Usefulness of a simple self-administered joint condition assessment sheet to predict the need for orthopaedic intervention in the management of haemophilic arthropathy.

PubMed

Masaoka, T; Amano, K; Takedani, H; Suzuki, T; Otaki, M; Seita, I; Tateiwa, T; Shishido, T; Yamamoto, K; Fukutake, K

2017-03-01

Detecting signs of joint deterioration is important for early effective orthopaedic intervention in managing haemophilic arthropathy. We developed a simple, patient self-administered sheet to evaluate the joint condition, and assessed the predictive ability of this assessment sheet for the need for an orthopaedic intervention. This was a single-centre, cross-sectional study. The association between the score of each of the four items of the assessment sheet (bleeding, swelling, pain and physical impairment) and the results of radiological findings and physical examinations based on Haemophilia Joint Health Score 2.1 was assessed. An optimal scoring system was explored by the area under the curve (AUC). The cut-off value for the need for surgery or physiotherapy was determined using the receiver operating characteristic curve procedure. Forty-two patients were included. The 'physical impairment' item showed the highest correlation coefficient with the results of radiographic and physical examinations (range: 0.57-0.76). The AUC of finally adjusted scoring indicates good ability to discriminate between patients with and without a need for orthopaedic intervention. The positive predictive value was the highest at a cut-off value of 4 points for knees (63.0%) and ankles (70.0%), at 5 points for elbows (66.7%) and the highest predictive accuracy at the cut-off value of 4 points for all the joints. The linear trend of the need for an orthopaedic intervention was observed with an increasing score. The joint condition assessment sheet can help clinicians assess the need for orthopaedic intervention for haemophilic arthropathy in Japanese patients with haemophilia. © 2016 John Wiley & Sons Ltd.

AAC and Early Intervention for Children with Cerebral Palsy: Parent Perceptions and Child Risk Factors

PubMed Central

Smith, Ashlyn L.; Hustad, Katherine C.

2015-01-01

The current study examined parent perceptions of communication, the focus of early intervention goals and strategies, and factors predicting the implementation of augmentative and alternative communication (AAC) for 26, 2-year-old children with cerebral palsy. Parents completed a communication questionnaire and provided early intervention plans detailing child speech and language goals. Results indicated that receptive language had the strongest association with parent perceptions of communication. Children who were not talking received a greater number of intervention goals, had a greater variety of goals, and had more AAC goals than children who were emerging and established talkers. Finally, expressive language had the strongest influence on AAC decisions. Results are discussed in terms of the relationship between parent perceptions and language skills, communication as an emphasis in early intervention, AAC intervention decisions, and the importance of receptive language. PMID:26401966

Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

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

Wagner, Marlies, E-mail: marlies.wagner@kgu.de; Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com; Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de

2013-08-01

PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebralmore » PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.« less

Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs.

PubMed

Bennet, Sean M P; Böhn, Lena; Störsrud, Stine; Liljebo, Therese; Collin, Lena; Lindfors, Perjohan; Törnblom, Hans; Öhman, Lena; Simrén, Magnus

2018-05-01

The effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response. Sixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available. Responders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption. A low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles. NCT02107625. 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/.

Machine learning for outcome prediction of acute ischemic stroke post intra-arterial therapy.

PubMed

Asadi, Hamed; Dowling, Richard; Yan, Bernard; Mitchell, Peter

2014-01-01

Stroke is a major cause of death and disability. Accurately predicting stroke outcome from a set of predictive variables may identify high-risk patients and guide treatment approaches, leading to decreased morbidity. Logistic regression models allow for the identification and validation of predictive variables. However, advanced machine learning algorithms offer an alternative, in particular, for large-scale multi-institutional data, with the advantage of easily incorporating newly available data to improve prediction performance. Our aim was to design and compare different machine learning methods, capable of predicting the outcome of endovascular intervention in acute anterior circulation ischaemic stroke. We conducted a retrospective study of a prospectively collected database of acute ischaemic stroke treated by endovascular intervention. Using SPSS®, MATLAB®, and Rapidminer®, classical statistics as well as artificial neural network and support vector algorithms were applied to design a supervised machine capable of classifying these predictors into potential good and poor outcomes. These algorithms were trained, validated and tested using randomly divided data. We included 107 consecutive acute anterior circulation ischaemic stroke patients treated by endovascular technique. Sixty-six were male and the mean age of 65.3. All the available demographic, procedural and clinical factors were included into the models. The final confusion matrix of the neural network, demonstrated an overall congruency of ∼ 80% between the target and output classes, with favourable receiving operative characteristics. However, after optimisation, the support vector machine had a relatively better performance, with a root mean squared error of 2.064 (SD: ± 0.408). We showed promising accuracy of outcome prediction, using supervised machine learning algorithms, with potential for incorporation of larger multicenter datasets, likely further improving prediction. Finally, we propose that a robust machine learning system can potentially optimise the selection process for endovascular versus medical treatment in the management of acute stroke.

Pilot Study of Kano "Attractive Quality" Techniques to Identify Change in Emergency Department Patient Experience.

PubMed

Bellamkonda, Venkatesh R; Kumar, Rishi; Scanlan-Hanson, Lori N; Hess, Jennifer J; Hellmich, Thomas R; Bellamkonda, Erica; Campbell, Ronna L; Hess, Erik P; Nestler, David M

2016-11-01

We describe the use of the Kano Attractive Quality analytic tool to improve an identified patient experience gap in perceived compassion by emergency department (ED) providers. In phase 1, point-of-service surveying assessed baseline patient perception of ED provider compassion. Phase 2 deployed Kano surveys to predict the effect of 4 proposed interventions on patient perception. Finally, phase 3 compared patients receiving standard care versus the Kano-identified intervention to assess the actual effect on patient experience. In phase 1, 193 of 200 surveys (97%) were completed, showing a baseline median score of 4 out of 5 (interquartile range [IQR] 3 to 5), with top box percentage of 33% for patients' perception of receiving compassionate care. In phase 2, 158 of 180 surveys (88%) using Kano-formatted questions were completed, and the data predicted that increasing shared decisionmaking would cause the greatest improvement in the patient experience. Finally, in phase 3, 45 of 49 surveys (92%) were returned and demonstrated a significant improvement in perceived concern and sensitivity, 5 (IQR 5 to 5) versus 4 (IQR 3 to 5) with a difference of 1 (95% CI 0.1-1.9) and a top box rating of 79% versus 35% with a difference of 44% (95% CI 12-66) by patients who received dedicated shared decisionmaking interventions versus those receiving standard of care. Kano analysis is likely predictive of change in patient experience. Kano methods may prove as useful in changing management of the health care industry as it has been in other industries. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Nanoparticles for Imaging, Sensing, and Therapeutic Intervention

PubMed Central

2014-01-01

Nanoparticles have the potential to contribute to new modalities in molecular imaging and sensing as well as in therapeutic interventions. In this Nano Focus article, we identify some of the current challenges and knowledge gaps that need to be confronted to accelerate the developments of various applications. Using specific examples, we journey from the characterization of these complex hybrid nanomaterials; continue with surface design and (bio)physicochemical properties, their fate in biological media and cells, and their potential for cancer treatment; and finally reflect on the role of animal models to predict their behavior in humans. PMID:24641589

The effectiveness of a Web-based personalized feedback and social norms alcohol intervention on United Kingdom university students: randomized controlled trial.

PubMed

Bewick, Bridgette M; West, Robert M; Barkham, Michael; Mulhern, Brendan; Marlow, Robert; Traviss, Gemma; Hill, Andrew J

2013-07-24

Alcohol consumption in the student population continues to be cause for concern. Building on the established evidence base for traditional brief interventions, interventions using the Internet as a mode of delivery are being developed. Published evidence of replication of initial findings and ongoing development and modification of Web-based personalized feedback interventions for student alcohol use is relatively rare. The current paper reports on the replication of the initial Unitcheck feasibility trial. To evaluate the effectiveness of Unitcheck, a Web-based intervention that provides instant personalized feedback on alcohol consumption. It was hypothesized that use of Unitcheck would be associated with a reduction in alcohol consumption. A randomized control trial with two arms (control=assessment only; intervention=fully automated personalized feedback delivered using a Web-based intervention). The intervention was available week 1 through to week 15. Students at a UK university who were completing a university-wide annual student union electronic survey were invited to participate in the current study. Participants (n=1618) were stratified by sex, age group, year of study, self-reported alcohol consumption, then randomly assigned to one of the two arms, and invited to participate in the current trial. Participants were not blind to allocation. In total, n=1478 (n=723 intervention, n=755 control) participants accepted the invitation. Of these, 70% were female, the age ranged from 17-50 years old, and 88% were white/white British. Data were collected electronically via two websites: one for each treatment arm. Participants completed assessments at weeks 1, 16, and 34. Assessment included CAGE, a 7-day retrospective drinking diary, and drinks consumed per drinking occasion. The regression model predicted a monitoring effect, with participants who completed assessments reducing alcohol consumption over the final week. Further reductions were predicted for those allocated to receive the intervention, and additional reductions were predicted as the number of visits to the intervention website increased. Unitcheck can reduce the amount of alcohol consumed, and the reduction can be sustained in the medium term (ie, 19 weeks after intervention was withdrawn). The findings suggest self-monitoring is an active ingredient to Web-based personalized feedback.

On the Reciprocal Association Between Loneliness and Subjective Well-being

PubMed Central

VanderWeele, Tyler J.; Hawkley, Louise C.; Cacioppo, John T.

2012-01-01

Loneliness has been shown to longitudinally predict subjective well-being. The authors used data from a longitudinal population-based study (2002–2006) of non-Hispanic white, African-American, and nonblack Latino-American persons born between 1935 and 1952 and living in Cook County, Illinois. They applied marginal structural models for time-varying exposures to examine the magnitude and persistence of the effects of loneliness on subjective well-being and of subjective well-being on loneliness. Their results indicate that, if interventions on loneliness were made 1 and 2 years prior to assessing final subjective well-being, then only the intervention 1 year prior would have an effect (standardized effect = −0.29). In contrast, increases in subjective well-being 1 year prior (standardized effect = −0.26) and 2 years prior (standardized effect = −0.13) to assessing final loneliness would both have an effect on an individual's final loneliness. These effects persist even after control is made for depressive symptoms, social support, and psychiatric conditions and medications as time-varying confounders. Results from this study indicate an asymmetrical and persistent feedback of fairly substantial magnitude between loneliness and subjective well-being. Mechanisms responsible for the asymmetry are discussed. Developing interventions for loneliness and subjective well-being could have substantial psychological and health benefits. PMID:23077285

Muscle mass and physical recovery in ICU: innovations for targeting of nutrition and exercise.

PubMed

Wischmeyer, Paul E; Puthucheary, Zudin; San Millán, Iñigo; Butz, Daniel; Grocott, Michael P W

2017-08-01

We have significantly improved hospital mortality from sepsis and critical illness in last 10 years; however, over this same period we have tripled the number of 'ICU survivors' going to rehabilitation. Furthermore, as up to half the deaths in the first year following ICU admission occur post-ICU discharge, it is unclear how many of these patients ever returned home or a meaningful quality of life. For those who do survive, recent data reveals many 'ICU survivors' will suffer significant functional impairment or post-ICU syndrome (PICS). Thus, new innovative metabolic and exercise interventions to address PICS are urgently needed. These should focus on optimal nutrition and lean body mass (LBM) assessment, targeted nutrition delivery, anabolic/anticatabolic strategies, and utilization of personalized exercise intervention techniques, such as utilized by elite athletes to optimize preparation and recovery from critical care. New data for novel LBM analysis technique such as computerized tomography scan and ultrasound analysis of LBM are available showing objective measures of LBM now becoming more practical for predicting metabolic reserve and effectiveness of nutrition/exercise interventions. 13C-Breath testing is a novel technique under study to predict infection earlier and predict over-feeding and under-feeding to target nutrition delivery. New technologies utilized routinely by athletes such as muscle glycogen ultrasound also show promise. Finally, the role of personalized cardiopulmonary exercise testing to target preoperative exercise optimization and post-ICU recovery are becoming reality. New innovative techniques are demonstrating promise to target recovery from PICS utilizing a combination of objective LBM and metabolic assessment, targeted nutrition interventions, personalized exercise interventions for prehabilitation and post-ICU recovery. These interventions should provide hope that we will soon begin to create more 'survivors' and fewer victim's post-ICU care.

Persuasive system design does matter: a systematic review of adherence to web-based interventions.

PubMed

Kelders, Saskia M; Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia E W C

2012-11-14

Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p=.004), setup (p<.001), updates (p<.001), frequency of interaction with a counselor (p<.001), the system (p=.003) and peers (p=.017), duration (F=6.068, p=.004), adherence (F=4.833, p=.010) and the number of primary task support elements (F=5.631, p=.005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.

Does the "new philosophy" in predictive, preventive and personalised medicine require new ethics?

PubMed

Gefenas, Eugenijus; Cekanauskaite, Asta; Tuzaite, Egle; Dranseika, Vilius; Characiejus, Dainius

2011-06-01

This paper maps the ethical issues that arise in the context of personalised medicine. First, it highlights the ethical problems related to increased predictive power of modern diagnostic interventions. Such problems emerge because the ability to identify individuals or groups of individuals that can potentially benefit from a particular therapeutic intervention also raises a question of personal responsibility for health-related behaviour and lifestyle. The second major area of ethical concern is related to health prevention and distributive justice. The paper discusses the ethical challenges brought by the personalised medicine in the context of the Additional Protocol to the Convention on Human Rights and Biomedicine concerning Genetic Testing for Health Purposes. Finally, it notes that the issue of consent in the context of biobanks, the need to rethink the prevalent models of research designs and to communicate relevant findings to the donors of biological materials deserve further discussion.

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.

Predictive models of long-term anatomic outcome in age-related macular degeneration treated with as-needed Ranibizumab.

PubMed

Gonzalez-Buendia, Lucia; Delgado-Tirado, Santiago; Sanabria, M Rosa; Fernandez, Itziar; Coco, Rosa M

2017-08-18

To analyze predictors and develop predictive models of anatomic outcome in neovascular age-related macular degeneration (AMD) treated with as-needed ranibizumab after 4 years of follow-up. A multicenter consecutive case series non-interventional study was performed. Clinical, funduscopic and OCT characteristics of 194 treatment-naïve patients with AMD treated with as-needed ranibizumab for at least 2 years and up to 4 years were analyzed at baseline, 3 months and each year until the end of the follow-up. Baseline demographic and angiographic characteristics were also evaluated. R Statistical Software was used for statistical analysis. Main outcome measure was final anatomic status. Factors associated with less probability of preserved macula were diagnosis in 2009, older age, worse vision, presence of atrophy/fibrosis, pigment epithelium detachment, and geographic atrophy/fibrotic scar/neovascular AMD in the fellow eye. Factors associated with higher probability of GA were presence of atrophy and greater number of injections, whereas male sex, worse vision, lesser change in central macular thickness and presence of fibrosis were associated with less probability of GA as final macular status. Predictive model of preserved macula vs. GA/fibrotic scar showed sensibility of 77.78% and specificity of 69.09%. Predictive model of GA vs. fibrotic scar showed sensibility of 68.89% and specificity of 72.22%. We identified predictors of final macular status, and developed two predictive models. Predictive models that we propose are based on easily harvested variables, and, if validated, could be a useful tool for individual patient management and clinical research studies.

The relationship between tobacco access and use among adolescents: a four community study.

PubMed

Altman, D G; Wheelis, A Y; McFarlane, M; Lee, H; Fortmann, S P

1999-03-01

The objective of this study was to examine the effectiveness of a longitudinal community intervention on the reduction of tobacco sales to minors and subsequent effects on tobacco consumption by youths. The study was conducted in Monterey County, CA. Four rural communities were randomized into treatment and comparison arms of the study and middle and high school students in each of these communities completed surveys assessing knowledge, attitude, and behavior. The main outcome measures were retail tobacco sales to minors as measured through store visits (tobacco purchase surveys) and self-reported consumption of tobacco. Over a three-year period, a diverse array of community interventions were implemented in the intervention communities. These included community education, merchant education, and voluntary policy change. In the treatment communities, the proportion of stores selling tobacco to minors dropped from 75% at baseline to 0% at the final post-test. In the comparison communities, the proportions were 64% and 39%, respectively. Although the availability of tobacco through commercial outlets was reduced substantially in intervention communities, youths reported still being able to obtain tobacco from other sources. Predicted treatment effects on reported use of tobacco among youths were observed cross-sectionally and longitudinally for younger students (7th graders). The intervention did not impact tobacco use among older students (9th and 11th graders) although the trends were in the predicted direction for 9th graders. A significant intervention effect was found for sex--females in the intervention communities were less likely to use tobacco post-intervention than females in the comparison communities. Tobacco sales to minors can be reduced through a broad-based intervention. To prevent or reduce tobacco use by youths, however, multiple supply-and demand-focused strategies are needed.

Evaluating the Validity of the Client Evaluation of Motivational Interviewing Scale in a Brief Motivational Intervention for College Student Drinkers.

PubMed

Madson, Michael B; Villarosa, Margo C; Schumacher, Julie A; Mohn, Richard S

2016-06-01

The Client Evaluation of Motivational Interviewing scale (CEMI) is a measure for assessing client perceptions of clinicians' use of motivational interviewing (MI). This study explored the factorial, convergent and predictive validity of the CEMI with a sample of 137 college students who completed a brief motivational intervention for alcohol harm reduction. A two factor structure was confirmed, supporting previous findings of relational and technical subscales. The CEMI technical subscale partially mediated an increase in readiness to change drinking, while the relational subscale did not. Higher scores on CEMI technical subscale predicted higher scores on the tasks, bond and goals subscales of the Working Alliance Inventory while higher scores on the CEMI relationship subscale predicted an increase in the goals subscale. Finally, the correlations between the CEMI subscales and observer-rated MI spirit score and MI adherent and non-adherent behavioral counts were in the expected directions but did not reach statistical significance. Further revision and evaluation of the CEMI is recommended. Clinical, training and research implications are provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-term surgical outcomes of retinal detachment in patients with Stickler syndrome

PubMed Central

Reddy, Devasis N; Yonekawa, Yoshihiro; Thomas, Benjamin J; Nudleman, Eric D; Williams, George A

2016-01-01

Purpose The aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome. Patients and methods This study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital. Results Sixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P<0.001), and patients with poorer presenting VA were more likely to require silicone oil tamponade at final follow-up (P=0.04). Conclusion Repair of retinal detachment in patients with Stickler syndrome often requires multiple surgeries, and visual outcomes are variable. Presenting VA is significantly predictive of long-term VA outcomes. PMID:27574392

Causal Rasch models.

PubMed

Stenner, A Jackson; Fisher, William P; Stone, Mark H; Burdick, Donald S

2013-01-01

Rasch's unidimensional models for measurement show how to connect object measures (e.g., reader abilities), measurement mechanisms (e.g., machine-generated cloze reading items), and observational outcomes (e.g., counts correct on reading instruments). Substantive theory shows what interventions or manipulations to the measurement mechanism can be traded off against a change to the object measure to hold the observed outcome constant. A Rasch model integrated with a substantive theory dictates the form and substance of permissible interventions. Rasch analysis, absent construct theory and an associated specification equation, is a black box in which understanding may be more illusory than not. Finally, the quantitative hypothesis can be tested by comparing theory-based trade-off relations with observed trade-off relations. Only quantitative variables (as measured) support such trade-offs. Note that to test the quantitative hypothesis requires more than manipulation of the algebraic equivalencies in the Rasch model or descriptively fitting data to the model. A causal Rasch model involves experimental intervention/manipulation on either reader ability or text complexity or a conjoint intervention on both simultaneously to yield a successful prediction of the resultant observed outcome (count correct). We conjecture that when this type of manipulation is introduced for individual reader text encounters and model predictions are consistent with observations, the quantitative hypothesis is sustained.

Causal Rasch models

PubMed Central

Stenner, A. Jackson; Fisher, William P.; Stone, Mark H.; Burdick, Donald S.

2013-01-01

Rasch's unidimensional models for measurement show how to connect object measures (e.g., reader abilities), measurement mechanisms (e.g., machine-generated cloze reading items), and observational outcomes (e.g., counts correct on reading instruments). Substantive theory shows what interventions or manipulations to the measurement mechanism can be traded off against a change to the object measure to hold the observed outcome constant. A Rasch model integrated with a substantive theory dictates the form and substance of permissible interventions. Rasch analysis, absent construct theory and an associated specification equation, is a black box in which understanding may be more illusory than not. Finally, the quantitative hypothesis can be tested by comparing theory-based trade-off relations with observed trade-off relations. Only quantitative variables (as measured) support such trade-offs. Note that to test the quantitative hypothesis requires more than manipulation of the algebraic equivalencies in the Rasch model or descriptively fitting data to the model. A causal Rasch model involves experimental intervention/manipulation on either reader ability or text complexity or a conjoint intervention on both simultaneously to yield a successful prediction of the resultant observed outcome (count correct). We conjecture that when this type of manipulation is introduced for individual reader text encounters and model predictions are consistent with observations, the quantitative hypothesis is sustained. PMID:23986726

Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

PubMed Central

Kok, Robin N; Ossebaard, Hans C; Van Gemert-Pijnen, Julia EWC

2012-01-01

Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere. PMID:23151820

Assessing the Clinical Impact of Risk Prediction Models With Decision Curves: Guidance for Correct Interpretation and Appropriate Use

PubMed Central

Brown, Marshall D.; Zhu, Kehao; Janes, Holly

2016-01-01

The decision curve is a graphical summary recently proposed for assessing the potential clinical impact of risk prediction biomarkers or risk models for recommending treatment or intervention. It was applied recently in an article in Journal of Clinical Oncology to measure the impact of using a genomic risk model for deciding on adjuvant radiation therapy for prostate cancer treated with radical prostatectomy. We illustrate the use of decision curves for evaluating clinical- and biomarker-based models for predicting a man’s risk of prostate cancer, which could be used to guide the decision to biopsy. Decision curves are grounded in a decision-theoretical framework that accounts for both the benefits of intervention and the costs of intervention to a patient who cannot benefit. Decision curves are thus an improvement over purely mathematical measures of performance such as the area under the receiver operating characteristic curve. However, there are challenges in using and interpreting decision curves appropriately. We caution that decision curves cannot be used to identify the optimal risk threshold for recommending intervention. We discuss the use of decision curves for miscalibrated risk models. Finally, we emphasize that a decision curve shows the performance of a risk model in a population in which every patient has the same expected benefit and cost of intervention. If every patient has a personal benefit and cost, then the curves are not useful. If subpopulations have different benefits and costs, subpopulation-specific decision curves should be used. As a companion to this article, we released an R software package called DecisionCurve for making decision curves and related graphics. PMID:27247223

Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program.

PubMed

Christensen, Helen; Griffiths, Kathy; Groves, Chloe; Korten, Ailsa

2006-01-01

Little is known about the predictors of symptom change or the methods that might increase user 'compliance' on websites designed to improve mental health outcomes. The present paper: (i) examines predictors of expected final depression and anxiety scores on the MoodGYM website as a function of user characteristics; and (ii) compares the compliance rates of the original site with the new public version of the site (MoodGYM Mark II). The latter site requires compulsory completion of 'core' online assessments and may increase completion of site questionnaires. MoodGYM Mark I participants were 19,607 visitors (public registrants) between April 2001 and September 2003 plus 182 participants who had been randomly assigned to MoodGYM in an earlier trial (The BlueMood Trial). MoodGYM Mark II participants were 38,791 public registrants of the MoodGYM Mark II site collected between September 2003 and October 2004. Symptom assessments are repeated within the website intervention to allow the examination of change in symptoms. Outcome variables were gender, initial depression severity scores, number of assessments completed and final anxiety and depression scores. Men are predicted to be 0.19 units (SE=0.095) higher than women on depression, controlling for the initial depression level and number of modules completed. For initial depression scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. For initial anxiety scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. Mark II registrants were more likely than to Mark I registrants to complete onsite assessments. Visitors to the MoodGYM site are likely to have better psychological outcomes if they complete more of the site material. Compulsory completion of core sections increases assessment completion. There is a need to examine further the significance of attrition from online interventions, to develop methods of handling missing data, and to investigate strategies to improve visitor dropout.

Patient-specific simulation of the intrastromal ring segment implantation in corneas with keratoconus.

PubMed

Lago, M A; Rupérez, M J; Monserrat, C; Martínez-Martínez, F; Martínez-Sanchis, S; Larra, E; Díez-Ajenjo, M A; Peris-Martínez, C

2015-11-01

The purpose of this study was the simulation of the implantation of intrastromal corneal-ring segments for patients with keratoconus. The aim of the study was the prediction of the corneal curvature recovery after this intervention. Seven patients with keratoconus diagnosed and treated by implantation of intrastromal corneal-ring segments were enrolled in the study. The 3D geometry of the cornea of each patient was obtained from its specific topography and a hyperelastic model was assumed to characterize its mechanical behavior. To simulate the intervention, the intrastromal corneal-ring segments were modeled and placed at the same location at which they were placed in the surgery. The finite element method was then used to obtain a simulation of the deformation of the cornea after the ring segment insertion. Finally, the predicted curvature was compared with the real curvature after the intervention. The simulation of the ring segment insertion was validated comparing the curvature change with the data after the surgery. Results showed a flattening of the cornea which was in consonance with the real improvement of the corneal curvature. The mean difference obtained was of 0.74 mm using properties of healthy corneas. For the first time, a patient-specific model of the cornea has been used to predict the outcomes of the surgery after the intrastromal corneal-ring segments implantation in real patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prenatal tobacco prevention and cessation interventions for women in low- and middle-income countries.

PubMed

Oncken, Cheryl A; Dietz, Patricia M; Tong, Van T; Belizán, José M; Tolosa, Jorge E; Berghella, Vincenzo; Goldenberg, Robert L; Lando, Harry A; Samet, Jonathan M; Bloch, Michele H

2010-01-01

Although the prevalence of tobacco use is decreasing in many high-income countries, it is increasing in many low- and middle-income countries. The health and economic burden of increasing tobacco use and dependence is predictable and will have devastating effects in countries with limited resources, particularly for vulnerable populations such as pregnant women. We sought to review effective tobacco prevention and intervention strategies for decreasing tobacco use and secondhand smoke exposure before and during pregnancy in high-, middle-, and low-income countries. We reviewed several types of interventions, including population-level efforts (increasing tobacco prices, implementing tobacco control policies), community interventions, clinical interventions, and pharmacological treatments. A second purpose of this report is to present findings of an international expert working group that was convened to review the evidence and to establish research priorities in the following areas: (a) preventing the uptake and reducing tobacco use among girls and women of reproductive age; and (b) reducing tobacco use and secondhand smoke exposure among pregnant women. The working group considered the evidence on existing interventions in terms of burden of disease, intervention impact, intervention costs, feasibility of integration into existing services, uniqueness of the contribution, and overall feasibility. Finally, we present the working group's recommendations for intervention research priorities.

Towards an Effective Health Interventions Design: An Extension of the Health Belief Model

PubMed Central

Orji, Rita; Vassileva, Julita; Mandryk, Regan

2012-01-01

Introduction The recent years have witnessed a continuous increase in lifestyle related health challenges around the world. As a result, researchers and health practitioners have focused on promoting healthy behavior using various behavior change interventions. The designs of most of these interventions are informed by health behavior models and theories adapted from various disciplines. Several health behavior theories have been used to inform health intervention designs, such as the Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model (HBM). However, the Health Belief Model (HBM), developed in the 1950s to investigate why people fail to undertake preventive health measures, remains one of the most widely employed theories of health behavior. However, the effectiveness of this model is limited. The first limitation is the low predictive capacity (R2 < 0.21 on average) of existing HBM’s variables coupled with the small effect size of individual variables. The second is lack of clear rules of combination and relationship between the individual variables. In this paper, we propose a solution that aims at addressing these limitations as follows: (1) we extended the Health Belief Model by introducing four new variables: Self-identity, Perceived Importance, Consideration of Future Consequences, and Concern for Appearance as possible determinants of healthy behavior. (2) We exhaustively explored the relationships/interactions between the HBM variables and their effect size. (3) We tested the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model. Methods: To achieve the objective of this paper, we conducted a quantitative study of 576 participants’ eating behavior. Data for this study were collected over a period of one year (from August 2011 to August 2012). The questionnaire consisted of validated scales assessing the HBM determinants – perceived benefit, barrier, susceptibility, severity, cue to action, and self-efficacy – using 7-point Likert scale. We also assessed other health determinants such as consideration of future consequences, self-identity, concern for appearance and perceived importance. To analyses our data, we employed factor analysis and Partial Least Square Structural Equation Model (PLS-SEM) to exhaustively explore the interaction/relationship between the determinants and healthy eating behavior. We tested for the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model and investigated possible mediating effects. Results: The results show that the three newly added determinants are better predictors of healthy behavior. Our extended HBM model lead to approximately 78% increase (from 40 to 71%) in predictive capacity compared to the old model. This shows the suitability of our extended HBM for use in predicting healthy behavior and in informing health intervention design. The results from examining possible relationships between the determinants in our model lead to an interesting discovery of some mediating relationships between the HBM’s determinants, therefore, shedding light on some possible combinations of determinants that could be employed by intervention designers to increase the effectiveness of their design. Conclusion: Consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behavior that can be manipulated by healthy eating intervention design. Most importantly, the result from our model established the existence of some mediating relationships among the determinants. The knowledge of both the direct and indirect relationships sheds some light on the possible combination rules. PMID:23569653

The relationship between formative and summative examinations and PANCE scores; can the past predict the future?

PubMed

Massey, Scott; Stallman, John; Lee, Louise; Klingaman, Kathy; Holmerud, David

2011-01-01

This paper describes how a systematic analysis of students at risk for failing the Physician Assistant National Certifying Examination (PANCE) may be used to identify which students may benefit from intervention prior to taking the PANCE and thus increase the likelihood of successful completion of the PANCE. The intervention developed and implemented uses various formative and summative examinations to predict students' PANCE scores with a high degree of accuracy. Eight end-of-rotation exams (EOREs) based upon discipline-specific diseases and averaging 100 questions each, a 360-question PANCE simulation (SUMM I), the PACKRAT, and a 700-question summative cognitive examination based upon the NCCPA blueprint (SUMM II) were administered to all students enrolled in the program during the clinical year starting in January 2010 and concluding in December 2010. When the PACKRAT, SUMM I, SUMM II, and the surgery, women's health, and pediatrics EOREs were combined in a regression model, an Rvalue of 0.87 and an R2 of 0.75 were obtained. A predicted score was generated for the class of 2009. The predicted PANCE score based upon this model had a final correlation of 0.790 with the actual PANCE score. This pilot study demonstrated that valid predicted scores could be generated from formative and summative examinations to provide valuable feedback and to identify students at risk of failing the PANCE.

Assessing the Availability of Users to Engage in Just-in-Time Intervention in the Natural Environment.

PubMed

Sarker, Hillol; Sharmin, Moushumi; Ali, Amin Ahsan; Rahman, Md Mahbubur; Bari, Rummana; Hossain, Syed Monowar; Kumar, Santosh

Wearable wireless sensors for health monitoring are enabling the design and delivery of just-in-time interventions (JITI). Critical to the success of JITI is to time its delivery so that the user is available to be engaged. We take a first step in modeling users' availability by analyzing 2,064 hours of physiological sensor data and 2,717 self-reports collected from 30 participants in a week-long field study. We use delay in responding to a prompt to objectively measure availability. We compute 99 features and identify 30 as most discriminating to train a machine learning model for predicting availability. We find that location, affect, activity type, stress, time, and day of the week, play significant roles in predicting availability. We find that users are least available at work and during driving, and most available when walking outside. Our model finally achieves an accuracy of 74.7% in 10-fold cross-validation and 77.9% with leave-one-subject-out.

Assessing the Availability of Users to Engage in Just-in-Time Intervention in the Natural Environment

PubMed Central

Sarker, Hillol; Sharmin, Moushumi; Ali, Amin Ahsan; Rahman, Md. Mahbubur; Bari, Rummana; Hossain, Syed Monowar; Kumar, Santosh

2015-01-01

Wearable wireless sensors for health monitoring are enabling the design and delivery of just-in-time interventions (JITI). Critical to the success of JITI is to time its delivery so that the user is available to be engaged. We take a first step in modeling users’ availability by analyzing 2,064 hours of physiological sensor data and 2,717 self-reports collected from 30 participants in a week-long field study. We use delay in responding to a prompt to objectively measure availability. We compute 99 features and identify 30 as most discriminating to train a machine learning model for predicting availability. We find that location, affect, activity type, stress, time, and day of the week, play significant roles in predicting availability. We find that users are least available at work and during driving, and most available when walking outside. Our model finally achieves an accuracy of 74.7% in 10-fold cross-validation and 77.9% with leave-one-subject-out. PMID:25798455

The role of preschool teacher-child interactions in academic adjustment: An intervention study with Playing-2-gether.

PubMed

Van Craeyevelt, Sanne; Verschueren, Karine; Vancraeyveldt, Caroline; Wouters, Sofie; Colpin, Hilde

2017-09-01

Social relationships can serve as important risk or protective factors for child development in general, and academic adjustment in particular. This study investigated the role of teacher-child interactions in academic adjustment among preschool boys at risk of externalizing behaviour, using a randomized controlled trial study with Playing-2-gether (P2G), a 12-week indicated two-component intervention aimed at improving the affective quality of the teacher-child relationship and teacher behaviour management. In a sample of 175 preschool boys showing signs of externalizing behaviour (M age  = 4 years, 9 months, SD age  = 7 months) and their teachers, we investigated P2G effects on academic engagement as well as on language achievement. Academic engagement was rated by teachers at three occasions within one school year (T1 = pretest, T3 = post-test, and T2 = in-between intervention components). Language achievement was assessed by researchers at pre- and post-test, using a standardized test. Cross-lagged path analyses revealed a direct intervention effect of P2G on academic engagement at Time 2. In addition, a significant indirect intervention effect was found on academic engagement at Time 3 through academic engagement at Time 2. Finally, academic engagement at Time 2 was found to predict language achievement at post-test. A marginally significant indirect intervention effect was found on language achievement at Time 3, through academic engagement at Time 2. This intervention study suggests that teacher-child interactions predict academic engagement over time, which in turn improves language achievement among preschool boys at risk of externalizing behaviour. © 2017 The British Psychological Society.

Brief intervention to encourage empathic discipline cuts suspension rates in half among adolescents

PubMed Central

Okonofua, Jason A.; Paunesku, David; Walton, Gregory M.

2016-01-01

Growing suspension rates predict major negative life outcomes, including adult incarceration and unemployment. Experiment 1 tested whether teachers (n = 39) could be encouraged to adopt an empathic rather than punitive mindset about discipline—to value students’ perspectives and sustain positive relationships while encouraging better behavior. Experiment 2 tested whether an empathic response to misbehavior would sustain students’ (n = 302) respect for teachers and motivation to behave well in class. These hypotheses were confirmed. Finally, a randomized field experiment tested a brief, online intervention to encourage teachers to adopt an empathic mindset about discipline. Evaluated at five middle schools in three districts (Nteachers = 31; Nstudents = 1,682), this intervention halved year-long student suspension rates from 9.6% to 4.8%. It also bolstered respect the most at-risk students, previously suspended students, perceived from teachers. Teachers’ mindsets about discipline directly affect the quality of teacher–student relationships and student suspensions and, moreover, can be changed through scalable intervention. PMID:27114516

Brief intervention to encourage empathic discipline cuts suspension rates in half among adolescents.

PubMed

Okonofua, Jason A; Paunesku, David; Walton, Gregory M

2016-05-10

Growing suspension rates predict major negative life outcomes, including adult incarceration and unemployment. Experiment 1 tested whether teachers (n = 39) could be encouraged to adopt an empathic rather than punitive mindset about discipline-to value students' perspectives and sustain positive relationships while encouraging better behavior. Experiment 2 tested whether an empathic response to misbehavior would sustain students' (n = 302) respect for teachers and motivation to behave well in class. These hypotheses were confirmed. Finally, a randomized field experiment tested a brief, online intervention to encourage teachers to adopt an empathic mindset about discipline. Evaluated at five middle schools in three districts (Nteachers = 31; Nstudents = 1,682), this intervention halved year-long student suspension rates from 9.6% to 4.8%. It also bolstered respect the most at-risk students, previously suspended students, perceived from teachers. Teachers' mindsets about discipline directly affect the quality of teacher-student relationships and student suspensions and, moreover, can be changed through scalable intervention.

A Retrospective Medical Records Review of Risk Factors for the Development of Respiratory Tract Secretions (Death Rattle) in the Dying Patient.

PubMed

Kolb, Hildegard; Snowden, Austyn; Stevens, Elaine; Atherton, Iain

2018-05-09

Identification of risk factors predicting the development of death rattle. Respiratory tract secretions, often called death rattle, are among the most common symptoms in dying patients around the world. It is unknown whether death rattle causes distress in patients, but it has been globally reported that distress levels can be high in family members. Although there is a poor evidence base, treatment with antimuscarinic medication is standard practice worldwide and prompt intervention is recognised as crucial for effectiveness. The identification of risk factors for the development of death rattle would allow for targeted interventions. A case ̶ control study was designed to retrospectively review two hundred consecutive medical records of mainly cancer patients who died in a hospice inpatient setting between 2009 - 2011. Fifteen potential risk factors including the original factors weight, smoking, final opioid dose and final Midazolam dose were investigated. Binary logistic regression to identify risk factors for death rattle development. Univariate analysis showed death rattle was significantly associated with final Midazolam doses and final opioid doses, length of dying phase and anticholinergic drug load in the pre-terminal phase. In the final logistic regression model only Midazolam was statistically significant and only at final doses of 20 mg/24hrs or over (OR 3.81 CI 1.41-10.34). Dying patients with a requirement for a high dose of Midazolam have an increased likelihood of developing death rattle. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain.

PubMed

Goossens, Mariëlle E J B; Vlaeyen, Johan W S; Hidding, Alita; Kole-Snijders, Ank; Evers, Silvia M A A

2005-01-01

Patients' initial beliefs about the success of a given pain treatment are shown to have an important influence on the final treatment outcome. The aims of the paper are to assess determinants of patients' treatment expectancy and to examine the extent to which treatment expectancy predicts the short-term and long-term outcome of cognitive-behavioral treatment of chronic pain. This study employs the data of 2 pooled randomized clinical trials evaluating the effectiveness of cognitive-behavioral interventions for 171 patients with fibromyalgia and chronic low back pain. Pretreatment and posttreatment expectancy were measured by a short questionnaire, which was based on the procedure by Borkovec and Nau. Four composite outcome variables (pain coping and control, motoric behavior, negative affect, and quality of life) were measured before and after the intervention and at 12 months follow-up. Furthermore, several patient characteristics were taken into account. Patients with higher treatment expectancies significantly received less disability compensation and were less fearful. A regression model of 3 factors (better pain coping and control, active and positive interpretation of pain, and less disability compensation) significantly explained 10% of the variance in pretreatment expectancy. Pretreatment expectancy significantly predicted each of the 4 outcome measures immediately after treatment and at 12 months follow-up. This study corroborates the importance of treatment expectation before entering a cognitive-behavioral intervention in patients with chronic musculoskeletal pain.

Treatment Compliance in Adolescents after Attempted Suicide: A Two-Year Follow-Up Study

PubMed Central

Burns, Craig D.; Cortell, Ranon; Wagner, Barry M.

2008-01-01

Objective To describe mental health services utilization for adolescents after attempted suicide, explore factors related to treatment compliance, and determine the relationship between compliance and suicidality. Method Eighty-five adolescents (ages 13–18) who had attempted suicide and their families were recruited from four psychiatric hospitals and were evaluated for symptoms of psychopathology. Subsequent assessments were conducted every six months for two years to determine treatment utilization, treatment compliance (non-adherence to medication regimes or non-attendance of psychosocial treatments against provider advice), attitudes towards treatments utilized, and further suicide attempts and ideation. Results Adolescents with a disruptive behavior disorder diagnosis were less compliant with individual psychotherapy, as were those with a substance dependence other than alcohol or marijuana. Those with an affective/anxiety disorder diagnosis were less compliant with psychopharmacological interventions (6 months post attempt). Parental perception of treatment as helpful was predictive of greater compliance, while adolescents' attitudes towards treatment were not predictive of compliance. Finally, compliance with treatment was not generally predictive of future suicidality. Conclusion Interventions focused on increasing compliance with mental health treatment for adolescent suicide attempters should focus on specific child psychopathology, as well as parental attitudes towards treatment. PMID:18596554

How learning shapes the empathic brain.

PubMed

Hein, Grit; Engelmann, Jan B; Vollberg, Marius C; Tobler, Philippe N

2016-01-05

Deficits in empathy enhance conflicts and human suffering. Thus, it is crucial to understand how empathy can be learned and how learning experiences shape empathy-related processes in the human brain. As a model of empathy deficits, we used the well-established suppression of empathy-related brain responses for the suffering of out-groups and tested whether and how out-group empathy is boosted by a learning intervention. During this intervention, participants received costly help equally often from an out-group member (experimental group) or an in-group member (control group). We show that receiving help from an out-group member elicits a classical learning signal (prediction error) in the anterior insular cortex. This signal in turn predicts a subsequent increase of empathy for a different out-group member (generalization). The enhancement of empathy-related insula responses by the neural prediction error signal was mediated by an establishment of positive emotions toward the out-group member. Finally, we show that surprisingly few positive learning experiences are sufficient to increase empathy. Our results specify the neural and psychological mechanisms through which learning interacts with empathy, and thus provide a neurobiological account for the plasticity of empathic reactions.

How learning shapes the empathic brain

PubMed Central

Hein, Grit; Vollberg, Marius C.; Tobler, Philippe N.

2016-01-01

Deficits in empathy enhance conflicts and human suffering. Thus, it is crucial to understand how empathy can be learned and how learning experiences shape empathy-related processes in the human brain. As a model of empathy deficits, we used the well-established suppression of empathy-related brain responses for the suffering of out-groups and tested whether and how out-group empathy is boosted by a learning intervention. During this intervention, participants received costly help equally often from an out-group member (experimental group) or an in-group member (control group). We show that receiving help from an out-group member elicits a classical learning signal (prediction error) in the anterior insular cortex. This signal in turn predicts a subsequent increase of empathy for a different out-group member (generalization). The enhancement of empathy-related insula responses by the neural prediction error signal was mediated by an establishment of positive emotions toward the out-group member. Finally, we show that surprisingly few positive learning experiences are sufficient to increase empathy. Our results specify the neural and psychological mechanisms through which learning interacts with empathy, and thus provide a neurobiological account for the plasticity of empathic reactions. PMID:26699464

Prosociality: the contribution of traits, values, and self-efficacy beliefs.

PubMed

Caprara, Gian Vittorio; Alessandri, Guido; Eisenberg, Nancy

2012-06-01

The present study examined how agreeableness, self-transcendence values, and empathic self-efficacy beliefs predict individuals' tendencies to engage in prosocial behavior (i.e., prosociality) across time. Participants were 340 young adults, 190 women and 150 men, age approximately 21 years at Time 1 and 25 years at Time 2. Measures of agreeableness, self-transcendence, empathic self-efficacy beliefs, and prosociality were collected at 2 time points. The findings corroborated the posited paths of relations, with agreeableness directly predicting self-transcendence and indirectly predicting empathic self-efficacy beliefs and prosociality. Self-transcendence mediated the relation between agreeableness and empathic self-efficacy beliefs. Empathic self-efficacy beliefs mediated the relation of agreeableness and self-transcendence to prosociality. Finally, earlier prosociality predicted agreeableness and empathic self-efficacy beliefs assessed at Time 2. The posited conceptual model accounted for a significant portion of variance in prosociality and provides guidance to interventions aimed at promoting prosociality. 2012 APA, all rights reserved

Do patterns of change during treatment for panic disorder predict future panic symptoms?

PubMed Central

Steinman, Shari A.; Hunter, Michael D.; Teachman, Bethany A.

2012-01-01

Background and Objectives Cognitive-behavioral therapies are currently the gold standard for panic disorder treatment, with well-documented treatment response. However, following interventions, some individuals continue to improve, while others experience a return of symptoms. The field lacks reliable ways to predict follow-up symptomology. In the current study, a cluster analysis with a repeated measures design was conducted to examine change patterns over 12 weeks of cognitive behavioral group therapy for panic disorder. The central aim of the study was to evaluate if change patterns predict level of panic symptom severity at a six month follow-up in this sample. Methods Individuals with panic disorder (N = 36) completed a measure of panic symptoms (Panic Disorder Severity Scale) at the outset of every therapy session and at a six month follow-up. Results Results revealed three patterns of change in this specific trial, which significantly predicted level of panic symptoms six months post-treatment, beyond initial or final level of panic symptoms, and beyond total symptom change. Limitations Given the relatively small, lab-based sample, replications in other settings and samples will be important. Conclusions Overall, results provide initial evidence that change patterns are meaningful predictors of panic symptom severity well after the final session of treatment. PMID:23187115

Psychological pain interventions and neurophysiology: implications for a mechanism-based approach.

PubMed

Flor, Herta

2014-01-01

This article provides an illustrative overview of neurophysiological changes related to acute and chronic pain involving structural and functional brain changes, which might be the targets of psychological interventions. A number of psychological pain treatments have been examined with respect to their effects on brain activity, ranging from cognitive- and operant behavioral interventions, meditation and hypnosis, to neuro- and biofeedback, discrimination training, imagery and mirror treatment, as well as virtual reality and placebo applications. These treatments affect both ascending and descending aspects of pain processing and act through brain mechanisms that involve sensorimotor areas as well as those involved in affective-motivational and cognitive-evaluative aspects. The analysis of neurophysiological changes related to effective psychological pain treatment can help to identify subgroups of patients with chronic pain who might profit from different interventions, can aid in predicting treatment outcome, and can assist in identifying responders and nonresponders, thus enhancing the efficacy and efficiency of psychological interventions. Moreover, new treatment targets can be developed and tested. Finally, the use of neurophysiological measures can also aid in motivating patients to participate in psychological interventions and can increase their acceptance in clinical practice. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Motivational impairment predicts functional remission in first-episode psychosis: 3-Year follow-up of the randomized controlled trial on extended early intervention.

PubMed

Chang, Wing Chung; Kwong, Vivian Wing Yan; Or Chi Fai, Philip; Lau, Emily Sin Kei; Chan, Gloria Hoi Kei; Jim, Olivia Tsz Ting; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

2018-02-01

Functional remission represents an intermediate functional milestone toward recovery. Differential relationships of negative symptom sub-domains with functional remission in first-episode psychosis are understudied. We aimed to examine rate and predictors of functional remission in people with first-episode psychosis in the context of a 3-year follow-up of a randomized controlled trial comparing 1-year extension of early intervention (i.e. 3-year early intervention) with step-down psychiatric care (i.e. 2-year early intervention). A total of 160 participants were recruited upon completion of a 2-year specialized early intervention program for first-episode psychosis in Hong Kong and underwent a 1-year randomized controlled trial comparing 1-year extended early intervention with step-down care. Participants were followed up and reassessed 3 years after inclusion to the trial (i.e. 3-year follow-up). Functional remission was operationalized as simultaneous fulfillment of attaining adequate functioning (measured by Social and Occupational Functioning Scale and Role Functioning Scale) at 3-year follow-up and sustained employment in the last 6 months of 3-year study period. Negative symptom measure was delineated into amotivation (i.e. motivational impairment) and diminished expression (i.e. reduced affect and speech output). Data analysis was based on 143 participants who completed follow-up functional assessments. A total of 31 (21.7%) participants achieved functional remission status at 3-year follow-up. Multivariate regression analysis showed that lower levels of amotivation ( p = 0.010) and better functioning at study intake ( p = 0.004) independently predicted functional remission (Final model: Nagelkerke R 2  = 0.40, χ 2  = 42.9, p < 0.001). Extended early intervention, duration of untreated psychosis and diminished expression did not predict functional remission. Only approximately one-fifths of early psychosis patients were found to achieve functional remission. Functional impairment remains an unmet treatment need in the early stage of psychotic illness. Our results further suggest that amotivation may represent a critical therapeutic target for functional remission attainment in early psychosis.

The final size of a SARS epidemic model without quarantine

NASA Astrophysics Data System (ADS)

Hsu, Sze-Bi; Roeger, Lih-Ing W.

2007-09-01

In this article, we present the continuing work on a SARS model without quarantine by Hsu and Hsieh [Sze-Bi Hsu, Ying-Hen Hsieh, Modeling intervention measures and severity-dependent public response during severe acute respiratory syndrome outbreak, SIAM J. Appl. Math. 66 (2006) 627-647]. An "acting basic reproductive number" [psi] is used to predict the final size of the susceptible population. We find the relation among the final susceptible population size S[infinity], the initial susceptible population S0, and [psi]. If [psi]>1, the disease will prevail and the final size of the susceptible, S[infinity], becomes zero; therefore, everyone in the population will be infected eventually. If [psi]<1, the disease dies out, and then S[infinity]>0 which means part of the population will never be infected. Also, when S[infinity]>0, S[infinity] is increasing with respect to the initial susceptible population S0, and decreasing with respect to the acting basic reproductive number [psi].

Predicting Sexual Assault Perpetration in the US Army Using Administrative Data

PubMed Central

Rosellini, Anthony J.; Monahan, John; Street, Amy E.; Petukhova, Maria V.; Sampson, Nancy A.; Benedek, David M.; Bliese, Paul; Stein, Murray B.; Ursano, Robert J.; Kessler, Ronald C.

2017-01-01

Introduction The Department of Defense uses a universal prevention framework for sexual assault prevention, with each branch implementing their own branch-wide programs. Intensive interventions exist, but would be cost-effective only if targeted at high-risk personnel. This study developed actuarial models to identify male U.S. Army soldiers at high risk of administratively-recorded sexual assault perpetration. Methods This study investigated administratively-recorded sexual assault perpetration among the 821,807 male Army soldiers serving 2004–2009. Other temporally prior administrative data were used as predictors. Penalized discrete-time (person-month) survival analysis (conducted in 2016) was used to select the smallest possible number of stable predictors to maximize number of sexual assaults among the 5% of soldiers with highest predicted risk of perpetration (top-ventile concentration of risk [COR]). Separate models were developed for assaults against non-family and intra-family adults and minors. Results 4,640 male soldiers were found to be perpetrators against non-family adults, 1,384 against non-family minors, 380 against intra-family adults, and 335 against intra-family minors. Top-ventile COR was 16.2–20.2% predicting perpetration against non-family adults and minors and 34.2–65.1% against intra-family adults and minors. Final predictors consisted largely of measures of prior crime involvement and the presence-treatment of mental disorders. Conclusions Administrative data can be used to develop actuarial models that identify a high proportion of sexual assault perpetrators. If a system is developed to routinely consolidate administrative predictors, predictions could be generated periodically to identify those in need of preventive intervention. Whether this would be cost-effective, though, would depend on intervention costs, effectiveness, and competing risks. PMID:28818420

Test selection, adaptation, and evaluation: a systematic approach to assess nutritional influences on child development in developing countries.

PubMed

Prado, Elizabeth L; Hartini, Sri; Rahmawati, Atik; Ismayani, Elfa; Hidayati, Astri; Hikmah, Nurul; Muadz, Husni; Apriatni, Mandri S; Ullman, Michael T; Shankar, Anuraj H; Alcock, Katherine J

2010-03-01

Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context. We present several principles for the selection, adaptation, and evaluation of tests assessing the developmental outcomes of nutrition interventions in developing countries where standard assessment tests do not exist. We then report the application of these principles for a nutrition trial on the Indonesian island of Lombok. Three hundred children age 22-55 months in Lombok participated in a series of pilot tests for the purpose of test adaptation and evaluation. Four hundred and eighty-seven 42-month-old children in Lombok were tested on the finalized test battery. The developmental assessment tests were adapted to the local context and evaluated for a number of psychometric properties, including convergent and discriminant validity, which were measured based on multiple regression models with maternal education, depression, and age predicting each test score. The adapted tests demonstrated satisfactory psychometric properties and the expected pattern of relationships with the three maternal variables. Maternal education significantly predicted all scores but one, maternal depression predicted socio-emotional competence, socio-emotional problems, and vocabulary, while maternal age predicted socio-emotional competence only. Following the methodological principles we present resulted in tests that were appropriate for children in Lombok and informative for evaluating the developmental outcomes of nutritional supplementation in the research context. Following this approach in future studies will help to determine which interventions most effectively improve child development in developing countries.

Predicting non-familial major physical violent crime perpetration in the US Army from administrative data.

PubMed

Rosellini, A J; Monahan, J; Street, A E; Heeringa, S G; Hill, E D; Petukhova, M; Reis, B Y; Sampson, N A; Bliese, P; Schoenbaum, M; Stein, M B; Ursano, R J; Kessler, R C

2016-01-01

Although interventions exist to reduce violent crime, optimal implementation requires accurate targeting. We report the results of an attempt to develop an actuarial model using machine learning methods to predict future violent crimes among US Army soldiers. A consolidated administrative database for all 975 057 soldiers in the US Army in 2004-2009 was created in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Of these soldiers, 5771 committed a first founded major physical violent crime (murder-manslaughter, kidnapping, aggravated arson, aggravated assault, robbery) over that time period. Temporally prior administrative records measuring socio-demographic, Army career, criminal justice, medical/pharmacy, and contextual variables were used to build an actuarial model for these crimes separately among men and women using machine learning methods (cross-validated stepwise regression, random forests, penalized regressions). The model was then validated in an independent 2011-2013 sample. Key predictors were indicators of disadvantaged social/socioeconomic status, early career stage, prior crime, and mental disorder treatment. Area under the receiver-operating characteristic curve was 0.80-0.82 in 2004-2009 and 0.77 in the 2011-2013 validation sample. Of all administratively recorded crimes, 36.2-33.1% (male-female) were committed by the 5% of soldiers having the highest predicted risk in 2004-2009 and an even higher proportion (50.5%) in the 2011-2013 validation sample. Although these results suggest that the models could be used to target soldiers at high risk of violent crime perpetration for preventive interventions, final implementation decisions would require further validation and weighing of predicted effectiveness against intervention costs and competing risks.

Predicting non-familial major physical violent crime perpetration in the U.S. Army from administrative data

PubMed Central

Rosellini, Anthony J.; Monahan, John; Street, Amy E.; Heeringa, Steven G.; Hill, Eric D.; Petukhova, Maria; Reis, Ben Y.; Sampson, Nancy A.; Bliese, Paul; Schoenbaum, Michael; Stein, Murray B.; Ursano, Robert; Kessler, Ronald C.

2016-01-01

BACKGROUND Although interventions exist to reduce violent crime, optimal implementation requires accurate targeting. We report the results of an attempt to develop an actuarial model using machine learning methods to predict future violent crimes among U.S. Army soldiers. METHODS A consolidated administrative database for all 975,057 soldiers in the U.S. Army in 2004-2009 was created in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). 5,771 of these soldiers committed a first founded major physical violent crime (murder-manslaughter, kidnapping, aggravated arson, aggravated assault, robbery) over that time period. Temporally prior administrative records measuring socio-demographic, Army career, criminal justice, medical/pharmacy, and contextual variables were used to build an actuarial model for these crimes separately among men and women using machine learning methods (cross-validated stepwise regression; random forests; penalized regressions). The model was then validated in an independent 2011-2013 sample. RESULTS Key predictors were indicators of disadvantaged social/socio-economic status, early career stage, prior crime, and mental disorder treatment. Area under the receiver operating characteristic curve was .80-.82 in 2004-2009 and .77 in a 2011-2013 validation sample. 36.2-33.1% (male-female) of all administratively-recorded crimes were committed by the 5% of soldiers having highest predicted risk in 2004-2009 and an even higher proportion (50.5%) in the 2011-2013 validation sample. CONCLUSIONS Although these results suggest that the models could be used to target soldiers at high risk of violent crime perpetration for preventive interventions, final implementation decisions would require further validation and weighing of predicted effectiveness against intervention costs and competing risks. PMID:26436603

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

PubMed

Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

2016-01-01

To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, P<0.0001), fovea (r=0.4605, P=0.0007), no PVR (r=0.3138, P=0.0250), better baseline BCVA (r=0.7291, P<0.0001), shorter operative duration (r=0.3233, P=0.0207) and longer follow up (r=-0.3358, P=0.0160) were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, P<0.0001], shorter symptoms duration (PR(2)=0.0609, P=0.0101), longer follow up duration (PR(2)=0.0278, P=0.0477) and shorter operative duration (PR(2)=0.0338, P=0.0350). Patients with vision improvement took up 49.02% (25/51). Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Eating disorders: Insights from imaging and behavioral approaches to treatment.

PubMed

Stice, Eric; Shaw, Heather

2017-11-01

Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.

Predicting dropout using student- and school-level factors: An ecological perspective.

PubMed

Wood, Laura; Kiperman, Sarah; Esch, Rachel C; Leroux, Audrey J; Truscott, Stephen D

2017-03-01

High school dropout has been associated with negative outcomes, including increased rates of unemployment, incarceration, and mortality. Dropout rates vary significantly depending on individual and environmental factors. The purpose of our study was to use an ecological perspective to concurrently explore student- and school-level predictors associated with dropout for the purpose of better understanding how to prevent it. We used the Education Longitudinal Study of 2002 dataset. Participants included 14,106 sophomores across 684 public and private schools. We identified variables of interest based on previous research on dropout and implemented hierarchical generalized linear modeling. In the final model, significant student-level predictors included academic achievement, retention, sex, family socioeconomic status (SES), and extracurricular involvement. Significant school-level predictors included school SES and school size. Race/ethnicity, special education status, born in the United States, English as first language, school urbanicity, and school region did not significantly predict dropout after controlling for the aforementioned predictors. Implications for prevention and intervention efforts within a multitiered intervention model are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma.

PubMed

Rong, S S; Feng, M Y; Wang, N; Meng, H; Thomas, R; Fan, S; Wang, R; Wang, X; Tang, X; Liang, Y B

2013-03-01

To evaluate the association between early and late postoperative intraocular pressure (IOP) and determine if early postoperative IOP can predict the surgical outcome. A total of 165 consecutive patients with primary angle-closure glaucoma (PACG) undergoing primary mitomycin-C-augmented trabeculectomy underwent a comprehensive eye examination before surgery and were followed-up on days 1, 7, 14, and 30, and months 3, 6, 12, and 18. IOPs on days 1, 7, 14, and 30 were stratified into groups A (<10 mm Hg), B (≥10 and <15 mm Hg), C (≥15 and <20 mm Hg), and D (≥20 mm Hg). Differences between groups were analyzed using analysis of variance (ANOVA) and Fisher's exact test. Multivariable regression was used to exam the predictive ability of early IOP for final outcome. The mean age was 62.5±7.9 years and 41.21% (n=68) were males. Stratified by IOP on days 1, 7, 14, and 30, respectively, mean IOPs at month 18 were different among groups A, B, C, and D (ANOVA, P=0.047, P=0.033, P=0.008, and P<0.001, respectively). Once the IOPs were settled with interventions on day 7 a higher IOP level was associated with decreasing success rate under different outcome definitions, final IOP <15 mm Hg (Fisher's exact P=0.001) and <20 mm Hg (P=0.039) without medication. Multiple regression showed early IOP predicted final IOP independently from baseline variables. A cutoff value of 13.5 mm Hg on day 7 achieved an accuracy of 80.0 and 57.1% in predicting IOP<15 mm Hg without medication and failure after surgery, respectively. The IOP at 18 months following primary antifibrotic-augmented trabeculectomy in PACG patients is associated with and predicted by the postoperative IOPs at 1 month. Control of early IOP to 13.5 or less may provide better outcomes.

Anxiety, social skills, friendship quality, and peer victimization: an integrated model.

PubMed

Crawford, A Melissa; Manassis, Katharina

2011-10-01

This cross-sectional study investigated whether anxiety and social functioning interact in their prediction of peer victimization. A structural equation model linking anxiety, social skills, and friendship quality to victimization was tested separately for children with anxiety disorders and normal comparison children to explore whether the processes involved in victimization differ for these groups. Participants were 8-14 year old children: 55 (34 boys, 21 girls) diagnosed with an anxiety disorder and 85 (37 boys, 48 girls) normal comparison children. The final models for both groups yielded two independent pathways to victimization: (a) anxiety independently predicted being victimized; and (b) poor social skills predicted lower friendship quality, which in turn, placed a child at risk for victimization. These findings have important implications for the treatment of childhood anxiety disorders and for school-based anti-bullying interventions, but replication with larger samples is indicated. Copyright © 2011 Elsevier Ltd. All rights reserved.

Results of a large-scale randomized behavior change intervention on road safety in Kenya.

PubMed

Habyarimana, James; Jack, William

2015-08-25

Road accidents kill 1.3 million people each year, most in the developing world. We test the efficacy of evocative messages, delivered on stickers placed inside Kenyan matatus, or minibuses, in reducing road accidents. We randomize the intervention, which nudges passengers to complain to their drivers directly, across 12,000 vehicles and find that on average it reduces insurance claims rates of matatus by between one-quarter and one-third and is associated with 140 fewer road accidents per year than predicted. Messages promoting collective action are especially effective, and evocative images are an important motivator. Average maximum speeds and average moving speeds are 1-2 km/h lower in vehicles assigned to treatment. We cannot reject the null hypothesis of no placebo effect. We were unable to discern any impact of a complementary radio campaign on insurance claims. Finally, the sticker intervention is inexpensive: we estimate the cost-effectiveness of the most impactful stickers to be between $10 and $45 per disability-adjusted life-year saved.

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

Stathakis, S; Defoor, D; Linden, P

Purpose: To study the frequency of Multi-Leaf Collimator (MLC) leaf failures, investigate methods to predict them and reduce linac downtime. Methods: A Varian HD120 MLC was used in our study. The hyperterminal MLC errors logged from 06/2012 to 12/2014 were collected. Along with the hyperterminal errors, the MLC motor changes and all other MLC interventions by the linear accelerator engineer were recorded. The MLC dynalog files were also recorded on a daily basis for each treatment and during linac QA. The dynalog files were analyzed to calculate root mean square errors (RMS) and cumulative MLC travel distance per motor. Anmore » in-house MatLab code was used to analyze all dynalog files, record RMS errors and calculate the distance each MLC traveled per day. Results: A total of 269 interventions were recorded over a period of 18 months. Of these, 146 included MLC motor leaf change, 39 T-nut replacements, and 84 MLC cleaning sessions. Leaves close to the middle of each side required the most maintenance. In the A bank, leaves A27 to A40 recorded 73% of all interventions, while the same leaves in the B bank counted for 52% of the interventions. On average, leaves in the middle of the bank had their motors changed approximately every 1500m of travel. Finally, it was found that the number of RMS errors increased prior to an MLC motor change. Conclusion: An MLC dynalog file analysis software was developed that can be used to log daily MLC usage. Our eighteen-month data analysis showed that there is a correlation between the distance an MLC travels, the RMS and the life of the MLC motor. We plan to use this tool to predict MLC motor failures and with proper and timely intervention, reduce the downtime of the linac during clinical hours.« less

When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change.

PubMed

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2015-03-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded 3 main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to nonpatient (vs. patient) populations, were implemented in nonclinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PsycINFO Database Record (c) 2015 APA, all rights reserved.

When It Comes to Lifestyle Recommendations, More is Sometimes Less: A Meta-Analysis of Theoretical Assumptions Underlying the Effectiveness of Interventions Promoting Multiple Behavior Domain Change

PubMed Central

Wilson, Kristina; Senay, Ibrahim; Durantini, Marta; Sánchez, Flor; Hennessy, Michael; Spring, Bonnie; Albarracín, Dolores

2016-01-01

A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded three main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to non-patient (vs. patient) populations, were implemented in non-clinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions. PMID:25528345

How learning analytics can early predict under-achieving students in a blended medical education course.

PubMed

Saqr, Mohammed; Fors, Uno; Tedre, Matti

2017-07-01

Learning analytics (LA) is an emerging discipline that aims at analyzing students' online data in order to improve the learning process and optimize learning environments. It has yet un-explored potential in the field of medical education, which can be particularly helpful in the early prediction and identification of under-achieving students. The aim of this study was to identify quantitative markers collected from students' online activities that may correlate with students' final performance and to investigate the possibility of predicting the potential risk of a student failing or dropping out of a course. This study included 133 students enrolled in a blended medical course where they were free to use the learning management system at their will. We extracted their online activity data using database queries and Moodle plugins. Data included logins, views, forums, time, formative assessment, and communications at different points of time. Five engagement indicators were also calculated which would reflect self-regulation and engagement. Students who scored below 5% over the passing mark were considered to be potentially at risk of under-achieving. At the end of the course, we were able to predict the final grade with 63.5% accuracy, and identify 53.9% of at-risk students. Using a binary logistic model improved prediction to 80.8%. Using data recorded until the mid-course, prediction accuracy was 42.3%. The most important predictors were factors reflecting engagement of the students and the consistency of using the online resources. The analysis of students' online activities in a blended medical education course by means of LA techniques can help early predict underachieving students, and can be used as an early warning sign for timely intervention.

The Theory of Planned Behavior as a Model of Heavy Episodic Drinking Among College Students

PubMed Central

Collins, Susan E.; Carey, Kate B.

2008-01-01

This study provided a simultaneous, confirmatory test of the theory of planned behavior (TPB) in predicting heavy episodic drinking (HED) among college students. It was hypothesized that past HED, drinking attitudes, subjective norms and drinking refusal self-efficacy would predict intention, which would in turn predict future HED. Participants consisted of 131 college drinkers (63% female) who reported having engaged in HED in the previous two weeks. Participants were recruited and completed questionnaires within the context of a larger intervention study (see Collins & Carey, 2005). Latent factor structural equation modeling was used to test the ability of the TPB to predict HED. Chi-square tests and fit indices indicated good fit for the final structural models. Self-efficacy and attitudes but not subjective norms significantly predicted baseline intention, and intention and past HED predicted future HED. Contrary to hypotheses, however, a structural model excluding past HED provided a better fit than a model including it. Although further studies must be conducted before a definitive conclusion is reached, a TPB model excluding past behavior, which is arguably more parsimonious and theory driven, may provide better prediction of HED among college drinkers than a model including past behavior. PMID:18072832

Workaholism and relationship quality: a spillover-crossover perspective.

PubMed

Bakker, Arnold B; Demerouti, Evangelia; Burke, Ronald

2009-01-01

This study of 168 dual-earner couples examined the relationship between workaholism and relationship satisfaction. More specifically, on the basis of the literature, it was hypothesized that workaholism is positively related to work-family conflict. In addition, the authors predicted that workaholism is related to reduced support provided to the partner, through work-family conflict, and that individuals who receive considerable support from their partners are more satisfied with their relationship. Finally, the authors hypothesized direct crossover of relationship satisfaction between partners. The results of structural equation modeling analyses using the matched responses of both partners supported these hypotheses. Moreover, in line with predictions, the authors found that gender did not affect the strength of the relationships in the proposed model. The authors discuss workplace interventions as possible ways to help workaholics and their partners.

Risk Prediction Models in Psychiatry: Toward a New Frontier for the Prevention of Mental Illnesses.

PubMed

Bernardini, Francesco; Attademo, Luigi; Cleary, Sean D; Luther, Charles; Shim, Ruth S; Quartesan, Roberto; Compton, Michael T

2017-05-01

We conducted a systematic, qualitative review of risk prediction models designed and tested for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and psychotic disorders. Our aim was to understand the current state of research on risk prediction models for these 5 disorders and thus future directions as our field moves toward embracing prediction and prevention. Systematic searches of the entire MEDLINE electronic database were conducted independently by 2 of the authors (from 1960 through 2013) in July 2014 using defined search criteria. Search terms included risk prediction, predictive model, or prediction model combined with depression, bipolar, manic depressive, generalized anxiety, posttraumatic, PTSD, schizophrenia, or psychosis. We identified 268 articles based on the search terms and 3 criteria: published in English, provided empirical data (as opposed to review articles), and presented results pertaining to developing or validating a risk prediction model in which the outcome was the diagnosis of 1 of the 5 aforementioned mental illnesses. We selected 43 original research reports as a final set of articles to be qualitatively reviewed. The 2 independent reviewers abstracted 3 types of data (sample characteristics, variables included in the model, and reported model statistics) and reached consensus regarding any discrepant abstracted information. Twelve reports described models developed for prediction of major depressive disorder, 1 for bipolar disorder, 2 for generalized anxiety disorder, 4 for posttraumatic stress disorder, and 24 for psychotic disorders. Most studies reported on sensitivity, specificity, positive predictive value, negative predictive value, and area under the (receiver operating characteristic) curve. Recent studies demonstrate the feasibility of developing risk prediction models for psychiatric disorders (especially psychotic disorders). The field must now advance by (1) conducting more large-scale, longitudinal studies pertaining to depression, bipolar disorder, anxiety disorders, and other psychiatric illnesses; (2) replicating and carrying out external validations of proposed models; (3) further testing potential selective and indicated preventive interventions; and (4) evaluating effectiveness of such interventions in the context of risk stratification using risk prediction models. © Copyright 2017 Physicians Postgraduate Press, Inc.

Early childhood predictors of mothers' and fathers' relationships with adolescents with developmental disabilities.

PubMed

Mitchell, D B; Hauser-Cram, P

2010-06-01

The importance of positive parent-adolescent relationships is stressed in research on adolescents, although very little is known about this relationship when a teen has developmental disabilities (DD). We investigated the relationships of adolescents with disabilities with their mothers and their fathers in order to answer a number of questions regarding these relationships. In particular, we asked: are there differences in the relationships of mothers and fathers with their adolescent with DD? Are there early childhood predictors of the parent-teen relationship and are those based on variables that are amenable to intervention? Finally, do these predictors differ for mothers and fathers? This study focused on the relationships of 72 mothers and 53 fathers with their 15-year-old teens with DD and their predictors from the early childhood years. Data were collected from parents through interviews and self-administered questionnaires, and from their children with disabilities through structured assessment when children were age 3 years and again at age 15 years. Analyses indicated that both mother-teen and father-teen relationships were predicted by earlier parenting stress. The father-teen relationship was also predicted by early behaviour problems, but this relation was mediated by parenting stress. Socio-economic status, type of disability and the child's level of functioning were not predictive of later relationships between parents and teens. Mothers and fathers did not differ significantly in their reports of perceived positive relationships with their teens. The findings from this study suggest two important points of potential intervention during the early intervention years. First, parenting assistance and support to reduce stress during the early childhood years can benefit both mothers and fathers. Second, helping families and children cope with and diminish problem behaviours is likely to yield multiple advantages for parents and children and deserves emphasis in early intervention and pre-school programmes.

PRIME – PRocess modelling in ImpleMEntation research: selecting a theoretical basis for interventions to change clinical practice

PubMed Central

Walker, Anne E; Grimshaw, Jeremy; Johnston, Marie; Pitts, Nigel; Steen, Nick; Eccles, Martin

2003-01-01

Background Biomedical research constantly produces new findings but these are not routinely translated into health care practice. One way to address this problem is to develop effective interventions to translate research findings into practice. Currently a range of empirical interventions are available and systematic reviews of these have demonstrated that there is no single best intervention. This evidence base is difficult to use in routine settings because it cannot identify which intervention is most likely to be effective (or cost effective) in a particular situation. We need to establish a scientific rationale for interventions. As clinical practice is a form of human behaviour, theories of human behaviour that have proved useful in other similar settings may provide a basis for developing a scientific rationale for the choice of interventions to translate research findings into clinical practice. The objectives of the study are: to amplify and populate scientifically validated theories of behaviour with evidence from the experience of health professionals; to use this as a basis for developing predictive questionnaires using replicable methods; to identify which elements of the questionnaire (i.e., which theoretical constructs) predict clinical practice and distinguish between evidence compliant and non-compliant practice; and on the basis of these results, to identify variables (based on theoretical constructs) that might be prime targets for behaviour change interventions. Methods We will develop postal questionnaires measuring two motivational, three action and one stage theory to explore five behaviours with 800 general medical and 600 general dental practitioners. We will collect data on performance for each of the behaviours. The relationships between predictor variables (theoretical constructs) and outcome measures (data on performance) in each survey will be assessed using multiple regression analysis and structural equation modelling. In the final phase of the project, the findings from all surveys will be analysed simultaneously adopting a random effects approach to investigate whether the relationships between predictor variables and outcome measures are modified by behaviour, professional group or geographical location. PMID:14683530

RFA Guardian: Comprehensive Simulation of Radiofrequency Ablation Treatment of Liver Tumors.

PubMed

Voglreiter, Philip; Mariappan, Panchatcharam; Pollari, Mika; Flanagan, Ronan; Blanco Sequeiros, Roberto; Portugaller, Rupert Horst; Fütterer, Jurgen; Schmalstieg, Dieter; Kolesnik, Marina; Moche, Michael

2018-01-15

The RFA Guardian is a comprehensive application for high-performance patient-specific simulation of radiofrequency ablation of liver tumors. We address a wide range of usage scenarios. These include pre-interventional planning, sampling of the parameter space for uncertainty estimation, treatment evaluation and, in the worst case, failure analysis. The RFA Guardian is the first of its kind that exhibits sufficient performance for simulating treatment outcomes during the intervention. We achieve this by combining a large number of high-performance image processing, biomechanical simulation and visualization techniques into a generalized technical workflow. Further, we wrap the feature set into a single, integrated application, which exploits all available resources of standard consumer hardware, including massively parallel computing on graphics processing units. This allows us to predict or reproduce treatment outcomes on a single personal computer with high computational performance and high accuracy. The resulting low demand for infrastructure enables easy and cost-efficient integration into the clinical routine. We present a number of evaluation cases from the clinical practice where users performed the whole technical workflow from patient-specific modeling to final validation and highlight the opportunities arising from our fast, accurate prediction techniques.

Event-rate and delta inflation when evaluating mortality as a primary outcome from randomized controlled trials of nutritional interventions during critical illness: a systematic review.

PubMed

Summers, Matthew J; Chapple, Lee-anne S; McClave, Stephen A; Deane, Adam M

2016-04-01

There is a lack of high-quality evidence that proves that nutritional interventions during critical illness reduce mortality. We evaluated whether power calculations for randomized controlled trials (RCTs) of nutritional interventions that used mortality as the primary outcome were realistic, and whether overestimation was systematic in the studies identified to determine whether this was due to overestimates of event rate or delta. A systematic review of the literature between 2005 and 2015 was performed to identify RCTs of nutritional interventions administered to critically ill adults that had mortality as the primary outcome. Predicted event rate (predicted mortality during the control), predicted mortality during intervention, predicted delta (predicted difference between mortality during the control and intervention), actual event rate (observed mortality during control), observed mortality during intervention, and actual delta (difference between observed mortality during the control and intervention) were recorded. The event-rate gap (predicted event rate minus observed event rate), the delta gap (predicted delta minus observed delta), and the predicted number needed to treat were calculated. Data are shown as median (range). Fourteen articles were extracted, with power calculations provided for 10 studies. The predicted event rate was 29.9% (20.0–52.4%), and the predicted delta was 7.9% (3.0–20.0%). If the study hypothesis was proven correct then, on the basis of the power calculations, the number needed to treat would have been 12.7 (5.0–33.3) patients. The actual event rate was 25.3% (6.1–50.0%), the observed mortality during the intervention was 24.4% (6.3–39.7%), and the actual delta was 0.5% (−10.2–10.3%), such that the event-rate gap was 2.6% (−3.9–23.7%) and delta gap was 7.5% (3.2–25.2%). Overestimates of delta occur frequently in RCTs of nutritional interventions in the critically ill that are powered to determine a mortality benefit. Delta inflation may explain the number of "negative" studies in this field of research.

Agreement and Coverage of Indicators of Response to Intervention: A Multimethod Comparison and Simulation

ERIC Educational Resources Information Center

Fletcher, Jack M.; Stuebing, Karla K.; Barth, Amy E.; Miciak, Jeremy; Francis, David J.; Denton, Carolyn

2014-01-01

Purpose: Agreement across methods for identifying students as inadequate responders or as learning disabled is often poor. We report (1) an empirical examination of final status (postintervention benchmarks) and dual-discrepancy growth methods based on growth during the intervention and final status for assessing response to intervention and (2) a…

Rational selection of experimental readout and intervention sites for reducing uncertainties in computational model predictions.

PubMed

Flassig, Robert J; Migal, Iryna; der Zalm, Esther van; Rihko-Struckmann, Liisa; Sundmacher, Kai

2015-01-16

Understanding the dynamics of biological processes can substantially be supported by computational models in the form of nonlinear ordinary differential equations (ODE). Typically, this model class contains many unknown parameters, which are estimated from inadequate and noisy data. Depending on the ODE structure, predictions based on unmeasured states and associated parameters are highly uncertain, even undetermined. For given data, profile likelihood analysis has been proven to be one of the most practically relevant approaches for analyzing the identifiability of an ODE structure, and thus model predictions. In case of highly uncertain or non-identifiable parameters, rational experimental design based on various approaches has shown to significantly reduce parameter uncertainties with minimal amount of effort. In this work we illustrate how to use profile likelihood samples for quantifying the individual contribution of parameter uncertainty to prediction uncertainty. For the uncertainty quantification we introduce the profile likelihood sensitivity (PLS) index. Additionally, for the case of several uncertain parameters, we introduce the PLS entropy to quantify individual contributions to the overall prediction uncertainty. We show how to use these two criteria as an experimental design objective for selecting new, informative readouts in combination with intervention site identification. The characteristics of the proposed multi-criterion objective are illustrated with an in silico example. We further illustrate how an existing practically non-identifiable model for the chlorophyll fluorescence induction in a photosynthetic organism, D. salina, can be rendered identifiable by additional experiments with new readouts. Having data and profile likelihood samples at hand, the here proposed uncertainty quantification based on prediction samples from the profile likelihood provides a simple way for determining individual contributions of parameter uncertainties to uncertainties in model predictions. The uncertainty quantification of specific model predictions allows identifying regions, where model predictions have to be considered with care. Such uncertain regions can be used for a rational experimental design to render initially highly uncertain model predictions into certainty. Finally, our uncertainty quantification directly accounts for parameter interdependencies and parameter sensitivities of the specific prediction.

Behavioral momentum theory: equations and applications.

PubMed

Nevin, John A; Shahan, Timothy A

2011-01-01

Behavioral momentum theory provides a quantitative account of how reinforcers experienced within a discriminative stimulus context govern the persistence of behavior that occurs in that context. The theory suggests that all reinforcers obtained in the presence of a discriminative stimulus increase resistance to change, regardless of whether those reinforcers are contingent on the target behavior, are noncontingent, or are even contingent on an alternative behavior. In this paper, we describe the equations that constitute the theory and address their application to issues of particular importance in applied settings. The theory provides a framework within which to consider the effects of interventions such as extinction, noncontingent reinforcement, differential reinforcement of alternative behavior, and other phenomena (e.g., resurgence). Finally, the theory predicts some counterintuitive and potentially counterproductive effects of alternative reinforcement, and can serve as an integrative guide for intervention when its terms are identified with the relevant conditions of applied settings.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention.

PubMed

Powell, Sarah R; Cirino, Paul T; Malone, Amelia S

2017-07-01

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes.

PubMed

Olson-Kennedy, Johanna; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C; Meyer-Bahlburg, Heino F L; Garofalo, Robert; Meyer, Walter; Rosenthal, Stephen M

2016-04-01

The review summarizes relevant research focused on prevalence and natural history of gender nonconforming/transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people.

Hospital-acquired complications in a randomized controlled clinical trial of a geriatric consultation team.

PubMed

Becker, P M; McVey, L J; Saltz, C C; Feussner, J R; Cohen, H J

1987-05-01

As part of a controlled clinical trial of a geriatric consultation team (GCT), we investigated whether a GCT could affect the incidence of hospital-acquired complications in elderly patients. One hundred eighty-five patients, aged 75 years and older, were randomized into an intervention (N = 92) and a control (N = 93) group. Members of the intervention group received a GCT consultation and were routinely followed up throughout their hospitalization. The incidence of hospital-acquired complications for the entire study population was 38%. The type and rate of hospital-acquired complications in the intervention and control groups were not significantly different. Functional status on admission and admission to the psychiatry service were predictive for the occurrence of a hospital-acquired complication. In a broadly selected population such as this, the intensity of care available through a GCT was unable to reduce the occurrence of hospital-acquired complications. However, since this is only one aspect of a GCT function, and others may be of great importance, such aspects, and more targeted populations, must be evaluated before final conclusions can be reached about GCT efficiency.

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men.

PubMed

Catalano, Hannah Priest; Knowlden, Adam P; Birch, David A; Leeper, James D; Paschal, Angelia M; Usdan, Stuart L

2017-04-01

The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants were unvaccinated college men aged 18-26 years attending a large public university in the southeastern United States during Spring 2015. A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.

Predictive Utility of Brief Alcohol Use Disorders Identification Test (AUDIT) for human immunodeficiency virus antiretroviral medication nonadherence.

PubMed

Broyles, Lauren Matukaitis; Gordon, Adam J; Sereika, Susan M; Ryan, Christopher M; Erlen, Judith A

2011-10-01

Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of 2 cognitive-behavioral ART adherence interventions, the authors sought to determine if results on 2 common alcohol screening tests (Alcohol Use Disorders Identification Test--Consumption [AUDIT-C] and its binge-related question [AUDIT-3]) predict ART nonadherence. Twenty-seven percent of the sample (n = 308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C-positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (P = .036). Although AUDIT-3-positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management.

Predictive Utility of Brief AUDIT for HIV Antiretroviral Medication Nonadherence

PubMed Central

Broyles, Lauren Matukaitis; Gordon, Adam J.; Sereika, Susan M.; Ryan, Christopher M.; Erlen, Judith A.

2012-01-01

Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus HIV/AIDS providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of two cognitive-behavioral ART adherence interventions, we sought to determine if results on two common alcohol screening tests (Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) and its binge-related question (AUDIT-3)) predict ART nonadherence. Twenty seven percent of the sample (n=308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (p=.036). While AUDIT-3 positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management. PMID:22014256

Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience.

PubMed

Bergeron, Sherry; Senn, Charlene Y

2003-01-01

This study was designed to test an exploratory path model predicting health care utilization by lesbian women. Using structural equation modeling we examined the joint influence of internalized homophobia, feminism, comfort with health care providers (HCPs), education, and disclosure of sexual identity both in one's life and to one's HCP on health care utilization. Surveys were completed by 254 Canadian lesbian women (54% participation rate) recruited through snowball sampling and specialized media. The majority (95%) of women were White, 3% (n = 7) were women of colour, and the remaining six women did not indicate ethnicity. Participants ranged in age from 18 to 67 with a mean age of 38.85 years (SD = 9.12). In the final path model, higher education predicted greater feminism, more disclosure to HCPs, and better utilization of health services. Feminism predicted both decreased levels of internalized homophobia and increased disclosure across relationships. Being more open about one's sexual identity was related to increased disclosure to HCPs, which in turn, led to better health care utilization. Finally, the more comfortable women were with their HCP the more likely they were to seek preventive care. All paths were significant at p < .01. The path model offers insight into potential target areas for intervention with the goal of improving health care utilization in lesbian women.

Predicting Negative Emotions Based on Mobile Phone Usage Patterns: An Exploratory Study

PubMed Central

Yang, Pei-Ching; Chang, Chia-Chi; Chiang, Jung-Hsien; Chen, Ying-Yeh

2016-01-01

Background Prompt recognition and intervention of negative emotions is crucial for patients with depression. Mobile phones and mobile apps are suitable technologies that can be used to recognize negative emotions and intervene if necessary. Objective Mobile phone usage patterns can be associated with concurrent emotional states. The objective of this study is to adapt machine-learning methods to analyze such patterns for the prediction of negative emotion. Methods We developed an Android-based app to capture emotional states and mobile phone usage patterns, which included call logs (and use of apps). Visual analog scales (VASs) were used to report negative emotions in dimensions of depression, anxiety, and stress. In the system-training phase, participants were requested to tag their emotions for 14 consecutive days. Five feature-selection methods were used to determine individual usage patterns and four machine-learning methods were tested. Finally, rank product scoring was used to select the best combination to construct the prediction model. In the system evaluation phase, participants were then requested to verify the predicted negative emotions for at least 5 days. Results Out of 40 enrolled healthy participants, we analyzed data from 28 participants, including 30% (9/28) women with a mean (SD) age of 29.2 (5.1) years with sufficient emotion tags. The combination of time slots of 2 hours, greedy forward selection, and Naïve Bayes method was chosen for the prediction model. We further validated the personalized models in 18 participants who performed at least 5 days of model evaluation. Overall, the predictive accuracy for negative emotions was 86.17%. Conclusion We developed a system capable of predicting negative emotions based on mobile phone usage patterns. This system has potential for ecological momentary intervention (EMI) for depressive disorders by automatically recognizing negative emotions and providing people with preventive treatments before it escalates to clinical depression. PMID:27511748

Developing and Evaluating Interventions Aimed at Increasing Retention of Special Education Teachers (Teacher Support & Retention Project). Final Report.

ERIC Educational Resources Information Center

Cooley, Elizabeth

This final report describes the activities and outcomes of a 3-year federally funded project that developed and evaluated interventions aimed at increasing retention of special education teachers. The interventions developed and evaluated consisted of: (1) a series of stress management workshops aimed at preventing or alleviating teacher burnout,…

INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidates.

PubMed

Camolas, José; Santos, Osvaldo; Moreira, Pedro; do Carmo, Isabel

Preoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control. Two-arms randomised controlled single-site study, with six-month duration. Patients were recruited from an Obesity Treatment Unit's waiting list. For the intervention group (IG), an operating procedure manual was used, nutritionists received training/supervision regarding INDIVIDUO's procedures. Control group (CG) received health literacy-promoting intervention. Intention-to-treat and per-control analysis were used. Outcomes included weight, metabolic control variables (blood pressure, glycemia, insulinemia, triglycerides, cholesterol), measures of eating and physical activity patterns, hedonic hunger, autonomous/controlled regulation, perceived competence for diet (PCS-diet) and quality of life. Primary outcomes were weight and metabolic control. Effect size was estimated by odds ratio and Cohens'd coefficient. Overall, 94 patients participated (IG:45; CG:49) and 60 completed the study (IG:29; CG:31). Intervention patients lost an excess 9.68% body weight (%EWL), vs. 0.51% for CG. Adjusting for age and baseline BMI, allocation group remained an independent predictor of %EWL (B=8.43, 95%CI: 2.79-14.06). IG had a six-fold higher probability (OR: 6.35, 95%CI: 1.28-31.56) of having adequate/controlled fasting glycemia at final evaluation. PCS-diet at final evaluation was independently predicted by baseline PCS-diet (B=0.31, 95%CI: 0.06-0.64), variation in autonomous regulation (B=0.43, 95%CI: 0.15-0.71) and allocation group (B=0.26, 95%CI: 0.04-1.36). Results on weight and metabolic control support INDIVIDUO as a valuable clinical tool for obesity surgery candidates counseling. Additionally, intervention associated with perceived competence for weight-control behaviours and autonomous regulation. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Calcification Remodeling Index Characterized by Cardiac CT as a Novel Parameter to Predict the Use of Rotational Atherectomy for Coronary Intervention of Lesions with Moderate to Severe Calcification

PubMed Central

Yu, Mengmeng; Li, Yuehua; Li, Wenbin; Lu, Zhigang; Wei, Meng

2017-01-01

Objective To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. Materials and Methods Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area. Other parameters such as calcium volume, regional Agatston score, calcification length, and involved calcium arc quadrant were also recorded. Results A total of 223 patients with 241 calcified lesions were finally included. Lesions with RA tended to have larger calcium volume, higher regional Agatston score, more involved calcium arc quadrants, and significantly smaller calcification remodeling index than lesions without RA. Receiver operating characteristic curve analysis revealed that the best cutoff value of calcification remodeling index was 0.84 (area under curve = 0.847, p < 0.001). Calcification remodeling index ≤ 0.84 was the strongest independent predictor (odds ratio: 251.47, p < 0.001) for using RA. Conclusion Calcification remodeling index was significantly correlated with the incidence of using RA to aid PCI. Calcification remodeling index ≤ 0.84 was the strongest independent predictor for using RA prior to stent implantation. PMID:28860893

Development of an Evidence-Informed Blog to Promote Healthy Eating Among Mothers: Use of the Intervention Mapping Protocol

PubMed Central

2017-01-01

Background Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature. Objective The objective of this study was to describe the application of the Intervention Mapping (IM) protocol to develop an evidence-informed blog to promote healthy eating among French-Canadian mothers of preschool and school-aged children. Methods The following six steps of the IM protocol were performed. In Step 1, a preliminary needs assessment included a literature search on theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults (ie, knowledge, beliefs about capabilities, beliefs about consequences, intention/goals) and a qualitative study including focus groups to identify female Internet users’ perceptions of their use of healthy eating blogs. In Step 2, two behavioral outcomes were selected (ie, increase daily intakes of Vegetables and Fruits and Milk and Alternatives of mothers to reach Canadian dietary recommendations) and subsequently divided into six performance objectives inspired by national and international dietary recommendations such as planning for healthy meals. A matrix of change objectives was then created by crossing performance objectives with theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults. Step 3 consisted of selecting theory-based intervention methods (eg, modeling and goal setting) and translating them into practical applications for the context of a dietary intervention delivered through a blog. A 6-month intervention was developed in Step 4 in which we aimed to address one performance objective per month in weekly blog publications written by a registered dietitian. For Step 5, we sought to include engagement-promoting methods (eg, peer and counselor support) to promote mothers’ use of the blog and adherence to the intervention. Finally in Step 6, a randomized controlled trial has been launched to evaluate the effects of the blog on dietary behaviors of French-Canadian mothers. Results The intervention study is expected to be completed in March 2018. Conclusions An intervention mapping protocol allowed for effective decision making in the development of a novel knowledge translation tool to increase adherence to dietary recommendations among mothers of preschool and school-aged children. PMID:28526669

Negative Emotions and Suicidal Ideation During Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

PubMed Central

Kiosses, Dimitris N.; Gross, James J.; Banerjee, Samprit; Duberstein, Paul R.; Putrino, David; Alexopoulos, George S.

2017-01-01

Objectives To examine the relationship of negative emotions with suicidal ideation during 12-weeks of Problem Adaptation Therapy (PATH) vs. Supportive Therapy of Cognitively Impaired Older Adults (ST-CI). We hypothesize that: a) improved negative emotions are associated with reduced suicidal ideation; b) PATH improves negative emotions more than ST-CI; and c) improved negative emotions, rather than other depression symptoms, predict reduction in suicidal ideation. Design RCT of two home-delivered psychosocial interventions. Setting Weill-Cornell Institute of Geriatric Psychiatry; interventions and assessments were conducted at participants’ home. Participants 74 older participants (65–95 years old) with MDD and cognitive impairment were recruited in collaboration with community agencies. The sample reported less intense feelings than suicidal intention. Interventions PATH focuses on improving emotion regulation whereas ST-CI focuses on non-specific therapeutic factors, such as understanding and empathy. Measurements Improved negative emotions are measured as improvement in Montgomery Asberg’s Depression Rating Scales’ (MADRS) observer-ratings of sadness, anxiety, guilt, hopelessness and anhedonia. Suicidal ideation was assessed with the MADRS Suicide Item. Results MADRS Negative Emotions scores were significantly associated with suicidal ideation during the course of treatment (F[1, 165]=12.73, p=0.0005). PATH participants had significantly greater improvement in MADRS emotions than ST-CI participants (treatment group by time: F[1,63.2]=7.02, p=0.0102). Finally, improved negative emotions, between lagged and follow-up interview, significantly predicted reduction in suicidal ideation at follow-up interview (F[1, 96]=9.95, p=0.0022). Conclusions Our findings that improvement in negative emotions mediates reduction in suicidal ideation may guide the development of psychosocial interventions for reduction of suicidal ideation. PMID:28223082

Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.

PubMed

Biswas, Santanu; Subramanian, Abhishek; ELMojtaba, Ibrahim M; Chattopadhyay, Joydev; Sarkar, Ram Rup

2017-01-01

Visceral leishmaniasis (VL) is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.

Utility of an Abbreviated Dizziness Questionnaire to Differentiate between Causes of Vertigo and Guide Appropriate Referral: A Multicenter Prospective Blinded Study

PubMed Central

Roland, Lauren T.; Kallogjeri, Dorina; Sinks, Belinda C.; Rauch, Steven D.; Shepard, Neil T.; White, Judith A.; Goebel, Joel A.

2015-01-01

Objective Test performance of a focused dizziness questionnaire’s ability to discriminate between peripheral and non-peripheral causes of vertigo. Study Design Prospective multi-center Setting Four academic centers with experienced balance specialists Patients New dizzy patients Interventions A 32-question survey was given to participants. Balance specialists were blinded and a diagnosis was established for all participating patients within 6 months. Main outcomes Multinomial logistic regression was used to evaluate questionnaire performance in predicting final diagnosis and differentiating between peripheral and non-peripheral vertigo. Univariate and multivariable stepwise logistic regression were used to identify questions as significant predictors of the ultimate diagnosis. C-index was used to evaluate performance and discriminative power of the multivariable models. Results 437 patients participated in the study. Eight participants without confirmed diagnoses were excluded and 429 were included in the analysis. Multinomial regression revealed that the model had good overall predictive accuracy of 78.5% for the final diagnosis and 75.5% for differentiating between peripheral and non-peripheral vertigo. Univariate logistic regression identified significant predictors of three main categories of vertigo: peripheral, central and other. Predictors were entered into forward stepwise multivariable logistic regression. The discriminative power of the final models for peripheral, central and other causes were considered good as measured by c-indices of 0.75, 0.7 and 0.78, respectively. Conclusions This multicenter study demonstrates a focused dizziness questionnaire can accurately predict diagnosis for patients with chronic/relapsing dizziness referred to outpatient clinics. Additionally, this survey has significant capability to differentiate peripheral from non-peripheral causes of vertigo and may, in the future, serve as a screening tool for specialty referral. Clinical utility of this questionnaire to guide specialty referral is discussed. PMID:26485598

Perioperative Care and the Importance of Continuous Quality Improvement—A Controlled Intervention Study in Three Tanzanian Hospitals

PubMed Central

Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia

2015-01-01

Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Discussion Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392

Perioperative Care and the Importance of Continuous Quality Improvement--A Controlled Intervention Study in Three Tanzanian Hospitals.

PubMed

Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia

2015-01-01

Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, p<0.001). Postoperative Inpatient Care initially improved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p <0.001), while postoperative care did not significantly change. Anaesthetic Complication Rate in the intervention hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (p<0.0010). Surgical Case Fatality Rate in the control group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.

A multinational review of recent trends and reports in dementia caregiver burden.

PubMed

Torti, Frank M; Gwyther, Lisa P; Reed, Shelby D; Friedman, Joëlle Y; Schulman, Kevin A

2004-01-01

This systematic review of the literature focuses on the influence of ethnic, cultural, and geographic factors on the caregivers of patients with dementia. In particular, we explore the impact of cultural expectations on five important questions: 1) Do the characteristics of dementia affect caregiver burden? 2) Do characteristics of the caregiver independently predict burden? 3) Does the caregiver affect patient outcomes? 4) Does support or intervention for caregiver result in reduced caregiver burden or improved patient outcomes? 5) Finally, do patient interventions result in reduced caregiver burden or improved patient outcomes? Our findings suggest that noncognitive, behavioral disturbances of patients with dementia result in increased caregiver burden and that female caregivers bear a particularly heavy burden across cultures, particularly in Asian societies. Caregiver burden influences time to medical presentation of patients with dementia, patient condition at presentation, and patient institutionalization. Moreover, interventions designed to reduce caregiver burden have been largely, although not universally, unsuccessful. Pharmacological treatments for symptoms of dementia were found to be beneficial in reducing caregiver burden. The consistency of findings across studies, geographic regions, cultural differences, and heathcare delivery systems is striking. Yet, there are critical differences in cultural expectations and social resources. Future interventions to reduce caregiver burden must consider these differences, identify patients and caregivers at greatest risk, and develop targeted programs that combine aspects of a number of interventional strategies.

A network model for Ebola spreading.

PubMed

Rizzo, Alessandro; Pedalino, Biagio; Porfiri, Maurizio

2016-04-07

The availability of accurate models for the spreading of infectious diseases has opened a new era in management and containment of epidemics. Models are extensively used to plan for and execute vaccination campaigns, to evaluate the risk of international spreadings and the feasibility of travel bans, and to inform prophylaxis campaigns. Even when no specific therapeutical protocol is available, as for the Ebola Virus Disease (EVD), models of epidemic spreading can provide useful insight to steer interventions in the field and to forecast the trend of the epidemic. Here, we propose a novel mathematical model to describe EVD spreading based on activity driven networks (ADNs). Our approach overcomes the simplifying assumption of homogeneous mixing, which is central to most of the mathematically tractable models of EVD spreading. In our ADN-based model, each individual is not bound to contact every other, and its network of contacts varies in time as a function of an activity potential. Our model contemplates the possibility of non-ideal and time-varying intervention policies, which are critical to accurately describe EVD spreading in afflicted countries. The model is calibrated from field data of the 2014 April-to-December spreading in Liberia. We use the model as a predictive tool, to emulate the dynamics of EVD in Liberia and offer a one-year projection, until December 2015. Our predictions agree with the current vision expressed by professionals in the field, who consider EVD in Liberia at its final stage. The model is also used to perform a what-if analysis to assess the efficacy of timely intervention policies. In particular, we show that an earlier application of the same intervention policy would have greatly reduced the number of EVD cases, the duration of the outbreak, and the infrastructures needed for the implementation of the intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Contribution of neurocognition to 18-month employment outcomes in first-episode psychosis.

PubMed

Karambelas, George J; Cotton, Sue M; Farhall, John; Killackey, Eóin; Allott, Kelly A

2017-10-27

To examine whether baseline neurocognition predicts vocational outcomes over 18 months in patients with first-episode psychosis enrolled in a randomized controlled trial of Individual Placement and Support or treatment as usual. One-hundred and thirty-four first-episode psychosis participants completed an extensive neurocognitive battery. Principal axis factor analysis using PROMAX rotation was used to determine the underlying structure of the battery. Setwise (hierarchical) multiple linear and logistic regressions were used to examine predictors of (1) total hours employed over 18 months and (2) employment status, respectively. Neurocognition factors were entered in the models after accounting for age, gender, premorbid IQ, negative symptoms, treatment group allocation and employment status at baseline. Five neurocognitive factors were extracted: (1) processing speed, (2) verbal learning and memory, (3) knowledge and reasoning, (4) attention and working memory and (5) visual organization and memory. Employment status over 18 months was not significantly predicted by any of the predictors in the final model. Total hours employed over 18 months were significantly predicted by gender (P = .027), negative symptoms (P = .032) and verbal learning and memory (P = .040). Every step of the regression model was a significant predictor of total hours worked overall (final model: P = .013). Verbal learning and memory, negative symptoms and gender were implicated in duration of employment in first-episode psychosis. The other neurocognitive domains did not significantly contribute to the prediction of vocational outcomes over 18 months. Interventions targeting verbal memory may improve vocational outcomes in early psychosis. © 2017 John Wiley & Sons Australia, Ltd.

Model‐Based Approach to Predict Adherence to Protocol During Antiobesity Trials

PubMed Central

Sharma, Vishnu D.; Combes, François P.; Vakilynejad, Majid; Lahu, Gezim; Lesko, Lawrence J.

2017-01-01

Abstract Development of antiobesity drugs is continuously challenged by high dropout rates during clinical trials. The objective was to develop a population pharmacodynamic model that describes the temporal changes in body weight, considering disease progression, lifestyle intervention, and drug effects. Markov modeling (MM) was applied for quantification and characterization of responder and nonresponder as key drivers of dropout rates, to ultimately support the clinical trial simulations and the outcome in terms of trial adherence. Subjects (n = 4591) from 6 Contrave® trials were included in this analysis. An indirect‐response model developed by van Wart et al was used as a starting point. Inclusion of drug effect was dose driven using a population dose‐ and time‐dependent pharmacodynamic (DTPD) model. Additionally, a population‐pharmacokinetic parameter‐ and data (PPPD)‐driven model was developed using the final DTPD model structure and final parameter estimates from a previously developed population pharmacokinetic model based on available Contrave® pharmacokinetic concentrations. Last, MM was developed to predict transition rate probabilities among responder, nonresponder, and dropout states driven by the pharmacodynamic effect resulting from the DTPD or PPPD model. Covariates included in the models and parameters were diabetes mellitus and race. The linked DTPD‐MM and PPPD‐MM was able to predict transition rates among responder, nonresponder, and dropout states well. The analysis concluded that body‐weight change is an important factor influencing dropout rates, and the MM depicted that overall a DTPD model‐driven approach provides a reasonable prediction of clinical trial outcome probabilities similar to a pharmacokinetic‐driven approach. PMID:28858397

The predictive capacity of perceived expressed emotion as a dynamic entity of adolescents from the general community.

PubMed

Hale, William W; Raaijmakers, Quinten A W; van Hoof, Anne; Meeus, Wim H J

2011-06-01

In previous studies, it has been demonstrated that high parental expressed emotion (EE) is predictive of depressive, aggressive and delinquency symptoms of adolescents. Two issues have received much less prominence in EE research, these being studies of adolescent perceived EE and the measurement of the EE as a dynamic, developmental construct. This 4-year, three-wave, longitudinal study of perceived EE of adolescents from the general community examines if adolescent perceived EE measured with the traditional, one-measurement EE approach as well as adolescent perceived EE measured with a repeated measured, dynamic EE approach can predict adolescent depressive, aggressive and delinquency symptoms. Dutch adolescents (N = 285; 51% girls; M = 13 years) from the general community were prospectively studied annually for 4 years. At all waves, the adolescents completed the Level of Expressed Emotion (LEE) questionnaire and at the final wave also completed self-rated measures of depressive, aggressive and delinquent symptoms. Growth models were used to predict adolescent symptoms from adolescent perceived EE. Growth models significantly predicted adolescent depressive, aggressive and delinquency symptoms from adolescent perceived EE. This study of the LEE demonstrates that developmental characteristics of EE are predictive of adolescents' symptoms. These findings hold implications for current EE intervention therapies and the conceptualization of EE.

Spatiotemporal Analysis of Malaria in Urban Ahmedabad (Gujarat), India: Identification of Hot Spots and Risk Factors for Targeted Intervention

PubMed Central

Parizo, Justin; Sturrock, Hugh J. W.; Dhiman, Ramesh C.; Greenhouse, Bryan

2016-01-01

The world population, especially in developing countries, has experienced a rapid progression of urbanization over the last half century. Urbanization has been accompanied by a rise in cases of urban infectious diseases, such as malaria. The complexity and heterogeneity of the urban environment has made study of specific urban centers vital for urban malaria control programs, whereas more generalizable risk factor identification also remains essential. Ahmedabad city, India, is a large urban center located in the state of Gujarat, which has experienced a significant Plasmodium vivax and Plasmodium falciparum disease burden. Therefore, a targeted analysis of malaria in Ahmedabad city was undertaken to identify spatiotemporal patterns of malaria, risk factors, and methods of predicting future malaria cases. Malaria incidence in Ahmedabad city was found to be spatially heterogeneous, but temporally stable, with high spatial correlation between species. Because of this stability, a prediction method utilizing historic cases from prior years and seasons was used successfully to predict which areas of Ahmedabad city would experience the highest malaria burden and could be used to prospectively target interventions. Finally, spatial analysis showed that normalized difference vegetation index, proximity to water sources, and location within Ahmedabad city relative to the dense urban core were the best predictors of malaria incidence. Because of the heterogeneity of urban environments and urban malaria itself, the study of specific large urban centers is vital to assist in allocating resources and informing future urban planning. PMID:27382081

Predictors of Program Use and Child and Parent Outcomes of A Brief Online Parenting Intervention.

PubMed

Baker, Sabine; Sanders, Matthew R

2017-10-01

Web-based parenting interventions have the potential to increase the currently low reach of parenting programs, but few evidence-based online programs are available, and little is known about who benefits from this delivery format. This study investigated if improvements in child behavior and parenting, following participation in a brief online parenting program (Triple P Online Brief), can be predicted by family and program-related factors. Participants were 100 parents of 2-9-year-old children displaying disruptive behavior problems. Regression analyses showed that higher baseline levels of child behavior problems, older parental age and more intense conflict over parenting pre-intervention predicted greater improvement in child behavior at 9-month follow-up. Improvement in parenting was predicted by higher pre-intervention levels of ineffective parenting. Family demographics, parental adjustment and program related factors did not predict treatment outcomes. Younger child age and lower disagreement over parenting pre-intervention predicted completion of the recommended minimum dose of the program.

A Forgiveness Intervention for Women With Fibromyalgia Who Were Abused in Childhood: A Pilot Study

PubMed Central

2014-01-01

This pilot study compared the efficacy of a forgiveness intervention with a fibromyalgia (FM) health intervention on women with FM who have experienced emotional, physical, or sexual abuse, and emotional or physical neglect, in childhood by one of their parents. Eleven women with FM between the ages of 21 and 68 were randomized to the forgiveness intervention (n = 5) or the FM health intervention (n = 6), and completed the once-weekly individualized program for 24 weeks. The participants completed measures assessing forgiveness, overall FM health, depression, anger, anxiety, self-esteem, and coping strategies at the pretest, the posttest, and the 12-week follow-up test. They also completed the forgiveness intervention and FM health intervention final tests at the posttest, which assessed their knowledge on forgiveness and FM health. The forgiveness intervention participants had greater improvements in forgiveness (p < .001) and overall FM health (p = .046) from the pretest to the posttest, and in forgiveness (p = .018) and state anger (p = .027) from the pretest to the follow-up test than the FM health intervention participants. Moreover, the forgiveness intervention participants scored higher on the forgiveness final test than the FM health intervention participants (p < .001), and the FM health intervention participants scored higher on the FM health final test than the forgiveness intervention participants (p < .001). The results indicate that the forgiveness intervention was potentially helpful in improving forgiveness and overall FM health, and in decreasing state anger of this particular sample of women with FM. PMID:25914886

Can Rheumatologists Predict Eventual Need for Orthopaedic Intervention in Patients with Rheumatoid Arthritis? Results of a Systematic Review and Analysis of Two UK Inception Cohorts.

PubMed

Nikiphorou, Elena; Carpenter, Lewis; Norton, Sam; Morris, Stephen; MacGregor, Alex; Dixey, Josh; Williams, Peter; Kiely, Patrick; Walsh, David Andrew; Young, Adam

2017-03-01

The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention. A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA. Manuscripts were selected if they met inclusion criteria of cohort study design, diagnosis of RA, follow-up duration/disease duration ≥3 years, any orthopaedic surgical interventions recorded, and then summarised for predictive factors. A separate predictive analysis was performed on two consecutive UK Early RA cohorts, linked to national datasets. The literature search identified 15 reports examining predictive factors for orthopaedic intervention, 4 inception, 5 prospective and 6 retrospective. Despite considerable variation, acute phase, x-ray scores, women and genotyping were the most commonly reported prognostic markers. The current predictive analysis included 1602 procedures performed in 711 patients (25-year cumulative incidence 26%). Earlier recruitment year, erosions and lower haemoglobin predicted both intermediate and major surgery (P<0.05). Studies report variations in type of and predictive power of clinical and laboratory parameters for different surgical interventions suggesting specific contributions from different pathological and/or patient-level factors. Our current analysis suggests that attention to non-inflammatory factors in addition to suppression of inflammation is needed to minimise the burden of orthopaedic surgery.

The role of helplessness, outcome expectation for exercise and literacy in predicting disability and symptoms in older adults with arthritis.

PubMed

Bhat, Anita A; DeWalt, Darren A; Zimmer, Catherine R; Fried, Bruce J; Callahan, Leigh F

2010-10-01

To examine the effect of outcome expectation for exercise (OEE), helplessness, and literacy on arthritis outcomes in 2 community-based lifestyle randomized controlled trials (RCTs) conducted in urban and rural communities with older adults with arthritis. Data from 391 participants in 2 RCTs were combined to examine associations of 2 psychosocial variables: helplessness and OEE, and literacy with arthritis outcomes. Arthritis outcomes namely, the Health Assessment Questionnaire-Disability Index (HAQ-DI) and arthritis symptoms pain, fatigue and stiffness Visual Analogue Scales (VAS), were measured at baseline and at the end of the interventions. Complete baseline and post-intervention data were analyzed using STATA version 9. Disability after intervention was not predicted by helplessness, literacy, or OEE in the adjusted model. Arthritis symptoms after the intervention were all significantly predicted by helplessness at various magnitudes in adjusted models, but OEE and literacy were not significant predictors. When literacy, helplessness, and OEE were examined as predictors of arthritis outcomes in intervention trials, they did not predict disability. However, helplessness predicted symptoms of pain, fatigue, and stiffness, but literacy did not predict symptoms. Future sustainable interventions may include self-management components that address decreasing helplessness to improve arthritis outcomes. (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders

PubMed Central

Hardison, Mark E.

2017-01-01

Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation included gender, number of sessions completed, and performance of work simulation activities. Maximum hours per session was the only significant predictor of success in the comprehensive rehabilitation program. This study identifies new factors associated with success in occupational rehabilitation, specifically highlighting the importance of intensity (i.e., session length and number of sessions) of therapy and occupation-based activities for this population. PMID:28027046

"She Finally Smiles … for Real": Reducing Depressive Symptoms and Bolstering Resilience Through a Camp Intervention for LGBTQ Youth.

PubMed

Gillig, Traci K; Miller, Lynn C; Cox, Courtney M

2017-11-29

While summer camps are a recognized evidence-based strategy for building social and emotional skills among youth (U.S. Centers for Disease Control and Prevention [CDC], 2009), no known studies have evaluated the effects of camp programming for LGBTQ youth in the United States. This pilot study evaluates a novel program (Brave Trails) for LGBTQ youth ages 12 to 20, using a pre-post camper survey (N = 56) and a post-camp parent survey (N = 54). Results show campers experienced increases in identity affirmation and hope and a reduction in depressive symptoms. Regression analyses found changes in identity affirmation predicted reductions in depressive symptoms and increases in resilience. Additionally, campers' experience of key camp programming features predicted changes in depressive symptoms. Findings from the parent survey were consistent with camper survey results. Theoretical and practical implications are discussed.

76 FR 37341 - Final Priority; Rehabilitation Research and Training Center-Interventions To Promote Community...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... research, demonstration projects, training, and related activities, to develop methods, procedures, and... DEPARTMENT OF EDUCATION [CFDA Number: 84.133B-1] Final Priority; Rehabilitation Research and... priority for a Rehabilitation Research and Training Center (RRTC) on Interventions to Promote Community...

Predicting having condoms available among adolescents: the role of personal norm and enjoyment.

PubMed

Jellema, Ilke J; Abraham, Charles; Schaalma, Herman P; Gebhardt, Winifred A; van Empelen, Pepijn

2013-05-01

Having condoms available has been shown to be an important predictor of condom use. We examined whether or not personal norm and goal enjoyment contribute to predicting having condoms available in the context of cognition specified by the theory of planned behaviour (TPB). Prospective survey study, with a baseline and follow-up measurement (at 3 months). Data were gathered using an online survey. In total 282 adolescents (mean age = 15.6, 74% female adolescents) completed both questionnaires. At baseline, demographics, sexual experience, condom use, TPB variables, descriptive norm, personal norm, and enjoyment towards having condoms available were measured. At T2 (3 months later) having condoms available was measured. Direct and moderating effects of personal norm and goal enjoyment were examined by means of hierarchical linear regression analyses. Regression analyses yielded a direct effect of self-efficacy and personal norm on condom availability. In addition, moderation of the intention-behaviour relation by goal enjoyment added to the variance explained. The final model explained approximately 35% of the variance in condom availability. Personal norm and goal enjoyment add to the predictive utility of a TPB model of having condoms available and may be useful intervention targets. What is already known about this subject? Having condoms available is an important prerequisite for actual condom use. The theory of planned behaviour has successfully been applied to explain condom availability behaviour. The theory of planned behaviour has been criticized for not adequately taking into account affective motivation. What does this study add? Personal norm and goal enjoyment add to the predictive utility of the model. Personal norm explains condom availability directly, enjoyment increases intention enactment. Personal norm and goal enjoyment therefore are useful intervention targets. © 2012 The British Psychological Society.

Microbial Performance of Food Safety Control and Assurance Activities in a Fresh Produce Processing Sector Measured Using a Microbial Assessment Scheme and Statistical Modeling.

PubMed

Njage, Patrick Murigu Kamau; Sawe, Chemutai Tonui; Onyango, Cecilia Moraa; Habib, I; Njagi, Edmund Njeru; Aerts, Marc; Molenberghs, Geert

2017-01-01

Current approaches such as inspections, audits, and end product testing cannot detect the distribution and dynamics of microbial contamination. Despite the implementation of current food safety management systems, foodborne outbreaks linked to fresh produce continue to be reported. A microbial assessment scheme and statistical modeling were used to systematically assess the microbial performance of core control and assurance activities in five Kenyan fresh produce processing and export companies. Generalized linear mixed models and correlated random-effects joint models for multivariate clustered data followed by empirical Bayes estimates enabled the analysis of the probability of contamination across critical sampling locations (CSLs) and factories as a random effect. Salmonella spp. and Listeria monocytogenes were not detected in the final products. However, none of the processors attained the maximum safety level for environmental samples. Escherichia coli was detected in five of the six CSLs, including the final product. Among the processing-environment samples, the hand or glove swabs of personnel revealed a higher level of predicted contamination with E. coli , and 80% of the factories were E. coli positive at this CSL. End products showed higher predicted probabilities of having the lowest level of food safety compared with raw materials. The final products were E. coli positive despite the raw materials being E. coli negative for 60% of the processors. There was a higher probability of contamination with coliforms in water at the inlet than in the final rinse water. Four (80%) of the five assessed processors had poor to unacceptable counts of Enterobacteriaceae on processing surfaces. Personnel-, equipment-, and product-related hygiene measures to improve the performance of preventive and intervention measures are recommended.

Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention.

PubMed

Miovský, Michal; Vonkova, Hana; Čablová, Lenka; Gabrhelík, Roman

2015-11-01

To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Early Intervention Preservice Preparation: Program Evaluation and Reflections. Master's Personnel Prep Program. Final Report.

ERIC Educational Resources Information Center

Bricker, Diane; Squires, Jane

This final report discusses the activities and outcomes of the early intervention interdisciplinary preservice program at the University of Oregon. This master's degree program used both "measurement of" and "reflection about" preservice efforts to address important questions regarding program effectiveness and identify…

Sustainability of Promising Innovations, November 1, 1998-October 31, 2002. Final Report.

ERIC Educational Resources Information Center

Vadasy, Patricia

This final report discusses the activities and outcomes of a project designed to investigate the sustainability of two federally funded intervention programs by school staff. The first, Eastlake High School Inclusion Program, implemented processes and instructional interventions designed to support the full inclusion of students with disabilities…

Services for Children with Deaf-Blindness Pilot Project. Final Report.

ERIC Educational Resources Information Center

Stremel, Kathleen

This final report describes a pilot project, "Quality Service Provision for Infants and Young Children with Deaf-Blindness: A Mechanism for State Intervention Teams," developed and implemented at the University of Southern Mississippi. The project developed a model of an intervention team that provides intensive training and technical…

Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior.

PubMed

Diep, Cassandra S; Beltran, Alicia; Chen, Tzu-An; Thompson, Debbe; O'Connor, Teresia; Hughes, Sheryl; Baranowski, Janice; Baranowski, Tom

2015-06-01

To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales. An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05. Houston, TX, USA. Three hundred and seven parents (mostly mothers) of pre-school children. Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child's vegetable consumption. The final model's adjusted R 2 was 0·486. This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.

Prefrontal mediation of the reading network predicts intervention response in dyslexia.

PubMed

Aboud, Katherine S; Barquero, Laura A; Cutting, Laurie E

2018-04-01

A primary challenge facing the development of interventions for dyslexia is identifying effective predictors of intervention response. While behavioral literature has identified core cognitive characteristics of response, the distinction of reading versus executive cognitive contributions to response profiles remains unclear, due in part to the difficulty of segregating these constructs using behavioral outputs. In the current study we used functional neuroimaging to piece apart the mechanisms of how/whether executive and reading network relationships are predictive of intervention response. We found that readers who are responsive to intervention have more typical pre-intervention functional interactions between executive and reading systems compared to nonresponsive readers. These findings suggest that intervention response in dyslexia is influenced not only by domain-specific reading regions, but also by contributions from intervening domain-general networks. Our results make a significant gain in identifying predictive bio-markers of outcomes in dyslexia, and have important implications for the development of personalized clinical interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of an Evidence-Informed Blog to Promote Healthy Eating Among Mothers: Use of the Intervention Mapping Protocol.

PubMed

Dumas, Audrée-Anne; Lemieux, Simone; Lapointe, Annie; Provencher, Véronique; Robitaille, Julie; Desroches, Sophie

2017-05-19

Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature. The objective of this study was to describe the application of the Intervention Mapping (IM) protocol to develop an evidence-informed blog to promote healthy eating among French-Canadian mothers of preschool and school-aged children. The following six steps of the IM protocol were performed. In Step 1, a preliminary needs assessment included a literature search on theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults (ie, knowledge, beliefs about capabilities, beliefs about consequences, intention/goals) and a qualitative study including focus groups to identify female Internet users' perceptions of their use of healthy eating blogs. In Step 2, two behavioral outcomes were selected (ie, increase daily intakes of Vegetables and Fruits and Milk and Alternatives of mothers to reach Canadian dietary recommendations) and subsequently divided into six performance objectives inspired by national and international dietary recommendations such as planning for healthy meals. A matrix of change objectives was then created by crossing performance objectives with theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults. Step 3 consisted of selecting theory-based intervention methods (eg, modeling and goal setting) and translating them into practical applications for the context of a dietary intervention delivered through a blog. A 6-month intervention was developed in Step 4 in which we aimed to address one performance objective per month in weekly blog publications written by a registered dietitian. For Step 5, we sought to include engagement-promoting methods (eg, peer and counselor support) to promote mothers' use of the blog and adherence to the intervention. Finally in Step 6, a randomized controlled trial has been launched to evaluate the effects of the blog on dietary behaviors of French-Canadian mothers. The intervention study is expected to be completed in March 2018. An intervention mapping protocol allowed for effective decision making in the development of a novel knowledge translation tool to increase adherence to dietary recommendations among mothers of preschool and school-aged children. ©Audrée-Anne Dumas, Simone Lemieux, Annie Lapointe, Véronique Provencher, Julie Robitaille, Sophie Desroches. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 19.05.2017.

Research Priorities for Gender Nonconforming/Transgender Youth: Gender Identity Development and Biopsychosocial Outcomes

PubMed Central

Olson-Kennedy, J; Cohen-Kettenis, P. T.; Kreukels, B.P.C; Meyer-Bahlburg, H.F.L; Garofalo, R; Meyer, W; Rosenthal, S.M.

2016-01-01

This review summarizes relevant research focused on prevalence and natural history of gender non-conforming / transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Recent findings Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured in order to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Summary Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people. PMID:26825472

Gender differences in condom use prediction with Theory of Reasoned Action and Planned Behaviour: the role of self-efficacy and control.

PubMed

Muñoz-Silva, A; Sánchez-García, M; Nunes, C; Martins, A

2007-10-01

There is much evidence that demonstrates that programs and interventions based on the theoretical models of the Theory of Reasoned Action (TRA) and the Theory of Planned Behaviour (TPB) have been effective in the prevention of the sexual transmission of HIV. The objective of this work is to compare the effectiveness of both models in the prediction of condom use, distinguishing two components inside the variable Perceived Behavioural Control of the TPB model: self-efficacy and control. The perspective of gender differences is also added. The study was carried out in a sample of 601 Portuguese and Spanish university students. The results show that the females have a higher average in all the TPB variables than males, except in the frequency of condom use: females request the use of condoms less frequently than males. On the other hand, for both females and males the TPB model predicts better condom-use intention than the TRA. However there are no differences between the two models in relation to the prediction of condom-use behaviour. For prediction of intention, the most outstanding variable among females is attitude, while among males they are subjective norm and self-efficacy. Finally, we analyze the implications of these data from a theoretical and practical point of view.

Developmental outcomes of toddlers of young Latina mothers: Cultural, family, and parenting factors.

PubMed

Grau, Josefina M; Duran, Petra A; Castellanos, Patricia; Smith, Erin N; Silberman, Stephanie G; Wood, Lauren E

2015-11-01

Children of adolescent mothers are at risk for poor developmental outcomes. This study is among the first to examine how cultural, family, and parenting factors prospectively predict the cognitive and language development of children of young Latina mothers (N=170; Mage=17.9 years). Mothers were interviewed and observed interacting with their children at 18 months (W1). Children were tested at 18 (W1) and 24 (W2) months. Mothers' cultural orientation (W1) was related to aspects of the childrearing environment (W1), which in turn had implications for the children's development (W2). Specifically, a stronger orientation toward American culture was related to higher mother-reported engagement in parenting by their own mothers (grandmothers), which in turn predicted stronger gains in cognitive and expressive language functioning from W1 to W2. A stronger Latino orientation related to the display of more directiveness and greater mother-reported engagement by the children's biological fathers; directiveness, in turn, predicted fewer gains in cognitive functioning only when father engagement was low and did not predict expressive language development. Finally, mothers' display of more positive affect, a stronger American orientation, and higher grandmother engagement uniquely predicted gains in W2 expressive language functioning. Implications for intervention are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Developmental Outcomes of Toddlers of Young Latina Mothers: Cultural, Family, and Parenting Factors

PubMed Central

Grau, Josefina M.; Duran, Petra A.; Castellanos, Patricia; Smith, Erin N.; Silberman, Stephanie G.; Wood, Lauren

2015-01-01

Children of adolescent mothers are at risk for poor developmental outcomes. This study is among the first to examine how cultural, family, and parenting factors prospectively predict the cognitive and language development of children of young Latina mothers (N=170; Mage = 17.9 years). Mothers were interviewed and observed interacting with their children at 18 months (W1). Children were tested at 18 (W1) and 24 (W2) months. Mothers’ cultural orientation (W1) was related to aspects of the childrearing environment (W1), which in turn had implications for the children's development (W2). Specifically, a stronger orientation toward American culture was related to higher mother-reported engagement in parenting by their own mothers (grandmothers), which in turn predicted stronger gains in cognitive and expressive language functioning from W1 to W2. A stronger Latino orientation related to the display of more directiveness and greater mother-reported engagement by the children's biological fathers; directiveness, in turn, predicted fewer gains in cognitive functioning only when father engagement was low and did not predict expressive language development. Finally, mothers’ display of more positive affect, a stronger American orientation, and higher grandmother engagement uniquely predicted gains in W2 expressive language functioning. Implications for intervention are discussed. PMID:26454205

Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

PubMed Central

Castelnuovo, Gianluca; Giusti, Emanuele M.; Manzoni, Gian Mauro; Saviola, Donatella; Gatti, Arianna; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara A. M.; Corti, Stefania; Novelli, Margherita; Villa, Valentina; Cottini, Andrea; Lai, Carlo; Pagnini, Francesco; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Capodaglio, Paolo; D'Aniello, Guido E.; Scarpina, Federica; Brioschi, Andrea; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan G.; Wiederhold, Brenda; Tamburin, Stefano

2016-01-01

Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions. PMID:27148104

Examining the mediational role of psychological flexibility, pain catastrophizing, and visceral sensitivity in the relationship between psychological distress, irritable bowel symptom frequency, and quality of life.

PubMed

Cassar, G E; Knowles, S; Youssef, G J; Moulding, R; Uiterwijk, D; Waters, L; Austin, D W

2018-06-08

The aim of the current study was to use Structural Equation Modelling (SEM) to examine whether psychological flexibility (i.e. mindfulness, acceptance, valued-living) mediates the relationship between distress, irritable bowel syndrome (IBS) symptom frequency, and quality of life (QoL). Ninety-two individuals participated in the study (12 male, 80 female, M age  = 36.24) by completing an online survey including measures of visceral sensitivity, distress, IBS-related QoL, mindfulness, bowel symptoms, pain catastrophizing, acceptance, and valued-living. A final model with excellent fit was identified. Psychological distress significantly and directly predicted pain catastrophizing, valued-living, and IBS symptom frequency. Pain catastrophizing directly predicted visceral sensitivity and acceptance, while visceral sensitivity significantly and directly predicted IBS symptom frequency and QoL. Symptom frequency also had a direct and significant relationship with QoL. The current findings suggest that interventions designed to address unhelpful cognitive processes related to visceral sensitivity, pain catastrophizing, and psychological distress may be of most benefit to IBS-related QoL.

Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks: the Feeding Your Baby (FYB) cohort study

PubMed Central

Donnan, Peter T; Dalzell, Janet; Symon, Andrew; Rauchhaus, Petra; Monteith-Hodge, Ewa; Kellett, Gillian; Wyatt, Jeremy C; Whitford, Heather M

2013-01-01

Objective To derive prediction models for both initiation and cessation of breastfeeding using demographic, psychological and obstetric variables. Design A prospective cohort study. Setting Women delivering at Ninewells Hospital, Dundee, UK. Data sources Demographic data and psychological measures were obtained during pregnancy by questionnaire. Birth details, feeding method at birth and at hospital discharge were obtained from the Ninewells hospital database, Dundee, UK. Breastfeeding women were followed up by text messages every 2 weeks until 16 weeks or until breastfeeding was discontinued to ascertain feeding method and feeding intentions. Participants Pregnant women over 30 weeks gestation aged 16 years and above, living in Dundee, booked to deliver at Ninewells Hospital, Dundee, and able to speak English. Main outcome measure Initiation and cessation of breastfeeding. Results From the total cohort of women at delivery (n=344) 68% (95% CI 63% to 73%) of women had started breastfeeding at discharge. Significant predictors of initiating breastfeeding were older age, parity, greater intention to breastfeed from a Theory of Planned Behaviour (TPB)-based questionnaire, higher Iowa Infant Feeding Assessment Scale (IIFAS) score as well as living with a husband or partner. For the final model, the AUROC was 0.967. For those who initiated breastfeeding (n=233), the strongest predictors of stopping were low intention to breastfeed from TPB, low IIFAS score and non-managerial/professional occupations. Conclusions The findings from this study will be used to inform the protocol for an intervention study to encourage and support prolonged breastfeeding as intentions appear to be a key intervention focus for initiation. The predictive models could be used to identify women at high risk of not initiating and also women at high risk of stopping for interventions to improve the longevity of breastfeeding. PMID:23906958

Male Batterers’ Alcohol Use and Gambling Behavior

PubMed Central

Febres, Jeniimarie; Shorey, Ryan; Strong, David; Ninnemann, Andrew; Elmquist, Joanna; Andersen, Shawna M.; Bucossi, Meggan; Schonbrun, Yael C.; Temple, Jeff R.; Stuart, Gregory L.

2012-01-01

Little work has examined the interrelations among intimate partner violence (IPV), alcohol use, and gambling behavior, and no studies have examined these relationships among males court-ordered to batterer intervention programs (BIPs). The aim of the current investigation was to explore the associations between IPV, alcohol use, and gambling behavior among 341 males court-mandated to attend BIPs utilizing self-report measures. Voluntary, anonymous questionnaires were administered and completed during regularly scheduled BIP sessions. Compared to the general population, a higher percentage of the sample met criteria for pathological gambling (9%), and problem gambling (17%). Further, males exhibiting pathological gambling were more likely to be hazardous drinkers, and hazardous drinkers were more likely to exhibit pathological gambling. Additionally, pathological gamblers were at an increased risk for the perpetration of both physical and sexual aggression. Finally, gambling behavior uniquely predicted the perpetration of sexual aggression above and beyond alcohol use, impulsivity, and relationship satisfaction. The implications of these results for future research and intervention are discussed. PMID:21516369

Primary Pediatric Care Psychopharmacology: Focus on medications for ADHD, depression and anxiety

PubMed Central

Strawn, Jeffrey R.; Dobson, Eric; Giles, Lisa

2016-01-01

The evidence base for psychopharmacologic interventions in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) has dramatically increased over the past two decades. Psychopharmacologic interventions commonly utilized in the pediatric primary care setting—selective serotonin (norepinephrine) reuptake inhibitors (SSRIs/SSNRIs), stimulants and α2 agonists—are reviewed. General pharmacologic principles are summarized along with class-related side effects and tolerability concerns (e.g., suicidality and activation in antidepressant-treated youth as well as insomnia, irritability, anorexia in stimulant-treated pediatric patients). Selected landmark trials of antidepressant medications in youth with depressive disorders (Treatment of Adolescent Depression Study [TADS] and the Treatment of SSRI-Resistant Depression Study [TADS]) and anxiety disorders (Child/Adolescent Anxiety Multimodal Study [CAMS] and Child/Adolescent Anxiety Multimodal Extended Long-term Study [CAMELS]) are described in addition to the Multimodal Treatment of ADHD Study. Finally, available data are presented that are related to prediction of treatment outcomes in youth with depressive disorders, anxiety disorders and ADHD. PMID:28043839

Academic procrastination and academic performance: An initial basis for intervention.

PubMed

Goroshit, Marina

2018-01-01

Academic procrastination is a prevalent phenomenon with a range of negative outcomes. Many studies focused on causes and correlates of academic procrastination; however, the study of interventions for academic procrastination is scarce. The present study is an initial effort to study the relationship between academic procrastination, online course participation, and achievement, as a basis for developing an intervention for academic procrastination. Findings indicated that studying procrastination was negatively associated with final exam grade as well as with the three online course participation measures. Final exam grade was positively associated with two of the online course participation measures, and they positively correlated with each other. In addition, results indicated that studying procrastination, in combination with online course participation measures, explained about 50% of variance in final exam's grade. Frequency of activities in course Web site had the strongest positive effect on final exam's grade. These findings strengthen the notion that studying procrastination is an impediment to students' academic performance and outcomes and clarifies the need to develop and study academic interventions for academic procrastination as a means to decrease its prevalence in academic settings.

Model-Based Approach to Predict Adherence to Protocol During Antiobesity Trials.

PubMed

Sharma, Vishnu D; Combes, François P; Vakilynejad, Majid; Lahu, Gezim; Lesko, Lawrence J; Trame, Mirjam N

2018-02-01

Development of antiobesity drugs is continuously challenged by high dropout rates during clinical trials. The objective was to develop a population pharmacodynamic model that describes the temporal changes in body weight, considering disease progression, lifestyle intervention, and drug effects. Markov modeling (MM) was applied for quantification and characterization of responder and nonresponder as key drivers of dropout rates, to ultimately support the clinical trial simulations and the outcome in terms of trial adherence. Subjects (n = 4591) from 6 Contrave ® trials were included in this analysis. An indirect-response model developed by van Wart et al was used as a starting point. Inclusion of drug effect was dose driven using a population dose- and time-dependent pharmacodynamic (DTPD) model. Additionally, a population-pharmacokinetic parameter- and data (PPPD)-driven model was developed using the final DTPD model structure and final parameter estimates from a previously developed population pharmacokinetic model based on available Contrave ® pharmacokinetic concentrations. Last, MM was developed to predict transition rate probabilities among responder, nonresponder, and dropout states driven by the pharmacodynamic effect resulting from the DTPD or PPPD model. Covariates included in the models and parameters were diabetes mellitus and race. The linked DTPD-MM and PPPD-MM was able to predict transition rates among responder, nonresponder, and dropout states well. The analysis concluded that body-weight change is an important factor influencing dropout rates, and the MM depicted that overall a DTPD model-driven approach provides a reasonable prediction of clinical trial outcome probabilities similar to a pharmacokinetic-driven approach. © 2017, The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

Implementing a Complex Intervention to Support Personal Recovery: A Qualitative Study Nested within a Cluster Randomised Controlled Trial

PubMed Central

Leamy, Mary; Clarke, Eleanor; Le Boutillier, Clair; Bird, Victoria; Janosik, Monika; Sabas, Kai; Riley, Genevieve; Williams, Julie; Slade, Mike

2014-01-01

Objective To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams. Design Process evaluation nested within a cluster randomised controlled trial (RCT). Participants 28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports. Setting 14 community-based mental health teams in two UK sites (one urban, one semi-rural) who received the intervention. Results The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles. Conclusions Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would maximise the likelihood of adequate implementation and hence reduce waste in research expenditure. Trial Registration Controlled-Trials.com ISRCTN02507940 PMID:24875748

Implementing a complex intervention to support personal recovery: a qualitative study nested within a cluster randomised controlled trial.

PubMed

Leamy, Mary; Clarke, Eleanor; Le Boutillier, Clair; Bird, Victoria; Janosik, Monika; Sabas, Kai; Riley, Genevieve; Williams, Julie; Slade, Mike

2014-01-01

To investigate staff and trainer perspectives on the barriers and facilitators to implementing a complex intervention to help staff support the recovery of service users with a primary diagnosis of psychosis in community mental health teams. Process evaluation nested within a cluster randomised controlled trial (RCT). 28 interviews with mental health care staff, 3 interviews with trainers, 4 focus groups with intervention teams and 28 written trainer reports. 14 community-based mental health teams in two UK sites (one urban, one semi-rural) who received the intervention. The factors influencing the implementation of the intervention can be organised under two over-arching themes: Organisational readiness for change and Training effectiveness. Organisational readiness for change comprised three sub-themes: NHS Trust readiness; Team readiness; and Practitioner readiness. Training effectiveness comprised three sub-themes: Engagement strategies; Delivery style and Modelling recovery principles. Three findings can inform future implementation and evaluation of complex interventions. First, the underlying intervention model predicted that three areas would be important for changing practice: staff skill development; intention to implement; and actual implementation behaviour. This study highlighted the importance of targeting the transition from practitioners' intent to implement to actual implementation behaviour, using experiential learning and target setting. Second, practitioners make inferences about organisational commitment by observing the allocation of resources, Knowledge Performance Indicators and service evaluation outcome measures. These need to be aligned with recovery values, principles and practice. Finally, we recommend the use of organisational readiness tools as an inclusion criteria for selecting both organisations and teams in cluster RCTs. We believe this would maximise the likelihood of adequate implementation and hence reduce waste in research expenditure. Controlled-Trials.com ISRCTN02507940.

Potentially inappropriate medications in elderly Japanese patients: effects of pharmacists' assessment and intervention based on Screening Tool of Older Persons' Potentially Inappropriate Prescriptions criteria ver.2.

PubMed

Kimura, T; Ogura, F; Yamamoto, K; Uda, A; Nishioka, T; Kume, M; Makimoto, H; Yano, I; Hirai, M

2017-04-01

The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (stopp) criteria were updated in 2014 (stopp criteria ver.2), but few studies have evaluated the usefulness of stopp criteria in elderly patients. This prospective observational study evaluated the prevalence of potentially inappropriate medications (PIMs), and the efficacy of hospital pharmacists' assessment and intervention based on stopp criteria ver.2. The study was conducted at three medical units of Kobe University Hospital between April 2015 and March 2016. Pharmacists assessed and detected PIMs based on stopp criteria ver.2 and considered the patient's intention to change the prescription at the time of admission of each patient. If the pharmacists judged that benefits outweighed risks of prescription change and the patients consented to change the medications, they recommended the doctor to change the prescription. If there was a risk of exacerbation of disease by the change of medications and the pharmacists judged it to be difficult to adjust medications during hospitalization or the patients did not consent to change the medications, they did not recommend to change it. The pharmacists and the doctors discussed and finally decided whether to change the PIMs or not. The number of patients prescribed PIMs, the number and contents of PIMs, and the number of medications changed after pharmacists' intervention were calculated. Totally, 822 new inpatients aged ≥65 years prescribed ≥1 daily medicine were included. Their median (interquartile range) age was 75·0 (71·0-80·0) years, and 54·9% were male. According to the criteria, 346 patients (42·1%) were prescribed ≥1 PIMs. Patients prescribed PIMs took significantly more medications than others: 10·0 (7·0-13·0) vs. 6·0 (4·0-9·0), P < 0·001. The total number of PIMs was 651%, 47·6% of which (n = 310) were recommended the doctors to change, and 292 of 651 PIMs (44·9%) were finally discontinued/changed after pharmacists' assessment and intervention. PIMs related to benzodiazepines, including Z-drugs, were most frequent, with a detailed classifications as follows (changed/total): (i) benzodiazepines for 4 or more weeks (75/205), (ii) drugs that predictably increase the risk of falls in older people (benzodiazepines) (30/67) and (iii) drugs that predictably increase the risk of falls in older people (hypnotic Z-drugs) (15/31). Over 40% elderly patients were prescribed PIMs, and pharmacists' assessments and interventions based on stopp criteria ver.2 were useful in detecting and correcting prescription of PIMs. © 2016 John Wiley & Sons Ltd.

Interaction Analysis of Longevity Interventions Using Survival Curves.

PubMed

Nowak, Stefan; Neidhart, Johannes; Szendro, Ivan G; Rzezonka, Jonas; Marathe, Rahul; Krug, Joachim

2018-01-06

A long-standing problem in ageing research is to understand how different factors contributing to longevity should be expected to act in combination under the assumption that they are independent. Standard interaction analysis compares the extension of mean lifespan achieved by a combination of interventions to the prediction under an additive or multiplicative null model, but neither model is fundamentally justified. Moreover, the target of longevity interventions is not mean life span but the entire survival curve. Here we formulate a mathematical approach for predicting the survival curve resulting from a combination of two independent interventions based on the survival curves of the individual treatments, and quantify interaction between interventions as the deviation from this prediction. We test the method on a published data set comprising survival curves for all combinations of four different longevity interventions in Caenorhabditis elegans . We find that interactions are generally weak even when the standard analysis indicates otherwise.

Interaction Analysis of Longevity Interventions Using Survival Curves

PubMed Central

Nowak, Stefan; Neidhart, Johannes; Szendro, Ivan G.; Rzezonka, Jonas; Marathe, Rahul; Krug, Joachim

2018-01-01

A long-standing problem in ageing research is to understand how different factors contributing to longevity should be expected to act in combination under the assumption that they are independent. Standard interaction analysis compares the extension of mean lifespan achieved by a combination of interventions to the prediction under an additive or multiplicative null model, but neither model is fundamentally justified. Moreover, the target of longevity interventions is not mean life span but the entire survival curve. Here we formulate a mathematical approach for predicting the survival curve resulting from a combination of two independent interventions based on the survival curves of the individual treatments, and quantify interaction between interventions as the deviation from this prediction. We test the method on a published data set comprising survival curves for all combinations of four different longevity interventions in Caenorhabditis elegans. We find that interactions are generally weak even when the standard analysis indicates otherwise. PMID:29316622

Validating an instrument for selecting interventions to change physician practice patterns: a Michigan Consortium for Family Practice Research study.

PubMed

Green, Lee A; Gorenflo, Daniel W; Wyszewianski, Leon

2002-11-01

The goal of this study was to develop a psychometric instrument that classified physiciansamprsquo response styles to new information as seekers, receptives, traditionalists, or pragmatists. This classification was based on specific combinations of 3 scales: (a) belief in evidence vs experience as the basis of knowledge, (b) willingness to diverge from common or previous practice, and (c) sensitivity to pragmatic concerns of practice. The instrument will help focus efforts to change practice more accurately. This was a cross-sectional study of physician responses to a psychometric instrument. Paper-and-pencil survey forms were distributed to 3 waves of physicians, with revision for improved internal consistency at each iteration. Participants were 1393 primary care physicians at continuing education events in the Midwest or at primary care clinic sites in the Veteransamprsquo Health Administration system. Internal consistency was measured by factor analysis with orthogonal rotation and Cronbachamprsquos alpha. A total of 1287 usable instruments were returned (106, 1120, and 61 in the 3 iterations, respectively), representing approximately three fourths of distributed forms. Final scale internal consistencies were a = 0.79, b = 0.74, and c = 0.68. The patterns of scores on the 3 scales were consistent with the predictions of the theoretical scheme of physician types. The "seeker" type was the rarest, at fewer than 3%. It is possible to reliably classify physicians into categories that a theoretical framework predicts will respond differently to different interventions for implementing guidelines and translating research findings into practice. The next step is to demonstrate that the classification predicts physician practice behavior.

Increasing Prediction the Original Final Year Project of Student Using Genetic Algorithm

NASA Astrophysics Data System (ADS)

Saragih, Rijois Iboy Erwin; Turnip, Mardi; Sitanggang, Delima; Aritonang, Mendarissan; Harianja, Eva

2018-04-01

Final year project is very important forgraduation study of a student. Unfortunately, many students are not seriouslydidtheir final projects. Many of studentsask for someone to do it for them. In this paper, an application of genetic algorithms to predict the original final year project of a studentis proposed. In the simulation, the data of the final project for the last 5 years is collected. The genetic algorithm has several operators namely population, selection, crossover, and mutation. The result suggest that genetic algorithm can do better prediction than other comparable model. Experimental results of predicting showed that 70% was more accurate than the previous researched.

The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

PubMed

Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

2018-01-01

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

Development and validation of the Bullying and Cyberbullying Scale for Adolescents: A multi-dimensional measurement model.

PubMed

Thomas, Hannah J; Scott, James G; Coates, Jason M; Connor, Jason P

2018-05-03

Intervention on adolescent bullying is reliant on valid and reliable measurement of victimization and perpetration experiences across different behavioural expressions. This study developed and validated a survey tool that integrates measurement of both traditional and cyber bullying to test a theoretically driven multi-dimensional model. Adolescents from 10 mainstream secondary schools completed a baseline and follow-up survey (N = 1,217; M age  = 14 years; 66.2% male). The Bullying and cyberbullying Scale for Adolescents (BCS-A) developed for this study comprised parallel victimization and perpetration subscales, each with 20 items. Additional measures of bullying (Olweus Global Bullying and the Forms of Bullying Scale [FBS]), as well as measures of internalizing and externalizing problems, school connectedness, social support, and personality, were used to further assess validity. Factor structure was determined, and then, the suitability of items was assessed according to the following criteria: (1) factor interpretability, (2) item correlations, (3) model parsimony, and (4) measurement equivalence across victimization and perpetration experiences. The final models comprised four factors: physical, verbal, relational, and cyber. The final scale was revised to two 13-item subscales. The BCS-A demonstrated acceptable concurrent and convergent validity (internalizing and externalizing problems, school connectedness, social support, and personality), as well as predictive validity over 6 months. The BCS-A has sound psychometric properties. This tool establishes measurement equivalence across types of involvement and behavioural forms common among adolescents. An improved measurement method could add greater rigour to the evaluation of intervention programmes and also enable interventions to be tailored to subscale profiles. © 2018 The British Psychological Society.

Predicting Intervention Effectiveness from Oral Reading Accuracy and Rate Measures through the Learning Hierarchy/Instructional Hierarchy

ERIC Educational Resources Information Center

Szadokierski, Isadora Elisabeth

2012-01-01

The current study used the Learning Hierarchy/Instructional Hierarchy (LH/IH) to predict intervention effectiveness based on the reading skills of students who are developing reading fluency. Pre-intervention reading accuracy and rate were assessed for 49 second and third grade participants who then participated in a brief experimental analysis…

Pre-trial Intervention: The Manhattan Court Employment Project of the Vera Institute of Justice. Final Report.

ERIC Educational Resources Information Center

Vera Inst. of Justice, New York, NY.

The final report of an experimental pre-trial intervention program of intensive manpower services (individual and group counseling and job, training, or academic placement with the help of career developers) for selected defendants in Manhattan covers the period November 1967 through October 1970. After three years and 1,300 participants,…

A behavioral economic measure of demand for alcohol predicts brief intervention outcomes.

PubMed

MacKillop, James; Murphy, James G

2007-07-10

Considerable basic and clinical research supports a behavioral economic conceptualization of alcohol and drug dependence. One behavioral economic approach to assess motivation for a drug is the use of demand curves, or quantitative representations of drug consumption and drug-reinforced responding across a range of prices. This study used a hypothetical alcohol purchase task to generate demand curves, and examined whether the resulting demand curve parameters predicted drinking outcomes following a brief intervention. Participants were 51 college student drinkers (67% female; 94% Caucasian; drinks/week: M=24.57, S.D.=8.77) who completed a brief alcohol intervention. Consistent with predictions, a number of demand curve indices significantly predicted post-intervention alcohol use and frequency of heavy drinking episodes, even after controlling for baseline drinking and other pertinent covariates. Most prominently, O(max) (i.e., maximum alcohol expenditure) and breakpoint (i.e., sensitivity of consumption to increasing price) predicted greater drinking at 6-month post-intervention follow-up. These results indicate that a behavioral economic measure of alcohol demand may have utility in characterizing the malleability of alcohol consumption. Moreover, these results support the utility of translating experimental assays of reinforcement into clinical research.

Predicting adult weight change in the real world: a systematic review and meta-analysis accounting for compensatory changes in energy intake or expenditure.

PubMed

Dhurandhar, E J; Kaiser, K A; Dawson, J A; Alcorn, A S; Keating, K D; Allison, D B

2015-08-01

Public health and clinical interventions for obesity in free-living adults may be diminished by individual compensation for the intervention. Approaches to predict weight outcomes do not account for all mechanisms of compensation, so they are not well suited to predict outcomes in free-living adults. Our objective was to quantify the range of compensation in energy intake or expenditure observed in human randomized controlled trials (RCTs). We searched multiple databases (PubMed, CINAHL, SCOPUS, Cochrane, ProQuest, PsycInfo) up to 1 August 2012 for RCTs evaluating the effect of dietary and/or physical activity interventions on body weight/composition. subjects per treatment arm ≥5; ≥1 week intervention; a reported outcome of body weight/body composition; the intervention was either a prescribed amount of over- or underfeeding and/or supervised or monitored physical activity was prescribed; ≥80% compliance; and an objective method was used to verify compliance with the intervention (for example, observation and electronic monitoring). Data were independently extracted and analyzed by multiple reviewers with consensus reached by discussion. We compared observed weight change with predicted weight change using two models that predict weight change accounting only for metabolic compensation. Twenty-eight studies met inclusion criteria. Overfeeding studies indicate 96% less weight gain than expected if no compensation occurred. Dietary restriction and exercise studies may result in up to 12-44% and 55-64% less weight loss than expected, respectively, under an assumption of no behavioral compensation. Compensation is substantial even in high-compliance conditions, resulting in far less weight change than would be expected. The simple algorithm we report allows for more realistic predictions of intervention effects in free-living populations by accounting for the significant compensation that occurs.

Prediction of sport adherence through the influence of autonomy-supportive coaching among spanish adolescent athletes.

PubMed

Almagro, Bartolomé J; Sáenz-López, Pedro; Moreno, Juan A

2010-01-01

The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.

Prediction of Sport Adherence Through the Influence of Autonomy-Supportive Coaching Among Spanish Adolescent Athletes

PubMed Central

Almagro, Bartolomé J.; Sáenz-López, Pedro; Moreno, Juan A.

2010-01-01

The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key points Importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Intrinsic motivation predicted the intention to be physically active in the future. PMID:24149380

Masculine norms, disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse.

PubMed

Easton, Scott D

2014-02-01

Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N=487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables-use of physical force by the abuser-was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

The basic reproduction number R0 and effectiveness of reactive interventions during dengue epidemics: the 2002 dengue outbreak in Easter Island, Chile.

PubMed

Chowell, Gerardo; Fuentes, R; Olea, A; Aguilera, X; Nesse, H; Hyman, J M

2013-01-01

We use a stochastic simulation model to explore the effect of reactive intervention strategies during the 2002 dengue outbreak in the small population of Easter Island, Chile. We quantified the effect of interventions on the transmission dynamics and epidemic size as a function of the simulated control intensity levels and the timing of initiation of control interventions. Because no dengue outbreaks had been reported prior to 2002 in Easter Island, the 2002 epidemic provided a unique opportunity to estimate the basic reproduction number R0 during the initial epidemic phase, prior to the start of control interventions. We estimated R0 at 27.2 (95%CI: 14.8, 49.3). We found that the final epidemic size is highly sensitive to the timing of start of interventions. However, even when the control interventions start several weeks after the epidemic onset, reactive intervention efforts can have a significant impact on the final epidemic size. Our results indicate that the rapid implementation of control interventions can have a significant effect in reducing the epidemic size of dengue epidemics.

Biomarker-based risk prediction in the community.

PubMed

AbouEzzeddine, Omar F; McKie, Paul M; Scott, Christopher G; Rodeheffer, Richard J; Chen, Horng H; Michael Felker, G; Jaffe, Allan S; Burnett, John C; Redfield, Margaret M

2016-11-01

Guided by predictive characteristics of cardiovascular biomarkers, we explored the clinical implications of a simulated biomarker-guided heart failure (HF) and major adverse cardiovascular events (MACE) prevention strategy in the community. In a community cohort (n = 1824), the predictive characteristics for HF and MACE of galectin-3 (Gal-3), ST2, high-sensitivity cardiac troponin I (hscTnI), high-sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) were established. We performed number needed to screen (NNS) and treat (NNT) with the intervention analyses according to biomarker screening strategy and intervention efficacy in persons with at least one cardiovascular risk factor. In the entire cohort, for both HF and MACE, the predictive characteristics of NT-proBNP and hscTnI were superior to other biomarkers; alone, in a multimarker model, and adjusting for clinical risk factors. An NT-proBNP-guided preventative intervention with an intervention effect size (4-year hazard ratio for intervention in biomarker positive cohort) of ≤0.7 would reduce the global burden of HF by ≥20% and MACE by ≥15%. From this simulation, the NNS to prevent one HF event or MACE in 4 years would be ≤100 with a NNT to prevent one HF event of ≤20 and one MACE of ≤10. The predictive characteristics of NT-proBNP and hscTnI for HF or MACE in the community are superior to other biomarkers. Biomarker-guided preventative interventions with reasonable efficacy would compare favourably to established preventative interventions. This data provides a framework for biomarker selection which may inform design of biomarker-guided preventative intervention trials. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment.

PubMed

Kiosses, Dimitris N; Gross, James J; Banerjee, Samprit; Duberstein, Paul R; Putrino, David; Alexopoulos, George S

2017-06-01

To examine the relationship of negative emotions with suicidal ideation during 12 weeks of Problem Adaptation Therapy (PATH) versus Supportive Therapy of Cognitively Impaired Older Adults (ST-CI), hypothesizing that improved negative emotions are associated with reduced suicidal ideation, PATH improves negative emotions more than ST-CI, and improved negative emotions, rather than other depression symptoms, predict reduction in suicidal ideation. In a randomized controlled trial of two home-delivered psychosocial interventions, 74 older participants (65-95 years old) with major depressive disorder and cognitive impairment were recruited in collaboration with community agencies. The sample reported less intense feelings than suicidal intention. Interventions and assessments were conducted in participants' homes. PATH focuses on improving emotion regulation, whereas ST-CI focuses on nonspecific therapeutic factors, such as understanding and empathy. Improved negative emotions were measured as improvement in Montgomery Asberg's Depression Rating Scales' (MADRS) observer ratings of sadness, anxiety, guilt, hopelessness, and anhedonia. Suicidal ideation was assessed with the MADRS Suicide Item. MADRS Negative Emotions scores were significantly associated with suicidal ideation during the course of treatment (F [1,165]  = 12.73, p = 0.0005). PATH participants had significantly greater improvement in MADRS emotions than ST-CI participants (treatment group by time: F [1,63.2]  = 7.02, p = 0.0102). Finally, improved negative emotions, between lagged and follow-up interview, significantly predicted reduction in suicidal ideation at follow-up interview (F [1, 96]  = 9.95, p = 0.0022). Findings thatimprovement in negative emotions mediates reduction in suicidal ideation may guide the development of psychosocial interventions for reduction of suicidal ideation (clinicaltrials.gov; NCT00368940). Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention

PubMed Central

White, Barry A. B.; Temple, Judy A.; Reynolds, Arthur J.

2016-01-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979–1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention. PMID:27867324

Predicting Adult Criminal Behavior from Juvenile Delinquency: Ex-Ante vs. Ex-Post Benefits of Early Intervention.

PubMed

White, Barry A B; Temple, Judy A; Reynolds, Arthur J

2010-12-01

Recent analyses of the long-term societal benefits from early intervention (prenatal care, home visitation, and high quality preschool) for at-risk children commonly include significant savings to society in the form of reduced juvenile delinquency and adult criminal behavior. However, a nontrivial proportion of the reported benefits of several early intervention programs are based on forecasts of criminal behavior throughout adulthood conditional on intervention effects on delinquency in adolescence. Data from the Chicago Longitudinal Study (CLS), an investigation of the life course of 1,539 children from low-income families born in 1979-1980, are used to investigate the bias resulting from predicting the effect of early intervention on adult criminal behavior from the effect on delinquency in adolescence. The investigation concludes that the general method used to predict adult criminal behavior results in a conservative estimate of the reduction in the cost of adult criminal behavior attributed to early intervention.

The importance of measuring growth in response to intervention models: Testing a core assumption✩

PubMed Central

Schatschneider, Christopher; Wagner, Richard K.; Crawford, Elizabeth C.

2011-01-01

A core assumption of response to instruction or intervention (RTI) models is the importance of measuring growth in achievement over time in response to effective instruction or intervention. Many RTI models actively monitor growth for identifying individuals who need different levels of intervention. A large-scale (N=23,438), two-year longitudinal study of first grade children was carried out to compare the predictive validity of measures of achievement status, growth in achievement, and their combination for predicting future reading achievement. The results indicate that under typical conditions, measures of growth do not make a contribution to prediction that is independent of measures of achievement status. These results question the validity of a core assumption of RTI models. PMID:22224065

The working alliance and Clinician-assisted Emotional Disclosure for rheumatoid arthritis.

PubMed

Lumley, Mark A; Anderson, Timothy; Ankawi, Brett; Goldman, Gregory; Perri, LisaCaitlin M; Bianco, Joseph A; Keefe, Francis J

2018-01-01

The working alliance predicts improvement following general psychotherapy, but how it operates in brief interventions conducted with medically ill patients is unknown. Also, the role of the working alliance may differ in emotion-focused versus educational interventions. We report secondary analyses of a randomized clinical trial (Keefe et al.) [35], in which patients with rheumatoid arthritis (RA) received four nurse-provided sessions of either a) Clinician-assisted Emotional Disclosure (CAED), which emphasized the disclosure, expression, and processing of emotions related to stressful events; or b) Arthritis Education (AE), which provided basic education about RA. The Working Alliance Inventory was completed by both patient and nurse after each session. Patients were evaluated on multiple health measures at baseline and 1, 3, and 12months post-treatment. Analyses compared the alliance between interventions and related the alliance to outcomes within interventions. Patients in CAED reported a lower alliance than patients in AE. Interestingly, in CAED, lower alliance ratings predicted better outcomes (improved functioning, lower pain behaviors, lower inflammation, lower daily stress), whereas in AE, the working alliance was largely not predictive of outcomes. Having nurses encourage emotional disclosure among patients with RA reduced the patients' working alliance, but a lower alliance nonetheless predicted better patient outcomes, perhaps reflecting successful engagement in an intervention that is emotionally and relationally challenging. The level and predictive validity of the working alliance likely depends on patient, provider, and intervention factors, and further study of the working alliance in psychosocial interventions in the medical context is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Construct and Predictive Validity of Social Acceptability: Scores From High School Teacher Ratings on the School Intervention Rating Form

ERIC Educational Resources Information Center

Harrison, Judith R.; State, Talida M.; Evans, Steven W.; Schamberg, Terah

2016-01-01

The purpose of this study was to evaluate the construct and predictive validity of scores on a measure of social acceptability of class-wide and individual student intervention, the School Intervention Rating Form (SIRF), with high school teachers. Utilizing scores from 158 teachers, exploratory factor analysis revealed a three-factor (i.e.,…

Putting habit into practice, and practice into habit: a process evaluation and exploration of the acceptability of a habit-based dietary behaviour change intervention.

PubMed

Gardner, Benjamin; Sheals, Kate; Wardle, Jane; McGowan, Laura

2014-10-30

Forming 'habit' - defined as a learned process that generates automatic responses to contextual cues - has been suggested as a mechanism for behaviour maintenance, but few studies have applied habit theory to behaviour change. This study used process evaluation data, taken from a randomised controlled trial of a healthy child-feeding intervention for parents previously shown to be effective, to explore the applicability to dietary behaviour change of predictions and recommendations drawn from habit theory. The intervention supported parents in pursuing child-feeding habit goals in three domains (giving fruit and vegetables, water, healthy snacks), over four fortnightly home visits. We explored whether (a) the habit-formation model was acceptable to participants, (b) better-specified habit-formation goals yielded greater habit gains, and (c) habit gains were sustained (d) even when subsequent, new habit goals were pursued. Qualitative and quantitative data were taken from 57 parents randomised to the intervention arm, and so analyses presented here used a pre-post intervention design. Thematic analysis of post-intervention qualitative interviews evaluated acceptability, and self-reported habit goals were content-analysed. ANOVAs explored changes in habit strength, recorded at home visits and one- and two-month follow-ups, across time and goals. Participants understood and engaged positively with the habit-formation approach. Although many seemingly poorly-specified habit goals were set, goal characteristics had minimal impact on habit strength, which were achieved within two weeks for all behaviours (p's < .001), and were maintained or had increased further by the final follow-up. The habit-formation model appears to be an acceptable and fruitful basis for dietary behaviour change.

Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention.

PubMed

Owen, Jason E; Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

2016-06-01

Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56-0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08-1.84, ps < 0.001) and total time of intervention (Ds = 1.13-1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement.

Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention

PubMed Central

Curran, Michaela; Bantum, Erin O'Carroll; Hanneman, Robert

2016-01-01

Abstract Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56–0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08–1.84, ps < 0.001) and total time of intervention (Ds = 1.13–1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement. PMID:27327066

Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact.

PubMed

Kumar, Vishwajeet; Kumar, Aarti; Darmstadt, Gary L

2010-12-01

Despite an established evidence base of simple, affordable, and low-cost interventions to avert neonatal deaths, global progress in reducing neonatal mortality has stagnated in recent years. Under-recognition of the critical role played by behavior change in ensuring adoption and dissemination of innovations is a major reason for this gap between evidence and impact. A general lack of understanding of the mechanisms underlying behavior change at a population level coupled with an under-appreciation of the sociocultural context of newborn care behaviors has underscored ill-informed approaches towards behavior change that have met with limited success. This article draws upon available evidence from prevention-oriented, community-based newborn survival trials to derive insights into the role of behavior change in neonatal mortality reduction. We propose a simple model, the intervention-causation pathway, to explain the pathway through which behavior change interventions may lead to reductions in mortality. Further, we explore the unique nature of newborn care behaviors and their underlying sociocultural context, along with state-of-the-art advances in social, behavioral, and management sciences. These principles form the basis of the behavior change management framework that has successfully guided intervention design and implementation, leading to high impact on neonatal mortality reduction, in Uttar Pradesh, India. We describe how the behavior change management framework can be applied to inform the design of theoretically and empirically sound behavior change interventions with greater precision, predictability and pace towards reduction in neonatal mortality. We finally touch upon key overarching principles that should guide intervention execution for maximal impact. Copyright © 2010 Elsevier Inc. All rights reserved.

Genome-wide profiles of CtBP link metabolism with genome stability and epithelial reprogramming in breast cancer.

PubMed

Di, Li-Jun; Byun, Jung S; Wong, Madeline M; Wakano, Clay; Taylor, Tara; Bilke, Sven; Baek, Songjoon; Hunter, Kent; Yang, Howard; Lee, Maxwell; Zvosec, Cecilia; Khramtsova, Galina; Cheng, Fan; Perou, Charles M; Miller, C Ryan; Raab, Rachel; Olopade, Olufunmilayo I; Gardner, Kevin

2013-01-01

The C-terminal binding protein (CtBP) is a NADH-dependent transcriptional repressor that links carbohydrate metabolism to epigenetic regulation by recruiting diverse histone-modifying complexes to chromatin. Here global profiling of CtBP in breast cancer cells reveals that it drives epithelial-to-mesenchymal transition, stem cell pathways and genome instability. CtBP expression induces mesenchymal and stem cell-like features, whereas CtBP depletion or caloric restriction reverses gene repression and increases DNA repair. Multiple members of the CtBP-targeted gene network are selectively downregulated in aggressive breast cancer subtypes. Differential expression of CtBP-targeted genes predicts poor clinical outcome in breast cancer patients, and elevated levels of CtBP in patient tumours predict shorter median survival. Finally, both CtBP promoter targeting and gene repression can be reversed by small molecule inhibition. These findings define broad roles for CtBP in breast cancer biology and suggest novel chromatin-based strategies for pharmacologic and metabolic intervention in cancer.

Structure of 311 service requests as a signature of urban location

PubMed Central

Wang, Lingjing; Qian, Cheng; Kats, Philipp; Kontokosta, Constantine; Sobolevsky, Stanislav

2017-01-01

While urban systems demonstrate high spatial heterogeneity, many urban planning, economic and political decisions heavily rely on a deep understanding of local neighborhood contexts. We show that the structure of 311 Service Requests enables one possible way of building a unique signature of the local urban context, thus being able to serve as a low-cost decision support tool for urban stakeholders. Considering examples of New York City, Boston and Chicago, we demonstrate how 311 Service Requests recorded and categorized by type in each neighborhood can be utilized to generate a meaningful classification of locations across the city, based on distinctive socioeconomic profiles. Moreover, the 311-based classification of urban neighborhoods can present sufficient information to model various socioeconomic features. Finally, we show that these characteristics are capable of predicting future trends in comparative local real estate prices. We demonstrate 311 Service Requests data can be used to monitor and predict socioeconomic performance of urban neighborhoods, allowing urban stakeholders to quantify the impacts of their interventions. PMID:29040314

Reciprocal Relationship between Internet Addiction and Network-Related Maladaptive Cognition among Chinese College Freshmen: A Longitudinal Cross-Lagged Analysis

PubMed Central

Han, Piguo; Wang, Peng; Lin, Qingnan; Tian, Yu; Gao, Fengqiang; Chen, Yingmin

2017-01-01

This study explored the reciprocal relationship between Internet addiction (IA) and network-related maladaptive cognition (NMC) in Chinese college freshmen. A short-term longitudinal survey with a sample of 213 college freshmen was conducted in Shandong province, China. The results revealed that IA can significantly predict the generation and development of NMCs, and that when such maladaptive cognitions have been established, they can further adversely affect the extent of the students’ IA. A vicious cycle was observed between these two variables, with IA having predictive priority in its relationship with NMC. This study also determined that the relationship between these two variables was the same for both males and females; therefore, the final model we established can be extensively applied to Chinese college freshmen, regardless of gender. Understanding the reciprocal relationship between these two variables can assist in interventions in IA at the outset of students’ college life. PMID:28690575

Structure of 311 service requests as a signature of urban location.

PubMed

Wang, Lingjing; Qian, Cheng; Kats, Philipp; Kontokosta, Constantine; Sobolevsky, Stanislav

2017-01-01

While urban systems demonstrate high spatial heterogeneity, many urban planning, economic and political decisions heavily rely on a deep understanding of local neighborhood contexts. We show that the structure of 311 Service Requests enables one possible way of building a unique signature of the local urban context, thus being able to serve as a low-cost decision support tool for urban stakeholders. Considering examples of New York City, Boston and Chicago, we demonstrate how 311 Service Requests recorded and categorized by type in each neighborhood can be utilized to generate a meaningful classification of locations across the city, based on distinctive socioeconomic profiles. Moreover, the 311-based classification of urban neighborhoods can present sufficient information to model various socioeconomic features. Finally, we show that these characteristics are capable of predicting future trends in comparative local real estate prices. We demonstrate 311 Service Requests data can be used to monitor and predict socioeconomic performance of urban neighborhoods, allowing urban stakeholders to quantify the impacts of their interventions.

Key Clinical Factors Predicting Adipokine and Oxidative Stress Marker Concentrations among Normal, Overweight and Obese Pregnant Women Using Artificial Neural Networks.

PubMed

Solis-Paredes, Mario; Estrada-Gutierrez, Guadalupe; Perichart-Perera, Otilia; Montoya-Estrada, Araceli; Guzmán-Huerta, Mario; Borboa-Olivares, Héctor; Bravo-Flores, Eyerahi; Cardona-Pérez, Arturo; Zaga-Clavellina, Veronica; Garcia-Latorre, Ethel; Gonzalez-Perez, Gabriela; Hernández-Pérez, José Alfredo; Irles, Claudine

2017-12-28

Maternal obesity has been related to adverse neonatal outcomes and fetal programming. Oxidative stress and adipokines are potential biomarkers in such pregnancies; thus, the measurement of these molecules has been considered critical. Therefore, we developed artificial neural network (ANN) models based on maternal weight status and clinical data to predict reliable maternal blood concentrations of these biomarkers at the end of pregnancy. Adipokines (adiponectin, leptin, and resistin), and DNA, lipid and protein oxidative markers (8-oxo-2'-deoxyguanosine, malondialdehyde and carbonylated proteins, respectively) were assessed in blood of normal weight, overweight and obese women in the third trimester of pregnancy. A Back-propagation algorithm was used to train ANN models with four input variables (age, pre-gestational body mass index (p-BMI), weight status and gestational age). ANN models were able to accurately predict all biomarkers with regression coefficients greater than R² = 0.945. P-BMI was the most significant variable for estimating adiponectin and carbonylated proteins concentrations (37%), while gestational age was the most relevant variable to predict resistin and malondialdehyde (34%). Age, gestational age and p-BMI had the same significance for leptin values. Finally, for 8-oxo-2'-deoxyguanosine prediction, the most significant variable was age (37%). These models become relevant to improve clinical and nutrition interventions in prenatal care.

Developing the content of two behavioural interventions: Using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1

PubMed Central

Hrisos, Susan; Eccles, Martin; Johnston, Marie; Francis, Jill; Kaner, Eileen FS; Steen, Nick; Grimshaw, Jeremy

2008-01-01

Background Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI) yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI) without prescribing antibiotics. Method Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2 targeted anticipated consequences and required GPs to respond to a "persuasive communication" containing a series of pictures representing the consequences of managing URTI with and without antibiotics. Conclusion It is feasible to systematically develop theoretically-based interventions to change professional practice. Two interventions were designed that differentially target generalisable constructs predictive of GP management of URTI. Our detailed and scientific rationale for the choice and design of our interventions will provide a basis for understanding any effects identified in their evaluation. Trial registration Clinicaltrials.gov NCT00376142 PMID:18194527

[A Group Cognitive-Behavioural Intervention to Prevent Depression Relapse in Individuals Having Recently Returned to Work: Protocol and Feasibility].

PubMed

Lecomte, Tania; Corbière, Marc

Workplace depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated factors predicting return to work for people with depression, including studies evaluating return to work programs and organizational factors. Yet, a paucity of studies have targeted the prevention of depressive relapses at work, even though more than half of those having had a depression will have a depressive relapse in the near future.Objectives This article describes a research protocol involving a novel group intervention based on cognitive behavioural principles with the aim to optimize return to work and diminish risk of depressive relapses.Method This pilot study follows a randomized controlled trial design, with half the participants (N=25) receiving the group intervention and the other half (N=25) receiving usual services. The theoretical and empirical underpinnings of the intervention are described, along with a detailed presentation of the intervention and of the study's objectives. The group intervention consists of 8 sessions whereby Cognitive behavioural therapy (CBT) principles and techniques are applied to the following themes: (1) Coping with stress at work; (2) Recognizing and modifying my dysfunctional beliefs linked to work; (3) Overcoming obstacles linked to work functioning and maintaining work; (4) Negotiating needed work adjustments with the support of the immediate supervisor; (5) Finding my strengths and competencies related to work; (6) Accepting criticism and asserting myself appropriately at work; (7) Uncovering my best coping strategies for work.Results Qualitative information pertaining to the first two cohorts' participants' subjective appreciation of the group experience revealed that the intervention was perceived as very useful by all, with group support, namely harmony and interpersonal support, as well as CBT strategies being mentioned specifically.Conclusion Finally, the potential relevance of the group intervention will be brought forward.

Interdisciplinary Graduate Program: Rural Early Intervention Specialists for Low Incidence Disabilities (REIS/LID). Final Grant Performance Report [and] REIS/LID Student Guide.

ERIC Educational Resources Information Center

Maine Univ., Orono. Center for Community Inclusion.

This final report describes accomplishments and activities of a 3-year federally funded project of the University of Maine to develop and deliver a graduate Master's degree program in early intervention for infants and young children with low incidence disabilities. A curriculum was designed to prepare professionals to provide culturally relevant,…

Use and Effectiveness of a Video- and Text-Driven Web-Based Computer-Tailored Intervention: Randomized Controlled Trial.

PubMed

Walthouwer, Michel Jean Louis; Oenema, Anke; Lechner, Lilian; de Vries, Hein

2015-09-25

Many Web-based computer-tailored interventions are characterized by high dropout rates, which limit their potential impact. This study had 4 aims: (1) examining if the use of a Web-based computer-tailored obesity prevention intervention can be increased by using videos as the delivery format, (2) examining if the delivery of intervention content via participants' preferred delivery format can increase intervention use, (3) examining if intervention effects are moderated by intervention use and matching or mismatching intervention delivery format preference, (4) and identifying which sociodemographic factors and intervention appreciation variables predict intervention use. Data were used from a randomized controlled study into the efficacy of a video and text version of a Web-based computer-tailored obesity prevention intervention consisting of a baseline measurement and a 6-month follow-up measurement. The intervention consisted of 6 weekly sessions and could be used for 3 months. ANCOVAs were conducted to assess differences in use between the video and text version and between participants allocated to a matching and mismatching intervention delivery format. Potential moderation by intervention use and matching/mismatching delivery format on self-reported body mass index (BMI), physical activity, and energy intake was examined using regression analyses with interaction terms. Finally, regression analysis was performed to assess determinants of intervention use. In total, 1419 participants completed the baseline questionnaire (follow-up response=71.53%, 1015/1419). Intervention use declined rapidly over time; the first 2 intervention sessions were completed by approximately half of the participants and only 10.9% (104/956) of the study population completed all 6 sessions of the intervention. There were no significant differences in use between the video and text version. Intervention use was significantly higher among participants who were allocated to an intervention condition that matched their preferred intervention delivery format. There were no significant interaction terms for any of the outcome variables; a match and more intervention use did not result in better intervention effects. Participants with a high BMI and participants who felt involved and supported by the intervention were more likely to use the intervention more often. Video delivery of tailored feedback does not increase the use of Web-based computer-tailored interventions. However, intervention use can potentially be increased by delivering intervention content via participants' preferred intervention delivery format and creating feelings of relatedness. Because more intervention use was not associated with better intervention outcomes, more research is needed to examine the optimum number of intervention sessions in terms of maximizing use and effects. Nederlands Trial Register: NTR3501; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3501 (Archived by WebCite at http://www.webcitation.org/6b2tsH8Pk).

Personal Identity Development in Hispanic Immigrant Adolescents: Links with Positive Psychosocial Functioning, Depressive Symptoms, and Externalizing Problems

PubMed Central

Unger, Jennifer B.; Meca, Alan; Lorenzo-Blanco, Elma I.; Baezconde-Garbanati, Lourdes; Cano, Miguel Ángel; Piña-Watson, Brandy; Szapocznik, José; Zamboanga, Byron L.; Córdova, David; Romero, Andrea J.; Lee, Tae Kyoung; Soto, Daniel W.; Villamar, Juan A.; Lizzi, Karina M.; Des Rosiers, Sabrina E.; Pattarroyo, Monica

2016-01-01

The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (Mage = 14.51 years at baseline; SD = 0.88 years, range 14–17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention. PMID:27882458

Personal Identity Development in Hispanic Immigrant Adolescents: Links with Positive Psychosocial Functioning, Depressive Symptoms, and Externalizing Problems.

PubMed

Schwartz, Seth J; Unger, Jennifer B; Meca, Alan; Lorenzo-Blanco, Elma I; Baezconde-Garbanati, Lourdes; Cano, Miguel Ángel; Piña-Watson, Brandy; Szapocznik, José; Zamboanga, Byron L; Córdova, David; Romero, Andrea J; Lee, Tae Kyoung; Soto, Daniel W; Villamar, Juan A; Lizzi, Karina M; Des Rosiers, Sabrina E; Pattarroyo, Monica

2017-04-01

The present study was designed to examine trajectories of personal identity coherence and confusion among Hispanic recent-immigrant adolescents, as well as the effects of these trajectories on psychosocial and risk-taking outcomes. Personal identity is extremely important in anchoring young immigrants during a time of acute cultural change. A sample of 302 recently immigrated (5 years or less in the United States at baseline) Hispanic adolescents (M age  = 14.51 years at baseline; SD = 0.88 years, range 14-17) from Miami and Los Angeles (47 % girls) completed measures of personal identity coherence and confusion at the first five waves of a six-wave longitudinal study; and reported on positive psychosocial functioning, depressive symptoms, and externalizing problems at baseline and at Time 6. Results indicated that identity coherence increased linearly across time, but that there were no significant changes in confusion over time and no individual differences in confusion trajectories. Higher baseline levels of, and improvements in, coherence predicted higher levels of self-esteem, optimism, and prosocial behavior at the final study timepoint. Higher baseline levels of confusion predicted lower self-esteem, greater depressive symptoms, more aggressive behavior, and more rule breaking at the final study timepoint. These results are discussed in terms of the importance of personal identity for Hispanic immigrant adolescents, and in terms of implications for intervention.

Individualized Prediction of Heat Stress in Firefighters: A Data-Driven Approach Using Classification and Regression Trees.

PubMed

Mani, Ashutosh; Rao, Marepalli; James, Kelley; Bhattacharya, Amit

2015-01-01

The purpose of this study was to explore data-driven models, based on decision trees, to develop practical and easy to use predictive models for early identification of firefighters who are likely to cross the threshold of hyperthermia during live-fire training. Predictive models were created for three consecutive live-fire training scenarios. The final predicted outcome was a categorical variable: will a firefighter cross the upper threshold of hyperthermia - Yes/No. Two tiers of models were built, one with and one without taking into account the outcome (whether a firefighter crossed hyperthermia or not) from the previous training scenario. First tier of models included age, baseline heart rate and core body temperature, body mass index, and duration of training scenario as predictors. The second tier of models included the outcome of the previous scenario in the prediction space, in addition to all the predictors from the first tier of models. Classification and regression trees were used independently for prediction. The response variable for the regression tree was the quantitative variable: core body temperature at the end of each scenario. The predicted quantitative variable from regression trees was compared to the upper threshold of hyperthermia (38°C) to predict whether a firefighter would enter hyperthermia. The performance of classification and regression tree models was satisfactory for the second (success rate = 79%) and third (success rate = 89%) training scenarios but not for the first (success rate = 43%). Data-driven models based on decision trees can be a useful tool for predicting physiological response without modeling the underlying physiological systems. Early prediction of heat stress coupled with proactive interventions, such as pre-cooling, can help reduce heat stress in firefighters.

Time-varying SMART design and data analysis methods for evaluating adaptive intervention effects.

PubMed

Dai, Tianjiao; Shete, Sanjay

2016-08-30

In a standard two-stage SMART design, the intermediate response to the first-stage intervention is measured at a fixed time point for all participants. Subsequently, responders and non-responders are re-randomized and the final outcome of interest is measured at the end of the study. To reduce the side effects and costs associated with first-stage interventions in a SMART design, we proposed a novel time-varying SMART design in which individuals are re-randomized to the second-stage interventions as soon as a pre-fixed intermediate response is observed. With this strategy, the duration of the first-stage intervention will vary. We developed a time-varying mixed effects model and a joint model that allows for modeling the outcomes of interest (intermediate and final) and the random durations of the first-stage interventions simultaneously. The joint model borrows strength from the survival sub-model in which the duration of the first-stage intervention (i.e., time to response to the first-stage intervention) is modeled. We performed a simulation study to evaluate the statistical properties of these models. Our simulation results showed that the two modeling approaches were both able to provide good estimations of the means of the final outcomes of all the embedded interventions in a SMART. However, the joint modeling approach was more accurate for estimating the coefficients of first-stage interventions and time of the intervention. We conclude that the joint modeling approach provides more accurate parameter estimates and a higher estimated coverage probability than the single time-varying mixed effects model, and we recommend the joint model for analyzing data generated from time-varying SMART designs. In addition, we showed that the proposed time-varying SMART design is cost-efficient and equally effective in selecting the optimal embedded adaptive intervention as the standard SMART design.

Computer-Aided Drug Design in Epigenetics

NASA Astrophysics Data System (ADS)

Lu, Wenchao; Zhang, Rukang; Jiang, Hao; Zhang, Huimin; Luo, Cheng

2018-03-01

Epigenetic dysfunction has been widely implicated in several diseases especially cancers thus highlights the therapeutic potential for chemical interventions in this field. With rapid development of computational methodologies and high-performance computational resources, computer-aided drug design has emerged as a promising strategy to speed up epigenetic drug discovery. Herein, we make a brief overview of major computational methods reported in the literature including druggability prediction, virtual screening, homology modeling, scaffold hopping, pharmacophore modeling, molecular dynamics simulations, quantum chemistry calculation and 3D quantitative structure activity relationship that have been successfully applied in the design and discovery of epi-drugs and epi-probes. Finally, we discuss about major limitations of current virtual drug design strategies in epigenetics drug discovery and future directions in this field.

Computer-Aided Drug Design in Epigenetics

PubMed Central

Lu, Wenchao; Zhang, Rukang; Jiang, Hao; Zhang, Huimin; Luo, Cheng

2018-01-01

Epigenetic dysfunction has been widely implicated in several diseases especially cancers thus highlights the therapeutic potential for chemical interventions in this field. With rapid development of computational methodologies and high-performance computational resources, computer-aided drug design has emerged as a promising strategy to speed up epigenetic drug discovery. Herein, we make a brief overview of major computational methods reported in the literature including druggability prediction, virtual screening, homology modeling, scaffold hopping, pharmacophore modeling, molecular dynamics simulations, quantum chemistry calculation, and 3D quantitative structure activity relationship that have been successfully applied in the design and discovery of epi-drugs and epi-probes. Finally, we discuss about major limitations of current virtual drug design strategies in epigenetics drug discovery and future directions in this field. PMID:29594101

Post-traumatic stress disorder associated with sexual assault among women in the WHO World Mental Health Surveys.

PubMed

Scott, K M; Koenen, K C; King, A; Petukhova, M V; Alonso, J; Bromet, E J; Bruffaerts, R; Bunting, B; de Jonge, P; Haro, J M; Karam, E G; Lee, S; Medina-Mora, M E; Navarro-Mateu, F; Sampson, N A; Shahly, V; Stein, D J; Torres, Y; Zaslavsky, A M; Kessler, R C

2018-01-01

Sexual assault is a global concern with post-traumatic stress disorder (PTSD), one of the common sequelae. Early intervention can help prevent PTSD, making identification of those at high risk for the disorder a priority. Lack of representative sampling of both sexual assault survivors and sexual assaults in prior studies might have reduced the ability to develop accurate prediction models for early identification of high-risk sexual assault survivors. Data come from 12 face-to-face, cross-sectional surveys of community-dwelling adults conducted in 11 countries. Analysis was based on the data from the 411 women from these surveys for whom sexual assault was the randomly selected lifetime traumatic event (TE). Seven classes of predictors were assessed: socio-demographics, characteristics of the assault, the respondent's retrospective perception that she could have prevented the assault, other prior lifetime TEs, exposure to childhood family adversities and prior mental disorders. Prevalence of Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) PTSD associated with randomly selected sexual assaults was 20.2%. PTSD was more common for repeated than single-occurrence victimization and positively associated with prior TEs and childhood adversities. Respondent's perception that she could have prevented the assault interacted with history of mental disorder such that it reduced odds of PTSD, but only among women without prior disorders (odds ratio 0.2, 95% confidence interval 0.1-0.9). The final model estimated that 40.3% of women with PTSD would be found among the 10% with the highest predicted risk. Whether counterfactual preventability cognitions are adaptive may depend on mental health history. Predictive modelling may be useful in targeting high-risk women for preventive interventions.

Distal embolization during native vessel and vein graft coronary intervention with a vascular protection device: predictors of high-risk lesions.

PubMed

El-Jack, Seif S; Suwatchai, Pornratanarangsi; Stewart, James T; Ruygrok, Peter N; Ormiston, John A; West, Teena; Webster, Mark W I

2007-12-01

We sought to define clinical and angiographic variables that may predict patients and lesions at increased risk for distal embolism during percutaneous intervention (PCI), as assessed by debris retrieval from a distal-protection filter device. Distal thrombo- and atheroembolism may contribute to periprocedural myocardial necrosis during PCI, which may in turn affect long-term outcomes. Distal protection devices have been used to reduce this occurrence with variable outcomes depending on lesion and patient subsets. 194 consecutive patients in whom the FilterWire(R) device (FW) [Boston Scientific Corp., Natick, MA] was used for native coronary vessel (n =129) or vein graft (n = 65) PCI were studied. FW debris was visually analyzed using a semi-quantitative grading score. Patients with "significant" debris (particles > or = 1 mm diameter) were compared with those with "nonsignificant" debris (no debris or particles <1 mm) with respect to clinical (age, gender, coronary disease risk factors, clinical presentation, periprocedural medications), and angiographic (vessel treated, vessel size, lesion length, lesion characteristics, angiographic thrombus and TIMI flow before and after PCI) variables. Significant debris was retrieved in 55% of patients, more frequently from vein graft (69%) than native vessel lesions (48%, p = 0.006). No clinical characteristics predicted significant debris retrieval. Angiographic predictors of significant debris by multivariate analysis were longer stent length and final TIMI flow <3 (p = 0.009 and 0.007, respectively). Longer stent length, likely reflecting increased lesion length and plaque burden, predicted significant distal embolism during PCI in native vessel and vein graft lesions, as assessed by debris collected in a distal vascular protection device. This suggests that use of vascular protection devices should be considered during PCI of long lesions.

Cultural and Linguistic Adaptation of a Healthy Diet Text Message Intervention for Hispanic Adults Living in the United States.

PubMed

Cameron, Linda D; Durazo, Arturo; Ramírez, A Susana; Corona, Roberto; Ultreras, Mayra; Piva, Sonia

2017-03-01

Hispanics represent a critical target for culturally adapted diet interventions. In this formative research, we translated HealthyYouTXT, an mHealth program developed by the U.S. National Cancer Institute, into HealthyYouTXT en Español, a linguistically and culturally appropriate version for Spanish speakers in the United States. We report a three-stage, mixed-methods process through which we culturally adapted the text messages, evaluated their acceptability, and revised the program based on the findings. In Stage 1, we conducted initial translations and adaptations of the text libraries using an iterative, principle-guided process. In Stage 2, we used mixed methods including focus groups and surveys with 109 Hispanic adults to evaluate the acceptability and cultural appropriateness of the program. We used survey data to evaluate whether self-determination theory (SDT) factors (used to develop HealthyYouTXT) of autonomous motivation, controlled motivation, and amotivation and Hispanic cultural beliefs about familism, fatalism, and destiny predict program interest and its perceived efficacy. Mixed-methods analyses revealed substantial interest in HealthyYouTXT, with most participants desiring to use it and viewing it as highly efficacious. Both cultural beliefs (i.e., beliefs in destiny and, for men, high familism) and SDT motivations (i.e., autonomy) predicted HealthyYouTXT evaluations, suggesting utility in emphasizing them in messages. Higher destiny beliefs predicted lower interest, suggesting that they could impede program use. In Stage 3, we implemented the mixed-methods findings to finalize HealthyYouTXT en Español. The emergent linguistic principles and multistage, multimethods process can be applied in health communication adaptations.

An instrument based on protection motivation theory to predict Chinese adolescents' intention to engage in protective behaviors against schistosomiasis.

PubMed

Xiao, Han; Peng, Minjin; Yan, Hong; Gao, Mengting; Li, Jingjing; Yu, Bin; Wu, Hanbo; Li, Shiyue

2016-01-01

Further advancement in schistosomiasis prevention requires new tools to assess protective motivation, and promote innovative intervention program. This study aimed to develop and evaluate an instrument developed based on the Protection Motivation Theory (PMT) to predict protective behavior intention against schistosomiasis among adolescents in China. We developed the Schistosomiasis PMT Scale based on two appraisal pathways of protective motivation- threat appraisal pathway and coping appraisal pathway. Data from a large sample of middle school students ( n  = 2238, 51 % male, mean age 13.13 ± 1.10) recruited in Hubei, China was used to evaluated the validity and reliability of the scale. The final scale contains 18 items with seven sub-constructs. Cronbach's Alpha coefficients for the entire instrument was 0.76, and for the seven sub-constructs of severity, vulnerability, intrinsic reward, extrinsic reward, response efficacy, self-efficacy and response cost was 0.56, 0.82, 0.75, 0.80, 0.90, 0.72 and 0.70, respectively. The construct validity analysis revealed that the one level 7 sub-constructs model fitted data well (GFI = 0.98, CFI = 0.98, RMSEA = 0.03, Chi-sq/df = 3.90, p  < 0.001). Predictive validity showed that both the PMT instrument score and the 7 sub-construct scores were significantly correlated with the intention engaged in protective behavior against schistosomiasis ( p  < 0.05). This study provides a reliable and valid tool to measure protective motivation in schistosomiasis prevention control. Further studies are needed to develop more effective intervention programs for schistosomiasis prevention.

Post-traumatic stress disorder associated with sexual assault among women in the WHO World Mental Health Surveys

PubMed Central

Scott, Kate M.; Koenen, Karestan C.; King, Andrew; Petukhova, Maria V.; Alonso, Jordi; Bromet, Evelyn J.; Bruffaerts, Ronny; Bunting, Brendan; de Jonge, Peter; Haro, Josep Maria; Karam, Elie G.; Lee, Sing; Medina-Mora, Maria Elena; Navarro-Mateu, Fernando; Sampson, Nancy A.; Shahly, Victoria; Stein, Dan J.; Torres, Yolanda; Zaslavsky, Alan M.; Kessler, Ronald C.

2018-01-01

Background Sexual assault is a global concern with PTSD one of the common sequelae. Early intervention can help prevent PTSD, making identification of those at high risk for the disorder a priority. Lack of representative sampling of both sexual assault survivors and sexual assaults in prior studies might have reduced the ability to develop accurate prediction models for early identification of high-risk sexual assault survivors. Methods Data come from 12 face-to-face, cross-sectional surveys of community-dwelling adults conducted in 11 countries. Analysis was based on the data from the 411 women from these surveys for whom sexual assault was the randomly selected lifetime traumatic event (TE). Seven classes of predictors were assessed: socio-demographics, characteristics of the assault, the respondent’s retrospective perception that she could have prevented the assault, other prior lifetime TEs, exposure to childhood family adversities and prior mental disorders. Results Prevalence of DSM-IV PTSD associated with randomly-selected sexual assaults was 20.2%. PTSD was more common for repeated than single-occurrence victimization and positively associated with prior TEs and childhood adversities. Respondent perception that she could have prevented the assault interacted with history of mental disorder such that it reduced odds of PTSD but only among women without prior disorders (OR 0.2, 95% CI 0.1-0.9). The final model estimated that 40.3% of women with PTSD would be found among the 10% with the highest predicted risk. Conclusions Whether counterfactual preventability cognitions are adaptive may depend on mental health history. Predictive modelling may be useful in targeting high-risk women for preventive interventions. PMID:28625214

Social network analysis of children with autism spectrum disorder: Predictors of fragmentation and connectivity in elementary school classrooms

PubMed Central

Anderson, Ariana; Locke, Jill; Kretzmann, Mark; Kasari, Connie

2016-01-01

Although children with autism spectrum disorder are frequently included in mainstream classrooms, it is not known how their social networks change compared to typically developing children and whether the factors predictive of this change may be unique. This study identified and compared predictors of social connectivity of children with and without autism spectrum disorder using a social network analysis. Participants included 182 children with autism spectrum disorder and 152 children without autism spectrum disorder, aged 5–12 years in 152 general education K-5 classrooms. General linear models were used to compare how age, classroom size, gender, baseline connectivity, diagnosis, and intelligence quotient predicted changes in social connectivity (closeness). Gender and classroom size had a unique interaction in predicting final social connectivity and the change in connectivity for children with autism spectrum disorder; boys who were placed in larger classrooms showed increased social network fragmentation. This increased fragmentation for boys when placed in larger classrooms was not seen in typically developing boys. These results have implications regarding placement, intervention objectives, and ongoing school support that aimed to increase the social success of children with autism spectrum disorder in public schools. PMID:26567264

Origins of mother-child reminiscing style.

PubMed

Reese, Elaine; Meins, Elizabeth; Fernyhough, Charles; Centifanti, Luna

2018-04-26

Maternal elaborative reminiscing supports preschool children's autobiographical memory, self-concept, and emotion understanding. What are the factors contributing to mothers' elaborative style of reminiscing? In a longitudinal community sample (n = 170 at the final data point), this study explored the role of maternal depression (8-44 months), maternal sensitivity and maternal mind-mindedness (8 months), as well as child factors of joint attention (15 months), attachment security (15 months), and language (26 months) for mother-child reminiscing about a positive (happy) and a negative (scared) event at 44 months. Mothers could be classed into two groups of low versus increasing depression from 8 to 44 months, yet maternal depression did not uniquely predict mother-child reminiscing after accounting for maternal sensitivity and other factors. Instead, maternal sensitivity, children's joint attention, and language uniquely predicted children's elaborations about the scared event at 44 months, and maternal sensitivity uniquely predicted mothers' elaborations about the scared event at 44 months. Mothers who are more sensitive in early interactions may later be better at engaging their children when reminiscing about negative emotions. These findings have implications for the design of interventions targeted at supporting mothers to engage in elaborative reminiscing with their preschool children.

Predictive factors of open globe injury in patients requiring vitrectomy.

PubMed

Pimolrat, Weeraya; Choovuthayakorn, Janejit; Watanachai, Nawat; Patikulsila, Direk; Kunavisarut, Paradee; Chaikitmongkol, Voraporn; Ittipunkul, Nimitr

2014-01-01

To determine the outcomes and predictive factors of patients with open globe injury requiring pars plana vitrectomy (PPV). The medical records of 114 patients age 10 years or older who had undergone PPV due to ocular trauma, with at least 6 months follow up, were retrospectively reviewed. The mean age of the patients was 42 (SD14) years, with males accounting for 89% of the cases. Penetrating eye injury was the most common injury mechanism (43%) with most injuries occurring secondary to work related incidents (54%). After surgical interventions, 78% of the patients had visual improvement of one or more Snellen lines, while no light perception occurred in 10%. Anatomical attachment was achieved in 87% of eyes at the final follow up. Logistic regression analysis showed that the presence of a relative afferent pupillary defect (RAPD) was a significant predictive factor of visual outcome, while initial retinal detachment was a significant predictor of anatomical outcome. Pupillary reaction is an important presenting ocular sign in estimating the post-vitrectomy poor visual outcome for open globe injury. Vision was restored and improved in more than half of the patients in this study; however, long-term sequelae should be monitored. Copyright © 2013 Elsevier Ltd. All rights reserved.

Current controversies in the prediction, diagnosis, and management of cerebral vasospasm: where do we stand?

PubMed

Lee, Young; Zuckerman, Scott L; Mocco, J

2013-01-01

Aneurysmal subarachnoid hemorrhage occurs in approximately 30,000 persons in the United States each year. Around 30 percent of patients with aneurysmal subarachnoid hemorrhage suffer from cerebral ischemia and infarction due to cerebral vasospasm, a leading cause of treatable death and disability following aneurysmal subarachnoid hemorrhage. Methods used to predict, diagnose, and manage vasospasm are the topic of recent active research. This paper utilizes a comprehensive review of the recent literature to address controversies surrounding these topics. Evidence regarding the effect of age, smoking, and cocaine use on the incidence and outcome of vasospasm is reviewed. The abilities of different computed tomography grading schemes to predict vasospasm in the aftermath of subarachnoid hemorrhage are presented. Additionally, the utility of different diagnostic methods for the detection and visualization of vasospasm, including transcranial Doppler ultrasonography, CT angiography, digital subtraction angiography, and CT perfusion imaging is discussed. Finally, the recent literature regarding interventions for the prophylaxis and treatment of vasospasm, including hyperdynamic therapy, albumin, calcium channel agonists, statins, magnesium sulfate, and endothelin antagonists is summarized. Recent studies regarding each topic were reviewed for consensus recommendations from the literature, which were then presented.

[The third dimension tomography versus cranial X-ray cephalometry to predict maxilla advance by distraction in hypoplastic maxilla].

PubMed

Rosas-Muñoz, Arturo; Soriano-Padilla, Fernando; Rendón-Macías, Mario Enrique

2010-01-01

the osteogenic distraction is the treatment for the correction of the hypoplastic maxilla secondary to the repair of a cleft lip-palate. Its planning is based on articulated models. Our objective was to describe the accuracy of three-dimensional Cephalometry (CT3D) for projecting jaw displacement. three patients with hypoplastic maxilla. Interventions estimation of the advance required of lateral maxilla through Cephalometry of skull (CLC), CT3D and an articulated model (gold standard). Two months after distraction finalized the advance predicted was compared. the error of the advance projection in each patient was smaller with the CT3D versus CLC (+1, +1 and +1 mm versus -10, -14 and -9mm). Corrections post-distraction were of +25 %, +26 % and +38.4 % on the programmed one. CT3D predicted better the correction (+19 %, +10.8 %, +33.4 % versus CLC: -50 %; -60.8 % and -34.6 %). Chewing alterations were not seen in any patient. the planning of the necessary advance for distraction in patients with hypoplastic maxilla by CT3D can shorten the time of studies and should be consider as next to the projection of articulated model.

Training on the DSM-5 Cultural Formulation Interview Improves Cultural Competence in General Psychiatry Residents: A Multi-site Study.

PubMed

Mills, Stacia; Wolitzky-Taylor, Kate; Xiao, Anna Q; Bourque, Marie Claire; Rojas, Sandra M Peynado; Bhattacharya, Debanjana; Simpson, Annabelle K; Maye, Aleea; Lo, Pachida; Clark, Aaron; Lim, Russell; Lu, Francis G

2016-10-01

The authors assessed whether a 1-h didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves cultural competence of general psychiatry residents. Psychiatry residents at six residency programs completed demographics and pre-intervention questionnaires, were exposed to a 1-h session on the CFI, and completed a post-intervention questionnaire. Repeated measures ANCOVA compared pre- to post-intervention change. Linear regression assessed whether previous cultural experience predicted post-intervention scores. Mean scores on the questionnaire significantly changed from pre- to post-intervention (p < 0.001). Previous cultural experience did not predict post-intervention scores. Psychiatry residents' cultural competence scores improved with a 1-h session on the CFI but with notable limitations.

Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review.

PubMed

Goudet, Sophie; Griffiths, Paula; Bogin, Barry; Madise, Nyovani

2017-02-01

Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children's malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.

Impact of predictive model-directed end-of-life counseling for Medicare beneficiaries.

PubMed

Hamlet, Karen S; Hobgood, Adam; Hamar, Guy Brent; Dobbs, Angela C; Rula, Elizabeth Y; Pope, James E

2010-05-01

To validate a predictive model for identifying Medicare beneficiaries who need end-of-life care planning and to determine the impact on cost and hospice care of a telephonic counseling program utilizing this predictive model in 2 Medicare Health Support (MHS) pilots. Secondary analysis of data from 2 MHS pilot programs that used a randomized controlled design. A predictive model was developed using intervention group data (N = 43,497) to identify individuals at greatest risk of death. Model output guided delivery of a telephonic intervention designed to support educated end-of-life decisions and improve end-of-life provisions. Control group participants received usual care. As a primary outcome, Medicare costs in the last 6 months of life were compared between intervention group decedents (n = 3112) and control group decedents (n = 1630). Hospice admission rates and duration of hospice care were compared as secondary measures. The predictive model was highly accurate, and more than 80% of intervention group decedents were contacted during the 12 months before death. Average Medicare costs were $1913 lower for intervention group decedents compared with control group decedents in the last 6 months of life (P = .05), for a total savings of $5.95 million. There were no significant changes in hospice admissions or mean duration of hospice care. Telephonic end-of-life counseling provided as an ancillary Medicare service, guided by a predictive model, can reach a majority of individuals needing support and can reduce costs by facilitating voluntary election of less intensive care.

Early Diagnosis and Early Intervention in Cerebral Palsy

PubMed Central

Hadders-Algra, Mijna

2014-01-01

This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP). CP describes a group of disorders of the development of movement and posture, causing activity limitation that is attributed to disturbances that occurred in the fetal or infant brain. Therefore, the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuroimaging techniques, and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group, best prediction is achieved with the combination of neuroimaging and the assessment of general movements, in the latter group, best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high-risk infants without CP. In these infants, early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is urgently needed. PMID:25309506

Multimodal imaging-based therapeutic fingerprints for optimizing personalized interventions: Application to neurodegeneration.

PubMed

Iturria-Medina, Yasser; Carbonell, Félix M; Evans, Alan C

2018-06-14

Personalized Medicine (PM) seeks to assist the patients according to their specific treatment needs and potential intervention responses. However, in the neurological context, this approach is limited by crucial methodological challenges, such as the requirement for an understanding of the causal disease mechanisms and the inability to predict the brain's response to therapeutic interventions. Here, we introduce and validate the concept of the personalized Therapeutic Intervention Fingerprint (pTIF), which predicts the effectiveness of potential interventions for controlling a patient's disease evolution. Each subject's pTIF can be inferred from multimodal longitudinal imaging (e.g. amyloid-β, metabolic and tau PET; vascular, functional and structural MRI). We studied an aging population (N = 331) comprising cognitively normal and neurodegenerative patients, longitudinally scanned using six different neuroimaging modalities. We found that the resulting pTIF vastly outperforms cognitive and clinical evaluations on predicting individual variability in gene expression (GE) profiles. Furthermore, after regrouping the patients according to their predicted primary single-target interventions, we observed that these pTIF-based subgroups present distinctively altered molecular pathway signatures, supporting the across-population identification of dissimilar pathological stages, in active correspondence with different therapeutic needs. The results further evidence the imprecision of using broad clinical categories for understanding individual molecular alterations and selecting appropriate therapeutic needs. To our knowledge, this is the first study highlighting the direct link between multifactorial brain dynamics, predicted treatment responses, and molecular alterations at the patient level. Inspired by the principles of PM, the proposed pTIF framework is a promising step towards biomarker-driven assisted therapeutic interventions, with additional important implications for selective enrollment of patients in clinical trials. Copyright © 2018 Elsevier Inc. All rights reserved.

[Optimized assessment of the outcome in patients with radicular back pain of the lumbar spine. The modified NASS questionnaire].

PubMed

Janousek, M; Ferrari, S; Schmid, U D; Bischoff, H A; Balsiger, M; Theiler, R

2011-09-01

The purpose of the study was to present a reliable instrument with easy application to assess the outcome and improvement of therapy in patients with radicular symptoms of the lumbar spine. Data from patients who underwent microdiscectomy because of lumbar radicular symptoms were collected and analyzed and interviews were performed using the well-known North American Spine Society (NASS) lumbar spine questionnaire (17 items) before and after the intervention. In addition patient data including comorbidities were collected. By calculating effect size (ES) and standardized response mean (SRM) for each item of the questionnaire, the questions with the highest change before and after the intervention could be selected. A total of 139 patients undergoing microdiscectomy for lumbar radicular symptoms due to a disc herniation were included in the analysis. Concerning the three dimensions pain, neurological symptoms and impairment of activities in daily life, the questions with best predictive value (high ES and SRM) were selected. According to their clinical relevance eight questions of the NASS questionnaire were finally selected for the short form. This short, significant and easy to use questionnaire is in our opinion a useful instrument to assess the course of patients with radicular back pain and especially to measure and monitor the outcome of therapeutic interventions, in addition to conventional clinical diagnostics and examinations. This novel instrument could be a useful tool for improving quality assurance in conventional and interventional pain management of these patients.

Primary Pediatric Care Psychopharmacology: Focus on Medications for ADHD, Depression, and Anxiety.

PubMed

Strawn, Jeffrey R; Dobson, Eric T; Giles, Lisa L

2017-01-01

The evidence base for psychopharmacologic interventions in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) has dramatically increased over the past two decades. Psychopharmacologic interventions commonly utilized in the pediatric primary care setting-selective serotonin (norepinephrine) reuptake inhibitors (SSRIs/SSNRIs), stimulants and α 2 agonists-are reviewed. General pharmacologic principles are summarized along with class-related side effects and tolerability concerns (e.g., suicidality and activation in antidepressant-treated youth as well as insomnia, irritability, anorexia in stimulant-treated pediatric patients). Selected landmark trials of antidepressant medications in youth with depressive disorders [Treatment of Adolescent Depression Study (TADS) and the Treatment of SSRI-Resistant Depression Study (TADS)] and anxiety disorders [Child/Adolescent Anxiety Multimodal Study (CAMS) and Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS)] are described in addition to the Multimodal Treatment of ADHD Study. Finally, available data are presented that are related to prediction of treatment outcomes in youth with depressive disorders, anxiety disorders, and ADHD. Copyright © 2016 Mosby, Inc. All rights reserved.

Unique risk and protective factors for partner aggression in a large scale air force survey.

PubMed

Slep, Amy M Smith; Foran, Heather M; Heyman, Richard E; Snarr, Jeffery D

2010-08-01

The objective of this study is to examine risk factors of physical aggression against a partner in a large representative Active Duty Air Force sample. A stratified sample of 128,950 United States Active Duty members were invited to participate in an Air Force-wide anonymous online survey across 82 bases. The final sample (N = 52,780) was weighted to be representative of the United States Air Force. Backward stepwise regression analyses were conducted to identify unique predictors of partner physical aggression perpetration within and across different ecological levels (individual, family, organization, and community levels). Relationship satisfaction, alcohol problems, financial stress, and number of years in the military were identified as unique predictors of men's and women's perpetration of violence against their partner across ecological levels. Parental status, support from neighbors, personal coping, and support from formal agencies also uniquely predicted men's but not women's perpetration of violence across ecological levels. This study identified specific risk factors of partner violence that may be targeted by prevention and intervention efforts aimed at different levels of impact (e.g., family interventions, community-wide programs).

Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults.

PubMed

Angulo, Javier; El Assar, Mariam; Rodríguez-Mañas, Leocadio

2016-08-01

Frailty is a functional status that precedes disability and is characterized by decreased functional reserve and increased vulnerability. In addition to disability, the frailty phenotype predicts falls, institutionalization, hospitalization and mortality. Frailty is the consequence of the interaction between the aging process and some chronic diseases and conditions that compromise functional systems and finally produce sarcopenia. Many of the clinical manifestations of frailty are explained by sarcopenia which is closely related to poor physical performance. Reduced regenerative capacity, malperfusion, oxidative stress, mitochondrial dysfunction and inflammation compose the sarcopenic skeletal muscle alterations associated to the frailty phenotype. Inflammation appears as a common determinant for chronic diseases, sarcopenia and frailty. The strategies to prevent the frailty phenotype include an adequate amount of physical activity and exercise as well as pharmacological interventions such as myostatin inhibitors and specific androgen receptor modulators. Cell response to stress pathways such as Nrf2, sirtuins and klotho could be considered as future therapeutic interventions for the management of frailty phenotype and aging-related chronic diseases. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of the effectiveness of peer pressure to change disposition decisions and patient throughput by emergency physician.

PubMed

Wu, Kuan-Han; Cheng, Fu-Jen; Li, Chao-Jui; Cheng, Hsien-Hung; Lee, Wen-Huei; Lee, Chi-Wei

2013-03-01

The aim of this study was to develop a strategy for imposing peer pressure on emergency physicians to discharge patients and to evaluate patient throughput before and after intervention. A before-and-after study was conducted in a medical center with more than 120 000 annual emergency department (ED) visits. All nontraumatic adult patients who presented to the ED between 7:30 and 11:30 am Wednesday to Sunday were reviewed. We created a "team norm" imposed peer-pressure effect by announcing the patient discharge rate of each emergency physician through monthly e-mail reminders. Emergency department length of stay (LOS) and 8-hour (the end of shift) and final disposition of patients before (June 1, 2011-September 30, 2011) and after (October 1, 2011-January 30, 2012) intervention were compared. Patients enrolled before and after intervention totaled 3305 and 2945. No differences existed for age, sex, or average number of patient visits per shift. The 8-hour discharge rate increased significantly for all patients (53.5% vs 48.2%, P < .001), particularly for triage level III patients (odds ratio, 1.3; 95% confidence interval, 1.09-1.38) after intervention and without corresponding differences in the final disposition (P = .165) or admission rate (33.7% vs 31.6%, P = .079). Patients with a final discharge disposition had a shorter LOS (median, 140.4 min vs 158.3 min; P < .001) after intervention. The intervention strategy used peer pressure to enhance patient flow and throughput. More patients were discharged at the end of shifts, particularly triage level III patients. The ED LOS for patients whose final disposition was discharge decreased significantly. Copyright © 2013 Elsevier Inc. All rights reserved.

Development and implementation of a food store-based intervention to improve diet in the Republic of the Marshall Islands.

PubMed

Gittelsohn, Joel; Dyckman, William; Tan, May Lynn; Boggs, Malia K; Frick, Kevin D; Alfred, Julie; Winch, Peter J; Haberle, Heather; Palafox, Neal A

2006-10-01

Effective approaches for the prevention and reduction of obesity and obesity-related chronic diseases are urgently needed. Food store-centered programs represent one approach that may be both effective and sustainable. The authors developed a food store-based intervention in the Marshall Islands using qualitative and quantitative formative research methods, including a store usage survey (n = 184) and in-depth interviews with large-store managers (n = 13), small-store managers (n = 7), customers (n = 10), and community leaders (n = 4). This process was followed up by development and piloting of specific intervention components and workshops to finalize materials. The final intervention combined mass media (newspaper articles, video, radio announcements) and in-store components (shelf labels, cooking demonstrations, posters, recipe cards) and had high store-owner support and participation. High levels of exposure to the intervention were achieved during the 10-week period of implementation. This model for developing food store-based interventions is applicable to other settings.

Two men with multiple disabilities carry out an assembly work activity with the support of a technology system.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Green, Vanessa A; Oliva, Doretta; Campodonico, Francesca

2013-10-01

To assess whether two persons with multiple disabilities could learn a work activity (i.e., assembling trolley wheels) with the support of a technology system. After an initial baseline, the study compared the effects of intervention sessions relying on the technology system (which called the participants to the different workstations and provided feedback and final stimulation) with the effects of intervention sessions carried out without technology. The two types of intervention sessions were conducted according to an alternating treatments design. Eventually, only intervention sessions relying on the technology system were used. Both participants managed to assemble wheels independently during intervention sessions relying on the technology system while they failed during sessions without the system. Their performance was strengthened during the final part of the study, in which only sessions with the system occurred. Technology may be critical in helping persons with multiple disabilities manage multi-step work activities.

The Theory of Planned Behavior as a Predictor of Growth in Risky College Drinking*

PubMed Central

Collins, Susan E.; Witkiewitz, Katie; Larimer, Mary E.

2011-01-01

Objective: This study tested the Theory of Planned Behavior (TPB) as a predictor of growth in risky college drinking over a 3-month period. As predicted by the TPB model, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would predict intention to engage in risky drinking, which would in turn predict growth in future risky drinking. Method: Participants were 837 college drinkers (64.2% female) who were randomly selected from two U.S. West Coast universities to participate in a larger study on college drinking norms. This study used latent growth analyses to test the ability of the TPB to predict baseline levels of as well as linear and quadratic growth in risky college drinking (i.e., heavy episodic drinking and peak drinking quantity). Results: Chi-square tests and fit indices indicated close fit for the final structural models. Self-efficacy, attitudes, and subjective norms significantly predicted baseline intention, which in turn predicted future heavy episodic drinking. Self-efficacy and attitudes were also related to intention in the model of peak drinking; however, subjective norms were not a significant predictor of intention in the peak drinking model. Mediation analyses showed that intention to engage in risky drinking mediated the effects of self-efficacy and attitudes on growth in risky drinking. Conclusions: Findings supported the TPB in predicting risky college drinking. Although the current findings should be replicated before definitive conclusions are drawn, results suggest that feedback on self-efficacy, attitudes, and intentions to engage in risky drinking may be a helpful addition to personalized feedback interventions for this population. PMID:21388605

Using the health action process approach to predict and improve health outcomes in individuals with type 2 diabetes mellitus

PubMed Central

MacPhail, Mariana; Mullan, Barbara; Sharpe, Louise; MacCann, Carolyn; Todd, Jemma

2014-01-01

Background The purpose of this study was to explore the predictive utility of the Health Action Process Approach (HAPA) and test a HAPA-based healthy eating intervention, in adults with type 2 diabetes mellitus. Materials and methods The study employed a prospective, randomized, controlled trial design. The 4-month intervention consisted of self-guided HAPA-based workbooks in addition to two telephone calls to assist participants with the program implementation, and was compared to “treatment as usual”. Participants (n=87) completed health measures (diet, body mass index [BMI], waist circumference, blood pressure, blood glucose levels, lipid levels, and diabetes distress) and HAPA measures prior to the intervention and again upon completion 4 months later. Results The overall HAPA model predicted BMI, although only risk awareness and recovery self-efficacy were significant independent contributors. Risk awareness, intentions, and self-efficacy were also independent predictors of health outcomes; however, the HAPA did not predict healthy eating. No significant time × condition interaction effects were found for diet or any HAPA outcome measures. Conclusion Despite the success of HAPA in predicting health outcomes for those with type 2 diabetes mellitus, the intervention was unsuccessful in changing healthy eating or any of the other measured variables, and alternative low-cost health interventions for those with type 2 diabetes mellitus should be explored. PMID:25342914

Using impairment and cognitions to predict walking in osteoarthritis: A series of n-of-1 studies with an individually tailored, data-driven intervention.

PubMed

O'Brien, Nicola; Philpott-Morgan, Siôn; Dixon, Diane

2016-02-01

First, this study compares the ability of an integrated model of activity and activity limitations, the International Classification of Functioning, Disability and Health (ICF), and the Theory of Planned Behaviour (TPB) to predict walking within individuals with osteoarthritis. Second, the effectiveness of a walking intervention in these individuals is determined. A series of n-of-1 studies with an AB intervention design was used. Diary methods were used to study four community-dwelling individuals with lower-limb osteoarthritis. Data on impairment symptoms (pain, pain on movement, and joint stiffness), cognitions (intention, self-efficacy, and perceived controllability), and walking (step count) were collected twice daily for 12 weeks. At 6 weeks, an individually tailored, data-driven walking intervention using action planning or a control cognition manipulation was delivered. Simulation modelling analysis examined cross-correlations and differences in baseline and intervention phase means. Post-hoc mediation analyses examined theoretical relationships and multiple regression analyses compared theoretical models. Cognitions, intention in particular, were better and more consistent within individual predictors of walking than impairment. The walking intervention did not increase walking in any of the three participants receiving it. The integrated model and the TPB, which recognize a predictive role for cognitions, were significant predictors of walking variance in all participants, whilst the biomedical ICF model was only predictive for one participant. Despite the lack of evidence for an individually tailored walking intervention, predictive data suggest that interventions for people with osteoarthritis that address cognitions are likely to be more effective than those that address impairment only. Further within-individual investigation, including testing mediational relationships, is warranted. What is already known on this subject? N-of-1 methods have been used to study within-individual predictors of walking in healthy and chronic pain populations An integrated biomedical and behavioural model of activity and activity limitations recognizes the roles of impairment and psychology (cognitions) Interventions modifying cognitions can increase physical activity in people with mobility limitations What does this study add? N-of-1 methods are suitable to study within-individual predictors of walking and interventions in osteoarthritis An integrated and a psychological model are better predictors of walking in osteoarthritis than a biomedical model There was no support for an individually tailored, data-driven walking intervention. © 2015 The British Psychological Society.

The design of patient decision support interventions: addressing the theory-practice gap.

PubMed

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards Collaboration influence standards for the design of decision support interventions. However, this analysis points to the need to undertake more work in providing theoretical foundations for these interventions. © 2010 Blackwell Publishing Ltd.

Workday Sitting Time and Marital Status: Novel Pretreatment Predictors of Weight Loss in Overweight and Obese Men.

PubMed

Morgan, Philip J; Hollis, Jenna L; Young, Myles D; Collins, Clare E; Teixeira, Pedro J

2016-06-20

The evidence base for weight loss programs in men is limited. Gaining a greater understanding of which personal characteristics and pretreatment behaviors predict weight loss and attrition in male-only studies would be useful to inform the development of future interventions for men. In December 2010, 159 overweight/obese men (mean age = 47.5 years; body mass index = 32.7 kg/m 2 ) from the Hunter Region of New South Wales, Australia, participated in a randomized controlled trial testing the effectiveness of two versions of a 3-month gender-targeted weight loss program. In the current analyses, social-cognitive, behavioral, and demographic pretreatment characteristics were examined to determine if they predicted weight loss and attrition in the participants over 6 months. Generalized linear mixed models (intention-to-treat) revealed weight change was associated with education level (p = .02), marital status (p = .03), fat mass (p = .045), sitting time on nonwork (p = .046), and workdays (p = .03). Workday sitting time and marital status accounted for 6.5% (p = .01) of the variance in the final model. Attrition was associated with level of education (p = .01) and body fat percentage (p = .01), accounting for 9.5% (p = .002) of the variance in the final model. This study suggests men who spend a lot of time sitting at work, especially those who are not married, may require additional support to experience success in self-administered weight loss programs targeting males. Additional high-quality evidence is needed to improve the understanding which pretreatment behaviors and characteristics predict weight loss and attrition in men. © The Author(s) 2016.

Remote Health Monitoring Outcome Success Prediction Using Baseline and First Month Intervention Data.

PubMed

Alshurafa, Nabil; Sideris, Costas; Pourhomayoun, Mohammad; Kalantarian, Haik; Sarrafzadeh, Majid; Eastwood, Jo-Ann

2017-03-01

Remote health monitoring (RHM) systems are becoming more widely adopted by clinicians and hospitals to remotely monitor and communicate with patients while optimizing clinician time, decreasing hospital costs, and improving quality of care. In the Women's heart health study (WHHS), we developed Wanda-cardiovascular disease (CVD), where participants received healthy lifestyle education followed by six months of technology support and reinforcement. Wanda-CVD is a smartphone-based RHM system designed to assist participants in reducing identified CVD risk factors through wireless coaching using feedback and prompts as social support. Many participants benefitted from this RHM system. In response to the variance in participants' success, we developed a framework to identify classification schemes that predicted successful and unsuccessful participants. We analyzed both contextual baseline features and data from the first month of intervention such as activity, blood pressure, and questionnaire responses transmitted through the smartphone. A prediction tool can aid clinicians and scientists in identifying participants who may optimally benefit from the RHM system. Targeting therapies could potentially save healthcare costs, clinician, and participant time and resources. Our classification scheme yields RHM outcome success predictions with an F-measure of 91.9%, and identifies behaviors during the first month of intervention that help determine outcome success. We also show an improvement in prediction by using intervention-based smartphone data. Results from the WHHS study demonstrates that factors such as the variation in first month intervention response to the consumption of nuts, beans, and seeds in the diet help predict patient RHM protocol outcome success in a group of young Black women ages 25-45.

Boys with a simple delayed puberty reach their target height.

PubMed

Cools, B L M; Rooman, R; Op De Beeck, L; Du Caju, M V L

2008-01-01

Final height in boys with delayed puberty is thought to be below target height. This conclusion, however, is based on studies that included patients with genetic short stature. We therefore studied final height in a group of 33 untreated boys with delayed puberty with a target height >-1.5 SDS. Standing height, sitting height, weight and arm span width were measured in each patient. Final height was predicted by the method of Greulich and Pyle using the tables of Bailey and Pinneau for retarded boys at their bone age (PAH1) and the tables of Bailey and Pinneau for average boys plus six months (PAH2). Mean final height (175.8 +/- 6.5 cm) was appropriate for the mean target height (174.7 +/- 4.5 cm). The prediction method of Bailey and Pinneau overestimated the final height by 1.4 cm and the modified prediction method slightly underestimated the final height (-0.15 cm). Boys with untreated delayed puberty reach a final height appropriate for their target height. Final height was best predicted by the method of Bailey and Pinneau using the tables for average boys at their bone age plus six months. Copyright 2008 S. Karger AG, Basel.

Comparison of time series models for predicting campylobacteriosis risk in New Zealand.

PubMed

Al-Sakkaf, A; Jones, G

2014-05-01

Predicting campylobacteriosis cases is a matter of considerable concern in New Zealand, after the number of the notified cases was the highest among the developed countries in 2006. Thus, there is a need to develop a model or a tool to predict accurately the number of campylobacteriosis cases as the Microbial Risk Assessment Model used to predict the number of campylobacteriosis cases failed to predict accurately the number of actual cases. We explore the appropriateness of classical time series modelling approaches for predicting campylobacteriosis. Finding the most appropriate time series model for New Zealand data has additional practical considerations given a possible structural change, that is, a specific and sudden change in response to the implemented interventions. A univariate methodological approach was used to predict monthly disease cases using New Zealand surveillance data of campylobacteriosis incidence from 1998 to 2009. The data from the years 1998 to 2008 were used to model the time series with the year 2009 held out of the data set for model validation. The best two models were then fitted to the full 1998-2009 data and used to predict for each month of 2010. The Holt-Winters (multiplicative) and ARIMA (additive) intervention models were considered the best models for predicting campylobacteriosis in New Zealand. It was noticed that the prediction by an additive ARIMA with intervention was slightly better than the prediction by a Holt-Winter multiplicative method for the annual total in year 2010, the former predicting only 23 cases less than the actual reported cases. It is confirmed that classical time series techniques such as ARIMA with intervention and Holt-Winters can provide a good prediction performance for campylobacteriosis risk in New Zealand. The results reported by this study are useful to the New Zealand Health and Safety Authority's efforts in addressing the problem of the campylobacteriosis epidemic. © 2013 Blackwell Verlag GmbH.

Predicting U.S. Army suicides after hospitalizations with psychiatric diagnoses in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

PubMed Central

Kessler, Ronald C.; Warner, LTC Christopher H.; Ivany, LTC Christopher; Petukhova, Maria V.; Rose, Sherri; Bromet, Evelyn J.; Brown, LTC Millard; Cai, Tianxi; Colpe, Lisa J.; Cox, Kenneth L.; Fullerton, Carol S.; Gilman, Stephen E.; Gruber, Michael J.; Heeringa, Steven G.; Lewandowski-Romps, Lisa; Li, Junlong; Millikan-Bell, Amy M.; Naifeh, James A.; Nock, Matthew K.; Rosellini, Anthony J.; Sampson, Nancy A.; Schoenbaum, Michael; Stein, Murray B.; Wessely, Simon; Zaslavsky, Alan M.; Ursano, Robert J.

2014-01-01

IMPORTANCE The U.S. Army experienced a sharp rise in suicides beginning in 2004. Administrative data show that among those at highest risk are soldiers in the 12 months after inpatient treatment of a psychiatric disorder. OBJECTIVE To develop an actuarial risk algorithm predicting suicide in the 12 months after US Army soldier inpatient treatment of a psychiatric disorder to target expanded post-hospital care. DESIGN, SETTING, AND PARTICIPANTS There were 53,769 hospitalizations of active duty soldiers in 2004–2009 with ICD-9-CM psychiatric admission diagnoses. Administrative data available prior to hospital discharge abstracted from a wide range of data systems (socio81 demographic, Army career, criminal justice, medical/pharmacy) were used to predict suicides in the subsequent 12 months using machine learning methods (regression trees, penalized regressions) designed to evaluate cross-validated linear, nonlinear, and interactive predictive associations. MAIN OUTCOME Suicides of soldiers hospitalized with psychiatric disorders in the 12 months after hospital discharge. RESULTS 68 soldiers died by suicide within 12 months of hospital discharge (12.0% of all Army suicides), equivalent to 263.9 suicides/100,000 person-years compared to 18.5 suicides/100,000 person-years in the total Army. Strongest predictors included socio-demographics (male, late age of enlistment), criminal offenses (verbal violence, weapons possession), prior suicidality, aspects of prior psychiatric inpatient and outpatient treatment, and disorders diagnosed during the focal hospitalizations. 52.9% of post-hospital suicides occurred after the 5% of hospitalizations with highest predicted suicide risk (3,824.1 suicides/100,000 person years). These highest-risk hospitalizations also accounted for significantly elevated proportions of several other adverse post-hospital outcomes (unintentional injury deaths, suicide attempts, re-hospitalizations). CONCLUSIONS AND RELEVANCE The high concentration of risk of suicides and other adverse outcomes might justify targeting expanded post-hospital interventions to soldiers classified as having highest post-hospital suicide risk, although final determination requires careful consideration of intervention costs, comparative effectiveness, and possible adverse effects. PMID:25390793

Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study.

PubMed

Brady, Oliver J; Slater, Hannah C; Pemberton-Ross, Peter; Wenger, Edward; Maude, Richard J; Ghani, Azra C; Penny, Melissa A; Gerardin, Jaline; White, Lisa J; Chitnis, Nakul; Aguas, Ricardo; Hay, Simon I; Smith, David L; Stuckey, Erin M; Okiro, Emelda A; Smith, Thomas A; Okell, Lucy C

2017-07-01

Mass drug administration for elimination of Plasmodium falciparum malaria is recommended by WHO in some settings. We used consensus modelling to understand how to optimise the effects of mass drug administration in areas with low malaria transmission. We collaborated with researchers doing field trials to establish a standard intervention scenario and standard transmission setting, and we input these parameters into four previously published models. We then varied the number of rounds of mass drug administration, coverage, duration, timing, importation of infection, and pre-administration transmission levels. The outcome of interest was the percentage reduction in annual mean prevalence of P falciparum parasite rate as measured by PCR in the third year after the final round of mass drug administration. The models predicted differing magnitude of the effects of mass drug administration, but consensus answers were reached for several factors. Mass drug administration was predicted to reduce transmission over a longer timescale than accounted for by the prophylactic effect alone. Percentage reduction in transmission was predicted to be higher and last longer at lower baseline transmission levels. Reduction in transmission resulting from mass drug administration was predicted to be temporary, and in the absence of scale-up of other interventions, such as vector control, transmission would return to pre-administration levels. The proportion of the population treated in a year was a key determinant of simulated effectiveness, irrespective of whether people are treated through high coverage in a single round or new individuals are reached by implementation of several rounds. Mass drug administration was predicted to be more effective if continued over 2 years rather than 1 year, and if done at the time of year when transmission is lowest. Mass drug administration has the potential to reduce transmission for a limited time, but is not an effective replacement for existing vector control. Unless elimination is achieved, mass drug administration has to be repeated regularly for sustained effect. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Predictors of treatment use among foster mothers in an attachment-based intervention program.

PubMed

Bick, Johanna; Dozier, Mary; Moore, Shannon

2012-01-01

The current study examined predictors of treatment use among 56 foster mothers who participated in an attachment-based intervention program for foster infants. Foster mothers' levels of treatment use were coded at early, middle, and late phases of the intervention program. Foster mothers' states of mind with regard to attachment predicted their understanding of the intervention session concepts. Specifically, autonomous foster mothers showed higher levels of understanding at the start of the intervention program, when compared with non-autonomous foster mothers. State of mind with regard to attachment also predicted foster mothers' levels of reflective functioning during the intervention sessions. Autonomous foster mothers showed higher levels of reflective functioning at early, middle, and late stages of the intervention program, when compared with non-autonomous foster mothers. The relevance of these findings for both treatment effectiveness and treatment delivery is discussed.

Evaluation of scoring models for identifying the need for therapeutic intervention of upper gastrointestinal bleeding: A new prediction score model for Japanese patients.

PubMed

Iino, Chikara; Mikami, Tatsuya; Igarashi, Takasato; Aihara, Tomoyuki; Ishii, Kentaro; Sakamoto, Jyuichi; Tono, Hiroshi; Fukuda, Shinsaku

2016-11-01

Multiple scoring systems have been developed to predict outcomes in patients with upper gastrointestinal bleeding. We determined how well these and a newly established scoring model predict the need for therapeutic intervention, excluding transfusion, in Japanese patients with upper gastrointestinal bleeding. We reviewed data from 212 consecutive patients with upper gastrointestinal bleeding. Patients requiring endoscopic intervention, operation, or interventional radiology were allocated to the therapeutic intervention group. Firstly, we compared areas under the curve for the Glasgow-Blatchford, Clinical Rockall, and AIMS65 scores. Secondly, the scores and factors likely associated with upper gastrointestinal bleeding were analyzed with a logistic regression analysis to form a new scoring model. Thirdly, the new model and the existing model were investigated to evaluate their usefulness. Therapeutic intervention was required in 109 patients (51.4%). The Glasgow-Blatchford score was superior to both the Clinical Rockall and AIMS65 scores for predicting therapeutic intervention need (area under the curve, 0.75 [95% confidence interval, 0.69-0.81] vs 0.53 [0.46-0.61] and 0.52 [0.44-0.60], respectively). Multivariate logistic regression analysis retained seven significant predictors in the model: systolic blood pressure <100 mmHg, syncope, hematemesis, hemoglobin <10 g/dL, blood urea nitrogen ≥22.4 mg/dL, estimated glomerular filtration rate ≤ 60 mL/min per 1.73 m 2 , and antiplatelet medication. Based on these variables, we established a new scoring model with superior discrimination to those of existing scoring systems (area under the curve, 0.85 [0.80-0.90]). We developed a superior scoring model for identifying therapeutic intervention need in Japanese patients with upper gastrointestinal bleeding. © 2016 Japan Gastroenterological Endoscopy Society.

Improving attitudes towards children with disabilities in a school context: a cluster randomized intervention study.

PubMed

Godeau, Emmanuelle; Vignes, Céline; Sentenac, Mariane; Ehlinger, Virginie; Navarro, Félix; Grandjean, Hélène; Arnaud, Catherine

2010-10-01

although inclusive education of disabled children is now an accepted practice, it is often challenged by negative peer attitudes. We undertook an interventional study aimed at improving students' attitudes towards their disabled peers. the participants were students from the 7th grade of twelve paired schools (1509 students from 62 classes; age 12-13y), randomly allocated to an intervention group (205 males, 285 females) or a control group (132 males, 165 females). The intervention consisted of a mandatory comprehensive educational project on disability. The Chedoke-McMaster Attitudes Towards Children with Handicaps Scale (CATCH) was used to assess children's attitudes before (T0) and after (T1) intervention. The hierarchical structure of the data was taken into account by adjusting standard deviations and using linear multilevel models. seven hundred and eighty-four students had at least one score on the three domains (cognitive, affective, behavioural) of the CATCH at T0 and T1. The final scores were higher than baseline scores (total scores, intervention group: baseline score 25.6 (SD=5.4), final score 26.8 (5.9), p<0.001; baseline 25.2 (5.4), final 26.0 (5.7), p<0.009) with no significant difference between the intervention and control groups. Individual score changes over time were associated with baseline score (p<0.001 for total and all sub-scores). Lower improvement in attitudes was found in students from schools with special units for their peers with cognitive impairment for total (p=0.013), affective (p<0.001), and behavioural (p=0.001) scores, while higher improvement existed for the cognitive domain (p=0.029). although we found no effect of our intervention, we found an improvement in attitudes in the intervention and control groups that could be a result of the nature of the scales and questionnaires the students had to complete before the intervention.

Comparison of Predictive Modeling Methods of Aircraft Landing Speed

NASA Technical Reports Server (NTRS)

Diallo, Ousmane H.

2012-01-01

Expected increases in air traffic demand have stimulated the development of air traffic control tools intended to assist the air traffic controller in accurately and precisely spacing aircraft landing at congested airports. Such tools will require an accurate landing-speed prediction to increase throughput while decreasing necessary controller interventions for avoiding separation violations. There are many practical challenges to developing an accurate landing-speed model that has acceptable prediction errors. This paper discusses the development of a near-term implementation, using readily available information, to estimate/model final approach speed from the top of the descent phase of flight to the landing runway. As a first approach, all variables found to contribute directly to the landing-speed prediction model are used to build a multi-regression technique of the response surface equation (RSE). Data obtained from operations of a major airlines for a passenger transport aircraft type to the Dallas/Fort Worth International Airport are used to predict the landing speed. The approach was promising because it decreased the standard deviation of the landing-speed error prediction by at least 18% from the standard deviation of the baseline error, depending on the gust condition at the airport. However, when the number of variables is reduced to the most likely obtainable at other major airports, the RSE model shows little improvement over the existing methods. Consequently, a neural network that relies on a nonlinear regression technique is utilized as an alternative modeling approach. For the reduced number of variables cases, the standard deviation of the neural network models errors represent over 5% reduction compared to the RSE model errors, and at least 10% reduction over the baseline predicted landing-speed error standard deviation. Overall, the constructed models predict the landing-speed more accurately and precisely than the current state-of-the-art.

The RAPIDD ebola forecasting challenge: Synthesis and lessons learnt.

PubMed

Viboud, Cécile; Sun, Kaiyuan; Gaffey, Robert; Ajelli, Marco; Fumanelli, Laura; Merler, Stefano; Zhang, Qian; Chowell, Gerardo; Simonsen, Lone; Vespignani, Alessandro

2018-03-01

Infectious disease forecasting is gaining traction in the public health community; however, limited systematic comparisons of model performance exist. Here we present the results of a synthetic forecasting challenge inspired by the West African Ebola crisis in 2014-2015 and involving 16 international academic teams and US government agencies, and compare the predictive performance of 8 independent modeling approaches. Challenge participants were invited to predict 140 epidemiological targets across 5 different time points of 4 synthetic Ebola outbreaks, each involving different levels of interventions and "fog of war" in outbreak data made available for predictions. Prediction targets included 1-4 week-ahead case incidences, outbreak size, peak timing, and several natural history parameters. With respect to weekly case incidence targets, ensemble predictions based on a Bayesian average of the 8 participating models outperformed any individual model and did substantially better than a null auto-regressive model. There was no relationship between model complexity and prediction accuracy; however, the top performing models for short-term weekly incidence were reactive models with few parameters, fitted to a short and recent part of the outbreak. Individual model outputs and ensemble predictions improved with data accuracy and availability; by the second time point, just before the peak of the epidemic, estimates of final size were within 20% of the target. The 4th challenge scenario - mirroring an uncontrolled Ebola outbreak with substantial data reporting noise - was poorly predicted by all modeling teams. Overall, this synthetic forecasting challenge provided a deep understanding of model performance under controlled data and epidemiological conditions. We recommend such "peace time" forecasting challenges as key elements to improve coordination and inspire collaboration between modeling groups ahead of the next pandemic threat, and to assess model forecasting accuracy for a variety of known and hypothetical pathogens. Published by Elsevier B.V.

Use and Effectiveness of a Video- and Text-Driven Web-Based Computer-Tailored Intervention: Randomized Controlled Trial

PubMed Central

Oenema, Anke; Lechner, Lilian; de Vries, Hein

2015-01-01

Background Many Web-based computer-tailored interventions are characterized by high dropout rates, which limit their potential impact. Objective This study had 4 aims: (1) examining if the use of a Web-based computer-tailored obesity prevention intervention can be increased by using videos as the delivery format, (2) examining if the delivery of intervention content via participants’ preferred delivery format can increase intervention use, (3) examining if intervention effects are moderated by intervention use and matching or mismatching intervention delivery format preference, (4) and identifying which sociodemographic factors and intervention appreciation variables predict intervention use. Methods Data were used from a randomized controlled study into the efficacy of a video and text version of a Web-based computer-tailored obesity prevention intervention consisting of a baseline measurement and a 6-month follow-up measurement. The intervention consisted of 6 weekly sessions and could be used for 3 months. ANCOVAs were conducted to assess differences in use between the video and text version and between participants allocated to a matching and mismatching intervention delivery format. Potential moderation by intervention use and matching/mismatching delivery format on self-reported body mass index (BMI), physical activity, and energy intake was examined using regression analyses with interaction terms. Finally, regression analysis was performed to assess determinants of intervention use. Results In total, 1419 participants completed the baseline questionnaire (follow-up response=71.53%, 1015/1419). Intervention use declined rapidly over time; the first 2 intervention sessions were completed by approximately half of the participants and only 10.9% (104/956) of the study population completed all 6 sessions of the intervention. There were no significant differences in use between the video and text version. Intervention use was significantly higher among participants who were allocated to an intervention condition that matched their preferred intervention delivery format. There were no significant interaction terms for any of the outcome variables; a match and more intervention use did not result in better intervention effects. Participants with a high BMI and participants who felt involved and supported by the intervention were more likely to use the intervention more often. Conclusions Video delivery of tailored feedback does not increase the use of Web-based computer-tailored interventions. However, intervention use can potentially be increased by delivering intervention content via participants’ preferred intervention delivery format and creating feelings of relatedness. Because more intervention use was not associated with better intervention outcomes, more research is needed to examine the optimum number of intervention sessions in terms of maximizing use and effects. Trial Registration Nederlands Trial Register: NTR3501; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3501 (Archived by WebCite at http://www.webcitation.org/6b2tsH8Pk) PMID:26408488

Predictors of early versus late smoking abstinence within a 24-month disease management program.

PubMed

Cox, Lisa Sanderson; Wick, Jo A; Nazir, Niaman; Cupertino, A Paula; Mussulman, Laura M; Ahluwalia, Jasjit S; Ellerbeck, Edward F

2011-03-01

Standard smoking cessation treatment studies have been limited to 6- to 12-month follow-up, and examination of predictors of abstinence has been restricted to this timeframe. The KanQuit study enrolled 750 rural smokers across all stages of readiness to stop smoking and provided pharmacotherapy management and/or disease management, including motivational interviewing (MI) counseling every 6 months over 2 years. This paper examines differences in predictors of abstinence following initial (6-month) and extended (24-month) intervention. Baseline variables were analyzed as potential predictors of self-reported smoking abstinence at Month 6 and at Month 24. Chi-square tests, 2-sample t tests, and multiple logistic regression analyses were used to identify predictors of abstinence among 592 participants who completed assessment at baseline and Months 6 and 24. Controlling for treatment group, the final regression models showed that male gender and lower baseline cigarettes per day predicted abstinence at both 6 and 24 months. While remaining significant, the relative advantage of being male decreased over time. Global motivation to stop smoking, controlled motivation, and self-efficacy predicted abstinence at 6 months but did not predict abstinence at Month 24. In contrast, stage of change was strongly predictive of 24-month smoking status. While the importance of some predictors of successful smoking cessation appeared to diminish over time, initial lack of interest in cessation and number of cigarettes per day strongly predicted continued smoking following a 2-year program.

How "community" matters for how people interact with information: mixed methods study of young men who have sex with other men.

PubMed

Veinot, Tiffany Christine; Meadowbrooke, Chrysta Cathleen; Loveluck, Jimena; Hickok, Andrew; Bauermeister, Jose Artruro

2013-02-21

We lack a systematic portrait of the relationship between community involvement and how people interact with information. Young men who have sex with men (YMSM) are a population for which these relationships are especially salient: their gay community involvement varies and their information technology use is high. YMSM under age 24 are also one of the US populations with the highest risk of HIV/AIDS. To develop, test, and refine a model of gay community involvement (GCI) factors in human-information interaction (HII) as applied to HIV/AIDS information among YMSM, specifically examining the role of Internet use in GCI and HII. Mixed methods included: 1) online questionnaire with 194 YMSM; and 2) qualitative interviews with 19 YMSM with high GCI levels. Recruitment utilized social media, dating websites, health clinics, bars/clubs, and public postings. The survey included questions regarding HIV/AIDS-related information acquisition and use patterns, gay community involvement, risk behaviors, and technology use. For survey data, we tested multiple linear regression models using a series of community- and information-related variables as dependent variables. Independent variables included community- and information-related variables and demographic covariates. We then conducted a recursive path analysis in order to estimate a final model, which we refined through a grounded theory analysis of qualitative interview data. Four community-related variables significantly predicted how people interact with information (HII variables): 1) gay community involvement (GCI), 2) social costs of information seeking, 3) network expertise accessibility, and 4) community relevance. GCI was associated with significantly lower perceived social costs of HIV/AIDS information seeking (R(2)=0.07). GCI and social costs significantly predicted network expertise accessibility (R(2)=0.14). GCI predicted 14% of the variance in community relevance and 9% of the variance in information seeking frequency. Incidental HIV/AIDS information acquisition (IIA) was also significantly predicted by GCI (R(2)=0.16). 28% of the variance in HIV/AIDS information use was explained by community relevance, network expertise access, and both IIA and information seeking. The final path model showed good fit: the RSMEA was 0.054 (90% CI: .000-.101); the Chi-square was non-significant (χ(2)(11)=17.105; P=.105); and the CFI was 0.967. Qualitative findings suggest that the model may be enhanced by including information sharing: organizing events, disseminating messages, encouraging safety, and referring and recommending. Information sharing emerged under conditions of pro-social community value enactment and may have consequences for further HII. YMSM with greater GCI generally used the Internet more, although they chatted online less. HIV/AIDS-related HII and associated technology uses are community-embedded processes. The model provides theoretical mediators that may serve as a focus for intervention: 1) valuing HIV/AIDS information, through believing it is relevant to one's group, and 2) supportive and knowledgeable network members with whom to talk about HIV/AIDS. Pro-social community value endorsement and information sharing may also be important theoretical mediators. Our model could open possibilities for considering how informatics interventions can also be designed as community-level interventions and vice versa.

Critical Features Predicting Sustained Implementation of School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Mathews, Susanna; McIntosh, Kent; Frank, Jennifer L.; May, Seth L.

2014-01-01

The current study explored the extent to which a common measure of perceived implementation of critical features of Positive Behavioral Interventions and Supports (PBIS) predicted fidelity of implementation 3 years later. Respondents included school personnel from 261 schools across the United States implementing PBIS. School teams completed the…

An Investment Model Analysis of Relationship Stability among Women Court-Mandated to Violence Interventions

ERIC Educational Resources Information Center

Rhatigan, Deborah L.; Moore, Todd M.; Stuart, Gregory L.

2005-01-01

This investigation examined relationship stability among 60 women court-mandated to violence interventions by applying a general model (i.e., Rusbult's 1980 Investment Model) to predict intentions to leave current relationships. As in past research, results showed that Investment Model predictions were supported such that court-mandated women who…

A review of geographic information system and remote sensing with applications to the epidemiology and control of schistosomiasis in China.

PubMed

Yang, Guo-Jing; Vounatsou, Penelope; Zhou, Xiao-Nong; Utzinger, Jürg; Tanner, Marcel

2005-01-01

Geographic information system (GIS) and remote sensing (RS) technologies offer new opportunities for rapid assessment of endemic areas, provision of reliable estimates of populations at risk, prediction of disease distributions in areas that lack baseline data and are difficult to access, and guidance of intervention strategies, so that scarce resources can be allocated in a cost-effective manner. Here, we focus on the epidemiology and control of schistosomiasis in China and review GIS and RS applications to date. These include mapping prevalence and intensity data of Schistosoma japonicum at a large scale, and identifying and predicting suitable habitats for Oncomelania hupensis, the intermediate host snail of S. japonicum, at a small scale. Other prominent applications have been the prediction of infection risk due to ecological transformations, particularly those induced by floods and water resource developments, and the potential impact of climate change. We also discuss the limitations of the previous work, and outline potential new applications of GIS and RS techniques, namely quantitative GIS, WebGIS, and utilization of emerging satellite information, as they hold promise to further enhance infection risk mapping and disease prediction. Finally, we stress current research needs to overcome some of the remaining challenges of GIS and RS applications for schistosomiasis, so that further and sustained progress can be made to control this disease in China and elsewhere.

Studies in Bilingual Evaluation, Work Unit I: Bilingual Prediction Project. Final Report.

ERIC Educational Resources Information Center

de Porcel, Antonio; And Others

The final report of the Bilingual Prediction Project presents a review of the project from its inception in 1975 through completion in 1979. The main goal was to predict a student's academic ability in English. A prediction index was constructed in two stages. The first stage was a description of the target population and their school setting, as…

Patient and practitioner characteristics predict brief alcohol intervention in primary care.

PubMed

Kaner, E F; Heather, N; Brodie, J; Lock, C A; McAvoy, B R

2001-10-01

The effectiveness of an evidence-based health care intervention depends on it being delivered consistently to appropriate patients. Brief alcohol intervention is known to be effective at reducing excessive drinking and its concomitant health and social problems. However, a recent implementation trial reported partial delivery of brief alcohol intervention by general practitioners (GPs) which is likely to have reduced its impact. To investigate patient-practitioner characteristics influencing brief alcohol intervention in primary care. Cross-sectional analysis of 12,814 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires. Eighty-four GPs who had implemented a brief alcohol intervention programme in a previous trial based in the Northeast of England. GPs were requested to screen all adults (aged over 16 years) presenting to their surgery and follow a structured protocol to give a brief intervention (five minutes of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of the screening questionnaire were collected from all practices after a three-month implementation period. Although AUDIT identified 4080 'risk' drinkers, only 2043 (50%) received brief intervention. Risk drinkers that were most likely to receive brief intervention were males (58%), unemployed (61%), and technically-trained patients (55%). Risk drinkers that were least likely to receive brief intervention were females (44%), students (38%), and university educated patients (46%). Logistic regression modelling showed that patients' risk status was the most influential predictor of brief intervention. Also, GPs' experience of relevant training and longer average practice consultations predicted brief intervention. However, personal characteristics relating to patients and GPs also predicted brief intervention in routine practice. Interpersonal factors relating to patients and practitioners contributed to the selective provision of brief alcohol intervention in primary care. Ways should be found to remedy this situation or the impact of this evidence-based intervention may be reduced when implemented in routine practice.

Response to Intervention as a Predictor of Long-Term Reading Outcomes in Children with Dyslexia.

PubMed

van der Kleij, Sanne W; Segers, Eliane; Groen, Margriet A; Verhoeven, Ludo

2017-08-01

The goal of this study was to investigate how growth during a phonics-based intervention, as well as reading levels at baseline testing, predicted long-term reading outcomes of children with dyslexia. Eighty Dutch children with dyslexia who had completed a 50-week phonics-based intervention in grade 4 were tested in grade 5 on both word and pseudoword (following regular Dutch orthographic patterns) reading efficiency and compared to 93 typical readers. In grade 5 the children with dyslexia were still significantly slower in word and pseudoword reading than their typically developing peers. Results showed that long-term pseudoword reading in the group with dyslexia was predicted by pseudoword reading at pretest and growth in pseudoword reading during the intervention, which was itself predicted by pseudoword reading at pretest. This was not the case for word reading. We found that long-term word reading was directly predicted from pretest word reading, and indirectly via pretest pseudoword reading, via growth in pseudoword and word reading. It can be concluded that pseudoword reading is not only a good indicator of severity of reading difficulties in children with dyslexia, it is also an indicator of who will profit from intervention in the long-term. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE.

PubMed

Holtermann, Andreas; Jørgensen, Marie B; Gram, Bibi; Christensen, Jeanette R; Faber, Anne; Overgaard, Kristian; Ektor-Andersen, John; Mortensen, Ole S; Sjøgaard, Gisela; Søgaard, Karen

2010-03-09

A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group. The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration. ISRCTN96241850, NCT01015716 and NCT01007669.

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background, design and conceptual model of FINALE

PubMed Central

2010-01-01

Background A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. Methods/Design A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group. Discussion The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration. Trial registrations ISRCTN96241850, NCT01015716 and NCT01007669 PMID:20214807

Using kaizen to improve employee well-being: Results from two organizational intervention studies.

PubMed

von Thiele Schwarz, Ulrica; Nielsen, Karina M; Stenfors-Hayes, Terese; Hasson, Henna

2017-08-01

Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions.

Using kaizen to improve employee well-being: Results from two organizational intervention studies

PubMed Central

von Thiele Schwarz, Ulrica; Nielsen, Karina M; Stenfors-Hayes, Terese; Hasson, Henna

2016-01-01

Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions. PMID:28736455

Do Motivational Interviewing Behaviors Predict Reductions in Partner Aggression for Men and Women?

PubMed Central

Woodin, Erica M.; Sotskova, Alina; O’Leary, K. Daniel

2011-01-01

Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O’Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing. PMID:22119133

AGREEMENT AND COVERAGE OF INDICATORS OF RESPONSE TO INTERVENTION: A MULTI-METHOD COMPARISON AND SIMULATION

PubMed Central

Fletcher, Jack M.; Stuebing, Karla K.; Barth, Amy E.; Miciak, Jeremy; Francis, David J.; Denton, Carolyn A.

2013-01-01

Purpose Agreement across methods for identifying students as inadequate responders or as learning disabled is often poor. We report (1) an empirical examination of final status (post-intervention benchmarks) and dual-discrepancy growth methods based on growth during the intervention and final status for assessing response to intervention; and (2) a statistical simulation of psychometric issues that may explain low agreement. Methods After a Tier 2 intervention, final status benchmark criteria were used to identify 104 inadequate and 85 adequate responders to intervention, with comparisons of agreement and coverage for these methods and a dual-discrepancy method. Factors affecting agreement were investigated using computer simulation to manipulate reliability, the intercorrelation between measures, cut points, normative samples, and sample size. Results Identification of inadequate responders based on individual measures showed that single measures tended not to identify many members of the pool of 104 inadequate responders. Poor to fair levels of agreement for identifying inadequate responders were apparent between pairs of measures In the simulation, comparisons across two simulated measures generated indices of agreement (kappa) that were generally low because of multiple psychometric issues inherent in any test. Conclusions Expecting excellent agreement between two correlated tests with even small amounts of unreliability may not be realistic. Assessing outcomes based on multiple measures, such as level of CBM performance and short norm-referenced assessments of fluency may improve the reliability of diagnostic decisions. PMID:25364090

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials

PubMed Central

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-01-01

Objectives Total knee replacement can be a successful operation for pain relief. However, 10–34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. Setting We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Participants Adult patients receiving total knee replacement. Interventions Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Primary and secondary outcome measures Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. Results No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Conclusions Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. PMID:25967998

SIFT-OUT: Training for Systems Change in Early Intervention. Final Report.

ERIC Educational Resources Information Center

Winton, Pamela J.; Catlett, Camille

This report summarizes the activities of the SIFT-OUT program, a federally funded project designed to prepare teams of university faculty, family members, practitioners, and agency representatives from six states, to serve as leaders in providing early intervention training in their states. A total of 166 state-level early intervention leaders…

Estimating the Costs of Preventive Interventions

ERIC Educational Resources Information Center

Foster, E. Michael; Porter, Michele M.; Ayers, Tim S.; Kaplan, Debra L.; Sandler, Irwin

2007-01-01

The goal of this article is to improve the practice and reporting of cost estimates of prevention programs. It reviews the steps in estimating the costs of an intervention and the principles that should guide estimation. The authors then review prior efforts to estimate intervention costs using a sample of well-known but diverse studies. Finally,…

A Predictive Study of Pre-Service Teachers and Success in Final Student Internship

ERIC Educational Resources Information Center

Ingle, Karen M.

2017-01-01

Student teaching provides the final pre-service clinical teaching experience of an initial teacher preparation program. Research that specifically studies the pre-service student teacher and predictive factors of student teaching is limited. Identifying predictive factors that contribute to the success of student interns' student teaching…

Sympathetic- and Parasympathetic-linked Cardiac Function and Prediction of Externalizing Behavior, Emotion Regulation, and Prosocial Behavior among Preschoolers Treated for ADHD

PubMed Central

Beauchaine, Theodore P.; Gatzke-Kopp, Lisa; Neuhaus, Emily; Chipman, Jane; Reid, M. Jamila; Webster-Stratton, Carolyn

2014-01-01

Objective To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically-supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD). Method Cardiac pre-ejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), and index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4–6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed one of two versions of the Incredible Years parent and child interventions. Results Main effects of PEP activity and reactivity, and of RSA activity and reactivity were found. Although sample-wide improvements in behavior were observed at post treatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment. Conclusions We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation, and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children. PMID:23544677

Sympathetic- and parasympathetic-linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD.

PubMed

Beauchaine, Theodore P; Gatzke-Kopp, Lisa; Neuhaus, Emily; Chipman, Jane; Reid, M Jamila; Webster-Stratton, Carolyn

2013-06-01

To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD). Cardiac preejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), an index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4-6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed 1 of 2 versions of the Incredible Years parent and child interventions. Main effects of PEP activity and reactivity and of RSA activity and reactivity were found. Although samplewide improvements in behavior were observed at posttreatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment. We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children.

Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial.

PubMed

Farias, Catharinne C; Resqueti, Vanessa; Dias, Fernando A L; Borghi-Silva, Audrey; Arena, Ross; Fregonezi, Guilherme A F

2014-01-01

The current study evaluated the costs and benefits of a simple aerobic walking program for patients with chronic obstructive pulmonary disease (COPD). This was a blinded randomized controlled clinical trial that recruited 72 patients diagnosed with COPD, 40 of whom were included in the study and divided into two groups [control group (CG) and pulmonary rehabilitation group (GPR)]. We assessed pulmonary function, distance covered during the 6-minute walk test (6MWT), respiratory and peripheral muscle strength, health-related quality of life (HRQOL), body composition, and level of activities of daily living (ADLs) before and after an 8-week walking program. The financial costs were calculated according to the pricing table of the Brazilian Unified Health System (SUS). Only 34 of the 40 patients remained in the final sample; 16 in the CG and 18 in the GPR (FEV1: 50.9 ± 14% predicted and FEV1: 56 ± 0.5% predicted, respectively). The intervention group exhibited improvements in the 6MWT, sensation of dyspnea and fatigue, work performed, BODE index (p<0.01), HRQOL, ADL level (p<0.001), and lower limb strength (p<0.05). The final mean cost per patient for the GPR was R$ 148.75 (~US$ 75.00) and no patient significantly exceeded this value. However, 2 patients in the CG did exceed this value, incurring a cost of R$ 689.15 (~US$ 345.00). Aerobic walking demonstrated significant clinical benefits in a cost-efficient manner in patients with COPD.

Performance of the Fecal Immunochemical Test for Colorectal Cancer Screening Using Different Stool-Collection Devices: Preliminary Results from a Randomized Controlled Trial.

PubMed

Shin, Hye Young; Suh, Mina; Baik, Hyung Won; Choi, Kui Son; Park, Boyoung; Jun, Jae Kwan; Hwang, Sang-Hyun; Kim, Byung Chang; Lee, Chan Wha; Oh, Jae Hwan; Lee, You Kyoung; Han, Dong Soo; Lee, Do-Hoon

2016-11-15

We are in the process of conducting a randomized trial to determine whether compliance with the fecal immunochemical test (FIT) for colorectal cancer screening differs according to the stool-collection method. This study was an interim analysis of the performance of two stool-collection devices (sampling bottle vs conventional container). In total, 1,701 individuals (age range, 50 to 74 years) were randomized into the sampling bottle group (intervention arm) or the conventional container group (control arm). In both groups, we evaluated the FIT positivity rate, the positive predictive value for advanced neoplasia, and the detection rate for advanced neoplasia. The FIT positivity rates were 4.1% for the sampling bottles and 2.0% for the conventional containers; these values were significantly different. The positive predictive values for advanced neoplasia in the sampling bottles and conventional containers were 11.1% (95% confidence interval [CI], -3.4 to 25.6) and 12.0% (95% CI, -0.7 to 24.7), respectively. The detection rates for advanced neoplasia in the sampling bottles and conventional containers were 4.5 per 1,000 persons (95% CI, 2.0 to 11.0) and 2.4 per 1,000 persons (95% CI, 0.0 to 5.0), respectively. The impact of these findings on FIT screening performance was unclear in this interim analysis. This impact should therefore be evaluated in the final analysis following the final enrollment period.

Validation and refinement of a rule to predict emergency intervention in adult trauma patients.

PubMed

Haukoos, Jason S; Byyny, Richard L; Erickson, Catherine; Paulson, Stephen; Hopkins, Emily; Sasson, Comilla; Bender, Brooke; Gravitz, Craig S; Vogel, Jody A; Colwell, Christopher B; Moore, Ernest E

2011-08-01

Trauma centers use "secondary triage" to determine the necessity of trauma surgeon involvement. A clinical decision rule, which includes penetrating injury, an initial systolic blood pressure less than 100 mm Hg, or an initial pulse rate greater than 100 beats/min, was developed to predict which trauma patients require emergency operative intervention or emergency procedural intervention (cricothyroidotomy or thoracotomy) in the emergency department. Our goal was to validate this rule in an adult trauma population and to compare it with the American College of Surgeons' major resuscitation criteria. We used Level I trauma center registry data from September 1, 1995, through November 30, 2008. Outcomes were confirmed with blinded abstractors. Sensitivity, specificity, and 95% confidence intervals (CIs) were calculated. Our patient sample included 20,872 individuals. The median Injury Severity Score was 9 (interquartile range 4 to 16), 15.3% of patients had penetrating injuries, 13.5% had a systolic blood pressure less than 100 mm Hg, and 32.5% had a pulse rate greater than 100 beats/min. Emergency operative intervention or procedural intervention was required in 1,099 patients (5.3%; 95% CI 5.0% to 5.6%). The sensitivities and specificities of the rule and the major resuscitation criteria for predicting emergency operative intervention or emergency procedural intervention were 95.6% (95% CI 94.3% to 96.8%) and 56.1% (95% CI 55.4% to 56.8%) and 85.5% (95% CI 83.3% to 87.5%) and 80.9% (95% CI 80.3% to 81.4%), respectively. This new rule was more sensitive for predicting the need for emergency operative intervention or emergency procedural intervention directly compared with the American College of Surgeons' major resuscitation criteria, which may improve the effectiveness and efficiency of trauma triage. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

PubMed

Lock, Catherine A; Kaner, Eileen F S

2004-06-01

In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If patients are to experience the beneficial effects of a brief alcohol intervention, then there is a need to improve the accuracy of delivery.

High-Density Free Fluid on Computed Tomography: a Predictor of Surgical Intervention in Patients with Adhesive Small Bowel Obstruction.

PubMed

Matsushima, Kazuhide; Inaba, Kenji; Dollbaum, Ryan; Cheng, Vincent; Khan, Moazzam; Herr, Keith; Strumwasser, Aaron; Asturias, Sabrina; Dilektasli, Evren; Demetriades, Demetrios

2016-11-01

Patients with adhesive small bowel obstruction (ASBO) often develop intraabdominal free fluid (IFF). While IFF is a finding on abdominopelvic computed tomography (CT) associated with the need for surgical intervention, many patients with IFF can be still managed non-operatively. A previous study suggested that a higher red blood cell count of IFF is highly predictive of strangulated ASBO. We hypothesized that radiodensity in IFF (Hounsfield unit (HU)) on CT would predict the need for surgical intervention. Patients with clinicoradiological evidence of ASBO between January 2009 and December 2013 were identified. In patients with IFF > 3 cm 2 identified on CT, the HU was measured in the largest pocket of IFF. A sensitivity analysis was performed to determine a high-density HU threshold. The HU of patients who underwent therapeutic laparotomy was compared with those successfully discharged with non-operative management. A total of 318 patients with ASBO (median age 52 years, 56.0 % male) were identified. Of 111 patients who had IFF on CT, 55.9 % underwent therapeutic laparotomy and 15.3 % required bowel resection. Radiodensity of IFF in the operative group was significantly higher than that in the non-operative group (18.2 vs. 7.0 HU, p < 0.01). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of high-density IFF (>10 HU) to predict the need for surgical intervention were 83.9, 65.3, 75.4, 76.2, and 75.6 %, respectively. High-density IFF on CT was significantly associated with the need for surgical intervention in patients with ASBO. Prospective study to validate the predictive value of high-density IFF on CT will be warranted.

Specific attitudes which predict psychology students' intentions to seek help for psychological distress.

PubMed

Thomas, Susan J; Caputi, Peter; Wilson, Coralie J

2014-03-01

Although many postgraduate psychology programs address students' mental health, there are compelling indications that earlier, undergraduate, interventions may be optimal. We investigated specific attitudes that predict students' intentions to seek treatment for psychological distress to inform targeted interventions. Psychology students (N = 289; mean age = 19.75 years) were surveyed about attitudes and intentions to seek treatment for stress, anxiety, or depression. Less than one quarter of students reported that they would be likely to seek treatment should they develop psychological distress. Attitudes that predicted help-seeking intentions related to recognition of symptoms and the benefits of professional help, and openness to treatment for emotional problems. The current study identified specific attitudes which predict help-seeking intentions in psychology students. These attitudes could be strengthened in undergraduate educational interventions promoting well-being and appropriate treatment uptake among psychology students. © 2013 Wiley Periodicals, Inc.

Influences of peers, teachers, and climate on students' willingness to intervene when witnessing anti-transgender harassment.

PubMed

Wernick, Laura J; Kulick, Alex; Inglehart, M H

2014-08-01

Transgender young people are at increased risk for bullying, harassment, and negative mental health and academic outcomes compared to the general population as well as compared to other members of lesbian, gay, bisexual, transgender, queer, questioning, and similarly identified (LGBTQQ) communities. To inform interventions to support transgender students, the present study investigates students' willingness to intervene when witnessing anti-transgender harassment, using data collected from a participatory action research project investigating school climate. Multi-step linear regression was used to test the impacts of hearing transphobic language and witnessing teachers and others students intervene, while controlling for demographics and school. Hostile climate negatively predicted intervention intentions while witnessing peer intervention positively predicted likelihood to intervene. Witnessing teacher intervention did not significantly predict the outcome. These findings suggest that youth-led interventions in peer networks might be effective in diminishing transphobic bullying and supporting the healthy development of transgender young people. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Searching for a two-factor model of marriage duration: commentary on Gottman and Levenson.

PubMed

DeKay, Michael L; Greeno, Catherine G; Houck, Patricia R

2002-01-01

Gottman and Levenson (2002) report a number of post hoc ordinary least squares regressions to "predict" the length of marriage, given that divorce has occurred. We argue that the type of statistical model they use is inappropriate for answering clinically relevant questions about the causes and timing of divorce, and present several reasons why an alternative family of models called duration models would be more appropriate. The distribution of marriage length is not bimodal, as Gottman and Levenson suggest, and their search for a two-factor model for explaining marriage length is misguided. Their regression models omit many variables known to affect marriage length, and instead use variables that were pre-screened for their predictive ability. Their final model is based on data for only 15 cases, including one unusual case that has undue influence on the results. For these and other technical reasons presented in the text, we believe that Gottman and Levenson's results are not replicable, and that they should not be used to guide interventions for couples in clinical settings.

Dictyocaulus viviparus genome, variome and transcriptome elucidate lungworm biology and support future intervention

PubMed Central

McNulty, Samantha N.; Strübe, Christina; Rosa, Bruce A.; Martin, John C.; Tyagi, Rahul; Choi, Young-Jun; Wang, Qi; Hallsworth Pepin, Kymberlie; Zhang, Xu; Ozersky, Philip; Wilson, Richard K.; Sternberg, Paul W.; Gasser, Robin B.; Mitreva, Makedonka

2016-01-01

The bovine lungworm, Dictyocaulus viviparus (order Strongylida), is an important parasite of livestock that causes substantial economic and production losses worldwide. Here we report the draft genome, variome, and developmental transcriptome of D. viviparus. The genome (161 Mb) is smaller than those of related bursate nematodes and encodes fewer proteins (14,171 total). In the first genome-wide assessment of genomic variation in any parasitic nematode, we found a high degree of sequence variability in proteins predicted to be involved host-parasite interactions. Next, we used extensive RNA sequence data to track gene transcription across the life cycle of D. viviparus, and identified genes that might be important in nematode development and parasitism. Finally, we predicted genes that could be vital in host-parasite interactions, genes that could serve as drug targets, and putative RNAi effectors with a view to developing functional genomic tools. This extensive, well-curated dataset should provide a basis for developing new anthelmintics, vaccines, and improved diagnostic tests and serve as a platform for future investigations of drug resistance and epidemiology of the bovine lungworm and related nematodes. PMID:26856411

Impact of Child Sex Abuse on Adult Psychopathology: A Genetically and Epigenetically Informed Investigation

PubMed Central

Beach, Steven R. H.; Brody, Gene H.; Lei, Man Kit; Gibbons, Frederick X.; Gerrard, Meg; Simons, Ronald L.; Cutrona, Carolyn E.; Philibert, Robert A.

2013-01-01

Genetic, environmental, and epigenetic influences and their transactions were examined in a sample of 155 women from the Iowa Adoptee sample (IAS) who had been removed from their biological parents shortly after birth, and assessed when participants were an average of 41.10 years old. We observed an interactive effect of child sex abuse (CSA) and biological parent psychopathology (i.e., genetic load) on substance abuse as well as a main effect of CSA on substance abuse in adulthood. We also observed main effects of CSA and genetic load on depression and on antisocial characteristics. As predicted, CSA, but not genetic load or later substance abuse, was associated with epigenetic change. In addition, the interaction between genetic load and CSA predicted epigenetic change, indicating a potential genetic basis for differential impact of CSA on epigenetic change. Finally, epigenetic change partially mediated the effect of CSA on antisocial characteristics. The results suggest the relevance of genetic and epigenetic processes for future theorizing regarding marital and family precursors of several forms of adult psychopathology. Implications for preventive intervention are discussed. PMID:23421829

Assistance to States for the Education of Children with Disabilities and the Early Intervention Program for Infants and Toddlers with Disabilities. Final Regulations. Federal Register, Part II, Department of Education, 34 CFR Parts 300 and 303.

ERIC Educational Resources Information Center

Federal Register, 1999

1999-01-01

This document presents final regulations for the Assistance to States for Education of Children with Disabilities program under Part B of the Individuals with Disabilities Act (IDEA Part B) and the Early Intervention Program for Infants and Toddlers with Disabilities under Part C of the Act. These regulations are needed to implement changes made…

Reporting of complex interventions in clinical trials: development of a taxonomy to classify and describe fall-prevention interventions.

PubMed

Lamb, Sarah E; Becker, Clemens; Gillespie, Lesley D; Smith, Jessica L; Finnegan, Susanne; Potter, Rachel; Pfeiffer, Klaus

2011-05-17

Interventions for preventing falls in older people often involve several components, multidisciplinary teams, and implementation in a variety of settings. We have developed a classification system (taxonomy) to describe interventions used to prevent falls in older people, with the aim of improving the design and reporting of clinical trials of fall-prevention interventions, and synthesis of evidence from these trials. Thirty three international experts in falls prevention and health services research participated in a series of meetings to develop consensus. Robust techniques were used including literature reviews, expert presentations, and structured consensus workshops moderated by experienced facilitators. The taxonomy was refined using an international test panel of five health care practitioners. We assessed the chance corrected agreement of the final version by comparing taxonomy completion for 10 randomly selected published papers describing a variety of fall-prevention interventions. The taxonomy consists of four domains, summarized as the "Approach", "Base", "Components" and "Descriptors" of an intervention. Sub-domains include; where participants are identified; the theoretical approach of the intervention; clinical targeting criteria; details on assessments; descriptions of the nature and intensity of interventions. Chance corrected agreement of the final version of the taxonomy was good to excellent for all items. Further independent evaluation of the taxonomy is required. The taxonomy is a useful instrument for characterizing a broad range of interventions used in falls prevention. Investigators are encouraged to use the taxonomy to report their interventions.

Reporting of complex interventions in clinical trials: development of a taxonomy to classify and describe fall-prevention interventions

PubMed Central

2011-01-01

Background Interventions for preventing falls in older people often involve several components, multidisciplinary teams, and implementation in a variety of settings. We have developed a classification system (taxonomy) to describe interventions used to prevent falls in older people, with the aim of improving the design and reporting of clinical trials of fall-prevention interventions, and synthesis of evidence from these trials. Methods Thirty three international experts in falls prevention and health services research participated in a series of meetings to develop consensus. Robust techniques were used including literature reviews, expert presentations, and structured consensus workshops moderated by experienced facilitators. The taxonomy was refined using an international test panel of five health care practitioners. We assessed the chance corrected agreement of the final version by comparing taxonomy completion for 10 randomly selected published papers describing a variety of fall-prevention interventions. Results The taxonomy consists of four domains, summarized as the "Approach", "Base", "Components" and "Descriptors" of an intervention. Sub-domains include; where participants are identified; the theoretical approach of the intervention; clinical targeting criteria; details on assessments; descriptions of the nature and intensity of interventions. Chance corrected agreement of the final version of the taxonomy was good to excellent for all items. Further independent evaluation of the taxonomy is required. Conclusions The taxonomy is a useful instrument for characterizing a broad range of interventions used in falls prevention. Investigators are encouraged to use the taxonomy to report their interventions. PMID:21586143

Predicting Intervention Effectiveness from Reading Accuracy and Rate Measures through the Instructional Hierarchy: Evidence for a Skill-by-Treatment Interaction

ERIC Educational Resources Information Center

Szadokierski, Isadora; Burns, Matthew K.; McComas, Jennifer J.

2017-01-01

The current study used the learning hierarchy/instructional hierarchy phases of acquisition and fluency to predict intervention effectiveness based on preintervention reading skills. Preintervention reading accuracy (percentage of words read correctly) and rate (number of words read correctly per minute) were assessed for 49 second- and…

Designing a Minimal Intervention Strategy to Control Taenia solium.

PubMed

Lightowlers, Marshall W; Donadeu, Meritxell

2017-06-01

Neurocysticercosis is an important cause of epilepsy in many developing countries. The disease is a zoonosis caused by the cestode parasite Taenia solium. Many potential intervention strategies are available, however none has been able to be implemented and sustained. Here we predict the impact of some T. solium interventions that could be applied to prevent transmission through pigs, the parasite's natural animal intermediate host. These include minimal intervention strategies that are predicted to be effective and likely to be feasible. Logical models are presented which reflect changes in the risk that age cohorts of animals have for their potential to transmit T. solium. Interventions that include a combined application of vaccination, plus chemotherapy in young animals, are the most effective. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Regression models for predicting peak and continuous three-dimensional spinal loads during symmetric and asymmetric lifting tasks.

PubMed

Fathallah, F A; Marras, W S; Parnianpour, M

1999-09-01

Most biomechanical assessments of spinal loading during industrial work have focused on estimating peak spinal compressive forces under static and sagittally symmetric conditions. The main objective of this study was to explore the potential of feasibly predicting three-dimensional (3D) spinal loading in industry from various combinations of trunk kinematics, kinetics, and subject-load characteristics. The study used spinal loading, predicted by a validated electromyography-assisted model, from 11 male participants who performed a series of symmetric and asymmetric lifts. Three classes of models were developed: (a) models using workplace, subject, and trunk motion parameters as independent variables (kinematic models); (b) models using workplace, subject, and measured moments variables (kinetic models); and (c) models incorporating workplace, subject, trunk motion, and measured moments variables (combined models). The results showed that peak 3D spinal loading during symmetric and asymmetric lifting were predicted equally well using all three types of regression models. Continuous 3D loading was predicted best using the combined models. When the use of such models is infeasible, the kinematic models can provide adequate predictions. Finally, lateral shear forces (peak and continuous) were consistently underestimated using all three types of models. The study demonstrated the feasibility of predicting 3D loads on the spine under specific symmetric and asymmetric lifting tasks without the need for collecting EMG information. However, further validation and development of the models should be conducted to assess and extend their applicability to lifting conditions other than those presented in this study. Actual or potential applications of this research include exposure assessment in epidemiological studies, ergonomic intervention, and laboratory task assessment.

Enteric disease episodes and the risk of acquiring a future sexually transmitted infection: a prediction model in Montreal residents.

PubMed

Caron, Melissa; Allard, Robert; Bédard, Lucie; Latreille, Jérôme; Buckeridge, David L

2016-11-01

The sexual transmission of enteric diseases poses an important public health challenge. We aimed to build a prediction model capable of identifying individuals with a reported enteric disease who could be at risk of acquiring future sexually transmitted infections (STIs). Passive surveillance data on Montreal residents with at least 1 enteric disease report was used to construct the prediction model. Cases were defined as all subjects with at least 1 STI report following their initial enteric disease episode. A final logistic regression prediction model was chosen using forward stepwise selection. The prediction model with the greatest validity included age, sex, residential location, number of STI episodes experienced prior to the first enteric disease episode, type of enteric disease acquired, and an interaction term between age and male sex. This model had an area under the curve of 0.77 and had acceptable calibration. A coordinated public health response to the sexual transmission of enteric diseases requires that a distinction be made between cases of enteric diseases transmitted through sexual activity from those transmitted through contaminated food or water. A prediction model can aid public health officials in identifying individuals who may have a higher risk of sexually acquiring a reportable disease. Once identified, these individuals could receive specialized intervention to prevent future infection. The information produced from a prediction model capable of identifying higher risk individuals can be used to guide efforts in investigating and controlling reported cases of enteric diseases and STIs. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prediction of paroxysmal atrial fibrillation using recurrence plot-based features of the RR-interval signal.

PubMed

Mohebbi, Maryam; Ghassemian, Hassan

2011-08-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke. Predicting the onset of paroxysmal AF (PAF), based on noninvasive techniques, is clinically important and can be invaluable in order to avoid useless therapeutic intervention and to minimize risks for the patients. In this paper, we propose an effective PAF predictor which is based on the analysis of the RR-interval signal. This method consists of three steps: preprocessing, feature extraction and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the RR-interval signal is extracted. In the next step, the recurrence plot (RP) of the RR-interval signal is obtained and five statistically significant features are extracted to characterize the basic patterns of the RP. These features consist of the recurrence rate, length of longest diagonal segments (L(max )), average length of the diagonal lines (L(mean)), entropy, and trapping time. Recurrence quantification analysis can reveal subtle aspects of dynamics not easily appreciated by other methods and exhibits characteristic patterns which are caused by the typical dynamical behavior. In the final step, a support vector machine (SVM)-based classifier is used for PAF prediction. The performance of the proposed method in prediction of PAF episodes was evaluated using the Atrial Fibrillation Prediction Database (AFPDB) which consists of both 30 min ECG recordings that end just prior to the onset of PAF and segments at least 45 min distant from any PAF events. The obtained sensitivity, specificity, positive predictivity and negative predictivity were 97%, 100%, 100%, and 96%, respectively. The proposed methodology presents better results than other existing approaches.

An Empiric HIV Risk Scoring Tool to Predict HIV-1 Acquisition in African Women.

PubMed

Balkus, Jennifer E; Brown, Elizabeth; Palanee, Thesla; Nair, Gonasagrie; Gafoor, Zakir; Zhang, Jingyang; Richardson, Barbra A; Chirenje, Zvavahera M; Marrazzo, Jeanne M; Baeten, Jared M

2016-07-01

To develop and validate an HIV risk assessment tool to predict HIV acquisition among African women. Data were analyzed from 3 randomized trials of biomedical HIV prevention interventions among African women (VOICE, HPTN 035, and FEM-PrEP). We implemented standard methods for the development of clinical prediction rules to generate a risk-scoring tool to predict HIV acquisition over the course of 1 year. Performance of the score was assessed through internal and external validations. The final risk score resulting from multivariable modeling included age, married/living with a partner, partner provides financial or material support, partner has other partners, alcohol use, detection of a curable sexually transmitted infection, and herpes simplex virus 2 serostatus. Point values for each factor ranged from 0 to 2, with a maximum possible total score of 11. Scores ≥5 were associated with HIV incidence >5 per 100 person-years and identified 91% of incident HIV infections from among only 64% of women. The area under the curve (AUC) for predictive ability of the score was 0.71 (95% confidence interval [CI]: 0.68 to 0.74), indicating good predictive ability. Risk score performance was generally similar with internal cross-validation (AUC = 0.69; 95% CI: 0.66 to 0.73) and external validation in HPTN 035 (AUC = 0.70; 95% CI: 0.65 to 0.75) and FEM-PrEP (AUC = 0.58; 95% CI: 0.51 to 0.65). A discrete set of characteristics that can be easily assessed in clinical and research settings was predictive of HIV acquisition over 1 year. The use of a validated risk score could improve efficiency of recruitment into HIV prevention research and inform scale-up of HIV prevention strategies in women at highest risk.

Terminal - Tactical Separation Assured Flight Environment (T-TSafe)

NASA Technical Reports Server (NTRS)

Verma, Savita Arora; Tang, Huabin; Ballinger, Debbi

2011-01-01

The Tactical Separation Assured Flight Environment (TSAFE) has been previously tested as a conflict detection and resolution tool in the en-route phase of flight. Fast time simulations of a terminal version of this tool called Terminal TSAFE (T-TSAFE) have shown promise over the current conflict detection tools. It has shown to have fewer false alerts (as low as 2 per hour) and better prediction to conflict time than Conflict Alert. The tool will be tested in the simulated terminal area of Los Angeles International Airport, in a Human-in-the-loop experiment to identify controller procedures and information requirements. The simulation will include comparisons of T-TSAFE with NASA's version of Conflict Alert. Also, some other variables such as altitude entry by the controller, which improve T-TSAFE's predictions for conflict detection, will be tested. T-TSAFE integrates features of current conflict detection tools such as Automated Terminal Proximity Alert used to alleviate compression errors in the final approach phase. Based on fast-time simulation analysis, the anticipated benefits of T-TSAFE over Conflict Alert include reduced false/missed alerts and increased time to predicted loss of separation. Other metrics that will be used to evaluate the tool's impact on the controller include controller intervention, workload, and situation awareness.

The dynamics of attachment insecurity and paranoid thoughts: An experience sampling study.

PubMed

Sitko, Katarzyna; Varese, Filippo; Sellwood, William; Hammond, Amy; Bentall, Richard

2016-12-30

It has been proposed that insecure attachment can have adverse effects on the course of psychosis once symptoms have emerged. There is longitudinal evidence that increased insecure attachment is associated with increased severity of psychotic symptoms. The present study examined whether in the flow of daily life attachment insecurity fluctuates, whether elevated stress precedes the occurrence of attachment insecurity, and whether elevated attachment insecurity precedes the occurrence of paranoia. Twenty clinical participants with a psychosis-spectrum diagnosis and twenty controls were studied over six consecutive days using the experience sampling method (ESM). The findings revealed that fluctuations in attachment insecurity were significantly higher in the clinical group, that elevated stress predicted a subsequent increase in attachment insecurity, and that elevated attachment insecurity predicted a subsequent increase in paranoia; this effect was not observed in auditory hallucinations once co-occurring symptoms were controlled for. Finally, although previous ESM studies have shown that low self-esteem precedes the occurrence of paranoia, attachment insecurity continued to predict paranoia even when self-esteem was controlled for. The findings suggest that attachment security may be associated with a lower risk of paranoia, and that psychological interventions should address attachment beliefs and work towards establishing a sense of attachment security. Copyright © 2016. Published by Elsevier Ireland Ltd.

Attributions and self-efficacy for physical activity in multiple sclerosis.

PubMed

Nickel, D; Spink, K; Andersen, M; Knox, K

2014-01-01

Self-efficacy is an important predictor of health-related physical activity in multiple sclerosis (MS). While past experiences are believed to influence efficacy beliefs, the explanations individuals provide for these experiences also may be critical. Our objective was to test the hypothesis that perceived success or failure to accumulate 150 min of physical activity in the previous week would moderate the relationship between the attributional dimension of stability and self-efficacy to exercise in the future. Forty-two adults with MS participated in this cross-sectional descriptive study. Participants completed questions assessing physical activity, perceived outcome for meeting the recommended level of endurance activity, attributions for the outcome, and exercise self-efficacy. Results from hierarchical multiple regression revealed a significant main effect for perceived outcome predicting self-efficacy that was qualified by a significant interaction. The final model, which included perceived outcome, stability, and the interaction term, predicted 37% of the variance in exercise self-efficacy, F (3, 38) = 7.27, p = .001. Our findings suggest that the best prediction of self-efficacy in the MS population may include the interaction of specific attributional dimensions with success/failure at meeting the recommended physical activity dose. Attributions may be another target for interventions aimed at increasing the physical activity in MS.

Evaluation of a physical activity intervention for new parents: protocol paper for a randomized trial.

PubMed

Quinlan, Alison; Rhodes, Ryan E; Beauchamp, Mark R; Symons Downs, Danielle; Warburton, Darren E R; Blanchard, Chris M

2017-11-09

Identifying critical life transitions in people's physical activity behaviors may illuminate the most opportune intervention apertures for chronic disease prevention. A substantive evidence base now indicates that parenthood is one of these critical transition points for physical activity decline. This study will examine whether a brief theory-based intervention can prevent a decline in physical activity among new parents over 6 months following intervention. This study protocol represents the first dyad-based physical activity initiative in the parenthood literature involving both mothers and fathers; prior research has focused on only mothers or only fathers (albeit limited), and has shown only short-term changes in physical activity. This study will be investigating whether a theory-based physical activity intervention can maintain or improve moderate to vigorous intensity physical activity measured via accelerometry of new parents over a 6 month period following intervention compared to a control group. This study is a 6-month longitudinal randomized controlled trial. Parents are measured at baseline (2 months postpartum) with two assessment points at 6 weeks (3.5 months postpartum) and 3 months (5 months postpartum) and a final follow-up assessment at 6 months (8 months postpartum). The content of the theory-based intervention was derived from the results of our prior longitudinal trial of new parents using an adapted theory of planned behavior framework to predict changes in physical activity. A total of 152 couples have been recruited to date. Sixteen couples dropped out after baseline and a total of 88 couples have completed their 6-month measures. If the intervention proves successful, couple-based physical activity promotion efforts among parents could be a promising avenue to pursue to help mitigate the declines of physical activity levels during parenthood. These findings could inform public health materials and practitioners. This trial has been registered with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health on April 19, 2014. The registration ID is NCT02290808 .

Scaling rules for the final decline to extinction

PubMed Central

Griffen, Blaine D.; Drake, John M.

2009-01-01

Space–time scaling rules are ubiquitous in ecological phenomena. Current theory postulates three scaling rules that describe the duration of a population's final decline to extinction, although these predictions have not previously been empirically confirmed. We examine these scaling rules across a broader set of conditions, including a wide range of density-dependent patterns in the underlying population dynamics. We then report on tests of these predictions from experiments using the cladoceran Daphnia magna as a model. Our results support two predictions that: (i) the duration of population persistence is much greater than the duration of the final decline to extinction and (ii) the duration of the final decline to extinction increases with the logarithm of the population's estimated carrying capacity. However, our results do not support a third prediction that the duration of the final decline scales inversely with population growth rate. These findings not only support the current standard theory of population extinction but also introduce new empirical anomalies awaiting a theoretical explanation. PMID:19141422

The potential for technology in brief interventions for substance use, and during-session prediction of computer-delivered brief intervention response.

PubMed

Ondersma, Steven J; Grekin, Emily R; Svikis, Dace

2011-01-01

We first provide an overview of the potential of technology in the area of brief interventions for substance use and describe recent projects from our lab that are illustrative of that potential. Second, we present data from a study of during-session predictors of brief intervention response. In a sample of postpartum women (N = 39), several variables showed promise as predictors of later drug use, and a brief index derived from them predicted abstinence with a sensitivity of .7 and a specificity of .89. This promising approach and initial study findings support the importance of future research in this area.

Predicting Growth in Word Level Reading Skills in Children With Developmental Dyslexia Using an Object Rhyming Functional Neuroimaging Task.

PubMed

Farris, Emily A; Ring, Jeremiah; Black, Jeffrey; Lyon, G Reid; Odegard, Timothy N

2016-04-01

An object rhyming task that does not require text reading and is suitable for younger children was used to predict gains in word level reading skills following an intensive 2-year reading intervention for children with developmental dyslexia. The task evoked activation in bilateral inferior frontal regions. Growth in untimed pseudoword reading was associated with increased pre-intervention activation of the left inferior frontal gyrus, and growth in timed word reading was associated with pre-intervention activation of the left and right inferior frontal gyri. These analyses help identify pre-intervention factors that facilitate reading skill improvements in children with developmental dyslexia.

Epidemic Process over the Commute Network in a Metropolitan Area

PubMed Central

Yashima, Kenta; Sasaki, Akira

2014-01-01

An understanding of epidemiological dynamics is important for prevention and control of epidemic outbreaks. However, previous studies tend to focus only on specific areas, indicating that application to another area or intervention strategy requires a similar time-consuming simulation. Here, we study the epidemic dynamics of the disease-spread over a commute network, using the Tokyo metropolitan area as an example, in an attempt to elucidate the general properties of epidemic spread over a commute network that could be used for a prediction in any metropolitan area. The model is formulated on the basis of a metapopulation network in which local populations are interconnected by actual commuter flows in the Tokyo metropolitan area and the spread of infection is simulated by an individual-based model. We find that the probability of a global epidemic as well as the final epidemic sizes in both global and local populations, the timing of the epidemic peak, and the time at which the epidemic reaches a local population are mainly determined by the joint distribution of the local population sizes connected by the commuter flows, but are insensitive to geographical or topological structure of the network. Moreover, there is a strong relation between the population size and the time that the epidemic reaches this local population and we are able to determine the reason for this relation as well as its dependence on the commute network structure and epidemic parameters. This study shows that the model based on the connection between the population size classes is sufficient to predict both global and local epidemic dynamics in metropolitan area. Moreover, the clear relation of the time taken by the epidemic to reach each local population can be used as a novel measure for intervention; this enables efficient intervention strategies in each local population prior to the actual arrival. PMID:24905831

Defining and Predicting Patterns of Early Response in a Web-Based Intervention for Depression

PubMed Central

Arndt, Alice; Rubel, Julian; Berger, Thomas; Schröder, Johanna; Späth, Christina; Meyer, Björn; Greiner, Wolfgang; Gräfe, Viola; Hautzinger, Martin; Fuhr, Kristina; Rose, Matthias; Nolte, Sandra; Löwe, Bernd; Hohagen, Fritz; Klein, Jan Philipp; Moritz, Steffen

2017-01-01

Background Web-based interventions for individuals with depressive disorders have been a recent focus of research and may be an effective adjunct to face-to-face psychotherapy or pharmacological treatment. Objective The aim of our study was to examine the early change patterns in Web-based interventions to identify differential effects. Methods We applied piecewise growth mixture modeling (PGMM) to identify different latent classes of early change in individuals with mild-to-moderate depression (n=409) who underwent a CBT-based web intervention for depression. Results Overall, three latent classes were identified (N=409): Two early response classes (n=158, n=185) and one early deterioration class (n=66). Latent classes differed in terms of outcome (P<.001) and adherence (P=.03) in regard to the number of modules (number of modules with a duration of at least 10 minutes) and the number of assessments (P<.001), but not in regard to the overall amount of time using the system. Class membership significantly improved outcome prediction by 24.8% over patient intake characteristics (P<.001) and significantly added to the prediction of adherence (P=.04). Conclusions These findings suggest that in Web-based interventions outcome and adherence can be predicted by patterns of early change, which can inform treatment decisions and potentially help optimize the allocation of scarce clinical resources. PMID:28600278

Managing fatigue after cancer treatment: development of RESTORE, a web-based resource to support self-management.

PubMed

Foster, C; Calman, L; Grimmett, C; Breckons, M; Cotterell, P; Yardley, L; Joseph, J; Hughes, S; Jones, R; Leonidou, C; Armes, J; Batehup, L; Corner, J; Fenlon, D; Lennan, E; Morris, C; Neylon, A; Ream, E; Turner, L; Richardson, A

2015-08-01

The aim of this study is to co-create an evidence-based and theoretically informed web-based intervention (RESTORE) designed to enhance self-efficacy to live with cancer-related fatigue (CRF) following primary cancer treatment. A nine-step process informed the development of the intervention: (1) review of empirical literature; (2) review of existing patient resources; (3) establish theoretical framework; (4) establish design team with expertise in web-based interventions, CRF and people affected by cancer; (5) develop prototype intervention; (6) user testing phase 1; (7) refinement of prototype; (8) user testing phase 2; and (9) develop final intervention. Key stakeholders made a critical contribution at every step of intervention development, and user testing, which involved an iterative process and resulted in the final intervention. The RESTORE intervention has five sessions; sessions 1 and 2 include an introduction to CRF and goal setting. Sessions 3-5 can be tailored to user preference and are designed to cover areas of life where CRF may have an impact: home and work life, personal relationships and emotional adjustment. It is feasible to systematically 'co-create' an evidence-based and theory-driven web-based self-management intervention to support cancer survivors living with the consequences of cancer and its treatment. This is the first account of the development of a web-based intervention to support self-efficacy to manage CRF. An exploratory trial to test the feasibility and acceptability of RESTORE is now warranted. Copyright © 2015 John Wiley & Sons, Ltd.

Immediate Post Intervention Effects of Two Brief Youth Suicide Prevention Interventions.

ERIC Educational Resources Information Center

Randell, Brooke P.; Eggert, Leona L.; Pike, Kenneth C.

2001-01-01

Two brief suicide prevention protocols, Counselors CARE (C-Care) and C-Care plus a 12-session Coping and Support Training (CAST) peer group intervention, were evaluated for immediate post intervention effects. The predicted patterns of change were assessed using trend analyses on data available from three repeated measures. Both groups experienced…

Using predictive analytics and big data to optimize pharmaceutical outcomes.

PubMed

Hernandez, Inmaculada; Zhang, Yuting

2017-09-15

The steps involved, the resources needed, and the challenges associated with applying predictive analytics in healthcare are described, with a review of successful applications of predictive analytics in implementing population health management interventions that target medication-related patient outcomes. In healthcare, the term big data typically refers to large quantities of electronic health record, administrative claims, and clinical trial data as well as data collected from smartphone applications, wearable devices, social media, and personal genomics services; predictive analytics refers to innovative methods of analysis developed to overcome challenges associated with big data, including a variety of statistical techniques ranging from predictive modeling to machine learning to data mining. Predictive analytics using big data have been applied successfully in several areas of medication management, such as in the identification of complex patients or those at highest risk for medication noncompliance or adverse effects. Because predictive analytics can be used in predicting different outcomes, they can provide pharmacists with a better understanding of the risks for specific medication-related problems that each patient faces. This information will enable pharmacists to deliver interventions tailored to patients' needs. In order to take full advantage of these benefits, however, clinicians will have to understand the basics of big data and predictive analytics. Predictive analytics that leverage big data will become an indispensable tool for clinicians in mapping interventions and improving patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Interventional Application of Shape Memory Polymer Foam Final Report CRADA No. TC-02067-03

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

Maitland, D.; Metzger, M. F.

This was a collaborative effort between The Regents of the University of California, Lawrence Livermore National Laboratory (LLNL) and Sierra Interventions, LLC, to develop shape memory polymer foam devices for treating hemorrhagic stroke.

78 FR 56910 - Proposed Information Collection for Public Comment: Impact of Housing and Services Interventions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-16

... months), this final wave of data is critical to understanding how families fare after an intervention... the proper performance of the functions of the agency, including whether the information will have...

Multi-scale modeling for the transmission of influenza and the evaluation of interventions toward it.

PubMed

Guo, Dongmin; Li, King C; Peters, Timothy R; Snively, Beverly M; Poehling, Katherine A; Zhou, Xiaobo

2015-03-11

Mathematical modeling of influenza epidemic is important for analyzing the main cause of the epidemic and finding effective interventions towards it. The epidemic is a dynamic process. In this process, daily infections are caused by people's contacts, and the frequency of contacts can be mainly influenced by their cognition to the disease. The cognition is in turn influenced by daily illness attack rate, climate, and other environment factors. Few existing methods considered the dynamic process in their models. Therefore, their prediction results can hardly be explained by the mechanisms of epidemic spreading. In this paper, we developed a heterogeneous graph modeling approach (HGM) to describe the dynamic process of influenza virus transmission by taking advantage of our unique clinical data. We built social network of studied region and embedded an Agent-Based Model (ABM) in the HGM to describe the dynamic change of an epidemic. Our simulations have a good agreement with clinical data. Parameter sensitivity analysis showed that temperature influences the dynamic of epidemic significantly and system behavior analysis showed social network degree is a critical factor determining the size of an epidemic. Finally, multiple scenarios for vaccination and school closure strategies were simulated and their performance was analyzed.

Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments.

PubMed

Naqvi, Nasir H; Morgenstern, Jon

2015-01-01

Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

Efficacy of an evidence-based clinical decision support in primary care practices: a randomized clinical trial.

PubMed

McGinn, Thomas G; McCullagh, Lauren; Kannry, Joseph; Knaus, Megan; Sofianou, Anastasia; Wisnivesky, Juan P; Mann, Devin M

2013-09-23

There is consensus that incorporating clinical decision support into electronic health records will improve quality of care, contain costs, and reduce overtreatment, but this potential has yet to be demonstrated in clinical trials. To assess the influence of a customized evidence-based clinical decision support tool on the management of respiratory tract infections and on the effectiveness of integrating evidence at the point of care. In a randomized clinical trial, we implemented 2 well-validated integrated clinical prediction rules, namely, the Walsh rule for streptococcal pharyngitis and the Heckerling rule for pneumonia. INTERVENTIONS AND MAIN OUTCOMES AND MEASURES: The intervention group had access to the integrated clinical prediction rule tool and chose whether to complete risk score calculators, order medications, and generate progress notes to assist with complex decision making at the point of care. The intervention group completed the integrated clinical prediction rule tool in 57.5% of visits. Providers in the intervention group were significantly less likely to order antibiotics than the control group (age-adjusted relative risk, 0.74; 95% CI, 0.60-0.92). The absolute risk of the intervention was 9.2%, and the number needed to treat was 10.8. The intervention group was significantly less likely to order rapid streptococcal tests compared with the control group (relative risk, 0.75; 95% CI, 0.58-0.97; P= .03). The integrated clinical prediction rule process for integrating complex evidence-based clinical decision report tools is of relevant importance for national initiatives, such as Meaningful Use. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01386047.

Accuracy of physician-estimated probability of brain injury in children with minor head trauma.

PubMed

Daymont, Carrie; Klassen, Terry P; Osmond, Martin H

2015-07-01

To evaluate the accuracy of physician estimates of the probability of intracranial injury in children with minor head trauma. This is a subanalysis of a large prospective multicentre cohort study performed from July 2001 to November 2005. During data collection for the derivation of a clinical prediction rule for children with minor head trauma, physicians indicated their estimate of the probability of brain injury visible on computed tomography (P-Injury) and the probability of injury requiring intervention (P-Intervention) by choosing one of the following options: 0%, 1%, 2%, 3%, 4%, 5%, 10%, 20%, 30%, 40%, 50%, 75%, 90%, and 100%. We compared observed frequencies to expected frequencies of injury using Pearson's χ2-test in analyses stratified by the level of each type of predicted probability and by year of age. In 3771 eligible subjects, the mean predicted risk was 4.6% (P-Injury) and 1.4% (P-Intervention). The observed frequency of injury was 4.1% (any injury) and 0.6% (intervention). For all levels of P-Injury from 1% to 40%, the observed frequency of injury was consistent with the expected frequency. The observed frequencies for the 50%, 75%, and 90% levels were lower than expected (p<0.05). For estimates of P-Intervention, the observed frequency was consistently higher than the expected frequency. Physicians underestimated risk for infants (mean P-Intervention 6.2%, actual risk 12.3%, p<0.001). Physician estimates of probability of any brain injury in children were collectively accurate for children with low and moderate degrees of predicted risk. Risk was underestimated in infants.

Modeling Clinical Outcomes in Prostate Cancer: Application and Validation of the Discrete Event Simulation Approach.

PubMed

Pan, Feng; Reifsnider, Odette; Zheng, Ying; Proskorovsky, Irina; Li, Tracy; He, Jianming; Sorensen, Sonja V

2018-04-01

Treatment landscape in prostate cancer has changed dramatically with the emergence of new medicines in the past few years. The traditional survival partition model (SPM) cannot accurately predict long-term clinical outcomes because it is limited by its ability to capture the key consequences associated with this changing treatment paradigm. The objective of this study was to introduce and validate a discrete-event simulation (DES) model for prostate cancer. A DES model was developed to simulate overall survival (OS) and other clinical outcomes based on patient characteristics, treatment received, and disease progression history. We tested and validated this model with clinical trial data from the abiraterone acetate phase III trial (COU-AA-302). The model was constructed with interim data (55% death) and validated with the final data (96% death). Predicted OS values were also compared with those from the SPM. The DES model's predicted time to chemotherapy and OS are highly consistent with the final observed data. The model accurately predicts the OS hazard ratio from the final data cut (predicted: 0.74; 95% confidence interval [CI] 0.64-0.85 and final actual: 0.74; 95% CI 0.6-0.88). The log-rank test to compare the observed and predicted OS curves indicated no statistically significant difference between observed and predicted curves. However, the predictions from the SPM based on interim data deviated significantly from the final data. Our study showed that a DES model with properly developed risk equations presents considerable improvements to the more traditional SPM in flexibility and predictive accuracy of long-term outcomes. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomised clinical trial.

PubMed

Halvari, Anne E Münster; Halvari, Hallgeir; Williams, Geoffrey C; Deci, Edward L

2017-02-01

To test the hypothesis that a Self-Determination Theory (SDT) intervention designed to promote oral health care competence in an autonomy-supportive way would predict change in caries competence relative to standard care. Further, to test the SDT process path-model hypotheses with: (1) the intervention and individual differences in relative autonomous locus of causality (RALOC) predicting increases in caries competence, which in turn would positively predict dental attendance; (2) RALOC negatively predicting dental anxiety, which would negatively predict dental attendance; (3) RALOC and caries disease referred to the dentist after an autonomy-supportive clinical exam directly positively predicting dental attendance; and (4) the intervention moderating the link between RALOC and dental attendance. A randomised two-group experiment was conducted at a dental clinic with 138 patients (M age  = 23.31 yr., SD = 3.5), with pre- and post-measures in a period of 5.5 months. The experimental model was supported. The SDT path model fit the data well and supported the hypotheses explaining 63% of the variance in dental attendance. Patients personality (RALOC) and hygienists promoting oral health care competence in an autonomy-supportive way, performance of autonomy-supportive clinical exams and reductions of anxiety for dental treatment have important practical implications for patients' dental attendance.

The effect of a multi-component smoking cessation intervention in African American women residing in public housing.

PubMed

Andrews, Jeannette O; Felton, Gwen; Ellen Wewers, Mary; Waller, Jennifer; Tingen, Martha

2007-02-01

The purpose of this study was to test the effectiveness of a multi-component smoking cessation intervention in African American women residing in public housing. The intervention consisted of: (a) nurse led behavioral/empowerment counseling; (b) nicotine replacement therapy; and, (c) community health workers to enhance smoking self-efficacy, social support, and spiritual well-being. The results showed a 6-month continuous smoking abstinence of 27.5% and 5.7% in the intervention and comparison groups. Changes in social support and smoking self-efficacy over time predicted smoking abstinence, and self-efficacy mediated 6-month smoking abstinence outcomes. Spiritual well-being did not predict or mediate smoking abstinence outcomes. These findings support the use of a nurse/community health worker model to deliver culturally tailored behavioral interventions with marginalized communities.

Evaluating Fidelity: Predictive Validity for a Measure of Competent Adherence to the Oregon Model of Parent Management Training

PubMed Central

Forgatch, Marion S.; Patterson, Gerald R.; DeGarmo, David S.

2006-01-01

When efficacious interventions are implemented in real-world conditions, it is important to evaluate whether or not the programs are practiced as intended. This article presents the Fidelity of Implementation Rating System (FIMP), an observation-based measure assessing competent adherence to the Oregon model of Parent Management Training (PMTO). FIMP evaluates 5 dimensions of competent adherence to PMTO (i.e., knowledge, structure, teaching skill, clinical skill, and overall effectiveness) specified in the intervention model. Predictive validity for FIMP was evaluated with a subsample of stepfamilies participating in a preventive PMTO intervention. As hypothesized, high FIMP ratings predicted change in observed parenting practices from baseline to 12 months. The rigor and scope of adherence measures are discussed. PMID:16718302

Using Fuzzy-Trace Theory to Understand and Improve Health Judgments, Decisions, and Behaviors: A Literature Review

PubMed Central

Blalock, Susan J.; Reyna, Valerie F.

2016-01-01

Objective Fuzzy-trace theory is a dual-process model of memory, reasoning, judgment, and decision making that contrasts with traditional expectancy-value approaches. We review the literature applying fuzzy-trace theory to health with three aims: evaluating whether the theory’s basic distinctions have been validated empirically in the domain of health; determining whether these distinctions are useful in assessing, explaining, and predicting health-related psychological processes; and determining whether the theory can be used to improve health judgments, decisions, or behaviors, especially in comparison to other approaches. Methods We conducted a literature review using PubMed, PsycInfo, and Web of Science to identify empirical peer-reviewed papers that applied fuzzy-trace theory, or central constructs of the theory, to investigate health judgments, decisions, or behaviors. Results 79 studies were identified, over half published since 2012, spanning a wide variety of conditions and populations. Study findings supported the prediction that verbatim and gist representations are distinct constructs that can be retrieved independently using different cues. Although gist-based reasoning was usually associated with improved judgment and decision making, four sources of bias that can impair gist reasoning were identified. Finally, promising findings were reported from intervention studies that used fuzzy-trace theory to improve decision making and decrease unhealthy risk taking. Conclusions Despite large gaps in the literature, most studies supported all three aims. By focusing on basic psychological processes that underlie judgment and decision making, fuzzy-trace theory provides insights into how individuals make decisions involving health risks and suggests innovative intervention approaches to improve health outcomes. PMID:27505197

The longitudinal effect of concept map teaching on critical thinking of nursing students.

PubMed

Lee, Weillie; Chiang, Chi-Hua; Liao, I-Chen; Lee, Mei-Li; Chen, Shiah-Lian; Liang, Tienli

2013-10-01

Concept map is a useful cognitive tool for enhancing a student's critical thinking by encouraging students to process information deeply for understanding. However, there is limited understanding of longitudinal effects of concept map teaching on students' critical thinking. The purpose of the study was to investigate the growth and the other factors influencing the development of critical thinking in response to concept map as an interventional strategy for nursing students in a two-year registered nurse baccalaureate program. The study was a quasi-experimental and longitudinal follow-up design. A convenience sample was drawn from a university in central Taiwan. Data were collected at different time points at the beginning of each semester using structured questionnaires including Critical Thinking Scale and Approaches to Learning and Studying. The intervention of concept map teaching was given at the second semester in the Medical-Surgical Nursing course. The results of the findings revealed student started with a mean critical thinking score of 41.32 and decreased at a rate of 0.42 over time, although not significant. After controlling for individual characteristics, the final model revealed that the experimental group gained a higher critical thinking score across time than the control group. The best predictive variables of initial status in critical thinking were without clinical experience and a higher pre-test score. The growth in critical thinking was predicted best by a lower pre-test score, and lower scores on surface approach and organized study. Our study suggested that concept map is a useful teaching strategy to enhance student critical thinking. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Survey of Interventional Radiology Awareness Among Final-Year Medical Students in a European Country

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

Leong, Sum; Keeling, Aoife N.; Lee, Michael J., E-mail: mlee@rcsi.i

2009-07-15

Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%)more » replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract the brightest talents to the field.« less

A survey of interventional radiology awareness among final-year medical students in a European country.

PubMed

Leong, Sum; Keeling, Aoife N; Lee, Michael J

2009-07-01

Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract the brightest talents to the field.

Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust?☆

PubMed Central

Angott, Andrea M.; Comerford, David A.; Ubel, Peter A.

2014-01-01

Objective To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. Method In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants’ quality-of-life and mood forecasts for life with an ostomy were assessed. Results Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. Conclusion Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. Practice implications Video interventions focusing on patients’ experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy. PMID:23177398

Classification via Clustering for Predicting Final Marks Based on Student Participation in Forums

ERIC Educational Resources Information Center

Lopez, M. I.; Luna, J. M.; Romero, C.; Ventura, S.

2012-01-01

This paper proposes a classification via clustering approach to predict the final marks in a university course on the basis of forum data. The objective is twofold: to determine if student participation in the course forum can be a good predictor of the final marks for the course and to examine whether the proposed classification via clustering…

Psychosis prediction and clinical utility in familial high-risk studies: Selective review, synthesis, and implications for early detection and intervention

PubMed Central

Shah, Jai L.; Tandon, Neeraj; Keshavan, Matcheri S.

2016-01-01

Aim Accurate prediction of which individuals will go on to develop psychosis would assist early intervention and prevention paradigms. We sought to review investigations of prospective psychosis prediction based on markers and variables examined in longitudinal familial high-risk (FHR) studies. Methods We performed literature searches in MedLine, PubMed and PsycINFO for articles assessing performance characteristics of predictive clinical tests in FHR studies of psychosis. Studies were included if they reported one or more predictive variables in subjects at FHR for psychosis. We complemented this search strategy with references drawn from articles, reviews, book chapters and monographs. Results Across generations of familial high-risk projects, predictive studies have investigated behavioral, cognitive, psychometric, clinical, neuroimaging, and other markers. Recent analyses have incorporated multivariate and multi-domain approaches to risk ascertainment, although with still generally modest results. Conclusions While a broad range of risk factors has been identified, no individual marker or combination of markers can at this time enable accurate prospective prediction of emerging psychosis for individuals at FHR. We outline the complex and multi-level nature of psychotic illness, the myriad of factors influencing its development, and methodological hurdles to accurate and reliable prediction. Prospects and challenges for future generations of FHR studies are discussed in the context of early detection and intervention strategies. PMID:23693118

Strengthening Head Start Families: Reducing High Risk through Mental Health Prevention/Intervention (MHP/IP). Overview and Final Report.

ERIC Educational Resources Information Center

Hutchison, Mary Ann; And Others

The Mental Health Prevention/Intervention Project (MHP/IP) was designed to provide and assess comprehensive and effective mental health services to Head Start children, parents, families, and staff. Sponsored by the Latin American Civic Association (LACA) in Los Angeles, the 14-month intervention was implemented and assessed on three levels: (1)…

Early Intervention and AAC: What a Difference 30 Years Makes.

PubMed

Romski, MaryAnn; Sevcik, Rose A; Barton-Hulsey, Andrea; Whitmore, Ani S

2015-01-01

This article provides an overview of early intervention and AAC over the 30-year period since the founding of the journal Augmentative and Alternative Communication in 1985. It discusses the global context for early intervention and addresses issues pertaining to young children from birth to 6 years of age. It provides a narrative review and synthesis of the evidence base in AAC and early intervention. Finally, it provides implications for practice and future research directions.

[Design and validation of an instrument to assess families at risk for health problems].

PubMed

Puschel, Klaus; Repetto, Paula; Solar, María Olga; Soto, Gabriela; González, Karla

2012-04-01

There is a paucity of screening instruments with a high clinical predictive value to identify families at risk and therefore, develop focused interventions in primary care. To develop an easy to apply screening instrument with a high clinical predictive value to identify families with a higher health vulnerability. In the first stage of the study an instrument with a high content validity was designed through a review of existent instruments, qualitative interviews with families and expert opinions following a Delphi approach of three rounds. In the second stage, concurrent validity was tested through a comparative analysis between the pilot instrument and a family clinical interview conducted to 300 families randomly selected from a population registered at a primary care clinic in Santiago. The sampling was blocked based on the presence of diabetes, depression, child asthma, behavioral disorders, presence of an older person or the lack of previous conditions among family members. The third stage, was directed to test the clinical predictive validity of the instrument by comparing the baseline vulnerability obtained by the instrument and the change in clinical status and health related quality of life perceptions of the family members after nine months of follow-up. The final SALUFAM instrument included 13 items and had a high internal consistency (Cronbach's alpha: 0.821), high test re-test reproducibility (Pearson correlation: 0.84) and a high clinical predictive value for clinical deterioration (Odds ratio: 1.826; 95% confidence intervals: 1.101-3.029). SALUFAM instrument is applicable, replicable, has a high content validity, concurrent validity and clinical predictive value.

Structures of the recurrence plot of heart rate variability signal as a tool for predicting the onset of paroxysmal atrial fibrillation.

PubMed

Mohebbi, Maryam; Ghassemian, Hassan; Asl, Babak Mohammadzadeh

2011-05-01

This paper aims to propose an effective paroxysmal atrial fibrillation (PAF) predictor which is based on the analysis of the heart rate variability (HRV) signal. Predicting the onset of PAF, based on non-invasive techniques, is clinically important and can be invaluable in order to avoid useless therapeutic interventions and to minimize the risks for the patients. This method consists of four steps: Preprocessing, feature extraction, feature reduction, and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the HRV signal is extracted. In the next step, the recurrence plot (RP) of HRV signal is obtained and six features are extracted to characterize the basic patterns of the RP. These features consist of length of longest diagonal segments, average length of the diagonal lines, entropy, trapping time, length of longest vertical line, and recurrence trend. In the third step, these features are reduced to three features by the linear discriminant analysis (LDA) technique. Using LDA not only reduces the number of the input features, but also increases the classification accuracy by selecting the most discriminating features. Finally, a support vector machine-based classifier is used to classify the HRV signals. The performance of the proposed method in prediction of PAF episodes was evaluated using the Atrial Fibrillation Prediction Database which consists of both 30-minutes ECG recordings end just prior to the onset of PAF and segments at least 45 min distant from any PAF events. The obtained sensitivity, specificity, and positive predictivity were 96.55%, 100%, and 100%, respectively.

Reframing school dropout as a public health issue.

PubMed

Freudenberg, Nicholas; Ruglis, Jessica

2007-10-01

Good education predicts good health, and disparities in health and in educational achievement are closely linked. Despite these connections, public health professionals rarely make reducing the number of students who drop out of school a priority, although nearly one-third of all students in the United States and half of black, Latino, and American Indian students do not graduate from high school on time. In this article, we summarize knowledge on the health benefits of high school graduation and discuss the pathways by which graduating from high school contributes to good health. We examine strategies for reducing school dropout rates with a focus on interventions that improve school completion rates by improving students' health. Finally, we recommend actions health professionals can take to reframe the school dropout rate as a public health issue and to improve school completion rates in the United States.

Hispanic perspectives on sexual harassment and social support.

PubMed

Cortina, Lilia M

2004-05-01

Bridging the social support, sexual victimization, and cultural psychology literatures, this study examines social-support processes in the context of sexual harassment and Hispanic American culture. Surveys were administered to a community sample of Hispanic American working women, 249 of whom described some encounter with sexual harassment at work. Regression results provided mixed backing for hypotheses about support-seeking behavior, which appeared largely dependent on the social power of the harassment perpetrator. Additional findings upheld predictions about support-perception patterns; harassed women perceived more supportive social reactions when they turned to informal networks of friends and family, but responses were less positive when they turned to formal, organizational sources. Finally, as expected, perceived support and acculturation interacted to moderate relations between sexual harassment and job satisfaction. The article concludes with implications for research and interventions related to social support and sexual harassment.

The Utility of Brief Experimental Analysis and Extended Intervention Analysis in Selecting Effective Mathematics Interventions

ERIC Educational Resources Information Center

Mong, Michael D.; Mong, Kristi W.

2012-01-01

The present study evaluated the utility of brief experimental analysis (BEA) in predicting effective interventions for increasing the math fluency of 3 elementary students identified as having math skill deficits. Baseline data were collected followed by implementation of a BEA consisting of the following interventions: cover, copy, and compare,…

Participant Adherence Indicators Predict Changes in Blood Pressure, Anthropometric Measures, and Self-Reported Physical Activity in a Lifestyle Intervention: HUB City Steps

ERIC Educational Resources Information Center

Thomson, Jessica L.; Landry, Alicia S.; Zoellner, Jamie M.; Connell, Carol; Madson, Michael B.; Molaison, Elaine Fontenot; Yadrick, Kathy

2015-01-01

The objective of this secondary analysis was to evaluate the utility of several participant adherence indicators for predicting changes in clinical, anthropometric, dietary, fitness, and physical activity (PA) outcomes in a lifestyle intervention, HUB City Steps, conducted in a southern, African American cohort in 2010. HUB City Steps was a…

Effectiveness of a Predictive Algorithm in the Prevention of Exercise-Induced Hypoglycemia in Type 1 Diabetes.

PubMed

Abraham, Mary B; Davey, Raymond; O'Grady, Michael J; Ly, Trang T; Paramalingam, Nirubasini; Fournier, Paul A; Roy, Anirban; Grosman, Benyamin; Kurtz, Natalie; Fairchild, Janice M; King, Bruce R; Ambler, Geoffrey R; Cameron, Fergus; Jones, Timothy W; Davis, Elizabeth A

2016-09-01

Sensor-augmented pump therapy (SAPT) with a predictive algorithm to suspend insulin delivery has the potential to reduce hypoglycemia, a known obstacle in improving physical activity in patients with type 1 diabetes. The predictive low glucose management (PLGM) system employs a predictive algorithm that suspends basal insulin when hypoglycemia is predicted. The aim of this study was to determine the efficacy of this algorithm in the prevention of exercise-induced hypoglycemia under in-clinic conditions. This was a randomized, controlled cross-over study in which 25 participants performed 2 consecutive sessions of 30 min of moderate-intensity exercise while on basal continuous subcutaneous insulin infusion on 2 study days: a control day with SAPT alone and an intervention day with SAPT and PLGM. The predictive algorithm suspended basal insulin when sensor glucose was predicted to be below the preset hypoglycemic threshold in 30 min. We tested preset hypoglycemic thresholds of 70 and 80 mg/dL. The primary outcome was the requirement for hypoglycemia treatment (symptomatic hypoglycemia with plasma glucose <63 mg/dL or plasma glucose <50 mg/dL) and was compared in both control and intervention arms. Results were analyzed in 19 participants. In the intervention arm with both thresholds, only 6 participants (32%) required treatment for hypoglycemia compared with 17 participants (89%) in the control arm (P = 0.003). In participants with a 2-h pump suspension on intervention days, the plasma glucose was 84 ± 12 and 99 ± 24 mg/dL at thresholds of 70 and 80 mg/dL, respectively. SAPT with PLGM reduced the need for hypoglycemia treatment after moderate-intensity exercise in an in-clinic setting.

Student Characteristics as Predictors of Teachers’ Implementation of a Kindergarten Readiness Program

PubMed Central

Voegler-Lee, Mary Ellen; Kupersmidt, Janis B.; Field, Samuel; Willoughby, Michael T.

2017-01-01

Recent years have seen increasing numbers of classroom-based interventions designed to enhance the school readiness of at-risk preschoolers. Even the most comprehensive, well-designed programs can suffer from limited effectiveness due to low-frequency implementation by teachers. The current study presents findings from the Building Bridges project (BB), an integrated program targeting school readiness in Head Start and low-income child care centers. Previous studies have reported the role of teacher-level and program-level characteristics in predicting teacher implementation of an intervention. The present study examines the role of student characteristics—language and math ability, social skills, and behavioral functioning—in predicting implementation exposure. These associations were examined in the context of program type (Head Start, child care) and intervention condition (consultation, no consultation). 88 classrooms (41 Head Start, 47 child care) participated in the BB intervention. Implementation exposure was predicted by several distinct student characteristics. Teachers whose students exhibited poorer language skills implemented significantly more BB activities, a finding that was consistent across program types and intervention conditions. A marginally significant trend was identified for oppositional behavior when interacted with intervention group in that teachers whose students demonstrated higher rates of oppositional behavior implemented fewer intervention activities when they did not have a consultant. Teachers in child care centers with a BB consultant had higher rates of implementation than did teachers in all other groups. These findings provide important information regarding the student-level characteristics that should be evaluated in order to optimize implementation of an intervention. PMID:22615022

Predicting miRNA targets for head and neck squamous cell carcinoma using an ensemble method.

PubMed

Gao, Hong; Jin, Hui; Li, Guijun

2018-01-01

This study aimed to uncover potential microRNA (miRNA) targets in head and neck squamous cell carcinoma (HNSCC) using an ensemble method which combined 3 different methods: Pearson's correlation coefficient (PCC), Lasso and a causal inference method (i.e., intervention calculus when the directed acyclic graph (DAG) is absent [IDA]), based on Borda count election. The Borda count election method was used to integrate the top 100 predicted targets of each miRNA generated by individual methods. Afterwards, to validate the performance ability of our method, we checked the TarBase v6.0, miRecords v2013, miRWalk v2.0 and miRTarBase v4.5 databases to validate predictions for miRNAs. Pathway enrichment analysis of target genes in the top 1,000 miRNA-messenger RNA (mRNA) interactions was conducted to focus on significant KEGG pathways. Finally, we extracted target genes based on occurrence frequency ≥3. Based on an absolute value of PCC >0.7, we found 33 miRNAs and 288 mRNAs for further analysis. We extracted 10 target genes with predicted frequencies not less than 3. The target gene MYO5C possessed the highest frequency, which was predicted by 7 different miRNAs. Significantly, a total of 8 pathways were identified; the pathways of cytokine-cytokine receptor interaction and chemokine signaling pathway were the most significant. We successfully predicted target genes and pathways for HNSCC relying on miRNA expression data, mRNA expression profile, an ensemble method and pathway information. Our results may offer new information for the diagnosis and estimation of the prognosis of HNSCC.

Does adolescent risk taking imply weak executive function? A prospective study of relations between working memory performance, impulsivity, and risk taking in early adolescence.

PubMed

Romer, Daniel; Betancourt, Laura M; Brodsky, Nancy L; Giannetta, Joan M; Yang, Wei; Hurt, Hallam

2011-09-01

Studies of brain development suggest that the increase in risk taking observed during adolescence may be due to insufficient prefrontal executive function compared to a more rapidly developing subcortical motivation system. We examined executive function as assessed by working memory ability in a community sample of youth (n = 387, ages 10 to 12 at baseline) in three annual assessments to determine its relation to two forms of impulsivity (sensation seeking and acting without thinking) and a wide range of risk and externalizing behavior. Using structural equation modeling, we tested a model in which differential activation of the dorsal and ventral striatum produces imbalance in the function of these brain regions. For youth high in sensation seeking, both regions were predicted to develop with age. However, for youth high in the tendency to act without thinking, the ventral striatum was expected to dominate. The model predicted that working memory ability would exhibit (1) early weakness in youth high in acting without thinking but (2) growing strength in those high in sensation seeking. In addition, it predicted that (3) acting without thinking would be more strongly related to risk and externalizing behavior than sensation seeking. Finally, it predicted that (4) controlling for acting without thinking, sensation seeking would predict later increases in risky and externalizing behavior. All four of these predictions were confirmed. The results indicate that the rise in sensation seeking that occurs during adolescence is not accompanied by a deficit in executive function and therefore requires different intervention strategies from those for youth whose impulsivity is characterized by early signs of acting without thinking. © 2011 Blackwell Publishing Ltd.

A Final Approach Trajectory Model for Current Operations

NASA Technical Reports Server (NTRS)

Gong, Chester; Sadovsky, Alexander

2010-01-01

Predicting accurate trajectories with limited intent information is a challenge faced by air traffic management decision support tools in operation today. One such tool is the FAA's Terminal Proximity Alert system which is intended to assist controllers in maintaining safe separation of arrival aircraft during final approach. In an effort to improve the performance of such tools, two final approach trajectory models are proposed; one based on polynomial interpolation, the other on the Fourier transform. These models were tested against actual traffic data and used to study effects of the key final approach trajectory modeling parameters of wind, aircraft type, and weight class, on trajectory prediction accuracy. Using only the limited intent data available to today's ATM system, both the polynomial interpolation and Fourier transform models showed improved trajectory prediction accuracy over a baseline dead reckoning model. Analysis of actual arrival traffic showed that this improved trajectory prediction accuracy leads to improved inter-arrival separation prediction accuracy for longer look ahead times. The difference in mean inter-arrival separation prediction error between the Fourier transform and dead reckoning models was 0.2 nmi for a look ahead time of 120 sec, a 33 percent improvement, with a corresponding 32 percent improvement in standard deviation.

Disruption to functional networks in neonates with perinatal brain injury predicts motor skills at 8 months.

PubMed

Linke, Annika C; Wild, Conor; Zubiaurre-Elorza, Leire; Herzmann, Charlotte; Duffy, Hester; Han, Victor K; Lee, David S C; Cusack, Rhodri

2018-01-01

Functional connectivity magnetic resonance imaging (fcMRI) of neonates with perinatal brain injury could improve prediction of motor impairment before symptoms manifest, and establish how early brain organization relates to subsequent development. This cohort study is the first to describe and quantitatively assess functional brain networks and their relation to later motor skills in neonates with a diverse range of perinatal brain injuries. Infants ( n  = 65, included in final analyses: n  = 53) were recruited from the neonatal intensive care unit (NICU) and were stratified based on their age at birth (premature vs. term), and on whether neuropathology was diagnosed from structural MRI. Functional brain networks and a measure of disruption to functional connectivity were obtained from 14 min of fcMRI acquired during natural sleep at term-equivalent age. Disruption to connectivity of the somatomotor and frontoparietal executive networks predicted motor impairment at 4 and 8 months. This disruption in functional connectivity was not found to be driven by differences between clinical groups, or by any of the specific measures we captured to describe the clinical course. fcMRI was predictive over and above other clinical measures available at discharge from the NICU, including structural MRI. Motor learning was affected by disruption to somatomotor networks, but also frontoparietal executive networks, which supports the functional importance of these networks in early development. Disruption to these two networks might be best addressed by distinct intervention strategies.

A controlled evaluation of an eating disorders primary prevention videotape using the Elaboration Likelihood Model of Persuasion.

PubMed

Withers, Giselle F; Twigg, Kylie; Wertheim, Eleanor H; Paxton, Susan J

2002-11-01

The aim was to extend findings related to a previously reported eating disorders prevention program by comparing treatment and control groups, adding a follow-up, and examining whether receiver characteristics, personal relevance and need for cognition (NFC), could predict attitude change in early adolescent girls. Grade 7 girls were either shown a brief prevention videotape on dieting and body image (n = 104) or given no intervention (n = 114). All girls completed pre-, post- and 1-month follow-up questionnaires. The intervention group resulted in significantly more positive changes in attitude and knowledge at post-intervention, but only in knowledge at follow-up. There was no strong evidence that pre-intervention characteristics of recipients predicted responses to the videotape intervention when changes were compared to the control group. This prevention videotape appeared to have positive immediate effects, but additional intervention (e.g., booster sessions) may be required for longer-term change. Copyright 2002 Elsevier Science Inc.

Hybrid Model Predictive Control for Sequential Decision Policies in Adaptive Behavioral Interventions.

PubMed

Dong, Yuwen; Deshpande, Sunil; Rivera, Daniel E; Downs, Danielle S; Savage, Jennifer S

2014-06-01

Control engineering offers a systematic and efficient method to optimize the effectiveness of individually tailored treatment and prevention policies known as adaptive or "just-in-time" behavioral interventions. The nature of these interventions requires assigning dosages at categorical levels, which has been addressed in prior work using Mixed Logical Dynamical (MLD)-based hybrid model predictive control (HMPC) schemes. However, certain requirements of adaptive behavioral interventions that involve sequential decision making have not been comprehensively explored in the literature. This paper presents an extension of the traditional MLD framework for HMPC by representing the requirements of sequential decision policies as mixed-integer linear constraints. This is accomplished with user-specified dosage sequence tables, manipulation of one input at a time, and a switching time strategy for assigning dosages at time intervals less frequent than the measurement sampling interval. A model developed for a gestational weight gain (GWG) intervention is used to illustrate the generation of these sequential decision policies and their effectiveness for implementing adaptive behavioral interventions involving multiple components.

Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients.

PubMed

Kontodimopoulos, Nick; Bozios, Panagiotis; Yfantopoulos, John; Niakas, Dimitris

2013-04-01

The purpose of this methodological study was to to provide insight into the under-addressed issue of the longitudinal predictive ability of mapping models. Post-intervention predicted and reported utilities were compared, and the effect of disease severity on the observed differences was examined. A cohort of 120 rheumatoid arthritis (RA) patients (60.0% female, mean age 59.0) embarking on therapy with biological agents completed the Modified Health Assessment Questionnaire (MHAQ) and the EQ-5D at baseline, and at 3, 6 and 12 months post-intervention. OLS regression produced a mapping equation to estimate post-intervention EQ-5D utilities from baseline MHAQ data. Predicted and reported utilities were compared with t test, and the prediction error was modeled, using fixed effects, in terms of covariates such as age, gender, time, disease duration, treatment, RF, DAS28 score, predicted and reported EQ-5D. The OLS model (RMSE = 0.207, R(2) = 45.2%) consistently underestimated future utilities, with a mean prediction error of 6.5%. Mean absolute differences between reported and predicted EQ-5D utilities at 3, 6 and 12 months exceeded the typically reported MID of the EQ-5D (0.03). According to the fixed-effects model, time, lower predicted EQ-5D and higher DAS28 scores had a significant impact on prediction errors, which appeared increasingly negative for lower reported EQ-5D scores, i.e., predicted utilities tended to be lower than reported ones in more severe health states. This study builds upon existing research having demonstrated the potential usefulness of mapping disease-specific instruments onto utility measures. The specific issue of longitudinal validity is addressed, as mapping models derived from baseline patients need to be validated on post-therapy samples. The underestimation of post-treatment utilities in the present study, at least in more severe patients, warrants further research before it is prudent to conduct cost-utility analyses in the context of RA by means of the MHAQ alone.

Patient survival and surgical re-intervention predictors for intracapsular hip fractures.

PubMed

González Quevedo, David; Mariño, Iskandar Tamimi; Sánchez Siles, Juan Manuel; Escribano, Esther Romero; Granero Molina, Esther Judith; Enrique, David Bautista; Smoljanović, Tomislav; Pareja, Francisco Villanueva

2017-08-01

Choosing between total hip replacement (THR) and partial hip replacement (PHR) for patients with intracapsular hip fractures is often based on subjective factors. Predicting the survival of these patients and risk of surgical re-intervention is essential to select the most adequate implant. We conducted a retrospective cohort study on mortality of patients over 70 years with intracapsular hip fractures who were treated between January 2010 and December 2013, with either PHR or THR. Patients' information was withdrawn from our local computerized database. The age-adjusted Charlson comorbidity index (ACCI) and American Society of Anesthesiologists (ASA) score were calculated for all patients. The patients were followed for 2 years after surgery. Survival and surgical re-intervention rates were compared between the two groups using a Multivariate Cox proportional hazard model. A total of 356 individuals were included in this study. At 2 years of follow-up, 221 (74.4%) of the patients with ACCI score≤7 were still alive, in contrast to only 20 (29.0%) of those with ACCI score>7. In addition, 201 (76.2%) of the patients with ASA score≤3 were still alive after 2 years, compared to 30 (32.6%) of individuals with ASA >3. Patients with the ACCI score>7, and ASA score>3 had a significant increase in all-cause 2-year mortality (adjusted hazard ratio of 3.2, 95% CI 2.2-4.6; and 3.12, 95% CI 2.2-4.5, respectively). Patients with an ASA score>3 had a quasi-significant increase in the re-intervention risk (adjusted hazard ratio 2.2, 95% CI 1.0-5.1). The sensitivity, specificity, positive predictive value and negative predictive values of ACCI in predicting 2-year mortality were 39.2%, 91.1%, 71%, and 74.4%, respectively. On the other hand, the sensitivity, specificity, positive predictive value and negative predictive values of ASA score in predicting 2-year mortality were 49.6%, 79.1%, 67.4%, and 76.1%, respectively. Both ACCI and ASA scales were able to predict the 2-year survival of patients with intracapsular hip fractures. The ASA scale was also able to predict the risk of re-intervention in these patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parental feeding practices predict authoritative, authoritarian, and permissive parenting styles.

PubMed

Hubbs-Tait, Laura; Kennedy, Tay Seacord; Page, Melanie C; Topham, Glade L; Harrist, Amanda W

2008-07-01

Our goal was to identify how parental feeding practices from the nutrition literature link to general parenting styles from the child development literature to understand how to target parenting practices to increase effectiveness of interventions. Stand-alone parental feeding practices could be targeted independently. However, parental feeding practices linked to parenting styles require interventions treating underlying family dynamics as a whole. To predict parenting styles from feeding practices and to test three hypotheses: restriction and pressure to eat are positively related whereas responsibility, monitoring, modeling, and encouraging are negatively related to an authoritarian parenting style; responsibility, monitoring, modeling, and encouraging are positively related whereas restriction and pressure to eat are negatively related to an authoritative parenting style; a permissive parenting style is negatively linked with all six feeding practices. Baseline data of a randomized-controlled intervention study. Two hundred thirty-nine parents (93.5% mothers) of first-grade children (134 boys, 105 girls) enrolled in rural public schools. Parental responses to encouraging and modeling questionnaires and the Child Feeding Questionnaire, as well as parenting styles measured by the Parenting Styles and Dimensions Questionnaire. Correlation and regression analyses. Feeding practices explained 21%, 15%, and 8% of the variance in authoritative, authoritarian, and permissive parenting, respectively. Restriction, pressure to eat, and monitoring (negative) significantly predicted an authoritarian style (Hypothesis 1); responsibility, restriction (negative), monitoring, and modeling predicted an authoritative style (Hypothesis 2); and modeling (negative) and restriction significantly predicted a permissive style (Hypothesis 3). Parental feeding practices with young children predict general parenting styles. Interventions that fail to address underlying parenting styles are not likely to be successful.

How "Community" Matters for How People Interact With Information: Mixed Methods Study of Young Men Who Have Sex With Other Men

PubMed Central

Meadowbrooke, Chrysta Cathleen; Loveluck, Jimena; Hickok, Andrew; Bauermeister, Jose Artruro

2013-01-01

Background We lack a systematic portrait of the relationship between community involvement and how people interact with information. Young men who have sex with men (YMSM) are a population for which these relationships are especially salient: their gay community involvement varies and their information technology use is high. YMSM under age 24 are also one of the US populations with the highest risk of HIV/AIDS. Objective To develop, test, and refine a model of gay community involvement (GCI) factors in human-information interaction (HII) as applied to HIV/AIDS information among YMSM, specifically examining the role of Internet use in GCI and HII. Methods Mixed methods included: 1) online questionnaire with 194 YMSM; and 2) qualitative interviews with 19 YMSM with high GCI levels. Recruitment utilized social media, dating websites, health clinics, bars/clubs, and public postings. The survey included questions regarding HIV/AIDS–related information acquisition and use patterns, gay community involvement, risk behaviors, and technology use. For survey data, we tested multiple linear regression models using a series of community- and information-related variables as dependent variables. Independent variables included community- and information-related variables and demographic covariates. We then conducted a recursive path analysis in order to estimate a final model, which we refined through a grounded theory analysis of qualitative interview data. Results Four community-related variables significantly predicted how people interact with information (HII variables): 1) gay community involvement (GCI), 2) social costs of information seeking, 3) network expertise accessibility, and 4) community relevance. GCI was associated with significantly lower perceived social costs of HIV/AIDS information seeking (R 2=0.07). GCI and social costs significantly predicted network expertise accessibility (R 2=0.14). GCI predicted 14% of the variance in community relevance and 9% of the variance in information seeking frequency. Incidental HIV/AIDS information acquisition (IIA) was also significantly predicted by GCI (R 2=0.16). 28% of the variance in HIV/AIDS information use was explained by community relevance, network expertise access, and both IIA and information seeking. The final path model showed good fit: the RSMEA was 0.054 (90% CI: .000-.101); the Chi-square was non-significant (χ2(11)=17.105; P=.105); and the CFI was 0.967. Qualitative findings suggest that the model may be enhanced by including information sharing: organizing events, disseminating messages, encouraging safety, and referring and recommending. Information sharing emerged under conditions of pro-social community value enactment and may have consequences for further HII. YMSM with greater GCI generally used the Internet more, although they chatted online less. Conclusions HIV/AIDS–related HII and associated technology uses are community-embedded processes. The model provides theoretical mediators that may serve as a focus for intervention: 1) valuing HIV/AIDS information, through believing it is relevant to one’s group, and 2) supportive and knowledgeable network members with whom to talk about HIV/AIDS. Pro-social community value endorsement and information sharing may also be important theoretical mediators. Our model could open possibilities for considering how informatics interventions can also be designed as community-level interventions and vice versa. PMID:23428825

Conceptualising and mapping coupled estuary, coast and inner shelf sediment systems

NASA Astrophysics Data System (ADS)

French, Jon; Burningham, Helene; Thornhill, Gillian; Whitehouse, Richard; Nicholls, Robert J.

2016-03-01

Whilst understanding and predicting the effects of coastal change are primarily modelling problems, it is essential that we have appropriate conceptual frameworks for (1) the formalisation of existing knowledge; (2) the formulation of relevant scientific questions and management issues; (3) the implementation and deployment of predictive models; and (4) meaningful engagement involvement of stakeholders. Important progress continues to be made on the modelling front, but our conceptual frameworks have not evolved at a similar pace. Accordingly, this paper presents a new approach that re-engages with formal systems analysis and provides a mesoscale geomorphological context within which the coastal management challenges of the 21st century can be more effectively addressed. Coastal and Estuarine System Mapping (CESM) is founded on an ontology of landforms and human interventions that is partly inspired by the coastal tract concept and its temporal hierarchy of sediment sharing systems, but places greater emphasis on a hierarchy of spatial scales. This extends from coastal regions, through landform complexes, to landforms, the morphological adjustment of which is constrained by diverse forms of human intervention. Crucially, CESM integrates open coastal environments with estuaries and relevant portions of the inner shelf that have previously been treated separately. In contrast to the nesting of littoral cells that has hitherto framed shoreline management planning, CESM charts a complex web of interactions, of which a sub-set of mass transfer pathways defines the sediment budget, and a multitude of human interventions constrains natural landform behaviour. Conducted within a geospatial framework, CESM constitutes a form of knowledge formalisation in which disparate sources of information (published research, imagery, mapping, raw data etc.) are generalised into usable knowledge. The resulting system maps provide a framework for the development and application of predictive models and a repository for the outputs they generate (not least, flux estimates for the major sediment system pathways). They also permit comparative analyses of the relative abundance of landforms and the multi-scale interactions between them. Finally, they articulate scientific understanding of the structure and function of complex geomorphological systems in a way that is transparent and accessible to diverse stakeholder audiences. As our models of mesoscale landform evolution increase in sophistication, CESM provides a platform for a more participatory approach to their application to coastal and estuarine management.

Behavioral Economic Predictors of Brief Alcohol Intervention Outcomes

PubMed Central

Murphy, James G.; Dennhardt, Ashley A.; Martens, Matthew P.; Yurasek, Ali M.; Skidmore, Jessica R.; MacKillop, James; McDevitt-Murphy, Meghan E.

2015-01-01

Objective The present study attempted to determine if behavioral economic indices of elevated alcohol reward value, measured before and immediately after a brief alcohol intervention, predict treatment response. Method Participants were 133 heavy drinking college students (49.6% female, 51.4% male; 64.3% Caucasian, 29.5% African American) who were randomized to one of three conditions: motivational interviewing plus personalized feedback (BMI), computerized personalized feedback intervention (e-CHUG), and assessment only. Results Baseline levels of alcohol demand significantly predicted drinks per week and alcohol problems at 1-month (demand intensity= maximum expenditure) and 6-month (relative discretionary expenditures on alcohol) follow-up. BMI and e-CHUG were associated with an immediate post-session reduction in alcohol demand (p < .001, ηρ2 = .29) that persisted at the 1-month follow-up, with greater post-session reductions in the BMI condition (p = .02, ηρ2 = .06). Reductions in demand intensity and Omax (maximum expenditure) immediately post-intervention significantly predicted drinking reductions at one-month follow up (p = .04, ΔR2 = .02 & p = .01, ΔR2 = .03, respectively). Reductions in relative discretionary expenditures on alcohol at 1-month significantly predicted drinking (p = .002, ΔR2 = .06,) and alcohol problem (p < .001, ΔR2 = .13) reductions at the 6-month follow-up. Conclusions These results suggest that behavioral economic reward value indices may function as risk factors for poor intervention response and as clinically-relevant markers of change in heavy drinkers. PMID:26167945

Derivation and Evaluation of a Risk-Scoring Tool to Predict Participant Attrition in a Lifestyle Intervention Project.

PubMed

Jiang, Luohua; Yang, Jing; Huang, Haixiao; Johnson, Ann; Dill, Edward J; Beals, Janette; Manson, Spero M; Roubideaux, Yvette

2016-05-01

Participant attrition in clinical trials and community-based interventions is a serious, common, and costly problem. In order to develop a simple predictive scoring system that can quantify the risk of participant attrition in a lifestyle intervention project, we analyzed data from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention to prevent diabetes in 36 American Indian and Alaska Native communities. SDPI-DP participants were randomly divided into a derivation cohort (n = 1600) and a validation cohort (n = 801). Logistic regressions were used to develop a scoring system from the derivation cohort. The discriminatory power and calibration properties of the system were assessed using the validation cohort. Seven independent factors predicted program attrition: gender, age, household income, comorbidity, chronic pain, site's user population size, and average age of site staff. Six factors predicted long-term attrition: gender, age, marital status, chronic pain, site's user population size, and average age of site staff. Each model exhibited moderate to fair discriminatory power (C statistic in the validation set: 0.70 for program attrition, and 0.66 for long-term attrition) and excellent calibration. The resulting scoring system offers a low-technology approach to identify participants at elevated risk for attrition in future similar behavioral modification intervention projects, which may inform appropriate allocation of retention resources. This approach also serves as a model for other efforts to prevent participant attrition.

Derivation of indices of socioeconomic status for health services research in Asia

PubMed Central

Earnest, Arul; Ong, Marcus E.H.; Shahidah, Nur; Chan, Angelique; Wah, Win; Thumboo, Julian

2015-01-01

Background Environmental contexts have been shown to predict health behaviours and outcomes either directly or via interaction with individual risk factors. In this paper, we created indexes of socioeconomic disadvantage (SEDI) and socioeconomic advantage (SAI) in Singapore to test the applicability of these concepts in an Asian context. These indices can be used for health service resource allocation, research and advocacy. Methods We used principal component analysis (PCA) to create SEDI and SAI using a structured and iterative process to identify and include influential variables in the final index. Data at the master plan geographical level was obtained from the most recent Singapore census 2010. Results The 3 areas with highest SEDI scores were Outram (120.1), followed by Rochor (111.0) and Downtown Core (110.4). The areas with highest SAI scores were Tanglin, River Valley and Newton. The SAI had 89.6% of variation explained by the final model, as compared to 67.1% for SEDI, and we recommend using both indices in any analysis. Conclusion These indices may prove useful for policy-makers to identify spatially varying risk factors, and in turn help identify geographically targeted intervention programs, which can be more cost effective to conduct. PMID:26844087

Aging, the Central Nervous System, and Mobility in Older Adults: Interventions

PubMed Central

Hausdorff, Jeffrey M.; Studenski, Stephanie A.; Rosano, Caterina; Camicioli, Richard; Alexander, Neil B.; Chen, Wen G.; Lipsitz, Lewis A.; Carlson, Michelle C.

2016-01-01

Background: Research suggests that the central nervous system (CNS) and mobility are closely linked. CNS-mediated mobility impairment may represent a potentially new and prevalent syndrome within the older adult populations. Interventions targeting this group may have the potential to improve mobility and cognition and prevent disability. Methods: In 2012, the Gerontological Society of America (GSA) and the National Institute on Aging (NIA) sponsored a 3-year conference workshop series, “Aging, the CNS, and Mobility.” The goal of this third and final conference was to (i) report on the state of the science of interventions targeting CNS-mediated mobility impairment among community-dwelling older adults and (ii) partnering with the NIA, explore the future of research and intervention design focused on a potentially novel aging syndrome. Results: Evidence was presented in five main intervention areas: (i) pharmacology and diet; (ii) exercise; (iii) electrical stimulation; (iv) sensory stimulation/deprivation; and (v) a combined category of multimodal interventions. Workshop participants identified important gaps in knowledge and key recommendations for future interventions related to recruitment and sample selection, intervention design, and methods to measure effectiveness. Conclusions: In order to develop effective preventive interventions for this prevalent syndrome, multidisciplinary teams are essential particularly because of the complex nature of the syndrome. Additionally, integrating innovative methods into the design of interventions may help researchers better measure complex mechanisms, and finally, the value of understanding the link between the CNS and mobility should be conveyed to researchers across disciplines in order to incorporate cognitive and mobility measurements into study protocols. PMID:27154905

An Integrative Model of Physiological Traits Can be Used to Predict Obstructive Sleep Apnea and Response to Non Positive Airway Pressure Therapy.

PubMed

Owens, Robert L; Edwards, Bradley A; Eckert, Danny J; Jordan, Amy S; Sands, Scott A; Malhotra, Atul; White, David P; Loring, Stephen H; Butler, James P; Wellman, Andrew

2015-06-01

Both anatomical and nonanatomical traits are important in obstructive sleep apnea (OSA) pathogenesis. We have previously described a model combining these traits, but have not determined its diagnostic accuracy to predict OSA. A valid model, and knowledge of the published effect sizes of trait manipulation, would also allow us to predict the number of patients with OSA who might be effectively treated without using positive airway pressure (PAP). Fifty-seven subjects with and without OSA underwent standard clinical and research sleep studies to measure OSA severity and the physiological traits important for OSA pathogenesis, respectively. The traits were incorporated into a physiological model to predict OSA. The model validity was determined by comparing the model prediction of OSA to the clinical diagnosis of OSA. The effect of various trait manipulations was then simulated to predict the proportion of patients treated by each intervention. The model had good sensitivity (80%) and specificity (100%) for predicting OSA. A single intervention on one trait would be predicted to treat OSA in approximately one quarter of all patients. Combination therapy with two interventions was predicted to treat OSA in ∼50% of patients. An integrative model of physiological traits can be used to predict population-wide and individual responses to non-PAP therapy. Many patients with OSA would be expected to be treated based on known trait manipulations, making a strong case for the importance of non-anatomical traits in OSA pathogenesis and the effectiveness of non-PAP therapies. © 2015 Associated Professional Sleep Societies, LLC.

Beyond discrimination: A comparison of calibration methods and clinical usefulness of predictive models of readmission risk.

PubMed

Walsh, Colin G; Sharman, Kavya; Hripcsak, George

2017-12-01

Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions. To select a pragmatic means of calibrating predictive models that requires a minimum amount of validation data and that performs well in practice. To evaluate the impact of miscalibration on utility and cost via clinical usefulness analyses. Observational, retrospective cohort study with electronic health record data from 120,000 inpatient admissions at an urban, academic center in Manhattan. The primary outcome was thirty-day readmission for three causes: all-cause, congestive heart failure, and chronic coronary atherosclerotic disease. Predictive modeling was performed via L1-regularized logistic regression. Calibration methods were compared including Platt Scaling, Logistic Calibration, and Prevalence Adjustment. Performance of predictive modeling and calibration was assessed via discrimination (c-statistic), calibration (Spiegelhalter Z-statistic, Root Mean Square Error [RMSE] of binned predictions, Sanders and Murphy Resolutions of the Brier Score, Calibration Slope and Intercept), and clinical usefulness (utility terms represented as costs). The amount of validation data necessary to apply each calibration algorithm was also assessed. C-statistics by diagnosis ranged from 0.7 for all-cause readmission to 0.86 (0.78-0.93) for congestive heart failure. Logistic Calibration and Platt Scaling performed best and this difference required analyzing multiple metrics of calibration simultaneously, in particular Calibration Slopes and Intercepts. Clinical usefulness analyses provided optimal risk thresholds, which varied by reason for readmission, outcome prevalence, and calibration algorithm. Utility analyses also suggested maximum tolerable intervention costs, e.g., $1720 for all-cause readmissions based on a published cost of readmission of $11,862. Choice of calibration method depends on availability of validation data and on performance. Improperly calibrated models may contribute to higher costs of intervention as measured via clinical usefulness. Decision-makers must understand underlying utilities or costs inherent in the use-case at hand to assess usefulness and will obtain the optimal risk threshold to trigger intervention with intervention cost limits as a result. Copyright © 2017 Elsevier Inc. All rights reserved.

Interactive sections of an Internet-based intervention increase empowerment of chronic back pain patients: randomized controlled trial.

PubMed

Riva, Silvia; Camerini, Anne-Linda; Allam, Ahmed; Schulz, Peter J

2014-08-13

Chronic back pain (CBP) represents a significant public health problem. As one of the most common causes of disability and sick leave, there is a need to develop cost-effective ways, such as Internet-based interventions, to help empower patients to manage their disease. Research has provided evidence for the effectiveness of Internet-based interventions in many fields, but it has paid little attention to the reasons why they are effective. This study aims to assess the impact of interactive sections of an Internet-based self-management intervention on patient empowerment, their management of the disease, and, ultimately, health outcomes. A total of 51 patients were recruited through their health care providers and randomly assigned to either an experimental group with full access to the Internet-based intervention or a control group that was denied access to the interactive sections and knew nothing thereof. The intervention took 8 weeks. A baseline, a mid-term after 4 weeks, and a final assessment after 8 weeks measured patient empowerment, physical exercise, medication misuse, and pain burden. All patients completed the study. Overall, the intervention had a moderate effect (F1.52=2.83, P=.03, η(2)=0.30, d=0.55). Compared to the control group, the availability of interactive sections significantly increased patient empowerment (midterm assessment: mean difference=+1.2, P=.03, d=0.63; final assessment: mean difference=+0.8, P=.09, d=0.44) and reduced medication misuse (midterm assessment: mean difference=-1.5, P=.04, d=0.28; final assessment: mean difference=-1.6, P=.03, d=-0.55) in the intervention group. Both the frequency of physical exercise and pain burden decreased, but to equal measures in both groups. Results suggest that interactive sections as part of Internet-based interventions can positively alter patients' feelings of empowerment and help prevent medication misuse. Detrimental effects were not observed. ClinicalTrials.gov: NCT02114788; http://www.clinicaltrials.gov/ct2/show/NCT02114788 (Archived by WebCite at http://www.webcitation.org/6ROXYVoPR).

Costs and benefits of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease: a randomized controlled trial

PubMed Central

Farias, Catharinne C.; Resqueti, Vanessa; Dias, Fernando A. L.; Borghi-Silva, Audrey; Arena, Ross; Fregonezi, Guilherme A. F.

2014-01-01

Objective The current study evaluated the costs and benefits of a simple aerobic walking program for patients with chronic obstructive pulmonary disease (COPD). Method This was a blinded randomized controlled clinical trial that recruited 72 patients diagnosed with COPD, 40 of whom were included in the study and divided into two groups [control group (CG) and pulmonary rehabilitation group (GPR)]. We assessed pulmonary function, distance covered during the 6-minute walk test (6MWT), respiratory and peripheral muscle strength, health-related quality of life (HRQOL), body composition, and level of activities of daily living (ADLs) before and after an 8-week walking program. The financial costs were calculated according to the pricing table of the Brazilian Unified Health System (SUS). Results Only 34 of the 40 patients remained in the final sample; 16 in the CG and 18 in the GPR (FEV1: 50.9±14% predicted and FEV1: 56±0.5% predicted, respectively). The intervention group exhibited improvements in the 6MWT, sensation of dyspnea and fatigue, work performed, BODE index (p<0.01), HRQOL, ADL level (p<0.001), and lower limb strength (p<0.05). The final mean cost per patient for the GPR was R$ 148.75 (~US$ 75.00) and no patient significantly exceeded this value. However, 2 patients in the CG did exceed this value, incurring a cost of R$ 689.15 (~US$ 345.00). Conclusion Aerobic walking demonstrated significant clinical benefits in a cost-efficient manner in patients with COPD. PMID:24838809

A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives.

PubMed

Zapata-Diomedi, Belen; Gunn, Lucy; Giles-Corti, Billie; Shiell, Alan; Lennert Veerman, J

2018-01-01

The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining the Predictive Validity of a Dynamic Assessment of Decoding to Forecast Response to Tier 2 Intervention

ERIC Educational Resources Information Center

Cho, Eunsoo; Compton, Donald L.; Fuchs, Douglas; Fuchs, Lynn S.; Bouton, Bobette

2014-01-01

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small-group tutoring in a response-to-intervention model. First grade students (n = 134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in…

Predicting DNAPL Source Zone and Plume Response Using Site-Measured Characteristics

DTIC Science & Technology

2017-05-19

FINAL REPORT Predicting DNAPL Source Zone and Plume Response Using Site- Measured Characteristics SERDP Project ER-1613 MAY 2017...Final Report 3. DATES COVERED (From - To) 2007 - 2017 4. TITLE AND SUBTITLE PREDICTING DNAPL SOURCE ZONE AND PLUME RESPONSE USING SITE- MEASURED ...historical record of concentration and head measurements , particularly in the near-source region. For each site considered, currently available data

Baseline Gray- and White Matter Volume Predict Successful Weight Loss in the Elderly

PubMed Central

Mokhtari, Fatemeh; Paolini, Brielle M.; Burdette, Jonathan H.; Marsh, Anthony P.; Rejeski, W. Jack; Laurienti, Paul J.

2016-01-01

Objective The purpose of this study is to investigate if structural brain phenotypes can be used to predict weight loss success following behavioral interventions in older adults that are overweight or obese and have cardiometabolic dysfunction. Methods A support vector machine (SVM) with a repeated random subsampling validation approach was used to classify participants into the upper and lower halves of the weight loss distribution following 18 months of a weight loss intervention. Predictions were based on baseline brain gray matter (GM) and white matter (WM) volume from 52 individuals that completed the intervention and a magnetic resonance imaging session. Results The SVM resulted in an average classification accuracy of 72.62 % based on GM and WM volume. A receiver operating characteristic analysis indicated that classification performance was robust based on an area under the curve of 0.82. Conclusions Our findings suggest that baseline brain structure is able to predict weight loss success following 18 months of treatment. The identification of brain structure as a predictor of successful weight loss is an innovative approach to identifying phenotypes for responsiveness to intensive lifestyle interventions. This phenotype could prove useful in future research focusing on the tailoring of treatment for weight loss. PMID:27804273

Model-on-Demand Predictive Control for Nonlinear Hybrid Systems With Application to Adaptive Behavioral Interventions

PubMed Central

Nandola, Naresh N.; Rivera, Daniel E.

2011-01-01

This paper presents a data-centric modeling and predictive control approach for nonlinear hybrid systems. System identification of hybrid systems represents a challenging problem because model parameters depend on the mode or operating point of the system. The proposed algorithm applies Model-on-Demand (MoD) estimation to generate a local linear approximation of the nonlinear hybrid system at each time step, using a small subset of data selected by an adaptive bandwidth selector. The appeal of the MoD approach lies in the fact that model parameters are estimated based on a current operating point; hence estimation of locations or modes governed by autonomous discrete events is achieved automatically. The local MoD model is then converted into a mixed logical dynamical (MLD) system representation which can be used directly in a model predictive control (MPC) law for hybrid systems using multiple-degree-of-freedom tuning. The effectiveness of the proposed MoD predictive control algorithm for nonlinear hybrid systems is demonstrated on a hypothetical adaptive behavioral intervention problem inspired by Fast Track, a real-life preventive intervention for improving parental function and reducing conduct disorder in at-risk children. Simulation results demonstrate that the proposed algorithm can be useful for adaptive intervention problems exhibiting both nonlinear and hybrid character. PMID:21874087

Simultaneous 3D–2D image registration and C-arm calibration: Application to endovascular image-guided interventions

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

Mitrović, Uroš; Pernuš, Franjo; Likar, Boštjan

Purpose: Three-dimensional to two-dimensional (3D–2D) image registration is a key to fusion and simultaneous visualization of valuable information contained in 3D pre-interventional and 2D intra-interventional images with the final goal of image guidance of a procedure. In this paper, the authors focus on 3D–2D image registration within the context of intracranial endovascular image-guided interventions (EIGIs), where the 3D and 2D images are generally acquired with the same C-arm system. The accuracy and robustness of any 3D–2D registration method, to be used in a clinical setting, is influenced by (1) the method itself, (2) uncertainty of initial pose of the 3Dmore » image from which registration starts, (3) uncertainty of C-arm’s geometry and pose, and (4) the number of 2D intra-interventional images used for registration, which is generally one and at most two. The study of these influences requires rigorous and objective validation of any 3D–2D registration method against a highly accurate reference or “gold standard” registration, performed on clinical image datasets acquired in the context of the intervention. Methods: The registration process is split into two sequential, i.e., initial and final, registration stages. The initial stage is either machine-based or template matching. The latter aims to reduce possibly large in-plane translation errors by matching a projection of the 3D vessel model and 2D image. In the final registration stage, four state-of-the-art intrinsic image-based 3D–2D registration methods, which involve simultaneous refinement of rigid-body and C-arm parameters, are evaluated. For objective validation, the authors acquired an image database of 15 patients undergoing cerebral EIGI, for which accurate gold standard registrations were established by fiducial marker coregistration. Results: Based on target registration error, the obtained success rates of 3D to a single 2D image registration after initial machine-based and template matching and final registration involving C-arm calibration were 36%, 73%, and 93%, respectively, while registration accuracy of 0.59 mm was the best after final registration. By compensating in-plane translation errors by initial template matching, the success rates achieved after the final stage improved consistently for all methods, especially if C-arm calibration was performed simultaneously with the 3D–2D image registration. Conclusions: Because the tested methods perform simultaneous C-arm calibration and 3D–2D registration based solely on anatomical information, they have a high potential for automation and thus for an immediate integration into current interventional workflow. One of the authors’ main contributions is also comprehensive and representative validation performed under realistic conditions as encountered during cerebral EIGI.« less

Prediction of adult height by Tanner-Whitehouse method in young Caucasian male athletes.

PubMed

Ostojic, S M

2013-04-01

Although the accuracy of final height prediction using skeletal age development has been confirmed in many studies for children treated for congenital primary hypothyroidism, short normal children, constitutionally tall children, no studies compared the predicted adult height at young age with final stature in athletic population. In this study, the intention was to investigate to what extent the Tanner-Whitehouse (TW) method is adequate for prediction of final stature in young Caucasian male athletes. Prospective observational study. Plain radiographs of the left hand and wrist were obtained from 477 athletic children (ranging in age from 8.0 to 17.9 years) who came to the outpatient clinic between 2000 and 2011 for adult height estimation, with no orthopedic trauma suspected. Adult height was estimated using bone age rates according to TW method. Height was measured both at baseline and follow-up (at the age of 19 years). No significant difference was found between the estimated adult height (184.9 ± 9.7 cm) and final stature (185.6 ± 9.6 cm) [95% confidence interval (CI) 1.61-3.01, P = 0.55]. The relationship between estimated and final adult height was high (r = 0.96). Bland-Altman analysis confirmed that the 95% of differences between estimated adult height and final stature lie between limits of agreement (mean ± 2 SD) (-5.84 and 4.52 cm). TW method is an accurate method of predicting adult height in male normal-growing athletic boys.

Lung protection: an intervention for tidal volume reduction in a teaching intensive care unit.

PubMed

Briva, Arturo; Gaiero, Cristina

2016-01-01

To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside. In parallel, predicted body weight was estimated from knee height and included in clinical charts. One hundred fifty-nine patients were included. Predicted body weight assessed by knee height instead of visual evaluation revealed that the delivered tidal volume was significantly higher than predicted. After the inclusion of predicted body weight, we observed a sustained reduction in delivered tidal volume from a mean (standard error) of 8.97 ± 0.32 to 7.49 ± 0.19mL/kg (p < 0.002). Furthermore, the protocol adherence was subsequently sustained for 12 months (delivered tidal volume 7.49 ± 0.54 versus 7.62 ± 0.20mL/kg; p = 0.103). The lack of a reliable method to estimate the predicted body weight is a significant impairment for the application of a worldwide standard of care during mechanical ventilation. A combined intervention based on education and repeated feedbacks promoted sustained tidal volume education during the study period (12 months).

The added predictive value of biphasic events in ST analysis of the fetal electrocardiogram for intrapartum fetal monitoring.

PubMed

Becker, Jeroen H; Krikhaar, Anniek; Schuit, Ewoud; Mårtendal, Annika; Maršál, Karel; Kwee, Anneke; Visser, Gerard H A; Amer-Wåhlin, Isis

2015-02-01

To study the predictive value of biphasic ST-events for interventions for suspected fetal distress and adverse neonatal outcome, when using ST-analysis of the fetal electrocardiogram (FECG) for intrapartum fetal monitoring. Prospective cohort study. Three academic hospitals in Sweden. Women in labor with a high-risk singleton fetus in cephalic position beyond 36 weeks of gestation. In women in labor who were monitored with conventional cardiotocography, ST-waveform analysis was recorded and concealed. Traces with biphasic ST-events of the FECG (index) were compared with traces without biphasic events of the FECG. The ability of biphasic events to predict interventions for suspected fetal distress and adverse outcome was assessed using univariable and multivariable logistic regression analyses. Interventions for suspected fetal distress and adverse outcome (defined as presence of metabolic acidosis (i.e. umbilical cord pH <7.05 and base deficit in extracellular fluid >12 mmol), umbilical cord pH <7.00, 5-min Apgar score <7, admittance to neonatal intensive care unit or perinatal death). Although the presence of biphasic events of the FECG was associated with more interventions for fetal distress and an increased risk of adverse outcome compared with cases with no biphasic events, the presence of significant (i.e. intervention advised according to cardiotocography interpretation) biphasic events showed no independent association with interventions for fetal distress [odds ratio (OR) 1.71, 95% confidence interval (CI) 0.65-4.50] or adverse outcome (OR 1.96, 95% CI 0.74-5.24). The presence of significant biphasic events did not discriminate in the prediction of interventions for fetal distress or adverse outcome. Therefore, biphasic events in relation to ST-analysis monitoring during birth should be omitted if future studies confirm our findings. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

C-A4-01: Computerized Clinical Decision Support During Drug Ordering for Long-term Care Residents With Renal Insufficiency

PubMed Central

Field, Terry S; Rochon, Paula; Lee, Monica; Gavendo, Linda; Baril, Joann L; Gurwitz, Jerry H

2010-01-01

Objective: To determine whether a computerized clinical decision support system (CDSS) providing patient specific recommendations in real- time improves the quality of prescribing for long-term care residents with renal insufficiency. Design: A randomized trial within the long-stay units of a large long-term care facility. Randomization was within blocks by unit type. Alerts related to medication prescribing for residents with renal insufficiency were displayed to prescribers in the intervention units and hidden but tracked in control units. Measurement: The proportions of final drug orders that were appropriate were compared between intervention and control units within alert categories: recommended medication doses; recommended administration frequencies; recommendations to avoid the drug; 4) warnings of missing information. Results: The rates of alerts were nearly equal in the intervention and control units: 2.5 per 1000 resident days in the intervention units and 2.4 in the control units. The proportions of dose alerts for which the final drug orders were appropriate were similar between the intervention and control units (relative risk 0.95, 95% confidence interval 0.83, 1.1). For the remaining alert categories significantly higher proportions of final drug orders were appropriate in the intervention units: relative risk 2.4 for maximum frequency (1.4, 4.4); 2.6 for drugs that should be avoided (1.4, 5.0); and 1.8 for alerts to acquire missing information (1.1, 3.4). Overall, final drug orders were appropriate significantly more often than a relative risk 1.2 (1.0, 1.4). By tracking personnel time and expenditures, we estimated the cost of developing the CDSS as $48,668.57. Drug costs saved during the 12 months of the trial are estimated at $2,137. Conclusion: Clinical decision support for physicians prescribing medications for long-term care residents with renal insufficiency can improve the quality of prescribing decisions. However, patient well-being and quality of care rather than the business case related to cost savings are likely to be the key drivers for adoption of this HIT application.

Reverse-engineering the genetic circuitry of a cancer cell with predicted intervention in chronic lymphocytic leukemia.

PubMed

Vallat, Laurent; Kemper, Corey A; Jung, Nicolas; Maumy-Bertrand, Myriam; Bertrand, Frédéric; Meyer, Nicolas; Pocheville, Arnaud; Fisher, John W; Gribben, John G; Bahram, Seiamak

2013-01-08

Cellular behavior is sustained by genetic programs that are progressively disrupted in pathological conditions--notably, cancer. High-throughput gene expression profiling has been used to infer statistical models describing these cellular programs, and development is now needed to guide orientated modulation of these systems. Here we develop a regression-based model to reverse-engineer a temporal genetic program, based on relevant patterns of gene expression after cell stimulation. This method integrates the temporal dimension of biological rewiring of genetic programs and enables the prediction of the effect of targeted gene disruption at the system level. We tested the performance accuracy of this model on synthetic data before reverse-engineering the response of primary cancer cells to a proliferative (protumorigenic) stimulation in a multistate leukemia biological model (i.e., chronic lymphocytic leukemia). To validate the ability of our method to predict the effects of gene modulation on the global program, we performed an intervention experiment on a targeted gene. Comparison of the predicted and observed gene expression changes demonstrates the possibility of predicting the effects of a perturbation in a gene regulatory network, a first step toward an orientated intervention in a cancer cell genetic program.

Informing alcohol interventions for student service members/veterans: Normative perceptions and coping strategies.

PubMed

Miller, Mary Beth; Brett, Emma I; Leavens, Eleanor L; Meier, Ellen; Borsari, Brian; Leffingwell, Thad R

2016-06-01

The current study aimed to inform future interventions for heavy alcohol use and problems among college students by examining the utility of normative perceptions and coping strategies in predicting alcohol use among student service members/Veterans (SSM/Vs). SSM/Vs and civilian students (N=319) at a large university in the Southern Plains completed self-report measures of demographics, alcohol use and related behaviors, and coping strategies. Both SSM/Vs and civilian students significantly overestimated the typical weekly drinking quantities and frequencies of same-sex students on campus. Among SSM/Vs, normative perceptions of typical student (not military-specific) drinking and substance-related coping strategies significantly predicted drinks consumed per week, while substance-related coping predicted alcohol-related consequences. Despite the theoretical importance of similarity to normative referents, military-specific norms did not significantly improve the prediction of SSM/Vs' personal drinking behavior. Moreover, neither typical student nor military-specific norms predicted alcohol-related consequences among SSM/Vs after accounting for substance-related coping strategies. Future research may examine the efficacy of descriptive normative feedback and the importance of military-specific norms in alcohol interventions for SSM/Vs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Informing Alcohol Interventions for Student Service Members/Veterans: Normative Perceptions and Coping Strategies

PubMed Central

Miller, Mary Beth; Brett, Emma I.; Leavens, Eleanor L.; Meier, Ellen; Borsari, Brian; Leffingwell, Thad R.

2016-01-01

Objective The current study aimed to inform future interventions for heavy alcohol use and problems among college students by examining the utility of normative perceptions and coping strategies in predicting alcohol use among student service members/Veterans (SSM/Vs). Methods SSM/Vs and civilian students (N = 319) at a large university in the Southern Plains completed self-report measures of demographics, alcohol use and related behaviors, and coping strategies. Results Both SSM/Vs and civilian students significantly overestimated the typical weekly drinking quantities and frequencies of same-sex students on campus. Among SSM/Vs, normative perceptions of typical student (not military-specific) drinking and substance-related coping strategies significantly predicted drinks consumed per week, while substance-related coping predicted alcohol-related consequences. Conclusions Despite the theoretical importance of similarity to normative referents, military-specific norms did not significantly improve the prediction of SSM/Vs’ personal drinking behavior. Moreover, neither typical student nor military-specific norms predicted alcohol-related consequences among SSM/Vs after accounting for substance-related coping strategies. Future research may examine the efficacy of descriptive normative feedback and the importance of military-specific norms in alcohol interventions for SSM/Vs. PMID:26894552

Predicting success in an online parenting intervention: the role of child, parent, and family factors.

PubMed

Dittman, Cassandra K; Farruggia, Susan P; Palmer, Melanie L; Sanders, Matthew R; Keown, Louise J

2014-04-01

The present study involved an examination of the extent to which a wide range of child, parent, family, and program-related factors predicted child behavior and parenting outcomes after participation in an 8-session online version of the Triple P-Positive Parenting Program. Participants were mothers and fathers of 97 children aged between 3 and 8 years displaying elevated levels of disruptive behavior problems. For both mothers and fathers, poorer child behavior outcomes at postintervention were predicted by the number of sessions of the intervention completed by the family. For mothers, postintervention child behavior was also predicted by the quality of the mother-child relationship at baseline; for fathers, baseline child behavior severity was an additional predictor. Mothers' postintervention ineffective parenting was predicted by session completion and preintervention levels of ineffective parenting, whereas the only predictor of fathers' ineffective parenting at postintervention was preintervention levels of ineffective parenting. Socioeconomic risk, parental adjustment, and father participation in the intervention were not significant predictors of mother- or father-reported treatment outcomes. The implications of the findings for the provision of online parenting support are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Estimating Controller Intervention Probabilities for Optimized Profile Descent Arrivals

NASA Technical Reports Server (NTRS)

Meyn, Larry A.; Erzberger, Heinz; Huynh, Phu V.

2011-01-01

Simulations of arrival traffic at Dallas/Fort-Worth and Denver airports were conducted to evaluate incorporating scheduling and separation constraints into advisories that define continuous descent approaches. The goal was to reduce the number of controller interventions required to ensure flights maintain minimum separation distances of 5 nmi horizontally and 1000 ft vertically. It was shown that simply incorporating arrival meter fix crossing-time constraints into the advisory generation could eliminate over half of the all predicted separation violations and more than 80% of the predicted violations between two arrival flights. Predicted separation violations between arrivals and non-arrivals were 32% of all predicted separation violations at Denver and 41% at Dallas/Fort-Worth. A probabilistic analysis of meter fix crossing-time errors is included which shows that some controller interventions will still be required even when the predicted crossing-times of the advisories are set to add a 1 or 2 nmi buffer above the minimum in-trail separation of 5 nmi. The 2 nmi buffer was shown to increase average flight delays by up to 30 sec when compared to the 1 nmi buffer, but it only resulted in a maximum decrease in average arrival throughput of one flight per hour.

Predicting Response to Treatment in a Tier 2 Supplemental Vocabulary Intervention

ERIC Educational Resources Information Center

Kelley, Elizabeth; Leary, Emily; Goldstein, Howard

2018-01-01

Purpose: To effectively implement a response to intervention approach, there is a need for timely and specific information about student learning in response to treatment to ensure that treatment decisions are appropriate. This exploratory study examined responsivity to a supplemental, Tier 2 vocabulary intervention delivered to preschool children…

Beyond the usual suspects: target group- and behavior-specific factors add to a theory-based sun protection intervention for teenagers.

PubMed

Schüz, Natalie; Eid, Michael

2013-10-01

Sun protection standards among teenagers are low while sun exposure peaks in this age group. Study 1 explores predictors of adolescent protection intentions and exposure behavior. Study 2 tests the effectiveness of an intervention based on these predictors. Study 1(cross-sectional, N = 207, ages 15-18) and Study 2 (RCT, N = 253, ages 13-19) were conducted in schools. Path models were used to analyze data. Self-efficacy (β = .26, p < .001) and time perspective (β = .17, p = .014) were the strongest predictors of intentions; appearance motivation (β = .54, p < .001) and intention (β = -.18, p = .015) predicted behavior. The intervention effected changes in all predictors except self-efficacy. Changes in outcome expectancies (β = .19, p < .001) and time perspective (β = .09, p = .039) predicted changes in intention, while changes in intention (β = -.17, p = .002) and appearance motivation (β = .29, p < .001) predicted behavior changes. Target group- and behavior-specific intervention components are as important for changes in intentions and behavior as components derived from common health behavior theories.

Preventing Depression in Final Year Secondary Students: School-Based Randomized Controlled Trial

PubMed Central

Perry, Yael; Werner-Seidler, Aliza; Calear, Alison; Mackinnon, Andrew; King, Catherine; Scott, Jan; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Batterham, Philip J

2017-01-01

Background Depression often emerges for the first time during adolescence. There is accumulating evidence that universal depression prevention programs may have the capacity to reduce the impact of depression when delivered in the school environment. Objective This trial investigated the effectiveness of SPARX-R, a gamified online cognitive behavior therapy intervention for the prevention of depression relative to an attention-matched control intervention delivered to students prior to facing a significant stressor—final secondary school exams. It was hypothesized that delivering a prevention intervention in advance of a stressor would reduce depressive symptoms relative to the control group. Methods A cluster randomized controlled trial was conducted in 10 government schools in Sydney, Australia. Participants were 540 final year secondary students (mean 16.7 [SD 0.51] years), and clusters at the school level were randomly allocated to SPARX-R or the control intervention. Interventions were delivered weekly in 7 modules, each taking approximately 20 to 30 minutes to complete. The primary outcome was symptoms of depression as measured by the Major Depression Inventory. Intention-to-treat analyses were performed. Results Compared to controls, participants in the SPARX-R condition (n=242) showed significantly reduced depression symptoms relative to the control (n=298) at post-intervention (Cohen d=0.29) and 6 months post-baseline (d=0.21) but not at 18 months post-baseline (d=0.33). Conclusions This is the first trial to demonstrate a preventive effect on depressive symptoms prior to a significant and universal stressor in adolescents. It demonstrates that an online intervention delivered in advance of a stressful experience can reduce the impact of such an event on the potential development or exacerbation of depression. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12614000316606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365986 (Archived by WebCite at http://www.webcitation.org/ 6u7ou1aI9) PMID:29097357

The Efficacy of Endoscopic Palliation of Obstructive Jaundice in Hepatocellular Carcinoma

PubMed Central

Park, Semi; Park, Jeong Youp; Chung, Moon Jae; Chung, Jae Bock; Park, Seung Woo; Han, Kwang-Hyub; Song, Si Young

2014-01-01

Purpose Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. Materials and Methods From 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks. Results Clinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1±5.3 mg/dL vs. 23.1±10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p≤0.001). Conclusion Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC. PMID:25048484

[Ethical intervention in pragmatic regime].

PubMed

Maesschalck, Marc

2012-01-01

This article analyzes the impact of the neo-pragmatist turn in social sciences from the point of view of the method of ethical intervention. It focuses specifically on the idea of building a "learning community" as the horizon for strengthening participative 'capacitation'. It finally points at the limits of such a perspective, from the point of view of institutional building of new subjectivities through and beyond the practices proposed by ethical interventions.

Parental Licensure and Its Sanction.

ERIC Educational Resources Information Center

Gordon, Robert A.

1996-01-01

Suggests the use of scenario analysis in assessing some of the options offered as interventions to adolescent crime prevention, including child protection policies and guardianship, and parent licensing. Also explores the problem of racism and other social concerns in implementing some interventions. Finally, the influence of IQ on sociopathy is…

Behavior and neuroimaging at baseline predict individual response to combined mathematical and working memory training in children.

PubMed

Nemmi, Federico; Helander, Elin; Helenius, Ola; Almeida, Rita; Hassler, Martin; Räsänen, Pekka; Klingberg, Torkel

2016-08-01

Mathematical performance is highly correlated with several general cognitive abilities, including working memory (WM) capacity. Here we investigated the effect of numerical training using a number-line (NLT), WM training (WMT), or the combination of the two on a composite score of mathematical ability. The aim was to investigate if the combination contributed to the outcome, and determine if baseline performance or neuroimaging predict the magnitude of improvement. We randomly assigned 308, 6-year-old children to WMT, NLT, WMT+NLT or a control intervention. Overall, there was a significant effect of NLT but not WMT. The WMT+NLT was the only group that improved significantly more than the controls, although the interaction NLTxWM was non-significant. Higher WM and maths performance predicted larger benefits for WMT and NLT, respectively. Neuroimaging at baseline also contributed significant information about training gain. Different individuals showed as much as a three-fold difference in their responses to the same intervention. These results show that the impact of an intervention is highly dependent on individual characteristics of the child. If differences in responses could be used to optimize the intervention for each child, future interventions could be substantially more effective. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Increasing work-time influence: consequences for flexibility, variability, regularity and predictability.

PubMed

Nabe-Nielsen, Kirsten; Garde, Anne Helene; Aust, Birgit; Diderichsen, Finn

2012-01-01

This quasi-experimental study investigated how an intervention aiming at increasing eldercare workers' influence on their working hours affected the flexibility, variability, regularity and predictability of the working hours. We used baseline (n = 296) and follow-up (n = 274) questionnaire data and interviews with intervention-group participants (n = 32). The work units in the intervention group designed their own intervention comprising either implementation of computerised self-scheduling (subgroup A), collection of information about the employees' work-time preferences by questionnaires (subgroup B), or discussion of working hours (subgroup C). Only computerised self-scheduling changed the working hours and the way they were planned. These changes implied more flexible but less regular working hours and an experience of less predictability and less continuity in the care of clients and in the co-operation with colleagues. In subgroup B and C, the participants ended up discussing the potential consequences of more work-time influence without actually implementing any changes. Employee work-time influence may buffer the adverse effects of shift work. However, our intervention study suggested that while increasing the individual flexibility, increasing work-time influence may also result in decreased regularity of the working hours and less continuity in the care of clients and co-operation with colleagues.

Non-alcoholic fatty liver disease and impaired proinsulin conversion as newly identified predictors of the long-term non-response to a lifestyle intervention for diabetes prevention: results from the TULIP study.

PubMed

Schmid, Vera; Wagner, Robert; Sailer, Corinna; Fritsche, Louise; Kantartzis, Konstantinos; Peter, Andreas; Heni, Martin; Häring, Hans-Ulrich; Stefan, Norbert; Fritsche, Andreas

2017-12-01

Lifestyle intervention is effective to prevent type 2 diabetes. However, a considerable long-term non-response occurs to a standard lifestyle intervention. We investigated which risk phenotypes at baseline and their changes during the lifestyle intervention predict long-term glycaemic non-response to the intervention. Of 300 participants at high risk for type 2 diabetes who participated in a 24 month lifestyle intervention with diet modification and increased physical activity, 190 participants could be re-examined after 8.7 ± 1.6 years. All individuals underwent a five-point 75 g OGTT and measurements of body fat compartments and liver fat content with MRI and spectroscopy at baseline, 9 and 24 months during the lifestyle intervention, and at long-term follow-up. Fasting proinsulin to insulin conversion (PI/I ratio) and insulin sensitivity and secretion were calculated from the OGTT. Non-response to lifestyle intervention was defined as no decrease in glycaemia, i.e. no decrease in AUC for glucose at 0-120 min during OGTT (AUCglucose 0-120 min ). Before the lifestyle intervention, 56% of participants had normal glucose regulation and 44% individuals had impaired fasting glucose and/or impaired glucose tolerance. At long-term follow-up, 11% had developed diabetes. Multivariable regression analysis with adjustment for age, sex, BMI and change in BMI during the lifestyle intervention revealed that baseline insulin secretion and insulin sensitivity, as well as change in insulin sensitivity during the lifestyle intervention, predicted long-term glycaemic control after 9 years. In addition, increased hepatic lipid content as well as impaired fasting proinsulin conversion at baseline were newly detected phenotypes that independently predicted long-term glycaemic control. Increased hepatic lipid content and impaired proinsulin conversion are new predictors, independent of change in body weight, for non-response to lifestyle intervention in addition to the confirmed factors, impaired insulin secretion and insulin sensitivity.

Coparenting Quality During the First Three Months After Birth: The Role of Infant Sleep Quality

PubMed Central

McDaniel, Brandon T.; Teti, Douglas M.

2013-01-01

The transition to parenthood can be stressful for new parents, as parents must learn to take on new roles and responsibilities. Sleep disruption—which has been linked in prior research to parent distress and fatigue—is common in the early months. The current study is the first to our knowledge to examine infant sleep and its potential indirect influence on parents’ perceptions of coparenting quality at 1 and 3 months of infant age. Participants included 150 families. Mothers reported more night waking, poorer sleep quality, more depressive symptoms, and worse perceptions of coparenting quality as compared with fathers. We tested a structural model of infant and parent night waking and sleep quality as predictors of parent distress and coparenting using maximum likelihood estimation. The frequency of infant night waking predicted father and mother night waking, which in turn predicted parent sleep quality. Poor parent sleep quality predicted elevated depressive symptoms, and finally depressive symptoms were negatively related to perceptions of coparenting quality. Significant indirect effects between infant night waking and parent depression and coparenting quality were found. In summary, both mothers’ and fathers’ perceptions of coparenting were related to the unfolding parental dynamics that take place surrounding infant sleep difficulties. This held true even after controlling for parent education, family income, and infant temperament. Therefore, parenting may indirectly benefit from interventions targeting infant sleep difficulties. PMID:23244456

Application of biomarkers in cancer risk management: evaluation from stochastic clonal evolutionary and dynamic system optimization points of view.

PubMed

Li, Xiaohong; Blount, Patricia L; Vaughan, Thomas L; Reid, Brian J

2011-02-01

Aside from primary prevention, early detection remains the most effective way to decrease mortality associated with the majority of solid cancers. Previous cancer screening models are largely based on classification of at-risk populations into three conceptually defined groups (normal, cancer without symptoms, and cancer with symptoms). Unfortunately, this approach has achieved limited successes in reducing cancer mortality. With advances in molecular biology and genomic technologies, many candidate somatic genetic and epigenetic "biomarkers" have been identified as potential predictors of cancer risk. However, none have yet been validated as robust predictors of progression to cancer or shown to reduce cancer mortality. In this Perspective, we first define the necessary and sufficient conditions for precise prediction of future cancer development and early cancer detection within a simple physical model framework. We then evaluate cancer risk prediction and early detection from a dynamic clonal evolution point of view, examining the implications of dynamic clonal evolution of biomarkers and the application of clonal evolution for cancer risk management in clinical practice. Finally, we propose a framework to guide future collaborative research between mathematical modelers and biomarker researchers to design studies to investigate and model dynamic clonal evolution. This approach will allow optimization of available resources for cancer control and intervention timing based on molecular biomarkers in predicting cancer among various risk subsets that dynamically evolve over time.

Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling

PubMed Central

Rock, Kat S; Ndeffo-Mbah, Martial L; Castaño, Soledad; Palmer, Cody; Pandey, Abhishek; Atkins, Katherine E; Ndung’u, Joseph M; Hollingsworth, T Déirdre; Galvani, Alison; Bever, Caitlin; Chitnis, Nakul; Keeling, Matt J

2018-01-01

Abstract Background Control of gambiense sleeping sickness relies predominantly on passive and active screening of people, followed by treatment. Methods Mathematical modeling explores the potential of 3 complementary interventions in high- and low-transmission settings. Results Intervention strategies that included vector control are predicted to halt transmission most quickly. Targeted active screening, with better and more focused coverage, and enhanced passive surveillance, with improved access to diagnosis and treatment, are both estimated to avert many new infections but, when used alone, are unlikely to halt transmission before 2030 in high-risk settings. Conclusions There was general model consensus in the ranking of the 3 complementary interventions studied, although with discrepancies between the quantitative predictions due to differing epidemiological assumptions within the models. While these predictions provide generic insights into improving control, the most effective strategy in any situation depends on the specific epidemiology in the region and the associated costs. PMID:29860287

Discrete event simulation model of sudden cardiac death predicts high impact of preventive interventions.

PubMed

Andreev, Victor P; Head, Trajen; Johnson, Neil; Deo, Sapna K; Daunert, Sylvia; Goldschmidt-Clermont, Pascal J

2013-01-01

Sudden Cardiac Death (SCD) is responsible for at least 180,000 deaths a year and incurs an average cost of $286 billion annually in the United States alone. Herein, we present a novel discrete event simulation model of SCD, which quantifies the chains of events associated with the formation, growth, and rupture of atheroma plaques, and the subsequent formation of clots, thrombosis and on-set of arrhythmias within a population. The predictions generated by the model are in good agreement both with results obtained from pathological examinations on the frequencies of three major types of atheroma, and with epidemiological data on the prevalence and risk of SCD. These model predictions allow for identification of interventions and importantly for the optimal time of intervention leading to high potential impact on SCD risk reduction (up to 8-fold reduction in the number of SCDs in the population) as well as the increase in life expectancy.

The Role of Habit and Perceived Control on Health Behavior among Pregnant Women.

PubMed

Mullan, Barbara; Henderson, Joanna; Kothe, Emily; Allom, Vanessa; Orbell, Sheina; Hamilton, Kyra

2016-05-01

Many pregnant women do not adhere to physical activity and dietary recommendations. Research investigating what psychological processes might predict physical activity and healthy eating (fruit and vegetable consumption) during pregnancy is scant. We explored the role of intention, habit, and perceived behavioral control as predictors of physical activity and healthy eating. Pregnant women (N = 195, Mage = 30.17, SDage = 4.46) completed questionnaires at 2 time points. At Time 1, participants completed measures of intention, habit, and perceived behavioral control. At Time 2, participants reported on their behavior (physical activity and healthy eating) within the intervening week. Regression analysis determined whether Time 1 variables predicted behavior at Time 2. Interaction terms also were tested. Final regression models indicated that only intention and habit explained significant variance in physical activity, whereas habit and the interaction between intention and habit explained significant variance in healthy eating. Simple slopes analysis indicated that the relationship between intention and healthy eating behavior was only significant at high levels of habit. Findings highlight the influence of habit on behavior and suggest that automaticity interventions may be useful in changing health behaviors during pregnancy.

Explaining Differential Reporting of Victimization between Parents and Children: A Consideration of Social Biases.

PubMed

John, Sufna Gheyara; DiLalla, Lisabeth F

2013-09-01

Studies have shown that children and parents provide different reports of children's victimization, with children often reporting more victimization. However, the reason for this differential reporting is unclear. This study explored two types of social biases (emotion recognition and perceived impairment) in parents and children as possible reasons underlying differential reporting. Six- to 10-year-old children and one of their parents were tested in a lab. Testing included subjective measures of parent alexithymic traits, child perceived impairment from victimization, and child- and parent-reported frequency of children's peer victimization and internalizing and externalizing difficulties. Parents and children also completed an objective measure of emotion recognition. Both types of social bias significantly predicted reports of children's peer victimization frequency as well as internalizing and externalizing difficulties, as rated by parents and children. Moreover, child perceived impairment bias, rather than parent emotion bias, best predicted differential reporting of peer victimization. Finally, a significant interaction demonstrated that the influence of child perceived impairment bias on differential reporting was most salient in the presence of parent emotion bias. This underscores the importance of expanding interventions for victimized youth to include the restructuring of social biases.

Identification of functional candidates amongst hypothetical proteins of Mycobacterium leprae Br4923, a causative agent of leprosy.

PubMed

Naqvi, Ahmad Abu Turab; Ahmad, Faizan; Hassan, Md Imtaiyaz

2015-01-01

Mycobacterium leprae is an intracellular obligate parasite that causes leprosy in humans, and it leads to the destruction of peripheral nerves and skin deformation. Here, we report an extensive analysis of the hypothetical proteins (HPs) from M. leprae strain Br4923, assigning their functions to better understand the mechanism of pathogenesis and to search for potential therapeutic interventions. The genome of M. leprae encodes 1604 proteins, of which the functions of 632 are not known (HPs). In this paper, we predicted the probable functions of 312 HPs. First, we classified all HPs into families and subfamilies on the basis of sequence similarity, followed by domain assignment, which provides many clues for their possible function. However, the functions of 320 proteins were not predicted because of low sequence similarity with proteins of known function. Annotated HPs were categorized into enzymes, binding proteins, transporters, and proteins involved in cellular processes. We found several novel proteins whose functions were unknown for M. leprae. These proteins have a requisite association with bacterial virulence and pathogenicity. Finally, our sequence-based analysis will be helpful for further validation and the search for potential drug targets while developing effective drugs to cure leprosy.

Sexual risk behaviors by relationship type and trauma history among HIV-positive men who have sex with men.

PubMed

Kamen, Charles; Etter, Darryl; Flores, Sergio; Sharp, Susan; Lee, Susanne; Gore-Felton, Cheryl

2013-02-01

The association of trauma exposure and coping style to sexual risk behavior has yet to be fully examined in the context of primary and casual sexual partnerships. The current study assessed a high risk sexual behavior-unprotected anal intercourse (UAI)-in a high risk population of HIV-positive men who have sex with men (MSM) with a history of trauma. Using audio computer-assisted self-interview technology, 132 HIV-positive MSM completed measures of trauma exposure, trauma symptoms, coping strategies, and sexual risk behavior. Hierarchical logistic regression analyses indicated that completing more years of education and having experienced sexual abuse were positively associated with UAI with casual partners. Additionally, use of active coping was negatively associated with UAI with casual partners and the final model significantly predicted variance in UAI with casual partners. However, no variables were significantly associated with UAI with primary partners, suggesting that sexual risk behavior with primary partners may be associated with factors not commonly assessed in risk prediction or prevention research. We discuss the results in the context of developing new or modifying existing interventions to address rates of sexual risk in the relationships of HIV-positive MSM.

Child, parent and family factors as predictors of adjustment for siblings of children with a disability.

PubMed

Giallo, R; Gavidia-Payne, S

2006-12-01

Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling coping; (3) parent stress; (4) parenting; and (5) family resilience. Multiple regression techniques were used. It was found that parent and family factors were stronger predictors of sibling adjustment difficulties than siblings' own experiences of stress and coping. Specifically, socio-economic status, past attendance at a sibling support group, parent stress, family time and routines, family problem-solving and communication, and family hardiness-predicted sibling adjustment difficulties. Finally, siblings' perceived intensity of daily uplifts significantly predicted sibling prosocial behaviour. The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings are discussed.

Do ethnicity and gender matter when using the theory of planned behavior to understand fruit and vegetable consumption?

PubMed

Blanchard, Chris M; Kupperman, Janet; Sparling, Phillip B; Nehl, Eric; Rhodes, Ryan E; Courneya, Kerry S; Baker, Frank

2009-02-01

A majority of Americans do not meet the recommendation to eat five servings of fruits and vegetables per day (5-A-Day). The purpose of the present study was to examine the utility of the theory of planned behavior (TPB) for understanding 5-A-Day intentions and behavior and to determine whether any of the TPB relationships were moderated by ethnicity or gender. A total of 413 participants completed a baseline TPB questionnaire and a fruit and vegetable consumption measure 2 weeks later. Path analyses showed that affective attitude and perceived behavioral control significantly predicted intention for blacks, whites, males and females (R(2) ranged from .32 to .40), whereas subjective norm was a significant predictor for blacks, males, and females only. Intention significantly predicted 5-A-Day (R(2) ranged from .17 to .22) for all groups. Follow-up invariance analyses showed that the subjective norm/intention relationship was significantly stronger for black compared to white students. Finally, several key beliefs were identified for all four demographic groups. Therefore, the current results suggest that the TPB may be a useful framework to utilize when developing 5-A-Day interventions.

A systems approach to college drinking: development of a deterministic model for testing alcohol control policies.

PubMed

Scribner, Richard; Ackleh, Azmy S; Fitzpatrick, Ben G; Jacquez, Geoffrey; Thibodeaux, Jeremy J; Rommel, Robert; Simonsen, Neal

2009-09-01

The misuse and abuse of alcohol among college students remain persistent problems. Using a systems approach to understand the dynamics of student drinking behavior and thus forecasting the impact of campus policy to address the problem represents a novel approach. Toward this end, the successful development of a predictive mathematical model of college drinking would represent a significant advance for prevention efforts. A deterministic, compartmental model of college drinking was developed, incorporating three processes: (1) individual factors, (2) social interactions, and (3) social norms. The model quantifies these processes in terms of the movement of students between drinking compartments characterized by five styles of college drinking: abstainers, light drinkers, moderate drinkers, problem drinkers, and heavy episodic drinkers. Predictions from the model were first compared with actual campus-level data and then used to predict the effects of several simulated interventions to address heavy episodic drinking. First, the model provides a reasonable fit of actual drinking styles of students attending Social Norms Marketing Research Project campuses varying by "wetness" and by drinking styles of matriculating students. Second, the model predicts that a combination of simulated interventions targeting heavy episodic drinkers at a moderately "dry" campus would extinguish heavy episodic drinkers, replacing them with light and moderate drinkers. Instituting the same combination of simulated interventions at a moderately "wet" campus would result in only a moderate reduction in heavy episodic drinkers (i.e., 50% to 35%). A simple, five-state compartmental model adequately predicted the actual drinking patterns of students from a variety of campuses surveyed in the Social Norms Marketing Research Project study. The model predicted the impact on drinking patterns of several simulated interventions to address heavy episodic drinking on various types of campuses.

A Systems Approach to College Drinking: Development of a Deterministic Model for Testing Alcohol Control Policies*

PubMed Central

Scribner, Richard; Ackleh, Azmy S.; Fitzpatrick, Ben G.; Jacquez, Geoffrey; Thibodeaux, Jeremy J.; Rommel, Robert; Simonsen, Neal

2009-01-01

Objective: The misuse and abuse of alcohol among college students remain persistent problems. Using a systems approach to understand the dynamics of student drinking behavior and thus forecasting the impact of campus policy to address the problem represents a novel approach. Toward this end, the successful development of a predictive mathematical model of college drinking would represent a significant advance for prevention efforts. Method: A deterministic, compartmental model of college drinking was developed, incorporating three processes: (1) individual factors, (2) social interactions, and (3) social norms. The model quantifies these processes in terms of the movement of students between drinking compartments characterized by five styles of college drinking: abstainers, light drinkers, moderate drinkers, problem drinkers, and heavy episodic drinkers. Predictions from the model were first compared with actual campus-level data and then used to predict the effects of several simulated interventions to address heavy episodic drinking. Results: First, the model provides a reasonable fit of actual drinking styles of students attending Social Norms Marketing Research Project campuses varying by “wetness” and by drinking styles of matriculating students. Second, the model predicts that a combination of simulated interventions targeting heavy episodic drinkers at a moderately “dry” campus would extinguish heavy episodic drinkers, replacing them with light and moderate drinkers. Instituting the same combination of simulated interventions at a moderately “wet” campus would result in only a moderate reduction in heavy episodic drinkers (i.e., 50% to 35%). Conclusions: A simple, five-state compartmental model adequately predicted the actual drinking patterns of students from a variety of campuses surveyed in the Social Norms Marketing Research Project study. The model predicted the impact on drinking patterns of several simulated interventions to address heavy episodic drinking on various types of campuses. PMID:19737506

[The value of SYNTAX score in predicting outcome patients undergoing percutaneous coronary intervention].

PubMed

Gao, Yue-chun; Yu, Xian-peng; He, Ji-qiang; Chen, Fang

2012-01-01

To assess the value of SYNTAX score to predict major adverse cardiac and cerebrovascular events (MACCE) among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention. 190 patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention (PCI) with Cypher select drug-eluting stent were enrolled. SYNTAX score and clinical SYNTAX score were retrospectively calculated. Our clinical Endpoint focused on MACCE, a composite of death, nonfatal myocardial infarction (MI), stroke and repeat revascularization. The value of SYNTAX score and clinical SYNTAX score to predict MACCE were studied respectively. 29 patients were observed to suffer from MACCE, accounting 18.5% of the overall 190 patients. MACCE rates of low (≤ 20.5), intermediate (21.0 - 31.0), and high (≥ 31.5) tertiles according to SYNTAX score were 9.1%, 16.2% and 30.9% respectively. Both univariate and multivariate analysis showed that SYNTAX score was the independent predictor of MACCE. MACCE rates of low (≤ 19.5), intermediate (19.6 - 29.1), and high (≥ 29.2) tertiles according to clinical SYNTAX score were 14.9%, 9.8% and 30.6% respectively. Both univariate and multivariate analysis showed that clinical SYNTAX score was the independent predictor of MACCE. ROC analysis showed both SYNTAX score (AUC = 0.667, P = 0.004) and clinical SYNTAX score (AUC = 0.636, P = 0.020) had predictive value of MACCE. Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score. Both SYNTAX score and clinical SYNTAX score could be independent risk predictors for MACCE among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention. Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score in this group of patients.

[Food labeling and the prevention of overweight and obesity: a systematic review].

PubMed

Sebastián-Ponce, Miren Itxaso; Sanz-Valero, Javier; Wanden-Berghe, Carmina

2011-11-01

This article reports on a systematic review of articles on food labeling and the prevention of obesity and overweight, in the MEDLINE, EMBASE, Web of Knowledge, Cochrane Library Plus, Food Science and Technology Abstracts, LILACS, and CINAHL databases. The DeCS/MeSH descriptors were obesity and food labeling. 207 articles were retrieved. Using inclusion and exclusion criteria, 14 articles were selected: 11 were on food labeling and its impact on final food product consumption; 2 were on fast food establishments; 1 on sensory attributes as compared to health recommendations; and 2 on follow-up of interventions. Labeling has a positive effect on final food product consumption, in contrast with fast food restaurants. Sensory attributes were more effective than recommendations on the labels. Follow-up of interventions confirmed the long-term effect of the target interventions.

Hardiness commitment, gender, and age differentiate university academic performance.

PubMed

Sheard, Michael

2009-03-01

The increasing diversity of students, particularly in age, attending university has seen a concomitant interest in factors predicting academic success. This 2-year correlational study examined whether age, gender (demographic variables), and hardiness (cognitive/emotional variable) differentiate and predict university final degree grade point average (GPA) and final-year dissertation mark. Data are reported from a total of 134 university undergraduate students. Participants provided baseline data in questionnaires administered during the first week of their second year of undergraduate study and gave consent for their academic progress to be tracked. Final degree GPA and dissertation mark were the academic performance criteria. Mature-age students achieved higher final degree GPA compared to young undergraduates. Female students significantly outperformed their male counterparts in each measured academic assessment criteria. Female students also reported a significantly higher mean score on hardiness commitment compared to male students. commitment was the most significant positive correlate of academic achievement. Final degree GPA and dissertation mark were significantly predicted by commitment, and commitment and gender, respectively. The findings have implications for universities targeting academic support services to maximize student scholastic potential. Future research should incorporate hardiness, gender, and age with other variables known to predict academic success.

Aging, the Central Nervous System, and Mobility in Older Adults: Interventions.

PubMed

Varma, Vijay R; Hausdorff, Jeffrey M; Studenski, Stephanie A; Rosano, Caterina; Camicioli, Richard; Alexander, Neil B; Chen, Wen G; Lipsitz, Lewis A; Carlson, Michelle C

2016-11-01

Research suggests that the central nervous system (CNS) and mobility are closely linked. CNS-mediated mobility impairment may represent a potentially new and prevalent syndrome within the older adult populations. Interventions targeting this group may have the potential to improve mobility and cognition and prevent disability. In 2012, the Gerontological Society of America (GSA) and the National Institute on Aging (NIA) sponsored a 3-year conference workshop series, "Aging, the CNS, and Mobility." The goal of this third and final conference was to (i) report on the state of the science of interventions targeting CNS-mediated mobility impairment among community-dwelling older adults and (ii) partnering with the NIA, explore the future of research and intervention design focused on a potentially novel aging syndrome. Evidence was presented in five main intervention areas: (i) pharmacology and diet; (ii) exercise; (iii) electrical stimulation; (iv) sensory stimulation/deprivation; and (v) a combined category of multimodal interventions. Workshop participants identified important gaps in knowledge and key recommendations for future interventions related to recruitment and sample selection, intervention design, and methods to measure effectiveness. In order to develop effective preventive interventions for this prevalent syndrome, multidisciplinary teams are essential particularly because of the complex nature of the syndrome. Additionally, integrating innovative methods into the design of interventions may help researchers better measure complex mechanisms, and finally, the value of understanding the link between the CNS and mobility should be conveyed to researchers across disciplines in order to incorporate cognitive and mobility measurements into study protocols. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development of a Trans-disciplinary Intervention Module for Adolescent Girls on Self-awareness.

PubMed

John, Jasmine Mary; Navneetham, Janardhan; Nagendra, H R

2017-08-01

Mental health promotion among adolescents has been a key area of intervention for professionals working with children and adolescents. The opinions of experts in the field of mental health have taken to frame a trans-disciplinary intervention for adolescent girls on self awareness. To discuss the development and validation of a structured intervention by combining the knowledge from different disciplines in helping adolescents enhancing self awareness. Both qualitative and quantitative methodologies were followed for the development and validation of the module. First phase of the development of intervention module was the framing of intervention module after conducting in-depth interviews with experts in both mental health and yoga fields. Six experts each from mental health and yoga field were chosen for interview through convenient sampling. Validated interview guides were used for the process. The framed intervention module was given to six mental health experts and six yoga experts for content validation. The experts rated the usefulness of the intervention on a scale 0-4 (4=extremely helpful). The themes derived in the interviews were importance of self awareness, autonomy of self, physical level of self understanding, self regulation of emotions and self monitoring. The interviews were consolidated to frame the intervention module consisting of eight sessions having two parts in each session. Part one of each session is activities and interactions on mental health and part two is guided instructions for body focused meditation. Sessions were finalized with rating and suggestions from the experts. The final version of the module was pilot tested and had found to have enhanced self awareness among adolescent girls. Integration of multiple disciplines brought in novel perspectives in intervention.

Bridging the Research-to-Practice Gap in Autism Intervention: An Application of Diffusion of Innovation Theory

PubMed Central

Mandell, David S.

2011-01-01

There is growing evidence that efficacious interventions for autism are rarely adopted or successfully implemented in public mental health and education systems. We propose applying diffusion of innovation theory to further our understanding of why this is the case. We pose a practical set of questions that administrators face as they decide about the use of interventions. Using literature from autism intervention and dissemination science, we describe reasons why efficacious interventions for autism are rarely adopted, implemented, and maintained in community settings, all revolving around the perceived fit between the intervention and the needs and capacities of the setting. Finally, we suggest strategies for intervention development that may increase the probability that these interventions will be used in real-world settings. PMID:20717714

Parent attendance and homework adherence predict response to a family-school intervention for children with ADHD

PubMed Central

Clarke, Angela T.; Marshall, Stephen A.; Mautone, Jennifer A.; Soffer, Stephen L.; Jones, Heather A.; Costigan, Tracy E.; Patterson, Anwar; Jawad, Abbas F.; Power, Thomas J.

2013-01-01

Objective This study examined the relative contribution of two dimensions of parent engagement, attendance and homework adherence, to parent and child treatment response and explored whether early engagement was a stronger predictor of outcomes than later engagement. Method The sample consisted of parents of participants (n = 92; M age 9.4 years, SD = 1.27; 67% male; 69% White) in a 12-session evidence-based family-school intervention for children with ADHD. Attendance was assessed using clinician records, and homework adherence was measured by rating permanent products. Outcomes included parent and teacher ratings of family involvement in education, parenting practices, and child functioning. Results Accounting for the contributions of baseline scores and attendance, homework adherence was a significant predictor of parental self-efficacy, the parent-teacher relationship, parenting through positive involvement, and the child’s inattention to homework and homework productivity. Accounting for the contribution of baseline scores and homework adherence, attendance was a significant predictor of one outcome, the child’s academic productivity. Early homework adherence appeared to be more predictive of outcomes than later adherence, whereas attendance did not predict outcomes during either half of treatment. Conclusions These results indicate that, even in the context of evidence-based practice, it is the extent to which parents actively engage with treatment, rather than the number of sessions they attend, that is most important in predicting intervention response. Because attendance is limited as an index of engagement and a predictor of outcomes, increased efforts to develop interventions to promote parent adherence to behavioral interventions for children are warranted. PMID:23688140

Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review.

PubMed

Srigley, J A; Corace, K; Hargadon, D P; Yu, D; MacDonald, T; Fabrigar, L; Garber, G

2015-11-01

Despite the importance of hand hygiene in preventing transmission of healthcare-associated infections, compliance rates are suboptimal. Hand hygiene is a complex behaviour and psychological frameworks are promising tools to influence healthcare worker (HCW) behaviour. (i) To review the effectiveness of interventions based on psychological theories of behaviour change to improve HCW hand hygiene compliance; (ii) to determine which frameworks have been used to predict HCW hand hygiene compliance. Multiple databases and reference lists of included studies were searched for studies that applied psychological theories to improve and/or predict HCW hand hygiene. All steps in selection, data extraction, and quality assessment were performed independently by two reviewers. The search yielded 918 citations; seven met eligibility criteria. Four studies evaluated hand hygiene interventions based on psychological frameworks. Interventions were informed by goal setting, control theory, operant learning, positive reinforcement, change theory, the theory of planned behaviour, and the transtheoretical model. Three predictive studies employed the theory of planned behaviour, the transtheoretical model, and the theoretical domains framework. Interventions to improve hand hygiene adherence demonstrated efficacy but studies were at moderate to high risk of bias. For many studies, it was unclear how theories of behaviour change were used to inform the interventions. Predictive studies had mixed results. Behaviour change theory is a promising tool for improving hand hygiene; however, these theories have not been extensively examined. Our review reveals a significant gap in the literature and indicates possible avenues for novel research. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Parent attendance and homework adherence predict response to a family-school intervention for children with ADHD.

PubMed

Clarke, Angela T; Marshall, Stephen A; Mautone, Jennifer A; Soffer, Stephen L; Jones, Heather A; Costigan, Tracy E; Patterson, Anwar; Jawad, Abbas F; Power, Thomas J

2015-01-01

This study examined the relative contribution of two dimensions of parent engagement, attendance and homework adherence, to parent and child treatment response and explored whether early engagement was a stronger predictor of outcomes than later engagement. The sample consisted of parents of participants (n = 92; M age = 9.4 years, SD = 1.27; 67% male, 69% White) in a 12-session evidence-based family-school intervention for children with attention-deficit/hyperactivity disorder. Attendance was assessed using clinician records, and homework adherence was measured by rating permanent products. Outcomes included parent and teacher ratings of family involvement in education, parenting practices, and child functioning. Accounting for the contributions of baseline scores and attendance, homework adherence was a significant predictor of parental self-efficacy, the parent-teacher relationship, parenting through positive involvement, and the child's inattention to homework and homework productivity. Accounting for the contribution of baseline scores and homework adherence, attendance was a significant predictor of one outcome, the child's academic productivity. Early homework adherence appeared to be more predictive of outcomes than later adherence, whereas attendance did not predict outcomes during either half of treatment. These results indicate that, even in the context of evidence-based practice, it is the extent to which parents actively engage with treatment, rather than the number of sessions they attend, that is most important in predicting intervention response. Because attendance is limited as an index of engagement and a predictor of outcomes, increased efforts to develop interventions to promote parent adherence to behavioral interventions for children are warranted.

The effects of practice on movement distance and final position reproduction: implications for the equilibrium-point control of movements.

PubMed

Jaric, S; Corcos, D M; Gottlieb, G L; Ilic, D B; Latash, M L

1994-01-01

Predictions of two views on single-joint motor control, namely programming of muscle force patterns and equilibrium-point control, were compared with the results of experiments with reproduction of movement distance and final location during fast unidirectional elbow flexions. Two groups of subjects were tested. The first group practiced movements over a fixed distance (36 degrees), starting from seven different initial positions (distance group, DG). The second group practiced movements from the same seven initial positions to a fixed final location (location group, LG). Later, all the subjects were tested at the practiced task with their eyes closed, and then, unexpectedly for the subjects, they were tested at the other, unpracticed task. In both groups, the task to reproduce final position had lower indices of final position variability than the task to reproduce movement distance. Analysis of the linear regression lines between initial position and final position (or movement distance) also demonstrated a better (more accurate) performance during final position reproduction than during distance reproduction. The data are in a good correspondence with the predictions of the equilibrium-point hypothesis, but not with the predictions of the force-pattern control approach.

Charlotte Circle Outreach. Final Report.

ERIC Educational Resources Information Center

Calhoun, Mary Lynne; Rose, Terry L.; Prendergast, Donna

This final report details the activities of the Charlotte Circle Outreach, a program designed to provide technical assistance and training to early intervention programs offering services to infants and young children with substantial disabilities, ages birth through two years. This mission was accomplished through cooperative planning with…

A multilevel modeling approach to examining the implementation-effectiveness relationship of a behavior change intervention for health care professional trainees.

PubMed

Tomasone, Jennifer R; Sweet, Shane N; McReynolds, Stuart; Martin Ginis, Kathleen A

2017-09-01

Changing Minds, Changing Lives, a seminar-mediated behavior change intervention, aims to enhance health care professionals' (HCPs') social cognitions for discussing leisure-time physical activity (LTPA) with patients with physical disabilities. This study examines which seminar implementation variables (presenter characteristics, delivery components) predict effectiveness using multilevel modeling. HCP trainees (n = 564) attended 24 seminars and completed Theory of Planned Behavior-based measures for discussing LTPA at pre-, post-, 1-month post-, and 6-months post-seminar. Implementation variables were extracted from presenter-completed questionnaires/checklists. Seminars presented by a HCP predicted positive changes in all cognitions pre-post but negative changes in attitudes and perceived behavioral control (PBC) over follow-up (ps < .05). The number of seminars the presenter had delivered predicted negative changes in attitudes and PBC during follow-up (ps < .001). Inclusion of audiovisual components predicted positive changes in attitudes pre-post (p < .001). Presenter characteristics may be "key ingredients" to educational interventions for HCPs; however, future studies should examine additional implementation variables.

[Effective interventions to reduce absenteeism among hospital nurses].

PubMed

Blanca-Gutiérrez, Joaquín Jesús; Jiménez-Díaz, María del Carmen; Escalera-Franco, Luis Felipe

2013-01-01

To select and summarize the interventions that have proved effective in reducing absenteeism among hospital nurses. A scoping review was conducted through a literature search using Medline, Web of Science, Cinahl, Embase, Lilacs, Cuiden and Cochrane Library Plus databases. Of a total of 361 articles extracted, 15 were finally selected for this review. The implementation of multifaceted support or physical training programs can produce positive results in terms of reducing absenteeism among hospital nurses. Cognitive-behavioral type interventions require studies with larger samples to provide conclusive results. Establishing more flexible working shifts may also reduce absenteeism rates, although again studies with larger samples are needed. Programs aimed at managing change developed by nurses themselves, participatory management of professional relations, the support provided by supervisors who are opposed to hierarchical leadership styles, and wage supplements that reward the lack of absence can also reduce these types of indicators. Absenteeism can be considered as a final result and a consequence of the level of job satisfaction. The effectiveness of interventions to reduce absenteeism among hospital nurses will no doubt largely depend on the ability of these interventions to increase the job satisfaction of these workers. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

76 FR 31927 - Agency Information Collection Activities: Proposed Collection; Comment Request-Formative Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... (pretest) survey, and one at posttest, for a total of two responses each. Finally, the school foodservice... inform curriculum revisions. A longitudinal, repeated measure, pretest-posttest design with a combination... students will be asked to participate in a pre-intervention (pretest) survey, post-intervention (posttest...

Early Identification and Interventions for Dyslexia: A Contemporary View

ERIC Educational Resources Information Center

Snowling, Margaret J.

2013-01-01

This paper reviews current proposals concerning the definition of dyslexia and contrasts it with reading comprehension impairment. We then discuss methods for early identification and review evidence that teacher assessments and ratings may be valid screening tools. Finally, we argue that interventions should be theoretically motivated and…

The value of independent specialty designation for interventional cardiology.

PubMed

Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

2017-01-01

Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Perspective-Taking, Position Power, and Third Party Intervention Style: A Classroom Application.

ERIC Educational Resources Information Center

Schneider, David E.

In order to understand how power affects other relationships, to offer an exploratory methodology for operationalizing an intervention typology, and to eventually develop a theoretical model that predicts affective influence on third party intervention modes in given conflict situations, a pilot study hypothesized that the frequency of preferred…

Coparenting in immigrant Chinese Canadian families: the role of discrepancies in acculturation and expectations for adolescent assistance.

PubMed

Chance, Lauren J; Costigan, Catherine L; Leadbeater, Bonnie J

2013-12-01

For immigrant families, differential acculturation between mothers and fathers may present challenges to parenting adolescents. The current study investigated the concurrent relations among discrepancies in parental acculturation, discrepancies in parental expectations for adolescents, and coparenting quality with a sample of 162 married immigrant Chinese Canadian couples with adolescents (mean age = 14.94 years; SD = 1.73). Acculturation was assessed as parents' behavioral involvement in both Canadian and Chinese cultures. As predicted, mother-father differences in acculturation (in relation to both cultures) were related to discrepant expectations for how much adolescents should assist the family. Further, mother-father differences in Chinese acculturation were related to fathers' perceptions of a poorer coparenting relationship. Finally, this relation was partially mediated by discrepant parental expectations for adolescent assistance. Implications for parenting roles, enculturation, family dynamics, and intervention are considered.

Inoculating against eyewitness suggestibility via interpolated verbatim vs. gist testing.

PubMed

Pansky, Ainat; Tenenboim, Einat

2011-01-01

In real-life situations, eyewitnesses often have control over the level of generality in which they choose to report event information. In the present study, we adopted an early-intervention approach to investigate to what extent eyewitness memory may be inoculated against suggestibility, following two different levels of interpolated reporting: verbatim and gist. After viewing a target event, participants responded to interpolated questions that required reporting of target details at either the verbatim or the gist level. After 48 hr, both groups of participants were misled about half of the target details and were finally tested for verbatim memory of all the details. The findings were consistent with our predictions: Whereas verbatim testing was successful in completely inoculating against suggestibility, gist testing did not reduce it whatsoever. These findings are particularly interesting in light of the comparable testing effects found for these two modes of interpolated testing.

A Syrian golden hamster model recapitulating ebola hemorrhagic fever.

PubMed

Ebihara, Hideki; Zivcec, Marko; Gardner, Donald; Falzarano, Darryl; LaCasse, Rachel; Rosenke, Rebecca; Long, Dan; Haddock, Elaine; Fischer, Elizabeth; Kawaoka, Yoshihiro; Feldmann, Heinz

2013-01-15

Ebola hemorrhagic fever (EHF) is a severe viral infection for which no effective treatment or vaccine is currently available. While the nonhuman primate (NHP) model is used for final evaluation of experimental vaccines and therapeutic efficacy, rodent models have been widely used in ebolavirus research because of their convenience. However, the validity of rodent models has been questioned given their low predictive value for efficacy testing of vaccines and therapeutics, a result of the inconsistent manifestation of coagulopathy seen in EHF. Here, we describe a lethal Syrian hamster model of EHF using mouse-adapted Ebola virus. Infected hamsters displayed most clinical hallmarks of EHF, including severe coagulopathy and uncontrolled host immune responses. Thus, the hamster seems to be superior to the existing rodent models, offering a better tool for understanding the critical processes in pathogenesis and providing a new model for evaluating prophylactic and postexposure interventions prior to testing in NHPs.

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.

Enhancing the Relationship Adjustment of South Asian Canadian Couples Using a Systemic-Constructivist Approach to Couple Therapy.

PubMed

Ahmad, Saunia; Reid, David W

2016-10-01

The effectiveness of systemic-constructivist couple therapy (SCCT) in improving the relationship adjustment of South Asian Canadian couples in ways that attend to their culture was evaluated. The SCCT interventions engage partners in reflexive processing of both their own and their partner's ways of construing, and the reciprocity between these two. A core change mechanism of SCCT, couple identity ("we-ness"), that connotes the ability for thinking and experiencing relationally, was coded from verbatim transcripts of partners' within-session dialogue. As predicted, South Asian partners' relationship adjustment improved significantly from the first to final session of SCCT, and concurrent increases in each partner's couple identity mediated such improvements. The implications for considering culture and couple identity in couple therapy are discussed. Video Abstract is found in the online version of the article. © 2016 American Association for Marriage and Family Therapy.

A Syrian Golden Hamster Model Recapitulating Ebola Hemorrhagic Fever

PubMed Central

Ebihara, Hideki; Zivcec, Marko; Gardner, Donald; Falzarano, Darryl; LaCasse, Rachel; Rosenke, Rebecca; Long, Dan; Haddock, Elaine; Fischer, Elizabeth; Kawaoka, Yoshihiro; Feldmann, Heinz

2013-01-01

Ebola hemorrhagic fever (EHF) is a severe viral infection for which no effective treatment or vaccine is currently available. While the nonhuman primate (NHP) model is used for final evaluation of experimental vaccines and therapeutic efficacy, rodent models have been widely used in ebolavirus research because of their convenience. However, the validity of rodent models has been questioned given their low predictive value for efficacy testing of vaccines and therapeutics, a result of the inconsistent manifestation of coagulopathy seen in EHF. Here, we describe a lethal Syrian hamster model of EHF using mouse-adapted Ebola virus. Infected hamsters displayed most clinical hallmarks of EHF, including severe coagulopathy and uncontrolled host immune responses. Thus, the hamster seems to be superior to the existing rodent models, offering a better tool for understanding the critical processes in pathogenesis and providing a new model for evaluating prophylactic and postexposure interventions prior to testing in NHPs. PMID:23045629

Body composition, muscle capacity, and physical function in older adults: an integrated conceptual model.

PubMed

Brady, Anne O; Straight, Chad R; Evans, Ellen M

2014-07-01

The aging process leads to adverse changes in body composition (increases in fat mass and decreases in skeletal muscle mass), declines in physical function (PF), and ultimately increased risk for disability and loss of independence. Specific components of body composition or muscle capacity (strength and power) may be useful in predicting PF; however, findings have been mixed regarding the most salient predictor of PF. The development of a conceptual model potentially aids in understanding the interrelated factors contributing to PF with the factors of interest being physical activity, body composition, and muscle capacity. This article also highlights sex differences in these domains. Finally, factors known to affect PF, such as sleep, depression, fatigue, and self-efficacy, are discussed. Development of a comprehensive conceptual model is needed to better characterize the most salient factors contributing to PF and to subsequently inform the development of interventions to reduce physical disability in older adults.

Modeling Tool for Decision Support during Early Days of an Anthrax Event.

PubMed

Rainisch, Gabriel; Meltzer, Martin I; Shadomy, Sean; Bower, William A; Hupert, Nathaniel

2017-01-01

Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat.

Getting (the most) out of the research business: interventions for youth with T1DM.

PubMed

Harris, Michael A; Freeman, Kurt A; Duke, Danny C

2010-12-01

We review research on psychosocial interventions to improve outcomes for youth with type 1 diabetes mellitus. Specifically, we discuss individual- and small group-focused, family-focused, group-focused, and other interventions. After reviewing extant research in each area, we discuss how the current evidence base may be used to inform clinical practice. Finally, we conclude by discussing variations in effects of interventions on different outcomes (eg, glycemic control, family functioning) and how to consider this evidence when selecting treatments to transport into clinical settings.

Using fuzzy-trace theory to understand and improve health judgments, decisions, and behaviors: A literature review.

PubMed

Blalock, Susan J; Reyna, Valerie F

2016-08-01

Fuzzy-trace theory is a dual-process model of memory, reasoning, judgment, and decision making that contrasts with traditional expectancy-value approaches. We review the literature applying fuzzy-trace theory to health with 3 aims: evaluating whether the theory's basic distinctions have been validated empirically in the domain of health; determining whether these distinctions are useful in assessing, explaining, and predicting health-related psychological processes; and determining whether the theory can be used to improve health judgments, decisions, or behaviors, especially compared to other approaches. We conducted a literature review using PubMed, PsycINFO, and Web of Science to identify empirical peer-reviewed papers that applied fuzzy-trace theory, or central constructs of the theory, to investigate health judgments, decisions, or behaviors. Seventy nine studies (updated total is 94 studies; see Supplemental materials) were identified, over half published since 2012, spanning a wide variety of conditions and populations. Study findings supported the prediction that verbatim and gist representations are distinct constructs that can be retrieved independently using different cues. Although gist-based reasoning was usually associated with improved judgment and decision making, 4 sources of bias that can impair gist reasoning were identified. Finally, promising findings were reported from intervention studies that used fuzzy-trace theory to improve decision making and decrease unhealthy risk taking. Despite large gaps in the literature, most studies supported all 3 aims. By focusing on basic psychological processes that underlie judgment and decision making, fuzzy-trace theory provides insights into how individuals make decisions involving health risks and suggests innovative intervention approaches to improve health outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept.

PubMed

Salazar-Austin, N; Kulich, M; Chingono, A; Chariyalertsak, S; Srithanaviboonchai, K; Gray, G; Richter, L; van Rooyen, H; Morin, S; Sweat, M; Mbwambo, J; Szekeres, G; Coates, T; Celentano, D

2018-02-01

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18-24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61-0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05-1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85-2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08-1.36), and marriage (aOR 1.55; 95% CI 1.37-1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18-24 vs. 25-32 years).

What do I have to lose? Effects of a psycho-educational intervention on cancer patient preference for resuscitation.

PubMed

Sears, Sharon R; Woodward, Julia T; Twillman, Robert K

2007-12-01

This original empirical study examined effects of a psycho-educational intervention on cancer patients' knowledge, concern, and preferences for cardiopulmonary resuscitation (CPR). We examined message framing as one factor that might impact subsequent decision making. In addition, we examined personality and coping style as predictors and moderators of patients' reactions to an informational intervention. As hypothesized, participants initially underestimated CPR complications and overestimated survival rates. The intervention significantly increased concern, improved knowledge, and decreased preference for CPR, particularly for participants receiving both numerical and descriptive information. Message framing of survival data did not uniquely affect CPR preference. Higher optimism predicted less increase in concern about CPR, and higher hope predicted greater decrease in preference for CPR. More approach coping related to increased concern about CPR and decreased preference for CPR.

Toward a better understanding of what makes positive psychology interventions work: predicting happiness and depression from the person × intervention fit in a follow-up after 3.5 years.

PubMed

Proyer, René T; Wellenzohn, Sara; Gander, Fabian; Ruch, Willibald

2015-03-01

Robust evidence exists that positive psychology interventions are effective in enhancing well-being and ameliorating depression. Comparatively little is known about the conditions under which they work best. Models describing characteristics that impact the effectiveness of positive interventions typically contain features of the person, of the activity, and the fit between the two. This study focuses on indicators of the person × intervention fit in predicting happiness and depressive symptoms 3.5 years after completion of the intervention. A sample of 165 women completed measures for happiness and depressive symptoms before and about 3.5 years after completion of a positive intervention (random assignment to one out of nine interventions, which were aggregated for the analyses). Four fit indicators were assessed: Preference; continued practice; effort; and early reactivity. Three out of four person × intervention fit indicators were positively related to happiness or negatively related to depression when controlled for the pretest scores. Together, they explained 6 per cent of the variance in happiness, and 10 per cent of the variance of depressive symptoms. Most tested indicators of a person × intervention fit are robust predictors of happiness and depressive symptoms-even after 3.5 years. They might serve for an early estimation of the effectiveness of a positive intervention. © 2014 The International Association of Applied Psychology.

Determinants of high and low attendance to diet and exercise interventions among overweight and obese older adults. Results from the arthritis, diet, and activity promotion trial.

PubMed

van Gool, Coen H; Penninx, Brenda W J H; Kempen, Gertrudis I J M; Miller, Gary D; van Eijk, Jacques Th M; Pahor, Marco; Messier, Stephen P

2006-06-01

Determinants of adherence to lifestyle regimens are ill understood. Attendance to intervention sessions is crucial for patients to acquire knowledge and skills regarding the core elements of an intervention. Therefore, we explored demographic, health-related, and social determinants of high and low attendance to diet and exercise sessions among overweight and obese patients with knee osteoarthritis (> or = 60 years; N = 206). The Arthritis, Diet, and Activity Promotion Trial was an 18-month randomized controlled trial on the effectiveness of dietary weight loss and exercise interventions. We conducted chi-square and t-tests, and logistic regression analyses on categories of short- and long-term attendance to intervention sessions. Over the 18-month duration of the study, 60.7% (+/- 28.5) of diet sessions, and 53.2% (+/- 29.0) of exercise sessions were attended. Not being married, low social participation, and single intervention randomization predicted high attendance to diet sessions during months 1-4. Exercising at home, and single intervention randomization predicted high attendance to exercise sessions during months 5-18. High attendance to sessions early in the intervention was a significant determinant of high session attendance thereafter. Offering people a choice where to exercise, and stimulating early intervention session attendance can be effective in improving long-term attendance to both interventions. Several determinants we found may be amenable to change to enhance intervention adherence of future randomized controlled trials involving dietary weight loss and/or physical exercise.

Structural Damage Prediction and Analysis for Hypervelocity Impact: Consulting

NASA Technical Reports Server (NTRS)

1995-01-01

A portion of the contract NAS8-38856, 'Structural Damage Prediction and Analysis for Hypervelocity Impacts,' from NASA Marshall Space Flight Center (MSFC), included consulting which was to be documented in the final report. This attachment to the final report contains memos produced as part of that consulting.

The effectiveness of asking behaviors among 9-11 year-old children in increasing home availability and children's intake of fruit and vegetables: results from the Squire's Quest II self-regulation game intervention.

PubMed

DeSmet, Ann; Liu, Yan; De Bourdeaudhuij, Ilse; Baranowski, Tom; Thompson, Debbe

2017-04-21

Home environment has an important influence on children's fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire's Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children's FV intake. This study's aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)? This is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n = 100 child-parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n = 400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used. Baseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake. Children influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research. ClinicalTrials.gov NCT01004094 . Date registered 10/28/2009.

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning.

PubMed

Dalum, Peter; Schaalma, Herman; Kok, Gerjo

2012-02-01

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies. We found that guided practice, modelling, self-monitoring, coping planning, consciousness raising, dramatic relief and decisional balance were suitable methods for adolescent smoking cessation. We selected behavioural journalism, guided practice and Motivational Interviewing as strategies in our intervention. Intervention Mapping helped us to develop as systematic adolescent smoking cessation intervention with a clear link between behavioural goals, theoretical methods, practical strategies and materials and with a strong focus on implementation and recruitment. This paper does not present evaluation data.

Increasing URM Undergraduate Student Success through Assessment-Driven Interventions: A Multiyear Study Using Freshman-Level General Biology as a Model System

PubMed Central

Carmichael, Mary C.; St. Clair, Candace; Edwards, Andrea M.; Barrett, Peter; McFerrin, Harris; Davenport, Ian; Awad, Mohamed; Kundu, Anup; Ireland, Shubha Kale

2016-01-01

Xavier University of Louisiana leads the nation in awarding BS degrees in the biological sciences to African-American students. In this multiyear study with ∼5500 participants, data-driven interventions were adopted to improve student academic performance in a freshman-level general biology course. The three hour-long exams were common and administered concurrently to all students. New exam questions were developed using Bloom’s taxonomy, and exam results were analyzed statistically with validated assessment tools. All but the comprehensive final exam were returned to students for self-evaluation and remediation. Among other approaches, course rigor was monitored by using an identical set of 60 questions on the final exam across 10 semesters. Analysis of the identical sets of 60 final exam questions revealed that overall averages increased from 72.9% (2010) to 83.5% (2015). Regression analysis demonstrated a statistically significant correlation between high-risk students and their averages on the 60 questions. Additional analysis demonstrated statistically significant improvements for at least one letter grade from midterm to final and a 20% increase in the course pass rates over time, also for the high-risk population. These results support the hypothesis that our data-driven interventions and assessment techniques are successful in improving student retention, particularly for our academically at-risk students. PMID:27543637

Deriving a clinical prediction rule to target sexual healthcare to women attending British General Practices.

PubMed

Edelman, N L; Cassell, J A; Mercer, C H; Bremner, S A; Jones, C I; Gersten, A; deVisser, R O

2018-07-01

Some women attending General Practices (GPs) are at higher risk of unintended pregnancy (RUIP) and sexually transmitted infections (STI) than others. A clinical prediction rule (CPR) may help target resources using psychosocial questions as an acceptable, effective means of assessment. The aim was to derive a CPR that discriminates women who would benefit from sexual health discussion and intervention. Participants were recruited to a cross-sectional survey from six GPs in a city in South-East England in 2016. On arrival, female patients aged 16-44 years were invited to complete a questionnaire that addressed psychosocial factors, and the following self-reported outcomes: 2+ sexual partners in the last year (2PP) and RUIP. For each sexual risk, psychosocial questions were retained from logistic regression modelling which best discriminated women at risk using the C-statistic. Sensitivity and specificity were established in consultation with GP staff. The final sample comprised N = 1238 women. 2PP was predicted by 11 questions including age, binge-drinking weekly, ever having a partner who insulted you often, current smoking, and not cohabiting (C-statistic = 0.83, sensitivity = 73% and specificity = 77%). RUIP was predicted by 5 questions including sexual debut <16 years, and emergency contraception use in the last 6 months (C-statistic = 0.70, sensitivity = 69% and specificity = 57%). 2PP was better discriminated than RUIP but neither to a clinically-useful degree. The finding that different psychosocial factors predicted each outcome has implications for prevention strategies. Further research should investigate causal links between psychosocial factors and sexual risk. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Infant temperament reactivity and early maternal caregiving: independent and interactive links to later childhood attention-deficit/hyperactivity disorder symptoms.

PubMed

Miller, Natalie V; Degnan, Kathryn A; Hane, Amie A; Fox, Nathan A; Chronis-Tuscano, Andrea

2018-06-11

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with origins early in life. There is growing evidence that individual differences in temperament reactivity are predictive of ADHD symptoms, yet little is known about the relations between temperament reactivity in early infancy and later ADHD symptoms or the combined effect of reactivity with early environmental factors on ADHD symptom development. Using a 9-year prospective longitudinal design, this study tested the independent and interactive contributions of infant reactivity and maternal caregiving behaviors (MCB) on parent- and teacher-reported childhood ADHD symptoms. Participants included 291 children (132 male; 159 female) who participated in a larger study of temperament and social-emotional development. Reactivity was assessed by behavioral observation of negative affect, positive affect, and motor activity during novel stimuli presentations at 4 months of age. MCB were observed during a series of semistructured mother-infant tasks at 9 months of age. Finally, ADHD symptoms were assessed by parent- and teacher-report questionnaires at 7 and 9 years, respectively. Reactivity was predictive of ADHD symptoms, but results were sex specific. For boys, infant motor activity was positively predictive of later ADHD symptoms, but only at lower quality MCB. For girls, infant positive affect was positively predictive of later ADHD symptoms at lower quality MCB, and-unexpectedly-infant positive affect and motor activity were negatively predictive of later ADHD symptoms at higher quality MCB. These results point to early parenting as a moderating factor to mitigate temperament-related risk for later ADHD, suggesting this as a potential intervention target to mitigate risk for ADHD among reactive infants. © 2018 Association for Child and Adolescent Mental Health.

Ecological and personal predictors of science achievement in an urban center

NASA Astrophysics Data System (ADS)

Guidubaldi, John Michael

This study sought to examine selected personal and environmental factors that predict urban students' achievement test scores on the science subject area of the Ohio standardized test. Variables examined were in the general categories of teacher/classroom, student, and parent/home. It assumed that these clusters might add independent variance to a best predictor model, and that discovering relative strength of different predictors might lead to better selection of intervention strategies to improve student performance. This study was conducted in an urban school district and was comprised of teachers and students enrolled in ninth grade science in three of this district's high schools. Consenting teachers (9), students (196), and parents (196) received written surveys with questions designed to examine the predictive power of each variable cluster. Regression analyses were used to determine which factors best correlate with student scores and classroom science grades. Selected factors were then compiled into a best predictive model, predicting success on standardized science tests. Students t tests of gender and racial subgroups confirmed that there were racial differences in OPT scores, and both gender and racial differences in science grades. Additional examinations were therefore conducted for all 12 variables to determine whether gender and race had an impact on the strength of individual variable predictions and on the final best predictor model. Of the 15 original OPT and cluster variable hypotheses, eight showed significant positive relationships that occurred in the expected direction. However, when more broadly based end-of-the-year science class grade was used as a criterion, 13 of the 15 hypotheses showed significant relationships in the expected direction. With both criteria, significant gender and racial differences were observed in the strength of individual predictors and in the composition of best predictor models.

Prediction model of critical weight loss in cancer patients during particle therapy.

PubMed

Zhang, Zhihong; Zhu, Yu; Zhang, Lijuan; Wang, Ziying; Wan, Hongwei

2018-01-01

The objective of this study is to investigate the predictors of critical weight loss in cancer patients receiving particle therapy, and build a prediction model based on its predictive factors. Patients receiving particle therapy were enroled between June 2015 and June 2016. Body weight was measured at the start and end of particle therapy. Association between critical weight loss (defined as >5%) during particle therapy and patients' demographic, clinical characteristic, pre-therapeutic nutrition risk screening (NRS 2002) and BMI were evaluated by logistic regression and decision tree analysis. Finally, 375 cancer patients receiving particle therapy were included. Mean weight loss was 0.55 kg, and 11.5% of patients experienced critical weight loss during particle therapy. The main predictors of critical weight loss during particle therapy were head and neck tumour location, total radiation dose ≥70 Gy on the primary tumour, and without post-surgery, as indicated by both logistic regression and decision tree analysis. Prediction model that includes tumour locations, total radiation dose and post-surgery had a good predictive ability, with the area under receiver operating characteristic curve 0.79 (95% CI: 0.71-0.88) and 0.78 (95% CI: 0.69-0.86) for decision tree and logistic regression model, respectively. Cancer patients with head and neck tumour location, total radiation dose ≥70 Gy and without post-surgery were at higher risk of critical weight loss during particle therapy, and early intensive nutrition counselling or intervention should be target at this population. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Structures of the Recurrence Plot of Heart Rate Variability Signal as a Tool for Predicting the Onset of Paroxysmal Atrial Fibrillation

PubMed Central

Mohebbi, Maryam; Ghassemian, Hassan; Asl, Babak Mohammadzadeh

2011-01-01

This paper aims to propose an effective paroxysmal atrial fibrillation (PAF) predictor which is based on the analysis of the heart rate variability (HRV) signal. Predicting the onset of PAF, based on non-invasive techniques, is clinically important and can be invaluable in order to avoid useless therapeutic interventions and to minimize the risks for the patients. This method consists of four steps: Preprocessing, feature extraction, feature reduction, and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the HRV signal is extracted. In the next step, the recurrence plot (RP) of HRV signal is obtained and six features are extracted to characterize the basic patterns of the RP. These features consist of length of longest diagonal segments, average length of the diagonal lines, entropy, trapping time, length of longest vertical line, and recurrence trend. In the third step, these features are reduced to three features by the linear discriminant analysis (LDA) technique. Using LDA not only reduces the number of the input features, but also increases the classification accuracy by selecting the most discriminating features. Finally, a support vector machine-based classifier is used to classify the HRV signals. The performance of the proposed method in prediction of PAF episodes was evaluated using the Atrial Fibrillation Prediction Database which consists of both 30-minutes ECG recordings end just prior to the onset of PAF and segments at least 45 min distant from any PAF events. The obtained sensitivity, specificity, and positive predictivity were 96.55%, 100%, and 100%, respectively. PMID:22606666

Development and validation of a prediction algorithm for the onset of common mental disorders in a working population.

PubMed

Fernandez, Ana; Salvador-Carulla, Luis; Choi, Isabella; Calvo, Rafael; Harvey, Samuel B; Glozier, Nicholas

2018-01-01

Common mental disorders are the most common reason for long-term sickness absence in most developed countries. Prediction algorithms for the onset of common mental disorders may help target indicated work-based prevention interventions. We aimed to develop and validate a risk algorithm to predict the onset of common mental disorders at 12 months in a working population. We conducted a secondary analysis of the Household, Income and Labour Dynamics in Australia Survey, a longitudinal, nationally representative household panel in Australia. Data from the 6189 working participants who did not meet the criteria for a common mental disorders at baseline were non-randomly split into training and validation databases, based on state of residence. Common mental disorders were assessed with the mental component score of 36-Item Short Form Health Survey questionnaire (score ⩽45). Risk algorithms were constructed following recommendations made by the Transparent Reporting of a multivariable prediction model for Prevention Or Diagnosis statement. Different risk factors were identified among women and men for the final risk algorithms. In the training data, the model for women had a C-index of 0.73 and effect size (Hedges' g) of 0.91. In men, the C-index was 0.76 and the effect size was 1.06. In the validation data, the C-index was 0.66 for women and 0.73 for men, with positive predictive values of 0.28 and 0.26, respectively Conclusion: It is possible to develop an algorithm with good discrimination for the onset identifying overall and modifiable risks of common mental disorders among working men. Such models have the potential to change the way that prevention of common mental disorders at the workplace is conducted, but different models may be required for women.

Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease

PubMed Central

Prince, Anya E.R.

2015-01-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body. PMID:26339500

Prevention for those who can pay: insurance reimbursement of genetic-based preventive interventions in the liminal state between health and disease.

PubMed

Prince, Anya E R

2015-07-01

Clinical use of genetic testing to predict adult onset conditions allows individuals to minimize or circumvent disease when preventive medical interventions are available. Recent policy recommendations and changes expand patient access to information about asymptomatic genetic conditions and create mechanisms for expanded insurance coverage for genetic tests. The American College of Medical Genetics and Genomics (ACMG) recommends that laboratories provide incidental findings of medically actionable genetic variants after whole genome sequencing. The Patient Protection and Affordable Care Act (ACA) established mechanisms to mandate coverage for genetic tests, such as BRCA. The ACA and ACMG, however, do not address insurance coverage for preventive interventions. These policies equate access to testing as access to prevention, without exploring the accessibility and affordability of interventions. In reality, insurance coverage for preventive interventions in asymptomatic adults is variable given the US health insurance system's focus on treatment. Health disparities will be exacerbated if only privileged segments of society can access preventive interventions, such as prophylactic surgeries, screenings, or medication. To ensure equitable access to interventions, federal or state legislatures should mandate insurance coverage for both predictive genetic testing and recommended follow-up interventions included in a list established by an expert panel or regulatory body.

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2016-12-01

1 Award Number: W81XWH-12-2-0118 TITLE: Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic Ossification in Severely...December 2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION...COVERED 30Sep2012 - 29Sep2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic

CYBER: CHANGING THE LANDSCAPE OF FOREIGN INTERVENTION IN DEMOCRATIC ELECTIONS

DTIC Science & Technology

than the costs); and 3) the methods and tools for intervening are readily available. Cyber has had a significant impact on all three of the components...significant domestic actor and can act unilaterally to influence public opinion. Second, cyber lowers both the actual and perceived costs of...intervention. Finally, cyber methods and tools are available to almost anyone at any level. Cyber has lowered the barrier to electoral intervention. As a

Predictors of Consistent Condom Use Among Young African American Women

PubMed Central

DiClemente, Ralph J.; Salazar, Laura F.; Wingood, Gina M.; McDermott-Sales, Jessica; Young, April M.; Rose, Eve

2012-01-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15–21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions. PMID:21796442

Predictors of consistent condom use among young African American women.

PubMed

Crosby, Richard A; DiClemente, Ralph J; Salazar, Laura F; Wingood, Gina M; McDermott-Sales, Jessica; Young, April M; Rose, Eve

2013-03-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.

Lung protection: an intervention for tidal volume reduction in a teaching intensive care unit

PubMed Central

Briva, Arturo; Gaiero, Cristina

2016-01-01

Objective To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. Methods The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside. In parallel, predicted body weight was estimated from knee height and included in clinical charts. Results One hundred fifty-nine patients were included. Predicted body weight assessed by knee height instead of visual evaluation revealed that the delivered tidal volume was significantly higher than predicted. After the inclusion of predicted body weight, we observed a sustained reduction in delivered tidal volume from a mean (standard error) of 8.97 ± 0.32 to 7.49 ± 0.19mL/kg (p < 0.002). Furthermore, the protocol adherence was subsequently sustained for 12 months (delivered tidal volume 7.49 ± 0.54 versus 7.62 ± 0.20mL/kg; p = 0.103). Conclusion The lack of a reliable method to estimate the predicted body weight is a significant impairment for the application of a worldwide standard of care during mechanical ventilation. A combined intervention based on education and repeated feedbacks promoted sustained tidal volume education during the study period (12 months). PMID:27925055

Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015.

PubMed

Mehmandar, Mohammadreza; Soori, Hamid; Mehrabi, Yadolah

2016-01-01

Predicting the trend in traffic accidents deaths and its analysis can be a useful tool for planning and policy-making, conducting interventions appropriate with death trend, and taking the necessary actions required for controlling and preventing future occurrences. Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015. It was a cross-sectional study. All the information related to fatal traffic accidents available in the database of Iran Legal Medicine Organization from 2004 to the end of 2013 were used to determine the change points (multi-variable time series analysis). Using autoregressive integrated moving average (ARIMA) model, traffic accidents death rates were predicted for 2014 and 2015, and a comparison was made between this rate and the predicted value in order to determine the efficiency of the model. From the results, the actual death rate in 2014 was almost similar to that recorded for this year, while in 2015 there was a decrease compared with the previous year (2014) for all the months. A maximum value of 41% was also predicted for the months of January and February, 2015. From the prediction and analysis of the death trends, proper application and continuous use of the intervention conducted in the previous years for road safety improvement, motor vehicle safety improvement, particularly training and culture-fostering interventions, as well as approval and execution of deterrent regulations for changing the organizational behaviors, can significantly decrease the loss caused by traffic accidents.

Transactions Between Substance Use Intervention, the Oxytocin Receptor (OXTR) Gene, and Peer Substance Use Predicting Youth Alcohol Use.

PubMed

Cleveland, H Harrington; Griffin, Amanda M; Wolf, Pedro S A; Wiebe, Richard P; Schlomer, Gabriel L; Feinberg, Mark E; Greenberg, Mark T; Spoth, Richard L; Redmond, Cleve; Vandenbergh, David J

2018-01-01

This study investigated the oxytocin receptor (OXTR) gene's moderation of associations between exposure to a substance misuse intervention, average peer substance use, and adolescents' own alcohol use during the 9th-grade. OXTR genetic risk was measured using five single nucleotide polymorphisms (SNPs), and peer substance use was based on youths' nominated closest friends' own reports of alcohol, cigarette, and marijuana use, based on data from the PROSPER project. Regression models revealed several findings. First, low OXTR risk was linked to affiliating with friends who reported less substance use in the intervention condition but not the control condition. Second, affiliating with high substance-using friends predicted youth alcohol risk regardless of OXTR risk or intervention condition. Third, although high OXTR risk youth in the intervention condition who associated with low substance-using friends reported somewhat higher alcohol use than comparable youth in the control group, the absolute level of alcohol use among these youth was still among the lowest in the sample.

Exploring healthy eating among ethnic minority students using mobile technology: Feasibility and adherence.

PubMed

Rodgers, Rachel F; Franko, Debra L; Shiyko, Mariya; Intille, Stephen; Wilson, Kelcey; O'Carroll, Dympna; Lovering, Meghan; Matsumoto, Atsushi; Iannuccilli, Alyssa; Luk, Stephanie; Shoemaker, Helen

2016-09-01

Interventions aiming to help ethnically diverse emerging adults engage in healthy eating have had limited success. The aim of this study was to assess the feasibility of and adherence to an intervention capitalizing on mobile technology to improve healthy eating. Participants created an online photo food journal and received motivational text messages three times a day. Satisfaction with the intervention was assessed, as were control variables including depression and body dissatisfaction. In addition, weight and height were measured. Levels of adherence to the photo food journal were high with approximately two photos posted a day at baseline. However, adherence rates decreased over the course of the study. Body dissatisfaction positively predicted adherence, while body mass index negatively predicted study satisfaction. Mobile technology provides innovative avenues for healthy eating interventions. Such interventions appear acceptable and feasible for a short period; however, more work is required to evaluate their viability regarding long-term engagement. © The Author(s) 2015.

Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention.

PubMed

Banerjee, Moitree; Cavanagh, Kate; Strauss, Clara

2018-01-01

Little is known about the factors associated with engagement in mindfulness-based interventions (MBIs). Moreover, engagement in MBIs is usually defined in terms of class attendance ('physical engagement') only. However, in the psychotherapy literature, there is increasing emphasis on measuring participants' involvement with interventions ('psychological engagement'). This study tests a model that rumination and worry act as barriers to physical and psychological engagement in MBIs and that this in turn impedes learning mindfulness. One hundred and twenty-four participants were given access to a 2-week online mindfulness-based self-help (MBSH) intervention. Self-report measures of mindfulness, rumination, worry, positive beliefs about rumination, positive beliefs about worry and physical and psychological engagement were administered. A path analysis was used to test the linear relationships between the variables. Physical and psychological engagement were identified as two distinct constructs. Findings were that rumination and worry both predicted psychological disengagement in MBSH. Psychological engagement predicted change in the describe, act with awareness, non-judge and non-react facets of mindfulness while physical engagement only predicted changes in the non-react facet of mindfulness. Thus, rumination and worry may increase risk of psychological disengagement from MBSH which may in turn hinder cultivating mindfulness. Future suggestions for practice are discussed.

Identification of factors that affect the adoption of an ergonomic intervention among Emergency Medical Service workers.

PubMed

Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W

2012-01-01

This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.

Economic Models for Projecting Industrial Capacity for Defense Production: A Review

DTIC Science & Technology

1983-02-01

macroeconomic forecast to establish the level of civilian final demand; all use the DoD Bridge Table to allocate budget category outlays to industries. Civilian...output table.’ 3. Macroeconomic Assumptions and the Prediction of Final Demand All input-output models require as a starting point a prediction of final... macroeconomic fore- cast of GNP and its components and (2) a methodology to transform these forecast values of consumption, investment, exports, etc. into

Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane Database of Systematic Reviews

PubMed Central

Turner, Rebecca M; Davey, Jonathan; Clarke, Mike J; Thompson, Simon G; Higgins, Julian PT

2012-01-01

Background Many meta-analyses contain only a small number of studies, which makes it difficult to estimate the extent of between-study heterogeneity. Bayesian meta-analysis allows incorporation of external evidence on heterogeneity, and offers advantages over conventional random-effects meta-analysis. To assist in this, we provide empirical evidence on the likely extent of heterogeneity in particular areas of health care. Methods Our analyses included 14 886 meta-analyses from the Cochrane Database of Systematic Reviews. We classified each meta-analysis according to the type of outcome, type of intervention comparison and medical specialty. By modelling the study data from all meta-analyses simultaneously, using the log odds ratio scale, we investigated the impact of meta-analysis characteristics on the underlying between-study heterogeneity variance. Predictive distributions were obtained for the heterogeneity expected in future meta-analyses. Results Between-study heterogeneity variances for meta-analyses in which the outcome was all-cause mortality were found to be on average 17% (95% CI 10–26) of variances for other outcomes. In meta-analyses comparing two active pharmacological interventions, heterogeneity was on average 75% (95% CI 58–95) of variances for non-pharmacological interventions. Meta-analysis size was found to have only a small effect on heterogeneity. Predictive distributions are presented for nine different settings, defined by type of outcome and type of intervention comparison. For example, for a planned meta-analysis comparing a pharmacological intervention against placebo or control with a subjectively measured outcome, the predictive distribution for heterogeneity is a log-normal (−2.13, 1.582) distribution, which has a median value of 0.12. In an example of meta-analysis of six studies, incorporating external evidence led to a smaller heterogeneity estimate and a narrower confidence interval for the combined intervention effect. Conclusions Meta-analysis characteristics were strongly associated with the degree of between-study heterogeneity, and predictive distributions for heterogeneity differed substantially across settings. The informative priors provided will be very beneficial in future meta-analyses including few studies. PMID:22461129

The "ick" Factor Matters: Disgust Prospectively Predicts Avoidance in Chemotherapy Patients.

PubMed

Reynolds, Lisa M; Bissett, Ian P; Porter, David; Consedine, Nathan S

2016-12-01

Chemotherapy can be physically and psychologically demanding. Avoidance and withdrawal are common among patients coping with these demands. This report compares established emotional predictors of avoidance during chemotherapy (embarrassment; distress) with an emotion (disgust) that has been unstudied in this context. This report outlines secondary analyses of an RCT where 68 cancer patients undergoing chemotherapy were randomized to mindfulness or relaxation interventions. Self-reported baseline disgust (DS-R), embarrassment (SES-SF), and distress (Distress Thermometer) were used to prospectively predict multiple classes of avoidance post-intervention and at 3 months follow-up. Measures assessed social avoidance, cognitive and emotional avoidance (IES Avoidance), as well as information seeking and treatment adherence (General Adherence Scale). Repeated-measures ANOVAs evaluated possible longitudinal changes in disgust and forward entry regression models contrasted the ability of the affective variables to predict avoidance. Although disgust did not change over time or vary between groups, greater disgust predicted greater social, cognitive, and emotional avoidance, as well as greater information seeking. Social avoidance was predicted by trait embarrassment and distress predicted non-adherence. This report represents the first investigation of disgust's ability to prospectively predict avoidance in people undergoing chemotherapy. Compared to embarrassment and distress, disgust was a more consistent predictor across avoidance domains and its predictive ability was evident across a longer period of time. Findings highlight disgust's role as an indicator of likely avoidance in this health context. Early identification of cancer patients at risk of deleterious avoidance may enable timely interventions and has important clinical implications (ACTRN12613000238774).

Kansas Early Childhood Research Institute on Transitions. Final Report.

ERIC Educational Resources Information Center

Rice, Mabel L.; O'Brien, Marion

This final report describes research projects and other activities of the Kansas Early Childhood Research Institute (KECRI), a multi-investigator, cross-disciplinary Institute focusing on successful transitions for young (birth to age 8) children with disabilities or developmental delays. Interventions were developed, evaluated, and disseminated…

Gut Microbiota Signatures Predict Host and Microbiota Responses to Dietary Interventions in Obese Individuals

PubMed Central

Korpela, Katri; Flint, Harry J.; Johnstone, Alexandra M.; Lappi, Jenni; Poutanen, Kaisa; Dewulf, Evelyne; Delzenne, Nathalie; de Vos, Willem M.; Salonen, Anne

2014-01-01

Background Interactions between the diet and intestinal microbiota play a role in health and disease, including obesity and related metabolic complications. There is great interest to use dietary means to manipulate the microbiota to promote health. Currently, the impact of dietary change on the microbiota and the host metabolism is poorly predictable and highly individual. We propose that the responsiveness of the gut microbiota may depend on its composition, and associate with metabolic changes in the host. Methodology Our study involved three independent cohorts of obese adults (n = 78) from Belgium, Finland, and Britain, participating in different dietary interventions aiming to improve metabolic health. We used a phylogenetic microarray for comprehensive fecal microbiota analysis at baseline and after the intervention. Blood cholesterol, insulin and inflammation markers were analyzed as indicators of host response. The data were divided into four training set – test set pairs; each intervention acted both as a part of a training set and as an independent test set. We used linear models to predict the responsiveness of the microbiota and the host, and logistic regression to predict responder vs. non-responder status, or increase vs. decrease of the health parameters. Principal Findings Our models, based on the abundance of several, mainly Firmicute species at baseline, predicted the responsiveness of the microbiota (AUC  =  0.77–1; predicted vs. observed correlation  =  0.67–0.88). Many of the predictive taxa showed a non-linear relationship with the responsiveness. The microbiota response associated with the change in serum cholesterol levels with an AUC of 0.96, highlighting the involvement of the intestinal microbiota in metabolic health. Conclusion This proof-of-principle study introduces the first potential microbial biomarkers for dietary responsiveness in obese individuals with impaired metabolic health, and reveals the potential of microbiota signatures for personalized nutrition. PMID:24603757

Aggression and social withdrawal as viewed by children's peers: conceptual issues in assessment and implications for intervention.

PubMed Central

Younger, A J; Schneider, B H; Daniels, T

1991-01-01

Children's peer assessments of aggressive and withdrawn behavior are fundamentally related to developmental changes in their understanding of others. This article synthesizes research relevant to the thesis that peer assessments are dependent on children's ability both to recall the previous behavior of their peers and to predict their likely future behavior. Social schema theory, borrowed from adult social psychology, is highly relevant to such recall and prediction. Age differences, affective biases, and gender roles may color children's assessments of their peers' social behavior. Such influences should be taken into account when conceptualizing interventions aimed at enhancing children's peer status, and in measuring the success of these interventions. PMID:1958647

Prevention effects on trajectories of African American adolescents' exposure to interparental conflict and depressive symptoms.

PubMed

Barton, Allen W; Beach, Steven R H; Kogan, Steven M; Stanley, Scott M; Fincham, Frank D; Hurt, Tera R; Brody, Gene H

2015-04-01

The present study investigates the trajectory of children's exposure to interparental conflict during adolescence, its effects on adolescents' psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or preadolescent child participated in a randomized control trial of the Promoting Strong African American Families program, a newly developed program targeting couple and cocaregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of 2 years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents' report of youth exposure to interparental conflict, but not for child's report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents' reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed. (c) 2015 APA, all rights reserved).

Prevention effects on trajectories of African American adolescents' exposure to interparental conflict and depressive symptoms

PubMed Central

Barton, Allen W.; Beach, Steven R. H.; Kogan, Steven M.; Stanley, Scott M.; Fincham, Frank D.; Hurt, Tera R.; Brody, Gene H.

2015-01-01

The present study investigates the trajectory of children's exposure to interparental conflict during adolescence, its effects on adolescents' psychological adjustment, as well as the ability of a family-centered prevention program to alter this trajectory. A total of 331 African American couples with an adolescent or pre-adolescent child participated in a randomized control trial of the Promoting Strong African American Families (ProSAAF) program, a newly-developed program targeting couple and co-caregiving processes. Using a multi-informant, latent growth curve approach, child exposure to interparental conflict during adolescence was found to be stable over a period of two years among families in the control group, but significantly declined among families in the treatment condition. Rates of change were significantly different between intervention and control groups based on parents' report of youth exposure to interparental conflict, but not for child's report. Structural equation models found trajectory parameters of interparental conflict predicted changes in adolescent depressive symptoms, with increasing rates of changes in conflict associated with increases in adolescent internalizing symptoms over the 2-year duration of the study. Finally, a significant indirect effect was identified linking treatment, changes in parents' reports of child exposure to interparental conflict, and adolescent depressive symptoms. The implications for research and intervention are discussed. PMID:25844492

Psychometric evaluation of the Work Readiness Questionnaire in schizophrenia.

PubMed

Potkin, Steven G; Bugarski-Kirola, Dragana; Edgar, Chris J; Soliman, Sherif; Le Scouiller, Stephanie; Kunovac, Jelena; Miguel Velasco, Eugenio; Garibaldi, George M

2016-04-01

Unemployment can negatively impact quality of life among patients with schizophrenia. Employment status depends on ability, opportunity, education, and cultural influences. A clinician-rated scale of work readiness, independent of current work status, can be a valuable assessment tool. A series of studies were conducted to create and validate a Work Readiness Questionnaire (WoRQ) for clinicians to assess patient ability to engage in socially useful activity, independent of work availability. Content validity, test-retest and inter-rater reliability, and construct validity were evaluated in three separate studies. Content validity was supported. Cronbach's α was 0.91, in the excellent range. Clinicians endorsed WoRQ concepts, including treatment adherence, physical appearance, social competence, and symptom control. The final readiness decision showed good test-retest reliability and moderate inter-rater reliability. Work readiness was associated with higher function and lower levels of negative symptoms. Low positive and high negative predictive values confirmed the concept validity. The WoRQ has suitable psychometric properties for use in a clinical trial for patients with a broad range of symptom severity. The scale may be applicable to assess therapeutic interventions. It is not intended to assess eligibility for supported work interventions. The WoRQ is suitable for use in schizophrenia clinical trials to assess patient work functional potential.

High prevalence of forced sex among non-brothel based, wine shop centered sex workers in Chennai, India.

PubMed

Go, Vivian F; Srikrishnan, Aylur K; Parker, Corette Breeden; Salter, Megan; Green, Annette M; Sivaram, Sudha; Johnson, Sethulakshmi C; Latkin, Carl; Davis, Wendy; Solomon, Suniti; Celentano, David D

2011-01-01

Sexual violence has been shown to increase women's risk of HIV infection. India is a country where the HIV epidemic is growing among women and intimate partner violence (IPV) is pervasive. This study examined prevalence of and factors associated with forced sex among female sex workers (FSWs) in Chennai, India. We conducted a probability survey among FSWs in 24 slum venues and identified predictive factors for recent forced sex using univariate and multivariable proportional odds models. Among 522 FSWs, 28% reported having forced sex with one partner and 35% with 2+ partners. In the final multivariable model, women who had a high number of partners who had a strong tendency to drink alcohol before sex were more likely to have experienced forced sex, and women who had both unprotected sex with a nonspousal partner and > 20 days of alcohol consumption in the last 30 days were more likely to have experienced forced sex. Discussion about family violence with larger social networks was independently associated with lower odds of forced sex among FSWs. HIV interventions for FSWs and their clients aimed at reducing alcohol consumption and encouraging condom use could be enhanced by violence prevention interventions to facilitate discourse about sexual violence.

Developing a risk prediction model for the functional outcome after hip arthroscopy.

PubMed

Stephan, Patrick; Röling, Maarten A; Mathijssen, Nina M C; Hannink, Gerjon; Bloem, Rolf M

2018-04-19

Hip arthroscopic treatment is not equally beneficial for every patient undergoing this procedure. Therefore, the purpose of this study was to develop a clinical prediction model for functional outcome after surgery based on preoperative factors. Prospective data was collected on a cohort of 205 patients having undergone hip arthroscopy between 2011 and 2015. Demographic and clinical variables and patient reported outcome (PRO) scores were collected, and considered as potential predictors. Successful outcome was defined as either a Hip Outcome Score (HOS)-ADL score of over 80% or improvement of 23%, defined by the minimal clinical important difference, 1 year after surgery. The prediction model was developed using backward logistic regression. Regression coefficients were converted into an easy to use prediction rule. The analysis included 203 patients, of which 74% had a successful outcome. Female gender (OR: 0.37 (95% CI 0.17-0.83); p = 0.02), pincer impingement (OR: 0.47 (95% CI 0.21-1.09); p = 0.08), labral tear (OR: 0.46 (95% CI 0.20-1.06); p = 0.07), HOS-ADL score (IQR OR: 2.01 (95% CI 0.99-4.08); p = 0.05), WHOQOL physical (IQR OR: 0.43 (95% CI 0.22-0.87); p = 0.02) and WHOQOL psychological (IQR OR: 2.40 (95% CI 1.38-4.18); p = < 0.01) were factors in the final prediction model of successful functional outcome 1 year after hip arthroscopy. The model's discriminating accuracy turned out to be fair, as 71% (95% CI: 64-80%) of the patients were classified correctly. The developed prediction model can predict the functional outcome of patients that are considered for a hip arthroscopic intervention, containing six easy accessible preoperative risk factors. The model can be further improved trough external validation and/or adding additional potential predictors.

What interventions are effective on reducing inequalities in maternal and child health in low- and middle-income settings? A systematic review.

PubMed

Yuan, Beibei; Målqvist, Mats; Trygg, Nadja; Qian, Xu; Ng, Nawi; Thomsen, Sarah

2014-06-21

The deadline for achieving Millennium Development Goals 4 and 5 is approaching, but inequalities between disadvantaged and other populations is a significant barrier for progress towards achieving these goals. This systematic review aims to collect evidence about the differential effects of interventions on different sociodemographic groups in order to identify interventions that were effective in reducing maternal or child health inequalities. We searched the PubMed, EMBASE and other relevant databases. The reference lists of included reviews were also screened to find more eligible studies. We included experimental or observational studies that assessed the effects of interventions on maternal and child health, but only studies that report quantitative inequality outcomes were finally included for analysis. 22 articles about the effectiveness of interventions on equity in maternal and child health were finally included. These studies covered five kinds of interventions: immunization campaigns, nutrition supplement programs, health care provision improvement interventions, demand side interventions, and mixed interventions. The outcome indicators covered all MDG 4 and three MDG 5 outcomes. None of the included studies looked at equity in maternal mortality, adolescent birth rate and unmet need for family planning. The included studies reported inequalities based on gender, income, education level or comprehensive socioeconomic status. Stronger or moderate evidence showed that all kinds of the included interventions may be more effective in improving maternal or child health for those from disadvantaged groups. Studies about the effectiveness of interventions on equity in maternal or child health are limited. The limited evidence showed that the interventions that were effective in reducing inequity included the improvement of health care delivery by outreach methods, using human resources in local areas or provided at the community level nearest to residents and the provision of financial or knowledge support to demand side.

Factors related to parental age of first concern in toddlers with autism spectrum disorder.

PubMed

Matheis, Maya; Matson, Johnny L; Burns, Claire O; Jiang, Xinrui; Peters, W Jason; Moore, Michael; de Back, Kaitlin A; Estabillo, Jasper

2017-05-01

The age of first concern (AOC) of parents of children with autism spectrum disorders (ASD) has substantial implications for early diagnosis and intervention. The current study sought to determine the average AOC, what types of first concerns are most common, and what factors predict earlier AOC in toddlers with ASD. This study analyzed the predictive influence of the type of concern, symptom severity, medical diagnoses, and other independent variables on AOC among toddlers with ASD using multiple regressions. The mean AOC was found to be 13.97 months (SD = 7.86). The most commonly reported first concern was speech/language. First concerns related to communication, speech/language predicted later AOC, while motor concerns predicted earlier AOC. Concerns that are more closely related to social communication deficits characteristic of ASD predicted later AOC. The implications of these findings on screening/assessment and intervention are discussed.

Treatment Techniques and Outcomes in Multidimensional Family Therapy for Adolescent Behavior Problems

PubMed Central

Hogue, Aaron; Dauber, Sarah; Samuolis, Jessica; Liddle, Howard A.

2010-01-01

The link between treatment techniques and long-term treatment outcome was examined in an empirically supported family-based treatment for adolescent drug abuse. Observational ratings of therapist interventions were used to predict outcomes at 6 and 12 months posttreatment for 63 families receiving multidimensional family therapy. Greater use of in-session family-focused techniques predicted reduction in internalizing symptoms and improvement in family cohesion. Greater use of family-focused techniques also predicted reduced externalizing symptoms and family conflict, but only when adolescent focus was also high. In addition, greater use of adolescent-focused techniques predicted improvement in family cohesion and family conflict. Results suggest that both individual and multiperson interventions can exert an influential role in family-based therapy for clinically referred adolescents. PMID:17176187

Exposure and response prevention process predicts treatment outcome in youth with OCD.

PubMed

Kircanski, Katharina; Peris, Tara S

2015-04-01

Recent research on the treatment of adults with anxiety disorders suggests that aspects of the in-session exposure therapy process are relevant to clinical outcomes. However, few comprehensive studies have been conducted with children and adolescents. In the present study, 35 youth diagnosed with primary obsessive-compulsive disorder (OCD; M age = 12.9 years, 49% male, 63% Caucasian) completed 12 sessions of exposure and response prevention (ERP) in one of two treatment conditions as part of a pilot randomized controlled testing of a family focused intervention for OCD. Key exposure process variables, including youth self-reported distress during ERP and the quantity and quality of ERP completed, were computed. These variables were examined as predictors of treatment outcomes assessed at mid-treatment, post-treatment, and three-month follow-up, partialing treatment condition. In general, greater variability of distress during ERP and completing a greater proportion of combined exposures (i.e., exposures targeting more than one OC symptom at once) were predictive of better outcomes. Conversely, greater distress at the end of treatment was generally predictive of poorer outcomes. Finally, several variables, including within- and between-session decreases in distress during ERP, were not consistently predictive of outcomes. Findings signal potentially important facets of exposure for youth with OCD and have implications for treatment. A number of results also parallel recent findings in the adult literature, suggesting that there may be some continuity in exposure processes from child to adult development. Future work should examine additional measures of exposure process, such as psychophysiological arousal during exposure, in youth.

Drinking Motives in the Prospective Prediction of Unique Alcohol-Related Consequences in College Students

PubMed Central

Merrill, Jennifer E.; Wardell, Jeffrey D.; Read, Jennifer P.

2014-01-01

Objective: Although college students experience a diverse range of alcohol consequences, most studies focus on global, rather than distinct, consequence types. One predictor of unique consequences—drinking motives—has been studied only cross-sectionally. We aimed to examine the prediction of unique alcohol consequence domains (social/interpersonal, academic/occupational, risky behavior, impaired control, poor self-care, diminished self-perception, blackout drinking, and physiological dependence) by coping and enhancement motives over the course of one year. We hypothesized that coping motives would directly predict and that enhancement motives would indirectly (through alcohol use) predict unique consequences. Method: Web surveys were administered to a sample of college students (n = 552, 62% female) at the beginning of the fall semester for 2 consecutive academic years. Structural equation modeling was used to test direct and indirect paths from motives to consequences. Results: The data supported hypothesized direct, prospective paths from coping motives to several alcohol consequences (impaired control, diminished self-perception, poor self-care, risky behaviors, academic/occupational, and physiological dependence). These associations were not mediated by alcohol consumption. Enhancement motives were indirectly associated with all eight consequence domains by way of increased alcohol use at follow-up. Models were invariant across gender, year in school, and symptoms of posttraumatic stress. Conclusions: Findings suggest that whether motives act as a final common pathway to problem drinking may depend on which motives and which drinking outcomes are examined. As coping motives demonstrate a direct link to unique alcohol problem types over time, individuals endorsing these motives may need to be prioritized for intervention. PMID:24411801

Features of objectified body consciousness and sociocultural perspectives as risk factors for disordered eating among late-adolescent women and men.

PubMed

Jackson, Todd; Chen, Hong

2015-10-01

Body surveillance and body shame are features of objectified body consciousness (OBC) that have been linked to disordered eating, yet the evidence base is largely cross-sectional and limited to samples in certain Western countries. Furthermore, it is not clear whether these factors contribute to the prediction of eating disturbances independent of conceptually related risk factors emphasized within other sociocultural accounts. In this prospective study, body surveillance, body shame, and features of complementary sociocultural models (i.e., perceived appearance pressure from mass media and close interpersonal networks, appearance social comparisons, negative affect, body dissatisfaction) were assessed as risk factors for and concomitants of eating disturbances over time. University-age, mainland Chinese women (n = 2144) and men (n = 1017) completed validated measures of eating-disorder pathology and hypothesized risk factors at baseline (T1) and 1-year follow-up (T2). Among women, elevations on T1 measures of sociocultural-model features predicted more T2 eating disturbances, independent of T1 disturbances. After controlling for other T1 predictors, body surveillance and shame made modest unique contributions to the model. Finally, heightened T2 body dissatisfaction, media, and interpersonal appearance pressure, negative affect, and body shame predicted concomitant increases in T2 eating concerns. For men, T1 features of sociocultural accounts (negative affect, body dissatisfaction) but not OBC predicted T2 eating disturbances, along with attendant elevations in T2 negative affect, interpersonal appearance pressure, and body shame. Implications are discussed for theory and intervention that target disordered eating. (c) 2015 APA, all rights reserved).

Crash risk and aberrant driving behaviors among bus drivers: the role of personality and attitudes towards traffic safety.

PubMed

Mallia, Luca; Lazuras, Lambros; Violani, Cristiano; Lucidi, Fabio

2015-06-01

Several studies have shown that personality traits and attitudes toward traffic safety predict aberrant driving behaviors and crash involvement. However, this process has not been adequately investigated in professional drivers, such as bus drivers. The present study used a personality-attitudes model to assess whether personality traits predicted aberrant self-reported driving behaviors (driving violations, lapses, and errors) both directly and indirectly, through the effects of attitudes towards traffic safety in a large sample of bus drivers. Additionally, the relationship between aberrant self-reported driving behaviors and crash risk was also assessed. Three hundred and one bus drivers (mean age=39.1, SD=10.7 years) completed a structured and anonymous questionnaire measuring personality traits, attitudes toward traffic safety, self-reported aberrant driving behaviors (i.e., errors, lapses, and traffic violations), and accident risk in the last 12 months. Structural equation modeling analysis revealed that personality traits were associated to aberrant driving behaviors both directly and indirectly. In particular altruism, excitement seeking, and normlessness directly predicted bus drivers' attitudes toward traffic safety which, in turn, were negatively associated with the three types of self-reported aberrant driving behaviors. Personality traits relevant to emotionality directly predicted bus drivers' aberrant driving behaviors, without any mediation of attitudes. Finally, only self-reported violations were related to bus drivers' accident risk. The present findings suggest that the hypothesized personality-attitudes model accounts for aberrant driving behaviors in bus drivers, and provide the empirical basis for evidence-based road safety interventions in the context of public transport. Copyright © 2015 Elsevier Ltd. All rights reserved.

What Specific Facets of Executive Function are Associated with Academic Functioning in Youth with Attention-Deficit/Hyperactivity Disorder?

PubMed Central

Langberg, Joshua M.; Dvorsky, Melissa R.; Evans, Steven W.

2013-01-01

The purpose of the study was to evaluate the relation between ratings of Executive Function (EF) and academic functioning in a sample of 94 middle-school-aged youth with Attention-Deficit/Hyperactivity Disorder (ADHD; Mage = 11.9; 78% male; 21% minority). This study builds on prior work by evaluating associations between multiple specific aspects of EF (e.g., working memory, inhibition, and planning and organization) as rated by both parents and teachers on the Behavior Rating Inventory of Executive Function (BRIEF), with multiple academic outcomes, including school grades and homework problems. Further, this study examined the relationship between EF and academic outcomes above and beyond ADHD symptoms and controlled for a number of potentially important covariates, including intelligence and achievement scores. The EF Planning and Organization subscale as rated by both parents and teachers predicted school grades above and beyond symptoms of ADHD and relevant covariates. Parent ratings of youth’s ability to transition effectively between tasks/situations (Shift subscale) also predicted school grades. Parent-rated symptoms of inattention, hyperactivity/impulsivity, and planning and organization abilities were significant in the final model predicting homework problems. In contrast, only symptoms of inattention and the Organization of Materials subscale from the BRIEF were significant in the teacher model predicting homework problems. Organization and planning abilities are highly important aspects academic functioning for middle-school-aged youth with ADHD. Implications of these findings for the measurement of EF, and organization and planning abilities in particular, are discussed along with potential implications for intervention. PMID:23640285

Longitudinal Effects of Latino Parent Cultural Stress, Depressive Symptoms, and Family Functioning on Youth Emotional Well-Being and Health Risk Behaviors.

PubMed

Lorenzo-Blanco, Elma I; Meca, Alan; Unger, Jennifer B; Romero, Andrea; Szapocznik, José; Piña-Watson, Brandy; Cano, Miguel Ángel; Zamboanga, Byron L; Baezconde-Garbanati, Lourdes; Des Rosiers, Sabrina E; Soto, Daniel W; Villamar, Juan A; Lizzi, Karina M; Pattarroyo, Monica; Schwartz, Seth J

2017-12-01

U.S. Latino parents can face cultural stressors in the form of acculturative stress, perceived discrimination, and a negative context of reception. It stands to reason that these cultural stressors may negatively impact Latino youth's emotional well-being and health risk behaviors by increasing parents' depressive symptoms and compromising the overall functioning of the family. To test this possibility, we analyzed data from a six-wave longitudinal study with 302 recently immigrated (<5 years in the United States) Latino parents (74% mothers, M age  = 41.09 years) and their adolescent children (47% female, M age  = 14.51 years). Results of a cross-lagged analysis indicated that parent cultural stress predicted greater parent depressive symptoms (and not vice versa). Both parent cultural stress and depressive symptoms, in turn, predicted lower parent-reported family functioning, which mediated the links from parent cultural stress and depressive symptoms to youth alcohol and cigarette use. Parent cultural stress also predicted lower youth-reported family functioning, which mediated the link from parent cultural stress to youth self-esteem. Finally, mediation analyses indicated that parent cultural stress predicted youth alcohol use by a way of parent depressive symptoms and parent-reported family functioning. Our findings point to parent depressive symptoms and family functioning as key mediators in the links from parent cultural stress to youth emotional well-being and health risk behaviors. We discuss implications for research and preventive interventions. © 2016 Family Process Institute.

Executive Function Processes Predict Mobility Outcomes in Older Adults

PubMed Central

Gothe, Neha P.; Fanning, Jason; Awick, Elizabeth; Chung, David; Wójcicki, Thomas R.; Olson, Erin A.; Mullen, Sean P.; Voss, Michelle; Erickson, Kirk I.; Kramer, Arthur F.; McAuley, Edward

2013-01-01

BACKGROUND: There is growing evidence suggesting an association between cognitive function and physical performance in late life. This study examined the relationship between performance on executive function measures and subsequent mobility outcomes among community dwelling older adults across a 12-month randomized controlled exercise trial. DESIGN: Randomized controlled clinical trial SETTING: Champaign-Urbana, Illinois PARTICIPANTS: Community dwelling older adults (N = 179; Mage = 66.4) INTERVENTION: A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group MEASUREMENTS: Established cognitive tests of executive function including the flanker task, task switching and a dual task paradigm, and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. METHODS: Participants completed the cognitive measures at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted post-intervention functional performance after controlling for age, sex, education, cardiorespiratory fitness and baseline mobility levels. RESULTS: Our analyses revealed that selective baseline executive function measures, particularly performance on the flanker task (β’s =.15 to .17) and the Wisconsin card sort test (β’s =.11 to .16) consistently predicted mobility outcomes at month 12. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of the intervention group. CONCLUSION: Executive functions of inhibitory control, mental set shifting and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that can be attenuated by well-designed interventions to improve cognitive performance. PMID:24521364

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

PubMed

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-05-12

Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. 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.

Predicting 30-Day Hospital Readmissions in Acute Myocardial Infarction: The AMI "READMITS" (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus, Nonmale Sex, Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score.

PubMed

Nguyen, Oanh Kieu; Makam, Anil N; Clark, Christopher; Zhang, Song; Das, Sandeep R; Halm, Ethan A

2018-04-17

Readmissions after hospitalization for acute myocardial infarction (AMI) are common. However, the few currently available AMI readmission risk prediction models have poor-to-modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate AMI readmission risk prediction model to identify high-risk patients as early as possible during hospitalization. We used electronic health record data from consecutive AMI hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all-cause nonelective 30-day readmissions, using stepwise backward selection and 5-fold cross-validation. Of 826 patients hospitalized with AMI, 13% had a 30-day readmission. The first-day AMI model (the AMI "READMITS" score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systolic blood pressure, had an optimism-corrected C-statistic of 0.73 (95% confidence interval, 0.71-0.74) and was well calibrated. The full-stay AMI model, which included 3 additional predictors (use of intravenous diuretics, anemia on discharge, and discharge to postacute care), had an optimism-corrected C-statistic of 0.75 (95% confidence interval, 0.74-0.76) with minimally improved net reclassification and calibration. Both AMI models outperformed corresponding multicondition readmission models. The parsimonious AMI READMITS score enables early prospective identification of high-risk AMI patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full-stay AMI readmission model only modestly outperformed the AMI READMITS score in terms of discrimination, but surprisingly did not meaningfully improve reclassification. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Trial for the Prevention of Depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial.

PubMed

Perry, Yael; Calear, Alison L; Mackinnon, Andrew; Batterham, Philip J; Licinio, Julio; King, Catherine; Thomsen, Noel; Scott, Jan; Donker, Tara; Merry, Sally; Fleming, Theresa; Stasiak, Karolina; Werner-Seidler, Aliza; Christensen, Helen

2015-10-12

Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations. Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools. This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling. Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606 . Registered 25 March 2014.

All That Glitters Is not Gold: Consumer Health Informatics and Education in the Era of Social Media and Health Apps

PubMed Central

Staccini, P.

2016-01-01

Summary Objective To summarize the state of the art published during the year 2015 in the areas related to consumer health informatics and education with a special emphasis on unintended consequences of applying mobile and social media technologies in that domain. Methods We conducted a systematic review of articles published in PubMed with a predefined set of queries, which lead to the selection of over 700 potential relevant articles. Section editors screened those papers on the title, abstract, and finally complete paper basis, taking into account the papers’ relevance for the section topic. The 15 most representative papers were finally selected by consensus between the two section editors and submitted for full review and scoring to external reviewers and the yearbook editors. Based on the final scoring, section editors selected the best five papers. Results The five best papers can be grouped in two major areas: 1) Digital health literacy and 2) Quality and safety concerns. Regarding health literacy issues of patients with chronic conditions such as asthma, online interventions should rather focus on changing patient beliefs about the disease than on supporting them in the management of their pathology since personally controlled health management systems do not show expected benefits,. Nevertheless, encouraging and training chronic patients for an active online health information–seeking behaviour substantially decreases state anxiety level. Regarding safety and privacy issues, even recommended health-related apps available on mobile phones do not guarantee personal data protection. Furthermore, the analysis indicated that patients undergoing Internet interventions experienced at least one adverse event that might be related to treatment. At least, predictive factors have been identified in order to credit or not a health rumour. Conclusions Trusting digital and connected health can be achieved if patients, health care professionals, and industrials build a shared model of health data management integrating ethics rules. Only increasing efforts in education with regards of digital health would help reach this goal., This would not resolve all frauds and security issues but at least improve their detection. PMID:27830250

All that Glitters Is not Gold: Consumer Health Informatics and Education in the Era of Social Media and Health Apps. Findings from the Yearbook 2016 Section on Consumer Health Informatics.

PubMed

Fernandez-Luque, L; Staccini, P

2016-11-10

To summarize the state of the art published during the year 2015 in the areas related to consumer health informatics and education with a special emphasis on unintended consequences of applying mobile and social media technologies in that domain. We conducted a systematic review of articles published in PubMed with a predefined set of queries, which lead to the selection of over 700 potential relevant articles. Section editors screened those papers on the title, abstract, and finally complete paper basis, taking into account the papers' relevance for the section topic. The 15 most representative papers were finally selected by consensus between the two section editors and submitted for full review and scoring to external reviewers and the yearbook editors. Based on the final scoring, section editors selected the best five papers. The five best papers can be grouped in two major areas: 1) Digital health literacy and 2) Quality and safety concerns. Regarding health literacy issues of patients with chronic conditions such as asthma, online interventions should rather focus on changing patient beliefs about the disease than on supporting them in the management of their pathology since personally controlled health management systems do not show expected benefits,. Nevertheless, encouraging and training chronic patients for an active online health information-seeking behaviour substantially decreases state anxiety level. Regarding safety and privacy issues, even recommended health-related apps available on mobile phones do not guarantee personal data protection. Furthermore, the analysis indicated that patients undergoing Internet interventions experienced at least one adverse event that might be related to treatment. At least, predictive factors have been identified in order to credit or not a health rumour. Trusting digital and connected health can be achieved if patients, health care professionals, and industrials build a shared model of health data management integrating ethics rules. Only increasing efforts in education with regards of digital health would help reach this goal., This would not resolve all frauds and security issues but at least improve their detection.

Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation: an experimental study.

PubMed

Alfonsson, Sven; Johansson, Karin; Uddling, Jonas; Hursti, Timo

2017-01-26

Adherence to treatment homework is associated with positive outcomes in behavioral psychotherapy but compliance to assignments is still often moderate. Whether adherence can be predicted by different types of motivation for the task and whether motivation plays different roles in face-to-face compared to online psychotherapy is unknown. If models of motivation, such as Self-determination theory, can be used to predict patients' behavior, it may facilitate further research into homework promotion. The aims of this study were, therefore, to investigate whether motivation variables could predict adherence to a prescribed assignment in face-to-face and online interventions using a psychotherapy analog model. A total of 100 participants were included in this study and randomized to either a face-to-face or online intervention. Participants in both groups received a psychoeducation session and were given an assignment for the subsequent week. The main outcome measurements were self-reported motivation and adherence to the assignment. Participant in the face-to-face condition reported significantly higher levels of motivation and showed higher levels of adherence compared to participants in the online condition. Adherence to the assignment was positively associated with intrinsic motivation and intervention credibility in the whole sample and especially in the online group. This study shows that intrinsic motivation and intervention credibility are strong predictors of adherence to assignments, especially in online interventions. The results indicate that intrinsic motivation may be partly substituted with face-to-face contact with a therapist. It may also be possible to identify patients with low motivation in online interventions who are at risk of dropping out. Methods for making online interventions more intrinsically motivating without increasing external pressure are needed. clinicaltrials.gov NCT02895308 . Retrospectively registered 30 August 2016.

Which psychological, social and physical environmental characteristics predict changes in physical activity and sedentary behaviors during early retirement? A longitudinal study

PubMed Central

Van Dyck, Delfien; Cardon, Greet

2017-01-01

Background In the context of healthy ageing, it is necessary to identify opportunities to implement health interventions in order to develop an active lifestyle with sufficient physical activity and limited sedentary time in middle-aged and older adults. The transition to retirement is such an opportunity, as individuals tend to establish new routines at the start of retirement. Before health interventions can be developed, the psychological, social and physical environmental determinants of physical activity and sedentary behaviors during early retirement should be identified, ideally with longitudinal studies. The aim of this paper was first to examine whether psychological, social and physical environmental factors at the start of retirement predict longitudinal changes in physical activity and sedentary behaviors during the first years of retirement. Second, moderating effects of gender and educational levels were examined. Methods This longitudinal study was conducted in Flanders, Belgium. In total, 180 recently retired (>1 month, <2 years at baseline) adults completed a postal questionnaire twice (in 2012–2013 and two years later in 2014–2015). The validated questionnaire assessed socio-demographic information, physical activity, sedentary behaviors, and psychological, social and physical environmental characteristics. Multiple moderated hierarchic regression analyses were conducted in SPSS 22.0. Results Higher perceived residential density (p < 0.001) and lower aesthetics (p = 0.08) predicted an increase in active transportation (adjusted R2 = 0.18). Higher baseline self-efficacy was associated with an increase in leisure-time physical activity (p = 0.001, adjusted R2 = 0.13). A more positive perception of old age (p = 0.04) and perceiving less street connectivity (p = 0.001) were associated with an increase in screen time (adjusted R2 = 0.06). Finally, higher baseline levels of modeling from friends (p = 0.06) and lower perceived land use mix access (p = 0.09) predicted an increase in car use (adjusted R2 = 0.06). A few moderating effects, mainly of educational level, were found. Discussion Walkability characteristics (perceived residential density) and self-efficacy at the start of retirement are the most important predictors of longitudinal changes in active transportation and leisure-time physical activity. Few moderating effects were found, so health interventions at the start of retirement focusing on self-efficacy and specific walkability characteristics could be effective to increase physical activity in recently retired adults. No firm conclusions can be drawn on the importance of the examined predictors to explain change in car use and screen time, possibly other factors like the home environment, or automatic processes and habit strength are more important to explain sedentary behaviors. PMID:28507817

The Association between Expressive Grammar Intervention and Social and Emergent Literacy Outcomes for Preschoolers with SLI

ERIC Educational Resources Information Center

Washington, Karla N.

2013-01-01

Purpose: To determine whether (a) expressive grammar intervention facilitated social and emergent literacy outcomes better than no intervention and (b) expressive grammar gains and/or initial expressive grammar level predicted social and emergent literacy outcomes. Method: This investigation was a follow-up to a recently published study exploring…

Direct and Indirect Effects of Media Literacy Training on Third Graders' Decision-making for Alcohol.

ERIC Educational Resources Information Center

Austin, Erica Weintraub; Johnson, Kristine Kay

One major challenge for intervention regarding alcohol is to target children with age-appropriate strategies while predictive risk and protective factors are still forming. Most intervention research has focused on children of preadolescent or adolescent ages, but recent work suggests that interventions may be most effective with children prior to…

A group-based counselling intervention for depression comorbid with HIV/AIDS using a task shifting approach in South Africa: a randomized controlled pilot study.

PubMed

Petersen, I; Hanass Hancock, J; Bhana, A; Govender, K

2014-04-01

Co-morbid depression in HIV-positive patients on anti-retroviral (ART) treatment poses a public health threat. It compromises treatment adherence and accelerates disease progression. This study aimed to assess the feasibility of a group-based counselling intervention for depressed HIV-positive patients in primary health care (PHC) in South Africa using a task shifting approach. Using a randomized control design, 76 HIV-positive patients with co-morbid depression were initially recruited. This reduced to 34 in the final cohort. Participants were assessed using the Patient Health Questionnaire (PHQ9), Hopkins Symptom Checklist (HSCL-25) and Multidimensional Scale of Perceived Social Support (MSPSS) at baseline and 3-month follow-up. The intervention was adapted from a local group-based Interpersonal Therapy (IPT) intervention. Process evaluation interviews were held with the HIV counsellors who delivered the intervention and a sub-sample of participants. Repeated measures ANOVA analysis showed significantly greater improvement on depression scores on the PHQ9 in the intervention group compared to the control group. A significant decline in the mean scores on the HSCL-25 was found for both groups although this was more pronounced for the intervention group. There was no significant improvement in the MSPSS scores. The small sample size of the final cohort affected the power of the study to detect significant differences between the intervention and control groups on the MSPSS. Longer term impact of the intervention is unknown. These preliminary findings suggest that group-based counselling for depression in HIV-positive patients can potentially be effectively delivered by appropriately trained and supported lay HIV counsellors. The need for a larger trial is indicated. Copyright © 2014 Elsevier B.V. All rights reserved.

A Self-Regulation-Based eHealth Intervention to Promote a Healthy Lifestyle: Investigating User and Website Characteristics Related to Attrition.

PubMed

Van der Mispel, Celien; Poppe, Louise; Crombez, Geert; Verloigne, Maïté; De Bourdeaudhuij, Ilse

2017-07-11

eHealth interventions can reach large populations and are effective in increasing physical activity (PA) and fruit and vegetable intake. Nevertheless, the effects of eHealth interventions are overshadowed by high attrition rates. Examining more closely when users decide to leave the intervention can help eHealth developers to make informed decisions about which intervention components should be reshaped or simply removed. Investigating which users are more likely to quit an intervention can inform developers about whether and how their intervention should be adapted to specific subgroups of users. This study investigated the pattern of attrition in a Web-based intervention to increase PA, fruit, and vegetable intake. The first aim was to describe attrition rates according to different self-regulation components. A second aim was to investigate whether certain user characteristics are predictors for start session completion, returning to a follow-up session and intervention completion. The sample consisted of 549 adults who participated in an online intervention, based on self-regulation theory, to promote PA and fruit and vegetable intake, called "MyPlan 1.0." Using descriptive analysis, attrition was explored per self-regulation component (eg, action planning and coping planning). To identify which user characteristics predict completion, logistic regression analyses were conducted. At the end of the intervention program, there was an attrition rate of 78.2% (330/422). Attrition rates were very similar for the different self-regulation components. However, attrition levels were higher for the fulfillment of questionnaires (eg, to generate tailored feedback) than for the more interactive components. The highest amount of attrition could be observed when people were asked to make their own action plan. There were no significant predictors for first session completion. Yet, two subgroups had a lower chance to complete the intervention, namely male users (OR: 2.24, 95% CI=1.23-4.08) and younger adults (OR: 1.02, 95% CI=1.00-1.04). Furthermore, younger adults were less likely to return to the website for the first follow-up after one week (OR: 1.03, 95% CI=1.01-1.04). This study informs us that eHealth interventions should avoid the use of extensive questionnaires and that users should be provided with a rationale for several components (eg, making an action plan and completing questions). Furthermore, future interventions should focus first on motivating users for the behavior change before guiding them through action planning. Though, this study provides no evidence for removal of one of the self-regulation techniques based on attrition rates. Finally, strong efforts are needed to motivate male users and younger adults to complete eHealth interventions. ©Celien Van der Mispel, Louise Poppe, Geert Crombez, Maïté Verloigne, Ilse De Bourdeaudhuij. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.07.2017.

Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals.

PubMed

Banks, M D; Graves, N; Bauer, J D; Ash, S

2013-01-01

This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Statistical models were developed to predict 'cases of pressure ulcer avoided', 'number of bed days gained' and 'change to economic costs' in public hospitals in 2002-2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12, 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Children in Hospitals: A Model Program. Final Report.

ERIC Educational Resources Information Center

Brill, Nancy; Cohen, Sarale

This final report describes the rationale, goals and activities of a federally funded project that was designed to develop a model intervention program for hospitalized chronically ill children between birth and five years. The focus of the program was to promote optimal emotional development: attachment, separation, individualization, and…

Challenges of Applying a Comprehensive Model of Intervention Fidelity

PubMed Central

Bosak, Kelly; Pozehl, Bunny; Yates, Bernice

2014-01-01

Applying a comprehensive model of fidelity to interventions delivered by Information and Communication Technology (ICT) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and to provide standardized feedback, rather than deliver the intervention in-person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions delivered by the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions using ICT, such as the Internet are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills is key to ensuring intervention fidelity. The final challenges involve evaluating and reporting fidelity. PMID:21474676

Physical Activity and Nutrition Health Promotion Interventions: What Is Working for People with Intellectual Disabilities?

ERIC Educational Resources Information Center

Heller, Tamar; McCubbin, Jeffrey A.; Drum, Charles; Peterson, Jana

2011-01-01

A scoping review of studies on physical activity and nutrition health promotion interventions for individuals with intellectual disabilities was conducted. Searches included MEDLINE, PsycINFO, and CINAHL databases from 1986 through July 2006. The final number included 11 articles comprising 12 studies. Generally, this review indicated some…

Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) Primary Version

ERIC Educational Resources Information Center

DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

2015-01-01

A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured…

Exploring Cultural Competence amongst OT Students.

PubMed

Govender, Pragashnie; Mpanza, December M; Carey, Tarryn; Jiyane, Kwenzile; Andrews, Bicolé; Mashele, Sam

2017-01-01

Occupational therapy relies primarily on communication between the therapist and client for effective intervention. Adequate communication may be influenced by language and cultural differences between the therapist and client. Cultural competence in relation to language and culture is thus a vital part in practice. Limited research exists on cultural competence in occupational therapy students. This study thus aimed to explore the cultural competence of final year students and their perceptions of their own cultural competence, with respect to language and culture in their practice as students. An explorative qualitative study design was utilised with a nonprobability purposeful sample of 21 final year undergraduate students at a tertiary institute in South Africa. Three focus groups were conducted, comprising between 6 and 8 students in each group. Thematic analysis using inductive reasoning was undertaken in order to analyse the students' experiences and understanding of cultural competence. Findings of the study suggest that cultural competence, in relation to language and culture, influences the occupational therapy intervention process. It was shown to both positively and negatively influence intervention through supporting or hindering rapport building, client centeredness, and effective intervention.

Using patient engagement in the design and rationale of a trial for women with depression in obstetrics and gynecology practices.

PubMed

Poleshuck, Ellen; Wittink, Marsha; Crean, Hugh; Gellasch, Tara; Sandler, Mardy; Bell, Elaine; Juskiewicz, Iwona; Cerulli, Catherine

2015-07-01

Significant health disparities exist among socioeconomically disadvantaged women, who experience elevated rates of depression and increased risk for poor depression treatment engagement and outcomes. We aimed to use stakeholder input to develop innovative methods for a comparative effectiveness trial to address the needs of socioeconomically disadvantaged women with depression in women's health practices. Using a community advisory board, focus groups, and individual patient input, we determined the feasibility and acceptability of an electronic psychosocial screening and referral tool; developed and finalized a prioritization tool for women with depression; and piloted the prioritization tool. Two intervention approaches, enhanced screening and referral using an electronic psychosocial screening, and mentoring using the prioritization tool, were developed as intervention options for socioeconomically disadvantaged women attending women's health practices. We describe the developmental steps and the final design for the comparative effectiveness trial evaluating both intervention approaches. Stakeholder input allowed us to develop an acceptable clinical trial of two patient-centered interventions with patient-driven outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Exploring Cultural Competence amongst OT Students

PubMed Central

Mpanza, December M.; Carey, Tarryn; Jiyane, Kwenzile; Andrews, Bicolé; Mashele, Sam

2017-01-01

Occupational therapy relies primarily on communication between the therapist and client for effective intervention. Adequate communication may be influenced by language and cultural differences between the therapist and client. Cultural competence in relation to language and culture is thus a vital part in practice. Limited research exists on cultural competence in occupational therapy students. This study thus aimed to explore the cultural competence of final year students and their perceptions of their own cultural competence, with respect to language and culture in their practice as students. An explorative qualitative study design was utilised with a nonprobability purposeful sample of 21 final year undergraduate students at a tertiary institute in South Africa. Three focus groups were conducted, comprising between 6 and 8 students in each group. Thematic analysis using inductive reasoning was undertaken in order to analyse the students' experiences and understanding of cultural competence. Findings of the study suggest that cultural competence, in relation to language and culture, influences the occupational therapy intervention process. It was shown to both positively and negatively influence intervention through supporting or hindering rapport building, client centeredness, and effective intervention. PMID:29097961

Reciprocal longitudinal relations between weight/shape concern and comorbid pathology among women at very high risk for eating disorder onset.

PubMed

Fitzsimmons-Craft, Ellen E; Eichen, Dawn M; Kass, Andrea E; Trockel, Mickey; Crosby, Ross D; Taylor, C Barr; Wilfley, Denise E

2017-12-28

Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models. Participants were 185 women aged 18-25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt. Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt. Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change. Level I, evidence obtained from a properly designed randomized controlled trial.

Prediction of Mass Evaporation of During Measurements of Thermophysical Properties Using an Electrostatic Levitator

NASA Astrophysics Data System (ADS)

Lee, J.; Matson, D. M.

2014-10-01

This paper describes the prediction of mass evaporation of at% alloys during thermophysical property measurements using the electrostatic levitator at NASA Marshall Space Flight Center in Huntsville, AL. The final mass, final composition, and activity of individual component are considered in the calculation of mass evaporation. The predicted reduction in mass and variation in composition are validated with six ESL samples which underwent different thermal cycles. The predicted mass evaporation and composition shift show good agreement with experiments with the maximum relative errors of 4.8 % and 1.7 %, respectively.

Analyzing older users' home telehealth services acceptance behavior-applying an Extended UTAUT model.

PubMed

Cimperman, Miha; Makovec Brenčič, Maja; Trkman, Peter

2016-06-01

Although telehealth offers an improved approach to providing healthcare services, its adoption by end users remains slow. With an older population as the main target, these traditionally conservative users pose a big challenge to the successful implementation of innovative telehealth services. The objective of this study was to develop and empirically test a model for predicting the factors affecting older users' acceptance of Home Telehealth Services (HTS). A survey instrument was administered to 400 participants aged 50 years and above from both rural and urban environments in Slovenia. Structural equation modeling was applied to analyze the causal effect of seven hypothesized predicting factors. HTS were introduced as a bundle of functionalities, representing future services that currently do not exist. This enabled users' perceptions to be measured on the conceptual level, rather than attitudes to a specific technical solution. Six relevant predictors were confirmed in older users' HTS acceptance behavior, with Performance Expectancy (r=0.30), Effort Expectancy (r=0.49), Facilitating Conditions (r=0.12), and Perceived Security (r=0.16) having a direct impact on behavioral intention to use HTS. In addition, Computer Anxiety is positioned as an antecedent of Effort Expectancy with a strong negative influence (r=-0.61), and Doctor's Opinion influence showed a strong impact on Performance Expectancy (r=0.31). The results also indicate Social Influence as an irrelevant predictor of acceptance behavior. The model of six predictors yielded 77% of the total variance explained in the final measured Behavioral Intention to Use HTS by older adults. The level at which HTS are perceived as easy to use and manage is the leading acceptance predictor in older users' HTS acceptance. Together with Perceived Usefulness and Perceived Security, these three factors represent the key influence on older people's HTS acceptance behavior. When promoting HTS, interventions should focus to portray it as secure. Marketing interventions should focus also on promoting HTS among health professionals, using them as social agents to frame the services as useful and beneficial. The important role of computer anxiety may result in a need to use different equipment such as a tablet computer to access HTS. Finally, this paper introduces important methodological guidelines for measuring perceptions on a conceptual level of future services that currently do not exist. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Invited address: Street killings: prediction of homicide offenders and their victims.

PubMed

Loeber, Rolf; Ahonen, Lia

2013-11-01

The article reports on childhood predictors (explanatory, behavioral and offenses) to predict homicide offenders in the longitudinal Pittsburgh Youth Study, and compares these predictors with predictors of homicide victims in the same study. This forms the basis for formulating antecedents that are shared between homicide offenders and homicide victims at a young age (ages 7–11) and antecedents that are not shared or are unique for each. Implications of the research are highlighted for early intervention and for interventions with high-risk offenders.

The study designed by a committee: design of the Multisite Violence Prevention Project.

PubMed

Henry, David B; Farrell, Albert D

2004-01-01

This article describes the research design of the Multisite Violence Prevention Project (MVPP), organized and funded by the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC). CDC's objectives, refined in the course of collaboration among investigators, were to evaluate the efficacy of universal and targeted interventions designed to produce change at the school level. The project's design was developed collaboratively, and is a 2 x 2 cluster-randomized true experimental design in which schools within four separate sites were assigned randomly to four conditions: (1) no-intervention control group, (2) universal intervention, (3) targeted intervention, and (4) combined universal and targeted interventions. A total of 37 schools are participating in this study with 8-12 schools per site. The impact of the interventions on two successive cohorts of sixth-grade students will be assessed based on multiple waves of data from multiple sources of information, including teachers, students, parents, and archival data. The nesting of students within teachers, families, schools and sites created a number of challenges for designing and implementing the study. The final design represents both resolution and compromise on a number of creative tensions existing in large-scale prevention trials, including tensions between cost and statistical power, and between internal and external validity. Strengths and limitations of the final design are discussed.

The Study Designed by a Committee

PubMed Central

Henry, David B.; Farrell, Albert D.

2009-01-01

This article describes the research design of the Multisite Violence Prevention Project (MVPP), organized and funded by the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC). CDC's objectives, refined in the course of collaboration among investigators, were to evaluate the efficacy of universal and targeted interventions designed to produce change at the school level. The project's design was developed collaboratively, and is a 2 × 2 cluster-randomized true experimental design in which schools within four separate sites were assigned randomly to four conditions: (1) no-intervention control group, (2) universal intervention, (3) targeted intervention, and (4) combined universal and targeted interventions. A total of 37 schools are participating in this study with 8–12 schools per site. The impact of the interventions on two successive cohorts of sixth-grade students will be assessed based on multiple waves of data from multiple sources of information, including teachers, students, parents, and archival data. The nesting of students within teachers, families, schools and sites created a number of challenges for designing and implementing the study. The final design represents both resolution and compromise on a number of creative tensions existing in large-scale prevention trials, including tensions between cost and statistical power, and between internal and external validity. Strengths and limitations of the final design are discussed. PMID:14732183

Rites of passage and healing efficacy: an ethnographic study of an intimate partner violence intervention.

PubMed

Wozniak, Danielle F

2009-01-01

Concepts of health or healing remain conspicuously absent in intimate partner violence intervention literature and practice within the USA. Instead, interventions generally end with 'equilibrium' or 'maintenance' in which women are no longer in crisis and are no longer in a violent relationship. But this ignores an important and necessary trajectory for intervention - healing. Following the logic of Van Gennep (1960) and Turner (1969), I suggest that most interventions leave women in a state of liminality, struggling to develop an alternative social and interpersonal identity to that of 'victim of abuse', or a 'survivor of violence'. This paper examines final stage healing as a rite of passage effected in an experimental women-centred intervention.

Early Literacy Instruction and Intervention

PubMed Central

Al Otaiba, Stephanie; Foorman, Barbara

2014-01-01

The purpose of this paper is to describe the efficacy of early literacy interventions and to discuss possible roles for volunteer tutors in helping prevent reading difficulties within the Response to Intervention process. First, we describe a landmark study that evaluated the impact of primary classroom instruction on reducing the proportion of students at risk for reading failure, and a more recent series of studies exploring the effects of individualizing classroom reading instruction based on students’ initial skills. Second, we review studies of more intensive early intervention to demonstrate how these interventions substantially reduce the proportion of students at risk. Third, we examine effective tutoring models that utilize volunteers. Finally, we discuss the potential role of community tutors in supporting primary classroom instruction and secondary interventions. PMID:25221452

Development of equations to predict the influence of floor space on average daily gain, average daily feed intake and gain : feed ratio of finishing pigs.

PubMed

Flohr, J R; Dritz, S S; Tokach, M D; Woodworth, J C; DeRouchey, J M; Goodband, R D

2018-05-01

Floor space allowance for pigs has substantial effects on pig growth and welfare. Data from 30 papers examining the influence of floor space allowance on the growth of finishing pigs was used in a meta-analysis to develop alternative prediction equations for average daily gain (ADG), average daily feed intake (ADFI) and gain : feed ratio (G : F). Treatment means were compiled in a database that contained 30 papers for ADG and 28 papers for ADFI and G : F. The predictor variables evaluated were floor space (m2/pig), k (floor space/final BW0.67), Initial BW, Final BW, feed space (pigs per feeder hole), water space (pigs per waterer), group size (pigs per pen), gender, floor type and study length (d). Multivariable general linear mixed model regression equations were used. Floor space treatments within each experiment were the observational and experimental unit. The optimum equations to predict ADG, ADFI and G : F were: ADG, g=337.57+(16 468×k)-(237 350×k 2)-(3.1209×initial BW (kg))+(2.569×final BW (kg))+(71.6918×k×initial BW (kg)); ADFI, g=833.41+(24 785×k)-(388 998×k 2)-(3.0027×initial BW (kg))+(11.246×final BW (kg))+(187.61×k×initial BW (kg)); G : F=predicted ADG/predicted ADFI. Overall, the meta-analysis indicates that BW is an important predictor of ADG and ADFI even after computing the constant coefficient k, which utilizes final BW in its calculation. This suggests including initial and final BW improves the prediction over using k as a predictor alone. In addition, the analysis also indicated that G : F of finishing pigs is influenced by floor space allowance, whereas individual studies have concluded variable results.

Soluble receptor for advanced glycation end products as a potential biomarker to predict weight loss and improvement of insulin sensitivity by a very low calorie diet of obese human subjects.

PubMed

Hagen, Imke; Schulte, Dominik M; Müller, Nike; Martinsen, Jessica; Türk, Kathrin; Hedderich, Jürgen; Schreiber, Stefan; Laudes, Matthias

2015-06-01

Obesity is associated with low-grade systemic inflammation which is thought to trigger the development of comorbidities such as type 2 diabetes. The soluble receptor for advanced glycation end products (sRAGE) belongs to the innate immune system and has been linked to obesity, recently. The aim of the present study was to examine whether serum sRAGE concentrations are related to the grade of weight loss and improvement of insulin resistance due to a very low calorie diet (VLCD). 22 severe obese subjects (Median Body Mass Index (BMI): 44.5kg/m(2)) were included in a dietary intervention study of 6month, consisting of a very low calorie formula diet phase (VLCD: 800kcal/d) for 12 weeks and a following 12 week weight maintenance phase. Fasting glucose, fasting insulin, adiponectin, leptin and sRAGE were determined from sera. Insulin sensitivity was estimated by Homeostasis Model Assessment (HOMA) index and leptin-to-adiponectin-ratio (LAR). Mean body weight reduction by VLCD accounted to 21.7kg with a significant improvement of insulin resistance. At baseline, sRAGE serum levels were significantly inversely related to BMI (rS=-0.642, p=0.001) and HOMA (rS=-0.419, p=0.041). Of interest, sRAGE serum levels at baseline were significantly lower in study subjects with greater reduction of BMI (p=0.017). In addition, a significantly greater HOMA reduction was observed in subjects with lower sRAGE serum levels at baseline (p=0.006). Finally, correlation analysis revealed, that changes of sRAGE serum levels were significantly correlated to changes of BMI (rS=-0.650, p=0.022) during intervention. Anti-inflammatory sRAGE might be a potential future biomarker to predict weight loss and improvement of insulin resistance by a VLCD whereby lower baseline sRAGE serum levels indicate a better outcome of the dietary intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Modelling elderly patients' perception of the community pharmacist image when providing professional services.

PubMed

Sabater-Galindo, Marta; Sabater-Hernández, Daniel; Ruiz de Maya, Salvador; Gastelurrutia, Miguel Angel; Martínez-Martínez, Fernando; Benrimoj, Shalom I

2017-06-01

Professional pharmaceutical services may impact on patient's health behaviour as well as influence on patients' perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients' beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients' perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients' HBs to patient's perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that 'Perceived benefits' were significantly associated with 'Perceived Pharmacist Image' in the whole sample. Differences were found in the IG with also 'Self-efficacy' significantly influencing 'Perceived pharmacist image'. A model of patients' HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients' HBs that in turn influence public perception of the pharmacist.

New Medical and Surgical Insights Into Neonatal Necrotizing Enterocolitis: A Review.

PubMed

Frost, Brandy L; Modi, Biren P; Jaksic, Tom; Caplan, Michael S

2017-01-01

Necrotizing enterocolitis (NEC) has long remained a significant cause of morbidity and mortality in neonatal intensive care units. While the mainstay of treatment for this devastating condition remains largely supportive, research efforts continue to be directed toward understanding pathophysiology as well as how best to approach surgical management when indicated. In this review, we first examine recent medical observations, including overviews on the microbiome and a brief review of the use of probiotics. Next, we discuss the use of biomarkers and how clinicians may be able to use them in the future to predict the course of disease and, perhaps, the need for surgical intervention. We then provide an overview on the use of exclusive human milk feeding and the utility of this approach in preventing NEC. Finally, we discuss recent developments in the surgical management of NEC, beginning with indications for surgery and following with a section on technical surgical considerations, including peritoneal drain vs laparotomy. The review concludes with outcomes from infants with surgically treated NEC. Although medical treatment options for NEC are largely unchanged, understanding of the disease continues to evolve. As new research methods are developed, NEC pathophysiology can be more completely understood. In time, it is hoped that data from ongoing and planned clinical trials will allow us to routinely add targeted preventive measures in addition to human milk, such as prebiotics and probiotics, to the management of high-risk infants. In addition, the discovery of novel biomarkers may not only prove useful in predicting severity of illness but also will hopefully allow for identification of the disease prior to onset of clinical signs. Finally, continued investigation into optimizing surgical outcomes is essential in this population of infants, many of whom require long-term parenteral therapy and intestinal rehabilitation.

Determinants of pediatric cataract program outcomes and follow-up in a large series in Mexico.

PubMed

Congdon, Nathan G; Ruiz, Sergio; Suzuki, Maki; Herrera, Veronica

2007-10-01

To report determinants of outcomes and follow-up in a large Mexican pediatric cataract project. Hospital Luis Sanchez Bulnes, Mexico City, Mexico. Data were collected prospectively from a pediatric cataract surgery program at the Hospital Luis Sanchez Bulnes, implemented by Helen Keller International. Preoperative data included age, sex, baseline visual acuity, type of cataract, laterality, and presence of conditions such as amblyopia. Surgical data included vitrectomy, capsulotomy, complications, and use of intraocular lenses (IOLs). Postoperative data included final visual acuity, refraction, number of follow-up visits, and program support for follow-up. Of 574 eyes of 415 children (mean age 7.1 years +/- 4.7 [SD]), IOLs were placed in 416 (87%). At least 1 follow-up was attended by 408 patients (98.3%) (mean total follow-up 3.5 +/- 1.8 months); 40% of eyes achieved a final visual acuity of 6/18 or better. Children living farther from the hospital had fewer postoperative visits (P = .04), while children receiving program support had more visits (P = .001). Factors predictive of better acuity included receiving an IOL during surgery (P = .04) and provision of postoperative spectacles (P = .001). Predictive of worse acuity were amblyopia (P = .003), postoperative complications (P = .0001), unilateral surgery (P = .0075), and female sex (P = .045). The results underscore the importance of surgical training in reducing complications, early intervention before amblyopia (observed in 40% of patients) can develop, and vigorous treatment if amblyopia is present. The positive impact of program support on follow-up is encouraging, although direct financial support may pose a problem for sustainability. More work is needed to understand reasons for worse outcomes in girls.

Do Black Women's Religious Beliefs About Body Image Influence Their Confidence in Their Ability to Lose Weight?

PubMed

Bauer, Alexandria G; Berkley-Patton, Jannette; Bowe-Thompson, Carole; Ruhland-Petty, Therese; Berman, Marcie; Lister, Sheila; Christensen, Kelsey

2017-10-19

Black women are disproportionately burdened by obesity but maintain body satisfaction and strong religious commitment. Although faith-based weight-loss interventions have been effective at promoting weight loss among blacks, little is known about how body image and religious views contribute to weight-related beliefs among religious black women. The purpose of this study was to examine whether demographic and health history factors, religious involvement, and beliefs about body image could explain motivation and confidence to lose weight among a church-affiliated sample of black women. We recruited 240 church-affiliated black women aged 18 to 80 years (average age, 55 y; SD, 12.3) in 2014 from 6 black churches that participated in a larger study, Project FIT (Faith Influencing Transformation), a clustered, diabetes/heart disease/stroke intervention among black women and men. We used baseline data from Project FIT to conduct a cross-sectional study consisting of a survey. Variables approaching significance in preliminary correlation and χ 2 analyses were included in 2 multiple linear regression models examining motivation and confidence in ability to lose weight. In final regression models, body mass index was associated with motivation to lose weight (β = 0.283, P < .001), and beliefs about body image in relation to God predicted confidence to lose weight (β = 0.180, P = .01). Faith-based, weight-loss interventions targeting black women should emphasize physical well-being and highlight the health benefits of weight management rather than the benefits of altering physical appearance and should promote positive beliefs about body image, particularly relating to God.

The equivalence of numbers: The social value of avoiding health decline: An experimental web-based study

PubMed Central

Schwappach, David LB

2002-01-01

Background Health economic analysis aimed at informing policy makers and supporting resource allocation decisions has to evaluate not only improvements in health but also avoided decline. Little is known however, whether the "direction" in which changes in health are experienced is important for the public in prioritizing among patients. This experimental study investigates the social value people place on avoiding (further) health decline when directly compared to curative treatments in resource allocation decisions. Methods 127 individuals completed an interactive survey that was published in the World Wide Web. They were confronted with a standard gamble (SG) and three person trade-off tasks, either comparing improvements in health (PTO-Up), avoided decline (PTO-Down), or both, contrasting health changes of equal magnitude differing in the direction in which they are experienced (PTO-WAD). Finally, a direct priority ranking of various interventions was obtained. Results Participants strongly prioritized improving patients' health rather than avoiding decline. The mean substitution rate between health improvements and avoided decline (WAD) ranged between 0.47 and 0.64 dependent on the intervention. Weighting PTO values according to the direction in which changes in health are experienced improved their accuracy in predicting a direct prioritization ranking. Health state utilities obtained by the standard gamble method seem not to reflect social values in resource allocation contexts. Conclusion Results suggest that the utility of being cured of a given health state might not be a good approximation for the societal value of avoiding this health state, especially in cases of competition between preventive and curative interventions. PMID:11879529

Psychotherapeutic and work-oriented interventions: employment outcomes among young adults with work disability due to a mental disorder.

PubMed

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Koskinen, Aki; Tuisku, Katinka; Ervasti, Jenni; Virtanen, Marianna

2016-01-01

We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder. Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18‒34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years. Forty-six percent had no proposal for psychotherapy or a work-oriented intervention in their treatment and rehabilitation plan, 22 % had a plan for only a psychotherapeutic intervention, 23 % had a plan for only a work-oriented intervention, and 10 % had both types of interventions planned. Having a planned psychotherapeutic intervention (HR = 1.35, 95 % CI 1.07-1.69) and of the work-oriented interventions, planned rehabilitative courses and training (HR = 1.34, 95 % CI 1.03-1.70) predicted quicker entry into competitive employment. Having a plan for both a psychotherapeutic and work-oriented intervention was associated with being employed at the end of the follow-up (OR = 1.77, 95 % CI 1.07-2.95). Young adults with a long-term psychiatric work disability episode rarely have a recorded plan for rehabilitation in their treatment and rehabilitation plan although psychotherapeutic interventions and a combination of a psychotherapeutic and work-oriented intervention might help them gain employment.

Intra-Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience

PubMed Central

Arshad, Nur Zaiti Md; Ng, Beng Kwang; Paiman, Noor Asmaliza Md; Mahdy, Zaleha Abdullah; Noor, Rushdan Mohd

2018-01-01

Background: Accuracy of diagnosis with intra-operative frozen sections is extremely important in the evaluation of ovarian tumors so that appropriate surgical procedures can be selected. Study design: All patients who with intra-operative frozen sections for ovarian masses in a tertiary center over nine years from June 2008 until April 2017 were reviewed. Frozen section diagnosis and final histopathological reports were compared. Main outcome measures: Sensitivity, specificity, positive and negative predictive values of intra-operative frozen section as compared to final histopathological results for ovarian tumors. Results: A total of 92 cases were recruited for final evaluation. The frozen section diagnoses were comparable with the final histopathological reports in 83.7% of cases. The sensitivity, specificity, positive predictive value and negative predictive value for benign and malignant ovarian tumors were 95.6%, 85.1%, 86.0% and 95.2% and 69.2%, 100%, 100% and 89.2% respectively. For borderline ovarian tumors, the sensitivity and specificity were 76.2% and 88.7%, respectively; the positive predictive value was 66.7% and the negative predictive value was 92.7%. Conclusion: The accuracy of intra-operative frozen section diagnoses for ovarian tumors is high and this approach remains a reliable option in assessing ovarian masses intra-operatively. PMID:29373916

School Based Multicomponent Intervention for Obese Children in Udupi District, South India - A Randomized Controlled Trial.

PubMed

Nayak, Baby S; Bhat, Vinod H

2016-12-01

Childhood obesity and overweight is a global epidemics and has been increasing in the developing countries. Childhood obesity is linked with increased mortality and morbidity independent of adult obesity. Declining physical activity, access to junk food and parenting style are the major determinants of overweight in children. Thus, there is a need for increasing the physical activity of children, educating the parents as well as the children on lifestyle modification. This can be achieved through implementation of multicomponent intervention. To evaluate the effectiveness of multicomponent intervention on improving the lifestyle practices, reducing the body fat and improving the self esteem of obese children from selected schools of Udupi District, South India. A sample of 120 obese children were enrolled for multicomponent intervention. The components of multicomponent intervention were: education provided to the obese children on lifestyle modification, education of the parents and increasing the physical education activity of these children in the form of aerobics under the supervision of physical education teacher. There was an attrition of 25% in the intervention group. Thus the final sample in the intervention group was 90. Total sample of 131 overweight/ obese children enrolled as controls. There was an attrition of 20.61% in the control group. Thus, the final sample in the control group was 104. Intervention group received the multicomponent intervention for six month. Mixed Method Repeated measures Ananlysis of Variance (ANOVA) was applied for analysis of data. Results indicated that the intervention was effective in reducing the Body Mass Index (BMI), triceps, biceps, subscapular skin fold thickness of obese children. The intervention was also effective in improving the lifestyle practices and self-esteem of obese children. Overweight/obese children need to control diet and perform vigorous exercise at least for 20 minutes a day to reduce the excess fat and maintain their body fat level.

Glass Fibre/Epoxy Resin Interface Life-Time Prediction.

DTIC Science & Technology

1983-04-01

RD-Ai32 26 GLASS FIBRE /POXY RESIN INTERFACE LIFE-TIME PREDICTION 1/1 (U) BRISTOL UNIV (ENGLAND) H H WILLS PHYSICS LAB K H RSHBEE ET AL. APR 83...D 3005-MS GLASS FIBRE /EPOXY RESIN INTERFACE LIFE-TIME PREDICTION - Final Report by K H G Ashbee, Principal Investigator R Ho~l J P Sargent Elizabeth...REPORT h PERIOD COVERED. Glass Fibre /Epoxy Resin Interface Life-time F-inal Technical 11’ port PreictonApril 1981 - A:’ril 1983 6. PERFORMING ORG. REPORT

Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: a multivariate analysis from a cohort of 474 patients.

PubMed

Spinoit, Anne-Françoise; Poelaert, Filip; Van Praet, Charles; Groen, Luitzen-Albert; Van Laecke, Erik; Hoebeke, Piet

2015-04-01

There is an ongoing quest on how to minimize complications in hypospadias surgery. There is however a lack of high-quality data on the following parameters that might influence the outcome of primary hypospadias repair: age at initial surgery, the type of suture material, the initial technique, and the type of hypospadias. The objective of this study was to identify independent predictors for re-intervention in primary hypospadias repair. We retrospectively analyzed our database of 474 children undergoing primary hypospadias surgery. Univariate and multivariate logistic regression was performed to identify variables associated with re-intervention. A p-value <0.05 was considered statistically significant and therefore considered as a prognostic factor for re-intervention. Distal penile hypospadias was reported in 77.2% (n = 366), midpenile in 11.4% (n = 54) and proximal in 11.4% (n = 54) of children. Initial repair was based on an incised plate technique in 39.9% (n = 189), meatal advancement in 36.0% (n = 171), an onlay flap in 17.3% (n = 82) and other or combined techniques in 5.3% (n = 25). In 114 patients (24.1%) re-intervention was required (n = 114) of which 54 re-interventions (47.4%) were performed within the first year post-surgery, 17 (14.9%) in the second year and 43 (37.7%) later than 2 years after initial surgery. The reason for the first re-intervention was fistula in 52 patients (46.4%), meatal stenosis in 32 (28.6%), cosmesis in 35 (31.3%) and other in 14 (12.5%). The median time for re-intervention was 14 months after surgery [range 0-114]. Significant predictors for re-intervention on univariate logistic regression (polyglactin suture material versus poliglecaprone, proximal hypospadias, lower age at operation and other than meatal advancement repair) were put in a multivariate logistic regression model. Of all significant variables, only proximal hypospadias remained an independent predictor for re-intervention (OR 3.27; p = 0.012). The grade of hypospadias remains according to our retrospective analysis the only objective independent predicting factor for re-intervention in hypospadias surgery. This finding is rather obvious for everyone operating hypospadias. Curiously midpenile hypospadias cases were doing slightly better than distal hypospadias in terms of re-intervention rates. Our study however has also some shortcomings. First of all, data was gathered retrospectively and follow-up time was ill-balanced for several variables. We tried to correct this by applying sensitivity analysis, but possible associations between some variables and re-intervention might still be obscured by this. Standard questionnaires to analyze surgical outcome were not available. Therefore, we focused our analysis on re-intervention rate as this is a hard and clinically relevant end point. This retrospective analysis of a large hypospadias database with long-term follow-up indicates that the long-lasting debate about factors influencing the reoperation rate in hypospadias surgery might be futile: in experienced hands, the only variable that independently predicts for re-intervention is the severity of hypospadias, the only factor we cannot modify. This retrospective multivariate analysis of a large hypospadias database with long-term follow-up suggests that the only significant independent predictive factor for re-intervention is proximal hypospadias. In our series, technique did not influence the re-intervention rate. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Social network influences on initiation and maintenance of reduced drinking among college students.

PubMed

Reid, Allecia E; Carey, Kate B; Merrill, Jennifer E; Carey, Michael P

2015-02-01

To determine whether (a) social networks influence the extent to which college students initiate and/or maintain reductions in drinking following an alcohol intervention and (b) students with riskier networks respond better to a counselor-delivered, vs. a computer-delivered, intervention. Mandated students (N = 316; 63% male) provided their perceptions of peer network members' drinking statuses (e.g., heavy drinker) and how accepting each friend would be if the participant reduced his or her drinking. Next, they were randomized to receive a brief motivational intervention (BMI) or Alcohol Edu for Sanctions (EDU). In latent growth models controlling for baseline levels on outcomes, influences of social networks on 2 phases of intervention response were examined: initiation of reductions in drinks per heaviest week, peak blood alcohol content (BAC), and consequences at 1 month (model intercepts) and maintenance of reductions between 1 and 12 months (model slopes). Peer drinking status predicted initiation of reductions in drinks per heaviest week and peak BAC; peer acceptability predicted initial reductions in consequences. Peer Acceptability × Condition interactions were significant or marginal for all outcomes in the maintenance phase. In networks with higher perceived acceptability of decreasing use, BMI and EDU exhibited similar growth rates. In less accepting networks, growth rates were significantly steeper among EDU than BMI participants. For consumption outcomes, lower perceived peer acceptability predicted steeper rates of growth in drinking among EDU but not BMI participants. Understanding how social networks influence behavior change and how interventions mitigate their influence is important for optimizing efficacy of alcohol interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Self-focus, other-focus, and interpersonal needs as correlates of loneliness.

PubMed

Green, V A; Wildermuth, N L

1993-12-01

Residential college students (44 men, 51 women) participated in a questionnaire study to clarify the relationship between loneliness, self- or other-focus, and interpersonal needs. Contrary to predictions, loneliness was unrelated to self-focus, other-focus, or the ability to elicit disclosure from others. However, sex differences were found on interpersonal needs. Specifically, loneliness in men was predicted by a lack of expressed inclusion and a desire for control from others, while loneliness in women was predicted by a lack of expressed affection. These findings suggest that lonely men and women may benefit from different intervention strategies. Outcome studies are needed to ensure that such interventions actually reduce loneliness.

Predicting individual affect of health interventions to reduce HPV prevalence.

PubMed

Corley, Courtney D; Mihalcea, Rada; Mikler, Armin R; Sanfilippo, Antonio P

2011-01-01

Recently, human papilloma virus (HPV) has been implicated to cause several throat and oral cancers and HPV is established to cause most cervical cancers. A human papilloma virus vaccine has been proven successful to reduce infection incidence in FDA clinical trials, and it is currently available in the USA. Current intervention policy targets adolescent females for vaccination; however, the expansion of suggested guidelines may extend to other age groups and males as well. This research takes a first step toward automatically predicting personal beliefs, regarding health intervention, on the spread of disease. Using linguistic or statistical approaches, sentiment analysis determines a text's affective content. Self-reported HPV vaccination beliefs published in web and social media are analyzed for affect polarity and leveraged as knowledge inputs to epidemic models. With this in mind, we have developed a discrete-time model to facilitate predicting impact on the reduction of HPV prevalence due to arbitrary age- and gender-targeted vaccination schemes.

Predicting Individual Affect of Health Interventions to Reduce HPV Prevalence

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

Corley, Courtney D.; Mihalcea, Rada; Mikler, Armin R.

Recently, human papilloma virus has been implicated to cause several throat and oral cancers and hpv is established to cause most cervical cancers. A human papilloma virus vaccine has been proven successful to reduce infection incidence in FDA clinical trials and it is currently available in the United States. Current intervention policy targets adolescent females for vaccination; however, the expansion of suggested guidelines may extend to other age groups and males as well. This research takes a first step towards automatically predicting personal beliefs, regarding health intervention, on the spread of disease. Using linguistic or statistical approaches, sentiment analysis determinesmore » a texts affective content. Self-reported HPV vaccination beliefs published in web and social media are analyzed for affect polarity and leveraged as knowledge inputs to epidemic models. With this in mind, we have developed a discrete-time model to facilitate predicting impact on the reduction of HPV prevalence due to arbitrary age and gender targeted vaccination schemes.« less

Weight Shame, Social Connection, and Depressive Symptoms in Late Adolescence

PubMed Central

Brewis, Alexandra A.; Bruening, Meg

2018-01-01

Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address these complexities. Drawing on repeated measures in a large sample (N = 1443) of first-year (freshman), campus-resident university students across a nine-month period, we model how weight-related shame predicts depressive symptom levels, how being overweight (assessed by anthropometric measures) shapes that risk, and how social connection (openness to friendship) might mediate/moderate. Body shame directly, clearly, and repeatedly predicts depression symptom levels across the whole school year for all students, but overweight youth have significantly elevated risk. Social connections mediate earlier in the school year, and in all phases moderate, body shame effects on depression. Youth obesity interventions would be well-served recognizing and incorporating the influential roles of social-environmental factors like weight stigma and friendship in program design. PMID:29723962

Weight Shame, Social Connection, and Depressive Symptoms in Late Adolescence.

PubMed

Brewis, Alexandra A; Bruening, Meg

2018-05-01

Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address these complexities. Drawing on repeated measures in a large sample ( N = 1443) of first-year (freshman), campus-resident university students across a nine-month period, we model how weight-related shame predicts depressive symptom levels, how being overweight (assessed by anthropometric measures) shapes that risk, and how social connection (openness to friendship) might mediate/moderate. Body shame directly, clearly, and repeatedly predicts depression symptom levels across the whole school year for all students, but overweight youth have significantly elevated risk. Social connections mediate earlier in the school year, and in all phases moderate, body shame effects on depression. Youth obesity interventions would be well-served recognizing and incorporating the influential roles of social-environmental factors like weight stigma and friendship in program design.

Using behavioral theories of choice to predict drinking outcomes following a brief intervention.

PubMed

Murphy, James G; Correia, Christopher J; Colby, Suzanne M; Vuchinich, Rudy E

2005-05-01

Behavioral theories of choice predict that substance use is partly a function of the relative value of drugs in relation to other available reinforcers. This study evaluated this hypothesis in the context of predicting drinking outcomes following an alcohol abuse intervention. Participants (N = 54, 69% female, 31% male) were college student heavy drinkers who completed a single-session motivational intervention. Students completed a baseline measure of substance-related and substance-free activity participation and enjoyment. Only women showed a significant reduction in drinking at the 6-month follow-up, and the ratio of substance-related to substance-free reinforcement accounted for unique variance in their drinking outcomes. Women who at baseline derived a smaller proportion of their total reinforcement from substance use showed lower levels of follow-up drinking, even after the authors controlled for baseline drinking level. Male and female participants who reduced their drinking showed increased proportional reinforcement from substance-free activities. Copyright 2005 APA, all rights reserved.

Prediction impact curve is a new measure integrating intervention effects in the evaluation of risk models.

PubMed

Campbell, William; Ganna, Andrea; Ingelsson, Erik; Janssens, A Cecile J W

2016-01-01

We propose a new measure of assessing the performance of risk models, the area under the prediction impact curve (auPIC), which quantifies the performance of risk models in terms of their average health impact in the population. Using simulated data, we explain how the prediction impact curve (PIC) estimates the percentage of events prevented when a risk model is used to assign high-risk individuals to an intervention. We apply the PIC to the Atherosclerosis Risk in Communities (ARIC) Study to illustrate its application toward prevention of coronary heart disease. We estimated that if the ARIC cohort received statins at baseline, 5% of events would be prevented when the risk model was evaluated at a cutoff threshold of 20% predicted risk compared to 1% when individuals were assigned to the intervention without the use of a model. By calculating the auPIC, we estimated that an average of 15% of events would be prevented when considering performance across the entire interval. We conclude that the PIC is a clinically meaningful measure for quantifying the expected health impact of risk models that supplements existing measures of model performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Social Competence in Infants and Toddlers with Special Health Care Needs: The Roles of Parental Knowledge, Expectations, Attunement, and Attitudes toward Child Independence

PubMed Central

Zand, Debra; Pierce, Katherine; Thomson, Nicole; Baig, M. Waseem; Teodorescu, Cristiana; Nibras, Sohail; Maxim, Rolanda

2014-01-01

Little research has empirically addressed the relationships among parental knowledge of child development, parental attunement, parental expectations, and child independence in predicting the social competence of infants and toddlers with special health care needs. We used baseline data from the Strengthening Families Project, a prevention intervention study that tested Bavolek’s Nurturing Program for Parents and Their Children with Health Challenges to explore the roles of these variables in predicting social competence in infants and toddlers with special health care needs. Bivariate relationships among the study variables were explored and used to develop and test a model for predicting social competence among these children. Study findings pointed to a combination of indirect and direct influences of parent variables in predicting social competence. Results indicated that parents who encouraged healthy behaviors for developing a sense of power/independence were more likely to have children with social competence developing on schedule. Elements related to parental expectations, however, did not have the hypothesized relationships to social competence. The present study provides preliminary data to support the development of knowledge based interventions. Within medical settings, such interventions may indeed maximize benefit while minimizing cost. PMID:27417463

Predicting intention to attend and actual attendance at a universal parent-training programme: a comparison of social cognition models.

PubMed

Thornton, Sarah; Calam, Rachel

2011-07-01

The predictive validity of the Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) were examined in relation to 'intention to attend' and 'actual attendance' at a universal parent-training intervention for parents of children with behavioural difficulties. A validation and reliability study was conducted to develop two questionnaires (N = 108 parents of children aged 4-7).These questionnaires were then used to investigate the predictive validity of the two models in relation to 'intention to attend' and 'actual attendance' at a parent-training intervention ( N = 53 parents of children aged 4-7). Both models significantly predicted 'intention to attend a parent-training group'; however, the TPB accounted for more variance in the outcome variable compared to the HBM. Preliminary investigations highlighted that attendees were more likely to intend to attend the groups, have positive attitudes towards the groups, perceive important others as having positive attitudes towards the groups, and report elevated child problem behaviour scores. These findings provide useful information regarding the belief-based factors that affect attendance at universal parent-training groups. Possible interventions aimed at increasing 'intention to attend' and 'actual attendance' at parent-training groups are discussed.

Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs

PubMed Central

McCarthy, John F.; Katz, Ira R.; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M.; Nielson, Christopher; Schoenbaum, Michael

2015-01-01

Objectives. The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Methods. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Results. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Conclusions. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions. PMID:26066914

Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.

PubMed

McCarthy, John F; Bossarte, Robert M; Katz, Ira R; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M; Nielson, Christopher; Schoenbaum, Michael

2015-09-01

The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015

PubMed Central

Mehmandar, Mohammadreza; Soori, Hamid; Mehrabi, Yadolah

2016-01-01

Background: Predicting the trend in traffic accidents deaths and its analysis can be a useful tool for planning and policy-making, conducting interventions appropriate with death trend, and taking the necessary actions required for controlling and preventing future occurrences. Objective: Predicting and analyzing the trend of traffic accidents deaths in Iran in 2014 and 2015. Settings and Design: It was a cross-sectional study. Materials and Methods: All the information related to fatal traffic accidents available in the database of Iran Legal Medicine Organization from 2004 to the end of 2013 were used to determine the change points (multi-variable time series analysis). Using autoregressive integrated moving average (ARIMA) model, traffic accidents death rates were predicted for 2014 and 2015, and a comparison was made between this rate and the predicted value in order to determine the efficiency of the model. Results: From the results, the actual death rate in 2014 was almost similar to that recorded for this year, while in 2015 there was a decrease compared with the previous year (2014) for all the months. A maximum value of 41% was also predicted for the months of January and February, 2015. Conclusion: From the prediction and analysis of the death trends, proper application and continuous use of the intervention conducted in the previous years for road safety improvement, motor vehicle safety improvement, particularly training and culture-fostering interventions, as well as approval and execution of deterrent regulations for changing the organizational behaviors, can significantly decrease the loss caused by traffic accidents. PMID:27308255

Clinical and Vitamin Response to a Short-Term Multi-Micronutrient Intervention in Brazilian Children and Teens: From Population Data to Interindividual Responses.

PubMed

Mathias, Mariana Giaretta; Coelho-Landell, Carolina de Almeida; Scott-Boyer, Marie-Pier; Lacroix, Sébastien; Morine, Melissa J; Salomão, Roberta Garcia; Toffano, Roseli Borges Donegá; Almada, Maria Olímpia Ribeiro do Vale; Camarneiro, Joyce Moraes; Hillesheim, Elaine; de Barros, Tamiris Trevisan; Camelo-Junior, José Simon; Campos Giménez, Esther; Redeuil, Karine; Goyon, Alexandre; Bertschy, Emmanuelle; Lévêques, Antoine; Oberson, Jean-Marie; Giménez, Catherine; Carayol, Jerome; Kussmann, Martin; Descombes, Patrick; Métairon, Slyviane; Draper, Colleen Fogarty; Conus, Nelly; Mottaz, Sara Colombo; Corsini, Giovanna Zambianchi; Myoshi, Stephanie Kazu Brandão; Muniz, Mariana Mendes; Hernandes, Lívia Cristina; Venâncio, Vinícius Paula; Antunes, Lusania Maria Greggi; da Silva, Rosana Queiroz; Laurito, Taís Fontellas; Rossi, Isabela Ribeiro; Ricci, Raquel; Jorge, Jéssica Ré; Fagá, Mayara Leite; Quinhoneiro, Driele Cristina Gomes; Reche, Mariana Chinarelli; Silva, Paula Vitória Sozza; Falquetti, Letícia Lima; da Cunha, Thaís Helena Alves; Deminice, Thalia Manfrin Martins; Tambellini, Tâmara Hambúrguer; de Souza, Gabriela Cristina Arces; de Oliveira, Mariana Moraes; Nogueira-Pileggi, Vicky; Matsumoto, Marina Takemoto; Priami, Corrado; Kaput, Jim; Monteiro, Jacqueline Pontes

2018-03-01

Micronutrients are in small amounts in foods, act in concert, and require variable amounts of time to see changes in health and risk for disease. These first principles are incorporated into an intervention study designed to develop new experimental strategies for setting target recommendations for food bioactives for populations and individuals. A 6-week multivitamin/mineral intervention is conducted in 9-13 year olds. Participants (136) are (i) their own control (n-of-1); (ii) monitored for compliance; (iii) measured for 36 circulating vitamin forms, 30 clinical, anthropometric, and food intake parameters at baseline, post intervention, and following a 6-week washout; and (iv) had their ancestry accounted for as modifier of vitamin baseline or response. The same intervention is repeated the following year (135 participants). Most vitamins respond positively and many clinical parameters change in directions consistent with improved metabolic health to the intervention. Baseline levels of any metabolite predict its own response to the intervention. Elastic net penalized regression models are identified, and significantly predict response to intervention on the basis of multiple vitamin/clinical baseline measures. The study design, computational methods, and results are a step toward developing recommendations for optimizing vitamin levels and health parameters for individuals. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Testing Stage-Specific Effects of a Stage-Matched Intervention: A Randomized Controlled Trial Targeting Physical Exercise and Its Predictors

ERIC Educational Resources Information Center

Lippke, Sonia; Schwarzer, Ralf; Ziegelmann, Jochen P.; Scholz, Urte; Schuz, Benjamin

2010-01-01

Health education interventions can be tailored toward stages of change. This strategy is based on theories that predict at which stage which variables are indicative of subsequent behavior change processes. For example, planning is regarded as being effective in intenders. However, rather few studies have tested whether matched interventions are…

The Relationship between Coping Strategies and Perceived Stress in Telephone Intervention Volunteers at a Suicide Prevention Center.

ERIC Educational Resources Information Center

Mishara, Brian L.; Giroux, Guy

1993-01-01

Examined stress perceived by telephone intervention volunteers (N=80) at suicide prevention center. Only amount of experience in telephone intervention with suicidal persons predicted stress level before shift. Stress during high-urgency call was related to level of urgency of call; total length of all calls received; and coping mechanisms of…

Monitoring Children with Reading Disabilities' Response to Phonics Intervention: Are There Differences between Intervention Aligned and General Skill Progress Monitoring Assessments?

ERIC Educational Resources Information Center

Olinghouse, Natalie G.; Lambert, Warren; Compton, Donald L.

2006-01-01

This study investigated whether 2 different progress monitoring assessments differentially predicted growth in reading skills associated with systematic phonics instruction. Oral reading fluency (ORE) was compared with an intervention aligned word list (IAWL) as predictors of growth in untimed and timed decoding and word identification and text…

Examining Dosage Effects on Prevention Outcomes: Results from a Multi-Modal Longitudinal Preventive Intervention for Young Disruptive Boys

ERIC Educational Resources Information Center

Charlebois, Pierre; Brendgen, Mara; Vitaro, Frank; Normandeau, Sylvie; Boudreau, Jean-Francois

2004-01-01

The present study examined (a) the predictive effect of disruptive boys' attendance to a prevention program (i.e., dosage) on post-intervention academic achievement and behavior and (b) the potential moderating effects of child and family characteristics in this context. The 3-year intervention program included reading, self-regulation, and social…

Predicting Treatment Response in Social Anxiety Disorder From Functional Magnetic Resonance Imaging

PubMed Central

Doehrmann, Oliver; Ghosh, Satrajit S.; Polli, Frida E.; Reynolds, Gretchen O.; Horn, Franziska; Keshavan, Anisha; Triantafyllou, Christina; Saygin, Zeynep M.; Whitfield-Gabrieli, Susan; Hofmann, Stefan G.; Pollack, Mark; Gabrieli, John D.

2013-01-01

Context Current behavioral measures poorly predict treatment outcome in social anxiety disorder (SAD). To our knowledge, this is the first study to examine neuroimaging-based treatment prediction in SAD. Objective To measure brain activation in patients with SAD as a biomarker to predict subsequent response to cognitive behavioral therapy (CBT). Design Functional magnetic resonance imaging (fMRI) data were collected prior to CBT intervention. Changes in clinical status were regressed on brain responses and tested for selectivity for social stimuli. Setting Patients were treated with protocol-based CBT at anxiety disorder programs at Boston University or Massachusetts General Hospital and underwent neuroimaging data collection at Massachusetts Institute of Technology. Patients Thirty-nine medication-free patients meeting DSM-IV criteria for the generalized subtype of SAD. Interventions Brain responses to angry vs neutral faces or emotional vs neutral scenes were examined with fMRI prior to initiation of CBT. Main Outcome Measures Whole-brain regression analyses with differential fMRI responses for angry vs neutral faces and changes in Liebowitz Social Anxiety Scale score as the treatment outcome measure. Results Pretreatment responses significantly predicted subsequent treatment outcome of patients selectively for social stimuli and particularly in regions of higher-order visual cortex. Combining the brain measures with information on clinical severity accounted for more than 40% of the variance in treatment response and substantially exceeded predictions based on clinical measures at baseline. Prediction success was unaffected by testing for potential confounding factors such as depression severity at baseline. Conclusions The results suggest that brain imaging can provide biomarkers that substantially improve predictions for the success of cognitive behavioral interventions and more generally suggest that such biomarkers may offer evidence-based, personalized medicine approaches for optimally selecting among treatment options for a patient. PMID:22945462

A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions.

PubMed

Beatty, Lisa; Binnion, Claire

2016-12-01

A key issue regarding the provision of psychological therapy in a self-guided online format is low rates of adherence. The aim of this systematic review was to assess both quantitative and qualitative data on the predictors of adherence, as well as participant reported reasons for adhering or not adhering to online psychological interventions. Database searches of PsycINFO, Medline, and CINAHL identified 1721 potentially relevant articles published between 1 January 2000 and 25 November 2015. A further 34 potentially relevant articles were retrieved from reference lists. Articles that reported predictors of, or reasons for, adherence to an online psychological intervention were included. A total of 36 studies met the inclusion criteria. Predictors assessed included demographic, psychological, characteristics of presenting problem, and intervention/computer-related predictors. Evidence suggested that female gender, higher treatment expectancy, sufficient time, and personalized intervention content each predicted higher adherence. Age, baseline symptom severity, and control group allocation had mixed findings. The majority of assessed variables however, did not predict adherence. Few clear predictors of adherence emerged overall, and most results were either mixed or too preliminary to draw conclusions. More research of predictors associated with adherence to online interventions is warranted.

Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach.

PubMed

Hutting, Nathan; Detaille, Sarah I; Engels, Josephine A; Heerkens, Yvonne F; Staal, J Bart; Nijhuis-van der Sanden, Maria Wg

2015-01-01

To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as "self-management behavior at work" with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants. This study resulted in a theory- and practice-based self-management program, based on behavioral change theories, guideline-related evidence, and practice-based knowledge that fits the needs of employees with CANS.

miRNAs in human subcutaneous adipose tissue: Effects of weight loss induced by hypocaloric diet and exercise.

PubMed

Kristensen, Malene M; Davidsen, Peter K; Vigelsø, Andreas; Hansen, Christina N; Jensen, Lars J; Jessen, Niels; Bruun, Jens M; Dela, Flemming; Helge, Jørn W

2017-03-01

Obesity is central in the development of insulin resistance. However, the underlying mechanisms still need elucidation. Dysregulated microRNAs (miRNAs; post-transcriptional regulators) in adipose tissue may present an important link. The miRNA expression in subcutaneous adipose tissue from 19 individuals with severe obesity (10 women and 9 men) before and after a 15-week weight loss intervention was studied using genome-wide microarray analysis. The microarray results were validated with RT-qPCR, and pathway enrichment analysis of in silico predicted targets was performed to elucidate the biological consequences of the miRNA dysregulation. Lastly, the messenger RNA (mRNA) and/or protein expression of multiple predicted targets as well as several proteins involved in lipolysis were investigated. The intervention led to upregulation of miR-29a-3p and miR-29a-5p and downregulation of miR-20b-5p. The mRNA and protein expression of predicted targets was not significantly affected by the intervention. However, negative correlations between miR-20b-5p and the protein levels of its predicted target, acyl-CoA synthetase long-chain family member 1, were observed. Several other miRNA-target relationships correlated negatively, indicating possible miRNA regulation, including miR-29a-3p and lipoprotein lipase mRNA levels. Proteins involved in lipolysis were not affected by the intervention. Weight loss influenced several miRNAs, some of which were negatively correlated with predicted targets. These dysregulated miRNAs may affect adipocytokine signaling and forkhead box protein O signaling. © 2017 The Obesity Society.

A randomized controlled trial for families with preschool children - promoting healthy eating and active playtime by connecting to nature.

PubMed

Sobko, Tanja; Tse, Michael; Kaplan, Matthew

2016-06-13

Promotion of healthy lifestyles in children focuses predominantly on proper nutrition and physical activity, elements now widely recognised as essential for a healthy life. Systematic reviews have shown that nature-related activities also enhance general well-being as reflected in increased physical activity, a healthier diet, reduced stress and better sleep. Recent research suggests that many young children in Hong Kong between the ages of two and four in Hong Kong are more sedentary than recommended and seldom participate in active play, placing them at risk of becoming overweight or obese. The proposed project aims to investigate whether connecting families to nature positively influences physical activity (i.e., active playtime) and healthy eating routines in children aged 2 to 4. We recently conducted a pilot study in Hong Kong to develop a programme, Play & Grow, based on the most successful evidence-based international preschool interventions. In addition to adopting the healthy eating and physical activity elements of these interventions, this project will additionally include a third novel element of Connectedness to nature: discovering nature through games and awareness of sounds, touch, smells, and temperature. To test the effectiveness of this modified intervention, a randomised controlled trial (RCT) involving 240 families with children aged 2 to 4 will be conducted. Families and children will take part in weekly one-hour activity sessions for 10-weeks. Lifestyle-related habits will be assessed before and immediately after the 10-week intervention, with follow up testing at 6 and 12 months' post intervention. A novel measuring tool created specifically for assessing Connectedness to nature, Nature Relatedness Scale (NRS), will be validated and tested for reliability prior to the RCT. The results of the RCT are intended to be used to understand which components of the intervention are most effective. The objectives of this project will be achieved over a 30-month period and will contribute to the research that examines key components of successful healthy lifestyle promotion programmes during early childhood. We predict that the inclusion of Connectedness to nature will significantly improve recognised preschool interventions. Finally, the aim of targeting family involvement will hopefully increase the sustainability of longer-term lifestyle modifications in children. ClinicalTrials.gov, NCT02715544 . Registered 22 March 2016.

Applying a health action model to predict and improve healthy behaviors in coal miners.

PubMed

Vahedian-Shahroodi, Mohammad; Tehrani, Hadi; Mohammadi, Faeze; Gholian-Aval, Mahdi; Peyman, Nooshin

2018-05-01

One of the most important ways to prevent work-related diseases in occupations such as mining is to promote healthy behaviors among miners. This study aimed to predict and promote healthy behaviors among coal miners by using a health action model (HAM). The study was conducted on 200 coal miners in Iran in two steps. In the first step, a descriptive study was implemented to determine predictive constructs and effectiveness of HAM on behavioral intention. The second step involved a quasi-experimental study to determine the effect of an HAM-based education intervention. This intervention was implemented by the researcher and the head of the safety unit based on the predictive construct specified in the first step over 12 sessions of 60 min. The data was collected using an HAM questionnaire and a checklist of healthy behavior. The results of the first step of the study showed that attitude, belief, and normative constructs were meaningful predictors of behavioral intention. Also, the results of the second step revealed that the mean score of attitude and behavioral intention increased significantly after conducting the intervention in the experimental group, while the mean score of these constructs decreased significantly in the control group. The findings of this study showed that HAM-based educational intervention could improve the healthy behaviors of mine workers. Therefore, it is recommended to extend the application of this model to other working groups to improve healthy behaviors.

Biobehavioral Outcomes Following Psychological Interventions for Cancer Patients

PubMed Central

Andersen, Barbara L.

2007-01-01

Psychological interventions for adult cancer patients have primarily focused on reducing stress and enhancing quality of life. However, there has been expanded focus on biobehavioral outcomes—health behaviors, compliance, biologic responses, and disease outcomes—consistent with the Biobehavioral Model of cancer stress and disease course. The author reviewed this expanded focus in quasi-experimental and experimental studies of psychological interventions, provided methodologic detail, summarized findings, and highlighted novel contributions. A final section discussed methodologic issues, research directions, and challenges for the coming decade. PMID:12090371

Asphalt surface aging prediction (ASAP) system : final report.

DOT National Transportation Integrated Search

2010-09-01

The Asphalt Surface Aging Prediction (ASAP) project has been a 2.5 year effort to predict agerelated : embrittlement in asphalt pavement surfaces and to develop ground-based and airborne : systems to measure key spectral indicators needed for predict...

Multicultural Sex-Role Development in Young Children: Intervention Strategies. Final Report.

ERIC Educational Resources Information Center

Busch, Judith W.; Schau, Candace Garrett

This is the final report of a project that studied sex role stereotyping behavior among children in four preschools in Albuquerque, New Mexico, and attempted to intervene in the development of such stereotyping. The three phases of the study, which included contacting the schools, data collection and analysis, and information dissemination, are…

Pacific Basin Deaf-Blind Project. State & Multi State Projects for Children with Deaf-Blindness. Final Report, 1992-1995.

ERIC Educational Resources Information Center

Kelly, Dotty; Guerrero, Vincent Leon

This final report describes activities and accomplishments of the Pacific Basin Deaf-Blind Project, a 3-year federally funded project to provide technical assistance to public and private agencies, institutions, and organizations providing early intervention, educational, transitional, vocational, early identification, and related services to…

Creating Classroom Environments That Nurture Independence for Children Who Are Deafblind. Final Report.

ERIC Educational Resources Information Center

Rowland, Charity; Schweigert, Philip

This final report describes activities and accomplishments of a 4-year federally supported project to develop independence in 12 young children (ages 3-5) with deaf-blindness enrolled in the Portland (Oregon) Public Schools Early Intervention Program. The project focused on helping teachers learn to target communicative and cognitive learning…

An Integrated Parent-Teacher-Related Service Team Approach to Communication Intervention. Final Report.

ERIC Educational Resources Information Center

Stremel, Kathleen; Wilson, Rebecca

This final report describes a federally funded 3-year project for integrating related services within educational objectives for children (ages 3-10) with dual vision and hearing impairments. A Training-Utilization model of inservice training and technical assistance was developed, implemented, and evaluated to address the communication needs of…

CBSS Outreach Project: Computer-Based Study Strategies for Students with Learning Disabilities. Final Report.

ERIC Educational Resources Information Center

Anderson-Inman, Lynne; Ditson, Mary

This final report describes activities and accomplishments of the four-year Computer-Based Study Strategies (CBSS) Outreach Project at the University of Oregon. This project disseminated information about using computer-based study strategies as an intervention for students with learning disabilities and provided teachers in participating outreach…

"Teacher, I Can Read!" The Marvels of Early Intervention Strategies

ERIC Educational Resources Information Center

Murphy, Jean C.; Hernandez, Leonor

2011-01-01

"Teacher, I can read!" exclaimed Saree, a fourth-quarter second grader who was placed in the lowest of reading groups at a southwest side elementary school in Chicago. This was her proud announcement after three weeks of intensive intervention with Ms. Gomez, a student teacher in her final semester at Chicago State University. "Ms.…

A Study of the Effectiveness of a School Improvement Intervention (Success in Sight). Final Report. NCEE 2012-4014

ERIC Educational Resources Information Center

Wilkerson, Stephanie B.; Shannon, Lisa C.; Styers, Mary K.; Grant, Billie-Jo

2012-01-01

Success in Sight focuses on the interrelated parts of an education system. This systemic school improvement intervention is designed to address schools' specific needs while building their capacities to plan, implement, and evaluate school improvement practices. It is intended to help schools, leadership teams, and teachers systemically engage in…

Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

ERIC Educational Resources Information Center

Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

2014-01-01

This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants were…

The Effectiveness of Verbal Counseling VS. Social Interaction Counseling of College Males. Final Report.

ERIC Educational Resources Information Center

Stewart, Norman R.; Hay, Nancy M.

The purpose of this investigation was to assess the effectiveness of three different short-term treatment interventions with college males characterized by little or no dating behavior and fears about dating. The treatments were designed to produce evidence concerning the effectiveness of: (1) lay versus professional action interventions, (2)…

Nuffield Early Language Intervention: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Sibieta, Luke; Kotecha, Mehul; Skipp, Amy

2016-01-01

The Nuffield Early Language Intervention is designed to improve the spoken language ability of children during the transition from nursery to primary school. It is targeted at children with relatively poor spoken language skills. Three sessions per week are delivered to groups of two to four children starting in the final term of nursery and…

Parental Approach for Early Intervention of Learning Disabilities. Final Report 1972-1976.

ERIC Educational Resources Information Center

Corsini, David; Rothschild, Jennie

Presented is the program evaluation report of the Cheshire (Connecticut) Preschool Program for early intervention with a total of 64 mildly and severely handicapped children between 3 and 6 years old. It is explained that the mother-child project has served children with such handicapping conditions as hearing impairment, vision impairment,…

Using Mind Maps to Improve Medical Student Performance in a Pharmacology Course at Kunming Medical University.

PubMed

Ying, Guo; Jianping, Xie; Haiyun, Luo; Xia, Li; Jianyu, Yang; Qun, Xuan; Jianyun, Yu

2017-07-01

To determine whether students using mind maps would improve their performance in a final examination at the end of lecture-based pharmacology course. Aquasi-experimental study. Kunming Medical University, from September 2014 to January 2015. One hundred and twenty-two (122) third year undergraduate medical students, starting a 48-hour lecturebased pharmacology course, volunteered to use mind maps as one of their study strategies (intervention group), while the remaining 100 students in the class continued to use their usual study strategies (control group) over the duration of the course. The performance of both groups in the final course examination was compared. Students in the intervention group also completed a questionnaire on the usefulness of mind maps during the course and in preparation for the final examination. The students' performance of intervention group was superior to performance of the control group in all parts of a multi-modal final examination. For the multiple choice questions and comprehensive scores, average marks of 45.97 ±7.22 and 68.07 ±12.77, respectively were acquired by the control group, and 51.77 ±4.95 (p<0.01) and 80.05 ±7.54 (p<0.01), respectively by the intervention group. The median IQR scores for "filling in the blanks" questions, short answers questions and case analyses, were 6.00 (6.00), 8.00 (3.50), 8.75 (5.88), respectively for the control group, and were all significantly higher at 8.00 (4.00) (p=0.024), 10.00 (2.00) (p<0.001), and 11.00 (3.25) (p=0.002), respectively for the interventiongroup. Questionnaire responses showed that 95.45% thought that mind maps helped them to prepare more efficiently for the final exam; 90.91% believed that mind maps helped them to better understand all of pharmacology. Ninety-one percent also thought that mind maps would help them to better understand other disciplines, and 86.36% students would like the lecturers to utilize mind mapping as an alternative to conventional teaching formats, such as the use of Power Point. The addition of mind maps to students' study of pharmacology at Kunming Medical University improved their performance in all aspects of a multi-modal final examination.