally sampled patients with Graves' disease, 17 newly diagnosed, 140 treated, and 251 controls with nodular goitre completed the Hospital Anxiety and Depression Scale (HADS). The differences in the mean HADS scores between the groups were analysed using multiple linear regression, controlling for socio-demographic variables. HADS scores were also analysed dichotomized: a score >10 indicating probable ‘anxiety’/probable ‘depression’. Determinants of anxiety and depression symptoms in Graves' disease were examined using multiple linear regression. Results In Graves' disease levels of anxiety (p = 0.008) and depression (p = 0.014) were significantly higher than in controls. The prevalence of depression was 10% in Graves' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were associated with anxiety and depression symptoms. Conclusions Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity. PMID:25538899

Power, community mobilization, and condom use practices among female sex workers in Andhra Pradesh, India.

PubMed

Blankenship, Kim M; West, Brooke S; Kershaw, Trace S; Biradavolu, Monica R

2008-12-01

We used a structural interventions framework to analyse the associations between power and condom use among a sample of female sex workers (FSW), and how exposure to a local community mobilization intervention (CMI) affects these associations. Data came from a cross-sectional survey of 812 FSW in the East Godavari district of Andhra Pradesh, India, recruited through respondent-driven sampling. We identified three types of power - collective power, control over work, and economic power, and three dimensions of collective power - collective identity, efficacy, and agency. Multivariate logistic regression analysis was used to analyse the relationship of these three types of power and exposure to a CMI with consistent condom use with clients. A total of 803 respondents exchanged sex with an occasional or regular client in the 7 days before the interview. Multivariate logistic regression shows that control over both the type of sex [adjusted odds ratio (AOR) 1.70, 95% confidence interval (CI) 1.23-2.34] and the amount charged (AOR 1.56, 95% CI 1.12-2.16), and economic dependence (AOR 0.54, 95% CI 0.35-0.83) are associated with consistent condom use as is programme exposure (AOR 2.09, 95% CI 1.48-2.94). The interaction between programme exposure and collective agency was also significant (chi-square 6.62, P = 0.01). Among respondents who reported both programme exposure and high levels of collective agency, the odds ratio of consistent condom use was 2.5 times that of other FSW. A structural interventions framework is useful for understanding HIV risk among FSW. More needs to be done to promote FSW control over work and access to economic resources.

Measures of Heart Rate Variability in Individuals With Somatic Symptom Disorder.

PubMed

Huang, Wei-Lieh; Liao, Shih-Cheng; Yang, Cheryl C H; Kuo, Terry B J; Chen, Tzu-Ting; Chen, I-Ming; Gau, Susan Shur-Fen

2017-01-01

Little is known about autonomic nervous system activity in individuals with somatic symptom disorder (SSD) as defined by DSM-V criteria. The aims of this study were to investigate whether individuals with SSD differ from healthy controls in heart rate variability (HRV) measures of autonomic nervous system activity and whether sex has a moderating effect on this association. We recruited 168 individuals with SSD (35.1% men) and 106 healthy controls (27.4% men). Demographics, HRV, and psychological factors were measured using the Patient Health Questionnaire-15, Health Anxiety Questionnaire, Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory. Multiple regression analysis was used to examine the association of SSD with HRV, adjusting for demographic and psychological measures. Individuals with SSD had lower levels of total-power HRV and low-frequency HRV, but no differences in high-frequency (HF)-HRV were found. HRV differences between SSD and controls varied by sex and age (triple interaction TP-HRV β = -0.222, p < .001; low-frequency HRV β = -0.332, p < .001; and HF-HRV β = -0.167, p = .006). Whole-sample multiple regression analyses revealed significant sex differences in the magnitudes of the association between BDI-II with HF-HRV (β of sex*BDI-II: 0.761, p = .005) and analyses stratified by sex indicated that HF-HRV was significantly correlated with depression in men with SSD (r = -0.491, p < .001) but not in women with SSD (r = 0.057, p = .558). These results suggest that patients with SSD demonstrate different patterns of HRV and the patterns of association between HRV indices and psychological factors vary between men and women.

Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation

PubMed Central

Maafi, Alireza Amir; Haghdoost, Afrooz; Aarabi, Yasaman; Hajiabbasi, Asghar; Shenavar Masooleh, Irandokht; Zayeni, Habib; Ghalebaghi, Babak; Hassankhani, Amir; Bidari, Ali

2016-01-01

Background This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group (17.24 ± 13.50 and 9.91 ± 6.47 respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95–19.87, P = 0.05). Conclusions This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM. PMID:27413482

Effect of vitamin E supplementation on serum C-reactive protein level: a meta-analysis of randomized controlled trials.

PubMed

Saboori, S; Shab-Bidar, S; Speakman, J R; Yousefi Rad, E; Djafarian, K

2015-08-01

C-reactive protein (CRP), a marker of chronic inflammation, has a major role in the etiology of chronic disease. Vitamin E may have anti-inflammatory effects. However, there is no consensus on the effects of vitamin E supplementation on CRP levels in clinical trials. The aim of this study was to systematically review randomized controlled trials (RCTs) that report on the effects of vitamin E supplementation (α- and γ-tocopherols) on CRP levels. A systematic search of RCTs was conducted on Medline and EMBASE through PubMed, Scopus, Ovid and Science Direct, and completed by a manual review of the literature up to May 2014. Pooled effects were estimated by using random-effects models and heterogeneity was assessed by Cochran's Q and I(2) tests. Subgroup analyses and meta-regression analyses were also performed according to intervention duration, dose of supplementation and baseline level of CRP. Of 4734 potentially relevant studies, only 12 trials met the inclusion criteria with 246 participants in the intervention arms and 249 participants in control arms. Pooled analysis showed a significant reduction in CRP levels of 0.62 mg/l (95% confidence interval = -0.92, -0.31; P < 0.001) in vitamin E-treated individuals, with the evidence of heterogeneity across studies. This significant effect was maintained in all subgroups, although the univariate meta-regression analysis showed that the vitamin E supplementation dose, baseline level of CRP and duration of intervention were not the sources of the observed heterogeneity. The results of this meta-analysis suggest that supplementation with vitamin E in the form of either α-tocopherol or γ-tocopherol would reduce serum CRP levels.

Soya and isoflavone intakes associated with reduced risk of oesophageal cancer in north-west China.

PubMed

Tang, Li; Lee, Andy H; Xu, Fenglian; Zhang, Taotao; Lei, Jun; Binns, Colin W

2015-01-01

To ascertain the association between soya consumption, isoflavone intakes and oesophageal cancer risk in remote north-west China, where the incidence of oesophageal cancer is known to be high. Case-control study. Information on habitual consumption of soya foods and soya milk was obtained by personal interview. The intakes of isoflavones were then estimated using the US Department of Agriculture nutrient database. Logistic regression analyses were performed to assess the association between soya consumption, isoflavone intakes and oesophageal cancer risk. Urumqi and Shihezi, Xinjiang Uyghur Autonomous Region, China. Participants were 359 incident oesophageal cancer patients and 380 hospital-based controls. The oesophageal cancer patients consumed significantly less (P < 0·001) total soya foods (mean 57·2 (sd 119·0) g/d) and soya milk (mean 18·8 (sd 51·7) ml/d) than the controls (mean 93·3 (sd 121·5) g/d and mean 35·7 (sd 73·0) ml/d). Logistic regression analyses showed an inverse association between intake of soya products and the risk of oesophageal cancer. The adjusted odds were OR = 0·33 (95 % CI 0·22, 0·49) and OR = 0·48 (95 % CI 0·31, 0·74) for consuming at least 97 g of soya foods and 60 ml of soya milk daily (the highest tertiles of consumption), respectively, relative to the lowest tertiles of consumption. Similarly, inverse associations with apparent dose-response relationships were found between isoflavone intakes and oesophageal cancer risk. Habitual consumption of soya products appears to be associated with reduced risk of oesophageal cancer in north-west China.

Robust Association Between Inflammatory Bowel Disease and Generalized Anxiety Disorder: Findings from a Nationally Representative Canadian Study.

PubMed

Fuller-Thomson, Esme; Lateef, Rusan; Sulman, Joanne

2015-10-01

Although the link between inflammatory bowel diseases (IBD) and depression is well accepted, less is known about the relationship between IBD and anxiety disorders and factors associated with anxiety among those with IBD. Data were derived from the nationally representative 2012 Canadian Community Health Survey-Mental Health. The survey response rate was 68.9%. Two sets of analyses were undertaken. First, a series of logistic regression analyses were used to estimate the odd ratios of generalized anxiety disorder among those with IBD compared with those without (n = 22,522). The fully adjusted model controlled for sociodemographics, depression, substance abuse/dependence, pain, and adverse childhood experiences. Second, among those with IBD (n = 269), significant correlates of generalized anxiety disorder were identified using logistic regression. The presence of generalized anxiety disorder was determined using the WHO-CIDI lifetime criteria, and IBD was assessed by a self-reported health professional diagnosis. Individuals with IBD had over twice the odds of anxiety compared with those without IBD, even when controlling for a range of potential explanatory factors (odds ratio = 2.18; 95% confidence interval, 1.50-3.16). Controlling for chronic pain and childhood adversities attenuate the relationship the most. Among those with IBD, a history of childhood sexual abuse, female gender, and chronic pain are the strongest correlates of anxiety. Those with Crohn's and ulcerative colitis were equally vulnerable to generalized anxiety disorder. Our findings show that IBD is robustly related to generalized anxiety disorder. Health care professionals should be aware of the increased prevalence of generalized anxiety disorder among their patients with IBD, particularly women, those in chronic pain, and those with a history of childhood sexual abuse.

The direct and indirect cost burden of clinically significant and symptomatic uterine fibroids.

PubMed

Lee, David W; Ozminkowski, Ronald J; Carls, Ginger Smith; Wang, Shaohung; Gibson, Teresa B; Stewart, Elizabeth A

2007-05-01

To estimate direct medical costs and indirect (productivity related) for women age 25 to 54 who had clinically significant and symptomatic uterine fibroids (UF). We compared direct medical expenditures among 30,659 women who had clinically significant and symptomatic UF to expenditures among an equal number of matched controls who did not. We also compared indirect costs for a sub-sample of 910 employed women in each group. Regression analyses controlled for demographic and casemix factors. Mean 12-month direct medical costs for women with UF were $11,720 versus $3257 for controls, and mean 12-month indirect costs for women with UF were $11,752 versus $8083 for controls. Differences were statistically significant (P<0.0001). UF is a costly disorder and merits thought as interventions are considered to improve women's health and productivity.

Household water treatment in developing countries: comparing different intervention types using meta-regression.

PubMed

Hunter, Paul R

2009-12-01

Household water treatment (HWT) is being widely promoted as an appropriate intervention for reducing the burden of waterborne disease in poor communities in developing countries. A recent study has raised concerns about the effectiveness of HWT, in part because of concerns over the lack of blinding and in part because of considerable heterogeneity in the reported effectiveness of randomized controlled trials. This study set out to attempt to investigate the causes of this heterogeneity and so identify factors associated with good health gains. Studies identified in an earlier systematic review and meta-analysis were supplemented with more recently published randomized controlled trials. A total of 28 separate studies of randomized controlled trials of HWT with 39 intervention arms were included in the analysis. Heterogeneity was studied using the "metareg" command in Stata. Initial analyses with single candidate predictors were undertaken and all variables significant at the P < 0.2 level were included in a final regression model. Further analyses were done to estimate the effect of the interventions over time by MonteCarlo modeling using @Risk and the parameter estimates from the final regression model. The overall effect size of all unblinded studies was relative risk = 0.56 (95% confidence intervals 0.51-0.63), but after adjusting for bias due to lack of blinding the effect size was much lower (RR = 0.85, 95% CI = 0.76-0.97). Four main variables were significant predictors of effectiveness of intervention in a multipredictor meta regression model: Log duration of study follow-up (regression coefficient of log effect size = 0.186, standard error (SE) = 0.072), whether or not the study was blinded (coefficient 0.251, SE 0.066) and being conducted in an emergency setting (coefficient -0.351, SE 0.076) were all significant predictors of effect size in the final model. Compared to the ceramic filter all other interventions were much less effective (Biosand 0.247, 0.073; chlorine and safe waste storage 0.295, 0.061; combined coagulant-chlorine 0.2349, 0.067; SODIS 0.302, 0.068). A Monte Carlo model predicted that over 12 months ceramic filters were likely to be still effective at reducing disease, whereas SODIS, chlorination, and coagulation-chlorination had little if any benefit. Indeed these three interventions are predicted to have the same or less effect than what may be expected due purely to reporting bias in unblinded studies With the currently available evidence ceramic filters are the most effective form of HWT in the longterm, disinfection-only interventions including SODIS appear to have poor if any longterm public health benefit.

Predicting Word Reading Ability: A Quantile Regression Study

ERIC Educational Resources Information Center

McIlraith, Autumn L.

2018-01-01

Predictors of early word reading are well established. However, it is unclear if these predictors hold for readers across a range of word reading abilities. This study used quantile regression to investigate predictive relationships at different points in the distribution of word reading. Quantile regression analyses used preschool and…

Regression Discontinuity for Causal Effect Estimation in Epidemiology.

PubMed

Oldenburg, Catherine E; Moscoe, Ellen; Bärnighausen, Till

Regression discontinuity analyses can generate estimates of the causal effects of an exposure when a continuously measured variable is used to assign the exposure to individuals based on a threshold rule. Individuals just above the threshold are expected to be similar in their distribution of measured and unmeasured baseline covariates to individuals just below the threshold, resulting in exchangeability. At the threshold exchangeability is guaranteed if there is random variation in the continuous assignment variable, e.g., due to random measurement error. Under exchangeability, causal effects can be identified at the threshold. The regression discontinuity intention-to-treat (RD-ITT) effect on an outcome can be estimated as the difference in the outcome between individuals just above (or below) versus just below (or above) the threshold. This effect is analogous to the ITT effect in a randomized controlled trial. Instrumental variable methods can be used to estimate the effect of exposure itself utilizing the threshold as the instrument. We review the recent epidemiologic literature reporting regression discontinuity studies and find that while regression discontinuity designs are beginning to be utilized in a variety of applications in epidemiology, they are still relatively rare, and analytic and reporting practices vary. Regression discontinuity has the potential to greatly contribute to the evidence base in epidemiology, in particular on the real-life and long-term effects and side-effects of medical treatments that are provided based on threshold rules - such as treatments for low birth weight, hypertension or diabetes.

CUSUM-Logistic Regression analysis for the rapid detection of errors in clinical laboratory test results.

PubMed

Sampson, Maureen L; Gounden, Verena; van Deventer, Hendrik E; Remaley, Alan T

2016-02-01

The main drawback of the periodic analysis of quality control (QC) material is that test performance is not monitored in time periods between QC analyses, potentially leading to the reporting of faulty test results. The objective of this study was to develop a patient based QC procedure for the more timely detection of test errors. Results from a Chem-14 panel measured on the Beckman LX20 analyzer were used to develop the model. Each test result was predicted from the other 13 members of the panel by multiple regression, which resulted in correlation coefficients between the predicted and measured result of >0.7 for 8 of the 14 tests. A logistic regression model, which utilized the measured test result, the predicted test result, the day of the week and time of day, was then developed for predicting test errors. The output of the logistic regression was tallied by a daily CUSUM approach and used to predict test errors, with a fixed specificity of 90%. The mean average run length (ARL) before error detection by CUSUM-Logistic Regression (CSLR) was 20 with a mean sensitivity of 97%, which was considerably shorter than the mean ARL of 53 (sensitivity 87.5%) for a simple prediction model that only used the measured result for error detection. A CUSUM-Logistic Regression analysis of patient laboratory data can be an effective approach for the rapid and sensitive detection of clinical laboratory errors. Published by Elsevier Inc.

Exploratory Analysis of Exercise Adherence Patterns with Sedentary Pregnant Women

PubMed Central

Yeo, SeonAe; Cisewski, Jessi; Lock, Eric F.; Marron, J. S.

2010-01-01

Background It is not well understood how sedentary women who wish to engage in regular exercise adhere to interventions during pregnancy and what factors may influence adherence over time. Objective To examine longitudinal patterns of pregnant women’s adherence to exercise. Methods Exploratory secondary data analyses were carried out with 124 previously sedentary pregnant women (ages 31 ± 5 years; 85% non-Hispanic White) from a randomized controlled trial. Daily exercise logs (n = 92) from 18 through 35 weeks of gestation were explored using linear regression, functional data, and principal component analyses. Results Adherence decreased as gestation week increased (p < .001); the top adherers maintained levels of adherence, and the bottom adherers decreased levels of adherence; and adherence pattern was influenced by types of exercise throughout the study period. Discussion Exercise behavior patterns were explored in a randomized controlled trial study, using chronometric data on exercise attendance. A new analytic approach revealed that sedentary pregnant women may adopt exercise habits differently from other populations. PMID:20585224

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.

PubMed

Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C; Kirk, Catherine M; Bizimana, Justin I; Betancourt, Theresa S

2017-06-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

The impact of alcohol taxation on liver cirrhosis mortality.

PubMed

Ponicki, William R; Gruenewald, Paul J

2006-11-01

The objective of this study is to investigate the impact of distilled spirits, wine, and beer taxes on cirrhosis mortality using a large-panel data set and statistical models that control for various other factors that may affect that mortality. The analyses were performed on a panel of 30 U.S. license states during the period 1971-1998 (N = 840 state-by-year observations). Exogenous measures included current and lagged versions of beverage taxes and income, as well as controls for states' age distribution, religion, race, health care availability, urbanity, tourism, and local bans on alcohol sales. Regression analyses were performed using random-effects models with corrections for serial autocorrelation and heteroscedasticity among states. Cirrhosis rates were found to be significantly related to taxes on distilled spirits but not to taxation of wine and beer. Consistent results were found using different statistical models and model specifications. Consistent with prior research, cirrhosis mortality in the United States appears more closely linked to consumption of distilled spirits than to that of other alcoholic beverages.

Association between heavy precipitation events and waterborne outbreaks in four Nordic countries, 1992-2012.

PubMed

Guzman Herrador, Bernardo; de Blasio, Birgitte Freiesleben; Carlander, Anneli; Ethelberg, Steen; Hygen, Hans Olav; Kuusi, Markku; Lund, Vidar; Löfdahl, Margareta; MacDonald, Emily; Martinez-Urtaza, Jaime; Nichols, Gordon; Schönning, Caroline; Sudre, Bertrand; Trönnberg, Linda; Vold, Line; Semenza, Jan C; Nygård, Karin

2016-12-01

We conducted a matched case-control study to examine the association between heavy precipitation events and waterborne outbreaks (WBOs) by linking epidemiological registries and meteorological data between 1992 and 2012 in four Nordic countries. Heavy precipitation events were defined by above average (exceedance) daily rainfall during the preceding weeks using local references. We performed conditional logistic regression using the four previous years as the controls. Among WBOs with known onset date (n = 89), exceedance rainfall on two or more days was associated with occurrence of outbreak, OR = 3.06 (95% CI 1.38-6.78), compared to zero exceedance days. Stratified analyses revealed a significant association with single household water supplies, ground water as source and for outbreaks occurring during spring and summer. These findings were reproduced in analyses including all WBOs with known outbreak month (n = 186). The vulnerability of single households to WBOs associated with heavy precipitation events should be communicated to homeowners and implemented into future policy planning to reduce the risk of waterborne illness.

Value congruence, control, sense of community and demands as determinants of burnout syndrome among hospitality workers.

PubMed

Asensio-Martínez, Ángela; Leiter, Michael P; Gascón, Santiago; Gumuchian, Stephanie; Masluk, Bárbara; Herrera-Mercadal, Paola; Albesa, Agustín; García-Campayo, Javier

2017-09-07

Employees working in the hospitality industry are constantly exposed to occupational stressors that may lead employees into experiencing burnout syndrome. Research addressing the interactive effects of control, community and value congruence to alleviate the impact of workplace demands on experiencing burnout is relatively limited. The present study examined relationships among control, community and value congruence, workplace demands and the three components of burnout. A sample of 418 employees working in a variety of hospitality associations including restaurants and hotels in Spain were recruited. Moderation analyses and linear regressions analyzed the predictive power of control, community and value congruence as moderating variables. Results indicate that control, community and value congruence were successful buffers in the relationships between workplace demands and the burnout dimensions. The present findings offer suggestions for future research on potential moderating variables, as well as implications for reducing burnout among hospitality employees.

Life satisfaction and its correlates in older women with osteoarthritis.

PubMed

Tak, Sunghee H; Laffrey, Shirley C

2003-01-01

To identify the relationships among functional disability, chronic daily stress, coping strategies, beliefs about personal control, social support, and life satisfaction in older women with osteoarthritis. A descriptive, correlational design was used. The study participants were 107 women aged 60 years or older. Study participants completed six survey questionnaires and a demographic form. Bivariate correlational analyses showed that older women with poorer functional ability experienced greater chronic daily stress, reported more frequent use of emotion-focused coping strategies, and had a higher chance health locus of control. A hierarchic regression analysis revealed that the perceived social support and internal health locus of control significantly contributed to the prediction of life satisfaction after demographic, illness-related, and stress-related variables were controlled. Stress management strategies matched to the participants' style of coping process can increase their sense of control over their health and enhance their social networks and activities.

Life events, locus of control, and behavioral problems among Chinese adolescents.

PubMed

Liu, X; Kurita, H; Uchiyama, M; Okawa, M; Liu, L; Ma, D

2000-12-01

This study examined associations of life events and locus of control with behavioral problems among 1,365 Chinese adolescents by using the Youth Self-Report (YSR), Adolescent Self-Rating Life Events Checklist (ASLEC), and the Nowicki-Strickland Locus of Control Scale for Children. Results indicated that the overall prevalence of behavioral and emotional problems was 10.7% (95% CI = 9.9-11.5%). Logistic-regression analyses showed that a total of 13 negative life events mainly coming from academic domain and interpersonal relationships, high life-stress score, and high external locus score significantly increased the risk for behavioral problems. Life stress and locus of control significantly interacted with behavioral problems. These findings support the linkage between stressful life events and psychopathology in a general population of adolescents from mainland China, and demonstrate the stress-moderating effects of locus of control on psychopathology as well.

Predictors of social anxiety in an opioid dependent sample and a control sample.

PubMed

Shand, Fiona L; Degenhardt, Louisa; Nelson, Elliot C; Mattick, Richard P

2010-01-01

Compared to other mental health problems, social anxiety is under-acknowledged amongst opioid dependent populations. This study aimed to assess levels of social anxiety and identify its predictors in an opioid dependent sample and a matched control group. Opioid dependent participants (n=1385) and controls (n=417) completed the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and a diagnostic interview. Regression analyses were used to test a range of predictors of social anxiety. Opioid dependent cases had higher mean scores on both scales compared to controls. Predictors of social anxiety centred on emotional rejection in childhood, either by parents or peers. For opioid dependent cases, but not controls, lifetime non-opioid substance dependence (cannabis, sedatives, and tobacco) was associated with higher levels of social anxiety. However, much of the variance in social anxiety remains unexplained for this population.

Predictors of social anxiety in an opioid dependent sample and a control sample

PubMed Central

Shand, Fiona L.; Degenhardt, Louisa; Nelson, Elliot C.; Mattick, Richard P.

2010-01-01

Compared to other mental health problems, social anxiety is under-acknowledged amongst opioid dependent populations. This study aimed to assess levels of social anxiety and identify its predictors in an opioid dependent sample and a matched control group. Opioid dependent participants (n = 1385) and controls (n = 417) completed the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and a diagnostic interview. Regression analyses were used to test a range of predictors of social anxiety. Opioid dependent cases had higher mean scores on both scales compared to controls. Predictors of social anxiety centred on emotional rejection in childhood, either by parents or peers. For opioid dependent cases, but not controls, lifetime non-opioid substance dependence (cannabis, sedatives, and tobacco) was associated with higher levels of social anxiety. However, much of the variance in social anxiety remains unexplained for this population. PMID:19775865

Low Self-Control and Crime in Late Adulthood.

PubMed

Wolfe, Scott E; Reisig, Michael D; Holtfreter, Kristy

2016-10-01

This study investigates whether low self-control theory explains self-reported criminal activity in late adulthood. Cross-sectional survey data from telephone interviews conducted with individuals aged 60 years and older in Arizona and Florida (N = 2,000) are used. Regression analyses show that low self-control is related to criminal offending. The relationship between low self-control and offending persists after the introduction of potential mediators (e.g., unstructured socializing, negative emotions, and familial ties) and is even observed across different stages of late adulthood (i.e., young-old, old-old, and oldest-old) characterized by declining physical and cognitive abilities. Robustness checks using alternative measurement and modeling strategies also provide empirical support. Although strong causal inferences are limited by the nature of the data, the findings generally support the notion that low self-control theory partially explains criminal offending in late adulthood. © The Author(s) 2015.

The role of physical and mental health multimorbidity in suicidal ideation.

PubMed

Kavalidou, Katerina; Smith, Daniel J; O'Connor, Rory C

2017-02-01

Previous research has focused on the separate roles of mental illness and physical health conditions in suicide risk, with relatively few studies investigating the importance of physical and psychiatric disorder co-occurrence. We aimed to investigate whether suicidal ideation might be influenced by physical and mental ill-health multimorbidity. Data from the Adult Psychiatric Morbidity Survey of England were analysed. Participants who responded to the suicidal thoughts question were grouped into four distinct categories based on their health conditions (Common mental disorders (CMD) only, physical health conditions only, CMD/physical health multimorbidity and a control group with neither physical nor mental health conditions). Multinomial logistic regression analyses were conducted and odds ratios (OR) and 95% CIs are presented. In the fully adjusted model, both the multimorbidity and CMD-only groups were associated with higher levels of suicidal ideation relative to the control group. Secondary analyses of cross-sectional data. Although multimorbidity was associated with suicidal thoughts, it does not appear to elevate risk beyond the independent effects of common mental disorders or physical health problems. Primary care and mental health clinicians should consider assessment of suicidal ideation among patients with multimorbid physical/mental health conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Inhibiting food reward: delay discounting, food reward sensitivity, and palatable food intake in overweight and obese women

PubMed Central

Appelhans, Bradley M.; Woolf, Kathleen; Pagoto, Sherry L.; Schneider, Kristin L.; Whited, Matthew C.; Liebman, Rebecca

2012-01-01

Overeating is believed to result when the appetitive motivation to consume palatable food exceeds an individual’s capacity for inhibitory control of eating. This hypothesis was supported in recent studies involving predominantly normal weight women, but has not been tested in obese populations. The current study tested the interaction between food reward sensitivity and inhibitory control in predicting palatable food intake among energy-replete overweight and obese women (N=62). Sensitivity to palatable food reward was measured with the Power of Food Scale. Inhibitory control was assessed with a computerized choice task that captures the tendency to discount large delayed rewards relative to smaller immediate rewards. Participants completed an eating in the absence of hunger protocol in which homeostatic energy needs were eliminated with a bland preload of plain oatmeal, followed by a bogus laboratory taste test of palatable and bland snacks. The interaction between food reward sensitivity and inhibitory control was a significant predictor of palatable food intake in regression analyses controlling for body mass index and the amount of preload consumed. Probing this interaction indicated that higher food reward sensitivity predicted greater palatable food intake at low levels of inhibitory control, but was not associated with intake at high levels of inhibitory control. As expected, no associations were found in a similar regression analysis predicting intake of bland foods. Findings support a neurobehavioral model of eating behavior in which sensitivity to palatable food reward drives overeating only when accompanied by insufficient inhibitory control. Strengthening inhibitory control could enhance weight management programs. PMID:21475139

Security in Father-child Relationship and Behavior Problems in Sexually Abused Children.

PubMed

Parent-Boursier, Claudel; Hébert, Martine

2015-01-01

While the influence of mother-child relationships on children's recovery following sexual abuse has been documented, less is known about the possible contribution of father-child relationships on outcomes. The present study explored the contribution of children's perception of security in their relationship to the father on internalizing and externalizing behavior problems, while controlling for sociodemographic variables and variables associated with the mother-child relationship. Participants were 142 children who disclosed sexual abuse involving a perpetrator other than the biological father. Regression analyses indicated that children's perception of security to fathers contributed to the prediction of parental reports of children's behavior problems, even after controlling for maternal psychological distress and perception of security to mothers.

The interactive effects of proactive personality and work-family interference on well-being.

PubMed

Cunningham, Christopher J L; De La Rosa, Gabriel M

2008-07-01

Proactive personality was expected to moderate the relationship between controllable work and nonwork stressors (e.g., time-based work-family interference) and job/life satisfaction. Moderated multiple regression analyses of survey data from a sample of professionals (N=133) revealed a significant interaction between time-based family interfering-with work and proactive personality predicting life satisfaction and several main effects offering partial support for the hypothesized relationships (alpha<.05). No other interactions between proactive personality and other forms of work-family interference were observed. The benefits of proactive personality may only emerge when personal control over occupational stressors can be exercised. Copyright (c) 2008 APA, all rights reserved.

Graft Diameter as a Predictor for Revision Anterior Cruciate Ligament Reconstruction and KOOS and EQ-5D Values: A Cohort Study From the Swedish National Knee Ligament Register Based on 2240 Patients.

PubMed

Snaebjörnsson, Thorkell; Hamrin Senorski, Eric; Ayeni, Olufemi R; Alentorn-Geli, Eduard; Krupic, Ferid; Norberg, Fredrik; Karlsson, Jón; Samuelsson, Kristian

2017-07-01

Anterior cruciate ligament (ACL) reconstruction (ACLR) using a hamstring tendon (HT) autograft is an effective and widespread method. Recent studies have identified a relationship between the graft diameter and revision ACLR. To evaluate the influence of the graft diameter on revision ACLR and patient-reported outcomes in patients undergoing primary ACLR using HT autografts. Cohort study; Level of evidence, 2. A prospective cohort study was conducted using the Swedish National Knee Ligament Register (SNKLR) involving all patients undergoing primary ACLR using HT autografts. Patients with graft failure who needed revision surgery (cases) were compared with patients not undergoing revision surgery (controls). The control group was matched for sex, age, and graft fixation method in a 3:1 ratio. Conditional logistic regression was performed to produce odds ratios and 95% CIs. Univariate linear regression analyses were performed for patient-related outcomes. The Knee injury and Osteoarthritis Outcome Score (KOOS) and EuroQol 5 dimensions questionnaire (EQ-5D) values were obtained. A total of 2240 patients were included in which there were 560 cases and 1680 controls. No significant differences between the cases and controls were found for sex (52.9% male), mean age (21.7 years), and femoral and tibial fixation. The mean graft diameter for the cases was 8.0 ± 0.74 mm and for the controls was 8.1 ± 0.76 mm. In the present cohort, the likelihood of revision surgery for every 0.5-mm increase in the HT autograft diameter between 7.0 and 10.0 mm was 0.86 (95% CI, 0.75-0.99; P = .03). Univariate linear regression analysis found no significant regression coefficient for the change in KOOS or EQ-5D values. In a large cohort of patients after primary ACLR with HT autografts, an increase in the graft diameter between 7.0 and 10.0 mm resulted in a 0.86 times lower likelihood of revision surgery with every 0.5-mm increase. This study provides further evidence of the importance of the HT autograft size in intraoperative decision making.

A method for fitting regression splines with varying polynomial order in the linear mixed model.

PubMed

Edwards, Lloyd J; Stewart, Paul W; MacDougall, James E; Helms, Ronald W

2006-02-15

The linear mixed model has become a widely used tool for longitudinal analysis of continuous variables. The use of regression splines in these models offers the analyst additional flexibility in the formulation of descriptive analyses, exploratory analyses and hypothesis-driven confirmatory analyses. We propose a method for fitting piecewise polynomial regression splines with varying polynomial order in the fixed effects and/or random effects of the linear mixed model. The polynomial segments are explicitly constrained by side conditions for continuity and some smoothness at the points where they join. By using a reparameterization of this explicitly constrained linear mixed model, an implicitly constrained linear mixed model is constructed that simplifies implementation of fixed-knot regression splines. The proposed approach is relatively simple, handles splines in one variable or multiple variables, and can be easily programmed using existing commercial software such as SAS or S-plus. The method is illustrated using two examples: an analysis of longitudinal viral load data from a study of subjects with acute HIV-1 infection and an analysis of 24-hour ambulatory blood pressure profiles.

Continuous infusion of low-dose unfractionated heparin after aneurysmal subarachnoid hemorrhage: a preliminary study of cognitive outcomes.

PubMed

James, Robert F; Khattar, Nicolas K; Aljuboori, Zaid S; Page, Paul S; Shao, Elaine Y; Carter, Lacey M; Meyer, Kimberly S; Daniels, Michael W; Craycroft, John; Gaughen, John R; Chaudry, M Imran; Rai, Shesh N; Everhart, D Erik; Simard, J Marc

2018-05-11

OBJECTIVE Cognitive dysfunction occurs in up to 70% of aneurysmal subarachnoid hemorrhage (aSAH) survivors. Low-dose intravenous heparin (LDIVH) infusion using the Maryland protocol was recently shown to reduce clinical vasospasm and vasospasm-related infarction. In this study, the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive changes in aSAH patients treated with the Maryland LDIVH protocol compared with controls. METHODS A retrospective analysis of all patients treated for aSAH between July 2009 and April 2014 was conducted. Beginning in 2012, aSAH patients were treated with LDIVH in the postprocedural period. The MoCA was administered to all aSAH survivors prospectively during routine follow-up visits, at least 3 months after aSAH, by trained staff blinded to treatment status. Mean MoCA scores were compared between groups, and regression analyses were performed for relevant factors. RESULTS No significant differences in baseline characteristics were observed between groups. The mean MoCA score for the LDIVH group (n = 25) was 26.4 compared with 22.7 in controls (n = 22) (p = 0.013). Serious cognitive impairment (MoCA ≤ 20) was observed in 32% of controls compared with 0% in the LDIVH group (p = 0.008). Linear regression analysis demonstrated that only LDIVH was associated with a positive influence on MoCA scores (β = 3.68, p =0.019), whereas anterior communicating artery aneurysms and fevers were negatively associated with MoCA scores. Multivariable linear regression analysis resulted in all 3 factors maintaining significance. There were no treatment complications. CONCLUSIONS This preliminary study suggests that the Maryland LDIVH protocol may improve cognitive outcomes in aSAH patients. A randomized controlled trial is needed to determine the safety and potential benefit of unfractionated heparin in aSAH patients.

Memory complaints in epilepsy: An examination of the role of mood and illness perceptions.

PubMed

Tinson, Deborah; Crockford, Christopher; Gharooni, Sara; Russell, Helen; Zoeller, Sophie; Leavy, Yvonne; Lloyd, Rachel; Duncan, Susan

2018-03-01

The study examined the role of mood and illness perceptions in explaining the variance in the memory complaints of patients with epilepsy. Forty-four patients from an outpatient tertiary care center and 43 volunteer controls completed a formal assessment of memory and a verbal fluency test, as well as validated self-report questionnaires on memory complaints, mood, and illness perceptions. In hierarchical multiple regression analyses, objective memory test performance and verbal fluency did not contribute significantly to the variance in memory complaints for either patients or controls. In patients, illness perceptions and mood were highly correlated. Illness perceptions correlated more highly with memory complaints than mood and were therefore added to the multiple regression analysis. This accounted for an additional 25% of the variance, after controlling for objective memory test performance and verbal fluency, and the model was significant (model B). In order to compare with other studies, mood was added to a second model, instead of illness perceptions. This accounted for an additional 24% of the variance, which was again significant (model C). In controls, low mood accounted for 11% of the variance in memory complaints (model C2). A measure of illness perceptions was more highly correlated with the memory complaints of patients with epilepsy than with a measure of mood. In a hierarchical multiple regression model, illness perceptions accounted for 25% of the variance in memory complaints. Illness perceptions could provide useful information in a clinical investigation into the self-reported memory complaints of patients with epilepsy, alongside the assessment of mood and formal memory testing. Copyright © 2017 Elsevier Inc. All rights reserved.

Emotion-focused coping as a mediator of maternal cocaine abuse and antisocial behavior.

PubMed

Hien, Denise A; Miele, Gloria M

2003-03-01

A great deal of data implicate parental drug use as a potential risk factor for child abuse; however, theories for understanding the links between maternal drug use and antisocial behavior have yet to be examined empirically. This case-control study investigated correlates of adult antisocial behavior among 279 inner-city mothers in 3 comparison groups: drug abusers (n = 112), depressed mothers (n = 73), and nonsubstance abusing controls (n = 94). Using hierarchical regression techniques and mediational analyses controlling for ethnicity, current depression, and family history of substance abuse, support was provided for an emotion-focused coping style as a link between addictive and antisocial behavior. These results highlight the importance of focusing on emotion regulation models in the prevention and treatment of violence in drug-abusing women.

On the incremental validity of irrational beliefs to predict subjective well-being while controlling for personality factors.

PubMed

Spörrle, Matthias; Strobel, Maria; Tumasjan, Andranik

2010-11-01

This research examines the incremental validity of irrational thinking as conceptualized by Albert Ellis to predict diverse aspects of subjective well-being while controlling for the influence of personality factors. Rational-emotive behavior therapy (REBT) argues that irrational beliefs result in maladaptive emotions leading to reduced well-being. Although there is some early scientific evidence for this relation, it has never been investigated whether this connection would still persist when statistically controlling for the Big Five personality factors, which were consistently found to be important determinants of well-being. Regression analyses revealed significant incremental validity of irrationality over personality factors when predicting life satisfaction, but not when predicting subjective happiness. Results are discussed with respect to conceptual differences between these two aspects of subjective well-being.

Classification and regression tree analysis vs. multivariable linear and logistic regression methods as statistical tools for studying haemophilia.

PubMed

Henrard, S; Speybroeck, N; Hermans, C

2015-11-01

Haemophilia is a rare genetic haemorrhagic disease characterized by partial or complete deficiency of coagulation factor VIII, for haemophilia A, or IX, for haemophilia B. As in any other medical research domain, the field of haemophilia research is increasingly concerned with finding factors associated with binary or continuous outcomes through multivariable models. Traditional models include multiple logistic regressions, for binary outcomes, and multiple linear regressions for continuous outcomes. Yet these regression models are at times difficult to implement, especially for non-statisticians, and can be difficult to interpret. The present paper sought to didactically explain how, why, and when to use classification and regression tree (CART) analysis for haemophilia research. The CART method is non-parametric and non-linear, based on the repeated partitioning of a sample into subgroups based on a certain criterion. Breiman developed this method in 1984. Classification trees (CTs) are used to analyse categorical outcomes and regression trees (RTs) to analyse continuous ones. The CART methodology has become increasingly popular in the medical field, yet only a few examples of studies using this methodology specifically in haemophilia have to date been published. Two examples using CART analysis and previously published in this field are didactically explained in details. There is increasing interest in using CART analysis in the health domain, primarily due to its ease of implementation, use, and interpretation, thus facilitating medical decision-making. This method should be promoted for analysing continuous or categorical outcomes in haemophilia, when applicable. © 2015 John Wiley & Sons Ltd.

Visual field progression in glaucoma: total versus pattern deviation analyses.

PubMed

Artes, Paul H; Nicolela, Marcelo T; LeBlanc, Raymond P; Chauhan, Balwantray C

2005-12-01

To compare visual field progression with total and pattern deviation analyses in a prospective longitudinal study of patients with glaucoma and healthy control subjects. A group of 101 patients with glaucoma (168 eyes) with early to moderately advanced visual field loss at baseline (average mean deviation [MD], -3.9 dB) and no clinical evidence of media opacity were selected from a prospective longitudinal study on visual field progression in glaucoma. Patients were examined with static automated perimetry at 6-month intervals for a median follow-up of 9 years. At each test location, change was established with event and trend analyses of total and pattern deviation. The event analyses compared each follow-up test to a baseline obtained from averaging the first two tests, and visual field progression was defined as deterioration beyond the 5th percentile of test-retest variability at three test locations, observed on three consecutive tests. The trend analyses were based on point-wise linear regression, and visual field progression was defined as statistically significant deterioration (P < 5%) worse than -1 dB/year at three locations, confirmed by independently omitting the last and the penultimate observation. The incidence and the time-to-progression were compared between total and pattern deviation analyses. To estimate the specificity of the progression analyses, identical criteria were applied to visual fields obtained in 102 healthy control subjects, and the rate of visual field improvement was established in the patients with glaucoma and the healthy control subjects. With both event and trend methods, pattern deviation analyses classified approximately 15% fewer eyes as having progressed than did the total deviation analyses. In eyes classified as progressing by both the total and pattern deviation methods, total deviation analyses tended to detect progression earlier than the pattern deviation analyses. A comparison of the changes observed in MD and the visual fields' general height (estimated by the 85th percentile of the total deviation values) confirmed that change in the glaucomatous eyes almost always comprised a diffuse component. Pattern deviation analyses of progression may therefore underestimate the true amount of glaucomatous visual field progression. Pattern deviation analyses of visual field progression may underestimate visual field progression in glaucoma, particularly when there is no clinical evidence of increasing media opacity. Clinicians should have access to both total and pattern deviation analyses to make informed decisions on visual field progression in glaucoma.

Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus--results from LUMINA (LIX): a multiethnic US cohort.

PubMed

Durán-Barragán, S; McGwin, G; Vilá, L M; Reveille, J D; Alarcón, G S

2008-07-01

To examine if angiotensin-converting enzyme (ACE) inhibitor use delays the occurrence of renal involvement and decreases the risk of disease activity in SLE patients. SLE patients (Hispanics, African Americans and Caucasians) from the lupus in minorities: nature vs nurture (LUMINA) cohort were studied. Renal involvement was defined as ACR criterion and/or biopsy-proven lupus nephritis. Time-to-renal involvement was examined by univariable and multivariable Cox proportional hazards regression analyses. Disease activity was examined with a case-crossover design and a conditional logistic regression model; in the case intervals, a decrease in the SLAM-R score >or=4 points occurred but not in the control intervals. Eighty of 378 patients (21%) were ACE inhibitor users; 298 (79%) were not. The probability of renal involvement free-survival at 10 yrs was 88.1% for users and 75.4% for non-users (P = 0.0099, log rank test). Users developed persistent proteinuria and/or biopsy-proven lupus nephritis (7.1%) less frequently than non-users (22.9%), P = 0.016. By multivariable Cox proportional hazards regression analyses, ACE inhibitors use [hazard ratio (HR) 0.27; 95% CI 0.09, 0.78] was associated with a longer time-to-renal involvement occurrence whereas African American ethnicity (HR 3.31; 95% CI 1.44, 7.61) was with a shorter time. ACE inhibitor use (54/288 case and 254/1148 control intervals) was also associated with a decreased risk of disease activity (HR 0.56; 95% CI 0.34, 0.94). ACE inhibitor use delays the development of renal involvement and associates with a decreased risk of disease activity in SLE; corroboration of these findings in other lupus cohorts is desirable before practice recommendations are formulated.

Occupational asphalt is not associated with head and neck cancer.

PubMed

Fogleman, E V; Eliot, M; Michaud, D S; Nelson, H H; McClean, M D; Langevin, S M; Kelsey, K T

2015-10-01

Epidemiologic studies that evaluate the relationship between occupational asphalt exposure and head and neck cancer have had a limited ability to control for known risk factors such as smoking, alcohol and human papillomavirus (HPV). To better elucidate this relationship by including known risk factors in a large case-control study of head and neck squamous cell carcinoma (HNSCC) from the greater Boston area. We analysed the relationship between occupational asphalt exposure and HNSCC among men in the Greater Boston area of Massachusetts. Analyses were conducted using unconditional multivariable logistic regression, performed with adjustments for age, race, education, smoking, alcohol consumption and HPV serology. There were 753 cases and 913 controls. No associations between HNSCC and occupational asphalt exposure (neither among ever-exposed nor by occupational duration) were observed for exposures in any occupation or those restricted to the construction industry. We also observed no associations in subgroup analyses of never-smokers and ever-smokers. Adjusting for known risk factors further reduced the estimated effect of asphalt exposure on HNSCC risk. We found no evidence for an association between occupational asphalt exposure and HNSCC. The null findings from this well-controlled analysis could suggest that the risk estimates stemming from occupational cohort studies may be overestimated due to uncontrolled confounding and enhance the literature available for weighing cancer risk from occupational exposure to bitumen. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Poor methodological quality and reporting standards of systematic reviews in burn care management.

PubMed

Wasiak, Jason; Tyack, Zephanie; Ware, Robert; Goodwin, Nicholas; Faggion, Clovis M

2017-10-01

The methodological and reporting quality of burn-specific systematic reviews has not been established. The aim of this study was to evaluate the methodological quality of systematic reviews in burn care management. Computerised searches were performed in Ovid MEDLINE, Ovid EMBASE and The Cochrane Library through to February 2016 for systematic reviews relevant to burn care using medical subject and free-text terms such as 'burn', 'systematic review' or 'meta-analysis'. Additional studies were identified by hand-searching five discipline-specific journals. Two authors independently screened papers, extracted and evaluated methodological quality using the 11-item A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool and reporting quality using the 27-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Characteristics of systematic reviews associated with methodological and reporting quality were identified. Descriptive statistics and linear regression identified features associated with improved methodological quality. A total of 60 systematic reviews met the inclusion criteria. Six of the 11 AMSTAR items reporting on 'a priori' design, duplicate study selection, grey literature, included/excluded studies, publication bias and conflict of interest were reported in less than 50% of the systematic reviews. Of the 27 items listed for PRISMA, 13 items reporting on introduction, methods, results and the discussion were addressed in less than 50% of systematic reviews. Multivariable analyses showed that systematic reviews associated with higher methodological or reporting quality incorporated a meta-analysis (AMSTAR regression coefficient 2.1; 95% CI: 1.1, 3.1; PRISMA regression coefficient 6·3; 95% CI: 3·8, 8·7) were published in the Cochrane library (AMSTAR regression coefficient 2·9; 95% CI: 1·6, 4·2; PRISMA regression coefficient 6·1; 95% CI: 3·1, 9·2) and included a randomised control trial (AMSTAR regression coefficient 1·4; 95%CI: 0·4, 2·4; PRISMA regression coefficient 3·4; 95% CI: 0·9, 5·8). The methodological and reporting quality of systematic reviews in burn care requires further improvement with stricter adherence by authors to the PRISMA checklist and AMSTAR tool. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Resting-state functional connectivity in multiple sclerosis: an examination of group differences and individual differences.

PubMed

Janssen, Alisha L; Boster, Aaron; Patterson, Beth A; Abduljalil, Amir; Prakash, Ruchika Shaurya

2013-11-01

Multiple sclerosis (MS) is a neurodegenerative, inflammatory disease of the central nervous system, resulting in physical and cognitive disturbances. The goal of the current study was to examine the association between network integrity and composite measures of cognition and disease severity in individuals with relapsing-remitting MS (RRMS), relative to healthy controls. All participants underwent a neuropsychological and neuroimaging session, where resting-state data was collected. Independent component analysis and dual regression were employed to examine network integrity in individuals with MS, relative to healthy controls. The MS sample exhibited less connectivity in the motor and visual networks, relative to healthy controls, after controlling for group differences in gray matter volume. However, no alterations were observed in the frontoparietal, executive control, or default-mode networks, despite previous evidence of altered neuronal patterns during tasks of exogenous processing. Whole-brain, voxel-wise regression analyses with disease severity and processing speed composites were also performed to elucidate the brain-behavior relationship with neuronal network integrity. Individuals with higher levels of disease severity demonstrated reduced intra-network connectivity of the motor network, and the executive control network, while higher disease burden was associated with greater inter-network connectivity between the medial visual network and areas involved in visuomotor learning. Our findings underscore the importance of examining resting-state oscillations in this population, both as a biomarker of disease progression and a potential target for therapeutic intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Leukocyte telomere length correlates with glucose control in adults with recently diagnosed type 2 diabetes.

PubMed

Rosa, Erica Carine Campos Caldas; Dos Santos, Renan Renato Cruz; Fernandes, Luis Fernando Amarante; Neves, Francisco de Assis Rocha; Coelho, Michella Soares; Amato, Angelica Amorim

2018-01-01

We investigated leukocyte relative telomere length (TL) in patients with type 2 diabetes (T2D) diagnosed for no longer than five years and its association with clinical and biochemical variables. Peripheral blood leukocyte relative TL was investigated in 108 patients with T2D (87 women, 21 men) and 125 (37 women, 88 men) age-matched control subjects with normal glucose tolerance, by quantitative polymerase chain reaction. Multiple linear regression analysis was used to examine the association between relative TL and demographic, anthropometric and biochemical indicators of metabolic control among patients with T2D. Patients with T2D had a median time since diagnosis of 1 year and most were on metformin monotherapy, with satisfactory glucose control determined by HbA1c levels. Median relative TL was not different between patients with T2D and control subjects. However, multiple linear regression analyses showed that relative TL was inversely associated with time since T2D diagnosis, fasting plasma glucose levels and HbA1c levels, but not with HbA1c levels assessed in the preceding 5-12 months, after adjustment for age, sex and body mass index. This study suggests that relative TL is not shorter in patients with recently diagnosed T2D, but is inversely correlated with glucose levels, even among patients with overall satisfactory glucose control. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors of effects of lifestyle intervention on diabetes mellitus type 2 patients.

PubMed

Jacobsen, Ramune; Vadstrup, Eva; Røder, Michael; Frølich, Anne

2012-01-01

The main aim of the study was to identify predictors of the effects of lifestyle intervention on diabetes mellitus type 2 patients by means of multivariate analysis. Data from a previously published randomised clinical trial, which compared the effects of a rehabilitation programme including standardised education and physical training sessions in the municipality's health care centre with the same duration of individual counseling in the diabetes outpatient clinic, were used. Data from 143 diabetes patients were analysed. The merged lifestyle intervention resulted in statistically significant improvements in patients' systolic blood pressure, waist circumference, exercise capacity, glycaemic control, and some aspects of general health-related quality of life. The linear multivariate regression models explained 45% to 80% of the variance in these improvements. The baseline outcomes in accordance to the logic of the regression to the mean phenomenon were the only statistically significant and robust predictors in all regression models. These results are important from a clinical point of view as they highlight the more urgent need for and better outcomes following lifestyle intervention for those patients who have worse general and disease-specific health.

Normalization Approaches for Removing Systematic Biases Associated with Mass Spectrometry and Label-Free Proteomics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Callister, Stephen J.; Barry, Richard C.; Adkins, Joshua N.

2006-02-01

Central tendency, linear regression, locally weighted regression, and quantile techniques were investigated for normalization of peptide abundance measurements obtained from high-throughput liquid chromatography-Fourier transform ion cyclotron resonance mass spectrometry (LC-FTICR MS). Arbitrary abundances of peptides were obtained from three sample sets, including a standard protein sample, two Deinococcus radiodurans samples taken from different growth phases, and two mouse striatum samples from control and methamphetamine-stressed mice (strain C57BL/6). The selected normalization techniques were evaluated in both the absence and presence of biological variability by estimating extraneous variability prior to and following normalization. Prior to normalization, replicate runs from each sample setmore » were observed to be statistically different, while following normalization replicate runs were no longer statistically different. Although all techniques reduced systematic bias, assigned ranks among the techniques revealed significant trends. For most LC-FTICR MS analyses, linear regression normalization ranked either first or second among the four techniques, suggesting that this technique was more generally suitable for reducing systematic biases.« less

Coordinate based random effect size meta-analysis of neuroimaging studies.

PubMed

Tench, C R; Tanasescu, Radu; Constantinescu, C S; Auer, D P; Cottam, W J

2017-06-01

Low power in neuroimaging studies can make them difficult to interpret, and Coordinate based meta-analysis (CBMA) may go some way to mitigating this issue. CBMA has been used in many analyses to detect where published functional MRI or voxel-based morphometry studies testing similar hypotheses report significant summary results (coordinates) consistently. Only the reported coordinates and possibly t statistics are analysed, and statistical significance of clusters is determined by coordinate density. Here a method of performing coordinate based random effect size meta-analysis and meta-regression is introduced. The algorithm (ClusterZ) analyses both coordinates and reported t statistic or Z score, standardised by the number of subjects. Statistical significance is determined not by coordinate density, but by a random effects meta-analyses of reported effects performed cluster-wise using standard statistical methods and taking account of censoring inherent in the published summary results. Type 1 error control is achieved using the false cluster discovery rate (FCDR), which is based on the false discovery rate. This controls both the family wise error rate under the null hypothesis that coordinates are randomly drawn from a standard stereotaxic space, and the proportion of significant clusters that are expected under the null. Such control is necessary to avoid propagating and even amplifying the very issues motivating the meta-analysis in the first place. ClusterZ is demonstrated on both numerically simulated data and on real data from reports of grey matter loss in multiple sclerosis (MS) and syndromes suggestive of MS, and of painful stimulus in healthy controls. The software implementation is available to download and use freely. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining the Associations Among Home-School Dissonance, Amotivation, and Classroom Disruptive Behavior for Urban High School Students.

PubMed

Brown-Wright, Lynda; Tyler, Kenneth M; Graves, Scott L; Thomas, Deneia; Stevens-Watkins, Danelle; Mulder, Shambra

2013-01-01

The current study examined the association among home-school dissonance, amotivation, and classroom disruptive behavior among 309 high school juniors and seniors at two urban high schools in the Southern region of the country. Students completed two subscales of the Patterns of Learning Activities Scales (PALS) and one subscale of the Academic Motivation Scale (AMS). ANCOVA analyses revealed significant differences in classroom disruptive behaviors for the gender independent variable. Controlling for gender in the multiple hierarchical regression analyses, it was revealed that home-school dissonance significantly predicted both amotivation and classroom disruptive behavior. In addition, a Sobel mediation analysis showed that amotivation was a significant mediator of the association between home-school dissonance and classroom disruptive behavior. Findings and limitations are discussed.

Examining the Associations Among Home–School Dissonance, Amotivation, and Classroom Disruptive Behavior for Urban High School Students

PubMed Central

Brown-Wright, Lynda; Tyler, Kenneth M.; Graves, Scott L.; Thomas, Deneia; Stevens-Watkins, Danelle; Mulder, Shambra

2015-01-01

The current study examined the association among home–school dissonance, amotivation, and classroom disruptive behavior among 309 high school juniors and seniors at two urban high schools in the Southern region of the country. Students completed two subscales of the Patterns of Learning Activities Scales (PALS) and one subscale of the Academic Motivation Scale (AMS). ANCOVA analyses revealed significant differences in classroom disruptive behaviors for the gender independent variable. Controlling for gender in the multiple hierarchical regression analyses, it was revealed that home–school dissonance significantly predicted both amotivation and classroom disruptive behavior. In addition, a Sobel mediation analysis showed that amotivation was a significant mediator of the association between home–school dissonance and classroom disruptive behavior. Findings and limitations are discussed. PMID:27081213

Ecstasy Use and Suicidal Behavior Among Adolescents: Findings from a National Survey

PubMed Central

Kim, Jueun; Fan, Bin; Liu, Xinhua; Kerner, Nancy; Wu, Ping

2011-01-01

This study examines the relationship between ecstasy use and suicidal behaviors among adolescents in the United States. Data from the adolescent subsample (ages 12–17, N=19,301) of the 2000 NHSDA were used in the analyses. Information on adolescent substance use, suicidal behaviors and related socio-demographic, family and individual factors was obtained in the survey. The rate of past year suicide attempt among adolescents with lifetime ecstasy use was almost double that of adolescents who had used other drugs only, and nine times that of adolescents with no history of illicit drug use. In multinomial logistic regression analyses, controlling for related factors, the effect of ecstasy use remained significant. Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts. PMID:21631573

Brief Motivational Interventions Are Associated With Reductions in Alcohol-Impaired Driving Among College Drinkers.

PubMed

Teeters, Jenni B; Borsari, Brian; Martens, Matthew P; Murphy, James G

2015-09-01

Alcohol-impaired (AI) driving among college students remains a significant public health concern and may be the single most risky drinking outcome among young adults. Brief motivational interventions (BMIs) have been shown to reduce alcohol use and problems, but their specific efficacy for decreasing AI driving among college students is unknown. The present study analyzed data from three randomized controlled trials of BMI (Murphy et al., 2010: n = 74; Borsari et al., 2012: n = 530; and Martens et al., 2013: n = 365) to evaluate whether BMIs are associated with reductions in AI driving among college student drinkers. Participants in all three studies were randomized to BMI or control conditions. Participants reported whether they had driven under the influence (yes/no) following the BMI over the follow-up period. Separate binary logistic regression analyses were conducted for each study. For Studies 1 and 2, these analyses revealed that a BMI was significantly associated with reductions in AI driving at the final (6-month and 9-month, respectively) follow-up compared with the control condition. For Study 3, analyses revealed that a single-component BMI focused on the correction of misperceptions of descriptive norms was significantly associated with reductions in AI driving compared with the control group at the final (6-month) followup, whereas a single-component BMI focused on the use of protective behavioral strategies was not. Change in drinking level did not mediate the relationship between the condition and the change in AI driving. Counselor-administered BMIs that include descriptive normative feedback are associated with significant reductions in AI driving compared with control.

Ultrasound analysis of mental artery flow in elderly patients: a case–control study

PubMed Central

Baladi, Marina G; Tucunduva Neto, Raul R C M; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

2015-01-01

Objectives: Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. Methods: This case–control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. Results: A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86–15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Conclusions: Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height. PMID:26205777

Regression Analysis: Legal Applications in Institutional Research

ERIC Educational Resources Information Center

Frizell, Julie A.; Shippen, Benjamin S., Jr.; Luna, Andrew L.

2008-01-01

This article reviews multiple regression analysis, describes how its results should be interpreted, and instructs institutional researchers on how to conduct such analyses using an example focused on faculty pay equity between men and women. The use of multiple regression analysis will be presented as a method with which to compare salaries of…

Regression Effects in Angoff Ratings: Examples from Credentialing Exams

ERIC Educational Resources Information Center

Wyse, Adam E.

2018-01-01

This article discusses regression effects that are commonly observed in Angoff ratings where panelists tend to think that hard items are easier than they are and easy items are more difficult than they are in comparison to estimated item difficulties. Analyses of data from two credentialing exams illustrate these regression effects and the…

CyTOF workflow: differential discovery in high-throughput high-dimensional cytometry datasets

PubMed Central

Nowicka, Malgorzata; Krieg, Carsten; Weber, Lukas M.; Hartmann, Felix J.; Guglietta, Silvia; Becher, Burkhard; Levesque, Mitchell P.; Robinson, Mark D.

2017-01-01

High dimensional mass and flow cytometry (HDCyto) experiments have become a method of choice for high throughput interrogation and characterization of cell populations.Here, we present an R-based pipeline for differential analyses of HDCyto data, largely based on Bioconductor packages. We computationally define cell populations using FlowSOM clustering, and facilitate an optional but reproducible strategy for manual merging of algorithm-generated clusters. Our workflow offers different analysis paths, including association of cell type abundance with a phenotype or changes in signaling markers within specific subpopulations, or differential analyses of aggregated signals. Importantly, the differential analyses we show are based on regression frameworks where the HDCyto data is the response; thus, we are able to model arbitrary experimental designs, such as those with batch effects, paired designs and so on. In particular, we apply generalized linear mixed models to analyses of cell population abundance or cell-population-specific analyses of signaling markers, allowing overdispersion in cell count or aggregated signals across samples to be appropriately modeled. To support the formal statistical analyses, we encourage exploratory data analysis at every step, including quality control (e.g. multi-dimensional scaling plots), reporting of clustering results (dimensionality reduction, heatmaps with dendrograms) and differential analyses (e.g. plots of aggregated signals). PMID:28663787

No Association of Coronary Artery Disease with X-Chromosomal Variants in Comprehensive International Meta-Analysis

PubMed Central

Loley, Christina; Alver, Maris; Assimes, Themistocles L.; Bjonnes, Andrew; Goel, Anuj; Gustafsson, Stefan; Hernesniemi, Jussi; Hopewell, Jemma C.; Kanoni, Stavroula; Kleber, Marcus E.; Lau, King Wai; Lu, Yingchang; Lyytikäinen, Leo-Pekka; Nelson, Christopher P.; Nikpay, Majid; Qu, Liming; Salfati, Elias; Scholz, Markus; Tukiainen, Taru; Willenborg, Christina; Won, Hong-Hee; Zeng, Lingyao; Zhang, Weihua; Anand, Sonia S.; Beutner, Frank; Bottinger, Erwin P.; Clarke, Robert; Dedoussis, George; Do, Ron; Esko, Tõnu; Eskola, Markku; Farrall, Martin; Gauguier, Dominique; Giedraitis, Vilmantas; Granger, Christopher B.; Hall, Alistair S.; Hamsten, Anders; Hazen, Stanley L.; Huang, Jie; Kähönen, Mika; Kyriakou, Theodosios; Laaksonen, Reijo; Lind, Lars; Lindgren, Cecilia; Magnusson, Patrik K. E.; Marouli, Eirini; Mihailov, Evelin; Morris, Andrew P.; Nikus, Kjell; Pedersen, Nancy; Rallidis, Loukianos; Salomaa, Veikko; Shah, Svati H.; Stewart, Alexandre F. R.; Thompson, John R.; Zalloua, Pierre A.; Chambers, John C.; Collins, Rory; Ingelsson, Erik; Iribarren, Carlos; Karhunen, Pekka J.; Kooner, Jaspal S.; Lehtimäki, Terho; Loos, Ruth J. F.; März, Winfried; McPherson, Ruth; Metspalu, Andres; Reilly, Muredach P.; Ripatti, Samuli; Sanghera, Dharambir K.; Thiery, Joachim; Watkins, Hugh; Deloukas, Panos; Kathiresan, Sekar; Samani, Nilesh J.; Schunkert, Heribert; Erdmann, Jeanette; König, Inke R.

2016-01-01

In recent years, genome-wide association studies have identified 58 independent risk loci for coronary artery disease (CAD) on the autosome. However, due to the sex-specific data structure of the X chromosome, it has been excluded from most of these analyses. While females have 2 copies of chromosome X, males have only one. Also, one of the female X chromosomes may be inactivated. Therefore, special test statistics and quality control procedures are required. Thus, little is known about the role of X-chromosomal variants in CAD. To fill this gap, we conducted a comprehensive X-chromosome-wide meta-analysis including more than 43,000 CAD cases and 58,000 controls from 35 international study cohorts. For quality control, sex-specific filters were used to adequately take the special structure of X-chromosomal data into account. For single study analyses, several logistic regression models were calculated allowing for inactivation of one female X-chromosome, adjusting for sex and investigating interactions between sex and genetic variants. Then, meta-analyses including all 35 studies were conducted using random effects models. None of the investigated models revealed genome-wide significant associations for any variant. Although we analyzed the largest-to-date sample, currently available methods were not able to detect any associations of X-chromosomal variants with CAD. PMID:27731410

In vitro evaluation of Augmentin by broth microdilution and disk diffusion susceptibility testing: regression analysis, tentative interpretive criteria, and quality control limits.

PubMed Central

Fuchs, P C; Barry, A L; Thornsberry, C; Gavan, T L; Jones, R N

1983-01-01

Augmentin (Beecham Laboratories, Bristol, Tenn.), a combination drug consisting of two parts amoxicillin to one part clavulanic acid and a potent beta-lactamase inhibitor, was evaluated in vitro in comparison with ampicillin or amoxicillin or both for its inhibitory and bactericidal activities against selected clinical isolates. Regression analysis was performed and tentative disk diffusion susceptibility breakpoints were determined. A multicenter performance study of the disk diffusion test was conducted with three quality control organisms to determine tentative quality control limits. All methicillin-susceptible staphylococci and Haemophilus influenzae isolates were susceptible to Augmentin, although the minimal inhibitory concentrations for beta-lactamase-producing strains of both groups were, on the average, fourfold higher than those for enzyme-negative strains. Among the Enterobacteriaceae, Augmentin exhibited significantly greater activity than did ampicillin against Klebsiella pneumoniae, Citrobacter diversus, Proteus vulgaris, and about one-third of the Escherichia coli strains tested. Bactericidal activity usually occurred at the minimal inhibitory concentration. There was a slight inoculum concentration effect on the Augmentin minimal inhibitory concentrations. On the basis of regression and error rate-bounded analyses, the suggested interpretive disk diffusion susceptibility breakpoints for Augmentin are: susceptible, greater than or equal to 18 mm; resistant, less than or equal to 13 mm (gram-negative bacilli); and susceptible, greater than or equal to 20 mm (staphylococci and H. influenzae). The use of a beta-lactamase-producing organism, such as E. coli Beecham 1532, is recommended for quality assurance of Augmentin susceptibility testing. PMID:6625554

Publication bias in obesity treatment trials?

PubMed

Allison, D B; Faith, M S; Gorman, B S

1996-10-01

The present investigation examined the extent of publication bias (namely the tendency to publish significant findings and file away non-significant findings) within the obesity treatment literature. Quantitative literature synthesis of four published meta-analyses from the obesity treatment literature. Interventions in these studies included pharmacological, educational, child, and couples treatments. To assess publication bias, several regression procedures (for example weighted least-squares, random-effects multi-level modeling, and robust regression methods) were used to regress effect sizes onto their standard errors, or proxies thereof, within each of the four meta-analysis. A significant positive beta weight in these analyses signified publication bias. There was evidence for publication bias within two of the four published meta-analyses, such that reviews of published studies were likely to overestimate clinical efficacy. The lack of evidence for publication bias within the two other meta-analyses might have been due to insufficient statistical power rather than the absence of selection bias. As in other disciplines, publication bias appears to exist in the obesity treatment literature. Suggestions are offered for managing publication bias once identified or reducing its likelihood in the first place.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Qichun; Zhang, Xuesong; Xu, Xingya

Riverine carbon cycling is an important, but insufficiently investigated component of the global carbon cycle. Analyses of environmental controls on riverine carbon cycling are critical for improved understanding of mechanisms regulating carbon processing and storage along the terrestrial-aquatic continuum. Here, we compile and analyze riverine dissolved organic carbon (DOC) concentration data from 1402 United States Geological Survey (USGS) gauge stations to examine the spatial variability and environmental controls of DOC concentrations in the United States (U.S.) surface waters. DOC concentrations exhibit high spatial variability, with an average of 6.42 ± 6.47 mg C/ L (Mean ± Standard Deviation). In general,more » high DOC concentrations occur in the Upper Mississippi River basin and the Southeastern U.S., while low concentrations are mainly distributed in the Western U.S. Single-factor analysis indicates that slope of drainage areas, wetlands, forests, percentage of first-order streams, and instream nutrients (such as nitrogen and phosphorus) pronouncedly influence DOC concentrations, but the explanatory power of each bivariate model is lower than 35%. Analyses based on the general multi-linear regression models suggest DOC concentrations are jointly impacted by multiple factors. Soil properties mainly show positive correlations with DOC concentrations; forest and shrub lands have positive correlations with DOC concentrations, but urban area and croplands demonstrate negative impacts; total instream phosphorus and dam density correlate positively with DOC concentrations. Notably, the relative importance of these environmental controls varies substantially across major U.S. water resource regions. In addition, DOC concentrations and environmental controls also show significant variability from small streams to large rivers, which may be caused by changing carbon sources and removal rates by river orders. In sum, our results reveal that general multi-linear regression analysis of twenty one terrestrial and aquatic environmental factors can partially explain (56%) the DOC concentration variation. In conclusion, this study highlights the complexity of the interactions among these environmental factors in determining DOC concentrations, thus calls for processes-based, non-linear methodologies to constrain uncertainties in riverine DOC cycling.« less

Authors of clinical trials reported individual and financial conflicts of interest more frequently than institutional and nonfinancial ones: a methodological survey.

PubMed

Hakoum, Maram B; Jouni, Nahla; Abou-Jaoude, Eliane A; Hasbani, Divina Justina; Abou-Jaoude, Elias A; Lopes, Luciane Cruz; Khaldieh, Mariam; Hammoud, Mira Z; Al-Gibbawi, Mounir; Anouti, Sirine; Guyatt, Gordon; Akl, Elie A

2017-07-01

Conflicts of interest (COIs) are increasingly recognized as important to disclose and manage in health research. The objective of this study was to assess the reporting of both financial and nonfinancial COI by authors of randomized controlled trials published in a representative sample of clinical journals. We searched Ovid Medline and included a random sample of 200 randomized controlled trials published in 2015 in one of the 119 Core Clinical Journals. We classified COI using a comprehensive framework that includes the following: individual COIs (financial, professional, scholarly, advocatory, personal) and institutional COIs (financial, professional, scholarly, and advocatory). We conducted descriptive and regression analyses. Of the 200 randomized controlled trials, 188 (94%) reported authors' COI disclosures that were available in the main document (92%) and as International Committee of Medical Journal Editors forms accessible online (12%). Of the 188 trials, 57% had at least one author reporting at least one COI; in all these trials, at least one author reported financial COI. Institutional COIs (11%) and nonfinancial COIs (4%) were less commonly reported. References to COI disclosure statements for editors (1%) and medical writers (0%) were seldom present. Regression analyses showed positive associations between reporting individual financial COI and higher journal impact factor (odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.02-1.10), larger number of authors (OR = 1.10, 95% CI 1.02-1.20), affiliation with an institution from a high-income country (OR = 16.75, 95% CI 3.38-82.87), and trials reporting on pharmacological interventions (OR = 2.28, 95% CI 1.13-4.62). More than half of published randomized controlled trials report that at least one author has a COI. Trial authors report financial COIs more often than nonfinancial COIs and individual COIs more frequently than institutional COIs. Copyright © 2017 Elsevier Inc. All rights reserved.

What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

PubMed

Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

2007-08-15

Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

Can adverse maternal and perinatal outcomes be predicted when blood pressure becomes elevated? Secondary analyses from the CHIPS (Control of Hypertension In Pregnancy Study) randomized controlled trial.

PubMed

Magee, Laura A; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Gruslin, Andrée; Helewa, Michael; Hutton, Eileen; Lee, Shoo K; Logan, Alexander G; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G; Moutquin, Jean Marie

2016-07-01

For women with chronic or gestational hypertension in CHIPS (Control of Hypertension In Pregnancy Study, NCT01192412), we aimed to examine whether clinical predictors collected at randomization could predict adverse outcomes. This was a planned, secondary analysis of data from the 987 women in the CHIPS Trial. Logistic regression was used to examine the impact of 19 candidate predictors on the probability of adverse perinatal (pregnancy loss or high level neonatal care for >48 h, or birthweight <10th percentile) or maternal outcomes (severe hypertension, preeclampsia, or delivery at <34 or <37 weeks). A model containing all candidate predictors was used to start the stepwise regression process based on goodness of fit as measured by the Akaike information criterion. For face validity, these variables were forced into the model: treatment group ("less tight" or "tight" control), antihypertensive type at randomization, and blood pressure within 1 week before randomization. Continuous variables were represented continuously or dichotomized based on the smaller p-value in univariate analyses. An area-under-the-receiver-operating-curve (AUC ROC) of ≥0.70 was taken to reflect a potentially useful model. Point estimates for AUC ROC were <0.70 for all but severe hypertension (0.70, 95% CI 0.67-0.74) and delivery at <34 weeks (0.71, 95% CI 0.66-0.75). Therefore, no model warranted further assessment of performance. CHIPS data suggest that when women with chronic hypertension develop an elevated blood pressure in pregnancy, or formerly normotensive women develop new gestational hypertension, maternal and current pregnancy clinical characteristics cannot predict adverse outcomes in the index pregnancy. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

What Is Different About Worker’s Compensation Patients?

PubMed Central

Atlas, Steven J.; Tosteson, Tor D.; Hanscom, Brett; Blood, Emily A.; Pransky, Glenn S.; Abdu, William A.; Andersson, Gunnar B.; Weinstein, James N.

2010-01-01

Study Design Combined analysis of 2 prospective clinical studies. Objective To identify socioeconomic characteristics associated with workers’ compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Summary of Background Data Few studies have compared socioeconomic differences between those receiving or not receiving workers’ compensation with the same underlying clinical conditions. Methods Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers’ compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers’ compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Results Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers’ compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers’ compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers’ compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers’ compensation. Conclusion Clinical trials involving conditions commonly seen in patients with workers’ compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers’ compensation. Identifying the independent effects of workers’ compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status. PMID:17700451

Evaluating exposures to complex mixtures of chemicals during a new production process in the plastics industry.

PubMed

Meijster, Tim; Burstyn, Igor; Van Wendel De Joode, Berna; Posthumus, Maarten A; Kromhout, Hans

2004-08-01

The goal of this study was to monitor emission of chemicals at a factory where plastics products were fabricated by a new robotic (impregnated tape winding) production process. Stationary and personal air measurements were taken to determine which chemicals were released and at what concentrations. Principal component analyses (PCA) and linear regression were used to determine the emission sources of different chemicals found in the air samples. We showed that complex mixtures of chemicals were released, but most concentrations were below Dutch exposure limits. Based on the results of the principal component analyses, the chemicals found were divided into three groups. The first group consisted of short chain aliphatic hydrocarbons (C2-C6). The second group included larger hydrocarbons (C9-C11) and some cyclic hydrocarbons. The third group contained all aromatic and two aliphatic hydrocarbons. Regression analyses showed that emission of the first group of chemicals was associated with cleaning activities and the use of epoxy resins. The second and third group showed strong association with the type of tape used in the new tape winding process. High levels of CO and HCN (above exposure limits) were measured on one occasion when a different brand of impregnated polypropylene sulphide tape was used in the tape winding process. Plans exist to drastically increase production with the new tape winding process. This will cause exposure levels to rise and therefore further control measures should be installed to reduce release of these chemicals.

Automated analysis of heidelberg retina tomograph optic disc images by glaucoma probability score.

PubMed

Coops, Annemiek; Henson, David Barry; Kwartz, Anna J; Artes, Paul Habib

2006-12-01

To compare the diagnostic performance of the Heidelberg Retinal Tomograph's (HRT; Heidelberg Engineering GmbH, Dossenheim, Germany) glaucoma probability score (GPS), an automated, contour line-independent method of optic disc analysis with that of the Moorfields regression analysis (MRA). HRT images were obtained from one eye of 121 patients with glaucoma (median age, 70.2 years; median mean deviation [MD], -3.6 dB, range, +2.0 to -9.9 dB) and 95 healthy control subjects (median age, 59.7 years; median MD -0.1 dB, range +2.5 to -3.7). The diagnostic performances of GPS and MRA were evaluated by including borderline classifications, either as test negatives (most specific criteria) or as test positives (least specific criteria). Agreement between global and sectoral data of both analyses was established. Logistic regression analyses were performed to evaluate the effect of covariates such as optic disc size and age on the classification outcomes of both the GPS and the MRA. In 8 (7%) patients with glaucoma and 10 (11%) control subjects, the GPS failed to provide a complete global and sectoral optic disc classification. Although we could not identify a single distinct cause of this failure in the glaucoma group, failures in the control subjects occurred most often (7/10) with small and crowded optic discs. In subjects who were successfully classified at least globally by the GPS (117 patients with glaucoma, 88 control subjects), the diagnostic performances of GPS and MRA were similar (areas under the receiver operating characteristic [ROC] curve of 0.78 and 0.77, respectively; P > 0.1). With the GPS, sensitivity and specificity were 59% and 91% (most specific criteria) and 78% and 63% (least specific criteria), respectively. Combining GPS and MRA did not increase diagnostic performance significantly (ROC area of combined classifiers, 0.81). Both GPS and MRA were affected by disc size. In patients with glaucoma as well as healthy control subjects, the odds of a positive GPS classification (borderline or outside normal limits) increased by 21% (95% confidence interval [CI], 12%-30%) for each 0.1 mm2 increase in optic disc area. With the MRA, the corresponding increase was 15% (95% CI, 7%-23%). Optic disc area alone accounted for approximately 30% and 22% of the explained variance with the GPS and MRA, respectively (P < 0.001). The proportional-odds logistic regression confirmed that optic disc size affected mainly the tradeoff between true- and false-positive classifications (criterion) rather than the absolute performance of the analyses (area under the ROC curve). There was some evidence of an age effect with the MRA, which showed a 53% (95% CI, 16%-102%) increase in the odds of a positive test (borderline or outside normal limits) associated with each decade of age (P = 0.002), but no age effects were observed with the GPS (P > 0.1). The diagnostic performance of the contour line-independent GPS analysis is similar to that of the MRA. However, clinicians should be aware of the strong size dependence of both GPS and MRA. In large optic discs, both GPS and MRA are likely to produce many false-positive classifications. Correspondingly, the sensitivity to early damage is likely to be low in small optic discs. There is a need for automated classification systems that explicitly address the size dependence of current analyses.

Motivation and Barriers for Leisure-Time Physical Activity in Socioeconomically Disadvantaged Women.

PubMed

Santos, Inês; Ball, Kylie; Crawford, David; Teixeira, Pedro J

2016-01-01

The aim of this study was to examine cross-sectional and longitudinal associations between motivation and barriers for physical activity, and physical activity behavior in women living in socioeconomic disadvantage. This study also examined whether weight control intentions moderate those associations. Data from 1664 women aged 18-46 years was collected at baseline and three-year follow-up as part of the Resilience for Eating and Activity Despite Inequality study. In mail-based surveys, women reported sociodemographic and neighborhood environmental characteristics, intrinsic motivation, goals and perceived family barriers to be active, weight control intentions and leisure-time physical activity (assessed through the IPAQ-L). Linear regression models assessed the association of intrinsic motivation, goals and barriers with physical activity at baseline and follow-up, adjusting for environmental characteristics and also physical activity at baseline (for longitudinal analyses), and the moderating effects of weight control intentions were examined. Intrinsic motivation and, to a lesser extent, appearance and relaxation goals for being physically active were consistently associated with leisure-time physical activity at baseline and follow-up. Perceived family barriers, health, fitness, weight and stress relief goals were associated with leisure-time physical activity only at baseline. Moderated regression analyses revealed that weight control intentions significantly moderated the association between weight goals and leisure-time physical activity at baseline (β = 0.538, 99% CI = 0.057, 0.990) and between intrinsic motivation and leisure-time physical activity at follow-up (β = 0.666, 99% CI = 0.188, 1.145). For women actively trying to control their weight, intrinsic motivation was significantly associated with leisure-time physical activity at follow-up (β = 0.184, 99% CI = 0.097, 0.313). Results suggest that, especially in women trying to control their weight, intrinsic motivation plays an important role in sustaining physical activity participation over time. Also, weight goals for being physically active seem to play a role regarding short-term physical activity participation in this particular population. Addressing these motivational features may be important when promoting physical activity participation in women living in socioeconomically disadvantaged neighborhoods.

Motivation and Barriers for Leisure-Time Physical Activity in Socioeconomically Disadvantaged Women

PubMed Central

Santos, Inês; Ball, Kylie; Crawford, David; Teixeira, Pedro J.

2016-01-01

Introduction The aim of this study was to examine cross-sectional and longitudinal associations between motivation and barriers for physical activity, and physical activity behavior in women living in socioeconomic disadvantage. This study also examined whether weight control intentions moderate those associations. Methods Data from 1664 women aged 18–46 years was collected at baseline and three-year follow-up as part of the Resilience for Eating and Activity Despite Inequality study. In mail-based surveys, women reported sociodemographic and neighborhood environmental characteristics, intrinsic motivation, goals and perceived family barriers to be active, weight control intentions and leisure-time physical activity (assessed through the IPAQ-L). Linear regression models assessed the association of intrinsic motivation, goals and barriers with physical activity at baseline and follow-up, adjusting for environmental characteristics and also physical activity at baseline (for longitudinal analyses), and the moderating effects of weight control intentions were examined. Results Intrinsic motivation and, to a lesser extent, appearance and relaxation goals for being physically active were consistently associated with leisure-time physical activity at baseline and follow-up. Perceived family barriers, health, fitness, weight and stress relief goals were associated with leisure-time physical activity only at baseline. Moderated regression analyses revealed that weight control intentions significantly moderated the association between weight goals and leisure-time physical activity at baseline (β = 0.538, 99% CI = 0.057, 0.990) and between intrinsic motivation and leisure-time physical activity at follow-up (β = 0.666, 99% CI = 0.188, 1.145). For women actively trying to control their weight, intrinsic motivation was significantly associated with leisure-time physical activity at follow-up (β = 0.184, 99% CI = 0.097, 0.313). Conclusions Results suggest that, especially in women trying to control their weight, intrinsic motivation plays an important role in sustaining physical activity participation over time. Also, weight goals for being physically active seem to play a role regarding short-term physical activity participation in this particular population. Addressing these motivational features may be important when promoting physical activity participation in women living in socioeconomically disadvantaged neighborhoods. PMID:26808440

Modelling nitrate pollution pressure using a multivariate statistical approach: the case of Kinshasa groundwater body, Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Mfumu Kihumba, Antoine; Ndembo Longo, Jean; Vanclooster, Marnik

2016-03-01

A multivariate statistical modelling approach was applied to explain the anthropogenic pressure of nitrate pollution on the Kinshasa groundwater body (Democratic Republic of Congo). Multiple regression and regression tree models were compared and used to identify major environmental factors that control the groundwater nitrate concentration in this region. The analyses were made in terms of physical attributes related to the topography, land use, geology and hydrogeology in the capture zone of different groundwater sampling stations. For the nitrate data, groundwater datasets from two different surveys were used. The statistical models identified the topography, the residential area, the service land (cemetery), and the surface-water land-use classes as major factors explaining nitrate occurrence in the groundwater. Also, groundwater nitrate pollution depends not on one single factor but on the combined influence of factors representing nitrogen loading sources and aquifer susceptibility characteristics. The groundwater nitrate pressure was better predicted with the regression tree model than with the multiple regression model. Furthermore, the results elucidated the sensitivity of the model performance towards the method of delineation of the capture zones. For pollution modelling at the monitoring points, therefore, it is better to identify capture-zone shapes based on a conceptual hydrogeological model rather than to adopt arbitrary circular capture zones.

Psychological inflexibility and depressive symptoms among Asian English speakers: A study on Indian, Philippine, and Singaporean samples.

PubMed

Kato, Tsukasa

2016-04-30

Psychological inflexibility is a core concept in Acceptance and Commitment Therapy. The primary aim of this study was to examine psychological inflexibility and depressive symptoms among Asian English speakers. A total of 900 adults in India, the Philippines, and Singapore completed some measures related to psychological inflexibility and depressive symptoms through a Web-based survey. Multiple regression analyses revealed that higher psychological inflexibility was significantly associated with higher levels of depressive symptoms in all the samples, after controlling for the effects of gender, marital status, and interpersonal stress. In addition, the effect sizes of the changes in the R(2) values when only psychological flexibility scores were entered in the regression model were large for all the samples. Moreover, overall, the beta-weight of the psychological flexibility scores obtained by the Philippine sample was the lowest of all three samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Role of social support, hardiness, and acculturation as predictors of mental health among international students of Asian Indian origin.

PubMed

Atri, Ashutosh; Sharma, Manoj; Cottrell, Randall

This study determined the role of social support, hardiness, and acculturation as predictors of mental health among international Asian Indian students enrolled at two large public universities in Ohio. A sample of 185 students completed a 75-item online instrument assessing their social support levels, acculturation, hardiness, and their mental health. Regression analyses were conducted to test for variance in mental health attributable to each of the three independent variables. The final regression model revealed that the belonging aspect of social support, acculturation and prejudice of acculturation scale, and commitment and control of hardiness were all predictive of mental health (R2 = 0.523). Recommendations have been offered to develop interventions that will help strengthen the social support, hardiness, and acculturation of international students and help improve their mental health. Recommendations for development of future Web-based studies also are offered.

CADDIS Volume 4. Data Analysis: Basic Analyses

EPA Pesticide Factsheets

Use of statistical tests to determine if an observation is outside the normal range of expected values. Details of CART, regression analysis, use of quantile regression analysis, CART in causal analysis, simplifying or pruning resulting trees.

Effect of Placenta Previa on Preeclampsia

PubMed Central

Ying, Hao; Lu, Yi; Dong, Yi-Nuo; Wang, De-Fen

2016-01-01

Background The correlation between gestational hypertension-preeclampsia (GH-PE) and placenta previa (PP) is controversial. Specifically, it is unknown whether placenta previa has any effect on the various types of preeclampsia (PE), and the role PP with concurrent placenta accreta (PA) play in the occurrence of GH-PE are not well understood. Objective The aim of this study was to identify the effects of PP on GH, mild and severe preeclampsia (MPE and SPE), and early- and late-onset preeclampsia (EPE and LPE). Another aim of the study was to determine if concurrent PA impacts the relationship between PP and GH-PE. Methods A retrospective single-center study of 1,058 patients having singleton pregnancies with PP was performed, and 2,116 pregnant women were randomly included as controls. These cases were collected from a tertiary hospital and met the inclusion criteria for the study. Clinical information, including PP and the gestational age at the onset of GH-PE were collected. Binary and multiple logistic regression analyses were conducted after the confounding variables were controlled to assess the effects of PP on different types of GH-PE. Results There were 155 patients with GH-PE in the two groups. The incidences of GH-PE in the PP group and the control group were 2.5% (26/1058) and 6.1% (129/2116), respectively (P = 0.000). Binary and multiple regression analyses were conducted after controlling for confounding variables. Compared to the control group, in the PP group, the risk of GH-PE was reduced significantly by 78% (AOR: 0.216; 95% CI: 0.135–0.345); the risks of GH and PE were reduced by 55% (AOR: 0.451; 95% CI: 0.233–0.873) and 86% (AOR: 0.141; 95% CI: 0.073–0.271), respectively; the risks of MPE and SPE were reduced by 73% (AOR: 0.269; 95% CI: 0.087–0828) and 88% (AOR: 0.123; 95% CI: 0.055–0.279), respectively; and the risks of EPE and LPE were reduced by 95% (AOR: 0.047; 95% CI: 0.012–0.190) and 67% (AOR: 0.330; 95% CI: 0.153–0.715), respectively. The incidence of concurrent PA in women with PP was 5.86%; PP with PA did not significantly further reduce the incidence of GH-PE compared with PP without PA (1.64% vs. 2.51%, P>0.05). Binary logistic regression analyses were conducted after controlling for confounding variables, compared with the non-PP + GH-PE group, and the AOR of FGR in the non-PP + non-GH-PE group was 0.206 (0.124–0.342). Compared with the PP + GH-PE group, the AOR of FGR in the PP + non-GH-PE group was 0.430 (0.123–1.500). Conclusion PP is not only associated with a significant reduction in the incidence of GH-PE, but also is associated with a reduction in incidence of various types of PE. Concurrent PA and PP do not show association with a reduction in incidence of GH-PE. PMID:26731265

Neighbourhood social capital as a moderator between individual cognitions and sports behaviour among Dutch adolescents.

PubMed

Prins, R G; Beenackers, M A; Boog, M C; Van Lenthe, F J; Brug, J; Oenema, A

2014-03-01

This study aimed to explore whether individual cognitions and neighbourhood social capital strengthen each other in their relation with engaging in sports at least three times per week. Cross-sectional analyses on data from the last wave of the YouRAction trial (2009-2010, Rotterdam, the Netherlands; baseline response: 98%) were conducted. In total 1129 had data on the last wave questionnaire (93%) and 832 of them had complete data on a self-administered questionnaire on frequency of sports participation, perceived neighbourhood social capital, cognitions (attitude, subjective norm, perceived behavioural control and intention toward sport participation) and demographics. Ecometric methods were used to aggregate perceived neighbourhood social capital to the neighbourhood level. Multilevel logistic regression analyses (neighbourhood and individual as levels) were conducted to examine associations of cognitions, neighbourhood social capital and the social capital by individual cognition interaction with fit norm compliance. If the interaction was significant, simple slopes analyses were conducted to decompose interaction effects. It was found that neighbourhood social capital was significantly associated with fit norm compliance (OR: 5.40; 95% CI: 1.13-25.74). Moreover, neighbourhood social capital moderated the association of attitude, perceived behavioural control and intention with fit norm compliance. The simple slope analyses visualized that the associations of cognitions with fit norm compliance were stronger in case of more neighbourhood social capital. Hence, higher levels of neighbourhood social capital strengthen the associations of attitude, perceived behavioural control and intention in their association with fit norm compliance. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effectiveness of a worksite mindfulness-based multi-component intervention on lifestyle behaviors

PubMed Central

2014-01-01

Introduction Overweight and obesity are associated with an increased risk of morbidity. Mindfulness training could be an effective strategy to optimize lifestyle behaviors related to body weight gain. The aim of this study was to evaluate the effectiveness of a worksite mindfulness-based multi-component intervention on vigorous physical activity in leisure time, sedentary behavior at work, fruit intake and determinants of these behaviors. The control group received information on existing lifestyle behavior- related facilities that were already available at the worksite. Methods In a randomized controlled trial design (n = 257), 129 workers received a mindfulness training, followed by e-coaching, lunch walking routes and fruit. Outcome measures were assessed at baseline and after 6 and 12 months using questionnaires. Physical activity was also measured using accelerometers. Effects were analyzed using linear mixed effect models according to the intention-to-treat principle. Linear regression models (complete case analyses) were used as sensitivity analyses. Results There were no significant differences in lifestyle behaviors and determinants of these behaviors between the intervention and control group after 6 or 12 months. The sensitivity analyses showed effect modification for gender in sedentary behavior at work at 6-month follow-up, although the main analyses did not. Conclusions This study did not show an effect of a worksite mindfulness-based multi-component intervention on lifestyle behaviors and behavioral determinants after 6 and 12 months. The effectiveness of a worksite mindfulness-based multi-component intervention as a health promotion intervention for all workers could not be established. PMID:24467802

Validation of the Cepstral Spectral Index of Dysphonia (CSID) as a Screening Tool for Voice Disorders: Development of Clinical Cutoff Scores.

PubMed

Awan, Shaheen N; Roy, Nelson; Zhang, Dong; Cohen, Seth M

2016-03-01

The purposes of this study were to (1) evaluate the performance of the Cepstral Spectral Index of Dysphonia (CSID--a multivariate estimate of dysphonia severity) as a potential screening tool for voice disorder identification and (2) identify potential clinical cutoff scores to classify voice-disordered cases versus controls. Subjects were 332 men and women (116 men, 216 women) comprised of subjects who presented to a physician with a voice-related complaint and a group of non-voice-related control subjects. Voice-disordered cases versus controls were initially defined via three reference standards: (1) auditory-perceptual judgment (dysphonia +/-); (2) Voice Handicap Index (VHI) score (VHI +/-); and (3) laryngoscopic description (laryngoscopic +/-). Speech samples were analyzed using the Analysis of Dysphonia in Speech and Voice program. Cepstral and spectral measures were combined into a CSID multivariate formula which estimated dysphonia severity for Rainbow Passage samples (i.e., the CSIDR). The ability of the CSIDR to accurately classify cases versus controls in relation to each reference standard was evaluated via a combination of logistic regression and receiver operating characteristic (ROC) analyses. The ability of the CSIDR to discriminate between cases and controls was represented by the "area under the ROC curve" (AUC). ROC classification of dysphonia-positive cases versus controls resulted in a strong AUC = 0.85. A CSIDR cutoff of ≈24 achieved the best balance between sensitivity and specificity, whereas a more liberal cutoff score of ≈19 resulted in higher sensitivity while maintaining respectable specificity which may be preferred for screening purposes. Weaker but adequate AUCs = 0.75 and 0.73 were observed for the classification of VHI-positive and laryngoscopic-positive cases versus controls, respectively. Logistic regression analyses indicated that subject age may be a significant covariate in the discrimination of dysphonia-positive and VHI-positive cases versus controls. The CSIDR can provide a strong level of accuracy for the classification of voice-disordered cases versus controls, particularly when auditory-perceptual judgment is used as the reference standard. Although users often focus on a cutoff score that achieves a balance between sensitivity and specificity, more liberal cutoffs for screening purposes versus conservative cutoffs when cost or risk of further evaluation is deemed to be high should also be considered. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Obsessions and worry beliefs in an inpatient OCD population.

PubMed

Calleo, Jessica S; Hart, John; Björgvinsson, Thröstur; Stanley, Melinda A

2010-12-01

Dysfunctional beliefs in obsessive-compulsive disorder (OCD) and worry are thought to contribute to vulnerability and maintenance of pathological anxiety. In this study, five belief domains concerning responsibility/threat estimation, perfectionism, intolerance of uncertainty, importance/control of thoughts and thought-action fusion were examined to see whether they differentially predicted worry and obsession severity in patients with severe OCD. Correlational analysis revealed that perfectionism and intolerance of uncertainty were associated with worry, whereas beliefs in the importance and control of thoughts and thought-action fusion were associated with obsession severity when obsession severity and worry, respectively, were controlled. In regression analyses, thought-action fusion and intolerance of uncertainty predicted OCD severity. The relation between dysfunctional beliefs and specific subtypes of OCD symptoms was also examined. Specific relationships were identified, including perfectionism with ordering, obsessions with control/importance of thoughts and checking and washing with threat estimation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

PubMed

Hahm, Hyeouk Chris; Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women

PubMed Central

Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women’s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women’s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population. PMID:21259042

Stressful work environment and wellbeing: What comes first?

PubMed

Elovainio, Marko; Heponiemi, Tarja; Jokela, Markus; Hakulinen, Christian; Presseau, Justin; Aalto, Anna-Mari; Kivimäki, Mika

2015-07-01

The association between the psychosocial work environment, including job demands, job control, and organizational justice, and employee wellbeing has been well established. However, the exposure to adverse work environments is typically measured only using self-reported measures that are vulnerable to reporting bias, and thus any associations found may be explained by reverse causality. Using linear regression models and cross-lagged structural equation modeling (SEM), we tested the direction of the association between established job stress models (job demand control and organizational justice models) and 3 wellbeing indicators (psychological distress, sleeping problems, and job satisfaction) among 1524 physicians in a 4-year follow-up. Results from the longitudinal cross-lagged analyses showed that the direction of the association was from low justice to decreasing wellbeing rather than the reverse. Although the pattern was similar in job demands and job control, a reciprocal association was found between job control and psychological distress. (c) 2015 APA, all rights reserved).

Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care.

PubMed

Wilson, Tracey E; Kay, Emma Sophia; Turan, Bulent; Johnson, Mallory O; Kempf, Mirjam-Colette; Turan, Janet M; Cohen, Mardge H; Adimora, Adaora A; Pereyra, Margaret; Golub, Elizabeth T; Goparaju, Lakshmi; Murchison, Lynn; Wingood, Gina M; Metsch, Lisa R

2018-06-01

This study assessed longitudinal relationships between patient healthcare empowerment, engagement in care, and viral control in the Women's Interagency HIV Study, a prospective cohort study of U.S. women living with HIV. From April 2014 to March 2016, four consecutive 6-month visits were analyzed among 973 women to assess the impact of Time 1 healthcare empowerment variables (Tolerance for Uncertainty and the state of Informed Collaboration Committed Engagement) on Time 2 reports of ≥95% HIV medication adherence and not missing an HIV primary care appointment since last visit; and on HIV RNA viral control across Times 3 and 4, controlling for illicit drug use, heavy drinking, depression symptoms, age, and income. Data were analyzed in 2017. Adherence of ≥95% was reported by 83% of women, 90% reported not missing an appointment since the last study visit, and 80% were categorized as having viral control. Logistic regression analyses revealed a significant association between the Informed Collaboration Committed Engagement subscale and viral control, controlling for model covariates (AOR=1.08, p=0.04), but not for the Tolerance for Uncertainty subscale and viral control (AOR=0.99, p=0.68). In separate mediation analyses, the indirect effect of Informed Collaboration Committed Engagement on viral control through adherence (β=0.04, SE=0.02, 95% CI=0.02, 0.08), and the indirect effect of Informed Collaboration Committed Engagement on viral control through retention (β=0.01, SE=0.008, 95% CI=0.001, 0.030) were significant. Mediation analyses with Tolerance for Uncertainty as the predictor did not yield significant indirect effects. The Informed Collaboration Committed Engagement healthcare empowerment component is a promising pathway through which to promote engagement in care among women living with HIV. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Negative religious coping as a correlate of suicidal ideation in patients with advanced cancer

PubMed Central

Trevino, K. M.; Balboni, M.; Zollfrank, A.; Balboni, T.; Prigerson, H. G.

2016-01-01

Objective The purpose of this study is to examine the relationship between negative religious coping (NRC) and suicidal ideation in patients with advanced cancer, controlling for demographic and disease characteristics and risk and protective factors for suicidal ideation. Methods Adult patients with advanced cancer (life expectancy ≤6 months) were recruited from seven medical centers in the northeastern and southwestern USA (n = 603). Trained raters verbally administered the examined measures to patients upon study entry. Multivariable logistic regression analyses regressed suicidal ideation on NRC controlling for significant demographic, disease, risk, and protective factors. Results Negative religious coping was associated with an increased risk for suicidal ideation (OR, 2.65 [95% CI, 1.22, 5.74], p = 0.01) after controlling for demographic and disease characteristics, mental and physical health, self-efficacy, secular coping, social support, spiritual care received, global religiousness and spirituality, and positive religious coping. Conclusions Negative religious coping is a robust correlate of suicidal ideation. Assessment of NRC in patients with advanced cancer may identify patients experiencing spiritual distress and those at risk for suicidal ideation. Confirmation of these results in future studies would suggest the need for interventions targeting the reduction of NRC to reduce suicidal ideation among advanced cancer patients. PMID:24577802

The association between dietary lignans, phytoestrogen-rich foods, and fiber intake and postmenopausal breast cancer risk: a German case-control study.

PubMed

Zaineddin, Aida Karina; Buck, Katharina; Vrieling, Alina; Heinz, Judith; Flesch-Janys, Dieter; Linseisen, Jakob; Chang-Claude, Jenny

2012-01-01

Phytoestrogens are structurally similar to estrogens and may affect breast cancer risk by mimicking estrogenic/antiestrogenic properties. In Western societies, whole grains and possibly soy foods are rich sources of phytoestrogens. A population-based case-control study in German postmenopausal women was used to evaluate the association of phytoestrogen-rich foods and dietary lignans with breast cancer risk. Dietary data were collected from 2,884 cases and 5,509 controls using a validated food-frequency questionnaire, which included additional questions phytoestrogen-rich foods. Associations were assessed using conditional logistic regression. All analyses were adjusted for relevant risk and confounding factors. Polytomous logistic regression analysis was performed to evaluate the associations by estrogen receptor (ER) status. High and low consumption of soybeans as well as of sunflower and pumpkin seeds were associated with significantly reduced breast cancer risk compared to no consumption (OR = 0.83, 95% CI = 0.70-0.97; and OR = 0.66, 95% CI = 0.77-0.97, respectively). The observed associations were not differential by ER status. No statistically significant associations were found for dietary intake of plant lignans, fiber, or the calculated enterolignans. Our results provide evidence for a reduced postmenopausal breast cancer risk associated with increased consumption of sunflower and pumpkin seeds and soybeans.

Development and evaluation of an electromagnetic hypersensitivity questionnaire for Japanese people

PubMed Central

Tokiya, Mikiko; Mizuki, Masami; Miyata, Mikio; Kanatani, Kumiko T.; Takagi, Airi; Tsurikisawa, Naomi; Kame, Setsuko; Katoh, Takahiko; Tsujiuchi, Takuya; Kumano, Hiroaki

2016-01-01

The purpose of the present study was to evaluate the validity and reliability of a Japanese version of an electromagnetic hypersensitivity (EHS) questionnaire, originally developed by Eltiti et al. in the United Kingdom. Using this Japanese EHS questionnaire, surveys were conducted on 1306 controls and 127 self‐selected EHS subjects in Japan. Principal component analysis of controls revealed eight principal symptom groups, namely, nervous, skin‐related, head‐related, auditory and vestibular, musculoskeletal, allergy‐related, sensory, and heart/chest‐related. The reliability of the Japanese EHS questionnaire was confirmed by high to moderate intraclass correlation coefficients in a test–retest analysis, and high Cronbach's α coefficients (0.853–0.953) from each subscale. A comparison of scores of each subscale between self‐selected EHS subjects and age‐ and sex‐matched controls using bivariate logistic regression analysis, Mann–Whitney U‐ and χ 2 tests, verified the validity of the questionnaire. This study demonstrated that the Japanese EHS questionnaire is reliable and valid, and can be used for surveillance of EHS individuals in Japan. Furthermore, based on multiple logistic regression and receiver operating characteristic analyses, we propose specific preliminary criteria for screening EHS individuals in Japan. Bioelectromagnetics. 37:353–372, 2016. © 2016 The Authors. Bioelectromagnetics Published by Wiley Periodicals, Inc. PMID:27324106

Systematic review using meta-analyses to estimate dose-response relationships between iodine intake and biomarkers of iodine status in different population groups.

PubMed

Ristić-Medić, Danijela; Dullemeijer, Carla; Tepsić, Jasna; Petrović-Oggiano, Gordana; Popović, Tamara; Arsić, Aleksandra; Glibetić, Marija; Souverein, Olga W; Collings, Rachel; Cavelaars, Adriënne; de Groot, Lisette; van't Veer, Pieter; Gurinović, Mirjana

2014-03-01

The objective of this systematic review was to identify studies investigating iodine intake and biomarkers of iodine status, to assess the data of the selected studies, and to estimate dose-response relationships using meta-analysis. All randomized controlled trials, prospective cohort studies, nested case-control studies, and cross-sectional studies that supplied or measured dietary iodine and measured iodine biomarkers were included. The overall pooled regression coefficient (β) and the standard error of β were calculated by random-effects meta-analysis on a double-log scale, using the calculated intake-status regression coefficient (β) for each individual study. The results of pooled randomized controlled trials indicated that the doubling of dietary iodine intake increased urinary iodine concentrations by 14% in children and adolescents, by 57% in adults and the elderly, and by 81% in pregnant women. The dose-response relationship between iodine intake and biomarkers of iodine status indicated a 12% decrease in thyroid-stimulating hormone and a 31% decrease in thyroglobulin in pregnant women. The model of dose-response quantification used to describe the relationship between iodine intake and biomarkers of iodine status may be useful for providing complementary evidence to support recommendations for iodine intake in different population groups.

What does theory-driven evaluation add to the analysis of self-reported outcomes of diabetes education? A comparative realist evaluation of a participatory patient education approach.

PubMed

Pals, Regitze A S; Olesen, Kasper; Willaing, Ingrid

2016-06-01

To explore the effects of the Next Education (NEED) patient education approach in diabetes education. We tested the use of the NEED approach at eight intervention sites (n=193). Six additional sites served as controls (n=58). Data were collected through questionnaires, interviews and observations. We analysed data using descriptive statistics, logistic regression and systematic text condensation. Results from logistic regression demonstrated better overall assessment of education program experiences and enhanced self-reported improvements in maintaining medications correctly among patients from intervention sites, as compared to control sites. Interviews and observations suggested that improvements in health behavior could be explained by mechanisms related to the education setting, including using person-centeredness and dialogue. However, similar mechanisms were observed at control sites. Observations suggested that the quality of group dynamics, patients' motivation and educators' ability to facilitate participation in education, supported by the NEED approach, contributed to better results at intervention sites. The use of participatory approaches and, in particular, the NEED patient education approach in group-based diabetes education improved self-management skills and health behavior outcomes among individuals with diabetes. The use of dialogue tools in diabetes education is advised for educators. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Examining gender salary disparities: an analysis of the 2003 multistate salary survey.

PubMed

Brown, Lawrence M; Schommer, Jon C; Mott, Dave; Gaither, Caroline A; Doucette, William R; Zgarrick, Dave P; Droege, Marcus

2006-09-01

Pharmacist salary and wage surveys have been conducted at the state and national level for more than 20 years; however, it is not known to what extent, if any, wage disparities due to gender still exist. The overall objective of this study was to determine if wage disparities exist among male and female pharmacists at the multistate and individual state level for each of 6 states studied. A secondary objective was to explore the effect of various demographic variables on the hourly wages of pharmacists. Data were collected from 1,688 pharmacists in 6 states during 2003 using a cross-sectional descriptive survey design. A multiple regression analysis on hourly wage testing the effects of state of practice, practice setting, position, terminal degree, and years in practice was conducted. Subsequent multiple regression analyses were conducted individually for each of the 6 states to test the effects of the above variables on hourly wage for both male and female pharmacists, followed by state-level analyses for male and female pharmacists, respectively. For the pooled data, all variables were found to be significant predictors of hourly wage, except for earning a PharmD degree without a residency or graduate degree. Gender was not a significant predictor of wage disparities in the state-level analyses. Position was the only significant predictor of wage disparities in all states (except Tennessee) such that pharmacists in management positions make significantly higher salaries than those in staff positions. The results of these analyses suggest that wage disparities due to gender do not exist at the state level for the 6 states surveyed, when controlling for practice setting, position, terminal degree, and years in practice. The larger number of men in management positions may explain lower wages for female pharmacists.

Gene-diet interaction effects on BMI levels in the Singapore Chinese population.

PubMed

Chang, Xuling; Dorajoo, Rajkumar; Sun, Ye; Han, Yi; Wang, Ling; Khor, Chiea-Chuen; Sim, Xueling; Tai, E-Shyong; Liu, Jianjun; Yuan, Jian-Min; Koh, Woon-Puay; van Dam, Rob M; Friedlander, Yechiel; Heng, Chew-Kiat

2018-02-24

Recent genome-wide association studies (GWAS) have identified 97 body-mass index (BMI) associated loci. We aimed to evaluate if dietary intake modifies BMI associations at these loci in the Singapore Chinese population. We utilized GWAS information from six data subsets from two adult Chinese population (N = 7817). Seventy-eight genotyped or imputed index BMI single nucleotide polymorphisms (SNPs) that passed quality control procedures were available in all datasets. Alternative Healthy Eating Index (AHEI)-2010 score and ten nutrient variables were evaluated. Linear regression analyses between z score transformed BMI (Z-BMI) and dietary factors were performed. Interaction analyses were performed by introducing the interaction term (diet x SNP) in the same regression model. Analysis was carried out in each cohort individually and subsequently meta-analyzed using the inverse-variance weighted method. Analyses were also evaluated with a weighted gene-risk score (wGRS) contructed by BMI index SNPs from recent large-scale GWAS studies. Nominal associations between Z-BMI and AHEI-2010 and some dietary factors were identified (P = 0.047-0.010). The BMI wGRS was robustly associated with Z-BMI (P = 1.55 × 10 - 15 ) but not with any dietary variables. Dietary variables did not significantly interact with the wGRS to modify BMI associations. When interaction analyses were repeated using individual SNPs, a significant association between cholesterol intake and rs4740619 (CCDC171) was identified (β = 0.077, adjP interaction  = 0.043). The CCDC171 gene locus may interact with cholesterol intake to increase BMI in the Singaporean Chinese population, however most known obesity risk loci were not associated with dietary intake and did not interact with diet to modify BMI levels.

A Facebook Follow-Up Strategy for Rural Drug-Using Women.

PubMed

Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B

2017-06-01

Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.

The in vitro wear behavior of experimental resin-based composites derived from a commercial formulation.

PubMed

Finlay, Nessa; Hahnel, Sebastian; Dowling, Adam H; Fleming, Garry J P

2013-04-01

To investigate the short- and long-term in vitro wear resistance of experimental resin-based composites (RBCs) derived from a commercial formulation. Six experimental RBCs were manufactured by manipulating the monomeric resin composition and the filler characteristics of Grandio (Voco GmbH, Cuxhaven, Germany). The Oregon Health Sciences University (OHSU) oral wear simulator was used in the presence of a food-like slurry to simulate three-body abrasion and attrition wear for 50,000, 150,000 and 300,000 cycles. A three-dimensional image of each wear facet was created and the total volumetric wear (mm(3)) and maximum wear depth (μm) were quantified for the RBC and antagonist. Statistical analyses of the total volumetric wear and maximum wear depth data (two- and one-way analyses of variance (ANOVA), with Tukey's post hoc tests where required) and regression analyses, were conducted at p=0.05. Two-way ANOVAs identified a significant effect of RBC material×wear cycles, RBC material and wear cycles (all p<0.0001). Regression analyses showed significant increases in the total volumetric wear (p≤0.001) and maximum wear depth data (p≤0.004) for all RBCs with increasing wear cycles. Differences between all RBC materials were evident after ≥150,000 wear cycles and antagonist wear provided valuable information to support the experimental findings. Wear simulating machines can provide an indication of the clinical performance but clinical performance is multi-factorial and wear is only a single facet. Employing experimental RBCs provided by a dental manufacturer rather than using self-manufactured RBCs or dental products provides increased experimental control by limiting the variables involved. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Fragile--Handle with Care: Regression Analyses That Include Categorical Data.

ERIC Educational Resources Information Center

Brown, Diane Peacock

In education and the social sciences, problems of interest to researchers and users of research often involve variables that do not meet the assumptions of regression in the area of an equal interval scale relative to a zero point. Various coding schemes exist that allow the use of regression while still answering the researcher's questions of…

Health and Stress Management and Mental-health Disability Claims.

PubMed

Marchand, Alain; Haines, Victor Y; Harvey, Steve; Dextras-Gauthier, Julie; Durand, Pierre

2016-12-01

This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Causal inference and longitudinal data: a case study of religion and mental health.

PubMed

VanderWeele, Tyler J; Jackson, John W; Li, Shanshan

2016-11-01

We provide an introduction to causal inference with longitudinal data and discuss the complexities of analysis and interpretation when exposures can vary over time. We consider what types of causal questions can be addressed with the standard regression-based analyses and what types of covariate control and control for the prior values of outcome and exposure must be made to reason about causal effects. We also consider newer classes of causal models, including marginal structural models, that can assess questions of the joint effects of time-varying exposures and can take into account feedback between the exposure and outcome over time. Such feedback renders cross-sectional data ineffective for drawing inferences about causation. The challenges are illustrated by analyses concerning potential effects of religious service attendance on depression, in which there may in fact be effects in both directions with service attendance preventing the subsequent depression, but depression itself leading to lower levels of the subsequent religious service attendance. Longitudinal designs, with careful control for prior exposures, outcomes, and confounders, and suitable methodology, will strengthen research on mental health, religion and health, and in the biomedical and social sciences generally.

Developmental dyslexia and phonological processing in European Portuguese orthography.

PubMed

Moura, Octávio; Moreno, Joana; Pereira, Marcelino; Simões, Mário R

2015-02-01

This study analysed the performance of phonological processing, the diagnostic accuracy and the influence on reading in children who were native speakers of an orthography of intermediate depth. Portuguese children with developmental dyslexia (DD; N=24; aged 10-12 years), chronological age (CA)-matched controls (N=24; aged 10-12 years) and reading level (RL)-matched controls (N=24; aged 7-9 years) were tested on measures of phonological processing (phonological awareness, naming speed and verbal short-term memory) and reading. The results indicated that the children with DD performed significantly poorer in all measures compared with the CA and RL. Phonological awareness and naming speed showed a high accuracy (receiver operating characteristics curve analysis) for discriminating the children with DD from the CA and RL, whereas the presence of abnormally low scores in phonological awareness and naming speed was more frequent in the DD group than in the controls and the normative population. Hierarchical linear regression analyses revealed that phonological awareness was the most important predictor of all reading accuracy measures, whereas naming speed was particularly related to text reading fluency. Copyright © 2014 John Wiley & Sons, Ltd.

Determinants of spirometric abnormalities among silicotic patients in Hong Kong.

PubMed

Leung, Chi C; Chang, Kwok C; Law, Wing S; Yew, Wing W; Tam, Cheuk M; Chan, Chi K; Wong, Man Y

2005-09-01

Silicosis is the second commonest notified occupational disease in Hong Kong. To characterize the determinants of spirometric abnormalities in silicosis. The spirometric patterns of consecutive silicotic patients on confirmation by the Pneumoconiosis Medical Board from 1991 to 2002 were correlated with demographic characteristics, occupational history, smoking history, tuberculosis (TB) history and radiographic features by univariate and multiple regression analyses. Of 1576 silicotic patients included, 55.6% showed normal spirometry, 28.5% normal forced vital capacity (FVC>or=80% predicted) but reduced forced expiratory ratio (FER<70%), 7.6% reduced FVC but normal FER, and 8.4% reduced both FVC and FER. Age, ever-smoking, cigarette pack-years, industry, job type, history of TB, size of lung nodules and progressive massive fibrosis (PMF) were all significantly associated with airflow limitation on univariate analysis (all P<0.05), while sex and profusion of nodules were not. Only age, cigarette pack-years, history of TB, size of lung nodules and PMF remained as significant independent predictors of airflow obstruction in multiple logistic regression analysis. After controlling for airflow obstruction, only shorter exposure duration, history of TB and profusion of nodules were significant independent predictors of reduced FVC. As well as age, history of TB, cigarette pack-years, PMF and nodule size contributed comparable effects to airflow obstruction in multiple linear regression analyses, while profusion of nodules was the strongest factor for reduced vital capacity. In an occupational compensation setting, disease indices and history of tuberculosis are independent predictors of both airflow obstruction and reduced vital capacity for silicotic patients.

Multiple regression and inverse moments improve the characterization of the spatial scaling behavior of daily streamflows in the Southeast United States

USGS Publications Warehouse

Farmer, William H.; Over, Thomas M.; Vogel, Richard M.

2015-01-01

Understanding the spatial structure of daily streamflow is essential for managing freshwater resources, especially in poorly-gaged regions. Spatial scaling assumptions are common in flood frequency prediction (e.g., index-flood method) and the prediction of continuous streamflow at ungaged sites (e.g. drainage-area ratio), with simple scaling by drainage area being the most common assumption. In this study, scaling analyses of daily streamflow from 173 streamgages in the southeastern US resulted in three important findings. First, the use of only positive integer moment orders, as has been done in most previous studies, captures only the probabilistic and spatial scaling behavior of flows above an exceedance probability near the median; negative moment orders (inverse moments) are needed for lower streamflows. Second, assessing scaling by using drainage area alone is shown to result in a high degree of omitted-variable bias, masking the true spatial scaling behavior. Multiple regression is shown to mitigate this bias, controlling for regional heterogeneity of basin attributes, especially those correlated with drainage area. Previous univariate scaling analyses have neglected the scaling of low-flow events and may have produced biased estimates of the spatial scaling exponent. Third, the multiple regression results show that mean flows scale with an exponent of one, low flows scale with spatial scaling exponents greater than one, and high flows scale with exponents less than one. The relationship between scaling exponents and exceedance probabilities may be a fundamental signature of regional streamflow. This signature may improve our understanding of the physical processes generating streamflow at different exceedance probabilities. 

Cigarette Smoking and the Risk of Barrett's Esophagus

PubMed Central

Kubo, Ai; Levin, T.R.; Block, Gladys; Rumore, Gregory; Quesenberry, Charles P.; Buffler, Patricia; Corley, Douglas A.

2008-01-01

Introduction We examined the association between smoking and the risk of Barrett's esophagus (BE), a metaplastic precursor to esophageal adenocarcinoma. Methods We conducted a case-control study within the Kaiser Permanente Northern California population. Patients with a new diagnosis of BE (n=320) were matched to persons with gastroesophageal reflux disease (GERD) (n=316) and to population controls (n=317). Information was collected using validated questionnaires from direct in-person interviews and electronic databases. Analyses used multivariate unconditional logistic regression that controlled for age, gender, race and education. Results Ever smoking status, smoking intensity (pack-years), and smoking cessation were not associated with the risk of BE. Stratified analyses suggested that ever smoking may be associated with an increased risk of BE among some groups (compared to population controls): persons with long-segment Barrett's esophagus (odds ratio [OR]=1.72, 95% confidence interval [CI] 1.12-2.63); subjects without GERD symptoms (OR=3.98, 95% CI 1.58-10.0); obese subjects (OR=3.38, 95%CI 1.46-7.82); and persons with a large abdominal circumference (OR=3.02, 95%CI (1.18-2.75)). Conclusion Smoking was not a strong or consistent risk factor for BE in a large community-based study, although associations may be present in some population subgroups. PMID:18853262

How standard is standard care? Exploring control group outcomes in behaviour change interventions for young people with type 1 diabetes.

PubMed

Ayling, K; Brierley, S; Johnson, B; Heller, S; Eiser, C

2015-01-01

Poor descriptions of standard care may compromise interpretation of results in randomised controlled trials (RCTs) of health interventions. We investigated quality of standard care in RCTs of behaviour change interventions for young people with type 1 diabetes and consider implications for evaluating trial outcomes. We conducted systematic searches for articles published between 1999 and 2012. We extracted standard care descriptions and contacted trial authors to complete a checklist of standard care activities. The relationship between standard care quality and outcomes was examined via subgroup meta-analyses and meta-regression. Standard care descriptions, standard care quality, and relationships between standard care quality with medical and psychological outcomes. We identified 20 RCTs described across 26 articles. Published descriptions of standard care were limited to service-level features. Author responses indicated standard care provision extended beyond published accounts. Subgroup analyses suggested control groups receiving higher standard care quality showed larger improvements in both medical and psychological outcomes, although standard care quality did not predict outcomes significantly. The quality of care delivered to control group participants can influence outcomes of RCTs. Inadequate reporting exacerbates this issue by masking variations between trials. We argue for increased clarity in reporting standard care in future trials.

Investigating consummatory and anticipatory pleasure across motivation deficits in schizophrenia and healthy controls.

PubMed

Da Silva, Susana; Saperia, Sarah; Siddiqui, Ishraq; Fervaha, Gagan; Agid, Ofer; Daskalakis, Z Jeff; Ravindran, Arun; Voineskos, Aristotle N; Zakzanis, Konstantine K; Remington, Gary; Foussias, George

2017-08-01

Anhedonia has traditionally been considered a characteristic feature of schizophrenia, but the true nature of this deficit remains elusive. This study sought to investigate consummatory and anticipatory pleasure as it relates to motivation deficits. Eighty-four outpatients with schizophrenia and 81 healthy controls were administered the Temporal Experience of Pleasure Scale (TEPS), as well as a battery of clinical and cognitive assessments. Multivariate analyses of variance were used to examine the experience of pleasure as a function of diagnosis, and across levels of motivation deficits (i.e. low vs. moderate. vs. high) in schizophrenia. Hierarchical regression analyses were also conducted to evaluate the predictive value of amotivation in relation to the TEPS. There were no significant differences between schizophrenia and healthy control groups for either consummatory or anticipatory pleasure. Within the schizophrenia patients, only those with high levels of amotivation were significantly impaired in consummatory and anticipatory pleasure compared to low and moderate groups, and compared to healthy controls. Further, our results revealed that amotivation significantly predicts both consummatory and anticipatory pleasure, with no independent contribution of group. Utilizing study samples with a wide range of motivation deficits and incorporating objective paradigms may provide a more comprehensive understanding of hedonic deficits. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Carrying the pain of abuse: gender-specific findings on the relationship between childhood physical abuse and obesity in adulthood.

PubMed

Fuller-Thomson, Esme; Sinclair, Deborah A; Brennenstuhl, Sarah

2013-01-01

Childhood abuse has been associated with negative adult health outcomes, including obesity. This study sought to investigate the association between childhood physical abuse and adult obesity, while controlling for five clusters of potentially confounding factors: childhood stressors, socioeconomic indicators, marital status, health behaviors, and mental health. Representative data from the 2005 Canadian Community Health Survey were selected. The response rate was approximately 84%. Gender-specific logistic regression analyses determined the association between abuse and obesity, while controlling for age and race and five clusters of potentially confounding factors. Of the 12,590 respondents with complete data, 2,787 were obese and 976 reported physical abuse as a child or adolescent by someone close to them. Among women with childhood physical abuse compared to no abuse, the odds of obesity were 35% higher, even when controlling for age, race, and the five clusters of factors (odds ratio (OR) = 1.35; 95% confidence interval (CI) = 1.09, 1.67). Childhood physical abuse was not associated with adult obesity among men (OR = 1.12; 95% CI = 0.82, 1.53). This study provides one of the first population-based, gender-specific analyses of the association between childhood physical abuse and obesity controlling for a wide range of factors. The gender-specific findings require further exploration.

Higher cardio-respiratory fitness is associated with increased mental and physical quality of life in people with bipolar disorder: A controlled pilot study.

PubMed

Vancampfort, Davy; Hagemann, Noemi; Wyckaert, Sabine; Rosenbaum, Simon; Stubbs, Brendon; Firth, Joseph; Schuch, Felipe B; Probst, Michel; Sienaert, Pascal

2017-10-01

The aim of this study was to investigate whether cardiorespiratory fitness among outpatients with bipolar disorder is associated with health related quality of life (HRQL) and explore differences versus healthy controls. Outpatients with bipolar disorder and healthy controls matched for age, sex and body mass index completed the 36-item Short Form Health Survey, the Positive-and-Negative-Affect-Schedule (PANAS), a maximal cardiorespiratory fitness test, and wore a Sensewear Armband to measure physical activity and sedentary behavior for eight days. Unpaired t-tests, Pearson correlations and backward regression analyses were performed. Outpatients with bipolar disorder (n = 20; 14♀; 47.9 ± 7.9 years) had a significantly lower physical and mental HRQL than healthy controls (n = 20; 14♀; 47.8 ± 7.6 years), a lower maximum oxygen uptake (VO 2 max) and were more sedentary. While no significant correlates were found for HRQL in controls, higher VO 2 max values and lower PANAS negative affect scores predicted better physical and mental HRQL in people with bipolar disorder. The final regression model explained 68% and 58% of the variability in physical and mental HRQL respectively. Cardiorespiratory fitness is associated with mental and physical HRQL among people with bipolar disorder. The current study offers novel targets for scientific investigation and clinical interventions to increase HRQL in people with bipolar disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of a randomized controlled trial to assess the six-months effects of a school based smoking prevention program in Saudi Arabia.

PubMed

Mohammed, Mutaz; Eggers, Sander Matthijs; Alotaiby, Fahad F; de Vries, Nanne; de Vries, Hein

2016-09-01

To examine the efficacy of a smoking prevention program which aimed to address smoking related cognitions and smoking behavior among Saudi adolescents age 13 to 15. A randomized controlled trial was used. Respondents in the experimental group (N=698) received five in-school sessions, while those in the control group (N=683) received no smoking prevention information (usual curriculum). Post-intervention data was collected six months after baseline. Logistic regression analysis was applied to assess effects on smoking initiation, and linear regression analysis was applied to assess changes in beliefs and analysis of covariance (ANCOVA) was used to assess intervention effects. All analyses were adjusted for the nested structure of students within schools. At post-intervention respondents from the experimental group reported in comparison with those from the control group a significantly more negative attitude towards smoking, stronger social norms against smoking, higher self-efficacy towards non-smoking, more action planning to remain a non-smoker, and lower intentions to smoke in the future. Smoking initiation was 3.2% in the experimental group and 8.8% in the control group (p<0.01). The prevention program reinforced non-smoking cognitions and non-smoking behavior. Therefore it is recommended to implement the program at a national level in Saudi-Arabia. Future studies are recommended to assess long term program effects and the conditions favoring national implementation of the program. Copyright © 2016 Elsevier Inc. All rights reserved.

Modeling for influenza vaccines and adjuvants profile for safety prediction system using gene expression profiling and statistical tools

PubMed Central

Sasaki, Eita; Momose, Haruka; Hiradate, Yuki; Furuhata, Keiko; Takai, Mamiko; Asanuma, Hideki; Ishii, Ken J.

2018-01-01

Historically, vaccine safety assessments have been conducted by animal testing (e.g., quality control tests and adjuvant development). However, classical evaluation methods do not provide sufficient information to make treatment decisions. We previously identified biomarker genes as novel safety markers. Here, we developed a practical safety assessment system used to evaluate the intramuscular, intraperitoneal, and nasal inoculation routes to provide robust and comprehensive safety data. Influenza vaccines were used as model vaccines. A toxicity reference vaccine (RE) and poly I:C-adjuvanted hemagglutinin split vaccine were used as toxicity controls, while a non-adjuvanted hemagglutinin split vaccine and AddaVax (squalene-based oil-in-water nano-emulsion with a formulation similar to MF59)-adjuvanted hemagglutinin split vaccine were used as safety controls. Body weight changes, number of white blood cells, and lung biomarker gene expression profiles were determined in mice. In addition, vaccines were inoculated into mice by three different administration routes. Logistic regression analyses were carried out to determine the expression changes of each biomarker. The results showed that the regression equations clearly classified each vaccine according to its toxic potential and inoculation amount by biomarker expression levels. Interestingly, lung biomarker expression was nearly equivalent for the various inoculation routes. The results of the present safety evaluation were confirmed by the approximation rate for the toxicity control. This method may contribute to toxicity evaluation such as quality control tests and adjuvant development. PMID:29408882

An evaluation of supervised classifiers for indirectly detecting salt-affected areas at irrigation scheme level

NASA Astrophysics Data System (ADS)

Muller, Sybrand Jacobus; van Niekerk, Adriaan

2016-07-01

Soil salinity often leads to reduced crop yield and quality and can render soils barren. Irrigated areas are particularly at risk due to intensive cultivation and secondary salinization caused by waterlogging. Regular monitoring of salt accumulation in irrigation schemes is needed to keep its negative effects under control. The dynamic spatial and temporal characteristics of remote sensing can provide a cost-effective solution for monitoring salt accumulation at irrigation scheme level. This study evaluated a range of pan-fused SPOT-5 derived features (spectral bands, vegetation indices, image textures and image transformations) for classifying salt-affected areas in two distinctly different irrigation schemes in South Africa, namely Vaalharts and Breede River. The relationship between the input features and electro conductivity measurements were investigated using regression modelling (stepwise linear regression, partial least squares regression, curve fit regression modelling) and supervised classification (maximum likelihood, nearest neighbour, decision tree analysis, support vector machine and random forests). Classification and regression trees and random forest were used to select the most important features for differentiating salt-affected and unaffected areas. The results showed that the regression analyses produced weak models (<0.4 R squared). Better results were achieved using the supervised classifiers, but the algorithms tend to over-estimate salt-affected areas. A key finding was that none of the feature sets or classification algorithms stood out as being superior for monitoring salt accumulation at irrigation scheme level. This was attributed to the large variations in the spectral responses of different crops types at different growing stages, coupled with their individual tolerances to saline conditions.

Time series regression model for infectious disease and weather.

PubMed

Imai, Chisato; Armstrong, Ben; Chalabi, Zaid; Mangtani, Punam; Hashizume, Masahiro

2015-10-01

Time series regression has been developed and long used to evaluate the short-term associations of air pollution and weather with mortality or morbidity of non-infectious diseases. The application of the regression approaches from this tradition to infectious diseases, however, is less well explored and raises some new issues. We discuss and present potential solutions for five issues often arising in such analyses: changes in immune population, strong autocorrelations, a wide range of plausible lag structures and association patterns, seasonality adjustments, and large overdispersion. The potential approaches are illustrated with datasets of cholera cases and rainfall from Bangladesh and influenza and temperature in Tokyo. Though this article focuses on the application of the traditional time series regression to infectious diseases and weather factors, we also briefly introduce alternative approaches, including mathematical modeling, wavelet analysis, and autoregressive integrated moving average (ARIMA) models. Modifications proposed to standard time series regression practice include using sums of past cases as proxies for the immune population, and using the logarithm of lagged disease counts to control autocorrelation due to true contagion, both of which are motivated from "susceptible-infectious-recovered" (SIR) models. The complexity of lag structures and association patterns can often be informed by biological mechanisms and explored by using distributed lag non-linear models. For overdispersed models, alternative distribution models such as quasi-Poisson and negative binomial should be considered. Time series regression can be used to investigate dependence of infectious diseases on weather, but may need modifying to allow for features specific to this context. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Memory control beliefs and everyday forgetfulness in adulthood: the effects of selection, optimization, and compensation strategies.

PubMed

Scheibner, Gunnar Benjamin; Leathem, Janet

2012-01-01

Controlling for age, gender, education, and self-rated health, the present study used regression analyses to examine the relationships between memory control beliefs and self-reported forgetfulness in the context of the meta-theory of Selective Optimization with Compensation (SOC). Findings from this online survey (N = 409) indicate that, among adult New Zealanders, a higher sense of memory control accounts for a 22.7% reduction in self-reported forgetfulness. Similarly, optimization was found to account for a 5% reduction in forgetfulness while the strategies of selection and compensation were not related to self-reports of forgetfulness. Optimization partially mediated the beneficial effects that some memory beliefs (e.g., believing that memory decline is inevitable and believing in the potential for memory improvement) have on forgetfulness. It was concluded that memory control beliefs are important predictors of self-reported forgetfulness while the support for the SOC model in the context of memory controllability and everyday forgetfulness is limited.

Understanding the association between maltreatment history and adolescent risk behavior by examining popularity motivations and peer group control.

PubMed

Ellis, Wendy E; Wolfe, David A

2009-10-01

The purpose of the present study was to examine how peer group processes of pressure and control and individual motivations for popularity would add to, and moderate the relationship between, childhood maltreatment and risky behavior in adolescence. A total of 1558 youth (804 girls) from three high schools in Ontario, Canada (M age = 15.02 years, SD = .86) reported on their alcohol use, delinquent behavior, childhood experiences of physical and emotional maltreatment and neglect, peer group processes involving control and individual popularity motivations. Regression analyses showed that, beyond the significant contributions of childhood maltreatment, peer group control predicted risky alcohol use and delinquent behavior. Peer group control and popularity motivations exacerbated the negative effect of physical maltreatment on delinquent behavior. Boys' experiences of peer group control were more strongly linked to alcohol use and delinquent behavior than girls'. These results suggest that there is a significant window of opportunity during adolescence where the peer group context can exacerbate or buffer childhood experiences.

Study to eliminate ground resonance using active controls

NASA Technical Reports Server (NTRS)

Straub, F. K.

1984-01-01

The effectiveness of active control blade feathering in increasing rotor body damping and the possibility to eliminate ground resonance instabilities were investigated. An analytical model representing rotor flapping and lead-lag degrees of freedom and body pitch, roll, longitudinal and lateral motion is developed. Active control blade feathering is implemented as state variable feedback through a conventional swashplate. The influence of various feedback states, feedback gain, and weighting between the cyclic controls is studied through stability and response analyses. It is shown that blade cyclic inplane motion, roll rate and roll acceleration feedback can add considerable damping to the system and eliminate ground resonance instabilities, which the feedback phase is also a powerful parameter, if chosen properly, it maximizes augmentation of the inherent regressing lag mode damping. It is shown that rotor configuration parameters, like blade root hinge offset, flapping stiffness, and precone considerably influence the control effectiveness. It is found that active control is particularly powerful for hingeless and bearingless rotor systems.

Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men.

PubMed

Kapadia, F; Siconolfi, D E; Barton, S; Olivieri, B; Lombardo, L; Halkitis, P N

2013-06-01

Associations between social support network characteristics and sexual risk among racially/ethnically diverse young men who have sex with men (YMSM) were examined using egocentric network data from a prospective cohort study of YMSM (n = 501) recruited in New York City. Bivariate and multivariable logistic regression analyses examined associations between social support network characteristics and sexual risk taking behaviors in Black, Hispanic/Latino, and White YMSM. Bivariate analyses indicated key differences in network size, composition, communication frequency and average relationship duration by race/ethnicity. In multivariable analyses, controlling for individual level sociodemographic, psychosocial and relationship factors, having a sexual partner in one's social support network was associated with unprotected sexual behavior for both Hispanic/Latino (AOR = 3.90) and White YMSM (AOR = 4.93). Further examination of key network characteristics across racial/ethnic groups are warranted in order to better understand the extant mechanisms for provision of HIV prevention programming to racially/ethnically diverse YMSM at risk for HIV.

Comparison of detection methods for HPV status as a prognostic marker for loco-regional control after radiochemotherapy in patients with HNSCC.

PubMed

Linge, Annett; Schötz, Ulrike; Löck, Steffen; Lohaus, Fabian; von Neubeck, Cläre; Gudziol, Volker; Nowak, Alexander; Tinhofer, Inge; Budach, Volker; Sak, Ali; Stuschke, Martin; Balermpas, Panagiotis; Rödel, Claus; Bunea, Hatice; Grosu, Anca-Ligia; Abdollahi, Amir; Debus, Jürgen; Ganswindt, Ute; Lauber, Kirsten; Pigorsch, Steffi; Combs, Stephanie E; Mönnich, David; Zips, Daniel; Baretton, Gustavo B; Buchholz, Frank; Krause, Mechthild; Belka, Claus; Baumann, Michael

2018-04-01

To compare six HPV detection methods in pre-treatment FFPE tumour samples from patients with locally advanced head and neck squamous cell carcinoma (HNSCC) who received postoperative (N = 175) or primary (N = 90) radiochemotherapy. HPV analyses included detection of (i) HPV16 E6/E7 RNA, (ii) HPV16 DNA (PCR-based arrays, A-PCR), (iii) HPV DNA (GP5+/GP6+ qPCR, (GP-PCR)), (iv) p16 (immunohistochemistry, p16 IHC), (v) combining p16 IHC and the A-PCR result and (vi) combining p16 IHC and the GP-PCR result. Differences between HPV positive and negative subgroups were evaluated for the primary endpoint loco-regional control (LRC) using Cox regression. Correlation between the HPV detection methods was high (chi-squared test, p < 0.001). While p16 IHC analysis resulted in several false positive classifications, A-PCR, GP-PCR and the combination of p16 IHC and A-PCR or GP-PCR led to results comparable to RNA analysis. In both cohorts, Cox regression analyses revealed significantly prolonged LRC for patients with HPV positive tumours irrespective of the detection method. The most stringent classification was obtained by detection of HPV16 RNA, or combining p16 IHC with A-PCR or GP-PCR. This approach revealed the lowest rate of recurrence in patients with tumours classified as HPV positive and therefore appears most suited for patient stratification in HPV-based clinical studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive-compulsive disorder.

PubMed

Cano, M; Alonso, P; Martínez-Zalacaín, I; Subirà, M; Real, E; Segalàs, C; Pujol, J; Cardoner, N; Menchón, J M; Soriano-Mas, C

2018-04-01

The assessment of inter-regional functional connectivity (FC) has allowed for the description of the putative mechanism of action of treatments such as deep brain stimulation (DBS) of the nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Nevertheless, the possible FC alterations of other clinically-effective DBS targets have not been explored. Here we evaluated the FC patterns of the subthalamic nucleus (STN) and the bed nucleus of the stria terminalis (BNST) in patients with OCD, as well as their association with symptom severity. Eighty-six patients with OCD and 104 healthy participants were recruited. A resting-state image was acquired for each participant and a seed-based analysis focused on our two regions of interest was performed using statistical parametric mapping software (SPM8). Between-group differences in FC patterns were assessed with two-sample t test models, while the association between symptom severity and FC patterns was assessed with multiple regression analyses. In comparison with controls, patients with OCD showed: (1) increased FC between the left STN and the right pre-motor cortex, (2) decreased FC between the right STN and the lenticular nuclei, and (3) increased FC between the left BNST and the right frontopolar cortex. Multiple regression analyses revealed a negative association between clinical severity and FC between the right STN and lenticular nucleus. This study provides a neurobiological framework to understand the mechanism of action of DBS on the STN and the BNST, which seems to involve brain circuits related with motor response inhibition and anxiety control, respectively.

Left frontal cortex connectivity underlies cognitive reserve in prodromal Alzheimer disease

PubMed Central

Franzmeier, Nicolai; Duering, Marco; Weiner, Michael; Dichgans, Martin

2017-01-01

Objective: To test whether higher global functional connectivity of the left frontal cortex (LFC) in Alzheimer disease (AD) is associated with more years of education (a proxy of cognitive reserve [CR]) and mitigates the association between AD-related fluorodeoxyglucose (FDG)-PET hypometabolism and episodic memory. Methods: Forty-four amyloid-PET–positive patients with amnestic mild cognitive impairment (MCI-Aβ+) and 24 amyloid-PET–negative healthy controls (HC) were included. Voxel-based linear regression analyses were used to test the association between years of education and FDG-PET in MCI-Aβ+, controlled for episodic memory performance. Global LFC (gLFC) connectivity was computed through seed-based resting-state fMRI correlations between the LFC (seed) and each voxel in the gray matter. In linear regression analyses, education as a predictor of gLFC connectivity and the interaction of gLFC connectivity × FDG-PET hypometabolism on episodic memory were tested. Results: FDG-PET metabolism in the precuneus was reduced in MCI-Aβ+ compared to HC (p = 0.028), with stronger reductions observed in MCI-Aβ+ with more years of education (p = 0.006). In MCI-Aβ+, higher gLFC connectivity was associated with more years of education (p = 0.021). At higher levels of gLFC connectivity, the association between precuneus FDG-PET hypometabolism and lower memory performance was attenuated (p = 0.027). Conclusions: Higher gLFC connectivity is a functional substrate of CR that helps to maintain episodic memory relatively well in the face of emerging FDG-PET hypometabolism in early-stage AD. PMID:28188306

Impact of cognitive function on oral perception in independently living older people.

PubMed

Fukutake, Motoyoshi; Ogawa, Taiji; Ikebe, Kazunori; Mihara, Yusuke; Inomata, Chisato; Takeshita, Hajime; Matsuda, Kenichi; Hatta, Kodai; Gondo, Yasuyuki; Masui, Yukie; Inagaki, Hiroki; Arai, Yasumichi; Kamide, Kei; Ishizaki, Tatsuro; Maeda, Yoshinobu

2018-04-10

Oral tactile perception is important for better mastication, appetite, and enjoyment of food. However, previous investigations have not utilized comprehensible variables thought to have negative effect on oral perception, including aging, denture wearing, and cognitive function. The aim of this study was to elucidate the impact of cognitive function on oral perception in independently living older individuals. The study sample was comprised of 987 participants (466 males, 521 females; age 69-71 years). Oral examinations, assessments of cognitive function in preclinical level by Montreal Cognitive Assessment (MoCA)-J, and determination of oral stereognostic ability as an indicator of oral perception were performed. Related variables were selected by univariate analyses; then, multivariate logistic regression model analysis was conducted. Univariate analyses revealed that number of teeth, removable dentures usage, and cognitive function respectively had a significant relationship with stereognostic score. Next, the subjects were classified into good and poor perception groups (lowest 17.4%) according to oral stereognostic ability. Logistic regression analysis revealed that lower cognitive function was significantly associated with poor oral perception (OR = 0.934, p = 0.017) after controlling for other variables. Cognitive decline even in preclinical stage was associated with reduced oral perception after controlling for gender, tooth number and denture use in independent living older people. This study suggested that preclinical level of change in cognitive function affected oral perception. Dental practitioners and caregivers may need to pay attention to reduced oral perception among older people even if they do not have trouble in daily life.

Left frontal cortex connectivity underlies cognitive reserve in prodromal Alzheimer disease.

PubMed

Franzmeier, Nicolai; Duering, Marco; Weiner, Michael; Dichgans, Martin; Ewers, Michael

2017-03-14

To test whether higher global functional connectivity of the left frontal cortex (LFC) in Alzheimer disease (AD) is associated with more years of education (a proxy of cognitive reserve [CR]) and mitigates the association between AD-related fluorodeoxyglucose (FDG)-PET hypometabolism and episodic memory. Forty-four amyloid-PET-positive patients with amnestic mild cognitive impairment (MCI-Aβ+) and 24 amyloid-PET-negative healthy controls (HC) were included. Voxel-based linear regression analyses were used to test the association between years of education and FDG-PET in MCI-Aβ+, controlled for episodic memory performance. Global LFC (gLFC) connectivity was computed through seed-based resting-state fMRI correlations between the LFC (seed) and each voxel in the gray matter. In linear regression analyses, education as a predictor of gLFC connectivity and the interaction of gLFC connectivity × FDG-PET hypometabolism on episodic memory were tested. FDG-PET metabolism in the precuneus was reduced in MCI-Aβ+ compared to HC ( p = 0.028), with stronger reductions observed in MCI-Aβ+ with more years of education ( p = 0.006). In MCI-Aβ+, higher gLFC connectivity was associated with more years of education ( p = 0.021). At higher levels of gLFC connectivity, the association between precuneus FDG-PET hypometabolism and lower memory performance was attenuated ( p = 0.027). Higher gLFC connectivity is a functional substrate of CR that helps to maintain episodic memory relatively well in the face of emerging FDG-PET hypometabolism in early-stage AD. © 2017 American Academy of Neurology.

Characteristics of GHG flux from water-air interface along a reclaimed water intake area of the Chaobai River in Shunyi, Beijing

NASA Astrophysics Data System (ADS)

He, Baonan; He, Jiangtao; Wang, Jian; Li, Jie; Wang, Fei

2018-01-01

To understand greenhouse gas (GHG) flux in reclaimed water intake area impact on urban climate, 'static chamber' method was used to investigate the spatio-diurnal variations and the influence factors of GHG fluxes at water-air interface from Jian River to Chaobai River. Results showed that the average fluxes of CO2 from the Jian River and the Chaobai River were 73.46 mg(m2·h)-1 and -64.75 mg(m2·h)-1, respectively. CO2 was emitted the most in the Jian River, but it was absorbed from the atmosphere in the Chaobai River. Unary linear regression analyses demonstrated that Chlorophyll a (Chl a) and pH variation controlled the carbon source and sink from the Jian River to the Chaobai River. The diurnal variation of CO2 fluxes was higher at night than in the daytime in the Jian River, and it was the inverse in the Chaobai River, which highly correlated with dissociative CO2 and HCO3- transformation to CO32-. The average fluxes of CH4 from the Jian River and Chaobai River were 0.973 mg(m2·h)-1 and 5.556 mg(m2·h)-1, respectively, which increased along the water flow direction. Unary and multiple linear regression analyses demonstrated that Chl a and total organic carbon (TOC) controlled the increase of CH4 along the flow direction. The diurnal variation of CH4 fluxes was slightly higher in the daytime than at night due to the effect of water temperature.

Continuing or Temporarily Stopping Prestroke Antihypertensive Medication in Acute Stroke: An Individual Patient Data Meta-Analysis.

PubMed

Woodhouse, Lisa J; Manning, Lisa; Potter, John F; Berge, Eivind; Sprigg, Nikola; Wardlaw, Joanna; Lees, Kennedy R; Bath, Philip M; Robinson, Thompson G

2017-05-01

Over 50% of patients are already taking blood pressure-lowering therapy on hospital admission for acute stroke. An individual patient data meta-analysis from randomized controlled trials was undertaken to determine the effect of continuation versus temporarily stopping preexisting antihypertensive medication in acute stroke. Key databases were searched for trials against the following inclusion criteria: randomized design; stroke onset ≤48 hours; investigating the effect of continuation versus stopping prestroke antihypertensive medication; and follow-up of ≥2 weeks. Two randomized controlled trials were identified and included in this meta-analysis of individual patient data from 2860 patients with ≤48 hours of acute stroke. Risk of bias in each study was low. In adjusted logistic regression and multiple regression analyses (using random effects), we found no significant association between continuation of prestroke antihypertensive therapy (versus stopping) and risk of death or dependency at final follow-up: odds ratio 0.96 (95% confidence interval, 0.80-1.14). No significant associations were found between continuation (versus stopping) of therapy and secondary outcomes at final follow-up. Analyses for death and dependency in prespecified subgroups revealed no significant associations with continuation versus temporarily stopping therapy, with the exception of patients randomized ≤12 hours, in whom a difference favoring stopping treatment met statistical significance. We found no significant benefit with continuation of antihypertensive treatment in the acute stroke period. Therefore, there is no urgency to administer preexisting antihypertensive therapy in the first few hours or days after stroke, unless indicated for other comorbid conditions. © 2017 American Heart Association, Inc.

Spatial quantile regression using INLA with applications to childhood overweight in Malawi.

PubMed

Mtambo, Owen P L; Masangwi, Salule J; Kazembe, Lawrence N M

2015-04-01

Analyses of childhood overweight have mainly used mean regression. However, using quantile regression is more appropriate as it provides flexibility to analyse the determinants of overweight corresponding to quantiles of interest. The main objective of this study was to fit a Bayesian additive quantile regression model with structured spatial effects for childhood overweight in Malawi using the 2010 Malawi DHS data. Inference was fully Bayesian using R-INLA package. The significant determinants of childhood overweight ranged from socio-demographic factors such as type of residence to child and maternal factors such as child age and maternal BMI. We observed significant positive structured spatial effects on childhood overweight in some districts of Malawi. We recommended that the childhood malnutrition policy makers should consider timely interventions based on risk factors as identified in this paper including spatial targets of interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Variable selection and model choice in geoadditive regression models.

PubMed

Kneib, Thomas; Hothorn, Torsten; Tutz, Gerhard

2009-06-01

Model choice and variable selection are issues of major concern in practical regression analyses, arising in many biometric applications such as habitat suitability analyses, where the aim is to identify the influence of potentially many environmental conditions on certain species. We describe regression models for breeding bird communities that facilitate both model choice and variable selection, by a boosting algorithm that works within a class of geoadditive regression models comprising spatial effects, nonparametric effects of continuous covariates, interaction surfaces, and varying coefficients. The major modeling components are penalized splines and their bivariate tensor product extensions. All smooth model terms are represented as the sum of a parametric component and a smooth component with one degree of freedom to obtain a fair comparison between the model terms. A generic representation of the geoadditive model allows us to devise a general boosting algorithm that automatically performs model choice and variable selection.

Multicollinearity in spatial genetics: separating the wheat from the chaff using commonality analyses.

PubMed

Prunier, J G; Colyn, M; Legendre, X; Nimon, K F; Flamand, M C

2015-01-01

Direct gradient analyses in spatial genetics provide unique opportunities to describe the inherent complexity of genetic variation in wildlife species and are the object of many methodological developments. However, multicollinearity among explanatory variables is a systemic issue in multivariate regression analyses and is likely to cause serious difficulties in properly interpreting results of direct gradient analyses, with the risk of erroneous conclusions, misdirected research and inefficient or counterproductive conservation measures. Using simulated data sets along with linear and logistic regressions on distance matrices, we illustrate how commonality analysis (CA), a detailed variance-partitioning procedure that was recently introduced in the field of ecology, can be used to deal with nonindependence among spatial predictors. By decomposing model fit indices into unique and common (or shared) variance components, CA allows identifying the location and magnitude of multicollinearity, revealing spurious correlations and thus thoroughly improving the interpretation of multivariate regressions. Despite a few inherent limitations, especially in the case of resistance model optimization, this review highlights the great potential of CA to account for complex multicollinearity patterns in spatial genetics and identifies future applications and lines of research. We strongly urge spatial geneticists to systematically investigate commonalities when performing direct gradient analyses. © 2014 John Wiley & Sons Ltd.

A case-control study of the association between ulcerative colitis and hyperthyroidism in an Asian population.

PubMed

Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

2017-06-01

Ulcerative colitis (UC) is a chronic relapsing inflammatory disease with significant clinical diversity. However, the aetiology, pathogenesis and optimal treatment of UC remain unclear. The purpose of this case-control study was to investigate the association between previously diagnosed hyperthyroidism and UC using a large population-based data set in Taiwan. The data for this population-based case-control study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included 2709 patients with UC as cases and 8127 sex- and age-matched patients without UC as controls. A conditional logistic regression analysis was conducted to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between UC and prior hyperthyroidism. We found that, in total, 327 of the 10 836 sampled patients (3.02%) had previously been diagnosed with hyperthyroidism. There was a higher proportion of prior hyperthyroidism among cases than controls (4.10% vs 2.66%, P<.001). A conditional logistic regression showed that the OR of prior hyperthyroidism was 1.57 (95% CI=1.24-1.98) compared to controls. Similarly, after adjusting for monthly income, geographic location and urbanization level, cases were still more likely to have previously been diagnosed with hyperthyroidism than controls (OR=1.61, 95% CI=1.27-2.05). Furthermore, we analysed the ORs of prior hyperthyroidism between cases and controls according to age group. We found that of the youngest group of sampled patients (18-39 years), cases had the greatest adjusted OR for having previously been diagnosed with hyperthyroidism than controls (OR=1.98, 95% CI=1.04-3.79). This study demonstrated an association between UC and hyperthyroidism. © 2017 John Wiley & Sons Ltd.

[Nursing Workforce Characteristics and Control of Diabetes Mellitus in Primary Care: a Multilevel Analysis].

PubMed

Parro Moreno, Ana; Santiago Pérez, M Isolina; Abraira Santos, Victor; Aréjula Torres, José Luis Aréjula Torres; Díaz Holgado, Antonio; Gandarillas Grande, Ana; Morales Asencio, José Miguel; Serrano Gallardo, Pilar

2016-03-04

Nurse activity is determined by the characteristics of nursing staff. The objective was to determine the impact of Primary Health Care (PHC) nursing workforce characteristics on the control of Diabetes Mellitus (DM) in adults. Cross-sectional analytical study. Administrative and clinical registries and questionnaire PES-Nursing Work Index from PHC nurses. Participants 44.214 diabetic patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with higher socioeconomic situation and South-West Zone (SWZ) with lower socioeconomic situation, and their 507 reference nurses. Analyses were performed to multivariate multilevel logistic regression models. Poor DM control (figures equal or higher than 7% HbA1c). The prevalence of poor DM control was 40.1% [CI95%: 38.2-42.1]. There was a risk of 25% more of poor control if the patient changed centre and of 27% if changed of doctor-nurse pair. In the multilevel multivariate regression models: in SWZ increasing the ratio of patients over 65 years per nurse increased the poor control (OR=1.00008 [CI95%:1.00006-1.001]); and higher proportion of patients whose Hb1Ac was not measured at the centre contributed to poor DM control (OR=5.1 [CI95%:1.6-15.6]). In two models for health zone, the economic immigration condition increased poor control, in SWZ (OR=1.3 [CI95%:1.03-1.7]); and in NWZ (OR=1.29 [CI95%:1.03-1.6]). Higher 65 years old patients ratio per nurse, economic immigration condition and a higher proportion of patients whose Hb1Ac was not measured contribute to worse DM control.

HLA–B51/B5 and the Risk of Behçet’s Disease: A Systematic Review and Meta-Analysis of Case–Control Genetic Association Studies

PubMed Central

de MENTHON, MATHILDE; LAVALLEY, MICHAEL P.; MALDINI, CARLA; GUILLEVIN, LOÏC; MAHR, ALFRED

2013-01-01

Objective To quantify by meta-analysis the genetic effect of the HLA–B5 or HLA–B51 (HLA–B51/B5) allele on the risk of developing Behçet’s disease (BD) and to look for potential effect modifiers. Methods Relevant studies were identified using the PubMed Medline database and manual searches of the literature. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by using the random-effects model. Subgroup meta-analyses and meta-regression analyses were undertaken to investigate the effects of selected study-level parameters on the pooled OR. Heterogeneity was assessed using the I2 statistic. Pooled results were used to calculate population-attributable risks (PAR) for BD in relationship to HLA–B51/B5. Results A total of 4,800 patients with BD and 16,289 controls from 78 independent studies (published 1975–2007) were selected. The pooled OR of HLA–B51/B5 allele carriers to develop BD compared with noncarriers was 5.78 (95% CI 5.00–6.67), with moderate between-study heterogeneity (I2 = 61%). The subgroup analyses stratifying studies by geographic locations (Eastern Asia, Middle East/North Africa, Southern Europe, Northern/Eastern Europe) yielded consistent OR ranges (5.31–7.20), with I2 ranges of 52–70%. Univariate random-effects meta-regression indicated the percentage of male BD cases (P = 0.008) as a source of heterogeneity. The PAR within the various geographic areas were estimated at 32–52%. Conclusion The strength of the association between BD and HLA–B51/B5, and its consistency across populations of various ethnicities, lends further support to this allele being a primary and causal risk determinant for BD. Variations according to sex support an interaction of this allele with BD characteristics. PMID:19790126

Security in Father-child Relationship and Behavior Problems in Sexually Abused Children

PubMed Central

Parent-Boursier, Claudel; Hébert, Martine

2017-01-01

While the influence of mother-child relationships on children’s recovery following sexual abuse has been documented, less is known about the possible contribution of father-child relationships on outcomes. The present study explored the contribution of children’s perception of security in their relationship to the father on internalizing and externalizing behavior problems, while controlling for sociodemographic variables and variables associated with the mother-child relationship. Participants were 142 children who disclosed sexual abuse involving a perpetrator other than the biological father. Regression analyses indicated that children’s perception of security to fathers contributed to the prediction of parental reports of children’s behavior problems, even after controlling for maternal psychological distress and perception of security to mothers. PMID:29321696

The Association between Romantic Relationships and Delinquency in Adolescence and Young Adulthood

PubMed Central

Cui, Ming; Ueno, Koji; Fincham, Frank D.; Donnellan, M. Brent; Wickrama, K. A. S.

2011-01-01

This study examined the association between romantic relationships and delinquency in adolescence and young adulthood. Using a large, longitudinal, and nationally representative sample, results from negative binomial regressions showed a positive association between romantic involvement and delinquency in adolescence. Further, the cumulative number of romantic relationships from adolescence to young adulthood was positively related to delinquency in young adulthood even controlling for earlier delinquency in adolescence. These analyses also controlled for the effects of participant gender, age at initial assessment, puberty, race/ethnicity, and other demographic characteristics (e.g., family structure and parents’ education). Findings are discussed in terms of their implications for understanding the role of romantic relationships in the development of young people and for stimulating future research questions. PMID:22984343

Monitoring attentional style and medical regimen adherence in hemodialysis patients.

PubMed

Christensen, A J; Moran, P J; Lawton, W J; Stallman, D; Voigts, A L

1997-05-01

Previous research involving individuals facing chronic health problems suggests that an attentional style characterized by pronounced monitoring of threat-relevant information is associated with poorer behavioral and emotional adjustment. This study examined the hypothesis that a pronounced monitoring style would be associated with poorer medical regimen adherence in a sample of 51 chronic hemodialysis patients. Hierarchical regression analyses (controlling for demographic factors and trait anxiety) revealed that "high monitors" exhibited higher interdialysis weight gains and higher serum K values reflecting poorer adherence to fluid-intake and dietary restrictions. However, monitoring was not associated with a measure of medication adherence. Partial support was found for a model suggesting that a lack of perceived control is responsible for the relationship between higher monitoring and poorer adherence.

Optimal design and experimental analyses of a new micro-vibration control payload-platform

NASA Astrophysics Data System (ADS)

Sun, Xiaoqing; Yang, Bintang; Zhao, Long; Sun, Xiaofen

2016-07-01

This paper presents a new payload-platform, for precision devices, which possesses the capability of isolating the complex space micro-vibration in low frequency range below 5 Hz. The novel payload-platform equipped with smart material actuators is investigated and designed through optimization strategy based on the minimum energy loss rate, for the aim of achieving high drive efficiency and reducing the effect of the magnetic circuit nonlinearity. Then, the dynamic model of the driving element is established by using the Lagrange method and the performance of the designed payload-platform is further discussed through the combination of the controlled auto regressive moving average (CARMA) model with modified generalized prediction control (MGPC) algorithm. Finally, an experimental prototype is developed and tested. The experimental results demonstrate that the payload-platform has an impressive potential of micro-vibration isolation.

Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding.

PubMed

Malisoux, Laurent; Chambon, Nicolas; Delattre, Nicolas; Gueguen, Nils; Urhausen, Axel; Theisen, Daniel

2016-04-01

This randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology. Recreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet. The overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22). The overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults.

PubMed

Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A; Darling-Fisher, Cynthia S; Tate, Nutrena H; Stoddard, Sarah A; Martyn, Kristy K

2016-09-01

Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. ©2016 American Association of Nurse Practitioners.

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults

PubMed Central

Munro-Kramer, Michelle L.; Fava, Nicole M.; Saftner, Melissa A.; Darling-Fisher, Cynthia S.; Tate, Nutrena H.; Stoddard, Sarah A.; Martyn, Kristy K.

2016-01-01

Background and Purpose Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (15-23 years old) within their life context, as well as the association between these behaviors. Methods A secondary analysis of data on a subset of Arab-American participants obtained from a randomized control trial were utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n=24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n=57). Conclusions Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life events, and (b) minimal risk behaviors and positive life events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. Implications for Practice The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. PMID:26990394

Ecdysis period and rate deviations of dengue mosquito vector, Aedes aegypti reared in different artificial water-holding containers.

PubMed

Almanzor, Beatriz Louise J; Ho, Howell T; Carvajal, Thaddeus M

2016-03-01

Artificial water-holding containers (AWHCs) have been well-documented in many Aedes aegypti studies for dengue surveillance and developmental research. Hence, we investigated the role of different AHWCs on the development and ecdysis period of Ae. aegypti dengue vector, a container breeding mosquito. Nine types of AWHCs, namely glass, polystyrene foam, rubber, steel, porcelain, plastic, aluminum, clay and concrete, were chosen for the study. All AWHCs were subjected to the developmental assay for an observation period of 10 days. Regression and hazard analyses were employed to the developmental stages and the characteristics of the AWHCs. The observations revealed that Ae. aegypti development is fastest in glass and polystyrene containers while slowest in concrete containers. Moreover, pupal ecdysis appears to be the most affected by the characteristics of the AWHCs based on regression and hazard analyses. Characteristics of the container that can regulate water temperature seem to be the driving force with regards to the slow or fast development of Ae. aegypti, more notably in pupal ecdysis. The results of the study further strengthen our understanding on the dynamics of Ae. aegypti's developmental biology to different characteristics of artificial water containers. This, in turn, would aid in devising vector control strategies against dengue especially in endemic areas.

The Relationship between Perceived Health and Physical Activity Indoors, Outdoors in Built Environments, and Outdoors in Nature

PubMed Central

Pasanen, Tytti P; Tyrväinen, Liisa; Korpela, Kalevi M

2014-01-01

Background: A body of evidence shows that both physical activity and exposure to nature are connected to improved general and mental health. Experimental studies have consistently found short term positive effects of physical activity in nature compared with built environments. This study explores whether these benefits are also evident in everyday life, perceived over repeated contact with nature. The topic is important from the perspectives of city planning, individual well-being, and public health. Methods: National survey data (n = 2,070) from Finland was analysed using structural regression analyses. Perceived general health, emotional well-being, and sleep quality were regressed on the weekly frequency of physical activity indoors, outdoors in built environments, and in nature. Socioeconomic factors and other plausible confounders were controlled for. Results: Emotional well-being showed the most consistent positive connection to physical activity in nature, whereas general health was positively associated with physical activity in both built and natural outdoor settings. Better sleep quality was weakly connected to frequent physical activity in nature, but the connection was outweighed by other factors. Conclusion: The results indicate that nature provides an added value to the known benefits of physical activity. Repeated exercise in nature is, in particular, connected to better emotional well-being. PMID:25044598

Vitamin C Intake and Pancreatic Cancer Risk: A Meta-Analysis of Published Case-Control and Cohort Studies.

PubMed

Hua, Yong-Fei; Wang, Gao-Qing; Jiang, Wei; Huang, Jing; Chen, Guo-Chong; Lu, Cai-De

2016-01-01

Observational studies inconsistently reported the relationship between vitamin C intake and risk of pancreatic cancer. We conducted a meta-analysis of published case-control and cohort studies to quantify the association. Potentially eligible studies were found on PubMed and EMBASE databases through May 31, 2015. A random-effects model was assigned to compute summary point estimates with corresponding 95% confidence intervals (CIs). Subgroup and meta-regression analyses were also performed to explore sources of heterogeneity. Our final analyses included 20 observational studies comprising nearly 5 thousand cases of pancreatic cancer. When comparing the highest with the lowest categories of vitamin C intake, the summary odds ratio/relative risk for case-control studies (14 studies), cohort studies (6 studies) and all studies combined was 0.58 (95% CI: 0.52-0.66), 0.93 (95% CI: 0.78-1.11) and 0.66 (95% CI: 0.58-0.75), respectively. The difference in the findings between case-control and cohort studies was statistically significant (P < .001). Possible publication bias was shown in the meta-analysis of case-control studies. There is insufficient evidence to conclude any relationship between vitamin C intake and risk of pancreatic cancer. The strong inverse association observed in case-control studies may be affected by biases (eg, recall and selection biases) that particularly affect case-control studies and/or potential publication bias. Future prospective studies of vitamin C intake and pancreatic cancer are needed.

Buffering effects of job resources on the association of overtime work hours with psychological distress in Japanese white-collar workers.

PubMed

Hino, Ayako; Inoue, Akiomi; Kawakami, Norito; Tsuno, Kanami; Tomioka, Kimiko; Nakanishi, Mayuko; Mafune, Kosuke; Hiro, Hisanori

2015-07-01

The purpose of the present study was to investigate the buffering effects of job resources, utilizing the job demands-control (or demand-control-support) and effort-reward imbalance models (i.e., job control, workplace social support, and extrinsic reward), on the association of overtime work hours with psychological distress in Japanese employees. A total of 1,198 participants (valid response rate = 93.7 %) from five branches of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales assessing job resources, psychological distress, and demographic characteristics. We obtained the information on working hours in the most recent month from the personnel records of the surveyed company. Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of overtime work hours with each job resource was included in the model. Significant interaction effect of overtime work hours with job control was observed. Among the low job control group, the long overtime (80 h or more) subgroup had a significantly higher prevalence odds ratio of psychological distress compared to the short overtime (44 h or less) subgroup. No significant association of overtime work hours with psychological distress was found among the high job control group. On the other hand, there was no significant interaction effect of overtime work hours with workplace social support or extrinsic reward. The present findings suggest that high job control has an effect on reducing psychological distress in relation to overtime work hours in Japanese employees.

A Comparison between the Use of Beta Weights and Structure Coefficients in Interpreting Regression Results

ERIC Educational Resources Information Center

Tong, Fuhui

2006-01-01

Background: An extensive body of researches has favored the use of regression over other parametric analyses that are based on OVA. In case of noteworthy regression results, researchers tend to explore magnitude of beta weights for the respective predictors. Purpose: The purpose of this paper is to examine both beta weights and structure…

A tutorial on the piecewise regression approach applied to bedload transport data

Treesearch

Sandra E. Ryan; Laurie S. Porth

2007-01-01

This tutorial demonstrates the application of piecewise regression to bedload data to define a shift in phase of transport so that the reader may perform similar analyses on available data. The use of piecewise regression analysis implicitly recognizes different functions fit to bedload data over varying ranges of flow. The transition from primarily low rates of sand...

Stress in 1st-year women teachers: the context of social support and coping.

PubMed

Schonfeld, I S

2001-05-01

The effects of adverse work environments were examined in the context of other risk/protective factors in this extension of a short-term longitudinal study involving 184 newly appointed women teachers. Regression analyses revealed that-adjusting for preemployment levels of the outcomes and negative affectivity-social support and adversity in the fall work environment were among the factors that affected spring depressive symptoms, self-esteem, job satisfaction, and motivation to teach. Support from nonwork sources was directly related to future improved symptom levels and self-esteem; supervisor and colleague support were directly related to future job satisfaction. Effects of occupational coping, professional efficacy, locus of control, and school factors (e.g., special vs. regular education) were largely nonsignificant. Structural equation analyses indicated that adverse working conditions began to seriously affect the women soon after they started teaching.

The impact of downsizing on remaining workers' sickness absence.

PubMed

Østhus, Ståle; Mastekaasa, Arne

2010-10-01

It is generally assumed that organizational downsizing has considerable negative consequences, not only for workers that are laid off, but also for those who remain employed. The empirical evidence with regard to effects on sickness absence is, however, inconsistent. This study employs register data covering a major part of the total workforce in Norway over the period 2000-2003. The number of sickness absence episodes and the number of sickness absence days are analysed by means of Poisson regression. To control for both observed and unobserved stable individual characteristics, we use conditional (fixed effects) estimation. The analyses provide some weak indications that downsizing may lead to slightly less sickness absence, but the overall impression is that downsizing has few if any effects on the sickness absence of the remaining employees. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does early reading failure decrease children's reading motivation?

PubMed

Morgan, Paul L; Fuchs, Douglas; Compton, Donald L; Cordray, David S; Fuchs, Lynn S

2008-01-01

The authors used a pretest-posttest control group design with random assignment to evaluate whether early reading failure decreases children's motivation to practice reading. First, they investigated whether 60 first-grade children would report substantially different levels of interest in reading as a function of their relative success or failure in learning to read. Second, they evaluated whether increasing the word reading ability of 15 at-risk children would lead to gains in their motivation to read. Multivariate analyses of variance suggest marked differences in both motivation and reading practice between skilled and unskilled readers. However, bolstering at-risk children's word reading ability did not yield evidence of a causal relationship between early reading failure and decreased motivation to engage in reading activities. Instead, hierarchical regression analyses indicate a covarying relationship among early reading failure, poor motivation, and avoidance of reading.

The influence of inattention and rapid automatized naming on reading performance.

PubMed

Pham, Andy V; Fine, Jodene Goldenring; Semrud-Clikeman, Margaret

2011-04-01

The current study examined the relation between attention, rapid automatized naming (RAN), and reading fluency among typically developing children. A total of 104 third- and fourth-grade children (8-11 years of age) completed RAN measures consisting of four stimuli (letter, digit, color, and object) and an oral reading fluency measure from the Gray Oral Reading Test-Fourth Edition. Correlational and hierarchical regression analyses revealed that all four RAN stimuli, particularly letter RAN, were significant predictors of reading fluency. Additionally, parent and teacher ratings of inattention from the Swanson, Nolan and Pelham-Version Four rating scale predicted RAN after controlling for gender, working memory, and estimated IQ. Further analyses indicated that RAN performance mediated the relation between inattention and reading fluency. Results support the need to consider attentional variables when assessing reading performance, even among typically developing children.

What happens at work stays at work? Workplace supervisory social interactions and blood pressure outcomes.

PubMed

Wong, Jennifer H K; Kelloway, E Kevin

2016-04-01

We investigated the relationship between workplace supervisory social interactions and blood pressure outcomes using hourly diary entries and ambulatory blood pressure data from an experience sampling study of 55 long-term care employees. After accounting for relevant cardiovascular controls, significant effects of supervisory interactions on cardiovascular reactivity and recovery were found. Multilevel analyses revealed that negatively perceived supervisory interactions predicted higher systolic blood pressure at work (B = -1.59, p < .05, N observations = 422). Using time-lagged hierarchical regression analyses, the average perceived valence of supervisory interactions at work predicted average systolic blood pressure recovery after work (B = -14.52, p < .05, N = 33). Specifically, negatively perceived supervisory interactions at work predicted poorer cardiovascular recovery after work. Suggestions for improving practices in organizations and in experience sampling research are discussed. (c) 2016 APA, all rights reserved).

Types of employment and their associations with work characteristics and health in Swedish women and men.

PubMed

Samuelsson, Åsa; Houkes, Inge; Verdonk, Petra; Hammarström, Anne

2012-03-01

To investigate whether type of employment was related to work characteristics and health status at age 42 adjusted for health status at age 30 and whether gender moderates the associations. Questionnaire data was used from a 27-year follow-up study of school-leavers carried out in Luleå in the north of Sweden (response rate 94%). The study population consisted of 877 (47.8% women) working respondents. Data were analysed by means of t-tests, ANOVAs, and multiple linear regression analyses. Men were more often self-employed, while more women had temporary types of employment. Moreover, men reported more control over work and less emotional exhaustion than women. Compared to permanently employed, self-employed (men and women) perceived more control over work and better health status (p<0.01). Self-employed men also reported more demands and social support (p<0.05). People in temporary types of employment, however, reported less job control, as well as lower health status (only men) (p<0.01). Poor self-reported health and emotional exhaustion were significantly (p<0.05) associated with poor work characteristics (more demands, lower job control, and lower support). No direct associations between type of employment and health were found for women and men. However we find indications of an influence of type of employment on work and thereupon health, with job control playing an important role.

Quasi-causal associations of physical activity and neighborhood walkability with body mass index: a twin study.

PubMed

Duncan, Glen E; Cash, Stephanie Whisnant; Horn, Erin E; Turkheimer, Eric

2015-01-01

Physical activity, neighborhood walkability, and body mass index (BMI, kg/m(2)) associations were tested using quasi-experimental twin methods. We hypothesized that physical activity and walkability were independently associated with BMI within twin pairs, controlling for genetic and environmental background shared between them. Data were from 6376 (64% female; 58% identical) same-sex pairs, University of Washington Twin Registry, 2008-2013. Neighborhood walking, moderate-to-vigorous physical activity (MVPA), and BMI were self-reported. Residential address was used to calculate walkability. Phenotypic (non-genetically informed) and biometric (genetically informed) regression was employed, controlling for age, sex, and race. Walking and MVPA were associated with BMI in phenotypic analyses; associations were attenuated but significant in biometric analyses (Ps<0.05). Walkability was not associated with BMI, however, was associated with walking (but not MVPA) in both phenotypic and biometric analyses (Ps<0.05), with no attenuation accounting for shared genetic and environmental background. The association between activity and BMI is largely due to shared genetic and environmental factors, but a significant causal relationship remains accounting for shared background. Although walkability is not associated with BMI, it is associated with neighborhood walking (but not MVPA) accounting for shared background, suggesting a causal relationship between them. Copyright © 2014 Elsevier Inc. All rights reserved.

Depressive symptoms and psychosocial stress at work among older employees in three continents.

PubMed

Siegrist, Johannes; Lunau, Thorsten; Wahrendorf, Morten; Dragano, Nico

2012-07-20

To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia. Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006) testing associations of psychosocial stress at work ('effort-reward imbalance'; 'low control') with depressive symptoms. Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95% CI 1.02-2.63) in Japan to 1.97 (95% CI 1.75-2.23) in Europe and 2.28 (95% CI 1.59-3.28) in the USA. Odds ratios from additional longitudinal analyses (in 13 countries) controlling for baseline depression are smaller, but remain in part significant. Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.

Health among hospital employees in Europe: a cross-national study of the impact of work stress and work control.

PubMed

Pisljar, Tjasa; van der Lippe, Tanja; den Dulk, Laura

2011-03-01

This article analyses the effect of working conditions on the health of hospital employees across Europe. Hospital employees often have demanding jobs that increase their stress levels and, consequently, their risk of health problems. Work control - typified by employee autonomy and working time flexibility - helps them cope with high levels of work stress. Researchers have traditionally studied the relationship between working conditions, coping strategies and occupational health from an individual perspective. We argue that the individual work-health relationship is closely connected with the social and institutional context. This study explores how work stress and work control influence the health of hospital employees and aims to understand cross-country differences in this respect. Using data on over 1500 hospital employees who participated in the study 'Quality of work and life in a changing Europe' (2007) in eight European countries, we used ordinal regression analyses to test a range of hypotheses. The results show that work stress has a negative effect on the health of hospital employees, while work control is not found to have any effect on their health. Comparative analyses reveal that the effects of working conditions on health vary across European countries. While working overtime is more closely related to poorer health in Eastern European countries, we found evidence of a positive relationship between job autonomy and health in Western Europe only, indicating that circumstances in the working environment have differing effects on employee health in Eastern and Western Europe. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effectiveness of electronic stability control on single-vehicle accidents.

PubMed

Lyckegaard, Allan; Hels, Tove; Bernhoft, Inger Marie

2015-01-01

This study aims at evaluating the effectiveness of electronic stability control (ESC) on single-vehicle injury accidents while controlling for a number of confounders influencing the accident risk. Using police-registered injury accidents from 2004 to 2011 in Denmark with cars manufactured in the period 1998 to 2011 and the principle of induced exposure, 2 measures of the effectiveness of ESC were calculated: The crude odds ratio and the adjusted odds ratio, the latter by means of logistic regression. The logistic regression controlled for a number of confounding factors, of which the following were significant. For the driver: Age, gender, driving experience, valid driving license, and seat belt use. For the vehicle: Year of registration, weight, and ESC. For the accident surroundings: Visibility, light, and location. Finally, for the road: Speed limit, surface, and section characteristics. The present study calculated the crude odds ratio for ESC-equipped cars of getting in a single-vehicle injury accident as 0.40 (95% confidence interval [CI], 0.34-0.47) and the adjusted odds ratio as 0.69 (95% CI, 0.54-0.88). No difference was found in the effectiveness of ESC across the injury severity categories (slight, severe, and fatal). In line with previous results, this study concludes that ESC reduces the risk for single-vehicle injury accidents by 31% when controlling for various confounding factors related to the driver, the car, and the accident surroundings. Furthermore, it is concluded that it is important to control for human factors (at a minimum age and gender) in analyses where evaluations of this type are performed.

A case-control study of the risk factors for obstetric fistula in Tigray, Ethiopia.

PubMed

Lewis Wall, L; Belay, Shewaye; Haregot, Tesfahun; Dukes, Jonathan; Berhan, Eyoel; Abreha, Melaku

2017-12-01

We tested the null hypothesis that there were no differences between patients with obstetric fistula and parous controls without fistula. A unmatched case-control study was carried out comparing 75 women with a history of obstetric fistula with 150 parous controls with no history of fistula. Height and weight were measured for each participant, along with basic socio-demographic and obstetric information. Descriptive statistics were calculated and differences between the groups were analyzed using Student's t test, Mann-Whitney U test where appropriate, and Chi-squared or Fisher's exact test, along with backward stepwise logistic regression analyses to detect predictors of obstetric fistula. Associations with a p value <0.05 were considered significant. Patients with fistulas married earlier and delivered their first pregnancies earlier than controls. They had significantly less education, a higher prevalence of divorce/separation, and lived in more impoverished circumstances than controls. Fistula patients had worse reproductive histories, with greater numbers of stillbirths/abortions and higher rates of assisted vaginal delivery and cesarean section. The final logistic regression model found four significant risk factors for developing an obstetric fistula: age at marriage (OR 1.23), history of assisted vaginal delivery (OR 3.44), lack of adequate antenatal care (OR 4.43), and a labor lasting longer than 1 day (OR 14.84). Our data indicate that obstetric fistula results from the lack of access to effective obstetrical services when labor is prolonged. Rural poverty and lack of adequate transportation infrastructure are probably important co-factors in inhibiting access to needed care.

Alzheimer's disease is associated with prostate cancer: a population-based study.

PubMed

Lin, Herng-Ching; Kao, Li-Ting; Chung, Shiu-Dong; Huang, Chung-Chien; Shia, Ben-Chang; Huang, Chao-Yuan

2018-01-26

Alzheimer's disease and cancer are increasingly prevalent with advancing age. However, the association between Alzheimer's disease and prostate cancer remains unclear. The aim of this study was to examine the relationship between prior Alzheimer's disease and subsequent prostate cancer using a population-based dataset in Taiwan. Data for this study were sourced from the Taiwan Longitudinal Health Insurance Database 2005. This case-control study included 2101 prostate cancer patients as cases and 6303 matched controls. We used conditional logistic regression analyses to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI) for Alzheimer's disease between prostate cancer patients and controls. We found that of the 8404 sampled patients, 128 (1.5%) had been diagnosed with Alzheimer's disease prior to the index date. A Chi-squared test showed that there was a significant difference in the prevalences of prior Alzheimer's disease between prostate cancer patients and controls (2.1% vs. 1.3%, p < 0.001). The conditional logistic regression analysis showed that the OR of prior Alzheimer's disease for prostate cancer patients was 1.53 (95% CI: 1.06∼2.21) compared to controls. Furthermore, the OR of prior Alzheimer's disease for prostate cancer patients was 1.52 (95% CI: 1.04∼2.22) compared to controls after adjusting for hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, prostatitis, gonorrhea or chlamydia infection, testitis or epididymitis, and alcohol abuse/alcohol dependency syndrome. This study revealed an association between prior Alzheimer's disease and prostate cancer. We suggest that clinicians be alert to the increased risk of prostate cancer when caring for elderly individuals with Alzheimer's disease.

Brief Motivational Interventions Are Associated With Reductions in Alcohol-Impaired Driving Among College Drinkers

PubMed Central

Teeters, Jenni B.; Borsari, Brian; Martens, Matthew P.; Murphy, James G.

2015-01-01

Objective: Alcohol-impaired (AI) driving among college students remains a significant public health concern and may be the single most risky drinking outcome among young adults. Brief motivational interventions (BMIs) have been shown to reduce alcohol use and problems, but their specific efficacy for decreasing AI driving among college students is unknown. The present study analyzed data from three randomized controlled trials of BMI (Murphy et al., 2010: n = 74; Borsari et al., 2012: n = 530; and Martens et al., 2013: n = 365) to evaluate whether BMIs are associated with reductions in AI driving among college student drinkers. Method: Participants in all three studies were randomized to BMI or control conditions. Participants reported whether they had driven under the influence (yes/no) following the BMI over the follow-up period. Results: Separate binary logistic regression analyses were conducted for each study. For Studies 1 and 2, these analyses revealed that a BMI was significantly associated with reductions in AI driving at the final (6-month and 9-month, respectively) follow-up compared with the control condition. For Study 3, analyses revealed that a single-component BMI focused on the correction of misperceptions of descriptive norms was significantly associated with reductions in AI driving compared with the control group at the final (6-month) follow-up, whereas a single-component BMI focused on the use of protective behavioral strategies was not. Change in drinking level did not mediate the relationship between the condition and the change in AI driving. Conclusions: Counselor-administered BMIs that include descriptive normative feedback are associated with significant reductions in AI driving compared with control. PMID:26402350

Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.

PubMed

O'Connor, T M; Barry, P J; Jahangir, A; Finn, C; Buckley, B M; El-Gammal, A

2011-01-01

Arterial blood gases (ABGs) are often sampled incorrectly, leading to a 'mixed' or venous sample. Delays in analysis and air contamination are common. We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 · venous pH. There were no clinically significant differences in arterial PO₂ associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO₂ in all samples, including those that were immediately analyzed. Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO₂, indicating that air-contaminated ABGs should be discarded. Copyright © 2010 S. Karger AG, Basel.

PREvention STudy On preventing or reducing disability from musculoskeletal complaints in music school students (PRESTO): protocol of a randomised controlled trial.

PubMed

Baadjou, Vera A E; Verbunt, Jeanine A M C F; Eijsden-Besseling, Marjon D F van; Samama-Polak, Ans L W; Bie, Rob A D E; Smeets, Rob J E M

2014-12-01

Up to 87% of professional musicians develop work-related complaints of the musculoskeletal system during their careers. Music school students are at specific risk for developing musculoskeletal complaints and disabilities. This study aims to evaluate the effectiveness of a biopsychosocial prevention program to prevent or reduce disabilities from playing-related musculoskeletal disorders. Secondary objectives are evaluation of cost-effectiveness and feasibility. Healthy, first or second year students (n=150) will be asked to participate in a multicentre, single-blinded, parallel-group randomised controlled trial. Students randomised to the intervention group (n=75) will participate in a biopsychosocial prevention program that addresses playing-related health problems and provides postural training according to the Mensendieck or Cesar methods of postural exercise therapy, while incorporating aspects from behavioural change theories. A control group (n=75) will participate in a program that stimulates a healthy physical activity level using a pedometer, which conforms to international recommendations. No long-term effects are expected from this control intervention. Total follow-up duration is two years. The primary outcome measure is disability (Disabilities of Arm, Shoulder and Hand questionnaire). The secondary outcome measures are pain, quality of life and changes in health behaviour. Multilevel mixed-effect logistic or linear regression analyses will be performed to analyse the effects of the program on the aforementioned outcome measurements. Furthermore, cost-effectiveness, cost-utility and feasibility will be analysed. It is believed that this is the first comprehensive randomised controlled trial on the effect and rationale of a biopsychosocial prevention program for music students. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Neuroimaging studies of GABA in schizophrenia: a systematic review with meta-analysis.

PubMed

Egerton, A; Modinos, G; Ferrera, D; McGuire, P

2017-06-06

Data from animal models and from postmortem studies suggest that schizophrenia is associated with brain GABAergic dysfunction. The extent to which this is reflected in data from in vivo studies of GABA function in schizophrenia is unclear. The Medline database was searched to identify articles published until 21 October 2016. The search terms included GABA, proton magnetic resonance spectroscopy ( 1 H-MRS), positron emission tomography (PET), single photon emission computed tomography (SPECT), schizophrenia and psychosis. Sixteen GABA 1 H-MRS studies (538 controls, 526 patients) and seven PET/SPECT studies of GABA A /benzodiazepine receptor (GABA A /BZR) availability (118 controls, 113 patients) were identified. Meta-analyses of 1 H-MRS GABA in the medial prefrontal cortex (mPFC), parietal/occipital cortex (POC) and striatum did not show significant group differences (mFC: g=-0.3, 409 patients, 495 controls, 95% confidence interval (CI): -0.6 to 0.1; POC: g=-0.3, 139 patients, 111 controls, 95% CI: -0.9 to 0.3; striatum: g=-0.004, 123 patients, 95 controls, 95% CI: -0.7 to 0.7). Heterogeneity across studies was high (I 2 >50%), and this was not explained by subsequent moderator or meta-regression analyses. There were insufficient PET/SPECT receptor availability studies for meta-analyses, but a systematic review did not suggest replicable group differences in regional GABA A /BZR availability. The current literature does not reveal consistent alterations in in vivo GABA neuroimaging measures in schizophrenia, as might be hypothesized from animal models and postmortem data. The analysis highlights the need for further GABA neuroimaging studies with improved methodology and addressing potential sources of heterogeneity.

Neuroimaging studies of GABA in schizophrenia: a systematic review with meta-analysis

PubMed Central

Egerton, A; Modinos, G; Ferrera, D; McGuire, P

2017-01-01

Data from animal models and from postmortem studies suggest that schizophrenia is associated with brain GABAergic dysfunction. The extent to which this is reflected in data from in vivo studies of GABA function in schizophrenia is unclear. The Medline database was searched to identify articles published until 21 October 2016. The search terms included GABA, proton magnetic resonance spectroscopy (1H-MRS), positron emission tomography (PET), single photon emission computed tomography (SPECT), schizophrenia and psychosis. Sixteen GABA 1H-MRS studies (538 controls, 526 patients) and seven PET/SPECT studies of GABAA/benzodiazepine receptor (GABAA/BZR) availability (118 controls, 113 patients) were identified. Meta-analyses of 1H-MRS GABA in the medial prefrontal cortex (mPFC), parietal/occipital cortex (POC) and striatum did not show significant group differences (mFC: g=−0.3, 409 patients, 495 controls, 95% confidence interval (CI): −0.6 to 0.1; POC: g=−0.3, 139 patients, 111 controls, 95% CI: −0.9 to 0.3; striatum: g=−0.004, 123 patients, 95 controls, 95% CI: −0.7 to 0.7). Heterogeneity across studies was high (I2>50%), and this was not explained by subsequent moderator or meta-regression analyses. There were insufficient PET/SPECT receptor availability studies for meta-analyses, but a systematic review did not suggest replicable group differences in regional GABAA/BZR availability. The current literature does not reveal consistent alterations in in vivo GABA neuroimaging measures in schizophrenia, as might be hypothesized from animal models and postmortem data. The analysis highlights the need for further GABA neuroimaging studies with improved methodology and addressing potential sources of heterogeneity. PMID:28585933

Changes in the timing of snowmelt and streamflow in Colorado: A response to recent warming

USGS Publications Warehouse

Clow, David W.

2010-01-01

Trends in the timing of snowmelt and associated runoff in Colorado were evaluated for the 1978-2007 water years using the regional Kendall test (RKT) on daily snow-water equivalent (SWE) data from snowpack telemetry (SNOTEL) sites and daily streamflow data from headwater streams. The RKT is a robust, nonparametric test that provides an increased power of trend detection by grouping data from multiple sites within a given geographic region. The RKT analyses indicated strong, pervasive trends in snowmelt and streamflow timing, which have shifted toward earlier in the year by a median of 2-3 weeks over the 29-yr study period. In contrast, relatively few statistically significant trends were detected using simple linear regression. RKT analyses also indicated that November-May air temperatures increased by a median of 0.9 degrees C decade-1, while 1 April SWE and maximum SWE declined by a median of 4.1 and 3.6 cm decade-1, respectively. Multiple linear regression models were created, using monthly air temperatures, snowfall, latitude, and elevation as explanatory variables to identify major controlling factors on snowmelt timing. The models accounted for 45% of the variance in snowmelt onset, and 78% of the variance in the snowmelt center of mass (when half the snowpack had melted). Variations in springtime air temperature and SWE explained most of the interannual variability in snowmelt timing. Regression coefficients for air temperature were negative, indicating that warm temperatures promote early melt. Regression coefficients for SWE, latitude, and elevation were positive, indicating that abundant snowfall tends to delay snowmelt, and snowmelt tends to occur later at northern latitudes and high elevations. Results from this study indicate that even the mountains of Colorado, with their high elevations and cold snowpacks, are experiencing substantial shifts in the timing of snowmelt and snowmelt runoff toward earlier in the year.

Biomass Stoves and Lens Opacity and Cataract in Nepalese Women

PubMed Central

Pokhrel, Amod K.; Bates, Michael N.; Shrestha, Sachet P.; Bailey, Ian L.; DiMartino, Robert B.; Smith, Kirk R.; Joshi, N. D.

2014-01-01

Purpose Cataract is the most prevalent cause of blindness in Nepal. Several epidemiologic studies have associated cataracts with use of biomass cookstoves. These studies, however, have had limitations, including potential control selection bias and limited adjustment for possible confounding. This study, in Pokhara city, in an area of Nepal where biomass cookstoves are widely used without direct venting of the smoke to the outdoors, focuses on pre-clinical measures of opacity, while avoiding selection bias and taking into account comprehensive data on potential confounding factors Methods Using a cross-sectional study design, severity of lenticular damage, judged on the LOCS III scales, was investigated in females (n=143), aged 20-65 years, without previously diagnosed cataract. Linear and logistic regression analyses were used to examine the relationships with stove type and length of use. Clinically significant cataract, used in the logistic regression models, was defined as a LOCS III score > 2. Results Using gas cookstoves as the reference group, logistic regression analysis for nuclear cataract showed the evidence of relationships with stove type: for biomass stoves, the odds ratio (OR) was 2.58 (95% confidence interval [CI]: 1.22-5.46) and, for kerosene stoves, the OR was 5.18 (95% CI: 0.88-30.38). Similar results were found for nuclear color (LOCS III score > 2), but no association was found with cortical cataracts. Supporting a relationship between biomass stoves and nuclear cataract was a trend with years of exposure to biomass cookstoves (p=0.01). Linear regression analyses did not show clear evidence of an association between lenticular damage and stove types. Biomass fuel used for heating was not associated with any form of opacity. Conclusions This study provides support for associations of biomass and kerosene cookstoves with nuclear opacity and change in nuclear color. The novel associations with kerosene cookstove use deserve further investigation. PMID:23400024

Alcohol Misuse and Psychological Resilience among U.S. Iraq and Afghanistan Era Veteran Military Personnel

PubMed Central

Green, Kimberly T.; Beckham, Jean C.; Youssef, Nagy; Elbogen, Eric B.

2013-01-01

Objective The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse. Methodology Data were from National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up. Results Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models. Conclusions These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans. PMID:24090625

Impact of the Japanese 5S management method on patients' and caretakers' satisfaction: a quasi-experimental study in Senegal.

PubMed

Kanamori, Shogo; Castro, Marcia C; Sow, Seydou; Matsuno, Rui; Cissokho, Alioune; Jimba, Masamine

2016-01-01

The 5S method is a lean management tool for workplace organization, with 5S being an abbreviation for five Japanese words that translate to English as Sort, Set in Order, Shine, Standardize, and Sustain. In Senegal, the 5S intervention program was implemented in 10 health centers in two regions between 2011 and 2014. To identify the impact of the 5S intervention program on the satisfaction of clients (patients and caretakers) who visited the health centers. A standardized 5S intervention protocol was implemented in the health centers using a quasi-experimental separate pre-post samples design (four intervention and three control health facilities). A questionnaire with 10 five-point Likert items was used to measure client satisfaction. Linear regression analysis was conducted to identify the intervention's effect on the client satisfaction scores, represented by an equally weighted average of the 10 Likert items (Cronbach's alpha=0.83). Additional regression analyses were conducted to identify the intervention's effect on the scores of each Likert item. Backward stepwise linear regression ( n= 1,928) indicated a statistically significant effect of the 5S intervention, represented by an increase of 0.19 points in the client satisfaction scores in the intervention group, 6 to 8 months after the intervention ( p= 0.014). Additional regression analyses showed significant score increases of 0.44 ( p= 0.002), 0.14 ( p= 0.002), 0.06 ( p= 0.019), and 0.17 ( p= 0.044) points on four items, which, respectively were healthcare staff members' communication, explanations about illnesses or cases, and consultation duration, and clients' overall satisfaction. The 5S has the potential to improve client satisfaction at resource-poor health facilities and could therefore be recommended as a strategic option for improving the quality of healthcare service in low- and middle-income countries. To explore more effective intervention modalities, further studies need to address the mechanisms by which 5S leads to attitude changes in healthcare staff.

Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT.

PubMed

Voigt-Radloff, Sebastian; Graff, Maud; Leonhart, Rainer; Hüll, Michael; Rikkert, Marcel Olde; Vernooij-Dassen, Myrra

2011-08-09

Background The positive effects of the Dutch Community Occupational Therapy in Dementia programme on patients' daily functioning were not found in a multicentre randomised controlled trial (RCT) in Germany. Objectives To evaluate possible effect modification on the primary outcome within the German RCT with regard to (1) participant characteristics, (2) treatment performance and (3) healthcare service utilisation; and (4) to compare the design and primary outcome between the German and the original Dutch study. Methods (1) The impact of participant baseline data on the primary outcome was analysed in exploratory ANCOVA and regression analyses. (2) Therapists completed questionnaires on context and performance problems. The main problems were identified by a qualitative content analysis and focus-group discussion. Associations of the primary outcome with scores of participant adherence and treatment performance were evaluated by regression analysis. (3) Utilisation rates of healthcare services were controlled for significant group differences. (4) Differences in the Dutch and German study design were identified, and the primary outcome was contrasted at the item level. Results (1) Participant characteristics could not explain more than 5% of outcome variance. (2) The treatment performance of some active intervention components was poor but not significantly associated with the primary outcome. (3) There were no significant group differences in the utilisation of healthcare resources. (4) In contrast to the Dutch waiting-control group, the active intervention in the German control group may have reduced group differences in the current RCT. The German patients demonstrated a higher independence at baseline and less improvement in instrumental activities of daily living. Conclusion The differences in outcome may be explained by a more active control treatment, partially poor experimental treatment and less room for improvement in the German sample. Future cross-national transfers should be prepared by pilot studies assessing the applicability of the intervention and patient needs specific to the target country. Trial registration International Clinical Trials Registry Platform, DRKS00000053.

An Analysis of Terrestrial and Aquatic Environmental Controls of Riverine Dissolved Organic Carbon in the Conterminous United States

DOE PAGES

Yang, Qichun; Zhang, Xuesong; Xu, Xingya; ...

2017-05-29

Riverine carbon cycling is an important, but insufficiently investigated component of the global carbon cycle. Analyses of environmental controls on riverine carbon cycling are critical for improved understanding of mechanisms regulating carbon processing and storage along the terrestrial-aquatic continuum. Here, we compile and analyze riverine dissolved organic carbon (DOC) concentration data from 1402 United States Geological Survey (USGS) gauge stations to examine the spatial variability and environmental controls of DOC concentrations in the United States (U.S.) surface waters. DOC concentrations exhibit high spatial variability, with an average of 6.42 ± 6.47 mg C/ L (Mean ± Standard Deviation). In general,more » high DOC concentrations occur in the Upper Mississippi River basin and the Southeastern U.S., while low concentrations are mainly distributed in the Western U.S. Single-factor analysis indicates that slope of drainage areas, wetlands, forests, percentage of first-order streams, and instream nutrients (such as nitrogen and phosphorus) pronouncedly influence DOC concentrations, but the explanatory power of each bivariate model is lower than 35%. Analyses based on the general multi-linear regression models suggest DOC concentrations are jointly impacted by multiple factors. Soil properties mainly show positive correlations with DOC concentrations; forest and shrub lands have positive correlations with DOC concentrations, but urban area and croplands demonstrate negative impacts; total instream phosphorus and dam density correlate positively with DOC concentrations. Notably, the relative importance of these environmental controls varies substantially across major U.S. water resource regions. In addition, DOC concentrations and environmental controls also show significant variability from small streams to large rivers, which may be caused by changing carbon sources and removal rates by river orders. In sum, our results reveal that general multi-linear regression analysis of twenty one terrestrial and aquatic environmental factors can partially explain (56%) the DOC concentration variation. In conclusion, this study highlights the complexity of the interactions among these environmental factors in determining DOC concentrations, thus calls for processes-based, non-linear methodologies to constrain uncertainties in riverine DOC cycling.« less

Reduced Pineal Volume in Alzheimer Disease: A Retrospective Cross-sectional MR Imaging Study.

PubMed

Matsuoka, Teruyuki; Imai, Ayu; Fujimoto, Hiroshi; Kato, Yuka; Shibata, Keisuke; Nakamura, Kaeko; Yokota, Hajime; Yamada, Kei; Narumoto, Jin

2018-01-01

Purpose To evaluate pineal volume in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and healthy control subjects and to correlate the findings with results of cognitive testing and brain parenchymal volumes. Materials and Methods The ethics committee approved this retrospective study. The participants included 63 patients with AD, 33 patients with MCI, and 24 healthy control subjects. There were 36 men and 84 women, with a mean age (±standard deviation) of 76.7 years ± 7.6. The pineal gland volume and pineal parenchymal volume were measured by using three-dimensional volumetric magnetic resonance imaging (T1-weighted magnetization-prepared rapid gradient-echo sequence; spatial resolution, 0.9 × 0.98 × 0.98 mm). With age and total intracranial volume as covariates, analysis of covariance with the Bonferroni post hoc test was performed to compare the pineal volume among the AD, MCI, and control groups. Multiple regression analyses were used to identify predictor variables associated with pineal volume. Results The mean pineal gland volume in patients with AD (72.3 mm 3 ± 5.4; 95% confidence interval [CI]: 61.5 mm 3 , 83.1 mm 3 ) was significantly smaller than that in control subjects (102.1 mm 3 ± 9.0; 95% CI: 84.4 mm 3 , 119.9 mm 3 ) (P = .019). The mean pineal parenchymal volume in patients with AD (63.8 mm 3 ± 4.2; 95% CI: 55.4 mm 3 , 72.1 mm 3 ) was significantly smaller than that in patients with MCI (81.7 mm 3 ± 5.8; 95% CI: 70.3 mm 3 , 93.1 mm 3 ; P = .044) and control subjects (89.1 mm 3 ± 6.9; 95% CI: 75.4 mm 3 , 102.9 mm 3 ; P = .009). Multiple regression analyses demonstrated that the Mini-Mental State Examination score and total intracranial volume were significant independent predictors of both pineal gland volume and pineal parenchymal volume (P < .001). Conclusion Pineal volume reduction showed correlation with cognitive decline and thus might be useful to predict cognitive decline in patients with AD. © RSNA, 2017.

Ecologic regression analysis and the study of the influence of air quality on mortality.

PubMed Central

Selvin, S; Merrill, D; Wong, L; Sacks, S T

1984-01-01

This presentation focuses entirely on the use and evaluation of regression analysis applied to ecologic data as a method to study the effects of ambient air pollution on mortality rates. Using extensive national data on mortality, air quality and socio-economic status regression analyses are used to study the influence of air quality on mortality. The analytic methods and data are selected in such a way that direct comparisons can be made with other ecologic regression studies of mortality and air quality. Analyses are performed by use of two types of geographic areas, age-specific mortality of both males and females and three pollutants (total suspended particulates, sulfur dioxide and nitrogen dioxide). The overall results indicate no persuasive evidence exists of a link between air quality and general mortality levels. Additionally, a lack of consistency between the present results and previous published work is noted. Overall, it is concluded that linear regression analysis applied to nationally collected ecologic data cannot be used to usefully infer a causal relationship between air quality and mortality which is in direct contradiction to other major published studies. PMID:6734568

Premenopausal endogenous steroid hormones and breast cancer risk: results from the Nurses' Health Study II.

PubMed

Fortner, Renée T; Eliassen, A Heather; Spiegelman, Donna; Willett, Walter C; Barbieri, Robert L; Hankinson, Susan E

2013-03-06

Prior research supports an association between endogenous sex steroids and breast cancer among postmenopausal women; the association is less clear among premenopausal women. We evaluated the associations between estrogens, androgens, progesterone and sex hormone binding globulin (SHBG) and breast cancer in a nested case-control study in the Nurses' Health Study II. Between 1996 and 1999, 29,611 participants provided blood samples; 18,521 provided samples timed in early follicular and mid-luteal phases of the menstrual cycle. A total of 634 women, premenopausal at blood collection, developed breast cancer between 1999 and 2009 and were matched to 1,264 controls (514 cases and 1,030 controls with timed samples). We used conditional logistic regression controlling for breast cancer risk factors for overall analyses; unconditional logistic regression additionally controlling for matching factors was used for subgroup analyses. In analyses of premenopausal estrogens including breast cancers diagnosed both before and after menopause, there was no association between follicular estradiol, estrone and free estradiol and risk of either total or invasive breast cancer. Luteal estradiol was positively associated with estrogen receptor positive (ER+)/progesterone receptor positive (PR+) cancers (5th vs. 1st quintile odds ratio (OR): 1.7 (95% confidence interval (CI): 1.0 to 2.9), Ptrend = 0.02). Luteal estrone, free estradiol and progesterone were not associated with risk. Androgens were suggestively or significantly associated with risk when the sample was restricted to invasive tumors (for example, testosterone: OR: 1.4 (1.0 to 2.0), Ptrend = 0.23) and ER+/PR+ disease (testosterone: OR: 1.7 (1.1 to 2.6) Ptrend = 0.10; dehydroepiandrosterone sulfate (DHEAS) OR: 1.3 (0.8 to 2.0) Ptrend = 0.05). SHBG was not associated with breast cancer risk. The results varied by menopausal status at diagnosis, with follicular estradiol suggestively positively associated with breast cancers in women premenopausal at diagnosis (OR: 1.1 (0.9 to 1.3) and significantly inversely associated with postmenopausal disease (OR: 0.6 (0.4 to 0.9); Pheterogeneity < 0.01). Androgens were associated with modestly increased risk of breast cancer in this population, with stronger associations for invasive and ER+/PR+ disease. Luteal phase estradiol levels were suggestively associated with ER+/PR+ tumors but no other strong associations were observed with estrogens. Associations with follicular phase estrogens may vary by menopausal status at diagnosis, but case numbers were limited. Additional studies to confirm the role of premenopausal hormones in the etiology of both premenopausal and postmenopausal breast cancer are needed.

Evaluating the Effectiveness of Physlet-Based Materials in Supporting Conceptual Learning About Electricity

NASA Astrophysics Data System (ADS)

Ülen, Simon; Gerlič, Ivan; Slavinec, Mitja; Repnik, Robert

2017-04-01

To provide a good understanding of many abstract concepts in the field of electricity above that of their students is often a major challenge for secondary school teachers. Many educational researchers promote conceptual learning as a teaching approach that can help teachers to achieve this goal. In this paper, we present Physlet-based materials for supporting conceptual learning about electricity. To conduct research into the effectiveness of these materials, we designed two different physics courses: one group of students, the experimental group, was taught using Physlet-based materials and the second group of students, the control group, was taught using expository instruction without using Physlets. After completion of the teaching, we assessed students' thinking skills and analysed the materials with an independent t test, multiple regression analyses and one-way analysis of covariance. The test scores were significantly higher in the experimental group than in the control group ( p < 0.05). The results of this study confirmed the effectiveness of conceptual learning about electricity with the help of Physlet-based materials.

Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment

PubMed Central

Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C.; Kirk, Catherine M.; Bizimana, Justin I.; Betancourt, Theresa S.

2016-01-01

Fostering children is common in sub-Saharan Africa, but few studies examine these children’s mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10–17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes. PMID:27578000

Contributions of syntactic awareness to reading in Chinese-speaking adolescent readers with and without dyslexia.

PubMed

Chung, Kevin K H; Ho, Connie S-H; Chan, David W; Tsang, Suk-Man; Lee, Suk-Han

2013-02-01

This study investigated the relative contribution of syntactic awareness to Chinese reading among Chinese-speaking adolescent readers with and without dyslexia. A total of 78 junior high school students in Hong Kong, 26 dyslexic adolescent readers, 26 average adolescent readers of the same age (chronological age control group) and 26 younger readers matched with the same reading level (reading-level group) participated and were administered measures of IQ, syntactic awareness, morphological awareness, vocabulary knowledge, working memory, word reading, and reading comprehension. Results showed that dyslexic readers scored significantly lower than chronological age but similarly to reading level control groups in most measures, especially in the areas of syntactic skills. Analyses of individual data also revealed that over half of the dyslexic readers exhibited certain aspects of deficits in syntactic skills. In regression analyses, syntactic skills were the strongest predictors of ability in word reading and reading comprehension measures. This study highlights the uniquely important correlates of syntactic skills in Chinese reading acquisition and impairment. Copyright © 2013 John Wiley & Sons, Ltd.

Interventions to Improve Medication Adherence in Hypertensive Patients: Systematic Review and Meta-analysis.

PubMed

Conn, Vicki S; Ruppar, Todd M; Chase, Jo-Ana D; Enriquez, Maithe; Cooper, Pamela S

2015-12-01

This systematic review applied meta-analytic procedures to synthesize medication adherence interventions that focus on adults with hypertension. Comprehensive searching located trials with medication adherence behavior outcomes. Study sample, design, intervention characteristics, and outcomes were coded. Random-effects models were used in calculating standardized mean difference effect sizes. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression to explore associations between effect sizes and sample, design, and intervention characteristics. Effect sizes were calculated for 112 eligible treatment-vs.-control group outcome comparisons of 34,272 subjects. The overall standardized mean difference effect size between treatment and control subjects was 0.300. Exploratory moderator analyses revealed interventions were most effective among female, older, and moderate- or high-income participants. The most promising intervention components were those linking adherence behavior with habits, giving adherence feedback to patients, self-monitoring of blood pressure, using pill boxes and other special packaging, and motivational interviewing. The most effective interventions employed multiple components and were delivered over many days. Future research should strive for minimizing risks of bias common in this literature, especially avoiding self-report adherence measures.

Exercise motivation and adherence in cancer survivors after participation in a randomized controlled trial: an attribution theory perspective.

PubMed

Courneya, Kerry S; Friedenreich, Christine M; Sela, Rami A; Quinney, H Arthur; Rhodes, Ryan E; Jones, Lee W

2004-01-01

The purpose of this study was to examine postprogram exercise motivation and adherence in cancer survivors who participated in the Group Psychotherapy and Home-Based Physical Exercise (GROUP-HOPE; Courneya, Friedenreich, Sela, Quinney, & Rhodes, 2002) trial. At the completion of the GROUP-HOPE trial, 46 of 51 (90%) participants in the exercise group completed measures of attribution theory constructs. A 5-week follow-up self-report of exercise was then completed by 30 (65%) participants. Correlational analyses indicated that program exercise, perceived success, expected success, and affective reactions were strong predictors of postprogram exercise. In multivariate stepwise regression analyses, program exercise and perceived success were the strongest predictors of postprogram exercise. Additionally, perceived success was more important than objective success in understanding the attribution process, and it interacted with personal control to influence expected success and negative affect. Finally, postprogram quality of life and changes in physical fitness were correlates of perceived success. We concluded that attribution theory may have utility for understanding postprogram exercise motivation and adherence in cancer survivors.

[Analysis of intrusion errors in free recall].

PubMed

Diesfeldt, H F A

2017-06-01

Extra-list intrusion errors during five trials of the eight-word list-learning task of the Amsterdam Dementia Screening Test (ADST) were investigated in 823 consecutive psychogeriatric patients (87.1% suffering from major neurocognitive disorder). Almost half of the participants (45.9%) produced one or more intrusion errors on the verbal recall test. Correct responses were lower when subjects made intrusion errors, but learning slopes did not differ between subjects who committed intrusion errors and those who did not so. Bivariate regression analyses revealed that participants who committed intrusion errors were more deficient on measures of eight-word recognition memory, delayed visual recognition and tests of executive control (the Behavioral Dyscontrol Scale and the ADST-Graphical Sequences as measures of response inhibition). Using hierarchical multiple regression, only free recall and delayed visual recognition retained an independent effect in the association with intrusion errors, such that deficient scores on tests of episodic memory were sufficient to explain the occurrence of intrusion errors. Measures of inhibitory control did not add significantly to the explanation of intrusion errors in free recall, which makes insufficient strength of memory traces rather than a primary deficit in inhibition the preferred account for intrusion errors in free recall.

Randomized Trial of Intensive Housing Placement and Community Transition Services for Episodic and Recidivist Homeless Families

PubMed Central

Mitchell, Kristen; Pareti, Lauren; DeGenova, Joe; Heller, Anne; Hannigan, Anthony; Gholston, Jennifer

2013-01-01

Objectives. We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. Methods. Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. Results. Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P < .001), more commonly exited shelter with housing subsidies (75% vs 56%), stayed out of shelter longer (Cox regression, P = .011), and spent fewer total days in shelter (376 days vs 449 days). Home to Stay performed best with clients who entered shelter within 180 days of the pilot’s start date and had less impact on clients entering shelter before that time. Conclusions. Relative to standard services, Home to Stay services can accelerate exit from shelter and reduce return to shelter and total sheltered days for episodic and recidivist homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families. PMID:24148053

Burnout does not help predict depression among French school teachers.

PubMed

Bianchi, Renzo; Schonfeld, Irvin Sam; Laurent, Eric

2015-11-01

Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers. We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled for gender, age, and length of employment. Controlling for baseline depressive symptoms, linear regression analysis showed that burnout symptoms at time 1 (T1) did not predict depressive symptoms at time 2 (T2). Baseline depressive symptoms accounted for about 88% of the association between T1 burnout and T2 depressive symptoms. Only baseline depressive symptoms predicted depressive symptoms at follow-up. Similarly, logistic regression analysis revealed that burnout symptoms at T1 did not predict incident cases of major depression at T2 when depressive symptoms at T1 were included in the predictive model. Only baseline depressive symptoms predicted cases of major depression at follow-up. This study does not support the view that burnout is a phase in the development of depression. Assessing burnout symptoms in addition to "classical" depressive symptoms may not always improve our ability to predict future depression.

Multidimensional analysis of the effect of occupational exposure to organic solvents on lung cancer risk: the ICARE study

PubMed Central

Mattei, Francesca; Liverani, Silvia; Guida, Florence; Matrat, Mireille; Cenée, Sylvie; Azizi, Lamiae; Menvielle, Gwenn; Sanchez, Marie; Pilorget, Corinne; Lapôtre-Ledoux, Bénédicte; Luce, Danièle; Richardson, Sylvia; Stücker, Isabelle

2016-01-01

Background The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances. Objectives The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos. Methods We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case–control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression. Results After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters. Conclusions Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk. PMID:26911986

Resting state fMRI reveals a default mode dissociation between retrosplenial and medial prefrontal subnetworks in ASD despite motion scrubbing.

PubMed

Starck, Tuomo; Nikkinen, Juha; Rahko, Jukka; Remes, Jukka; Hurtig, Tuula; Haapsamo, Helena; Jussila, Katja; Kuusikko-Gauffin, Sanna; Mattila, Marja-Leena; Jansson-Verkasalo, Eira; Pauls, David L; Ebeling, Hanna; Moilanen, Irma; Tervonen, Osmo; Kiviniemi, Vesa J

2013-01-01

In resting state functional magnetic resonance imaging (fMRI) studies of autism spectrum disorders (ASDs) decreased frontal-posterior functional connectivity is a persistent finding. However, the picture of the default mode network (DMN) hypoconnectivity remains incomplete. In addition, the functional connectivity analyses have been shown to be susceptible even to subtle motion. DMN hypoconnectivity in ASD has been specifically called for re-evaluation with stringent motion correction, which we aimed to conduct by so-called scrubbing. A rich set of default mode subnetworks can be obtained with high dimensional group independent component analysis (ICA) which can potentially provide more detailed view of the connectivity alterations. We compared the DMN connectivity in high-functioning adolescents with ASDs to typically developing controls using ICA dual-regression with decompositions from typical to high dimensionality. Dual-regression analysis within DMN subnetworks did not reveal alterations but connectivity between anterior and posterior DMN subnetworks was decreased in ASD. The results were very similar with and without motion scrubbing thus indicating the efficacy of the conventional motion correction methods combined with ICA dual-regression. Specific dissociation between DMN subnetworks was revealed on high ICA dimensionality, where networks centered at the medial prefrontal cortex and retrosplenial cortex showed weakened coupling in adolescents with ASDs compared to typically developing control participants. Generally the results speak for disruption in the anterior-posterior DMN interplay on the network level whereas local functional connectivity in DMN seems relatively unaltered.

Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders.

PubMed

Seligman, D A; Pullinger, A G

2000-01-01

Confusion about the relationship of occlusion to temporomandibular disorders (TMD) persists. This study attempted to identify occlusal and attrition factors plus age that would characterize asymptomatic normal female subjects. A total of 124 female patients with intracapsular TMD were compared with 47 asymptomatic female controls for associations to 9 occlusal factors, 3 attrition severity measures, and age using classification tree, multiple stepwise logistic regression, and univariate analyses. Models were tested for accuracy (sensitivity and specificity) and total contribution to the variance. The classification tree model had 4 terminal nodes that used only anterior attrition and age. "Normals" were mainly characterized by low attrition levels, whereas patients had higher attrition and tended to be younger. The tree model was only moderately useful (sensitivity 63%, specificity 94%) in predicting normals. The logistic regression model incorporated unilateral posterior crossbite and mediotrusive attrition severity in addition to the 2 factors in the tree, but was slightly less accurate than the tree (sensitivity 51%, specificity 90%). When only occlusal factors were considered in the analysis, normals were additionally characterized by a lack of anterior open bite, smaller overjet, and smaller RCP-ICP slides. The log likelihood accounted for was similar for both the tree (pseudo R(2) = 29.38%; mean deviance = 0.95) and the multiple logistic regression (Cox Snell R(2) = 30.3%, mean deviance = 0.84) models. The occlusal and attrition factors studied were only moderately useful in differentiating normals from TMD patients.

"Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review".

PubMed

Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen

2017-10-01

The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.

Branched-chain amino acids for people with hepatic encephalopathy.

PubMed

Gluud, Lise Lotte; Dam, Gitte; Les, Iñigo; Córdoba, Juan; Marchesini, Giulio; Borre, Mette; Aagaard, Niels Kristian; Vilstrup, Hendrik

2015-02-25

Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. To evaluate the beneficial and harmful effects of BCAA versus any control intervention for people with hepatic encephalopathy. We identified trials through manual and electronic searches in The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index on 2 October 2014. We included randomised clinical trials, irrespective of the bias control, language, or publication status. The authors independently extracted data based on published reports and collected data from the primary investigators. We changed our primary outcomes in this update of the review to include mortality (all cause), hepatic encephalopathy (number of people without improved manifestations of hepatic encephalopathy), and adverse events. The analyses included random-effects and fixed-effect meta-analyses. We performed subgroup, sensitivity, regression, and trial sequential analyses to evaluate sources of heterogeneity (including intervention, and participant and trial characteristics), bias (using The Cochrane Hepato-Biliary Group method), small-study effects, and the robustness of the results after adjusting for sparse data and multiplicity. We graded the quality of the evidence using the GRADE approach. We found 16 randomised clinical trials including 827 participants with hepatic encephalopathy classed as overt (12 trials) or minimal (four trials). Eight trials assessed oral BCAA supplements and seven trials assessed intravenous BCAA. The control groups received placebo/no intervention (two trials), diets (10 trials), lactulose (two trials), or neomycin (two trials). In 15 trials, all participants had cirrhosis. Based on the combined Cochrane Hepato-Biliary Group score, we classed seven trials as low risk of bias and nine trials as high risk of bias (mainly due to lack of blinding or for-profit funding). In a random-effects meta-analysis of mortality, we found no difference between BCAA and controls (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.69 to 1.11; 760 participants; 15 trials; moderate quality of evidence). We found no evidence of small-study effects. Sensitivity analyses of trials with a low risk of bias found no beneficial or detrimental effect of BCAA on mortality. Trial sequential analysis showed that the required information size was not reached, suggesting that additional evidence was needed. BCAA had a beneficial effect on hepatic encephalopathy (RR 0.73, 95% CI 0.61 to 0.88; 827 participants; 16 trials; high quality of evidence). We found no small-study effects and confirmed the beneficial effect of BCAA in a sensitivity analysis that only included trials with a low risk of bias (RR 0.71, 95% CI 0.52 to 0.96). The trial sequential analysis showed that firm evidence was reached. In a fixed-effect meta-analysis, we found that BCAA increased the risk of nausea and vomiting (RR 5.56; 2.93 to 10.55; moderate quality of evidence). We found no beneficial or detrimental effects of BCAA on nausea or vomiting in a random-effects meta-analysis or on quality of life or nutritional parameters. We did not identify predictors of the intervention effect in the subgroup, sensitivity, or meta-regression analyses. In sensitivity analyses that excluded trials with a lactulose or neomycin control, BCAA had a beneficial effect on hepatic encephalopathy (RR 0.76, 95% CI 0.63 to 0.92). Additional sensitivity analyses found no difference between BCAA and lactulose or neomycin (RR 0.66, 95% CI 0.34 to 1.30). In this updated review, we included five additional trials. The analyses showed that BCAA had a beneficial effect on hepatic encephalopathy. We found no effect on mortality, quality of life, or nutritional parameters, but we need additional trials to evaluate these outcomes. Likewise, we need additional randomised clinical trials to determine the effect of BCAA compared with interventions such as non-absorbable disaccharides, rifaximin, or other antibiotics.

Branched-chain amino acids for people with hepatic encephalopathy.

PubMed

Gluud, Lise Lotte; Dam, Gitte; Les, Iñigo; Marchesini, Giulio; Borre, Mette; Aagaard, Niels Kristian; Vilstrup, Hendrik

2017-05-18

Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. To evaluate the beneficial and harmful effects of BCAA versus any control intervention for people with hepatic encephalopathy. We identified trials through manual and electronic searches in The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Science Citation Index Expanded and Conference Proceedings Citation Index - Science, and LILACS (May 2017). We included randomised clinical trials, irrespective of the bias control, language, or publication status. The authors independently extracted data based on published reports and collected data from the primary investigators. We changed our primary outcomes in this update of the review to include mortality (all cause), hepatic encephalopathy (number of people without improved manifestations of hepatic encephalopathy), and adverse events. The analyses included random-effects and fixed-effect meta-analyses. We performed subgroup, sensitivity, regression, and trial sequential analyses to evaluate sources of heterogeneity (including intervention, and participant and trial characteristics), bias (using The Cochrane Hepato-Biliary Group method), small-study effects, and the robustness of the results after adjusting for sparse data and multiplicity. We graded the quality of the evidence using the GRADE approach. We found 16 randomised clinical trials including 827 participants with hepatic encephalopathy classed as overt (12 trials) or minimal (four trials). Eight trials assessed oral BCAA supplements and seven trials assessed intravenous BCAA. The control groups received placebo/no intervention (two trials), diets (10 trials), lactulose (two trials), or neomycin (two trials). In 15 trials, all participants had cirrhosis. We classed seven trials as low risk of bias and nine trials as high risk of bias (mainly due to lack of blinding or for-profit funding). In a random-effects meta-analysis of mortality, we found no difference between BCAA and controls (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.69 to 1.11; 760 participants; 15 trials; moderate quality of evidence). We found no evidence of small-study effects. Sensitivity analyses of trials with a low risk of bias found no beneficial or detrimental effect of BCAA on mortality. Trial sequential analysis showed that the required information size was not reached, suggesting that additional evidence was needed. BCAA had a beneficial effect on hepatic encephalopathy (RR 0.73, 95% CI 0.61 to 0.88; 827 participants; 16 trials; high quality of evidence). We found no small-study effects and confirmed the beneficial effect of BCAA in a sensitivity analysis that only included trials with a low risk of bias (RR 0.71, 95% CI 0.52 to 0.96). The trial sequential analysis showed that firm evidence was reached. In a fixed-effect meta-analysis, we found that BCAA increased the risk of nausea and vomiting (RR 5.56; 2.93 to 10.55; moderate quality of evidence). We found no beneficial or detrimental effects of BCAA on nausea or vomiting in a random-effects meta-analysis or on quality of life or nutritional parameters. We did not identify predictors of the intervention effect in the subgroup, sensitivity, or meta-regression analyses. In sensitivity analyses that excluded trials with a lactulose or neomycin control, BCAA had a beneficial effect on hepatic encephalopathy (RR 0.76, 95% CI 0.63 to 0.92). Additional sensitivity analyses found no difference between BCAA and lactulose or neomycin (RR 0.66, 95% CI 0.34 to 1.30). In this updated review, we included five additional trials. The analyses showed that BCAA had a beneficial effect on hepatic encephalopathy. We found no effect on mortality, quality of life, or nutritional parameters, but we need additional trials to evaluate these outcomes. Likewise, we need additional randomised clinical trials to determine the effect of BCAA compared with interventions such as non-absorbable disaccharides, rifaximin, or other antibiotics.

Branched-chain amino acids for people with hepatic encephalopathy.

PubMed

Gluud, Lise Lotte; Dam, Gitte; Les, Iñigo; Córdoba, Juan; Marchesini, Giulio; Borre, Mette; Aagaard, Niels Kristian; Vilstrup, Hendrik

2015-09-17

Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. To evaluate the beneficial and harmful effects of BCAA versus any control intervention for people with hepatic encephalopathy. We identified trials through manual and electronic searches in The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index (August 2015). We included randomised clinical trials, irrespective of the bias control, language, or publication status. The authors independently extracted data based on published reports and collected data from the primary investigators. We changed our primary outcomes in this update of the review to include mortality (all cause), hepatic encephalopathy (number of people without improved manifestations of hepatic encephalopathy), and adverse events. The analyses included random-effects and fixed-effect meta-analyses. We performed subgroup, sensitivity, regression, and trial sequential analyses to evaluate sources of heterogeneity (including intervention, and participant and trial characteristics), bias (using The Cochrane Hepato-Biliary Group method), small-study effects, and the robustness of the results after adjusting for sparse data and multiplicity. We graded the quality of the evidence using the GRADE approach. We found 16 randomised clinical trials including 827 participants with hepatic encephalopathy classed as overt (12 trials) or minimal (four trials). Eight trials assessed oral BCAA supplements and seven trials assessed intravenous BCAA. The control groups received placebo/no intervention (two trials), diets (10 trials), lactulose (two trials), or neomycin (two trials). In 15 trials, all participants had cirrhosis. We classed seven trials as low risk of bias and nine trials as high risk of bias (mainly due to lack of blinding or for-profit funding). In a random-effects meta-analysis of mortality, we found no difference between BCAA and controls (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.69 to 1.11; 760 participants; 15 trials; moderate quality of evidence). We found no evidence of small-study effects. Sensitivity analyses of trials with a low risk of bias found no beneficial or detrimental effect of BCAA on mortality. Trial sequential analysis showed that the required information size was not reached, suggesting that additional evidence was needed. BCAA had a beneficial effect on hepatic encephalopathy (RR 0.73, 95% CI 0.61 to 0.88; 827 participants; 16 trials; high quality of evidence). We found no small-study effects and confirmed the beneficial effect of BCAA in a sensitivity analysis that only included trials with a low risk of bias (RR 0.71, 95% CI 0.52 to 0.96). The trial sequential analysis showed that firm evidence was reached. In a fixed-effect meta-analysis, we found that BCAA increased the risk of nausea and vomiting (RR 5.56; 2.93 to 10.55; moderate quality of evidence). We found no beneficial or detrimental effects of BCAA on nausea or vomiting in a random-effects meta-analysis or on quality of life or nutritional parameters. We did not identify predictors of the intervention effect in the subgroup, sensitivity, or meta-regression analyses. In sensitivity analyses that excluded trials with a lactulose or neomycin control, BCAA had a beneficial effect on hepatic encephalopathy (RR 0.76, 95% CI 0.63 to 0.92). Additional sensitivity analyses found no difference between BCAA and lactulose or neomycin (RR 0.66, 95% CI 0.34 to 1.30). In this updated review, we included five additional trials. The analyses showed that BCAA had a beneficial effect on hepatic encephalopathy. We found no effect on mortality, quality of life, or nutritional parameters, but we need additional trials to evaluate these outcomes. Likewise, we need additional randomised clinical trials to determine the effect of BCAA compared with interventions such as non-absorbable disaccharides, rifaximin, or other antibiotics.

Association between bibliometric parameters, reporting and methodological quality of randomised controlled trials in vascular and endovascular surgery.

PubMed

Hajibandeh, Shahab; Hajibandeh, Shahin; Antoniou, George A; Green, Patrick A; Maden, Michelle; Torella, Francesco

2017-04-01

Purpose We aimed to investigate association between bibliometric parameters, reporting and methodological quality of vascular and endovascular surgery randomised controlled trials. Methods The most recent 75 and oldest 75 randomised controlled trials published in leading journals over a 10-year period were identified. The reporting quality was analysed using the CONSORT statement, and methodological quality with the Intercollegiate Guidelines Network checklist. We used exploratory univariate and multivariable linear regression analysis to investigate associations. Findings Bibliometric parameters such as type of journal, study design reported in title, number of pages; external funding, industry sponsoring and number of citations are associated with reporting quality. Moreover, parameters such as type of journal, subject area and study design reported in title are associated with methodological quality. Conclusions The bibliometric parameters of randomised controlled trials may be independent predictors for their reporting and methodological quality. Moreover, the reporting quality of randomised controlled trials is associated with their methodological quality and vice versa.

Parental psychological control and dysfunctional separation-individuation: a tale of two different dynamics.

PubMed

Kins, Evie; Soenens, Bart; Beyers, Wim

2012-10-01

This study examined associations between psychologically controlling parenting and two possible manifestations of problematic separation-individuation (i.e., dysfunctional dependence and dysfunctional independence). To explain these associations, it has been argued that psychological control is an inherently independence-stifling parenting dimension that gives rise to a dysfunctional dependent orientation. In this study, it was argued that psychological control may relate to dysfunctional dependence and dysfunctional independence, depending on whether parents' use of psychological control is driven by issues of interpersonal closeness (i.e., dependency-oriented psychological control) or by issues of achievement (i.e., achievement-oriented psychological control). A Belgian sample of 232 emerging adults, involved in the process of home leaving, and their parents completed self-report questionnaires. Regression analyses indicated that domain-specific expressions of psychological control were related differentially to dysfunctional dependent and dysfunctional independent manifestations of problematic separation-individuation. Emerging adults' residential status did not moderate these associations. Implications and directions for future research are discussed. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Selenium and breast cancer risk: A prospective nested case-control study on serum selenium levels, smoking habits and overweight.

PubMed

Sandsveden, Malte; Manjer, Jonas

2017-11-01

Previous research has not been conclusive regarding the association between selenium (Se) and breast cancer. This study was conducted to clarify if there is an association between prediagnostic serum Se levels and breast cancer risk. A population based cohort, the Malmö Diet and Cancer Study, was used and linked with the Swedish cancer registry up to 31 December 2013. Our study included 1,186 women with breast cancer and an equal number of controls. Selenium levels were analysed from stored serum samples. The included individuals were divided into quartiles based on Se value and we compared breast cancer cases with controls using logistic regression yielding odds ratios (OR) with 95% confidence intervals. Serum Se was also analysed as a continuous variable regarding breast cancer risk. The analyses were adjusted for established risk factors and stratified on smoking status and body mass index (BMI). When comparing the highest Se quartile with the lowest, the adjusted OR for breast cancer was 0.98 (0.75-1.26). With selenium as a continuous variable the adjusted OR was 1.00 (1.00-1.01) per 10 ng/ml. When comparing the highest with the lowest Se quartile in women with BMI > 25 kg/m 2 the adjusted OR was 0.77 (0.53-1.14). We conclude that it is unlikely that prediagnostic serum selenium is overall associated with breast cancer risk and no modifying effect from BMI or smoking was seen. © 2017 UICC.

Inclusion of quasi-experimental studies in systematic reviews of health systems research.

PubMed

Rockers, Peter C; Røttingen, John-Arne; Shemilt, Ian; Tugwell, Peter; Bärnighausen, Till

2015-04-01

Systematic reviews of health systems research commonly limit studies for evidence synthesis to randomized controlled trials. However, well-conducted quasi-experimental studies can provide strong evidence for causal inference. With this article, we aim to stimulate and inform discussions on including quasi-experiments in systematic reviews of health systems research. We define quasi-experimental studies as those that estimate causal effect sizes using exogenous variation in the exposure of interest that is not directly controlled by the researcher. We incorporate this definition into a non-hierarchical three-class taxonomy of study designs - experiments, quasi-experiments, and non-experiments. Based on a review of practice in three disciplines related to health systems research (epidemiology, economics, and political science), we discuss five commonly used study designs that fit our definition of quasi-experiments: natural experiments, instrumental variable analyses, regression discontinuity analyses, interrupted times series studies, and difference studies including controlled before-and-after designs, difference-in-difference designs and fixed effects analyses of panel data. We further review current practices regarding quasi-experimental studies in three non-health fields that utilize systematic reviews (education, development, and environment studies) to inform the design of approaches for synthesizing quasi-experimental evidence in health systems research. Ultimately, the aim of any review is practical: to provide useful information for policymakers, practitioners, and researchers. Future work should focus on building a consensus among users and producers of systematic reviews regarding the inclusion of quasi-experiments. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A web-based peer-modeling intervention aimed at lifestyle changes in patients with coronary heart disease and chronic back pain: sequential controlled trial.

PubMed

Schweier, Rebecca; Romppel, Matthias; Richter, Cynthia; Hoberg, Eike; Hahmann, Harry; Scherwinski, Inge; Kosmützky, Gregor; Grande, Gesine

2014-07-23

Traditional secondary prevention programs often fail to produce sustainable behavioral changes in everyday life. Peer-modeling interventions and integration of peer experiences in health education are a promising way to improve long-term effects in behavior modification. However, effects of peer support modeling on behavioral change have not been evaluated yet. Therefore, we implemented and evaluated a website featuring patient narratives about successful lifestyle changes. Our aim is to examine the effects of using Web-based patient narratives about successful lifestyle change on improvements in physical activity and eating behavior for patients with coronary heart disease and chronic back pain 3 months after participation in a rehabilitation program. The lebensstil-aendern ("lifestyle-change") website is a nonrestricted, no-cost, German language website that provides more than 1000 video, audio, and text clips from interviews with people with coronary heart disease and chronic back pain. To test efficacy, we conducted a sequential controlled trial and recruited patients with coronary heart disease and chronic back pain from 7 inpatient rehabilitation centers in Germany. The intervention group attended a presentation on the website; the control group did not. Physical activity and eating behavior were assessed by questionnaire during the rehabilitation program and 12 weeks later. Analyses were conducted based on an intention-to-treat and an as-treated protocol. A total of 699 patients were enrolled and 571 cases were included in the analyses (control: n=313, intervention: n=258; female: 51.1%, 292/571; age: mean 53.2, SD 8.6 years; chronic back pain: 62.5%, 357/571). Website usage in the intervention group was 46.1% (119/258). In total, 141 trial participants used the website. Independent t tests based on the intention-to-treat protocol only demonstrated nonsignificant trends in behavioral change related to physical activity and eating behavior. Multivariate regression analyses confirmed belonging to the intervention group was an independent predictor of self-reported improvements in physical activity regularity (β=.09, P=.03) and using less fat for cooking (β=.09, P=.04). In independent t tests based on the as-treated protocol, website use was associated with higher self-reported improvements in integrating physical activity into daily routine (d=0.22, P=.02), in physical activity regularity (d=0.23, P=.02), and in using less fat for cooking (d=0.21, P=.03). Multivariate regression analyses revealed that using the website at least 3 times was the only factor associated with improved lifestyle behaviors. Usage of the lebensstil-aendern website corresponds to more positive lifestyle changes. However, as-treated analyses do not allow for differentiating between causal effects and selection bias. Despite these limitations, the trial indicates that more than occasional website usage is necessary to reach dose-response efficacy. Therefore, future studies should concentrate on strategies to improve adherence to Web-based interventions and to encourage more frequent usage of these programs.

An artificial neural network prediction model of congenital heart disease based on risk factors: A hospital-based case-control study.

PubMed

Li, Huixia; Luo, Miyang; Zheng, Jianfei; Luo, Jiayou; Zeng, Rong; Feng, Na; Du, Qiyun; Fang, Junqun

2017-02-01

An artificial neural network (ANN) model was developed to predict the risks of congenital heart disease (CHD) in pregnant women.This hospital-based case-control study involved 119 CHD cases and 239 controls all recruited from birth defect surveillance hospitals in Hunan Province between July 2013 and June 2014. All subjects were interviewed face-to-face to fill in a questionnaire that covered 36 CHD-related variables. The 358 subjects were randomly divided into a training set and a testing set at the ratio of 85:15. The training set was used to identify the significant predictors of CHD by univariate logistic regression analyses and develop a standard feed-forward back-propagation neural network (BPNN) model for the prediction of CHD. The testing set was used to test and evaluate the performance of the ANN model. Univariate logistic regression analyses were performed on SPSS 18.0. The ANN models were developed on Matlab 7.1.The univariate logistic regression identified 15 predictors that were significantly associated with CHD, including education level (odds ratio  = 0.55), gravidity (1.95), parity (2.01), history of abnormal reproduction (2.49), family history of CHD (5.23), maternal chronic disease (4.19), maternal upper respiratory tract infection (2.08), environmental pollution around maternal dwelling place (3.63), maternal exposure to occupational hazards (3.53), maternal mental stress (2.48), paternal chronic disease (4.87), paternal exposure to occupational hazards (2.51), intake of vegetable/fruit (0.45), intake of fish/shrimp/meat/egg (0.59), and intake of milk/soymilk (0.55). After many trials, we selected a 3-layer BPNN model with 15, 12, and 1 neuron in the input, hidden, and output layers, respectively, as the best prediction model. The prediction model has accuracies of 0.91 and 0.86 on the training and testing sets, respectively. The sensitivity, specificity, and Yuden Index on the testing set (training set) are 0.78 (0.83), 0.90 (0.95), and 0.68 (0.78), respectively. The areas under the receiver operating curve on the testing and training sets are 0.87 and 0.97, respectively.This study suggests that the BPNN model could be used to predict the risk of CHD in individuals. This model should be further improved by large-sample-size research.

Presenilin E318G variant and Alzheimer's disease risk: the Cache County study.

PubMed

Hippen, Ariel A; Ebbert, Mark T W; Norton, Maria C; Tschanz, JoAnn T; Munger, Ronald G; Corcoran, Christopher D; Kauwe, John S K

2016-06-29

Alzheimer's disease is the leading cause of dementia in the elderly and the third most common cause of death in the United States. A vast number of genes regulate Alzheimer's disease, including Presenilin 1 (PSEN1). Multiple studies have attempted to locate novel variants in the PSEN1 gene that affect Alzheimer's disease status. A recent study suggested that one of these variants, PSEN1 E318G (rs17125721), significantly affects Alzheimer's disease status in a large case-control dataset, particularly in connection with the APOEε4 allele. Our study looks at the same variant in the Cache County Study on Memory and Aging, a large population-based dataset. We tested for association between E318G genotype and Alzheimer's disease status by running a series of Fisher's exact tests. We also performed logistic regression to test for an additive effect of E318G genotype on Alzheimer's disease status and for the existence of an interaction between E318G and APOEε4. In our Fisher's exact test, it appeared that APOEε4 carriers with an E318G allele have slightly higher risk for AD than those without the allele (3.3 vs. 3.8); however, the 95 % confidence intervals of those estimates overlapped completely, indicating non-significance. Our logistic regression model found a positive but non-significant main effect for E318G (p = 0.895). The interaction term between E318G and APOEε4 was also non-significant (p = 0.689). Our findings do not provide significant support for E318G as a risk factor for AD in APOEε4 carriers. Our calculations indicated that the overall sample used in the logistic regression models was adequately powered to detect the sort of effect sizes observed previously. However, the power analyses of our Fisher's exact tests indicate that our partitioned data was underpowered, particularly in regards to the low number of E318G carriers, both AD cases and controls, in the Cache county dataset. Thus, the differences in types of datasets used may help to explain the difference in effect magnitudes seen. Analyses in additional case-control datasets will be required to understand fully the effect of E318G on Alzheimer's disease status.

Factors associated with active commuting to work among women.

PubMed

Bopp, Melissa; Child, Stephanie; Campbell, Matthew

2014-01-01

Active commuting (AC), the act of walking or biking to work, has notable health benefits though rates of AC remain low among women. This study used a social-ecological framework to examine the factors associated with AC among women. A convenience sample of employed, working women (n = 709) completed an online survey about their mode of travel to work. Individual, interpersonal, institutional, community, and environmental influences were assessed. Basic descriptive statistics and frequencies described the sample. Simple logistic regression models examined associations with the independent variables with AC participation and multiple logistic regression analysis determined the relative influence of social ecological factors on AC participation. The sample was primarily middle-aged (44.09±11.38 years) and non-Hispanic White (92%). Univariate analyses revealed several individual, interpersonal, institutional, community and environmental factors significantly associated with AC. The multivariable logistic regression analysis results indicated that significant factors associated with AC included number of children, income, perceived behavioral control, coworker AC, coworker AC normative beliefs, employer and community supports for AC, and traffic. The results of this study contribute to the limited body of knowledge on AC participation for women and may help to inform gender-tailored interventions to enhance AC behavior and improve health.

Beyond Reading Alone: The Relationship Between Aural Literacy And Asthma Management

PubMed Central

Rosenfeld, Lindsay; Rudd, Rima; Emmons, Karen M.; Acevedo-García, Dolores; Martin, Laurie; Buka, Stephen

2010-01-01

Objectives To examine the relationship between literacy and asthma management with a focus on the oral exchange. Methods Study participants, all of whom reported asthma, were drawn from the New England Family Study (NEFS), an examination of links between education and health. NEFS data included reading, oral (speaking), and aural (listening) literacy measures. An additional survey was conducted with this group of study participants related to asthma issues, particularly asthma management. Data analysis focused on bivariate and multivariable logistic regression. Results In bivariate logistic regression models exploring aural literacy, there was a statistically significant association between those participants with lower aural literacy skills and less successful asthma management (OR:4.37, 95%CI:1.11, 17.32). In multivariable logistic regression analyses, controlling for gender, income, and race in separate models (one-at-a-time), there remained a statistically significant association between those participants with lower aural literacy skills and less successful asthma management. Conclusion Lower aural literacy skills seem to complicate asthma management capabilities. Practice Implications Greater attention to the oral exchange, in particular the listening skills highlighted by aural literacy, as well as other related literacy skills may help us develop strategies for clear communication related to asthma management. PMID:20399060

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

PubMed

Helfrich, Christian D; Kohn, Marlana J; Stapleton, Austin; Allen, Claire L; Hammerback, Kristen Elizabeth; Chan, K C Gary; Parrish, Amanda T; Ryan, Daron E; Weiner, Bryan J; Harris, Jeffrey R; Hannon, Peggy A

2018-01-01

Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.

Association between statin therapy and tendon rupture: a case-control study.

PubMed

Beri, Abhimanyu; Dwamena, Francesca C; Dwamena, Ben A

2009-05-01

Although case reports of a possible association between statin therapy and tendon rupture have been published, no analytical studies exploring this relationship have been reported. We conducted a case-control study using the electronic medical records at Michigan State University from 2002 to 2007 to assess whether statin use is a risk factor for tendon rupture. We compared exposure to statins in 93 cases of tendon rupture with similar exposure in 279 sex- and age-matched controls. Exposure to statins was defined as documentation in the electronic medical record of statin use in the 12 months preceding tendon rupture. For controls, the exposure period was defined as 1 year preceding the last office visit. We used a multivariate logistic regression model, controlling for diabetes, renal disease, rheumatologic disease, and steroid use, to calculate the adjusted odds ratios (ORs). There was no significant difference between cases and controls in the rates of statin use, with either univariate [OR = 1.0, 95% confidence interval (CI) 0.54-1.84] or multivariate analyses (OR = 1.10, 95% CI 0.57-2.13). Based on predetermined subgroup analyses, statin exposure was found to be a significant risk factor for tendon rupture in women (adjusted OR = 3.76, 95% CI 1.11-12.75) but not in men (adjusted OR = 0.66, 95% CI 0.29-1.51). In conclusion, we found no overall association between statin use and tendon rupture, but subgroup analysis suggested that women with tendon rupture were more likely to be on statins.

Cerebrovascular accidents in patients treated for choroidal neovascularization with ranibizumab in randomized controlled trials.

PubMed

Bressler, Neil M; Boyer, David S; Williams, David F; Butler, Steven; Francom, Steven F; Brown, Benton; Di Nucci, Flavia; Cramm, Timothy; Tuomi, Lisa L; Ianchulev, Tsontcho; Rubio, Roman G

2012-10-01

To analyze cerebrovascular accidents (CVAs) pooled from large, randomized, controlled clinical trials of ranibizumab treatment for neovascular age-related macular degeneration. Events in five trials (FOCUS, MARINA, ANCHOR, PIER, and SAILOR) were analyzed using a standard safety monitoring process. Exact methods, stratified by study, were used to test for treatment differences based on odds ratios. A stepwise logistic regression model was fit to classify subjects' risk for CVA based on medical history. Treatment differences in CVA rates at 1 year or 2 years were evaluated within risk groups using stratified exact methods. Pooled 2-year CVA rates were <3%; odds ratios (95% confidence intervals) for CVA risk were 1.2 (0.4-4.4) for ranibizumab 0.3-mg versus control, 2.2 (0.8-7.1) for 0.5 mg versus control, and 1.5 (0.8-3.0) for 0.5-mg versus 0.3-mg ranibizumab. No substantial increased risk of CVA for 0.5 mg versus 0.3 mg was identified in pooled analyses or any of the individual trials. In pooled analyses, the difference between 0.5-mg ranibizumab and control was larger (7.7 [1.2-177]) among high-risk CVA patients. This analysis provided some evidence, although not definitive, of a potential increased risk of CVA with ranibizumab versus control or with 0.5-mg versus 0.3-mg ranibizumab. Continued monitoring for CVA within clinical trials seems warrented.

Maternal hypertension and risk for hypospadias in offspring.

PubMed

Agopian, A J; Hoang, Thanh T; Mitchell, Laura E; Morrison, Alanna C; Tu, Duong; Nassar, Natasha; Canfield, Mark A

2016-12-01

Hypospadias is one of the most common birth defects in male infants. Maternal hypertension is a suspected risk factor; however, few previous studies have addressed the possibility of reporting bias, and several previous studies have not accounted for hypospadias severity. We analyzed data from the Texas Birth Defects Registry for 10,924 nonsyndromic cases and statewide vital records for deliveries during 1999-2009, using Poisson regression. After adjustment for potential confounders, hypospadias was associated with maternal hypertension (adjusted prevalence ratio: 1.5, 95% confidence interval: 1.4-1.7). Similar associations were observed with gestational and pregestational hypertension, including separate analyses restricted to the subset of cases with severe (second- or third-degree) hypospadias. All of these associations were also similar among the subset of cases with isolated hypospadias (without additional birth defects). To evaluate the potential for bias due to potential hypertension misclassification, we repeated our analyses using logistic regression, comparing the cases to controls with other birth defects. In these analyses, the associations with gestational hypertension were similar, but adjusted associations with pregestational hypertension were no longer observed. Our findings support an association between gestational hypertension and hypospadias in offspring, but also suggest that previously observed associations with pregestational hypertension may have been inflated due to differential misclassification of hypertension (e.g., reporting bias). As gestational hypertension is recognized after hypospadias development, more research is needed to determine if this association reflects an increase in gestational hypertension risk secondary to hypospadias or if both conditions have shared risk factors (e.g., precursors of gestational hypertension). © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

When Significant Others Suffer: German Validation of the Burden Assessment Scale (BAS)

PubMed Central

Hunger, Christina; Krause, Lena; Hilzinger, Rebecca; Ditzen, Beate; Schweitzer, Jochen

2016-01-01

There is a need of an economical, reliable, and valid instrument in the German-speaking countries to measure the burden of relatives who care for mentally ill persons. We translated the Burden Assessment Scale (BAS) and conducted a study investigating factor structure, psychometric quality and predictive validity. We used confirmative factor analyses (CFA, maximum-likelihood method) to examine the dimensionality of the German BAS in a sample of 215 relatives (72% women; M = 32 years, SD = 14, range: 18 to 77; 39% employed) of mentally ill persons (50% (ex-)partner or (best) friend; M = 32 years, SD = 13, range 8 to 64; main complaints were depression and/or anxiety). Cronbach’s α determined the internal consistency. We examined predictive validity using regression analyses including the BAS and validated scales of social systems functioning (Experience In Social Systems Questionnaire, EXIS.pers, EXIS.org) and psychopathology (Brief Symptom Inventory, BSI). Variables that might have influenced the dependent variables (e.g. age, gender, education, employment and civil status) were controlled by their introduction in the first step, and the BAS in the second step of the regression analyses. A model with four correlated factors (Disrupted Activities, Personal Distress, Time Perspective, Guilt) showed the best fit. With respect to the number of items included, the internal consistency was very good. The modified German BAS predicted relatives’ social systems functioning and psychopathology. The economical design makes the 19-item BAS promising for practice-oriented research, and for studies under time constraints. Strength, limitations and future directions are discussed. PMID:27764109

Structural vascular disease in Africans: Performance of ethnic-specific waist circumference cut points using logistic regression and neural network analyses: The SABPA study.

PubMed

Botha, J; de Ridder, J H; Potgieter, J C; Steyn, H S; Malan, L

2013-10-01

A recently proposed model for waist circumference cut points (RPWC), driven by increased blood pressure, was demonstrated in an African population. We therefore aimed to validate the RPWC by comparing the RPWC and the Joint Statement Consensus (JSC) models via Logistic Regression (LR) and Neural Networks (NN) analyses. Urban African gender groups (N=171) were stratified according to the JSC and RPWC cut point models. Ultrasound carotid intima media thickness (CIMT), blood pressure (BP) and fasting bloods (glucose, high density lipoprotein (HDL) and triglycerides) were obtained in a well-controlled setting. The RPWC male model (LR ROC AUC: 0.71, NN ROC AUC: 0.71) was practically equal to the JSC model (LR ROC AUC: 0.71, NN ROC AUC: 0.69) to predict structural vascular -disease. Similarly, the female RPWC model (LR ROC AUC: 0.84, NN ROC AUC: 0.82) and JSC model (LR ROC AUC: 0.82, NN ROC AUC: 0.81) equally predicted CIMT as surrogate marker for structural vascular disease. Odds ratios supported validity where prediction of CIMT revealed -clinical -significance, well over 1, for both the JSC and RPWC models in African males and females (OR 3.75-13.98). In conclusion, the proposed RPWC model was substantially validated utilizing linear and non-linear analyses. We therefore propose ethnic-specific WC cut points (African males, ≥90 cm; -females, ≥98 cm) to predict a surrogate marker for structural vascular disease. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

Functional classification of grasp strategies used by hemiplegic patients

PubMed Central

Roby-Brami, Agnès; Robertson, Johanna; Roche, Nicolas

2017-01-01

This study aimed to identify and qualify grasp-types used by patients with stroke and determine the clinical parameters that could explain the use of each grasp. Thirty-eight patients with chronic stroke-related hemiparesis and a range of motor and functional capacities (17 females and 21 males, aged 25–78), and 10 healthy subjects were included. Four objects were used (tissue packet, teaspoon, bottle and tennis ball). Participants were instructed to “grasp the object as if you are going to use it”. Three trials were video-recorded for each object. A total of 456 grasps were analysed and rated using a custom-designed Functional Grasp Scale. Eight grasp-types were identified from the analysis: healthy subjects used Multi-pulpar, Pluri-digital, Lateral-pinch and Palmar grasps (Standard Grasps). Patients used the same grasps with in addition Digito-palmar, Raking, Ulnar and Interdigital grasps (Alternative Grasps). Only patients with a moderate or relatively good functional ability used Standard grasps. The correlation and regression analyses showed this was conditioned by sufficient finger and elbow extensor strength (Pluri-digital grasp); thumb extensor and wrist flexor strength (Lateral pinch) or in forearm supinator strength (Palmar grasp). By contrast, the patients who had severe impairment used Alternative grasps that did not involve the thumb. These strategies likely compensate specific impairments. Regression and correlation analyses suggested that weakness had a greater influence over grasp strategy than spasticity. This would imply that treatment should focus on improving hand strength and control although reducing spasticity may be useful in some cases. PMID:29125855

Factors influencing quit attempts among male daily smokers in China.

PubMed

Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira

2015-12-01

China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt. An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. Copyright © 2015 Elsevier Inc. All rights reserved.