Marital status integration and suicide: A meta-analysis and meta-regression.

PubMed

Kyung-Sook, Woo; SangSoo, Shin; Sangjin, Shin; Young-Jeon, Shin

2018-01-01

Marital status is an index of the phenomenon of social integration within social structures and has long been identified as an important predictor suicide. However, previous meta-analyses have focused only on a particular marital status, or not sufficiently explored moderators. A meta-analysis of observational studies was conducted to explore the relationships between marital status and suicide and to understand the important moderating factors in this association. Electronic databases were searched to identify studies conducted between January 1, 2000 and June 30, 2016. We performed a meta-analysis, subgroup analysis, and meta-regression of 170 suicide risk estimates from 36 publications. Using random effects model with adjustment for covariates, the study found that the suicide risk for non-married versus married was OR = 1.92 (95% CI: 1.75-2.12). The suicide risk was higher for non-married individuals aged <65 years than for those aged ≥65 years, and higher for men than for women. According to the results of stratified analysis by gender, non-married men exhibited a greater risk of suicide than their married counterparts in all sub-analyses, but women aged 65 years or older showed no significant association between marital status and suicide. The suicide risk in divorced individuals was higher than for non-married individuals in both men and women. The meta-regression showed that gender, age, and sample size affected between-study variation. The results of the study indicated that non-married individuals have an aggregate higher suicide risk than married ones. In addition, gender and age were confirmed as important moderating factors in the relationship between marital status and suicide. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social support at work and affective commitment to the organization: the moderating effect of job resource adequacy and ambient conditions.

PubMed

Rousseau, Vincent; Aubé, Caroline

2010-01-01

This study investigated whether both supervisor and coworker support may be positively related to affective commitment to the organization on one hand; and on the other hand, it examined the moderating effect of job resource adequacy and ambient conditions on these relationships. The sample included 215 participants working within a health care organization. Results of regression analysis showed that supervisor and coworker support have an additive effect on affective commitment. Hierarchical regression analyses indicated that supervisor and coworker support are more strongly related to affective commitment when job resource adequacy is high. Furthermore, ambient conditions moderate the relationship between supervisor support and affective commitment in such a way that favorable ambient conditions strengthen this relationship. Overall, these findings reinforce the importance of taking into account contingent factors in the study of antecedents of affective commitment to the organization.

Ethical climate as a moderator between organizational trust and whistle-blowing among nurses and secretaries

PubMed Central

Aydan, Seda; Kaya, Sidika

2018-01-01

Objectives: To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Methods: Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. Results: According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. Conclusion: In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels. PMID:29805421

Ethical climate as a moderator between organizational trust and whistle-blowing among nurses and secretaries.

PubMed

Aydan, Seda; Kaya, Sidika

2018-01-01

To reveal the effect of perception of ethical climate by nurses and secretaries and their level of organizational trust on their whistleblowing intention. Nurses and secretaries working in a University Hospital in Ankara, Turkey, were enrolled in the study conducted in 2016. Responses were received from 369 nurses and secretaries working at Clinics and Polyclinics. Path analysis, investigation of structural equation models used while multi-regression analysis was also applied. According to the regression model, ethical climate dimensions, profession, gender, and work place had significant impact on the whistleblowing intention. According to Path analysis, ethical climate had direct impact of 69% on whistleblowing intention. It was seen that organizational trust had an indirect impact of 27% on the whistleblowing score when ethical climate had a moderator role. In order to promote whistleblowing in organizations, it is important to keep the ethical climate perception of employees and the level of their organizational trust at high levels.

High-level language ability in healthy individuals and its relationship with verbal working memory.

PubMed

Antonsson, Malin; Longoni, Francesca; Einald, Christina; Hallberg, Lina; Kurt, Gabriella; Larsson, Kajsa; Nilsson, Tina; Hartelius, Lena

2016-01-01

The aims of the study were to investigate healthy subjects' performance on a clinical test of high-level language (HLL) and how it is related to demographic characteristics and verbal working memory (VWM). One hundred healthy subjects (20-79 years old) were assessed with the Swedish BeSS test (Laakso, Brunnegård, Hartelius, & Ahlsén, 2000) and two digit span tasks. Relationships between the demographic variables, VWM and BeSS were investigated both with bivariate correlations and multiple regression analysis. The results present the norms for BeSS. The correlations and multiple regression analysis show that demographic variables had limited influence on test performance. Measures of VWM were moderately related to total BeSS score and weakly to moderately correlated with five of the seven subtests. To conclude, education has an influence on the test as a whole but measures of VWM stood out as the most robust predictor of HLL.

Predictors of Persistent Axial Neck Pain After Cervical Laminoplasty.

PubMed

Kimura, Atsushi; Shiraishi, Yasuyuki; Inoue, Hirokazu; Endo, Teruaki; Takeshita, Katsushi

2018-01-01

Retrospective analysis of prospective data. The aim of this study was to reveal baseline predictors of persistent postlaminoplasty neck pain. Axial neck pain is one of the most common complications after cervical laminoplasty; however, baseline predictors of persistent postlaminoplasty neck pain are unclear. We analyzed data from 156 patients who completed a 2-year follow-up after double-door laminoplasty for degenerative cervical myelopathy. Patients rated the average intensity of axial neck pain in the last month using an 11-point numerical rating scale preoperatively and at the 2-year follow-up. The dependent variable was the presence of moderate-to-severe neck pain (numerical rating scale ≥4) at the 2-year follow-up. The independent variables included patient characteristics, baseline radiological parameters, surgical variables, baseline axial neck pain intensity, and baseline functions, which were measured by the Japanese Orthopaedic Association score and the Short Form-36 survey (SF-36). Logistic regression analysis was performed to identify independent predictors of moderate-to-severe neck pain after laminoplasty. At the 2-year follow-up, 51 patients (32%) had moderate-to-severe neck pain, and 106 patients (68%) had no or mild pain. Univariate analysis revealed that the ratio of cervical anterolisthesis, ratio of current smoking, baseline neck pain intensity, and baseline SF-36 Mental Component Summary differed significantly between the groups. Multivariate logistic regression analysis showed that independent predictors of moderate-to-severe neck pain at the 2-year follow-up include the presence of anterolisthesis, current smoking, moderate-to-severe baseline neck pain, and lower SF-36 Mental Component Summary. The presence of anterolisthesis and moderate-to-severe baseline neck pain were also associated with significantly poorer physical function after surgery. The presence of anterolisthesis was associated not only with the highest odds ratio of persistent neck pain but also with significantly poorer functional outcomes. Indications for cervical laminoplasty should be carefully determined in patients with cervical anterolisthesis. 4.

Psychosocial risk and protective factors for depression in the dialysis population: a systematic review and meta-regression analysis.

PubMed

Chan, Ramony; Steel, Zachary; Brooks, Robert; Heung, Tracy; Erlich, Jonathan; Chow, Josephine; Suranyi, Michael

2011-11-01

Research into the association between psychosocial factors and depression in End-Stage Renal Disease (ESRD) has expanded considerably in recent years identifying a range of factors that may act as important risk and protective factors of depression for this population. The present study provides the first systematic review and meta-analysis of this body of research. Published studies reporting associations between any psychosocial factor and depression were identified and retrieved from Medline, Embase, and PsycINFO, by applying optimised search strategies. Mean effect sizes were calculated for the associations across five psychosocial constructs (social support, personality attributes, cognitive appraisal, coping process, stress/stressor). Multiple hierarchical meta-regression analysis was applied to examine the moderating effects of methodological and substantive factors on the strength of the observed associations. 57 studies covering 58 independent samples with 5956 participants were identified, resulting in 246 effect sizes of the association between a range of psychosocial factors and depression. The overall mean effect size (Pearsons correlation coefficient) of the association between psychosocial factor and depression was 0.36. The effect sizes between the five psychosocial constructs and depression ranged from medium (0.27) to large levels (0.46) with personality attributes (0.46) and cognitive appraisal (0.46) having the largest effect sizes. In the meta-regression analyses, identified demographic (gender, age, location of study) and treatment (type of dialysis) characteristics moderated the strength of the associations with depression. The current analysis documents a moderate to large association between the presence of psychosocial risk factors and depression in ESRD. 2011. Published by Elsevier Inc. All rights reserved.

Brillouin Scattering Spectrum Analysis Based on Auto-Regressive Spectral Estimation

NASA Astrophysics Data System (ADS)

Huang, Mengyun; Li, Wei; Liu, Zhangyun; Cheng, Linghao; Guan, Bai-Ou

2018-06-01

Auto-regressive (AR) spectral estimation technology is proposed to analyze the Brillouin scattering spectrum in Brillouin optical time-domain refelectometry. It shows that AR based method can reliably estimate the Brillouin frequency shift with an accuracy much better than fast Fourier transform (FFT) based methods provided the data length is not too short. It enables about 3 times improvement over FFT at a moderate spatial resolution.

Social Support Moderates the Relationship Between Perceived Stress and Quality of Life in Patients With a Left Ventricular Assist Device.

PubMed

Abshire, Martha; Russell, Stuart D; Davidson, Patricia M; Budhathoki, Chakra; Han, Hae-Ra; Grady, Kathleen L; Desai, Shashank; Dennison Himmelfarb, Cheryl

2018-04-20

Living with a left ventricular assist device has significant psychosocial sequelae that affect health-related quality of life (HRQOL). The purpose of this study was to (1) describe psychosocial indicators of stress including perceived stress, depression, fatigue, and coping; (2) examine relationships among stress indicators by level of perceived stress; (3) examine relationships among indicators of stress and clinical outcomes; and (4) test the moderation of social support on the relationship between stress and clinical outcomes. Participants were recruited from 2 outpatient clinics in a cross-sectional study design. Standardized measures were self-administered via survey. Descriptive statistics, correlation, and multiple linear regression analysis were conducted. The sample (N = 62) was mostly male (78%), black (47%), and married (66%), with a mean age of 56.5 ± 13 years. The overall sample had a moderate stress profile: moderate perceived stress (mean, 11.7 ± 7), few depressive symptoms (mean, 3.2 ± 3.9), and moderate fatigue (mean, 14.3 ± 9.1). Increased perceived stress was associated with fatigue, depressive symptoms, and maladaptive coping (P < .001). Regression analysis demonstrated that perceived stress and fatigue were significant correlates of overall HRQOL (adj. R = 0.41, P < .0001). Social support moderated the relationship between perceived stress and HRQOL, controlling for fatigue (R = 0.49, P < .001). Individuals living with left ventricular assist device with high perceived stress have worse depressive symptoms, fatigue, and coping. The influence of high social support to improve the relationship between stress and HRQOL underscores the importance of a comprehensive plan to address psychosocial factors.

Moderators of fluoxetine treatment response for children and adolescents with comorbid depression and substance use disorders.

PubMed

Hirschtritt, Matthew E; Pagano, Maria E; Christian, Kelly M; McNamara, Nora K; Stansbrey, Robert J; Lingler, Jacqui; Faber, Jon E; Demeter, Christine A; Bedoya, Denise; Findling, Robert L

2012-06-01

Our recent 8-week, randomized, placebo-controlled trial of fluoxetine in adolescents (ages 12-17 years) with comorbid depression and substance use disorder (SUD) did not detect a significant antidepressant treatment effect. The purpose of this secondary analysis was to explore moderators of the effect of fluoxetine in this sample. Static moderators measured at baseline were depression chronicity and hopelessness severity; time-varying moderators measured at baseline and weekly during the 8-week trial period were alcohol and marijuana use severity. Treatment effects on depression outcomes were examined among moderating subgroups in random effects regression models. Subjects assigned to fluoxetine treatment with chronic depression at baseline (p = .04) or no more than moderate alcohol use during the trial (p = .04) showed significantly greater decline in depression symptoms in comparison to placebo-assigned subgroups. The current analysis suggests that youth with chronic depression and no more than moderate alcohol consumption are likely to respond better to treatment with fluoxetine compared with placebo than youth with transient depression and heavy alcohol use. Copyright © 2012 Elsevier Inc. All rights reserved.

Moderators of fluoxetine treatment response for children and adolescents with comorbid depression and substance use disorders

PubMed Central

Hirschtritt, Matthew E.; Pagano, Maria E.; Christian, Kelly M.; McNamara, Nora K.; Stansbrey, Robert J.; Lingler, Jacqui; Faber, Jon E.; Demeter, Christine A.; Bedoya, Denise; Findling, Robert L.

2012-01-01

Our recent 8-week, randomized, placebo-controlled trial of fluoxetine in adolescents (ages 12–17 years) with comorbid depression and substance use disorder (SUD) did not detect a significant antidepressant treatment effect. The purpose of this secondary analysis was to explore moderators of the effect of fluoxetine in this sample. Static moderators measured at baseline were depression chronicity and hopelessness severity; time-varying moderators measured at baseline and weekly during the 8-week trial period were alcohol and marijuana use severity. Treatment effects on depression outcomes were examined among moderating subgroups in random effects regression models. Subjects assigned to fluoxetine treatment with chronic depression at baseline (p = .04) or no more than moderate alcohol use during the trial (p = .04) showed significantly greater decline in depression symptoms in comparison to placebo-assigned subgroups. The current analysis suggests that youth with chronic depression and no more than moderate alcohol consumption are likely to respond better to treatment with fluoxetine compared with placebo than youth with transient depression and heavy alcohol use. PMID:22116008

The Influence of Social and Organizational Support on Transfer of Training: Evidence from Thailand

ERIC Educational Resources Information Center

Homklin, Tassanee; Takahashi, Yoshi; Techakanont, Kriengkrai

2014-01-01

This study focused on integrating social and organizational support as moderators into the main analysis model of the relationship between learning -- specifically perceived knowledge retained -- and its transfer as perceived by participants. We used hierarchical regression analysis in order to test our hypotheses. Results were generally…

A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder.

PubMed

Fornaro, Michele; Stubbs, Brendon

2015-06-01

Uncertainty exists regarding the prevalence and moderators of migraine comorbidity among people with bipolar disorder (BD). We conducted a meta-analysis and meta-regression to investigate the prevalence and moderators of migraine among people with BD. Two authors independently searched major electronic databases from inception till 02/2015. Articles were included that reported the prevalence of migraine in people with BD with or without a control group. A random effects meta-analysis and exploratory meta-regression were conducted. Fourteen studies were included encompassing 3976 individuals with BD (mean age 35.5 years, SD 7.6, 29% male). The overall pooled prevalence of migraine was 34.8% (95% CI=25.54-44.69). The prevalence of migraine was higher among people with BD-II (54.17%, 95% CI=31.52-75.95, n=742) compared to BD-I (32.7%, 95% CI=18.16-49.19, n=2138, z=3.97, p<0.0001). The prevalence of migraine was 33.9% (95% CI=26.02-42.44), 39.5% (95% CI=18.81-62.39) and 47.11% (95% CI=22.24-72.77) in North America, Europe and South America respectively. The prevalence of migraine was higher when classified according to recognized criteria at 47.91% (95% CI=32.51-63.5) compared to non-recognized criteria (20.0%, 95% CI=12.44-29.06, z=-8.40, p<0.0001). Meta regression suggests mean age may be a potential moderator. Migraine is common and burdensome among people with BD. People with BD-II appear to be particularly affected. Nonetheless, future research is required to better understand these relationships, with a special emphasis toward the course specifiers of comorbid migraine cases of either BD-I vs. BD-II. Copyright © 2015 Elsevier B.V. All rights reserved.

Leader charisma and affective team climate: the moderating role of the leader's influence and interaction.

PubMed

Hernández Baeza, Ana; Araya Lao, Cristina; García Meneses, Juliana; González Romá, Vicente

2009-11-01

In this study, we evaluate the role of leader charisma in fostering positive affective team climate and preventing negative affective climate. The analysis of a longitudinal database of 137 bank branches by means of hierarchical moderated regression shows that leader charisma has a stronger effect on team optimism than on team tension. In addition, the leader's influence and the frequency of leader-team interaction moderate the relationship between charisma and affective climate. However, whereas the leader's influence enhances the relationship between leader charisma and positive affective climate, the frequency of interaction has counterproductive effects.

Effect of removing the common mode errors on linear regression analysis of noise amplitudes in position time series of a regional GPS network & a case study of GPS stations in Southern California

NASA Astrophysics Data System (ADS)

Jiang, Weiping; Ma, Jun; Li, Zhao; Zhou, Xiaohui; Zhou, Boye

2018-05-01

The analysis of the correlations between the noise in different components of GPS stations has positive significance to those trying to obtain more accurate uncertainty of velocity with respect to station motion. Previous research into noise in GPS position time series focused mainly on single component evaluation, which affects the acquisition of precise station positions, the velocity field, and its uncertainty. In this study, before and after removing the common-mode error (CME), we performed one-dimensional linear regression analysis of the noise amplitude vectors in different components of 126 GPS stations with a combination of white noise, flicker noise, and random walking noise in Southern California. The results show that, on the one hand, there are above-moderate degrees of correlation between the white noise amplitude vectors in all components of the stations before and after removal of the CME, while the correlations between flicker noise amplitude vectors in horizontal and vertical components are enhanced from un-correlated to moderately correlated by removing the CME. On the other hand, the significance tests show that, all of the obtained linear regression equations, which represent a unique function of the noise amplitude in any two components, are of practical value after removing the CME. According to the noise amplitude estimates in two components and the linear regression equations, more accurate noise amplitudes can be acquired in the two components.

The joint moderating effect of health consciousness and healthy lifestyle on consumers' willingness to use functional foods in Taiwan.

PubMed

Chen, Mei-Fang

2011-08-01

Functional foods marketed as promoting health or reducing the risk of disease open a promising avenue for consumers to pursue a healthier life. Despite the stable growth in functional foods in Taiwan, at present little is known about whether or not consumers with varying degrees of health consciousness and different healthy lifestyles will have dissimilar attitudes toward functional foods and will vary in their willingness to use them. Regression analysis of this empirical study verifies that consumers' attitudes toward functional foods do have an impact on their willingness to use such foods. Moreover, moderated regression analysis (MRA) reveals that the joint moderator of health consciousness and healthy lifestyle indeed exerts an impact on consumers' willingness to consume functional foods. Finally, one-way ANOVA tests show that there are some differences between the consumers of the "Healthy Life Attentive" group and those of the "Healthy Life Inattentive" one both in attitudes toward and in willingness to consume functional foods. The empirical results and findings from this study would be valuable for the marketers in the functional food industry to formulate marketing communication strategies and facilitate this industry's development. Copyright © 2011 Elsevier Ltd. All rights reserved.

A behavioral economic reward index predicts drinking resolutions: moderation revisited and compared with other outcomes.

PubMed

Tucker, Jalie A; Roth, David L; Vignolo, Mary J; Westfall, Andrew O

2009-04-01

Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer term objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this "Alcohol-Savings Discretionary Expenditure" index predicted higher rates of abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation.

Leukoencephalopathy in childhood hematopoietic neoplasm caused by moderate-dose methotrexate and prophylactic cranial radiotherapy - an MR analysis

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

Matsumoto, Ko; Takahashi, Shoki; Higano, Shuichi

1995-07-15

The main purpose of this study was to determine influential factors related to minor leukoencephalopathy (LEP) caused by moderate-dose methotrexate (MTX) and prophylactic cranial radiotherapy (CRT) in childhood hematopoietic malignancies. We also compared the incidence of LEP following this treatment to that reported in the literature following treatment with high-dose MTX alone. Thirty-eight pediatric patients of hematopoietic malignancies (37 acute lymphoblastic leukemias, 1 non-Hodgkin lymphoma) who were given CRT (18-24 Gy) as well as prophylactic intrathecal and per os MTX were studied for leukoencephalopathy by magnetic resonance (MR) imaging. All the patients were free from grave neuropsychiatric disturbances. The datamore » were examined to elucidate the influential ones of five factors (patients` age, doses of intrathecal and per os MTX, dose of CRT, interval between treatment, and MR study) to develop LEP using multiple regression analysis. To compare the effect of moderate-dose MTX and prophylactic CRT on LEP to that of high-dose MTX alone, we conducted a literature review. Seven out of 38 patients (18%) developed LEP. From multiple regression analysis and partial correlation coefficients, the age and CRT dose seemed influential in the subsequent development of LEP. The incidence of LEP following treatment with moderate-dose MTX and prophylactic CRT appears to be less than that reported in the literature following treatment with intravenous high-dose MTX. However, even moderate-dose MTX in combination with CRT can result in a significant incidence of MR-detectable LEP, particularly in children 6 years of age or younger receiving 24 Gy. Leukoencephalopathy was caused by moderate-dose MTX and prophylactic CRT in pediatric patients, probably less frequently than by high-dose MTX treatment alone. The influential factors were patient`s age and CRT dose. 26 refs., 6 figs., 2 tabs.« less

The moderator-mediator role of social support in early adolescents.

PubMed

Yarcheski, A; Mahon, N E

1999-10-01

The purpose of this study was to examine social support as both a mediator and a moderator of the relationship between perceived stress and symptom patterns in early adolescents. Data were collected from 148 early adolescent boys and girls, ages 12 to 14, who responded to the Perceived Stress Scale, the Personal Resource Questionnaire 85-Part II, and the Symptom Pattern Scale. Using multiple regression analysis procedures specified for the testing of moderation and mediation, results indicated that social support did not play a moderating role in the relationship between perceived stress and symptom patterns, but social support did play a mediating role in this relationship. The findings are interpreted within the two major theoretical orientations that guided the study.

How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.

PubMed

Liu, Mingli; Wu, Lang; Ming, Qingsen

2015-01-01

To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. A meta-analysis and meta-regression. Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants' ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators. Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges' g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges' g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges' g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013). Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings.

Alcohol Use Severity Among Hispanic Emerging Adults in Higher Education: Understanding the Effect of Cultural Congruity.

PubMed

Cano, Miguel Ángel; Vaughan, Ellen L; de Dios, Marcel A; Castro, Yessenia; Roncancio, Angelica M; Ojeda, Lizette

2015-01-01

Identifying and understanding determinants of alcohol use behavior among Hispanic college students is an increasingly important public health issue, particularly during emerging adulthood. Studies examining ethnocultural determinants of alcohol use behavior among Hispanic college students have focused on direct associations with cultural orientation (e.g., acculturation and enculturation); yet there is a need for research that accounts for the complex interplay of other culturally relevant sociocultural factors. This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. A hierarchical linear regression and moderation analysis were conducted on a sample of 167 Hispanic emerging adults (ages 18-25) enrolled in college. All predictor variables entered in the regression model accounted for 20.9% of the variance in AUS. After controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS. Further, gender did not moderate either of these associations. Conversely, greater cultural congruity was associated with lower reports of AUS. A moderation analysis suggested that cultural congruity predicted lower reports of AUS among men, but not among women. This was the first known study to examine the association of cultural congruity with alcohol use. Findings highlight the value of examining contextual factors of culture and moving beyond reductive measures of cultural orientation.

Moderation analysis with missing data in the predictors.

PubMed

Zhang, Qian; Wang, Lijuan

2017-12-01

The most widely used statistical model for conducting moderation analysis is the moderated multiple regression (MMR) model. In MMR modeling, missing data could pose a challenge, mainly because the interaction term is a product of two or more variables and thus is a nonlinear function of the involved variables. In this study, we consider a simple MMR model, where the effect of the focal predictor X on the outcome Y is moderated by a moderator U. The primary interest is to find ways of estimating and testing the moderation effect with the existence of missing data in X. We mainly focus on cases when X is missing completely at random (MCAR) and missing at random (MAR). Three methods are compared: (a) Normal-distribution-based maximum likelihood estimation (NML); (b) Normal-distribution-based multiple imputation (NMI); and (c) Bayesian estimation (BE). Via simulations, we found that NML and NMI could lead to biased estimates of moderation effects under MAR missingness mechanism. The BE method outperformed NMI and NML for MMR modeling with missing data in the focal predictor, missingness depending on the moderator and/or auxiliary variables, and correctly specified distributions for the focal predictor. In addition, more robust BE methods are needed in terms of the distribution mis-specification problem of the focal predictor. An empirical example was used to illustrate the applications of the methods with a simple sensitivity analysis. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Using social cognitive theory to explain discretionary, "leisure-time" physical exercise among high school students.

PubMed

Winters, Eric R; Petosa, Rick L; Charlton, Thomas E

2003-06-01

To examine whether knowledge of high school students' actions of self-regulation, and perceptions of self-efficacy to overcome exercise barriers, social situation, and outcome expectation will predict non-school related moderate and vigorous physical exercise. High school students enrolled in introductory Physical Education courses completed questionnaires that targeted selected Social Cognitive Theory variables. They also self-reported their typical "leisure-time" exercise participation using a standardized questionnaire. Bivariate correlation statistic and hierarchical regression were conducted on reports of moderate and vigorous exercise frequency. Each predictor variable was significantly associated with measures of moderate and vigorous exercise frequency. All predictor variables were significant in the final regression model used to explain vigorous exercise. After controlling for the effects of gender, the psychosocial variables explained 29% of variance in vigorous exercise frequency. Three of four predictor variables were significant in the final regression equation used to explain moderate exercise. The final regression equation accounted for 11% of variance in moderate exercise frequency. Professionals who attempt to increase the prevalence of physical exercise through educational methods should focus on the psychosocial variables utilized in this study.

Relationships among race, education, criminal thinking, and recidivism: moderator and mediator effects.

PubMed

Walters, Glenn D

2014-02-01

Moderator and mediator relationships linking variables from three different theoretical traditions-race (subcultural theory), education (life-course theory), and criminal thinking (social learning theory)-and recidivism were examined in 1,101 released male federal prison inmates. Preliminary regression analyses indicated that racial status (White, Black, Hispanic) moderated the relationship between criminal thinking, as measured by the General Criminal Thinking (GCT) score of the Psychological Inventory of Criminal Thinking Styles (PICTS), and recidivism. Further analysis, however, revealed that it was not racial status, per se, that moderated the relationship between the PICTS and recidivism, but educational attainment. Whereas the PICTS was largely effective in predicting recidivism in inmates with 12 or more years of education, it was largely ineffective in predicting recidivism in inmates with fewer than 12 years of education. When education and the GCT score were compared as possible mediators of the race-recidivism relationship only the GCT successfully mediated this relationship. Sensitivity testing showed that the GCT mediating effect was moderately robust to violations of the sequential ignorability assumption on which causal mediation analysis rests. Moderator and mediator analyses are potentially important avenues through which theoretical constructs can be integrated and assessment strategies devised.

A Behavioral Economic Reward Index Predicts Drinking Resolutions: Moderation Re-visited and Compared with Other Outcomes

PubMed Central

Tucker, Jalie A.; Roth, David L.; Vignolo, Mary J.; Westfall, Andrew O.

2014-01-01

Data were pooled from three studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1-2 year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes compared to abstinence or relapse and to be predicted by more balanced pre-resolution monetary allocations between short- and longer-term objectives (i.e., drinking and saving for the future). Standardized odds ratios (OR) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this “Alcohol-Savings Discretionary Expenditure” index predicted higher rates of both abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared to moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of pre-resolution spending patterns aids in predicting moderation. PMID:19309182

The association between hyperoxia and patient outcomes after cardiac arrest: Analysis of a high-resolution database

PubMed Central

Elmer, Jonathan; Scutella, Michael; Pullalarevu, Raghevesh; Wang, Bo; Vaghasia, Nishit; Trzeciak, Stephen; Rosario-Rivera, Bedda L.; Guyette, Francis X.; Rittenberger, Jon C.; Dezfulian, Cameron

2014-01-01

Purpose Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. Methods This was a retrospective analysis of a single-center, prospective registry of consecutive cardiac arrest patients. We included patients who survived and were mechanically ventilated ≥24h after arrest. Our main exposure was arterial oxygen tension (PaO2), which we categorized hourly for 24 hours as severe hyperoxia (>300mmHg), moderate or probable hyperoxia (101-299mmHg), normoxia (60-100mmHg) or hypoxia (<60mmHg). We controlled for Utstein-style covariates, markers of disease severity and markers of care responsiveness. We performed unadjusted and multiple logistic regression to test the association between oxygen exposure and survival to discharge, and used ordered logistic regression to test the association of oxygen exposure with neurological outcome and Sequential Organ Failure Assessment (SOFA) score at 24h. Results Of 184 patients, 36% were exposed to severe hyperoxia and overall mortality was 54%. Severe hyperoxia, but not moderate or probable hyperoxia, was associated with decreased survival in both unadjusted and adjusted analysis (adjusted odds ratio (OR) for survival 0.83 per hour exposure, P=0.04). Moderate or probable hyperoxia was not associated with survival but was associated with improved SOFA score 24h (OR 0.92, P<0.01). Conclusion Severe hyperoxia was independently associated with decreased survival to hospital discharge. Moderate or probable hyperoxia was not associated with decreased survival and was associated with improved organ function at 24h. PMID:25472570

Impacts of floods on dysentery in Xinxiang city, China, during 2004-2010: a time-series Poisson analysis.

PubMed

Ni, Wei; Ding, Guoyong; Li, Yifei; Li, Hongkai; Jiang, Baofa

2014-01-01

Xinxiang, a city in Henan Province, suffered from frequent floods due to persistent and heavy precipitation from 2004 to 2010. In the same period, dysentery was a common public health problem in Xinxiang, with the proportion of reported cases being the third highest among all the notified infectious diseases. We focused on dysentery disease consequences of different degrees of floods and examined the association between floods and the morbidity of dysentery on the basis of longitudinal data during the study period. A time-series Poisson regression model was conducted to examine the relationship between 10 times different degrees of floods and the monthly morbidity of dysentery from 2004 to 2010 in Xinxiang. Relative risks (RRs) of moderate and severe floods on the morbidity of dysentery were calculated in this paper. In addition, we estimated the attributable contributions of moderate and severe floods to the morbidity of dysentery. A total of 7591 cases of dysentery were notified in Xinxiang during the study period. The effect of floods on dysentery was shown with a 0-month lag. Regression analysis showed that the risk of moderate and severe floods on the morbidity of dysentery was 1.55 (95% CI: 1.42-1.670) and 1.74 (95% CI: 1.56-1.94), respectively. The attributable risk proportions (ARPs) of moderate and severe floods to the morbidity of dysentery were 35.53 and 42.48%, respectively. This study confirms that floods have significantly increased the risk of dysentery in the study area. In addition, severe floods have a higher proportional contribution to the morbidity of dysentery than moderate floods. Public health action should be taken to avoid and control a potential risk of dysentery epidemics after floods.

Impacts of floods on dysentery in Xinxiang city, China, during 2004–2010: a time-series Poisson analysis

PubMed Central

Ni, Wei; Ding, Guoyong; Li, Yifei; Li, Hongkai; Jiang, Baofa

2014-01-01

Background Xinxiang, a city in Henan Province, suffered from frequent floods due to persistent and heavy precipitation from 2004 to 2010. In the same period, dysentery was a common public health problem in Xinxiang, with the proportion of reported cases being the third highest among all the notified infectious diseases. Objectives We focused on dysentery disease consequences of different degrees of floods and examined the association between floods and the morbidity of dysentery on the basis of longitudinal data during the study period. Design A time-series Poisson regression model was conducted to examine the relationship between 10 times different degrees of floods and the monthly morbidity of dysentery from 2004 to 2010 in Xinxiang. Relative risks (RRs) of moderate and severe floods on the morbidity of dysentery were calculated in this paper. In addition, we estimated the attributable contributions of moderate and severe floods to the morbidity of dysentery. Results A total of 7591 cases of dysentery were notified in Xinxiang during the study period. The effect of floods on dysentery was shown with a 0-month lag. Regression analysis showed that the risk of moderate and severe floods on the morbidity of dysentery was 1.55 (95% CI: 1.42–1.670) and 1.74 (95% CI: 1.56–1.94), respectively. The attributable risk proportions (ARPs) of moderate and severe floods to the morbidity of dysentery were 35.53 and 42.48%, respectively. Conclusions This study confirms that floods have significantly increased the risk of dysentery in the study area. In addition, severe floods have a higher proportional contribution to the morbidity of dysentery than moderate floods. Public health action should be taken to avoid and control a potential risk of dysentery epidemics after floods. PMID:25098726

Predictive factors for the severity of liver fibrosis in patients with chronic hepatitis C and moderate alcohol consumption.

PubMed

Vădan, Roxana; Gheorghe, Liana; Becheanu, Gabriel; Iacob, Răzvan; Iacob, Speranţa; Gheorghe, Cristian

2003-09-01

Among the histological lesions seen in chronic hepatitis C (CHC), the presence of steatosis, bile duct lesions and lymphoid aggregates are characteristic. Recent reports suggest that steatosis is an independent risk factor for liver fibrosis in CHC. The aim of our study was to determine the relative contribution of steatosis and moderate alcohol consumption to the severity of liver fibrosis in patients infected with genotype 1 hepatitis C virus. We evaluated the patients with biopsy proven CHC and no or only moderate alcohol intake (<40 g/day). The demographical parameters of the study population, the indices of alcohol consumption: erythrocyte median corpuscular volume (MCV), gamma-glutamyl transpeptidase (GGT), the histological characteristics were noted and a statistical analysis was performed in order to determine the factors independently associated with severe fibrosis and with severe steatosis. From the 200 patients included in the study, 82 were males and 118 females, with a mean age of 47.75+/-10.42 years. At univariate analysis, advanced (grade 2, 3) fibrosis correlated with: the age at the time of biopsy, increased inflammatory activity (HAI), moderate/severe steatosis, alcohol intake, elevated GGT and MCV values. After multivariate logistic regression only age, HAI and steatosis were independently associated with advanced fibrosis stage. Regarding hepatic steatosis, from the factors found to correlate with severe steatosis at univariate analysis (alcohol intake, elevated GGT and MCV levels, severe fibrosis), after multivariate logistic regression only the elevated level of GGT was an independent prognostic factor for severe steatosis. Steatosis is an important risk factor for the severity of liver disease in CHC patients. Among patients with genotype 1 hepatitis C virus infection and moderate alcohol intake, those with serum levels of GGT over two times the normal value are at high risk for severe steatosis.

Prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in insomnia sufferers: a study on 1311 subjects.

PubMed

Hein, Matthieu; Lanquart, Jean-Pol; Loas, Gwénolé; Hubain, Philippe; Linkowski, Paul

2017-07-06

Several studies have investigated the prevalence and risk factors of insomnia in subjects with obstructive sleep apnea syndrome. However, few studies have investigated the prevalence and risk factors for obstructive sleep apnea syndrome in insomnia sufferers. Thus, the aim of this study was to examine the prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in a large sample of insomnia sufferers. Data from 1311 insomnia sufferers who were recruited from the research database of the sleep laboratory of the Erasme Hospital were analysed. An apnea-hypopnea index of ≥15 events per hour was used as the cut-off score for moderate to severe obstructive sleep apnea syndrome. Logistic regression analyses were conducted to examine clinical and demographic risk factors of moderate to severe obstructive sleep apnea syndrome in insomnia sufferers. The prevalence of moderate to severe obstructive sleep apnea syndrome in our sample of insomnia sufferers was 13.88%. Multivariate logistic regression analysis revealed that male gender, snoring, excessive daytime sleepiness, lower maintenance insomnia complaint, presence of metabolic syndrome, age ≥ 50 & <65 years, age ≥ 65 years, BMI ≥ 25 & <30 kg/m 2 , BMI >30 kg/m 2 , and CRP >7 mg/L were significant risk factors of moderate to severe obstructive sleep apnea syndrome in insomnia sufferers. Moderate to severe obstructive sleep apnea syndrome is a common pathology in insomnia sufferers. The identification of these different risk factors advances a new perspective for more effective screening of moderate to severe obstructive sleep apnea syndrome in insomnia sufferers.

Moderated mediation analysis: An illustration using the association of gender with delinquency and mental health.

PubMed

Miles, Jeremy N V; Kulesza, Magdalena; Ewing, Brett; Shih, Regina A; Tucker, Joan S; D'Amico, Elizabeth J

When researchers find an association between two variables, it is useful to evaluate the role of other constructs in this association. While assessing these mediation effects, it is important to determine if results are equal for different groups. It is possible that the strength of a mediation effect may differ for males and females, for example - such an effect is known as moderated mediation. Participants were 2532 adolescents from diverse ethnic/racial backgrounds and equally distributed across gender. The goal of this study was to investigate parental respect as a potential mediator of the relationship between gender and delinquency and mental health, and to determine whether observed mediation is moderated by gender. Parental respect mediated the association between gender and both delinquency and mental health. Specifically, parental respect was a protective factor against delinquency and mental health problems for both females and males. Demonstrated the process of estimating models in Lavaan, using two approaches (i.e. single group regression and multiple group regression model), and including covariates in both models.

Moderated mediation analysis: An illustration using the association of gender with delinquency and mental health

PubMed Central

Miles, Jeremy N.V.; Kulesza, Magdalena; Ewing, Brett; Shih, Regina A.; Tucker, Joan S.; D’Amico, Elizabeth J.

2015-01-01

Purpose When researchers find an association between two variables, it is useful to evaluate the role of other constructs in this association. While assessing these mediation effects, it is important to determine if results are equal for different groups. It is possible that the strength of a mediation effect may differ for males and females, for example – such an effect is known as moderated mediation. Design Participants were 2532 adolescents from diverse ethnic/racial backgrounds and equally distributed across gender. The goal of this study was to investigate parental respect as a potential mediator of the relationship between gender and delinquency and mental health, and to determine whether observed mediation is moderated by gender. Findings Parental respect mediated the association between gender and both delinquency and mental health. Specifically, parental respect was a protective factor against delinquency and mental health problems for both females and males. Practical implications Demonstrated the process of estimating models in Lavaan, using two approaches (i.e. single group regression and multiple group regression model), and including covariates in both models. PMID:26500722

Rhythms of life: antecedents and outcomes of work-family balance in employed parents.

PubMed

Aryee, Samuel; Srinivas, E S; Tan, Hwee Hoon

2005-01-01

This study examined antecedents and outcomes of a fourfold taxonomy of work-family balance in terms of the direction of influence (work-family vs. family-work) and type of effect (conflict vs. facilitation). Respondents were full-time employed parents in India. Confirmatory factor analysis results provided evidence for the discriminant validity of M. R. Frone's (2003) fourfold taxonomy of work-family balance. Results of moderated regression analysis revealed that different processes underlie the conflict and facilitation components. Furthermore, gender had only a limited moderating influence on the relationships between the antecedents and the components of work-family balance. Last, work-family facilitation was related to the work outcomes of job satisfaction and organizational commitment.

Efficacy of Statin Therapy in Inducing Coronary Plaque Regression in Patients with Low Baseline Cholesterol Levels

PubMed Central

Nozue, Tsuyoshi; Yamamoto, Shingo; Tohyama, Shinichi; Fukui, Kazuki; Umezawa, Shigeo; Onishi, Yuko; Kunishima, Tomoyuki; Sato, Akira; Miyake, Shogo; Morino, Yoshihiro; Yamauchi, Takao; Muramatsu, Toshiya; Hibi, Kiyoshi; Terashima, Mitsuyasu; Suzuki, Hiroshi; Michishita, Ichiro

2016-01-01

Aim: The efficacy of statin therapy in inducing coronary plaque regression may depend on baseline cholesterol levels. We aimed to determine the efficacy of statin therapy in inducing coronary plaque regression in statin-naïve patients with low cholesterol levels using serial intravascular ultrasound (IVUS) data from the treatment with statin on atheroma regression evaluated by virtual histology IVUS (TRUTH) study. Methods: The TRUTH study is a prospective, multicenter trial, comparing the efficacies of pitavastatin and pravastatin in coronary plaque regression in 164 patients. All patients were statin-naïve and received statin therapy only after study enrollment. The primary endpoint was the observation of coronary plaque progression, despite statin therapy. Results: Serial IVUS data, at baseline and after an 8-month follow-up, were available for 119 patients. The patients were divided into three groups based on non-high-density lipoprotein cholesterol (HDL-C) levels—low: ≤ 140 mg/dl, n = 38; moderate: 141–169 mg/dl, n = 42; and high: ≥ 170 mg/dl, n = 39. Coronary plaque progression was noted in the low cholesterol group, whereas plaque regression was noted in the moderate and high cholesterol groups [%Δplaque volume: 2.3 ± 7.4 vs. − 2.7 ± 10.7 vs. − 3.2 ± 7.5, p = 0.004 (analysis of variance)]. After adjusting for all variables, a low non-HDLC level (≤ 140 mg/dl) was identified as an independent predictor of coronary plaque progression [odds ratio, 3.7; 95% confidence interval, 1.5–9.1, p = 0.004]. Conclusion: Serial IVUS data analysis indicated that statin therapy was less effective in inducing coronary plaque regression in patients with low cholesterol levels but more effective in those with high cholesterol levels at baseline. University Hospital Medical Information Network (UMIN) (UMIN ID: C000000311). PMID:27040362

The Effect of Teachers' Emotional Labour on Teaching Satisfaction: Moderation of Emotional Intelligence

ERIC Educational Resources Information Center

Yin, Hongbiao

2015-01-01

Teachers can be seen as emotional workers often needing to be sensitive to the demands that their work makes on their emotions, and skilful in regulating their feelings, but few quantitative studies have examined this issue systematically. Using hierarchical regression analysis to examine this issue, this study investigates teachers' perceptions…

Assessing Mediation Using Marginal Structural Models in the Presence of Confounding and Moderation

ERIC Educational Resources Information Center

Coffman, Donna L.; Zhong, Wei

2012-01-01

This article presents marginal structural models with inverse propensity weighting (IPW) for assessing mediation. Generally, individuals are not randomly assigned to levels of the mediator. Therefore, confounders of the mediator and outcome may exist that limit causal inferences, a goal of mediation analysis. Either regression adjustment or IPW…

Prevalence of and risk factors for depressive symptoms among people living with HIV/AIDS receiving antiretroviral treatment in Wuhan, China: a short report.

PubMed

Rong, Hu; Nianhua, Xie; Jun, Xu; Lianguo, Ruan; Si, Wu; Sheng, Wei; Heng, Guo; Xia, Wang

2017-12-01

We aimed to explore the prevalence of and risk factors for depressive symptoms (DS) among people living with HIV/AIDS (PLWHA) receiving antiretroviral treatment (ART) in Wuhan, Hubei, China. A cross-sectional study evaluating adult PLWHA receiving ART in nine designated clinical hospitals was conducted from October to December 2015. The validated Beck Depression Inventory (BDI) was used to assess DS in eligible participants. Socio-demographical, epidemiological and clinical data were directly extracted from the case reporting database of the China HIV/AIDS Information Network. Multinomial regression analysis was used to explore the risk factors for DS. 394 participants were finally included in all analyses. 40.3% were found to have DS with 13.7% having mild DS and 26.6% having moderate to severe DS. The results of multinomial regression analysis suggested that being married or living with a partner, recent experience of ART-related side effects, and/or history of HCV infection were positively associated with mild DS, while increasing age was positively associated with moderate to severe DS.

The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury.

PubMed

Min, Jung-Ah; Lee, Chang-Uk; Hwang, Sung-Il; Shin, Jung-In; Lee, Bum-Suk; Han, Sang-Hoon; Ju, Hye-In; Lee, Cha-Yeon; Lee, Chul; Chae, Jeong-Ho

2014-01-01

To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth. Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates. In the regression model of depression, the effect of pain severity on depression was decreased (β was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (β = 0.33, p = 0.038 and β = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (β = 0.51, p = 0.016). Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.

Time-varying effect moderation using the structural nested mean model: estimation using inverse-weighted regression with residuals

PubMed Central

Almirall, Daniel; Griffin, Beth Ann; McCaffrey, Daniel F.; Ramchand, Rajeev; Yuen, Robert A.; Murphy, Susan A.

2014-01-01

This article considers the problem of examining time-varying causal effect moderation using observational, longitudinal data in which treatment, candidate moderators, and possible confounders are time varying. The structural nested mean model (SNMM) is used to specify the moderated time-varying causal effects of interest in a conditional mean model for a continuous response given time-varying treatments and moderators. We present an easy-to-use estimator of the SNMM that combines an existing regression-with-residuals (RR) approach with an inverse-probability-of-treatment weighting (IPTW) strategy. The RR approach has been shown to identify the moderated time-varying causal effects if the time-varying moderators are also the sole time-varying confounders. The proposed IPTW+RR approach provides estimators of the moderated time-varying causal effects in the SNMM in the presence of an additional, auxiliary set of known and measured time-varying confounders. We use a small simulation experiment to compare IPTW+RR versus the traditional regression approach and to compare small and large sample properties of asymptotic versus bootstrap estimators of the standard errors for the IPTW+RR approach. This article clarifies the distinction between time-varying moderators and time-varying confounders. We illustrate the methodology in a case study to assess if time-varying substance use moderates treatment effects on future substance use. PMID:23873437

The Association Between Spontaneous Hyperventilation, Delayed Cerebral Ischemia, and Poor Neurological Outcome in Patients with Subarachnoid Hemorrhage.

PubMed

Williamson, Craig A; Sheehan, Kyle M; Tipirneni, Renuka; Roark, Christopher D; Pandey, Aditya S; Thompson, B Gregory; Rajajee, Venkatakrishna

2015-12-01

The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. This is a retrospective analysis of data from a prospectively collected cohort of SAH patients at an academic medical center. Spontaneous hyperventilation was defined by PaCO2 <35 mmHg and pH >7.45 and subdivided into moderate and severe groups. Clinical and demographic characteristics of patients with and without spontaneous hyperventilation were compared using χ (2) or t tests. Bivariate and multivariable logistic regression analyses were conducted to examine the association of moderate and severe hyperventilation with DCI and discharge neurological outcome. Of 207 patients, 113 (55 %) had spontaneous hyperventilation. Spontaneously hyperventilating patients had greater illness severity as measured by the Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), and SAH sum scores. They were also more likely to develop the following complications: pneumonia, neurogenic myocardial injury, systemic inflammatory response syndrome (SIRS), radiographic vasospasm, DCI, and poor neurological outcome. In a multivariable logistic regression model including age, gender, WFNS, SAH sum score, pneumonia, neurogenic myocardial injury, etiology, and SIRS, only moderate [odds ratio (OR) 2.49, 95 % confidence interval (CI) 1.10-5.62] and severe (OR 3.12, 95 % CI 1.30-7.49) spontaneous hyperventilation were associated with DCI. Severe spontaneous hyperventilation (OR 4.52, 95 % CI 1.37-14.89) was also significantly associated with poor discharge outcome in multivariable logistic regression analysis. Spontaneous hyperventilation is common in SAH and is associated with DCI and poor neurological outcome.

Feminist identity as a predictor of eating disorder diagnostic status.

PubMed

Green, Melinda A; Scott, Norman A; Riopel, Cori M; Skaggs, Anna K

2008-06-01

Passive Acceptance (PA) and Active Commitment (AC) subscales of the Feminist Identity Development Scale (FIDS) were examined as predictors of eating disorder diagnostic status as assessed by the Questionnaire for Eating Disorder Diagnoses (Q-EDD). Results of a hierarchical regression analysis revealed PA and AC scores were not statistically significant predictors of ED diagnostic status after controlling for diagnostic subtype. Results of a multiple regression analysis revealed FIDS as a statistically significant predictor of ED diagnostic status when failing to control for ED diagnostic subtype. Discrepancies suggest ED diagnostic subtype may serve as a moderator variable in the relationship between ED diagnostic status and FIDS. (c) 2008 Wiley Periodicals, Inc.

Indicators of Moderate and Severe Preeclampsia in Correlation with Maternal IL10

PubMed Central

Markova, Ana Daneva; Hadži-Lega, Marija; Mijakoski, Dragan

2016-01-01

AIM: The purpose of the actual study was to evaluate the relationship between the formation of anti-inflammatory cytokine IL10 and several indicators of moderate and severe preeclampsia in the third trimester of pregnancy. MATERIAL AND METHODS: Examination of the indicators of preeclampsia and maternal IL10 levels was conducted in 50 women with pregnancies complicated by varying degrees of preeclampsia in the third trimester of gestation as well as in 50 normotensive patients, hospitalized at the University Clinic of Gynecology and Obstetrics, Skopje, Republic of Macedonia. The levels of IL10 were determined with a commercial test developed by Orgenium Laboratories (Finland), using reagents from AviBion ELISA research kits. Patients with preeclampsia were categorized into moderate and severe preeclampsia group according to the degree of preeclampsia. Logistic regression analysis was used to determine the predictive value of different parameters for the occurrence of severe preeclampsia. Odds ratios and 95% Confidence Intervals were calculated in order to quantify independent associations. RESULTS: The regression analysis detected systolic blood pressure (160 mmHg or higher), diastolic blood pressure (100 mmHg or higher), persistent proteinuria in pregnancy, serum LDH concentration (450 U/L or higher) and reduced serum concentrations of IL10 as significant predictors of severe preeclampsia in pregnant women after adjusting for age. CONCLUSION: The findings of significantly lower serum IL10 concentrations in patients with severe preeclampsia in comparison with respective concentrations in patients with moderate preeclampsia can be considered as major pathognomonic laboratory sign of severe preeclampsia. PMID:27335593

Alcohol Use Severity among Hispanic Emerging Adults in Higher Education: Understanding the Effect of Cultural Congruity

PubMed Central

Cano, Miguel Ángel; Vaughan, Ellen L.; de Dios, Marcel A.; Castro, Yessenia; Roncancio, Angelica M.; Ojeda, Lizette

2016-01-01

Background Identifying and understanding determinants of alcohol use behavior among Hispanic college students is an increasingly important public health issue, particularly during emerging adulthood. Studies examining ethnocultural determinants of alcohol use behavior among Hispanic college students have focused on direct associations with cultural orientation (e.g., acculturation and enculturation); yet there is a need for research that accounts for the complex interplay of other culturally relevant sociocultural factors. Objectives This study examined associations of behavioral acculturation, behavioral enculturation, and cultural congruity (perception of cultural fit between the values of the academic environment and the student's personal values) with alcohol use severity (AUS); and tested if gender moderated those associations. Methods A hierarchical linear regression and moderation analysis were conducted on a sample of 167 Hispanic emerging adults (ages 18 to 25) enrolled in college. Results All predictor variables entered in the regression model accounted for 20.9% of the variance in AUS. After controlling for demographic variables and depressive symptoms, behavioral acculturation and enculturation did not have a statistically significant association with AUS. Further, gender did not moderate either of these associations. Conversely, greater cultural congruity was associated with lower reports of AUS. A moderation analysis suggested that cultural congruity predicted lower reports of AUS among men, but not among women. Conclusions This was the first known study to examine the association of cultural congruity with alcohol use. Findings highlight the value of examining contextual factors of culture and moving beyond reductive measures of cultural orientation. PMID:26574656

Social support as a moderator of positive psychological strengths and subjective well-being.

PubMed

Khan, Aqeel; Husain, Akbar

2010-04-01

The present study was conducted to examine: (a) the relation of positive psychological strengths, i.e., hope, optimism, self-efficacy, and resiliency, with subjective well-being, and (b) the role of social support as a moderator of positive psychological strengths and subjective well-being. The following hypotheses were proposed: (a) that positive psychological strengths would be positively related with subjective well-being and social support; (b) social support would moderate the relation of positive psychological strengths with subjective well-being. 116 men and 64 women (M age=21.53 yr., SD=4.99, range=33) from India participated. Significant positive relationships were found for positive psychological strengths with subjective well-being and with social support network (family, friends, and others). Regression analysis showed social support significantly moderated the relations of positive psychological strengths with subjective well-being.

Test Anxiety and Academic Performance among Undergraduates: The Moderating Role of Achievement Motivation.

PubMed

Balogun, Anthony Gbenro; Balogun, Shyngle Kolawole; Onyencho, Chidi Victor

2017-02-13

This study investigated the moderating role of achievement motivation in the relationship between test anxiety and academic performance. Three hundred and ninety three participants (192 males and 201 females) selected from a public university in Ondo State, Nigeria using a purposive sampling technique, participated in the study. They responded to measures of test anxiety and achievement motivation. Three hypotheses were tested using moderated hierarchical multiple regression analysis. Results showed that test anxiety had a negative impact on academic performance (β = -.23; p < .05). Achievement motivation had a positive impact on academic performance (β = .38; p < .05). Also, achievement motivation significantly moderated the relationship between test anxiety and academic performance (β = .10; p < .01). These findings suggest that university management should design appropriate psycho-educational interventions that would enhance students' achievement motivation.

Modifiable lifestyle factors affecting bone health using calcaneus quantitative ultrasound in adolescent girls.

PubMed

Robinson, M L; Winters-Stone, K; Gabel, K; Dolny, D

2007-08-01

One hundred and fourteen girls were measured for calcaneus QUS (stiffness index score), calcium intake, weight, and total hours spent in physical activity (moderate to high-impact activities and low to no-impact activities). Multiple regression analysis indicated that hours spent in moderate to high-impact activities, current calcium intake, and weight significantly predicted SI. To determine the influence of modifiable lifestyle factors on adolescent girls' bone health measured by calcaneus quantitative ultrasound (QUS). One hundred and fourteen girls, ages 14-18 (15.97 +/- .7), enrolled in high school physical education classes, were measured for calcaneus QUS (stiffness index score), height, weight, current calcium intake from 2-3 day food records, and estimated total hours spent in physical activity from kindergarten to present. Cumulative physical activity hours were separated into two classifications (according to their estimated strain from ground reaction force): moderate to high-impact activities and low to no-impact activities. Pearson correlations between stiffness index (SI) and age, height, weight, current calcium intake, and hours spent in moderate to high-impact versus low to no-impact activities indicated a positive relationships between SI and weight (r = .259, p = .005), current calcium intake (r = .286, p = .002), and hours spent in moderate to high-impact activities (r = .451, p < .001). Multiple regression between SI and the above independent variables indicated that collectively, hours spent in moderate to high-impact activities, current calcium intake, and weight (r (2) = .363, p = <.001) significantly predicted SI. Our data indicate that moderate to high-impact activities, current calcium intake, and weight positively influence bone properties of the calcaneus in adolescent girls.

Subjective Burden and Depression in Mothers of Children with Autism Spectrum Disorder in India: Moderating Effect of Social Support.

PubMed

Singh, Prerna; Ghosh, Subharati; Nandi, Subhrangshu

2017-10-01

The quantitative study assessed subjective burden, depression, and the moderating effect of social support in mothers of children with autism spectrum disorder (ASD) in India. Seventy mothers were interviewed using a structured interview schedule, which measured their subjective burden, depression, and social support from family, friends, and significant others. Data was analyzed using descriptive statistics and multiple regression analysis with interaction terms. Half of the mothers in the study reported depression of clinical significance. Higher subjective burden significantly predicted higher depression. Of the three sources of support, only medium/high family support had a direct impact on depression and also moderated the impact of the subjective burden of depression. Implications for practice and policy are discussed.

Meta-Analysis of the Reasoned Action Approach (RAA) to Understanding Health Behaviors.

PubMed

McEachan, Rosemary; Taylor, Natalie; Harrison, Reema; Lawton, Rebecca; Gardner, Peter; Conner, Mark

2016-08-01

Reasoned action approach (RAA) includes subcomponents of attitude (experiential/instrumental), perceived norm (injunctive/descriptive), and perceived behavioral control (capacity/autonomy) to predict intention and behavior. To provide a meta-analysis of the RAA for health behaviors focusing on comparing the pairs of RAA subcomponents and differences between health protection and health-risk behaviors. The present research reports a meta-analysis of correlational tests of RAA subcomponents, examination of moderators, and combined effects of subcomponents on intention and behavior. Regressions were used to predict intention and behavior based on data from studies measuring all variables. Capacity and experiential attitude had large, and other constructs had small-medium-sized correlations with intention; all constructs except autonomy were significant independent predictors of intention in regressions. Intention, capacity, and experiential attitude had medium-large, and other constructs had small-medium-sized correlations with behavior; intention, capacity, experiential attitude, and descriptive norm were significant independent predictors of behavior in regressions. The RAA subcomponents have utility in predicting and understanding health behaviors.

The Moderating Role of Autonomous Motivation on the Relationship between Subjective Well-Being and Physical Health

PubMed Central

Marcinko, Ivana

2015-01-01

The purpose of this study was to investigate the moderator effects of autonomous motivation on the relationship between subjective well-being and physical health. Using a cluster sampling approach 486 students (403 female and 83 male students) were included in this study. Subjective well-being, physical health and autonomous motivation were determined by self-report measures. Data were analysed using hierarchical regression analysis and analysis of variance. The results show that high self-determination moderates the relationship between high subjective well-being and physical health. Accordingly, the best physical health was reported by participants who had high level of subjective well-being and whose behaviours were self-determined. Additional analyses have shown that the moderating effect of self-determination is based on the moderational impact of autonomous motives and not the controlling ones. Additionally, whether autonomous motivation moderates the relationship between components of subjective well-being and physical health was also tested. The findings have shown that autonomous motives moderate relationship between physical health and one component of well-being, positive affect. Consequently, a good physical health was found among participants with high positive affect and behaviours regulated by high degree of autonomous motives. Conclusion which can be drawn from these findings is that if an individual behaves autonomously then it can contribute to positive mind—body influences and support their own health. PMID:25942449

The Moderating Role of Autonomous Motivation on the Relationship between Subjective Well-Being and Physical Health.

PubMed

Marcinko, Ivana

2015-01-01

The purpose of this study was to investigate the moderator effects of autonomous motivation on the relationship between subjective well-being and physical health. Using a cluster sampling approach 486 students (403 female and 83 male students) were included in this study. Subjective well-being, physical health and autonomous motivation were determined by self-report measures. Data were analysed using hierarchical regression analysis and analysis of variance. The results show that high self-determination moderates the relationship between high subjective well-being and physical health. Accordingly, the best physical health was reported by participants who had high level of subjective well-being and whose behaviours were self-determined. Additional analyses have shown that the moderating effect of self-determination is based on the moderational impact of autonomous motives and not the controlling ones. Additionally, whether autonomous motivation moderates the relationship between components of subjective well-being and physical health was also tested. The findings have shown that autonomous motives moderate relationship between physical health and one component of well-being, positive affect. Consequently, a good physical health was found among participants with high positive affect and behaviours regulated by high degree of autonomous motives. Conclusion which can be drawn from these findings is that if an individual behaves autonomously then it can contribute to positive mind-body influences and support their own health.

Exploring the Relations between Parent Depressive Symptoms, Family Religious Involvement, and Adolescent Depressive Symptoms: A Test of Moderation

ERIC Educational Resources Information Center

Hooper, Lisa M.; Caroline R. Newman

2011-01-01

Building on previous research, the current study examined the relations between parent depressive symptoms, family religious involvement, and adolescent depressive symptoms in a convenience sample of 74 parent-adolescent dyads of southern U.S. families. We used hierarchical regression analysis to explore whether family religious involvement…

Role Stress and Aggression among Young Adults: The Moderating Influences of Gender and Adolescent Aggression

ERIC Educational Resources Information Center

Liu, Ruth X.; Kaplan, Howard B.

2004-01-01

Using data provided by a panel of non-Hispanic white respondents, this study explored whether aggressive response to severe role stress during early adulthood depends on gender and on an adolescent history of aggression. Logistic regression analysis yielded these findings: Men who reported aggression during early adolescence were significantly…

The Effectiveness of Psychosocial Interventions Delivered by Teachers in Schools: A Systematic Review and Meta-Analysis.

PubMed

Franklin, Cynthia; Kim, Johnny S; Beretvas, Tasha S; Zhang, Anao; Guz, Samantha; Park, Sunyoung; Montgomery, Katherine; Chung, Saras; Maynard, Brandy R

2017-09-01

The growing mental health needs of students within schools have resulted in teachers increasing their involvement in the delivery of school-based, psychosocial interventions. Current research reports mixed findings concerning the effectiveness of psychosocial interventions delivered by teachers for mental health outcomes. This article presents a systematic review and meta-analysis that examined the effectiveness of school-based psychosocial interventions delivered by teachers on internalizing and externalizing outcomes and the moderating factors that influence treatment effects on these outcomes. Nine electronic databases, major journals, and gray literature (e.g., websites, conference abstract) were searched and field experts were contacted to locate additional studies. Twenty-four studies that met the study inclusion criteria were coded into internalizing or externalizing outcomes and further analyzed using robust variance estimation in meta-regression. Both publication and risk of bias of studies were further assessed. The results showed statistically significant reductions in students' internalizing outcomes (d = .133, 95% CI [.002, .263]) and no statistical significant effect for externalizing outcomes (d = .15, 95% CI [-.037, .066]). Moderator analysis with meta-regression revealed that gender (%male, b = -.017, p < .05), race (% Caucasian, b = .002, p < .05), and the tier of intervention (b = .299, p = .06) affected intervention effectiveness. This study builds on existing literature that shows that teacher-delivered Tier 1 interventions are effective interventions but also adds to this literature by showing that interventions are more effective with internalizing outcomes than on the externalizing outcomes. Moderator analysis also revealed treatments were more effective with female students for internalizing outcomes and more effective with Caucasian students for externalizing outcomes.

Burnout and Associated Factors among Iranian Emergency Medicine Practitioners.

PubMed

Jalili, Mohammad; Sadeghipour Roodsari, Gholamreza; Bassir Nia, Anahita

2013-09-01

Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, depersonalization and personal accomplishment, also demographic factors, work related factors and sources of stress in emergency department using anonymous self-administered questionnaire. Descriptive analysis, univariate analysis to evaluate association with higher score of burnout, and multivariate logistic regression analysis to predict high burnout in 3 subscales was performed. Totally, 165 questionnaires were filled (response rate: 88%; mean age: 33.6 years, 91% male). Mean burnout scores were 22.94 for emotional exhaustion (95% CI=20.78-25.01; moderate), 9.3 for depersonalization (95% CI=8.24-10.36; moderate to high), and 31.47 for personal accomplishment (95% CI=29.87-33.07; moderate to high). Frequent reported sources of stress were shortage of equipment, problem with work physical environment, and relationship with other services. All 19 sources of stress were associated with higher score of emotional exhaustion and depersonalization; while twelve out of 19 were significantly associated with lower level of personal accomplishment. In logistic regression model, the significant predictors for high emotional exhaustion were work overload, feeling of insecurity for future career and difficulties to balance professional and private life. Burnout is high among Iranian emergency medicine practitioners and some interventions can be proposed to reduce stress.

Neck-focused panic attacks among Cambodian refugees; a logistic and linear regression analysis.

PubMed

Hinton, Devon E; Chhean, Dara; Pich, Vuth; Um, Khin; Fama, Jeanne M; Pollack, Mark H

2006-01-01

Consecutive Cambodian refugees attending a psychiatric clinic were assessed for the presence and severity of current--i.e., at least one episode in the last month--neck-focused panic. Among the whole sample (N=130), in a logistic regression analysis, the Anxiety Sensitivity Index (ASI; odds ratio=3.70) and the Clinician-Administered PTSD Scale (CAPS; odds ratio=2.61) significantly predicted the presence of current neck panic (NP). Among the neck panic patients (N=60), in the linear regression analysis, NP severity was significantly predicted by NP-associated flashbacks (beta=.42), NP-associated catastrophic cognitions (beta=.22), and CAPS score (beta=.28). Further analysis revealed the effect of the CAPS score to be significantly mediated (Sobel test [Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182]) by both NP-associated flashbacks and catastrophic cognitions. In the care of traumatized Cambodian refugees, NP severity, as well as NP-associated flashbacks and catastrophic cognitions, should be specifically assessed and treated.

How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis

PubMed Central

Liu, Mingli; Wu, Lang; Ming, Qingsen

2015-01-01

Objective To perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. Design A meta-analysis and meta-regression. Method Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were: (1) intervention should be supervised physical activity, (2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept, (3) participants’ ages ranged from 3 to 20 years, and (4) a control or comparison group was included. For each study, study design, intervention design and participant characteristics were extracted. R software (version 3.1.3) and Stata (version 12.0) were used to synthesize effect sizes and perform moderation analyses for determining moderators. Results Twenty-five randomized controlled trial (RCT) studies and 13 non-randomized controlled trial (non-RCT) studies including a total of 2991 cases were identified. Significant positive effects were found in RCTs for intervention of physical activity alone on general self outcomes (Hedges’ g = 0.29, 95% confidence interval [CI]: 0.14 to 0.45; p = 0.001), self-concept (Hedges’ g = 0.49, 95%CI: 0.10 to 0.88, p = 0.014) and self-worth (Hedges’ g = 0.31, 95%CI: 0.13 to 0.49, p = 0.005). There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies. Meta-regression analysis revealed that higher treatment effects were associated with setting of intervention in RCTs (β = 0.31, 95%CI: 0.07 to 0.55, p = 0.013). Conclusion Intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings. PMID:26241879

Predictive factors of early moderate/severe ovarian hyperstimulation syndrome in non-polycystic ovarian syndrome patients: a statistical model.

PubMed

Ashrafi, Mahnaz; Bahmanabadi, Akram; Akhond, Mohammad Reza; Arabipoor, Arezoo

2015-11-01

To evaluate demographic, medical history and clinical cycle characteristics of infertile non-polycystic ovary syndrome (NPCOS) women with the purpose of investigating their associations with the prevalence of moderate-to-severe OHSS. In this retrospective study, among 7073 in vitro fertilization and/or intracytoplasmic sperm injection (IVF/ICSI) cycles, 86 cases of NPCO patients who developed moderate-to-severe OHSS while being treated with IVF/ICSI cycles were analyzed during the period of January 2008 to December 2010 at Royan Institute. To review the OHSS risk factors, 172 NPCOS patients without developing OHSS, treated at the same period of time, were selected randomly by computer as control group. We used multiple logistic regression in a backward manner to build a prediction model. The regression analysis revealed that the variables, including age [odds ratio (OR) 0.9, confidence interval (CI) 0.81-0.99], antral follicles count (OR 4.3, CI 2.7-6.9), infertility cause (tubal factor, OR 11.5, CI 1.1-51.3), hypothyroidism (OR 3.8, CI 1.5-9.4) and positive history of ovarian surgery (OR 0.2, CI 0.05-0.9) were the most important predictors of OHSS. The regression model had an area under curve of 0.94, presenting an allowable discriminative performance that was equal with two strong predictive variables, including the number of follicles and serum estradiol level on human chorionic gonadotropin day. The predictive regression model based on primary characteristics of NPCOS patients had equal specificity in comparison with two mentioned strong predictive variables. Therefore, it may be beneficial to apply this model before the beginning of ovarian stimulation protocol.

The associations between suicidal ideation and attempt and anxiety symptoms and the demographic, psychological, and social moderators in Taiwanese adolescents.

PubMed

Yen, Cheng-Fang; Lai, Chien-Yu; Ko, Chih-Hung; Liu, Tai-Ling; Tang, Tze-Chun; Wu, Yu-Yu; Yang, Pinchen

2014-01-01

The objectives of this study were to examine the associations between suicidal ideation and attempt and anxiety symptoms and the moderators in 5,027 Taiwanese adolescents. The associations between suicidal ideation and attempt and anxiety symptoms on the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T) were examined using logistic regression analysis. The moderating effects of demographic (gender and age), psychological (problematic alcohol use, severe depressive symptoms, and low self-esteem), and social factors (bullying victimization, and low family function) on the associations were examined. Adolescents who had anxiety symptoms were more likely to have suicidal ideation and attempt than those who did not have anxiety symptoms. Bullying victimization had a moderating effect on the association between suicidal ideation and anxiety symptoms. Assessment of suicidal ideation and attempt should be routine practice among adolescents who present with anxiety symptoms.

Bully victimization and emotional problems in adolescents:moderation by specific cognitive coping strategies?

PubMed

Garnefski, Nadia; Kraaij, Vivian

2014-10-01

Relationships between bully victimization and symptoms of depression/anxiety were examined. In addition, it was studied whether this relationship was moderated by specific cognitive coping strategies. Participants were 582 secondary school students who filled out online self-report questionnaires on bully victimization, cognitive coping, and depression/anxiety. (Moderated) Multiple Regression analysis was performed. Strong relationships were found between bully victimization and symptoms of depression and anxiety. On top of that, two cognitive coping strategies moderated the relationship between bullying and depression, i.e. rumination (strengthening) and positive refocusing (reducing). Cognitive coping strategies that moderated the effect of bullying on anxiety symptoms were rumination, catastrophizing (strengthening) and positive reappraisal (reducing). The results provide possible targets for intervention: when helping adolescents who have been bullied, maladaptive cognitive coping strategies could be assessed and challenged, while more adaptive strategies could be acquired. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis.

PubMed

Dekkers, Tycho J; Popma, Arne; Agelink van Rentergem, Joost A; Bexkens, Anika; Huizenga, Hilde M

2016-04-01

ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prediction of random-regression coefficient for daily milk yield after 305 days in milk by using the regression-coefficient estimates from the first 305 days.

PubMed

Yamazaki, Takeshi; Takeda, Hisato; Hagiya, Koichi; Yamaguchi, Satoshi; Sasaki, Osamu

2018-03-13

Because lactation periods in dairy cows lengthen with increasing total milk production, it is important to predict individual productivities after 305 days in milk (DIM) to determine the optimal lactation period. We therefore examined whether the random regression (RR) coefficient from 306 to 450 DIM (M2) can be predicted from those during the first 305 DIM (M1) by using a random regression model. We analyzed test-day milk records from 85690 Holstein cows in their first lactations and 131727 cows in their later (second to fifth) lactations. Data in M1 and M2 were analyzed separately by using different single-trait RR animal models. We then performed a multiple regression analysis of the RR coefficients of M2 on those of M1 during the first and later lactations. The first-order Legendre polynomials were practical covariates of random regression for the milk yields of M2. All RR coefficients for the additive genetic (AG) effect and the intercept for the permanent environmental (PE) effect of M2 had moderate to strong correlations with the intercept for the AG effect of M1. The coefficients of determination for multiple regression of the combined intercepts for the AG and PE effects of M2 on the coefficients for the AG effect of M1 were moderate to high. The daily milk yields of M2 predicted by using the RR coefficients for the AG effect of M1 were highly correlated with those obtained by using the coefficients of M2. Milk production after 305 DIM can be predicted by using the RR coefficient estimates of the AG effect during the first 305 DIM.

Prescription-drug-related risk in driving: comparing conventional and lasso shrinkage logistic regressions.

PubMed

Avalos, Marta; Adroher, Nuria Duran; Lagarde, Emmanuel; Thiessard, Frantz; Grandvalet, Yves; Contrand, Benjamin; Orriols, Ludivine

2012-09-01

Large data sets with many variables provide particular challenges when constructing analytic models. Lasso-related methods provide a useful tool, although one that remains unfamiliar to most epidemiologists. We illustrate the application of lasso methods in an analysis of the impact of prescribed drugs on the risk of a road traffic crash, using a large French nationwide database (PLoS Med 2010;7:e1000366). In the original case-control study, the authors analyzed each exposure separately. We use the lasso method, which can simultaneously perform estimation and variable selection in a single model. We compare point estimates and confidence intervals using (1) a separate logistic regression model for each drug with a Bonferroni correction and (2) lasso shrinkage logistic regression analysis. Shrinkage regression had little effect on (bias corrected) point estimates, but led to less conservative results, noticeably for drugs with moderate levels of exposure. Carbamates, carboxamide derivative and fatty acid derivative antiepileptics, drugs used in opioid dependence, and mineral supplements of potassium showed stronger associations. Lasso is a relevant method in the analysis of databases with large number of exposures and can be recommended as an alternative to conventional strategies.

Effects of platelet and plasma transfusion on outcome in traumatic brain injury patients with moderate bleeding diatheses.

PubMed

Anglin, Catherine O; Spence, Jeffrey S; Warner, Matthew A; Paliotta, Christopher; Harper, Caryn; Moore, Carol; Sarode, Ravi; Madden, Christopher; Diaz-Arrastia, Ramon

2013-03-01

Object Coagulopathy and thrombocytopenia are common after traumatic brain injury (TBI), yet transfusion thresholds for mildly to moderately abnormal ranges of international normalized ratio and platelet count remain controversial. This study evaluates associations between fresh frozen plasma (FFP) and platelet transfusions with long-term functional outcome and survival in TBI patients with moderate hemostatic laboratory abnormalities. Methods This study is a retrospective review of prospectively collected data of patients with mild to severe TBI. Data include patient demographics, several initial injury severity metrics, daily laboratory values, Glasgow Outcome Score- Extended (GOSE) scores, Functional Status Examination (FSE) scores, and survival to 6 months. Correlations were evaluated between these variables and transfusion of FFP, platelets, packed red blood cells (RBCs), cryoprecipitate, recombinant factor VIIa, and albumin. Ordinal regression was performed to account for potential confounding variables to further define relationships between transfusion status and long-term outcome. By analyzing collected data, mild to moderate coagulopathy was defined as an international normalized ratio 1.4-2.0, moderate thrombocytopenia as platelet count 50 × 10(9)/L to 107 × 10(9)/L, and moderate anemia as 21%-30% hematocrit. Results In patients with mild to moderate laboratory hematological abnormalities, univariate analysis shows significant correlations between poor outcome scores and FFP, platelet, or packed RBC transfusion; the volume of FFP or packed RBCs transfused also correlated with poor outcome. Several measures of initial injury and laboratory abnormalities also correlated with poor outcome. Patient age, initial Glasgow Coma Scale score, and highest recorded serum sodium were included in the ordinal regression model using backward variable selection. In the moderate coagulopathy subgroup, patients transfused with FFP were more likely to have a lower GOSE score relative to those who did not receive a transfusion (OR 5.20 [95% CI 1.72-15.73]). Patients with moderate coagulopathy who received FFP and packed RBCs were even more likely to be have a lower GOSE score (OR 7.17 [95% CI 2.12-24.12]). Moderately anemic patients who received packed RBCs alone were more likely to have a worse long-term functional outcome as determined by GOSE and FSE scores (GOSE: OR 2.41 [95% CI 1.51-3.85]; and FSE: OR 3.27 [95% CI 2.00-5.35]). No transfusion types or combinations were noted to significantly correlate with the 6-month mortality in ordinal regression. Conclusions In TBI patients with moderate coagulopathy, FFP transfusions alone or a combination of FFP and packed RBCs were associated with poorer long-term functional outcomes as measured by the GOSE. Red blood cell transfusions were associated with poor long-term functional outcome in TBI patients with moderate anemia. Platelet transfusion in patients with moderate thrombocytopenia was not significantly associated with outcome. Although transfusion is beneficial to many patients with severe hematological abnormalities, it is not without risk, and the indications for transfusion should be carefully considered in patients with moderate hematological abnormalities.

Sex moderates associations between perceptions of the physical and social environments and physical activity in youth.

PubMed

Moore, Justin B; Beets, Michael W; Kaczynski, Andrew T; Besenyi, Gina M; Morris, Sara F; Kolbe, Mary Bea

2014-01-01

To determine if the sex of the child moderates the relationships between perceptions of the physical/social environments and moderate to vigorous physical activity (MVPA) in youth. Cross-sectional. North Carolina. A final sample of 711 children, 8 to 17 years of age, was available for analysis. Self-reported presence of environmental factors previously identified to be associated with physical activity in youth was collected via survey. Daily MVPA was assessed via accelerometry for a minimum of 4 days. Multilevel linear regression models were employed, adjusted for clustering at the county and individual level. MVPA was first regressed onto sex and environmental perception items while controlling for grade and race. The interaction term between sex and environmental perception was then added to the model. A significant positive association was observed in the first models between MVPA and two items related to parent permission to (1) walk and (2) ride a bike in the neighborhood. These effects were fully moderated by sex, with males indicating "yes" on these items exhibiting 6.87 and 5.21 more minutes of MVPA (respectively) than males indicating "no." Environmental perceptions appear to be related to MVPA, but this relationship is present only in males. Future research should be conducted to identify modifiable social and physical characteristics that are associated with MVPA in females.

Negative affect, negative urgency, thought suppression, and bulimic symptoms: a moderated mediation analysis in a sample at-risk for bulimic symptoms.

PubMed

Lavender, Jason M; Green, Daniel; Anestis, Michael D; Tull, Matthew T; Gratz, Kim L

2015-05-01

Research suggests that negative affect, negative urgency, and thought suppression are related to bulimic symptoms, either directly or indirectly. This study examined associations between these constructs in a sample at-risk for bulimic symptoms. Participants (N = 80) recruited from a residential substance abuse treatment facility completed self-report questionnaires. A regression-based bootstrapping approach was used to examine the indirect effect of negative affect on bulimic symptoms through negative urgency and the moderating role of thought suppression in the association between negative affect and negative urgency. Results revealed a significant indirect effect, significant moderation, and a significant moderated mediation effect, with an indirect effect of negative affect on bulimic symptoms through negative urgency, conditional upon low to moderate (but not high) levels of thought suppression. These findings suggest that negative affect may promote rash actions, particularly in the context of low to moderate thought suppression, leading to increased risk of bulimic symptoms. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Excessive Daytime Sleepiness as an Indicator of Depression in Hispanic Americans.

PubMed

Nuyen, Brian A; Fox, Rina S; Malcarne, Vanessa L; Wachsman, Solenne I; Sadler, Georgia Robins

2016-09-01

Excessive daytime sleepiness (EDS) has been shown to be associated with depression; however, this relationship has not been confirmed among Hispanic Americans. This study examined the link between EDS and depression among Hispanic Americans (N = 411) and explored the potential moderating roles of age, gender, income, education, health status, and acculturation. The Epworth Sleepiness Scale and Patient Health Questionnaire-9 measured EDS and depression, respectively. Hierarchical linear regression demonstrated that EDS was significantly related to depression. Receiver operating characteristic curve analysis suggested that the Epworth Sleepiness Scale discriminated with adequate sensitivity and specificity between participants with moderately severe depression and those with less severe symptoms. No sociodemographic variables moderated the EDS-depression relationship. These findings suggest that depression should be considered when Hispanic Americans present with EDS. © The Author(s) 2016.

Training Approaches in Manufacturing SMEs: Measuring the Influence of Ownership, Structure and Markets

ERIC Educational Resources Information Center

Macpherson, Allan; Jayawarna, Dilani

2007-01-01

Purpose: This study aims to investigate the influence of a range of contingent factors that moderate the approaches to training in manufacturing SMEs. Design/methodology/approach: The study is based on a regression analysis of data from a survey of 198 manufacturing SMEs. Findings: The findings suggest that there will be times when formal training…

Effect of acute hypoxia on cognition: A systematic review and meta-regression analysis.

PubMed

McMorris, Terry; Hale, Beverley J; Barwood, Martin; Costello, Joseph; Corbett, Jo

2017-03-01

A systematic meta-regression analysis of the effects of acute hypoxia on the performance of central executive and non-executive tasks, and the effects of the moderating variables, arterial partial pressure of oxygen (PaO 2 ) and hypobaric versus normobaric hypoxia, was undertaken. Studies were included if they were performed on healthy humans; within-subject design was used; data were reported giving the PaO 2 or that allowed the PaO 2 to be estimated (e.g. arterial oxygen saturation and/or altitude); and the duration of being in a hypoxic state prior to cognitive testing was ≤6days. Twenty-two experiments met the criteria for inclusion and demonstrated a moderate, negative mean effect size (g=-0.49, 95% CI -0.64 to -0.34, p<0.001). There were no significant differences between central executive and non-executive, perception/attention and short-term memory, tasks. Low (35-60mmHg) PaO 2 was the key predictor of cognitive performance (R 2 =0.45, p<0.001) and this was independent of whether the exposure was in hypobaric hypoxic or normobaric hypoxic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring Perceived Barriers to Physical Activity in Adolescents.

PubMed

Gunnell, Katie E; Brunet, Jennifer; Wing, Erin K; Bélanger, Mathieu

2015-05-01

Perceived barriers to moderate-to-vigorous physical activity (PA) may contribute to the low rates of moderate-to-vigorous PA in adolescents. We examined the psychometric properties of scores from the perceived barriers to moderate-to-vigorous PA scale (PB-MVPA) by examining composite reliability and validity evidence based on the internal structure of the PB-MVPA and relations with other variables. This study was a cross-sectional analysis of data collected in 2013 from adolescents (N = 507; Mage = 12.40, SD = .62) via self-report scales. Using exploratory and confirmatory factor analyses, we found that perceived barriers were best represented as two factors representing internal (e.g., "I am not interested in physical activity") and external (e.g., "I need equipment I don't have") dimensions. Composite reliability was over .80. Using multiple regression to examine the relationship between perceived barriers and moderate-to-vigorous PA, we found that perceived internal barriers were inversely related to moderate-to-vigorous PA (β = -.32, p < .05). Based on results of the analysis of variances, there were no known-group sex differences for perceived internal and external barriers (p > .26). The PB-MVPA scale demonstrated evidence of score reliability and validity. To improve the understanding of the impact of perceived barriers on moderate-to- vigorous PA in adolescents, researchers should examine internal and external barriers separately.

Moderators of the mediated effect of intentions, planning, and saturated-fat intake in obese individuals.

PubMed

Soureti, Anastasia; Hurling, Robert; van Mechelen, Willem; Cobain, Mark; ChinAPaw, Mai

2012-05-01

The present study aimed to advance our understanding of health-related theory, that is, the alleged intention-behavior gap in an obese population. It examined the mediating effects of planning on the intention-behavior relationship and the moderated mediation effects of age, self-efficacy and intentions within this relationship. The study was conducted over a five-week period. Complete data from 571 obese participants were analyzed. The moderated mediation hypothesis was conducted using multiple-regression analysis. To test our theoretical model, intentions (Week 2), action self-efficacy (Week 2), maintenance self-efficacy (Week 5), planning (Week 5), and saturated-fat intake (Weeks 1 and 5) were measured by self-report. As hypothesized, planning mediated the intention-behavior relationship for perceived (two-item scale) and percentage-saturated-fat intake (measured by a food frequency questionnaire). Age, self-efficacy, and intention acted as moderators in the above mediation analysis. In specific, younger individuals, those with stronger intention, and people with higher levels of maintenance self-efficacy at higher levels of planning showed greater reductions in their perceived saturated-fat intake. For successful behavior change, knowledge of its mediators and moderators is needed. Future interventions targeting planning to change saturated-fat intake should be guided by people's intentions, age, and self-efficacy levels.

Facies development and paleoenvironment of the Hajajah Limestone Member, Aruma Formation, central Saudi Arabia

NASA Astrophysics Data System (ADS)

El-Sorogy, Abdelbaset S.; Ismail, Abdelmoneim; Youssef, Mohamed; Nour, Hamdy

2016-12-01

The Campanian Hajajah Limestone Member of the Aruma Formation was formed during two regressive episodes. Each of them formed of three depositional facies, from base to top: 1) intra-shelf basin facies, made up of fossiliferous green shale and mudstone with ostracods and badly preserved foraminifers. 2) fore-reef facies, consists of hard, massive, marly coralline limestone. The upper part is rich with low divers, badly to moderate preserved, solitary and colonial corals, and, 3) back reef and near-shore facies, consists of fossiliferous sandy dolomitized, bioturbated limestone with abundant reworked corals, bivalves, gastropods, and aggregate grains. On the basis of field observations, micro-and macrofossils and microfacies analysis, the Hajajah Limestone Member was deposited in distal marine settings below storm wave base in a low-energy environment changed upward to fore-reef framework in an open marine environment with moderate to high energy conditions and terminated with shallow marine facies with accumulation of skeletal grains by storms during regression.

Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders.

PubMed

Seligman, D A; Pullinger, A G

2000-01-01

Confusion about the relationship of occlusion to temporomandibular disorders (TMD) persists. This study attempted to identify occlusal and attrition factors plus age that would characterize asymptomatic normal female subjects. A total of 124 female patients with intracapsular TMD were compared with 47 asymptomatic female controls for associations to 9 occlusal factors, 3 attrition severity measures, and age using classification tree, multiple stepwise logistic regression, and univariate analyses. Models were tested for accuracy (sensitivity and specificity) and total contribution to the variance. The classification tree model had 4 terminal nodes that used only anterior attrition and age. "Normals" were mainly characterized by low attrition levels, whereas patients had higher attrition and tended to be younger. The tree model was only moderately useful (sensitivity 63%, specificity 94%) in predicting normals. The logistic regression model incorporated unilateral posterior crossbite and mediotrusive attrition severity in addition to the 2 factors in the tree, but was slightly less accurate than the tree (sensitivity 51%, specificity 90%). When only occlusal factors were considered in the analysis, normals were additionally characterized by a lack of anterior open bite, smaller overjet, and smaller RCP-ICP slides. The log likelihood accounted for was similar for both the tree (pseudo R(2) = 29.38%; mean deviance = 0.95) and the multiple logistic regression (Cox Snell R(2) = 30.3%, mean deviance = 0.84) models. The occlusal and attrition factors studied were only moderately useful in differentiating normals from TMD patients.

Relationship Between Column-Density and Surface Mixing Ratio: Statistical Analysis of O3 and NO2 Data from the July 2011 Maryland DISCOVER-AQ Mission

NASA Technical Reports Server (NTRS)

Flynn, Clare; Pickering, Kenneth E.; Crawford, James H.; Lamsol, Lok; Krotkov, Nickolay; Herman, Jay; Weinheimer, Andrew; Chen, Gao; Liu, Xiong; Szykman, James;

Osteoporosis Self-Assessment Tool for Asians Can Predict Neurologic Prognosis in Patients with Isolated Moderate Traumatic Brain Injury

PubMed Central

Chan, Hon-Man; Huang, Shiuh-Lin; Lin, Chih-Lung; Kwan, Aij-Lie; Lou, Yun-Ting; Chen, Chao-Wen

2015-01-01

Objectives Osteoporosis Self-Assessment Tool for Asians (OSTA) has been proved to be a simple and effective tool for recognizing osteoporosis risk. Our previous study has demonstrated that the preoperative OSTA index was a good prognostic predictor for stage II and III colon cancer patients after surgery. We aim to evaluate the value of OSTA index in prognostication of isolated traumatic brain injury with moderate severity (GCS 9-13). Methods We retrospectively reviewed all patients visiting Kaohsiung Medical University Hospital emergency department due to isolated moderate traumatic brain injury from Jan. 2010 to Dec. 2012. Background data (including the OSTA index), clinical presentations, management and outcomes (ICU admission days, total admission days, complications, Glasgow outcome score (GOS) at discharge, mortality) of the patients were recorded for further analysis. Our major outcome was good neurologic recovery defined as GOS of 5. Pearson chi-square test and the Mann-Whitney U test were used to compare demographic features. Multiple logistic regression was used to identify independent risk factors. Results 107 isolated moderate TBI patients were studied. 40 patients (37.4%) showed good recovery and 10 (9.3%) died at discharge. The univariate analysis revealed that younger age, higher OSTA index, lower ISS, lower AIS-H, and avoidance to neurosurgery were associated with better neurologic outcome for all moderate TBI patients. Multivariate analysis revealed that lower ISS, higher OSTA, and the avoidance of neurosurgery were independent risk factors predicting good neurologic recovery. Conclusion Higher ISS, lower OSTA index and exposure to neurosurgery were the independent risk factors for poorer recovery from isolated moderate TBI. In addition to labeling the cohort harboring osteoporotic risk, OSTA index could predict neurologic prognosis in patients with isolated moderate traumatic brain injury. PMID:26186582

Analysis of the labor productivity of enterprises via quantile regression

NASA Astrophysics Data System (ADS)

Türkan, Semra

2017-07-01

In this study, we have analyzed the factors that affect the performance of Turkey's Top 500 Industrial Enterprises using quantile regression. The variable about labor productivity of enterprises is considered as dependent variable, the variableabout assets is considered as independent variable. The distribution of labor productivity of enterprises is right-skewed. If the dependent distribution is skewed, linear regression could not catch important aspects of the relationships between the dependent variable and its predictors due to modeling only the conditional mean. Hence, the quantile regression, which allows modelingany quantilesof the dependent distribution, including the median,appears to be useful. It examines whether relationships between dependent and independent variables are different for low, medium, and high percentiles. As a result of analyzing data, the effect of total assets is relatively constant over the entire distribution, except the upper tail. It hasa moderately stronger effect in the upper tail.

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

PubMed

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

2016-06-07

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

Burnout and Associated Factors among Iranian Emergency Medicine Practitioners

PubMed Central

JALILI, Mohammad; SADEGHIPOUR ROODSARI, Gholamreza; BASSIR NIA, Anahita

2013-01-01

Abstract Background Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. Methods In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, depersonalization and personal accomplishment, also demographic factors, work related factors and sources of stress in emergency department using anonymous self-administered questionnaire. Descriptive analysis, univariate analysis to evaluate association with higher score of burnout, and multivariate logistic regression analysis to predict high burnout in 3 subscales was performed. Results Totally, 165 questionnaires were filled (response rate: 88%; mean age: 33.6 years, 91% male). Mean burnout scores were 22.94 for emotional exhaustion (95% CI=20.78-25.01; moderate), 9.3 for depersonalization (95% CI=8.24-10.36; moderate to high), and 31.47 for personal accomplishment (95% CI=29.87-33.07; moderate to high). Frequent reported sources of stress were shortage of equipment, problem with work physical environment, and relationship with other services. All 19 sources of stress were associated with higher score of emotional exhaustion and depersonalization; while twelve out of 19 were significantly associated with lower level of personal accomplishment. In logistic regression model, the significant predictors for high emotional exhaustion were work overload, feeling of insecurity for future career and difficulties to balance professional and private life. Conclusion Burnout is high among Iranian emergency medicine practitioners and some interventions can be proposed to reduce stress. PMID:26060665

Chronic low back pain and the transdiagnostic process: How do cognitive and emotional dysregulations contribute to the intensity of risk factors and pain?

PubMed

Le Borgne, Margaux; Boudoukha, Abdel Halim; Petit, Audrey; Roquelaure, Yves

2017-10-01

Based on a transdiagnostic approach, this study assesses the impact of cognitive and emotional processes (difficulties in emotional regulation, impulsiveness, rumination and somatosensory amplification) on the psychological risk factors of chronic low-back pain. The study was carried out with 256 patients with chronic low-back pain. All the variables were assessed through a booklet of 10 validated questionnaires. Multiple regression analysis and moderation analysis were performed. Predictors included in multiple regression models explain 3%-42% (adjusted R 2 ) of the variance in psychological risk factors. Moreover, analyses reveal a significant moderator effect of somatosensory amplification on the link between fear-avoidance beliefs linked to work and pain intensity (F (3;250) =12.33; p=.00), of somatosensory amplification and brooding on the link between depression and functional repercussions (FR) on everyday life (F (3;252) =13.36; p=.000; F (1;252) =12.42; p=.00), of the reflection dimension of rumination on the link between the helplessness dimension of catastrophizing and FRs on sociability (F (3;252) =37.02; p=.00). There is also a moderation analysis with a significant trend concerning the lack of emotional awareness and the difficulties in controlling impulsive behaviours. Our results indicate an important role of some dimensions of difficulties in emotional regulation, somatosensory amplification and rumination in the increase in negative affects and dysfunctional beliefs, and in the links between those psychological risk factors and pain/disability. This study identifies some cognitive and emotional dysregulations substantially involved in work-related chronic pain. This contribute to put in place psychotherapeutic protocols to tackle these deficits and dysregulations in a relevant way. Copyright © 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

PubMed

Wilks, Scott E; Vonk, M Elizabeth

2008-01-01

This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

Multiple Imputation of a Randomly Censored Covariate Improves Logistic Regression Analysis.

PubMed

Atem, Folefac D; Qian, Jing; Maye, Jacqueline E; Johnson, Keith A; Betensky, Rebecca A

2016-01-01

Randomly censored covariates arise frequently in epidemiologic studies. The most commonly used methods, including complete case and single imputation or substitution, suffer from inefficiency and bias. They make strong parametric assumptions or they consider limit of detection censoring only. We employ multiple imputation, in conjunction with semi-parametric modeling of the censored covariate, to overcome these shortcomings and to facilitate robust estimation. We develop a multiple imputation approach for randomly censored covariates within the framework of a logistic regression model. We use the non-parametric estimate of the covariate distribution or the semiparametric Cox model estimate in the presence of additional covariates in the model. We evaluate this procedure in simulations, and compare its operating characteristics to those from the complete case analysis and a survival regression approach. We apply the procedures to an Alzheimer's study of the association between amyloid positivity and maternal age of onset of dementia. Multiple imputation achieves lower standard errors and higher power than the complete case approach under heavy and moderate censoring and is comparable under light censoring. The survival regression approach achieves the highest power among all procedures, but does not produce interpretable estimates of association. Multiple imputation offers a favorable alternative to complete case analysis and ad hoc substitution methods in the presence of randomly censored covariates within the framework of logistic regression.

Structural and functional social network attributes moderate the association of self-rated health with mental health in midlife and older adults.

PubMed

Windsor, Tim D; Rioseco, Pilar; Fiori, Katherine L; Curtis, Rachel G; Booth, Heather

2016-01-01

Social relationships are multifaceted, and different social network components can operate via different processes to influence well-being. This study examined associations of social network structure and relationship quality (positive and negative social exchanges) with mental health in midlife and older adults. The focus was on both direct associations of network structure and relationship quality with mental health, and whether these social network attributes moderated the association of self-rated health (SRH) with mental health. Analyses were based on survey data provided by 2001 (Mean age = 65, SD = 8.07) midlife and older adults. We used Latent Class Analysis (LCA) to classify participants into network types based on network structure (partner status, network size, contact frequency, and activity engagement), and used continuous measures of positive and negative social exchanges to operationalize relationship quality. Regression analysis was used to test moderation. LCA revealed network types generally consistent with those reported in previous studies. Participants in more diverse networks reported better mental health than those categorized into a restricted network type after adjustment for age, sex, education, and employment status. Analysis of moderation indicated that those with poorer SRH were less likely to report poorer mental health if they were classified into more diverse networks. A similar moderation effect was also evident for positive exchanges. The findings suggest that both quantity and quality of social relationships can play a role in buffering against the negative implications of physical health decline for mental health.

Contrast sensitivity to spatial gratings in moderate and dim light conditions in patients with diabetes in the absence of diabetic retinopathy.

PubMed

Safi, Sare; Rahimi, Anoushiravan; Raeesi, Afsaneh; Safi, Hamid; Aghazadeh Amiri, Mohammad; Malek, Mojtaba; Yaseri, Mehdi; Haeri, Mohammad; Middleton, Frank A; Solessio, Eduardo; Ahmadieh, Hamid

2017-01-01

To evaluate the ability of contrast sensitivity (CS) to discriminate loss of visual function in diabetic subjects with no clinical signs of retinopathy relative to that of normal subjects. In this prospective cross-sectional study, we measured CS in 46 diabetic subjects with a mean age of 48±6 years, a best-corrected visual acuity of 20/20 and no signs of diabetic retinopathy. The CS in these subjects was compared with CS measurements in 46 normal control subjects at four spatial frequencies (3, 6, 12, 18 cycles per degree) under moderate (500 lux) and dim (less than 2 lux) background light conditions. CS was approximately 0.16 log units lower in patients with diabetes relative to controls both in moderate and in dim background light conditions. Logistic regression classification and receiver operating characteristic curve analysis indicated that CS analysis using two light conditions was more accurate (0.78) overall compared with CS analysis using only a single illumination condition (accuracy values were 0.67 and 0.70 in moderate and dim light conditions, respectively). Our results showed that patients with diabetes without clinical signs of retinopathy exhibit a uniform loss in CS at all spatial frequencies tested. Measuring the loss in CS at two spatial frequencies (3 and 6 cycles per degree) and two light conditions (moderate and dim) is sufficiently robust to classify diabetic subjects with no retinopathy versus control subjects.

Stress moderates the relationship between problematic Internet use by parents and problematic Internet use by adolescents.

PubMed

Lam, Lawrence T; Wong, Emmy M Y

2015-03-01

Based on the theoretical framework of Problem Behavior and Stress Reduction theories for problematic Internet use (PIU), this study aimed to investigate the relationship between parental PIU and the PIU among adolescents taking into consideration the stress levels of young people. This was a population-based parent and adolescent dyad health survey utilizing a random sampling technique. PIU for both parents and adolescents was measured by the Internet addiction test designed by Young. The stress level of adolescents was assessed using the stress subscale of the Depression Anxiety Stress Scale (DASS). Data were analyzed using logistic regression modeling techniques with adjustment for potential confounding factors with analysis on the modification effect of stress levels on the relationship between parent and adolescent PIU. Of the total 1,098 parent and adolescent dyads with usable information, 263 adolescents (24.0%) and 62 parents (5.7%) could be classified as moderate and severe problematic users of the Internet. About 14% (n = 157) of adolescents could be classified with moderate-to-severe stress. Regression analysis results suggested a significant interaction between parental PIU and adolescents' stress levels on adolescent PIU. Stratified regression analyses by stress level resulted in a significant parent and adolescent PIU relationship in the low stress group (odds ratio, 3.18; 95% confidence interval 1.65-6.14). However, the association between parent and adolescent PIU in the high stress group became insignificant. There was a significant parent and adolescent PIU relationship; however, this relationship is differentially affected by the stress status of the adolescent. The direct implication of the results is that parental Internet use should also be assessed and included as part of the treatment regime for adolescents. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Identifying predictors of childhood anaemia in north-east India.

PubMed

Dey, Sanku; Goswami, Sankar; Dey, Tanujit

2013-12-01

The objective of this study is to examine the factors that influence the occurrence of childhood anaemia in North-East India by exploring dataset of the Reproductive and Child Health-II Survey (RCH-II). The study population consisted of 10,137 children in the age-group of 0-6 year(s) from North-East India to explore the predictors of childhood anaemia by means of different background characteristics, such as place of residence, religion, household standard of living, literacy of mother, total children ever born to a mother, age of mother at marriage. Prevalence of anaemia among children was taken as a polytomous variable. The predicted probabilities of anaemia were established via multinomial logistic regression model. These probabilities provided the degree of assessment of the contribution of predictors in the prevalence of childhood anaemia. The mean haemoglobin concentration in children aged 0-6 year(s) was found to be 11.85 g/dL, with a standard deviation of 5.61 g/dL. The multiple logistic regression analysis showed that rural children were at greater risk of severe (OR = 2.035; p = 0.003) and moderate (OR = 1.23; p = 0.003) anaemia. All types of anaemia (severe, moderate, and mild) were more prevalent among Hindu children (OR = 2.971; p = 0.000), (OR = 1.195; p = 0.010), and (OR = 1.201; p = 0.011) than among children of other religions whereas moderate (OR = 1.406; p = 0.001) and mild (OR = 1.857; p=0.000) anaemia were more prevalent among Muslim children. The fecundity of the mother was found to have significant effect on anaemia. Women with multiple children were prone to greater risk of anaemia. The multiple logistic regression analysis also confirmed that children of literate mothers were comparatively at lesser risk of severe anaemia. Mother's age at marriage had a significant effect on anaemia of their children as well.

Evaluation of landsat imagery for detecting ice storm damage in upland forests of Eastern Kentucky

Treesearch

Henry W. McNab; Tracy Roof; Jeffrey F. Lewis; David L. Loftis

2007-01-01

Two categories of forest canopy damage (none to light vs. moderate to heavy) resulting from a 2003 ice storm in eastern Kentucky could be identified on readily available Landsat Thematic Mapper imagery using change detection techniques to evaluate the ratio of spectral bands 4 and 5. Regression analysis was used to evaluate several model formulations based on the...

Severely Elevated Blood Pressure and Early Mortality in Children with Traumatic Brain Injuries: The Neglected End of the Spectrum

PubMed Central

Borgman, Matthew A.; Cannon, Jeremy W.; Kuppermann, Nathan; Neff, Lucas P.

2018-01-01

Introduction In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. Methods This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3. We defined hypertension as moderate for systolic blood pressures (SBP) between the 95th and 99th percentile for age and gender and severe if greater than the 99th percentile. Hypotension was defined as SBP <90 mmHg for children >10 years or < 70mmHg + (2 × age) for children ≤10 years. We performed multivariable logistic regression and Cox regression to determine if BP categories were associated with mortality. Results Of 4,990 children included in the DoDTR, 740 met criteria for analysis. Fifty patients (6.8%) were hypotensive upon arrival to the ED, 385 (52.0%) were normotensive, 115 (15.5%) had moderate hypertension, and 190 (25.7%) had severe hypertension. When compared to normotensive patients, moderate and severe hypertension patients had similar Injury Severity Scores, similar AIS head scores, and similar frequencies of neurosurgical procedures. Multivariable logistic regression demonstrated that hypotension (odd ratio [OR] 2.85, 95 confidence interval [CI] 1.26–6.47) and severe hypertension (OR 2.58, 95 CI 1.32–5.03) were associated with increased 24-hour mortality. Neither hypotension (Hazard ratio (HR) 1.52, 95 CI 0.74–3.11) nor severe hypertension (HR 1.65, 95 CI 0.65–2.30) was associated with time to mortality. Conclusion Pediatric age-adjusted hypertension is frequent after severe TBI. Severe hypertension is strongly associated with 24-hour mortality. Pediatric age-adjusted blood pressure needs to be further evaluated as a critical marker of early mortality. PMID:29760839

Severely Elevated Blood Pressure and Early Mortality in Children with Traumatic Brain Injuries: The Neglected End of the Spectrum.

PubMed

Johnson, M Austin; Borgman, Matthew A; Cannon, Jeremy W; Kuppermann, Nathan; Neff, Lucas P

2018-05-01

In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3. We defined hypertension as moderate for systolic blood pressures (SBP) between the 95 th and 99 th percentile for age and gender and severe if greater than the 99th percentile. Hypotension was defined as SBP <90 mmHg for children >10 years or < 70mmHg + (2 × age) for children ≤10 years. We performed multivariable logistic regression and Cox regression to determine if BP categories were associated with mortality. Of 4,990 children included in the DoDTR, 740 met criteria for analysis. Fifty patients (6.8%) were hypotensive upon arrival to the ED, 385 (52.0%) were normotensive, 115 (15.5%) had moderate hypertension, and 190 (25.7%) had severe hypertension. When compared to normotensive patients, moderate and severe hypertension patients had similar Injury Severity Scores, similar AIS head scores, and similar frequencies of neurosurgical procedures. Multivariable logistic regression demonstrated that hypotension (odd ratio [OR] 2.85, 95 confidence interval [CI] 1.26-6.47) and severe hypertension (OR 2.58, 95 CI 1.32-5.03) were associated with increased 24-hour mortality. Neither hypotension (Hazard ratio (HR) 1.52, 95 CI 0.74-3.11) nor severe hypertension (HR 1.65, 95 CI 0.65-2.30) was associated with time to mortality. Pediatric age-adjusted hypertension is frequent after severe TBI. Severe hypertension is strongly associated with 24-hour mortality. Pediatric age-adjusted blood pressure needs to be further evaluated as a critical marker of early mortality.

Mangrove canopy density analysis using Sentinel-2A imagery satellite data

NASA Astrophysics Data System (ADS)

Wachid, M. N.; Hapsara, R. P.; Cahyo, R. D.; Wahyu, G. N.; Syarif, A. M.; Umarhadi, D. A.; Fitriani, A. N.; Ramadhanningrum, D. P.; Widyatmanti, W.

2017-06-01

Teluk Jor has alluvium surface sediment that came from volcanic materials. Sea wave that relatively calm and the closed beach shape support the existence of mangrove forest at Teluk Jor. Sentinel-2A imagery has a good spatial and spectral resolution for mangrove density study. The regression between samples and the NDVI values of Sentinel-2A used to analyze the mangrove canopy density. Mangrove canopy density was identified using field survey with transect method. The regression analysis shows field data and NDVI value has correlation R=0.7739 and coefficient of determination R2=0.5989. The result of the analysis shows area of low density 397,900 m2, moderate density 336,200 m2, the high density has 110,300 m2 and very high density has 500 m2. This research also found that mangrove genus in Teluk Jor consists of Rhizopora, Ceriops, Aegiceras and Sonneratia.

How Transformational Leadership Influences Work Engagement Among Nurses: Does Person-Job Fit Matter?

PubMed

Enwereuzor, Ibeawuchi K; Ugwu, Leonard I; Eze, Onyinyechi A

2018-03-01

The current study examines whether person-job fit moderates the relationship between transformational leadership and work engagement. Data were collected using cross-sectional design from 224 (15 male and 209 female) hospital nurses. Participants completed measures of transformational leadership, person-job fit, and work engagement. Moderated multiple regression results showed that transformational leadership had a significant positive predictive relationship with work engagement, and person-job fit had a significant positive predictive relationship with work engagement. Simple slope analysis showed that person-job fit moderated the relationship between transformational leadership and work engagement such that transformational leadership was more positively related to work engagement for nurses with high person-job fit compared with those with low person-job fit. Thus, all the hypotheses were confirmed. The findings were discussed, and suggestions for future research were offered.

Excessive Daytime Sleepiness as an Indicator of Depression in Hispanic Americans

PubMed Central

Malcarne, Vanessa L.; Wachsman, Solenne I.; Sadler, Georgia Robins

2016-01-01

Introduction Excessive daytime sleepiness (EDS) has been shown to be associated with depression; however, this relationship has not been confirmed among Hispanic Americans. Method This study examined the link between EDS and depression among Hispanic Americans (N = 411) and explored the potential moderating roles of age, gender, income, education, health status, and acculturation. The Epworth Sleepiness Scale and Patient Health Questionnaire–9 measured EDS and depression, respectively. Results Hierarchical linear regression demonstrated that EDS was significantly related to depression. Receiver operating characteristic curve analysis suggested that the Epworth Sleepiness Scale discriminated with adequate sensitivity and specificity between participants with moderately severe depression and those with less severe symptoms. No sociodemographic variables moderated the EDS–depression relationship. Conclusion These findings suggest that depression should be considered when Hispanic Americans present with EDS. PMID:27465932

Combined effects of positive and negative affectivity and job satisfaction on job performance and turnover intentions.

PubMed

Bouckenooghe, Dave; Raja, Usman; Butt, Arif Nazir

2013-01-01

Capturing data from employee-supervisor dyads (N = 321) from eight organizations in Pakistan, including human service organizations, an electronics assembly plant, a packaging material manufacturing company, and a small food processing plant, we used moderated regression analysis to examine whether the relationships between trait affect (positive affectivity [PA] and negative affectivity [NA]) and two key work outcome variables (job performance and turnover) are contingent upon the level of job satisfaction. We applied the Trait Activation Theory to explain the moderating effect of job satisfaction on the relationship between affect and performance and between affect and turnover. Overall, the data supported our hypotheses. Positive and negative affectivity influenced performance and the intention to quit, and job satisfaction moderated these relationships. We discuss in detail the results of these findings and their implications for research and practice.

Associations among job demands and resources, work engagement, and psychological distress: fixed-effects model analysis in Japan.

PubMed

Oshio, Takashi; Inoue, Akiomi; Tsutsumi, Akizumi

2018-05-25

We examined the associations among job demands and resources, work engagement, and psychological distress, adjusted for time-invariant individual attributes. We used data from a Japanese occupational cohort survey, which included 18,702 observations of 7,843 individuals. We investigated how work engagement, measured by the Utrecht Work Engagement Scale, was associated with key aspects of job demands and resources, using fixed-effects regression models. We further estimated the fixed-effects models to assess how work engagement moderated the association between each job characteristic and psychological distress as measured by Kessler 6 scores. The fixed-effects models showed that work engagement was positively associated with job resources, as did pooled cross-sectional and prospective cohort models. Specifically, the standardized regression coefficients (β) were 0.148 and 0.120 for extrinsic reward and decision latitude, respectively, compared to -0.159 and 0.020 for role ambiguity and workload and time pressure, respectively (p < 0.001 for all associations). Work engagement modestly moderated the associations of psychological distress with workload and time pressure and extrinsic reward; a one-standard deviation increase in work engagement moderated their associations by 19.2% (p < 0.001) and 11.3% (p = 0.034), respectively. Work engagement was associated with job demands and resources, which is in line with the theoretical prediction of the job demands-resources model, even after controlling for time-invariant individual attributes. Work engagement moderated the association between selected aspects of job demands and resources and psychological distress.

Testing direct and moderating effects of coping styles on the relationship between perceived stress and antenatal anxiety symptoms.

PubMed

Lau, Ying; Wang, Yuqiong; Kwong, Dennis Ho Keung; Wang, Ying

2015-01-01

The objective of this study was to test the direct and moderating effects of different coping styles in mitigating perceived stress associated with antenatal anxiety symptoms among 755 pregnant women in Chengdu. A cross-sectional study using a questionnaire survey was carried out. The Perceived Stress Scale, the Trait Coping Style Questionnaire and the Zung Self-rating Anxiety Scale were used to measure stress, coping and anxiety symptoms, respectively. Hierarchical regression analysis was used to test the direct and moderating effects of coping styles in the relationship between perceived stress and antenatal anxiety symptoms. Direct effects of negative coping (NC) styles were found. Women with higher NC scores were more likely to have anxiety symptoms. Positive coping (PC) styles had moderating effects on perceived stress, whereas NC styles did not. The findings of this study highlight the direct and moderating effects of coping styles. This knowledge is important to healthcare professionals in planning health service provision. Health services should dedicate resources to teaching pregnant women how to enhance PC styles, alter NC styles and cultivate optimistic thinking to alleviate anxiety symptoms.

Reduced COPD Exacerbation Risk Correlates With Improved FEV1: A Meta-Regression Analysis.

PubMed

Zider, Alexander D; Wang, Xiaoyan; Buhr, Russell G; Sirichana, Worawan; Barjaktarevic, Igor Z; Cooper, Christopher B

2017-09-01

The mechanism by which various classes of medication reduce COPD exacerbation risk remains unknown. We hypothesized a correlation between reduced exacerbation risk and improvement in airway patency as measured according to FEV 1 . By systematic review, COPD trials were identified that reported therapeutic changes in predose FEV 1 (dFEV 1 ) and occurrence of moderate to severe exacerbations. Using meta-regression analysis, a model was generated with dFEV 1 as the moderator variable and the absolute difference in exacerbation rate (RD), ratio of exacerbation rates (RRs), or hazard ratio (HR) as dependent variables. The analysis of RD and RR included 119,227 patients, and the HR analysis included 73,475 patients. For every 100-mL change in predose FEV 1 , the HR decreased by 21% (95% CI, 17-26; P < .001; R 2  = 0.85) and the absolute exacerbation rate decreased by 0.06 per patient per year (95% CI, 0.02-0.11; P = .009; R 2  = 0.05), which corresponded to an RR of 0.86 (95% CI, 0.81-0.91; P < .001; R 2  = 0.20). The relationship with exacerbation risk remained statistically significant across multiple subgroup analyses. A significant correlation between increased FEV 1 and lower COPD exacerbation risk suggests that airway patency is an important mechanism responsible for this effect. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Are core self-evaluations a suitable moderator in stressor-detachment relationships? A study among managers' perceived job demands, detachment and strain reactions.

PubMed

Hentrich, Stephan; Zimber, Andreas; Sosnowsky-Waschek, Nadia; Gregersen, Sabine; Petermann, Franz

2018-01-01

The relationships among job demands, personality factors, recovery and psychological health receive increasing attention but are not well understoodOBJECTIVE:Therefore, the present study tests moderating effects among a sample of managers as proposed by the stressor-detachment model. We aimed to determine whether core self-evaluations (CSE) had an influence on the correlations between detachment and strain reactions (depressive symptoms, irritation, exhaustion) and between job demands and detachment. Further, we tested whether detachment attenuates the positive relation between job demands and strain reactions. A convenience sample of managers in three German settings (N = 282) participated in the cross-sectional study. Results based on hierarchical regression analysis showed that high CSE significantly weakened the negative relationship between detachment and depressive symptoms in this sample. However, CSE did not moderate the negative relationship between job demands and detachment. Moreover, results revealed that detachment moderated the positive relation between job demands and exhaustion. The authors tested whether CSE was able to moderate the relationship between job demands, psychological detachment and different stress reactions. Although we found a significant interaction effect, CSE may be too distal to moderate all respective associations.

The moderating role of rational beliefs in the relationship between irrational beliefs and posttraumatic stress symptomology.

PubMed

Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

2014-05-01

Rational Emotive Behaviour Therapy (REBT) assumes that rational beliefs act as cognitive protective factors against the development of psychopathology; however little empirical evidence exists regarding the nature of the possible protective effects that they offer. The current study investigates whether rational beliefs moderate the impact of irrational beliefs on posttraumatic stress symptomology (PTS). Three hundred and thirteen active law enforcement, military, and related emergency service personnel took part in the current study. Sequential moderated multiple regression analysis was employed to investigate: (i) the direct impact of irrational beliefs on PTS; (ii) the direct impact of rational beliefs on PTS; (iii) the moderating effects of rational beliefs in the relationship between irrational beliefs and PTS. The irrational beliefs predicted by REBT theory emerged as critical predictors of PTS symptomology, in particular Depreciation beliefs. Rational beliefs (Preferences, and Acceptance beliefs) had a direct, negative impact on levels of PTS, and Acceptance beliefs moderated the impact of Catastrophizing beliefs on PTS. Irrational beliefs are important cognitive vulnerability factors in symptoms of PTS, while rational beliefs (Acceptance) appear to have a protective role in the emergence of PTS symptoms, both directly and by moderating the impact of Catastrophizing beliefs.

Relationship between work-family balance and job satisfaction among employees in China: A moderated mediation model.

PubMed

Yu, Yue; Wang, Yuchen; Zhang, Jianxin

2017-09-01

Previous studies have revealed the association between work-family balance and job satisfaction. The present research further explored the underlying mechanism of this association and aimed to provide a moderated mediation model to explain if personality traits moderate the relationship between work-family balance and job satisfaction through work engagement. A cross-sectional study was conducted in which 263 employees from a petrochemical enterprise in China completed self-report questionnaires including the Work-Family Balance Scale, the Utrecht Work Engagement Scale, the Big Five Inventory-10, and the Job Satisfaction Scale. Hierarchical regression analysis and structural equation modeling showed that work engagement partially mediated the relationship between work-family balance and job satisfaction, and the indirect effect was further moderated only by extraversion. Therefore, an integrative moderated mediation model was proposed wherein work-family balance boosts job satisfaction by first enhancing employees' work engagement, while the indirect effect was in turn moderated by extraversion. The results suggest that interventions for improving job satisfaction may be enhanced by targeting work engagement, especially for employees with higher extraversion. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Land surface temperature as potential indicator of burn severity in forest Mediterranean ecosystems

NASA Astrophysics Data System (ADS)

Quintano, C.; Fernández-Manso, A.; Calvo, L.; Marcos, E.; Valbuena, L.

2015-04-01

Forest fires are one of the most important causes of environmental alteration in Mediterranean countries. Discrimination of different degrees of burn severity is critical for improving management of fire-affected areas. This paper aims to evaluate the usefulness of land surface temperature (LST) as potential indicator of burn severity. We used a large convention-dominated wildfire, which occurred on 19-21 September, 2012 in Northwestern Spain. From this area, a 1-year series of six LST images were generated from Landsat 7 Enhanced Thematic Mapper (ETM+) data using a single channel algorithm. Further, the Composite Burn Index (CBI) was measured in 111 field plots to identify the burn severity level (low, moderate, and high). Evaluation of the potential relationship between post-fire LST and ground measured CBI was performed by both correlation analysis and regression models. Correlation coefficients were higher in the immediate post-fire LST images, but decreased during the fall of 2012 and increased again with a second maximum value in summer, 2013. A linear regression model between post-fire LST and CBI allowed us to represent spatially predicted CBI (R-squaredadj > 85%). After performing an analysis of variance (ANOVA) between post-fire LST and CBI, a Fisher's least significant difference test determined that two burn severity levels (low-moderate and high) could be statistically distinguished. The identification of such burn severity levels is sufficient and useful to forest managers. We conclude that summer post-fire LST from moderate resolution satellite data may be considered as a valuable indicator of burn severity for large fires in Mediterranean forest ecosytems.

Affective disorders and Health-Related Quality of Life (HRQoL) in adolescents and young adults with Multiple Sclerosis (MS): the moderating role of resilience.

PubMed

Rainone, Nunzia; Chiodi, Alessandro; Lanzillo, Roberta; Magri, Valeria; Napolitano, Anna; Morra, Vincenzo Brescia; Valerio, Paolo; Freda, Maria Francesca

2017-03-01

To investigate the moderating role of resilience in the relationship between affective disorders and Health-Related Quality of Life (HRQoL) for adolescents and young adults with multiple sclerosis (MS). A quantitative methodology was adopted. Fifty-three adolescents and young adults were interviewed to assess resilience as a personality trait (Ego-Resiliency Scale) and resilience as an interactive competence (CYRM-28), Health-Related Quality of Life (PedsQL 4.0), depression and anxiety (BDI-II and STAI-Y). Affective disorders, both depression (β = -.38, p < .001) and anxiety (State β = -.35, p < .001; Trait β = -.41, p < .001), were negatively associated with HRQoL. Data also showed that the resilience competencies using Individual (β = .22, p < .001) and relational resources (β = .12, p < .05) are significantly associated HRQoL. According to the regression analyses, we tested the moderating role of resilience competence using individual resources on the relationship between the Depression Cognitive Factor and Emotional Functioning. Data show that in step 2 of the regression analysis, we obtained a variation of β = -.45 (p < .001) to β = -.30 (p < .001) in the dimension for the Depression Cognitive Factor. The Sobel test showed that the moderating effect of resilience was significant regarding the increase in R 2 (p < .01). Resilience competence using individual resources moderates the relationship between the Depression Cognitive Factor and Emotional Functioning in adolescents with MS. Our study suggests that to improve well-being for adolescents with MS resilience could play a key role.

To Identify the Important Soil Properties Affecting Dinoseb Adsorption with Statistical Analysis

PubMed Central

Guan, Yiqing; Wei, Jianhui; Zhang, Danrong; Zu, Mingjuan; Zhang, Liru

2013-01-01

Investigating the influences of soil characteristic factors on dinoseb adsorption parameter with different statistical methods would be valuable to explicitly figure out the extent of these influences. The correlation coefficients and the direct, indirect effects of soil characteristic factors on dinoseb adsorption parameter were analyzed through bivariate correlation analysis, and path analysis. With stepwise regression analysis the factors which had little influence on the adsorption parameter were excluded. Results indicate that pH and CEC had moderate relationship and lower direct effect on dinoseb adsorption parameter due to the multicollinearity with other soil factors, and organic carbon and clay contents were found to be the most significant soil factors which affect the dinoseb adsorption process. A regression is thereby set up to explore the relationship between the dinoseb adsorption parameter and the two soil factors: the soil organic carbon and clay contents. A 92% of the variation of dinoseb sorption coefficient could be attributed to the variation of the soil organic carbon and clay contents. PMID:23737715

[Relationship between quality of life and disability level in patients with occupational disease].

PubMed

Li, Hongmei; Lin, Mingjing; Zhang, Wenwen; Li, Jing; Zou, Jianfang

2015-10-01

To investigate the relationship between the quality of life (QOL) and disability level in patients with occupational disease and to investigate the influencing factors for QOL. A total of 255 patients with occupational disease were selected from three specialized hospitals dedicated to occupational disease and the department of occupational medicine of one comprehensive hospital using cluster sampling from December 2013 to May 2014. A survey was carried out using WHOQOL-BREF and general questionnaire (including disability level), and statistical analysis was also performed using t test, F test, analysis of variance, and multivariate stepwise regression analysis. The QOL scores of patients with occupational diseases, from high to low, were social domain (11.48 ± 2.86), psychological domain (10.60 ± 2.28), physiological domain (10.54 ± 1.65), and environmental domain (10.50 ± 2.55), scores of which were significantly lower than the normal levels (P<0.05). QOL showed no significant differences between patients with occupational diseases of different disability levels (P>0.05). Also, QOL showed no significant differences between stage I, II and III patients with pneumoconiosis (P>0.05). The patients with pneumoconiosis were divided into mild, moderate, and severe groups, and the QOL scores of patients with mild pneumoconiosis in psychological and environmental domains were significantly higher than those of the patients with moderate or severe pneumoconiosis (P< 0.05). Patients with occupational poisoning was divided into mild, moderate and severe groups, and the three groups showed no significant differences in QOL score (P>0.05). Multivariate regression analysis showed that the QOL score of each domain was mainly influenced by the degree of lung injury, complications, course of disease, age of onset, income, and employment status. The QOL of patients with occupational disease is significantly reduced, and disability level cannot accurately reflect their QOL. The treatment of patients with occupational disease should focus on their complications, and at the same time QOL should also be improved.

Lower urinary tract symptoms and erectile dysfunction associated with depression among Japanese patients with late-onset hypogonadism symptoms.

PubMed

Takao, Tetsuya; Tsujimura, Akira; Okuda, Hidenobu; Yamamoto, Keisuke; Fukuhara, Shinichiro; Matsuoka, Yasuhiro; Miyagawa, Yasushi; Nonomura, Norio; Okuyama, Akihiko

2011-06-01

The aim of this study was to investigate the relation between lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and depression in Japanese patients with late-onset hypogonadism (LOH) symptoms. The study comprised 87 Japanese patients with LOH symptoms (>27 points on the Aging Males Symptoms Scale). Thirty-four patients were diagnosed as having depression and the remaining 53 patients were diagnosed as not having depression by the Mini International Neuropsychiatric Interview. We compared the International Index of Erectile Function (IIEF) 5, International Prostate Symptom Score (IPSS), IPSS quality-of-life (QOL) index, King's Health Questionnaire (KHQ), endocrinological data, and free uroflow study between depression and non-depression patients and performed multiple logistic regression analysis. IIEF5 scores of depression patients were significantly lower than those of non-depression patients. In KHQ, only the category of general health perceptions was significantly higher in depression patients than non-depression patients. However, IPSS, QOL index, and endocrinological and uroflowmetric data showed no significant difference between the groups. Multiple logistic regression analysis revealed moderate and severe ED to be risk factors for depression. However, LUTS are not related to depression. Moderate and severe ED is correlated with depression, whereas LUTS are not related to depression in Japanese LOH patients.

Post-wildfire summer greening depends on winter snowpack

NASA Astrophysics Data System (ADS)

Wilson, A.; Nolin, A. W.

2017-12-01

Forested, mountain landscapes in the Pacific Northwest (PNW) are changing at an unprecedented rate, largely due to shifts in the regional climate regime. Documented climatic trends include increasing wildfire frequency and intensity and an increasingly ephemeral snowpack, especially at moderate elevations. One relationship that has yet to be studied thoroughly is the dependence of post-wildfire forest recovery on winter snowpack. This study will correlate winter snowpack with summer greenness in the context of 15 recent severe wildfires across the PNW. Winter snow water equivalent will be estimated using a new Snow Cover Frequency (SCF) metric derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) daily snow cover product. Summer forest greenness will be assessed using the Enhanced Vegetation Index (EVI), also derived from daily MODIS reflectance data. Regression tree analysis will be employed to characterize the relative importance of snowpack, elevation, slope, aspect, soil texture, and summer precipitation to summer greenness. Using findings from the regression tree analysis, the most critical physiographic factors will frame a multivariate time series spanning the 5 years pre-wildfire and 5 years post-wildfire in an effort to illustrate how the snowpack-revegetation relationship persists over time. As northwestern mountainous forests become more vulnerable to wildfire activity, it will be vital to continue deepening our understanding of how snowpack matters to post-wildfire forest recovery.

IQ is an independent predictor of glycated haemoglobin level in young and middle-aged adults with intellectual disability.

PubMed

Yano, T; Miki, T; Itoh, T; Ohnishi, H; Asari, M; Chihiro, S; Yamamoto, A; Aotsuka, K; Kawakami, N; Ichikawa, J; Hirota, Y; Miura, T

2015-01-01

Here we examined whether intellectual disability is independently associated with hyperglycaemia. We recruited 233 consecutive young and middle-aged adults with intellectual disability. After exclusion of subjects on medication for metabolic diseases or with severe intellectual disability (IQ < 35), 121 subjects were divided by IQ into a group with moderate intellectual disability (35 ≤ IQ ≤ 50), a mild intellectual disability group (51 ≤ IQ ≤ 70) and a borderline group (IQ > 70). HbA1c level was higher in subjects with moderate intellectual disability (42 ± 9 mmol/mol; 6.0 ± 0.8%) than those in the borderline group (36 ± 4 mmol/mol; 5.5 ± 0.3%) and mild intellectual disability group (37 ± 5 mmol/mol; 5.5 ± 0.5%) groups. HbA1c level was correlated with age, BMI, blood pressure, serum triglycerides and IQ in simple linear regression analysis. Multiple regression analysis indicated that IQ, age, BMI and diastolic blood pressure were independent explanatory factors of HbA1c level. An unfavourable effect of intellectual disability on lifestyle and untoward effect of hyperglycaemia on cognitive function may underlie the association of low IQ with hyperglycaemia. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Evaluation of inner retinal layers as biomarkers in mild cognitive impairment to moderate Alzheimer’s disease

PubMed Central

Mukherjee, Dibyendu; Stinnett, Sandra S.; Cousins, Scott W.; Potter, Guy G.; Burke, James R.; Farsiu, Sina; Whitson, Heather E.

2018-01-01

Inner retina in Alzheimer's Disease (AD) may experience neuroinflammation resulting in atrophy. The objective of our study was to determine whether retinal GCIPL (ganglion cell-inner plexiform layer) or nerve fiber layer (NFL) thickness may serve as noninvasive biomarkers to diagnose AD. This cross-sectional case-control study enrolled 15 mild cognitive impairment (MCI) patients, 15 mild-moderate AD patients, and 18 cognitively normal adults. NFL and GCIPL thicknesses on optical coherence tomography (OCT) were measured using Duke Optical Coherence Tomography Retinal Analysis Program (DOCTRAP) and Spectralis software. We demonstrated that regional thicknesses of NFL or GCIPL on macular or nerve OCTs did not differ between groups. However, a multi-variate regression analysis identified macular areas with a significant thickening or thinning in NFL and GCIPL in MCI and AD patients. Our primary findings controvert previous reports of thinner NFL in moderate-to-severe AD. The areas of thickening of GCIPL and NFL in the macula adjacent to areas of thinning, as revealed by a more complex statistical model, suggest that NFL and GCIPL may undergo dynamic changes during AD progression. PMID:29420642

Comparing nouns and verbs in a lexical task.

PubMed

Cordier, Françoise; Croizet, Jean-Claude; Rigalleau, François

2013-02-01

We analyzed the differential processing of nouns and verbs in a lexical decision task. Moderate and high-frequency nouns and verbs were compared. The characteristics of our material were specified at the formal level (number of letters and syllables, number of homographs, orthographic neighbors, frequency and age of acquisition), and at the semantic level (imagery, number and strength of associations, number of meanings, context dependency). A regression analysis indicated a classical frequency effect and a word-type effect, with latencies for verbs being slower than for nouns. The regression analysis did not permit the conclusion that semantic effects were involved (particularly imageability). Nevertheless, the semantic opposition between nouns as prototypical representations of objects, and verbs as prototypical representation of actions was not tested in this experiment and remains a good candidate explanation of the response time discrepancies between verbs and nouns.

Identification of extremely premature infants at high risk of rehospitalization.

PubMed

Ambalavanan, Namasivayam; Carlo, Waldemar A; McDonald, Scott A; Yao, Qing; Das, Abhik; Higgins, Rosemary D

2011-11-01

Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

Identification of Extremely Premature Infants at High Risk of Rehospitalization

PubMed Central

Carlo, Waldemar A.; McDonald, Scott A.; Yao, Qing; Das, Abhik; Higgins, Rosemary D.

2011-01-01

OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002–2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%–42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge. PMID:22007016

Using integrated information systems in supply chain management

NASA Astrophysics Data System (ADS)

Gonzálvez-Gallego, Nicolás; Molina-Castillo, Francisco-Jose; Soto-Acosta, Pedro; Varajao, Joao; Trigo, Antonio

2015-02-01

The aim of this paper is to empirically test not only the direct effects of information and communication technology (ICT) capabilities and integrated information systems (IS) on firm performance, but also the moderating role of IS integration along the supply chain in the relationship between ICT external and capabilities and business performance. Data collected from 102 large Iberian firms from Spain and Portugal are used to test the research model. The hierarchical multiple regression analysis is employed to test the direct effects and the moderating relationships proposed. Results show that external and internal ICT capabilities are important drivers of firm performance, while merely having integrated IS do not lead to better firm performance. In addition, a moderating effect of IS integration in the relationship between ICT capabilities and business performance is found, although this integration only contributes to firm performance when it is directed to connect with suppliers or customers rather than when integrating the whole supply chain.

Mastery moderates the negative effect of stigma on depressive symptoms in people living with HIV.

PubMed

Rueda, Sergio; Gibson, Katherine; Rourke, Sean B; Bekele, Tsegaye; Gardner, Sandra; Cairney, John

2012-04-01

Stigma continues to have a negative effect on the care, treatment, and support of people living with HIV. This study presents baseline data from 825 participants taking part in a cohort study that collects data on the clinical profile and social determinants of health of people with HIV. We performed multivariate regression analysis to evaluate whether mastery and social support moderated the negative effect of stigma on depressive symptoms. Stigma was associated with depressive symptoms after controlling for potential demographic and clinical confounders. In addition, higher levels of mastery and social support were associated with lower levels of depression. However, only mastery moderated the negative effects of stigma on depressive symptoms. For individuals with high levels of mastery, greater exposure to stigma does not translate into greater distress. Interventions targeting the mental health concerns of people with HIV should increase their focus on improving people' sense of personal control.

Impact of Social Integration and Living Arrangements on Korean Older Adults' Depression: A Moderation Model.

PubMed

Lee, Youjung; Jang, Kyeonghee; Lockhart, Naorah C

2018-04-01

Depression among older adults is a challenging public health concern in Korea. Using panel data from the Korea Institute for Health and Social Affairs on Korean older adults and their family caregivers, this study explores significant predictors of depression among Korean older adults as well as the moderating effect of living arrangements on the association between social integration and depression. A multivariate logistic regression analysis showed that preexisting depression was the most significant predictor of Korean older adults' current depression, followed by health status and family support. In addition, social integration significantly decreased Korean older adults' depression. Importantly, a significant moderation effect of living arrangements between Korean older adults' social integration and depression was observed. This study implies the development of individually tailored and culturally responsive programs to engage marginalized Korean older adults living alone, helping foster their well-being and optimal aging.

Mediation and moderation of the association between cynical hostility and systolic blood pressure in low-income women.

PubMed

Versey, H Shellae; Kaplan, George A

2012-04-01

Hostility may be related to risk factors for cardiovascular disease (CVD), such as blood pressure. However, the process by which hostility affects blood pressure is not fully understood. The current study sought to evaluate abdominal obesity (waist-to-hip ratio [WHR]) as a potential mediator and modifier of the relationship between cynical hostility and systolic blood pressure (SBP) in a group of disadvantaged women. Path analysis and multiple regression models were used to identify mediating and moderating pathways in the relationship between cynical hostility and SBP. Results indicate a significant interaction between WHR and cynical hostility. WHR was a partial mediator and significant moderator of the association between hostility and blood pressure. These findings highlight the potential importance of examining abdominal obesity and psychosocial factors as conjunctive determinants of CVD and risk factors for related metabolic conditions.

Work-based resources as moderators of the relationship between work hours and satisfaction with work-family balance.

PubMed

Valcour, Monique

2007-11-01

This study reports an investigation of the relationships of work hours, job complexity, and control over work time to satisfaction with work-family balance. Based on data from a sample of 570 telephone call center representatives, a moderated hierarchical regression analysis revealed that work hours were negatively related to satisfaction with work-family balance, consistent with the resource drain perspective. Job complexity and control over work time were positively associated with satisfaction with work-family balance. Control over work time moderated the relationship such that as work hours rose, workers with low control experienced a decline in work-family balance satisfaction, while workers with high control did not. Results encourage greater research attention to work characteristics, such as job complexity and control over work time, and skills that represent resources useful to the successful integration of work and family demands. (c) 2007 APA

Family cohesion moderates the relationship between acculturative stress and depression in Japanese adolescent temporary residents.

PubMed

Roley, Michelle E; Kawakami, Ryoko; Baker, Jessica; Hurtado, Gabriela; Chin, Andrew; Hovey, Joseph D

2014-12-01

Acculturative stress is a risk factor for depression, and may be important in the risk for depression among acculturating Japanese adolescents. However, little to no research has been published on the mental health of acculturating Japanese adolescents. Further, although family cohesion has been shown to be protective against depression across ethnic groups, no prior research has examined family cohesion as a protective factor for Japanese adolescents. To examine these relationships, 26 Japanese temporary resident adolescents and 76 parents in the Midwest were recruited to participate. Moderate to strong correlations between acculturative stress, depression, likelihood for and seriousness of family conflict were found. A regression analysis found that likelihood for family conflict moderated the relationship between acculturative stress and depression. Findings broaden our understanding of the role of acculturative stress and family conflict on depression risk for Japanese adolescent immigrants.

Testing moderation in network meta-analysis with individual participant data

PubMed Central

Dagne, Getachew A.; Brown, C. Hendricks; Howe, George; Kellam, Sheppard G.; Liu, Lei

2016-01-01

Summary Meta-analytic methods for combining data from multiple intervention trials are commonly used to estimate the effectiveness of an intervention. They can also be extended to study comparative effectiveness, testing which of several alternative interventions is expected to have the strongest effect. This often requires network meta-analysis (NMA), which combines trials involving direct comparison of two interventions within the same trial and indirect comparisons across trials. In this paper, we extend existing network methods for main effects to examining moderator effects, allowing for tests of whether intervention effects vary for different populations or when employed in different contexts. In addition, we study how the use of individual participant data (IPD) may increase the sensitivity of NMA for detecting moderator effects, as compared to aggregate data NMA that employs study-level effect sizes in a meta-regression framework. A new network meta-analysis diagram is proposed. We also develop a generalized multilevel model for NMA that takes into account within- and between-trial heterogeneity, and can include participant-level covariates. Within this framework we present definitions of homogeneity and consistency across trials. A simulation study based on this model is used to assess effects on power to detect both main and moderator effects. Results show that power to detect moderation is substantially greater when applied to IPD as compared to study-level effects. We illustrate the use of this method by applying it to data from a classroom-based randomized study that involved two sub-trials, each comparing interventions that were contrasted with separate control groups. PMID:26841367

Contrast sensitivity to spatial gratings in moderate and dim light conditions in patients with diabetes in the absence of diabetic retinopathy

PubMed Central

Safi, Sare; Rahimi, Anoushiravan; Raeesi, Afsaneh; Safi, Hamid; Aghazadeh Amiri, Mohammad; Malek, Mojtaba; Yaseri, Mehdi; Haeri, Mohammad; Middleton, Frank A; Solessio, Eduardo; Ahmadieh, Hamid

2017-01-01

Objective To evaluate the ability of contrast sensitivity (CS) to discriminate loss of visual function in diabetic subjects with no clinical signs of retinopathy relative to that of normal subjects. Research design and methods In this prospective cross-sectional study, we measured CS in 46 diabetic subjects with a mean age of 48±6 years, a best-corrected visual acuity of 20/20 and no signs of diabetic retinopathy. The CS in these subjects was compared with CS measurements in 46 normal control subjects at four spatial frequencies (3, 6, 12, 18 cycles per degree) under moderate (500 lux) and dim (less than 2 lux) background light conditions. Results CS was approximately 0.16 log units lower in patients with diabetes relative to controls both in moderate and in dim background light conditions. Logistic regression classification and receiver operating characteristic curve analysis indicated that CS analysis using two light conditions was more accurate (0.78) overall compared with CS analysis using only a single illumination condition (accuracy values were 0.67 and 0.70 in moderate and dim light conditions, respectively). Conclusions Our results showed that patients with diabetes without clinical signs of retinopathy exhibit a uniform loss in CS at all spatial frequencies tested. Measuring the loss in CS at two spatial frequencies (3 and 6 cycles per degree) and two light conditions (moderate and dim) is sufficiently robust to classify diabetic subjects with no retinopathy versus control subjects. PMID:28878937

Independent Prognostic Factors for Acute Organophosphorus Pesticide Poisoning.

PubMed

Tang, Weidong; Ruan, Feng; Chen, Qi; Chen, Suping; Shao, Xuebo; Gao, Jianbo; Zhang, Mao

2016-07-01

Acute organophosphorus pesticide poisoning (AOPP) is becoming a significant problem and a potential cause of human mortality because of the abuse of organophosphate compounds. This study aims to determine the independent prognostic factors of AOPP by using multivariate logistic regression analysis. The clinical data for 71 subjects with AOPP admitted to our hospital were retrospectively analyzed. This information included the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, 6-h post-admission blood lactate levels, post-admission 6-h lactate clearance rates, admission blood cholinesterase levels, 6-h post-admission blood cholinesterase levels, cholinesterase activity, blood pH, and other factors. Univariate analysis and multivariate logistic regression analyses were conducted to identify all prognostic factors and independent prognostic factors, respectively. A receiver operating characteristic curve was plotted to analyze the testing power of independent prognostic factors. Twelve of 71 subjects died. Admission blood lactate levels, 6-h post-admission blood lactate levels, post-admission 6-h lactate clearance rates, blood pH, and APACHE II scores were identified as prognostic factors for AOPP according to the univariate analysis, whereas only 6-h post-admission blood lactate levels, post-admission 6-h lactate clearance rates, and blood pH were independent prognostic factors identified by multivariate logistic regression analysis. The receiver operating characteristic analysis suggested that post-admission 6-h lactate clearance rates were of moderate diagnostic value. High 6-h post-admission blood lactate levels, low blood pH, and low post-admission 6-h lactate clearance rates were independent prognostic factors identified by multivariate logistic regression analysis. Copyright © 2016 by Daedalus Enterprises.

Perceived health status and life satisfaction in old age, and the moderating role of social support.

PubMed

Dumitrache, Cristina G; Rubio, Laura; Rubio-Herrera, Ramona

2017-07-01

The aim of this study was on one hand to examine the associations between health impairment and life satisfaction, as well as social support and life satisfaction, and on the other, to analyze the moderating effect of social support with regard to health impairment and life satisfaction in a sample of community-dwelling older adults from urban areas of Granada, southern Spain. This was a cross-sectional survey in which a sample of 406 older adults with ages between 65 and 99 years old (M age = 74.88, SD = 6.75) was selected. Multiple stepwise regression analysis was used to assess the impact of health impairment and perceived social support on life satisfaction. Moderation analysis was performed using the bias-corrected and accelerated bootstrapping approach. Significant differences in life satisfaction scores were found by number and type of disease, restrictions in daily life activities and subjective health. Perceived health and perceived social support predicted life satisfaction. Besides global social support, emotional and affectionate support moderated the link between perceived health and life satisfaction. Older people who do not rate their health status positively and indicate low levels of social support have a higher risk of being dissatisfied with their lives and due to this they should receive special attention from gerontologists.

The role of impulsivity in the association between childhood trauma and dissociative psychopathology: mediation versus moderation.

PubMed

Somer, Eli; Ginzburg, Karni; Kramer, Lilach

2012-03-30

Previous studies on survivors of childhood trauma documented associations between psychological dysregulation, impulsivity, and both behavioral and emotional manifestations of distress. Yet, the mechanism that links these variables remains unclear. The current study aims to examine the pattern of relations between a history of child abuse, impulsivity and dissociation. More specifically, it examines whether impulsivity serves as a moderator or mediator in the association between childhood trauma and dissociation. Eighty-one inpatients from the acute wards of two psychiatric hospitals participated in this study. Data were collected by clinician-administered questionnaires. A highly significant linear hierarchical regression analysis revealed that both psychiatric comorbidity and childhood trauma made unique contributions to the variance of dissociation. Yet, the significant association between childhood trauma and dissociation decreased when impulsivity was entered into the regression model. Our findings suggest that impulsivity mediates the association between childhood trauma and dissociative psychopathology and imply that the identification and treatment of impulsivity could be a potentially valuable clinical target in individuals with dissociative disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of 1RM Prediction Equations for Bench Press in Moderately Trained Men.

PubMed

Macht, Jordan W; Abel, Mark G; Mullineaux, David R; Yates, James W

2016-10-01

Macht, JW, Abel, MG, Mullineaux, DR, and Yates, JW. Development of 1RM prediction equations for bench press in moderately trained men. J Strength Cond Res 30(10): 2901-2906, 2016-There are a variety of established 1 repetition maximum (1RM) prediction equations, however, very few prediction equations use anthropometric characteristics exclusively or in part, to estimate 1RM strength. Therefore, the purpose of this study was to develop an original 1RM prediction equation for bench press using anthropometric and performance characteristics in moderately trained male subjects. Sixty male subjects (21.2 ± 2.4 years) completed a 1RM bench press and were randomly assigned a load to complete as many repetitions as possible. In addition, body composition, upper-body anthropometric characteristics, and handgrip strength were assessed. Regression analysis was used to develop a performance-based 1RM prediction equation: 1RM = 1.20 repetition weight + 2.19 repetitions to fatigue - 0.56 biacromial width (cm) + 9.6 (R = 0.99, standard error of estimate [SEE] = 3.5 kg). Regression analysis to develop a nonperformance-based 1RM prediction equation yielded: 1RM (kg) = 0.997 cross-sectional area (CSA) (cm) + 0.401 chest circumference (cm) - 0.385%fat - 0.185 arm length (cm) + 36.7 (R = 0.81, SEE = 13.0 kg). The performance prediction equations developed in this study had high validity coefficients, minimal mean bias, and small limits of agreement. The anthropometric equations had moderately high validity coefficient but larger limits of agreement. The practical applications of this study indicate that the inclusion of anthropometric characteristics and performance variables produce a valid prediction equation for 1RM strength. In addition, the CSA of the arm uses a simple nonperformance method of estimating the lifter's 1RM. This information may be used to predict the starting load for a lifter performing a 1RM prediction protocol or a 1RM testing protocol.

Behavioral adjustment of siblings of children with autism engaged in applied behavior analysis early intervention programs: the moderating role of social support.

PubMed

Hastings, Richard P

2003-04-01

There have been few studies of the impact of intensive home-based early applied behavior analysis (ABA) intervention for children with autism on family functioning. In the present study, behavioral adjustment was explored in 78 siblings of children with autism on ABA programs. First, mothers' ratings of sibling adjustment were compared to a normative sample. There were no reported increases in behavioral adjustment problems in the present sample. Second, regression analyses revealed that social support functioned as a moderator of the impact of autism severity on sibling adjustment rather than a mediator or compensatory variable. In particular, siblings in families with a less severely autistic child had fewer adjustment problems when more formal social support was also available to the family. The implications of these data for future research and for practice are discussed.

Meta-regression approximations to reduce publication selection bias.

PubMed

Stanley, T D; Doucouliagos, Hristos

2014-03-01

Publication selection bias is a serious challenge to the integrity of all empirical sciences. We derive meta-regression approximations to reduce this bias. Our approach employs Taylor polynomial approximations to the conditional mean of a truncated distribution. A quadratic approximation without a linear term, precision-effect estimate with standard error (PEESE), is shown to have the smallest bias and mean squared error in most cases and to outperform conventional meta-analysis estimators, often by a great deal. Monte Carlo simulations also demonstrate how a new hybrid estimator that conditionally combines PEESE and the Egger regression intercept can provide a practical solution to publication selection bias. PEESE is easily expanded to accommodate systematic heterogeneity along with complex and differential publication selection bias that is related to moderator variables. By providing an intuitive reason for these approximations, we can also explain why the Egger regression works so well and when it does not. These meta-regression methods are applied to several policy-relevant areas of research including antidepressant effectiveness, the value of a statistical life, the minimum wage, and nicotine replacement therapy. Copyright © 2013 John Wiley & Sons, Ltd.

Associations among job demands and resources, work engagement, and psychological distress: fixed-effects model analysis in Japan

PubMed Central

Oshio, Takashi; Inoue, Akiomi

2018-01-01

Objectives: We examined the associations among job demands and resources, work engagement, and psychological distress, adjusted for time-invariant individual attributes. Methods: We used data from a Japanese occupational cohort survey, which included 18,702 observations of 7,843 individuals. We investigated how work engagement, measured by the Utrecht Work Engagement Scale, was associated with key aspects of job demands and resources, using fixed-effects regression models. We further estimated the fixed-effects models to assess how work engagement moderated the association between each job characteristic and psychological distress as measured by Kessler 6 scores. Results: The fixed-effects models showed that work engagement was positively associated with job resources, as did pooled cross-sectional and prospective cohort models. Specifically, the standardized regression coefficients (β) were 0.148 and 0.120 for extrinsic reward and decision latitude, respectively, compared to -0.159 and 0.020 for role ambiguity and workload and time pressure, respectively (p < 0.001 for all associations). Work engagement modestly moderated the associations of psychological distress with workload and time pressure and extrinsic reward; a one-standard deviation increase in work engagement moderated their associations by 19.2% (p < 0.001) and 11.3% (p = 0.034), respectively. Conclusions: Work engagement was associated with job demands and resources, which is in line with the theoretical prediction of the job demands-resources model, even after controlling for time-invariant individual attributes. Work engagement moderated the association between selected aspects of job demands and resources and psychological distress. PMID:29563368

Assessing mediation using marginal structural models in the presence of confounding and moderation

PubMed Central

Coffman, Donna L.; Zhong, Wei

2012-01-01

This paper presents marginal structural models (MSMs) with inverse propensity weighting (IPW) for assessing mediation. Generally, individuals are not randomly assigned to levels of the mediator. Therefore, confounders of the mediator and outcome may exist that limit causal inferences, a goal of mediation analysis. Either regression adjustment or IPW can be used to take confounding into account, but IPW has several advantages. Regression adjustment of even one confounder of the mediator and outcome that has been influenced by treatment results in biased estimates of the direct effect (i.e., the effect of treatment on the outcome that does not go through the mediator). One advantage of IPW is that it can properly adjust for this type of confounding, assuming there are no unmeasured confounders. Further, we illustrate that IPW estimation provides unbiased estimates of all effects when there is a baseline moderator variable that interacts with the treatment, when there is a baseline moderator variable that interacts with the mediator, and when the treatment interacts with the mediator. IPW estimation also provides unbiased estimates of all effects in the presence of non-randomized treatments. In addition, for testing mediation we propose a test of the null hypothesis of no mediation. Finally, we illustrate this approach with an empirical data set in which the mediator is continuous, as is often the case in psychological research. PMID:22905648

Assessing mediation using marginal structural models in the presence of confounding and moderation.

PubMed

Coffman, Donna L; Zhong, Wei

2012-12-01

This article presents marginal structural models with inverse propensity weighting (IPW) for assessing mediation. Generally, individuals are not randomly assigned to levels of the mediator. Therefore, confounders of the mediator and outcome may exist that limit causal inferences, a goal of mediation analysis. Either regression adjustment or IPW can be used to take confounding into account, but IPW has several advantages. Regression adjustment of even one confounder of the mediator and outcome that has been influenced by treatment results in biased estimates of the direct effect (i.e., the effect of treatment on the outcome that does not go through the mediator). One advantage of IPW is that it can properly adjust for this type of confounding, assuming there are no unmeasured confounders. Further, we illustrate that IPW estimation provides unbiased estimates of all effects when there is a baseline moderator variable that interacts with the treatment, when there is a baseline moderator variable that interacts with the mediator, and when the treatment interacts with the mediator. IPW estimation also provides unbiased estimates of all effects in the presence of nonrandomized treatments. In addition, for testing mediation we propose a test of the null hypothesis of no mediation. Finally, we illustrate this approach with an empirical data set in which the mediator is continuous, as is often the case in psychological research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Multinomial logistic regression analysis for differentiating 3 treatment outcome trajectory groups for headache-associated disability.

PubMed

Lewis, Kristin Nicole; Heckman, Bernadette Davantes; Himawan, Lina

2011-08-01

Growth mixture modeling (GMM) identified latent groups based on treatment outcome trajectories of headache disability measures in patients in headache subspecialty treatment clinics. Using a longitudinal design, 219 patients in headache subspecialty clinics in 4 large cities throughout Ohio provided data on their headache disability at pretreatment and 3 follow-up assessments. GMM identified 3 treatment outcome trajectory groups: (1) patients who initiated treatment with elevated disability levels and who reported statistically significant reductions in headache disability (high-disability improvers; 11%); (2) patients who initiated treatment with elevated disability but who reported no reductions in disability (high-disability nonimprovers; 34%); and (3) patients who initiated treatment with moderate disability and who reported statistically significant reductions in headache disability (moderate-disability improvers; 55%). Based on the final multinomial logistic regression model, a dichotomized treatment appointment attendance variable was a statistically significant predictor for differentiating high-disability improvers from high-disability nonimprovers. Three-fourths of patients who initiated treatment with elevated disability levels did not report reductions in disability after 5 months of treatment with new preventive pharmacotherapies. Preventive headache agents may be most efficacious for patients with moderate levels of disability and for patients with high disability levels who attend all treatment appointments. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Steep discounting of delayed monetary and food rewards in obesity: a meta-analysis.

PubMed

Amlung, M; Petker, T; Jackson, J; Balodis, I; MacKillop, J

2016-08-01

An increasing number of studies have investigated delay discounting (DD) in relation to obesity, but with mixed findings. This meta-analysis synthesized the literature on the relationship between monetary and food DD and obesity, with three objectives: (1) to characterize the relationship between DD and obesity in both case-control comparisons and continuous designs; (2) to examine potential moderators, including case-control v. continuous design, money v. food rewards, sample sex distribution, and sample age (18 years); and (3) to evaluate publication bias. From 134 candidate articles, 39 independent investigations yielded 29 case-control and 30 continuous comparisons (total n = 10 278). Random-effects meta-analysis was conducted using Cohen's d as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger tests, meta-regression of publication year and effect size, and imputation of missing studies. The primary analysis revealed a medium effect size across studies that was highly statistically significant (d = 0.43, p < 10-14). None of the moderators examined yielded statistically significant differences, although notably larger effect sizes were found for studies with case-control designs, food rewards and child/adolescent samples. Limited evidence of publication bias was present, although the Begg-Mazumdar test and meta-regression suggested a slightly diminishing effect size over time. Steep DD of food and money appears to be a robust feature of obesity that is relatively consistent across the DD assessment methodologies and study designs examined. These findings are discussed in the context of research on DD in drug addiction, the neural bases of DD in obesity, and potential clinical applications.

A Meta-Analysis of D-Cycloserine in Exposure-Based Treatment: Moderators of Treatment Efficacy, Response, and Diagnostic Remission

PubMed Central

McGuire, Joseph F.; Wu, Monica S.; Piacentini, John; McCracken, James T.; Storch, Eric A.

2018-01-01

Objective This meta-analysis examined treatment efficacy, treatment response, and diagnostic remission effect sizes (ES) and moderators of d-cycloserine (DCS) augmented exposure treatment in randomized controlled trials (RCTs) of individuals with anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Data Sources and Study Selection Using search terms d-cycloserine AND randomized controlled trial, PubMED (1965-May 2015), PsycInfo, and Scopus were searched for randomized placebo-controlled trials of DCS-augmented exposure therapy for anxiety disorders, OCD, and PTSD. Data Extraction Clinical variables and ES were extracted from 20 RCTs (957 participants). A random effects model calculated the ES for treatment efficacy, treatment response, and diagnostic remission using standardized rating scales. Subgroup analyses and meta-regression examined potential moderators. Results A small non-significant benefit of DCS augmentation compared to placebo augmentation was identified across treatment efficacy (g=0.15), response (RR=1.08), and remission (RR=1.109), with a moderately significant effect for anxiety disorders specifically (g=0.33, p=.03). At initial follow-up assessments, a small non-significant ES of DCS augmentation compared to placebo was found for treatment efficacy (g=0.21), response (RR=1.06), and remission (RR=1.12). Specific treatment moderators (e.g., comorbidity, medication status, gender, publication year) were found across conditions for both acute treatment and initial follow-up assessments. Conclusions DCS does not universally enhance treatment outcomes, but demonstrates promise for anxiety disorders. Distinct treatment moderators may account for discrepant findings across RCTs and disorders. Future trials may be strengthened by accounting for identified moderators in their design, with ongoing research needed on the mechanisms of DCS to tailor treatment protocols and maximize its benefit. PMID:27314661

[Evaluation of postoperative pain intensity after ear, nose, and throat surgery--the effect of intraoperative fentanyl use].

PubMed

Mizota, Toshiyuki; Suzuki, Haruyo; Daijo, Hiroki; Tanaka, Tomoharu; Fukuda, Kazuhiko

2014-11-01

This study was designed to determine postoperative pain levels after ear, nose, and throat (ENT) surgery, and also to examine whether intraoperative fentanyl use during ENT surgery enhances the quality of postoperative pain control. The distribution of pain scores and rescue analgesic requirements among 198 patients undergoing ENT surgery were examined. Multivariate logistic regression analysis was performed to identify independent factors associated with moderate to severe postoperative pain (maximal pain score ≥ 5 on the numerical rating scale) and postoperative nausea and vomiting (PONV). 27.8% of patients experienced moderate to severe postoperative pain after ENT surgery. The distribution of postoperative pain levels was similar among procedures performed on different anatomical regions. Intraoperative fentanyl use was not associated with moderate to severe postoperative pain (adjusted odds ratio (95% confidence interval) :1.03 (0.51-2.13))]. On the other hand, intraoperative fentanyl use was independently associated with PONV [3.10 (1.25-8.92); P = 0.0138]. Prevalence of moderate to severe postoperative pain after ENT surgery was approximately 28%. Intraoperative fentanyl use was not associated with a decreased incidence of moderate to severe postoperative pain, but was significantly associated with PONV.

Moderating Effects of Religiousness and Marriage Duration on the Relation Between Sexual and Marital Satisfaction Among Jewish Women.

PubMed

Lazar, Aryeh

2017-02-01

This study examined the moderating effects of religiousness and relationship duration on the association between sexual and marital satisfaction. For this purpose, 240 married Jewish women-religious and secular-responded to an online survey. Hierarchical regression analysis indicated that religiousness moderated the association between sexual and marital satisfaction which was found to be stronger for secular women than for religious women. Relationship duration also moderated the association between sexual and marital satisfaction which was found to be stronger for longer marital duration than for shorter marital duration. In addition, a significant three-way interaction (religiousness × relationship duration × sexual satisfaction) was also found where the association between the two types of satisfaction was stronger for religious women married for a longer time in comparison with those married for a shorter time. For secular women, relationship duration did not moderate the relation between sexual and marital satisfaction. An explanation based on differences in the manner in which religious and secular women perceive and relate to the sexual aspects of their marital relationship at different stages of the marriage is offered.

Joint Relationship Between Physical Activity, Weight Status, and Motor Skills in Children Aged 3 to 10 Years.

PubMed

DuBose, Katrina D; Gross McMillan, Amy; Wood, Aaron P; Sisson, Susan B

2018-06-01

While the relationships between physical activity (PA), obesity, and motor skills have been independently examined by previous research, this study explored both independent and combined relationships between children's PA, weight status, and motor skills within a multiple regression analysis. We measured height and weight and calculated body mass index (BMI) z scores for 96 children (3-10 years of age). We measured motor skills using the Movement Assessment Battery for Children-2nd edition (MABC-2), and we measured PA levels through accelerometry. Children with more time in moderate and moderate-to-vigorous PA had higher Total motor skill scores on the MABC-2. Further, children with higher moderate PA levels had higher Balance scores and those with moderate-to-vigorous PA demonstrated higher Aiming and Catching scores. Among children with healthier BMIs, more time spent in PA, regardless of intensity, was related to higher Aiming and Catching scores. Among children with BMI scores suggestive of overweight/obesity, both moderate and moderate-to-vigorous PA were positively related to Balance scores. In conclusion, while BMI z scores were not directly related to motor skills, PA levels were positively related to motor skills, and weight status mediated the relationship between PA and specific components of motor skills.

The relationship between concentration of clorophyll-a with skipjack (Katsuwonus pelamis, Linnaeus 1758) production at West Sumatera waters, Indonesia

NASA Astrophysics Data System (ADS)

Usman; Ersti Yulika Sari, T.; Syaifuddin; Audina

2017-01-01

The regression and correlation technic was uses to evaluated the contribution of chlorophyll-a concentration on variation of longline skipjack tuna production. An analysis was performed by placing Chlorophyll-a as predictor and Skipjack (Katsuwonus pelamis, Linnaeus 1758) production as dependent variable, using Chlorophyll-a derived from NPP VIIRS, and CPUE derived from longline fisherman log books for the year of 2013. Chlorophyll-a distribution which derived from NPP VIIRS between 0.13-0.26 mg/m3 whereas maximum CPUE as much as 0,1875 kg/trip in April. The regression equation obtained was CPUE = -1.12 + 11.5 Chl-a. Correlation between chlorophyll-a and CPUE have moderate relationship (r=0.51). From regression equation for those variables showed that the variation of chlorophyll-a had affected about 26% on variation of CPUE, only.

Velocity structure in long period variable star atmospheres

NASA Technical Reports Server (NTRS)

Pilachowski, C.; Wallerstein, G.; Willson, L. A.

1980-01-01

A regression analysis of the dependence of absorption line velocities on wavelength, line strength, excitation potential, and ionization potential is presented. The method determines the region of formation of the absorption lines for a given data and wavelength region. It is concluded that the scatter which is frequently found in velocity measurements of absorption lines in long period variables is probably the result of a shock of moderate amplitude located in or near the reversing layer and that the frequently observed correlation of velocity with excitation and ionization are a result of the velocity gradients produced by this shock in the atmosphere. A simple interpretation of the signs of the coefficients of the regression analysis is presented in terms of preshock, post shock, or across the shock, together with criteria for evaluating the validity of the fit. The amplitude of the reversing layer shock is estimated from an analysis of a series of plates for four long period variable stars along with the most probable stellar velocity for these stars.

Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care.

PubMed

Ebell, Mark H; Hansen, Jens Georg

2017-07-01

To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid). Signs, symptoms, C-reactive protein (CRP), and reference standard tests were prospectively recorded in 175 Danish patients aged 18 to 65 years seeking care for suspected acute rhinosinusitis. For each reference standard, we developed 2 clinical decision rules: a point score based on a logistic regression model and an algorithm based on a CART model. We identified low-, moderate-, and high-risk groups for acute rhinosinusitis or acute bacterial rhinosinusitis for each clinical decision rule. The point scores each had between 5 and 6 predictors, and an area under the receiver operating characteristic curve (AUROCC) between 0.721 and 0.767. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a 16%, 49%, and 73% likelihood of acute bacterial rhinosinusitis, respectively. CART models had an AUROCC ranging from 0.783 to 0.827. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a likelihood of acute bacterial rhinosinusitis of 6%, 31%, and 59% respectively. We have developed a series of clinical decision rules integrating signs, symptoms, and CRP to diagnose acute rhinosinusitis and acute bacterial rhinosinusitis with good accuracy. They now require prospective validation and an assessment of their effect on clinical and process outcomes. © 2017 Annals of Family Medicine, Inc.

Frequency doubling technology perimetry for detection of visual field progression in glaucoma: a pointwise linear regression analysis.

PubMed

Liu, Shu; Yu, Marco; Weinreb, Robert N; Lai, Gilda; Lam, Dennis Shun-Chiu; Leung, Christopher Kai-Shun

2014-05-02

We compared the detection of visual field progression and its rate of change between standard automated perimetry (SAP) and Matrix frequency doubling technology perimetry (FDTP) in glaucoma. We followed prospectively 217 eyes (179 glaucoma and 38 normal eyes) for SAP and FDTP testing at 4-month intervals for ≥36 months. Pointwise linear regression analysis was performed. A test location was considered progressing when the rate of change of visual sensitivity was ≤-1 dB/y for nonedge and ≤-2 dB/y for edge locations. Three criteria were used to define progression in an eye: ≥3 adjacent nonedge test locations (conservative), any three locations (moderate), and any two locations (liberal) progressed. The rate of change of visual sensitivity was calculated with linear mixed models. Of the 217 eyes, 6.1% and 3.9% progressed with the conservative criteria, 14.5% and 5.6% of eyes progressed with the moderate criteria, and 20.1% and 11.7% of eyes progressed with the liberal criteria by FDTP and SAP, respectively. Taking all test locations into consideration (total, 54 × 179 locations), FDTP detected more progressing locations (176) than SAP (103, P < 0.001). The rate of change of visual field mean deviation (MD) was significantly faster for FDTP (all with P < 0.001). No eyes showed progression in the normal group using the conservative and the moderate criteria. With a faster rate of change of visual sensitivity, FDTP detected more progressing eyes than SAP at a comparable level of specificity. Frequency doubling technology perimetry can provide a useful alternative to monitor glaucoma progression.

Anxiety Outcomes after Physical Activity Interventions: Meta-Analysis Findings

PubMed Central

Conn, Vicki S.

2011-01-01

Background Although numerous primary studies have documented the mental health benefits of physical activity (PA), no previous quantitative synthesis has examined anxiety outcomes of interventions to increase PA. Objectives This meta-analysis integrates extant research about anxiety outcomes from interventions to increase PA among healthy adults. Method Extensive literature searching located published and unpublished PA intervention studies with anxiety outcomes. Eligible studies reported findings from interventions designed to increase PA delivered to healthy adults without anxiety disorders. Data were coded from primary studies. Random-effects meta-analytic procedures were completed. Exploratory moderator analyses using meta-analysis ANOVA and regression analogues were conducted to determine if report, methods, sample, or intervention characteristics were associated with differences in anxiety outcomes. Results Data were synthesized across 3,289 subjects from 19 eligible reports. The overall mean anxiety effect size (d-index) for two-group comparisons was 0.22 with significant heterogeneity (Q = 32.15). Exploratory moderator analyses found larger anxiety improvement effect sizes among studies that included larger samples, used random allocation of subjects to treatment and control conditions, targeted only PA behavior instead of multiple health behaviors, included supervised exercise (vs. home-based PA), used moderate or high-intensity instead of low-intensity PA, and suggested subjects exercise at a fitness facility (vs. home) following interventions. Discussion These findings document that some interventions can decrease anxiety symptoms among healthy adults. Exploratory moderator analyses suggest possible directions for future primary research to compare interventions in randomized trials to confirm causal relationships. PMID:20410849

Phenotypes of comorbidity in OSAS patients: combining categorical principal component analysis with cluster analysis.

PubMed

Vavougios, George D; George D, George; Pastaka, Chaido; Zarogiannis, Sotirios G; Gourgoulianis, Konstantinos I

2016-02-01

Phenotyping obstructive sleep apnea syndrome's comorbidity has been attempted for the first time only recently. The aim of our study was to determine phenotypes of comorbidity in obstructive sleep apnea syndrome patients employing a data-driven approach. Data from 1472 consecutive patient records were recovered from our hospital's database. Categorical principal component analysis and two-step clustering were employed to detect distinct clusters in the data. Univariate comparisons between clusters included one-way analysis of variance with Bonferroni correction and chi-square tests. Predictors of pairwise cluster membership were determined via a binary logistic regression model. The analyses revealed six distinct clusters: A, 'healthy, reporting sleeping related symptoms'; B, 'mild obstructive sleep apnea syndrome without significant comorbidities'; C1: 'moderate obstructive sleep apnea syndrome, obesity, without significant comorbidities'; C2: 'moderate obstructive sleep apnea syndrome with severe comorbidity, obesity and the exclusive inclusion of stroke'; D1: 'severe obstructive sleep apnea syndrome and obesity without comorbidity and a 33.8% prevalence of hypertension'; and D2: 'severe obstructive sleep apnea syndrome with severe comorbidities, along with the highest Epworth Sleepiness Scale score and highest body mass index'. Clusters differed significantly in apnea-hypopnea index, oxygen desaturation index; arousal index; age, body mass index, minimum oxygen saturation and daytime oxygen saturation (one-way analysis of variance P < 0.0001). Binary logistic regression indicated that older age, greater body mass index, lower daytime oxygen saturation and hypertension were associated independently with an increased risk of belonging in a comorbid cluster. Six distinct phenotypes of obstructive sleep apnea syndrome and its comorbidities were identified. Mapping the heterogeneity of the obstructive sleep apnea syndrome may help the early identification of at-risk groups. Finally, determining predictors of comorbidity for the moderate and severe strata of these phenotypes implies a need to take these factors into account when considering obstructive sleep apnea syndrome treatment options. © 2015 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials

PubMed Central

Yuan, Qi-ling; Wang, Peng; Liu, Liang; Sun, Fu; Cai, Yong-song; Wu, Wen-tao; Ye, Mao-lin; Ma, Jiang-tao; Xu, Bang-bang; Zhang, Yin-gang

2016-01-01

The aims of this systematic review were to study the analgesic effect of real acupuncture and to explore whether sham acupuncture (SA) type is related to the estimated effect of real acupuncture for musculoskeletal pain. Five databases were searched. The outcome was pain or disability immediately (≤1 week) following an intervention. Standardized mean differences (SMDs) with 95% confidence intervals were calculated. Meta-regression was used to explore possible sources of heterogeneity. Sixty-three studies (6382 individuals) were included. Eight condition types were included. The pooled effect size was moderate for pain relief (59 trials, 4980 individuals, SMD −0.61, 95% CI −0.76 to −0.47; P < 0.001) and large for disability improvement (31 trials, 4876 individuals, −0.77, −1.05 to −0.49; P < 0.001). In a univariate meta-regression model, sham needle location and/or depth could explain most or all heterogeneities for some conditions (e.g., shoulder pain, low back pain, osteoarthritis, myofascial pain, and fibromyalgia); however, the interactions between subgroups via these covariates were not significant (P < 0.05). Our review provided low-quality evidence that real acupuncture has a moderate effect (approximate 12-point reduction on the 100-mm visual analogue scale) on musculoskeletal pain. SA type did not appear to be related to the estimated effect of real acupuncture. PMID:27471137

Acute respiratory distress syndrome in wartime military burns: application of the Berlin criteria.

PubMed

Belenkiy, Slava M; Buel, Allison R; Cannon, Jeremy W; Sine, Christy R; Aden, James K; Henderson, Jonathan L; Liu, Nehemiah T; Lundy, Jonathan B; Renz, Evan M; Batchinsky, Andriy I; Cancio, Leopoldo C; Chung, Kevin K

2014-03-01

Acute respiratory distress syndrome (ARDS) prevalence and related outcomes in burned military casualties from Iraq and Afghanistan have not been described previously. The objective of this article was to report ARDS prevalence and its associated in-hospital mortality in military burn patients. Demographic and physiologic data were collected retrospectively on mechanically ventilated military casualties admitted to our burn intensive care unit from January 2003 to December 2011. Patients with ARDS were identified in accordance with the new Berlin definition of ARDS. Subjects were categorized as having mild, moderate, or severe ARDS. Multivariate logistic regression identified independent risk factors for developing moderate-to-severe ARDS. The main outcome measure was the prevalence of ARDS in a cohort of patients burned as a result of recent combat operations. A total of 876 burned military casualties presented during the study period, of whom 291 (33.2%) required mechanical ventilation. Prevalence of ARDS in this cohort was 32.6%, with a crude overall mortality of 16.5%. Mortality increased significantly with ARDS severity: mild (11.1%), moderate (36.1%), and severe (43.8%) compared with no ARDS (8.7%) (p < 0.001). Predictors for the development of moderate or severe ARDS were inhalation injury (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.01-3.54; p = 0.046), Injury Severity Score (ISS) (OR, 1.04; 95% CI, 1.01-1.07; p = 0.0021), pneumonia (OR, 198; 95% CI, 1.07-3.66; p = 0.03), and transfusion of fresh frozen plasma (OR, 1.32; 95% CI, 1.01-1.72; p = 0.04). Size of burn was associated with moderate or severe ARDS by univariate analysis but was not an independent predictor of ARDS by multivariate logistic regression (p > 0.05). Age, size of burn, and moderate or severe ARDS were independent predictors of mortality. In this cohort of military casualties with thermal injuries, nearly a third required mechanical ventilation; of those, nearly one third developed ARDS, and nearly one third of patients with ARDS did not survive. Moderate and severe ARDS increased the odds of death by more than fourfold and ninefold, respectively. Epidemiologic/prognostic study, level III.

Application of the Berlin definition in PROMMTT patients: the impact of resuscitation on the incidence of hypoxemia.

PubMed

Robinson, Bryce R H; Cotton, Bryan A; Pritts, Timothy A; Branson, Richard; Holcomb, John B; Muskat, Peter; Fox, Erin E; Wade, Charles E; del Junco, Deborah J; Bulger, Eileen M; Cohen, Mitchell J; Schreiber, Martin A; Myers, John G; Brasel, Karen J; Phelan, Herbert A; Alarcon, Louis H; Rahbar, Mohammad H; Callcut, Rachael A

2013-07-01

Acute lung injury following trauma resuscitation remains a concern despite recent advances. With the use of the PROMMTT study population, the risk of hypoxemia and potential modifiable risk factors are studied. Patients with survival for 24 hours or greater with at least one intensive care unit day were included in the analysis. Hypoxemia was categorized using the Berlin definition for adult respiratory distress syndrome: none (PaO₂-to-FIO₂ ratio [P/F] > 300 mm Hg), mild (P/F, 201-300 mm Hg), moderate (P/F, 101-200 mm Hg) or severe (P/F ≤ 100 mm Hg). The cohort was dichotomized into those with none or mild hypoxemia and those with moderate or severe injury. Early resuscitation was defined as that occurring 0 hour to 6 hours from arrival; late resuscitation was defined as that occurring 7 hours to 24 hours. Multivariate logistic regression models were developed controlling for age, sex, mechanisms of injury, arrival physiology, individual Abbreviated Injury Scale (AIS) scores, blood transfusions, and crystalloid administration. Of the patients 58.7% (731 of 1,245) met inclusion criteria. Hypoxemia occurred in 69% (mild, 24%; moderate, 28%; severe, 17%). Mortality was highest (24%) in the severe group. During early resuscitation (0-6 h), logistic regression revealed age (odd ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.04), chest AIS score (OR, 1.31; 95% CI, 1.10-1.57), and intravenously administered crystalloid fluids given in 500 mL increments (OR, 1.12; 95% CI, 1.01-1.25) as predictive of moderate or severe hypoxemia. During late resuscitation, age (OR, 1.02; 95% CI, 1.00-1.04), chest AIS score (OR, 1.33; 95% CI, 1.11-1.59), and crystalloids given during this period (OR, 1.05; 95% CI, 1.01-1.10) were also predictive of moderate-to-severe hypoxemia. Red blood cell, plasma, and platelet transfusions (whether received during early or late resuscitation) failed to demonstrate an increased risk of developing moderate/severe hypoxemia. Severe chest injury, increasing age, and crystalloid-based resuscitation, but not blood transfusions, were associated with increased risk of developing moderate-to-severe hypoxemia following injury.

Moderating effects of coping on work stress and job performance for nurses in tertiary hospitals: a cross-sectional survey in China.

PubMed

Li, Li; Ai, Hua; Gao, Lei; Zhou, Hao; Liu, Xinyan; Zhang, Zhong; Sun, Tao; Fan, Lihua

2017-06-12

Work stress is a major problem for nurses and it can negatively influence job performance. Therefore, it is critical to explore variables that can reduce or buffer the negative effects of work stress. This study explores the moderating effects of coping strategies on the relationship between work stress and job performance for nurses in China. A cross-sectional survey of 852 nurses from four tertiary hospitals in Heilongjiang Province, China, was conducted in 2013. Descriptive statistics were reported for socioeconomic status and demographic characteristics, level of work stress, coping strategies, and job performance. Regression analysis was conducted to test the interaction between work stress and coping strategies on job performance. Three subscales of work stress were negatively related to job performance. Positive coping strategies moderated Patient Care and job performance while negative coping strategies moderated Workload and Time and performance, and between Working Environment and Resources and performance. Positive coping strategies reduce or buffer the negative effects of work stress on job performance and negative coping strategies increased the negative effects.

Spiritual Transcendence and Psychological Adjustment: The Moderating Role of Personality in Burn Patients.

PubMed

Jibeen, Tahira; Mahfooz, Musferah; Fatima, Shamem

2017-08-30

The current study examined the moderating role of personality traits (neuroticism and extraversion) on the relationship between spiritual transcendence and positive change, and spiritual transcendence and distress in burn patients. The sample (N = 98) comprised adult burn patients (age = 25-50) admitted to three hospitals in Lahore, Pakistan. They were assessed according to a demographic information sheet, the NEO Personality Inventory (McCrae and Costa in J Personal Soc Psychol 52:81-90, 1987), the Spiritual Transcendence Index (Seidlitz et al. in J Sci Study Relig 41:439-453, 2002), the Depression, Anxiety, Stress Scales-21 (Lovibond and Lovibond in Manual for the Depression Anxiety Stress scales, Psychology Foundation, Sydney, 1995), and the Perceived Benefit Scales (McMillen and Fisher in Soc Work Res 22(3):173-186, 1998). Stepwise moderated regression analysis showed that both personality traits (neuroticism and extraversion) played a moderating role in the relationship between spiritual transcendence and positive change, and spiritual transcendence and distress in burn patients. The findings highlight the potential role spiritual transcendence may have in understanding and improving the psychological adjustment of burn patients.

Perceived discrimination, family functioning, and depressive symptoms among immigrant women in Taiwan.

PubMed

Yang, Hao-Jan; Wu, Jyun-Yi; Huang, Sheng-Shiung; Lien, Mei-Huei; Lee, Tony Szu-Hsien

2014-10-01

This study examined the moderating effect of family functioning on the relationship between perceived discrimination and depressive symptoms in immigrant women. A total of 239 immigrant women were selected from four administrative regions in Central Taiwan. Questionnaires concerning perceived discrimination, family functioning (including family cohesion and family adaptability), depressive symptoms, and demographic characteristics were completed by either women themselves (N = 120) or their husbands (N = 119). The moderating effect of family functioning on the relationship between perceived discrimination and depression symptoms was analyzed using multiple regression analysis. Findings showed that a higher level of perceived discrimination among immigrant women is associated with more severe depressive symptoms. Family functioning serves as a moderator between the relationship of perceived discrimination and depressive symptoms, but the moderating effect of family adaptability was evident only in data reported by immigrant women. The results indicate that perceived discrimination has negative mental health implications, and also point to the importance of family functioning for depression. Findings suggest that providers should consider addressing immigrant women's mental health needs through declining their psychosocial distress at multiple ecological levels.

Gait and Glasgow Coma Scale scores can predict functional recovery in patients with traumatic brain injury☆

PubMed Central

Bilgin, Sevil; Guclu-Gunduz, Arzu; Oruckaptan, Hakan; Kose, Nezire; Celik, Bülent

2012-01-01

Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury. PMID:25624828

Stress as a mediator between work-family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence.

PubMed

Sharma, Jyoti; Dhar, Rajib Lochan; Tyagi, Akansha

2016-05-01

The study examined the extent to which work-family conflicts cause stress among nursing staff and its subsequent impact on their psychological health. It also examined if the emotional intelligence level of the nursing staff acted as a moderator between their level of stress and psychological health. A survey was carried out on 693 nursing staff associated with 33 healthcare institutions in Uttarakhand, India. A hierarchical multiple regression analysis was carried out to understand the relationships shared by independent (work-family conflicts) and dependent (psychological health) constructs with the mediator (stress) as well as the moderator (emotional intelligence). The results revealed that stress acted as a mediator between work-family conflict of the nursing staff and their psychological health. However, their emotional intelligence level acted as a moderator between their stress level and psychological health. To conclude, the crucial roles of emotional intelligence in controlling the impact of stress on psychological health along with the practical as well as theoretical implications are also discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Factors associated with differential response to online cognitive behavioural therapy.

PubMed

Button, Katherine S; Wiles, Nicola J; Lewis, Glyn; Peters, Tim J; Kessler, David

2012-05-01

Patients differ in their response to treatments. There is obvious clinical utility in establishing patient characteristics that are associated with differential treatment responses (i.e., are effect modifiers or moderators of treatment response). Factors that moderate response to cognitive behavioural therapy (CBT) remain unclear. This study investigates whether factors prognostic of general depression outcome generally are also moderators of response to online CBT in a sample of depressed patients recruited through U.K. general practices. Secondary analysis of a randomised controlled trial, internet-based psychotherapy for depression. A total of 297 patients referred from 55 U.K. general practices and suffering from depression were randomly allocated to receive either online CBT or waiting list control. Treatment effect was measured by comparing depression score at 4 months between randomization groups. Treatment effect modification was assessed using regression analyses focusing on interactions between treatment effect and putative moderator variables. Pretreatment severity and marital status moderated treatment response. More severe patients, and patients who were separated, widowed, or divorced, benefited most from the intervention. Weak evidence suggested that treatment effectiveness diminished with increasing recent adverse life events. No evidence was found to suggest that educational attainment, age, and history of depression-moderated treatment response. Secondary analyses of trials comparing two or more treatments allow factors that may moderate treatment response to be distinguished from more general prognostic indicators, although caution is needed in interpreting such exploratory analyses.

Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression

PubMed Central

Dipnall, Joanna F.

2016-01-01

Background Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study. Methods The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009–2010). Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators. Results After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30), serum glucose (OR 1.01; 95% CI 1.00, 1.01) and total bilirubin (OR 0.12; 95% CI 0.05, 0.28). Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016), and current smokers (p<0.001). Conclusion The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling methodology and was demonstrated to be a useful tool for detecting three biomarkers associated with depression for future hypothesis generation: red cell distribution width, serum glucose and total bilirubin. PMID:26848571

Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression.

PubMed

Dipnall, Joanna F; Pasco, Julie A; Berk, Michael; Williams, Lana J; Dodd, Seetal; Jacka, Felice N; Meyer, Denny

2016-01-01

Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study. The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009-2010). Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators. After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30), serum glucose (OR 1.01; 95% CI 1.00, 1.01) and total bilirubin (OR 0.12; 95% CI 0.05, 0.28). Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016), and current smokers (p<0.001). The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling methodology and was demonstrated to be a useful tool for detecting three biomarkers associated with depression for future hypothesis generation: red cell distribution width, serum glucose and total bilirubin.

Partial Least Squares Regression Can Aid in Detecting Differential Abundance of Multiple Features in Sets of Metagenomic Samples

PubMed Central

Libiger, Ondrej; Schork, Nicholas J.

2015-01-01

It is now feasible to examine the composition and diversity of microbial communities (i.e., “microbiomes”) that populate different human organs and orifices using DNA sequencing and related technologies. To explore the potential links between changes in microbial communities and various diseases in the human body, it is essential to test associations involving different species within and across microbiomes, environmental settings and disease states. Although a number of statistical techniques exist for carrying out relevant analyses, it is unclear which of these techniques exhibit the greatest statistical power to detect associations given the complexity of most microbiome datasets. We compared the statistical power of principal component regression, partial least squares regression, regularized regression, distance-based regression, Hill's diversity measures, and a modified test implemented in the popular and widely used microbiome analysis methodology “Metastats” across a wide range of simulated scenarios involving changes in feature abundance between two sets of metagenomic samples. For this purpose, simulation studies were used to change the abundance of microbial species in a real dataset from a published study examining human hands. Each technique was applied to the same data, and its ability to detect the simulated change in abundance was assessed. We hypothesized that a small subset of methods would outperform the rest in terms of the statistical power. Indeed, we found that the Metastats technique modified to accommodate multivariate analysis and partial least squares regression yielded high power under the models and data sets we studied. The statistical power of diversity measure-based tests, distance-based regression and regularized regression was significantly lower. Our results provide insight into powerful analysis strategies that utilize information on species counts from large microbiome data sets exhibiting skewed frequency distributions obtained on a small to moderate number of samples. PMID:26734061

The impact of emphysema on dosimetric parameters for stereotactic body radiotherapy of the lung

PubMed Central

Ochiai, Satoru; Nomoto, Yoshihito; Yamashita, Yasufumi; Inoue, Tomoki; Murashima, Shuuichi; Hasegawa, Daisuke; Kurita, Yoshie; Watanabe, Yui; Toyomasu, Yutaka; Kawamura, Tomoko; Takada, Akinori; Noriko; Kobayashi, Shigeki; Sakuma, Hajime

2016-01-01

The purpose of this study was to evaluate the impact of emphysematous changes in lung on dosimetric parameters in stereotactic body radiation therapy (SBRT) for lung tumor. A total of 72 treatment plans were reviewed, and dosimetric factors [including homogeneity index (HI) and conformity index (CI)] were evaluated. Emphysematous changes in lung were observed in 43 patients (60%). Patients were divided into three groups according to the severity of emphysema: no emphysema (n = 29), mild emphysema (n = 22) and moderate to severe emphysema groups (n = 21). The HI (P < 0.001) and the CI (P = 0.029) were significantly different in accordance with the severity of emphysema in one-way analysis of variance (ANOVA). The HI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema (Tukey, P < 0.001) and mild emphysema groups (P = 0.002). The CI value was significantly higher in the moderate to severe emphysema group compared with in the no emphysema group (P = 0.044). In multiple linear regression analysis, the severity of emphysema (P < 0.001) and the mean material density of the lung within the PTV (P < 0.001) were significant factors for HI, and the mean density of the lung within the PTV (P = 0.005) was the only significant factor for CI. The mean density of the lung within the PTV was significantly different in accordance with the severity of emphysema (one-way ANOVA, P = 0.008) and the severity of emphysema (P < 0.001) was one of the significant factors for the density of the lung within the PTV in multiple linear regression analysis. Our results suggest that emphysematous changes in the lung significantly impact on several dosimetric parameters in SBRT, and they should be carefully evaluated before treatment planning. PMID:27380802

The association of lung function and St. George's respiratory questionnaire with exacerbations in COPD: a systematic literature review and regression analysis.

PubMed

Martin, Amber L; Marvel, Jessica; Fahrbach, Kyle; Cadarette, Sarah M; Wilcox, Teresa K; Donohue, James F

2016-04-16

This study investigated the relationship between changes in lung function (as measured by forced expiratory volume in one second [FEV1]) and the St. George's Respiratory Questionnaire (SGRQ) and economically significant outcomes of exacerbations and health resource utilization, with an aim to provide insight into whether the effects of COPD treatment on lung function and health status relate to a reduced risk for exacerbations. A systematic literature review was conducted in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials of adult COPD patients published in English since 2002 in order to relate mean change in FEV1 and SGRQ total score to exacerbations and hospitalizations. These predictor/outcome pairs were analyzed using sample-size weighted regression analyses, which estimated a regression slope relating the two treatment effects, as well as a confidence interval and a test of statistical significance. Sixty-seven trials were included in the analysis. Significant relationships were seen between: FEV1 and any exacerbation (time to first exacerbation or patients with at least one exacerbation, p = 0.001); between FEV1 and moderate-to-severe exacerbations (time to first exacerbation, patients with at least one exacerbation, or annualized rate, p = 0.045); between SGRQ score and any exacerbation (time to first exacerbation or patients with at least one exacerbation, p = 0.0002) and between SGRQ score and moderate-to-severe exacerbations (time to first exacerbation or patients with at least one exacerbation, p = 0.0279; annualized rate, p = 0.0024). Relationships between FEV1 or SGRQ score and annualized exacerbation rate for any exacerbation or hospitalized exacerbations were not significant. The regression analysis demonstrated a significant association between improvements in FEV1 and SGRQ score and lower risk for COPD exacerbations. Even in cases of non-significant relationships, results were in the expected direction with few exceptions. The results of this analysis offer health care providers and payers a broader picture of the relationship between exacerbations and mean change in FEV1 as well as SGRQ score, and will help inform clinical and formulary-making decisions while stimulating new research questions for future prospective studies.

Teacher psychological needs, locus of control and engagement.

PubMed

Betoret, Fernando Doménech

2013-01-01

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

[The substitution effect of leadership substitutes for transformational leadership in nursing organization].

PubMed

Kim, Jeong-Hee

2006-04-01

This paper was conducted to examine the effects of transformational leadership behaviors, within the substitutes for leadership model (Kerr & Jermier, 1978). Data was collected from 181 staff nurses in 3 general hospitals, with self-reporting questionnaires (MLQ developed by Bass, rd-SLS developed by Podsakoff, et al., and MSQ developed by Weiss, et al.). Descriptive statistics, factor analysis, Cronbach's alpha and moderated regression analysis were used. 1) The transformational leader behaviors and substitutes for leadership each had correlations with job satisfaction. 2) The total amount of variance accounted for by the substitutes for leadership was substantially greater than by the transformational leadership behaviors. 3) Few of the substitutes variables moderated the relationships between the transformational leader behaviors and job satisfaction in a manner consistent with that specified by Howell, Dorfman, and Kerr (1986). The finding of this study suggest that leaders need to have a better understanding of those contextual variables that influence job satisfaction. Thus future research should focus attention on the moderating effects of substitutes, as well as the things that leaders can do to influence them. In addition, it may be good to examine the effects of substitutes on other criterion variables.

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

PubMed

Wang, Jingting; Shen, Nanping; Zhang, Xiaoyan; Shen, Min; Xie, Anwei; Howell, Doris; Yuan, Changrong

2017-12-01

Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

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

DOT National Transportation Integrated Search

1991-07-01

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

The Theory of Planned Behaviour and dietary patterns: A systematic review and meta-analysis.

PubMed

McDermott, M S; Oliver, M; Simnadis, T; Beck, E J; Coltman, T; Iverson, D; Caputi, P; Sharma, R

2015-12-01

Promoting adherence to healthy dietary patterns is a critical public health issue. Models of behaviour, such as the Theory of Planned Behaviour (TPB) allow programme designers to identify antecedents of dietary patterns and design effective interventions. The primary aim of this study was to examine the association between TPB variables and dietary patterns. A systematic literature search was conducted to identify relevant studies. Random-effects meta-analysis was used to calculate average correlations. Meta-regression was used to test the impact of moderator variables. In total, 22 reports met the inclusion criteria. Attitudes had the strongest association with intention (r+=0.61) followed by perceived behavioural control (PBC, r+=0.46) and subjective norm (r+=0.35). The association between intention and behaviour was r+=0.47, and between PBC and behaviour r+=0.32. Moderator analyses revealed that younger participants had stronger PBC-behaviour associations than older participants had, and studies recording participants' perceptions of behaviour reported significantly higher intention-behaviour associations than did those using less subjective measures. TPB variables were found to have medium to large associations with both intention and behaviour that were robust to the influence of key moderators. Recommendations for future research include further examination of the moderation of TPB variables by age and gender and the use of more valid measures of eating behaviour. Copyright © 2015 Elsevier Inc. All rights reserved.

Hearing Impairment and Incident Dementia: Findings from the English Longitudinal Study of Ageing.

PubMed

Davies, Hilary R; Cadar, Dorina; Herbert, Annie; Orrell, Martin; Steptoe, Andrew

2017-09-01

To determine whether hearing loss is associated with incident physician-diagnosed dementia in a representative sample. Retrospective cohort study. English Longitudinal Study of Ageing. Adults aged 50 and older. Cross-sectional associations between self-reported (n = 7,865) and objective hearing measures (n = 6,902) and dementia were examined using multinomial-logistic regression. The longitudinal association between self-reported hearing at Wave 2 (2004/05) and cumulative physician-diagnosed dementia up to Wave 7 (2014/15) was modelled using Cox proportional hazards regression. After adjustment for potential confounders, in cross-sectional analysis, participants who had self-reported or objective moderate and poor hearing were more likely to have a dementia diagnosis than those with normal hearing (self-reported: odds ratio OR = 1.6, 95% CI = 1.1-2.4 moderate hearing; OR = 2.6, 95% CI = 1.7-3.9 poor hearing, objective: OR = 1.6, 95% CI = 1.0-2.8 moderate hearing; OR = 4.4, 95% CI = 1.9-9.9 poor hearing). Longitudinally, the hazard of developing dementia was 1.4 (95% CI = 1.0-1.9) times as high in individuals who reported moderate hearing and 1.6 (95% CI = 1.1-2.0) times as high in those who reported poor hearing. Older adults with hearing loss are at greater risk of dementia than those with normal hearing. These findings are consistent with the rationale that correction of hearing loss could help delay the onset of dementia, or that hearing loss itself could serve as a risk indicator for cognitive decline. © 2017, The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D.

PubMed

Huang, Rui; Rao, Huiying; Shang, Jia; Chen, Hong; Li, Jun; Xie, Qing; Gao, Zhiliang; Wang, Lei; Wei, Jia; Jiang, Jianning; Sun, Jian; Jiang, Jiaji; Wei, Lai

2018-06-15

Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = - 0.134; 2000-4999 RMB, β = - 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.090), disease profile (cirrhosis, β = - 0.114), hyperlipidemia (β = - 0.065) and depression (β = - 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = - 0.129; 2000-4999 RMB, β = - 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.091), disease profile and depression (β = - 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL. ClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.

Association between Caregiving, Meaning in Life, and Life Satisfaction beyond 50 in an Asian Sample: Age as a Moderator

ERIC Educational Resources Information Center

Ang, Rebecca P.; O, Jiaqing

2012-01-01

The association between caregiving, meaning in life, and life satisfaction was examined in sample of 519 older Asian adults beyond 50 years of age. Two hierarchical multiple regression analyses were conducted to examine age as moderator of the associations between caregiving, meaning in life, and life satisfaction. Age moderated the association…

Nutritional status of under-five children in Bangladesh: a multilevel analysis.

PubMed

Alom, Jahangir; Quddus, Md Abdul; Islam, Mohammad Amirul

2012-09-01

The nutritional status of under-five children is a sensitive sign of a country's health status as well as economic condition. This study investigated the differential impact of some demographic, socioeconomic, environmental and health-related factors on the nutritional status among under-five children in Bangladesh using Bangladesh Demographic and Health Survey 2007 data. Two-level random intercept binary logistic regression models were used to identify the determinants of under-five malnutrition. The analyses revealed that 16% of the children were severely stunted and 25% were moderately stunted. Among the children under five years of age 3% were severely wasted and 14% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The main contributing factors for under-five malnutrition were found to be child's age, mother's education, father's education, father's occupation, family wealth index, currently breast-feeding, place of delivery and division. Significant community-level variations were found in the analyses.

Parenting styles and hormone levels as predictors of physical and indirect aggression in boys and girls.

PubMed

Pascual-Sagastizabal, Eider; Azurmendi, Aitziber; Braza, Francisco; Vergara, Ana I; Cardas, Jaione; Sánchez-Martín, José R

2014-01-01

This study examines the relationship between parenting style, androgen levels, and measures of physical and indirect aggression. Peer ratings of aggression were obtained from 159 eight-year-old children (89 boys and 70 girls). Parenting styles (authoritative, authoritarian or permissive) were assessed using the Parenting Styles and Dimensions Questionnaire (PSDQ).Saliva samples were obtained from children and assayed for testosterone and androstenedione concentrations. A regression analysis revealed that high testosterone levels were associated with a higher level of physical aggression in boys with authoritarian mothers. Testosterone was also found to moderate the relationship between father's authoritarian parenting and physical aggression in girls, with both moderate and high levels being significant. In relation to indirect aggression, moderate and high levels of testosterone were associated with higher levels of this type of aggression in girls with permissive mothers. Our results highlight the importance of taking into account the interaction of biological and psychosocial variables when investigating aggressive behavior. © 2014 Wiley Periodicals, Inc.

Work satisfaction and posttraumatic growth 1 year after the 2008 Wenchuan earthquake: the perceived stress as a moderating factor.

PubMed

Xu, Jiuping; Wu, Wei

2014-06-01

This study investigated the role of perceived stress as a possible moderating factor between posttraumatic growth (PTG) and work satisfaction. A stratified random sampling strategy was used to survey 2080 adult survivors of the 2008 Sichuan earthquake. The Posttraumatic Growth Inventory, the Job Satisfaction Index Scale and the Perceived Stress Scale were used in the assessment of the posttraumatic growth, work satisfaction and perceived stress respectively, and hierarchical multiple regression analyses were used for the analysis. The findings highlight work satisfaction as an important factor in both the prediction of posttraumatic growth and for its moderating effect on perceived stress. Some demographic characteristics, such as gender, education level, and housing condition were found to also affect the survivors' posttraumatic growth. This conclusion indicates that managers should pay closer attention to their employees' psychological state after a disaster and medical practitioners should consider survivors' work status and perceived stress when dispensing mental health care. Copyright © 2014 Elsevier Inc. All rights reserved.

Insight into mental illness, self-stigma, and the family burden of parents of persons with a severe mental illness.

PubMed

Hasson-Ohayon, Ilanit; Levy, Itamar; Kravetz, Shlomo; Vollanski-Narkis, Adi; Roe, David

2011-01-01

Parents of persons with severe mental illness (SMI) often experience burden due to the illness of their daughter or son. In the present study, the possibility that parents' self-stigma moderates the relationship between the parents' insight into a daughter's or son's illness and the parents' sense of burden was investigated. Levels of insight into a daughter's or son's mental illness, parent self-stigma, and parent burden of 127 parents of persons with an SMI were assessed. Regression analysis was used to test the putative moderating role of parents' self-stigma. Self-stigma was found to mediate rather than moderate the relationship between insight and burden. Accordingly, parent insight into the mental illness of a daughter or son appears to increase parent burden because it increases parent self-stigma. The implications of these findings for practice, theory, and future research are discussed. © 2011 Elsevier Inc. All rights reserved.

Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity.

PubMed

Hill, Trenesha L; Gray, Sarah A O; Kamps, Jodi L; Enrique Varela, R

2015-12-01

The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive functioning. For younger children with lower intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Similarly, for older children with higher intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Analyses by subscales suggest that this pattern is driven by the Conceptual subscale. Clinical and research implications are discussed.

Personality and the occupational stressor-strain relationship: the role of the Big Five.

PubMed

Grant, Sharon; Langan-Fox, Janice

2007-01-01

The role of the Big Five traits in the occupational stressor-strain relationship was investigated among 211 managers. Direct, mediated, and moderated effect models were used to investigate whether the Big Five affect strain directly (independently of stress), indirectly (via stress and coping), or interactively with stress. Personality, stress, coping, and strain variables were measured and analyzed with path analysis and hierarchical regression. The Neuroticism-physical strain relationship was partially mediated by perceived role conflict and substance use, and the Neuroticism-psychological strain relationship was mediated by perceived stress. Extraversion had a direct, positive effect on physical and psychological strain, and there was preliminary support for a moderating role of Conscientiousness in the perceived stressor-strain relationship. Agreeableness and Openness were unrelated to strain. (c) 2007 APA, all rights reserved.

Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity

PubMed Central

Hill, Trenesha L.; Gray, Sarah A. O.; Kamps, Jodi L.; Varela, R. Enrique

2016-01-01

The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive functioning. For younger children with lower intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Similarly, for older children with higher intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Analyses by subscales suggest that this pattern is driven by the Conceptual subscale. Clinical and research implications are discussed. PMID:26174048

Adult depression screening in Saudi primary care: prevalence, instrument and cost

PubMed Central

2014-01-01

Background By the year 2020 depression would be the second major cause of disability adjusted life years lost, as reported by the World Health Organization. Depression is a mental illness which causes persistent low mood, a sense of despair, and has multiple risk factors. Its prevalence in primary care varies between 15.3-22%, with global prevalence up to 13% and between 17-46% in Saudi Arabia. Despite several studies that have shown benefit of early diagnosis and cost-savings of up to 80%, physicians in primary care setting continue to miss out on 30-50% of depressed patients in their practices. Methods A cross sectional study was conducted at three large primary care centers in Riyadh, Saudi Arabia aiming at estimating point prevalence of depression and screening cost among primary care adult patients, and comparing Patient Health Questionnaires PHQ-2 with PHQ-9. Adult individuals were screened using Arabic version of PHQ-2 and PHQ-9. PHQ-2 scores were correlated with PHQ-9 scores using linear regression. A limited cost-analysis and cost saving estimates of depression screening was done using the Human Capital approach. Results Patients included in the survey analysis were 477, of whom 66.2% were females, 77.4% were married, and nearly 20% were illiterate. Patients exhibiting depressive symptoms on the basis of PHQ9 were 49.9%, of which 31% were mild, 13.4% moderate, 4.4% moderate-severe and 1.0% severe cases. Depression scores were significantly associated with female gender (p-value 0.049), and higher educational level (p-value 0.002). Regression analysis showed that PHQ-2 & PHQ-9 were strongly correlated R = 0.79, and R2 = 0.62. The cost-analysis showed savings of up to 500 SAR ($133) per adult patient screened once a year. Conclusion The point prevalence of screened depression is high in primary care visitors in Saudi Arabia. Gender and higher level of education were found to be significantly associated with screened depression. Majority of cases were mild to moderate, PHQ-2 was equivocal to PHQ 9 in utility and that screening for depression in primary care setting is cost saving. PMID:24992932

Predictive factors for moderate or severe exacerbations in asthma patients receiving outpatient care.

PubMed

Gutiérrez, Francisco Javier Álvarez; Galván, Marta Ferrer; Gallardo, Juan Francisco Medina; Mancera, Marta Barrera; Romero, Beatriz Romero; Falcón, Auxiliadora Romero

2017-05-02

Asthma exacerbations are important events that affect disease control, but predictive factors for severe or moderate exacerbations are not known. The objective was to study the predictive factors for moderate (ME) and severe (SE) exacerbations in asthma patients receiving outpatient care. Patients aged > 12 years with asthma were included in the study and followed-up at 4-monthly intervals over a 12-month period. Clinical (severity, level of control, asthma control test [ACT]), atopic, functional, inflammatory, SE and ME parameters were recorded. Univariate analysis was used to compare data from patients presenting at least 1 SE or ME during the follow-up period vs no exacerbations. Statistically significant (p <0.1) factors were then subjected to multiple analysis by binary logistic regression. A total of 330 patients completed the study, most of whom were atopic (76%), women (nearly 70%), with moderate and mild persistent asthma (>80%). Twenty-seven patients (8%) had a SE and 183 had a ME (58.5%) during follow-up. In the case of SEs, the only predictive factor identified in the multiple analysis was previous SE (baseline visit OR 4.218 95% CI 1.53-11.58, 4-month follow-up OR 6.88 95% CI 2.018-23.51) and inhalation technique (OR 3.572 95% CI 1.324-9.638). In the case of MEs, the only predictive factor found in the multiple analysis were previous ME (baseline visit OR 2.90 95% CI 1.54-5.48, 4-month follow- up OR 1.702 95% CI 1.146-2.529). The primary predictive factor for SE or ME is prior SE or ME, respectively. SEs seem to constitute a specific patient "phenotype", in which the sole predictive factor is prior SEs.

Caregiver Ratings of Long-term Executive Dysfunction and Attention Problems After Early Childhood Traumatic Brain Injury: Family Functioning Is Important

PubMed Central

Kurowski, Brad G.; Taylor, H. Gerry; Yeates, Keith Owen; Walz, Nicolay C.; Stancin, Terry; Wade, Shari L.

2013-01-01

Objective To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. Design A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Setting Three tertiary academic children’s hospital medical centers and one general medical center. Participants Children, ages 3–7 years, hospitalized for OI, moderate TBI, or severe TBI. Methods and Outcome Measurements Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children’s executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25–63 months). Analysis Group comparisons were conducted with use of t-tests, χ2 analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Results Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Conclusions Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood TBI could help target future interventions. PMID:21944301

Objectively assessed moderate-to-vigorous physical activity levels among primary school children in Norway: The Health Oriented Pedagogical Project (HOPP).

PubMed

Deng, Wei Hai; Fredriksen, Per Morten

2018-05-01

The objective was to investigate moderate-to-vigorous physical activity levels (MVPA) of primary school children at baseline of the Health Oriented Pedagogical Project (HOPP), Norway. Data on 2123 children aged 6-12 years were included for analysis (75% participation rate). Average minutes per day in MVPA was objectively measured using accelerometry based on seven-day averages. The sample was analysed for age-, sex-, socioeconomic-, and season-related patterns. A linear regression investigated the moderating effect of these factors as well as body mass index and waist circumference. Some 86.5% of the sample had at least 60 min/day MVPA, averaging 90.7 min/day. The main differences in daily averages were between age groups 6½-9 and 10-12 ( p < .05). Boys (95.8 min/day, 95% CI: 94.1-97.5) were more active than girls (85.6 min/day, 95% CI: 83.9-87.2) in all age groups ( p < .0001). MVPA was lower by 3.5 min ( p < .0001) per additional year of age in the linear regression (R 2 = 0.176) and was reduced by 20 min less per day in MVPA in the winter months compared with the summer months ( p < .0001). Physical activity levels are already in decline from 6-7 years old and are likely to continue to decline into adolescence. Interventions must therefore focus on primary school children.

Treatment with GLP1 receptor agonists reduce serum CRP concentrations in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.

PubMed

Mazidi, Mohsen; Karimi, Ehsan; Rezaie, Peyman; Ferns, Gordon A

2017-07-01

To undertake a systematic review and meta-analysis of randomized controlled trials of the effect of glucagon-like peptide-1 receptor agonist (GLP-1 RAs) therapy on serum C-reactive protein (CRP) concentrations. PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched for the period up until March 16, 2016. Prospective studies evaluating the impact of GLP-1 RAs on serum CRP were identified. A random effects model (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I 2 index. Random effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential moderator. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016036868. Meta-analysis of the data from 7 treatment arms revealed a significant reduction in serum CRP concentrations following treatment with GLP-1 RAs (WMD -2.14 (mg/dL), 95% CI -3.51, -0.78, P=0.002; I 2 96.1%). Removal of one study in the meta-analysis did not change the result in the sensitivity analysis (WMD -2.14 (mg/dL), 95% CI -3.51, -0.78, P=0.002; I 2 96.1%), indicating that our results could not be solely attributed to the effect of a single study. Random effects meta-regression was performed to evaluate the impact of potential moderator on the estimated effect size. Changes in serum CRP concentration were associated with the duration of treatment (slope -0.097, 95% CI -0.158, -0.042, P<0.001). This meta-analysis suggests that GLP-1 RAs therapy causes a significant reduction in CRP. Copyright © 2016 Elsevier Inc. All rights reserved.

Frequency of leisure activities and depressive symptomatology in elderly people: the moderating role of rumination.

PubMed

Fernández-Fernández, Virginia; Márquez-González, María; Losada-Baltar, Andrés; Romero-Moreno, Rosa

2014-02-01

The positive effects of leisure activities on depressive symptomatology are well known. However, the extent to which emotional regulation variables moderate that relationship has scarcely been studied, especially in older people. The aim of this study is to analyze the moderating role of rumination in the relation between leisure activities and depressive symptoms. Participants in this study were 311 people, aged 60 to 90 years (mean age: 71.27 years; SD: 6.99; 71.7% women). We evaluated depressive symptomatology, frequency of leisure activities, and rumination. We carried out a hierarchical regression analysis to confirm the moderating role of rumination. We obtained a model that explains 39.4% of the variance of depressive symptomatology. Main effects were found for the frequency of leisure activities (β = -0.397; p < 0.01) and for rumination (β = 0.497; p < 0.01). Moreover, we found a significant effect of the interaction between frequency of leisure activities and rumination (β = 0.110; p < 0.05), suggesting that rumination plays a moderating role in the relation between leisure activities and depressive symptomatology. A risk profile of elderly people may consist of those who engage in low levels of leisure activities but also use more frequently the dysfunctional emotional regulation strategy of rumination.

Feeding style differences in food parenting practices associated with fruit and vegetable intake in children from low-income families.

PubMed

Papaioannou, Maria A; Cross, Matthew B; Power, Thomas G; Liu, Yan; Qu, Haiyan; Shewchuk, Richard M; Hughes, Sheryl O

2013-01-01

To examine the moderating effects of feeding styles on the relationship between food parenting practices and fruit and vegetable (F & V) intake in low-income families with preschool-aged children. Focus group meetings with Head Start parents were conducted by using the nominal group technique. Parents completed information on food parenting practices and feeding styles. Three dietary recalls were collected on each child. Parents completed measures in Head Start centers and/or over the telephone. 667 parents of preschool-aged children participated. Food parenting practices and F & V intake. Mean differences in the food parenting practices across the 4 feeding styles were established through multivariate general linear modeling using MANOVA. Moderated multiple regression analysis was conducted to examine the moderating role of feeding style on food parenting practices and child F & V intake. The indulgent feeding style moderated the relationship between food parenting practices and child F & V intake. This study indicates that parents' feeding styles have a moderating effect on the relationship between the food parenting practices and children's F & V intake. This finding can facilitate the development of interventions aimed at reducing childhood overweight. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: predictors of latent class membership.

PubMed

Rosellini, Anthony J; Coffey, Scott F; Tracy, Melissa; Galea, Sandro

2014-01-01

The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Person-Centered Analysis of Posttraumatic Stress Disorder Symptoms Following a Natural Disaster: Predictors of Latent Class Membership

PubMed Central

Rosellini, Anthony J.; Coffey, Scott F.; Tracy, Melissa; Galea, Sandro

2014-01-01

The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs. PMID:24334161

Digital Games, Design, and Learning: A Systematic Review and Meta-Analysis.

PubMed

Clark, Douglas B; Tanner-Smith, Emily E; Killingsworth, Stephen S

2016-03-01

In this meta-analysis, we systematically reviewed research on digital games and learning for K-16 students. We synthesized comparisons of game versus nongame conditions (i.e., media comparisons) and comparisons of augmented games versus standard game designs (i.e., value-added comparisons). We used random-effects meta-regression models with robust variance estimates to summarize overall effects and explore potential moderator effects. Results from media comparisons indicated that digital games significantly enhanced student learning relative to nongame conditions ([Formula: see text] = 0.33, 95% confidence interval [0.19, 0.48], k = 57, n = 209). Results from value-added comparisons indicated significant learning benefits associated with augmented game designs ([Formula: see text] = 0.34, 95% confidence interval [0.17, 0.51], k = 20, n = 40). Moderator analyses demonstrated that effects varied across various game mechanics characteristics, visual and narrative characteristics, and research quality characteristics. Taken together, the results highlight the affordances of games for learning as well as the key role of design beyond medium.

Latent Profiles of Macronutrient Density and their Association with Mobility Limitations in an Observational Longitudinal Study of Older U.S. Adults.

PubMed

Bishop, N J; Zuniga, K E; Lucht, A L

2018-01-01

Our first objective was to estimate empirically-derived subgroups (latent profiles) of observed carbohydrate, protein, and fat intake density in a nationally representative sample of older U.S. adults. Our second objective was to determine whether membership in these groups was associated with levels of, and short term change in, physical mobility limitations. Measures of macronutrient density were taken from the 2013 Health Care and Nutrition Study, an off-year supplement to the Health and Retirement Study, which provided indicators of physical mobility limitations and sociodemographic and health-related covariates. 3,914 community-dwelling adults age 65 years and older. Percent of daily calories from carbohydrate, protein, and fat were calculated based on responses to a modified Harvard food frequency questionnaire. Latent profile analysis was used to describe unobserved heterogeneity in measures of carbohydrate, protein, and fat density. Mobility limitation counts were based on responses to 11 items indicating physical limitations. Poisson regression models with autoregressive controls were used to identify associations between macronutrient density profile membership and mobility limitations. Sociodemographic and health-related covariates were included in all Poisson regression models. Four latent subgroups of macronutrient density were identified: "High Carbohydrate", "Moderate with Fat", "Moderate", and "Low Carbohydrate/High Fat". Older adults with the lowest percentage of daily calories coming from carbohydrate and the greatest percentage coming from fat ("Low Carbohydrate/High Fat") were found to have greater reported mobility limitations in 2014 than those identified as having moderate macronutrient density, and more rapid two-year increases in mobility limitations than those identified as "Moderate with Fat" or "Moderate". Older adults identified as having the lowest carbohydrate and highest fat energy density were more likely to report a greater number of mobility limitations and experience greater increases in these limitations than those identified as having moderate macronutrient density. These results suggest that the interrelation of macronutrients must be considered by those seeking to reduce functional limitations among older adults through dietary interventions.

Transient elastography compared to liver biopsy and morphometry for predicting fibrosis in pediatric chronic liver disease: Does etiology matter?

PubMed Central

Behairy, Behairy El-Sayed; Sira, Mostafa Mohamed; Zalata, Khaled Refat; Salama, El-Sayed Ebrahem; Abd-Allah, Mohamed Ahmed

2016-01-01

AIM: To evaluate transient elastography (TE) as a noninvasive tool in staging liver fibrosis compared with liver biopsy and morphometry in children with different chronic liver diseases. METHODS: A total of 90 children [50 with chronic hepatitis C virus (HCV), 20 with autoimmune hepatitis (AIH) and 20 with Wilson disease] were included in the study and underwent liver stiffness measurement (LSM) using TE. Liver biopsies were evaluated for fibrosis, qualitatively, by Ishak score and quantitatively by fibrosis area fraction (FAF) using digital image analysis (morphometry). LSM was correlated with fibrosis and other studied variables using spearman correlation. A stepwise multiple regression analysis was also performed to examine independent factors associated with LSM. Different cut-off values of LSM were calculated for predicting individual fibrosis stages using receiver-operating characteristic curve. Cut-off values with optimal clinical performance (optimal sensitivity and specificity simultaneously) were selected. RESULTS: The majority of HCV group had minimal activity (80%) and no/mild fibrosis (72%). On the other hand, the majority of AIH group had mild to moderate activity (70%) and moderate to severe fibrosis (95%) and all Wilson disease group had mild to moderate activity (100%) and moderate to severe fibrosis (100%). LSM correlated significantly with both FAF and Ishak scores and the correlation appeared better with the latter (r = 0.839 vs 0.879, P < 0.0001 for both). LSM discriminated individual stages of fibrosis with high performance. Sensitivity ranged from 81.4% to 100% and specificity ranged from 75.0% to 97.2%. When we compared LSM values for the same stage of fibrosis, they varied according to the different etiologies. Higher values were in AIH (16.15 ± 7.23 kPa) compared to Wilson disease (8.30 ± 0.84 kPa) and HCV groups (7.43 ± 1.73 kPa). Multiple regression analysis revealed that Ishak fibrosis stage was the only independent variable associated with higher LSM (P < 0.0001). CONCLUSION: TE appears reliable in distinguishing different stages of liver fibrosis in children. However, its values vary according to the disease type. For that, a disease-specific estimation of cut-off values for fibrosis staging is worthy. PMID:27122674

[Risk factors for iron deficiency anemia in infants aged 6 to 12 months and its effects on neuropsychological development].

PubMed

Xu, Kang; Zhang, Cui-Mei; Huang, Lian-Hong; Fu, Si-Mao; Liu, Yu-Ling; Chen, Ang; Ou, Jun-Bin

2015-08-01

To study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants. A total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament. The univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (P<0.05). Setting the mild IDA group as control, the multivariate logistic regression analysis showed that multiple birth, premature birth, low birth weight (<2500 g), maternal anemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR>1; P<0.05); premature birth, breast feeding, and mixed feeding were the risk factors for moderate IDA (OR>1; P<0.05). The IDA group had significantly lower scores in Gesell general development quotient, gross motor, adaptive behavior, and fine motor than the control group (P<0.05). The IDA group had higher percentages of children with difficulty and intermediate difficulty temperaments than the control group (P<0.05). The IDA group had significantly higher scores in activity level, rhythmicity, adaptability, and perseverance than the control group (P<0.05). The severity of IDA is associated with premature birth, multiple birth, low birth weight, feeding pattern, maternal anemia during pregnancy and mother's lack of knowledge about IDA in infants aged 6-12 months. Infants with IDA have delayed neuromotor development and most of them have negative temperaments. More attention should be paid to mental and behavior problems for the infants. It is necessary to provide guidance for their parents in feeding and education.

Comparative study of Poincaré plot analysis using short electroencephalogram signals during anaesthesia with spectral edge frequency 95 and bispectral index.

PubMed

Hayashi, K; Yamada, T; Sawa, T

2015-03-01

The return or Poincaré plot is a non-linear analytical approach in a two-dimensional plane, where a timed signal is plotted against itself after a time delay. Its scatter pattern reflects the randomness and variability in the signals. Quantification of a Poincaré plot of the electroencephalogram has potential to determine anaesthesia depth. We quantified the degree of dispersion (i.e. standard deviation, SD) along the diagonal line of the electroencephalogram-Poincaré plot (named as SD1/SD2), and compared SD1/SD2 values with spectral edge frequency 95 (SEF95) and bispectral index values. The regression analysis showed a tight linear regression equation with a coefficient of determination (R(2) ) value of 0.904 (p < 0.0001) between the Poincaré index (SD1/SD2) and SEF95, and a moderate linear regression equation between SD1/SD2 and bispectral index (R(2)  = 0.346, p < 0.0001). Quantification of the Poincaré plot tightly correlates with SEF95, reflecting anaesthesia-dependent changes in electroencephalogram oscillation. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Test anxiety and academic performance in chiropractic students.

PubMed

Zhang, Niu; Henderson, Charles N R

2014-01-01

Objective : We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods : We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results : Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion : Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs.

Planning performance in schizophrenia patients: a meta-analysis of the influence of task difficulty and clinical and sociodemographic variables.

PubMed

Knapp, F; Viechtbauer, W; Leonhart, R; Nitschke, K; Kaller, C P

2017-08-01

Despite a large body of research on planning performance in adult schizophrenia patients, results of individual studies are equivocal, suggesting either no, moderate or severe planning deficits. This meta-analysis therefore aimed to quantify planning deficits in schizophrenia and to examine potential sources of the heterogeneity seen in the literature. The meta-analysis comprised outcomes of planning accuracy of 1377 schizophrenia patients and 1477 healthy controls from 31 different studies which assessed planning performance using tower tasks such as the Tower of London, the Tower of Hanoi and the Stockings of Cambridge. A meta-regression analysis was applied to assess the influence of potential moderator variables (i.e. sociodemographic and clinical variables as well as task difficulty). The findings indeed demonstrated a planning deficit in schizophrenia patients (mean effect size: ; 95% confidence interval 0.56-0.78) that was moderated by task difficulty in terms of the minimum number of moves required for a solution. The results did not reveal any significant relationship between the extent of planning deficits and sociodemographic or clinical variables. The current results provide first meta-analytic evidence for the commonly assumed impairments of planning performance in schizophrenia. Deficits are more likely to become manifest in problem items with higher demands on planning ahead, which may at least partly explain the heterogeneity of previous findings. As only a small fraction of studies reported coherent information on sample characteristics, future meta-analyses would benefit from more systematic reports on those variables.

2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Adult Dermatomyositis and Polymyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative.

PubMed

Aggarwal, Rohit; Rider, Lisa G; Ruperto, Nicolino; Bayat, Nastaran; Erman, Brian; Feldman, Brian M; Oddis, Chester V; Amato, Anthony A; Chinoy, Hector; Cooper, Robert G; Dastmalchi, Maryam; Fiorentino, David; Isenberg, David; Katz, James D; Mammen, Andrew; de Visser, Marianne; Ytterberg, Steven R; Lundberg, Ingrid E; Chung, Lorinda; Danko, Katalin; García-De la Torre, Ignacio; Song, Yeong Wook; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A; Miller, Frederick W; Vencovsky, Jiri

2017-05-01

To develop response criteria for adult dermatomyositis (DM) and polymyositis (PM). Expert surveys, logistic regression, and conjoint analysis were used to develop 287 definitions using core set measures. Myositis experts rated greater improvement among multiple pairwise scenarios in conjoint analysis surveys, where different levels of improvement in 2 core set measures were presented. The PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) method determined the relative weights of core set measures and conjoint analysis definitions. The performance characteristics of the definitions were evaluated on patient profiles using expert consensus (gold standard) and were validated using data from a clinical trial. The nominal group technique was used to reach consensus. Consensus was reached for a conjoint analysis-based continuous model using absolute percent change in core set measures (physician, patient, and extramuscular global activity, muscle strength, Health Assessment Questionnaire, and muscle enzyme levels). A total improvement score (range 0-100), determined by summing scores for each core set measure, was based on improvement in and relative weight of each core set measure. Thresholds for minimal, moderate, and major improvement were ≥20, ≥40, and ≥60 points in the total improvement score. The same criteria were chosen for juvenile DM, with different improvement thresholds. Sensitivity and specificity in DM/PM patient cohorts were 85% and 92%, 90% and 96%, and 92% and 98% for minimal, moderate, and major improvement, respectively. Definitions were validated in the clinical trial analysis for differentiating the physician rating of improvement (P < 0.001). The response criteria for adult DM/PM consisted of the conjoint analysis model based on absolute percent change in 6 core set measures, with thresholds for minimal, moderate, and major improvement. © 2017, American College of Rheumatology.

Censored quantile regression with recursive partitioning-based weights

PubMed Central

Wey, Andrew; Wang, Lan; Rudser, Kyle

2014-01-01

Censored quantile regression provides a useful alternative to the Cox proportional hazards model for analyzing survival data. It directly models the conditional quantile of the survival time and hence is easy to interpret. Moreover, it relaxes the proportionality constraint on the hazard function associated with the popular Cox model and is natural for modeling heterogeneity of the data. Recently, Wang and Wang (2009. Locally weighted censored quantile regression. Journal of the American Statistical Association 103, 1117–1128) proposed a locally weighted censored quantile regression approach that allows for covariate-dependent censoring and is less restrictive than other censored quantile regression methods. However, their kernel smoothing-based weighting scheme requires all covariates to be continuous and encounters practical difficulty with even a moderate number of covariates. We propose a new weighting approach that uses recursive partitioning, e.g. survival trees, that offers greater flexibility in handling covariate-dependent censoring in moderately high dimensions and can incorporate both continuous and discrete covariates. We prove that this new weighting scheme leads to consistent estimation of the quantile regression coefficients and demonstrate its effectiveness via Monte Carlo simulations. We also illustrate the new method using a widely recognized data set from a clinical trial on primary biliary cirrhosis. PMID:23975800

Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations.

PubMed

Hayes, Andrew F; Matthes, Jörg

2009-08-01

Researchers often hypothesize moderated effects, in which the effect of an independent variable on an outcome variable depends on the value of a moderator variable. Such an effect reveals itself statistically as an interaction between the independent and moderator variables in a model of the outcome variable. When an interaction is found, it is important to probe the interaction, for theories and hypotheses often predict not just interaction but a specific pattern of effects of the focal independent variable as a function of the moderator. This article describes the familiar pick-a-point approach and the much less familiar Johnson-Neyman technique for probing interactions in linear models and introduces macros for SPSS and SAS to simplify the computations and facilitate the probing of interactions in ordinary least squares and logistic regression. A script version of the SPSS macro is also available for users who prefer a point-and-click user interface rather than command syntax.

Eating in moderation and the essential role of awareness. A Dutch longitudinal study identifying psychosocial predictors.

PubMed

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

2015-04-01

Eating in moderation, i.e. the attempt to monitor and limit the intake of energy-dense foods, is a promising strategy in the prevention of weight gain. The purpose of this study was to examine which psychosocial factors derived from the I-Change Model (ICM) were associated with eating in moderation, and whether these factors differed between adults with a correct (aware) or incorrect (unaware) perception of their dietary behaviour. This study used a longitudinal design with measurements at baseline (N = 483) and six-month follow-up (N = 379). Eating in moderation was defined as the average daily energy intake from energy-dense food products and was measured by a validated food frequency questionnaire. Linear regression analyses were used to assess the associations between the ICM factors and eating in moderation. The moderating role of awareness was examined by including interactions between awareness and the ICM factors in the regression analyses using the pick-a-point approach to further examine the associations for aware and unaware participants. Participants who were aware of their dietary behaviour had a significantly lower average daily energy intake compared to those who were unaware. Eating in moderation was predicted by awareness, risk perception, social influence and intention. Among the aware participants, eating in moderation was predicted by risk perception, attitude, social influence and intention. Among the unaware participants, only risk perception and self-efficacy were significantly associated with eating in moderation. Our findings show that psychosocial factors may only predict eating in moderation when people are aware of their risk behaviour. Therefore, interventions aimed at promoting complex behaviours, such as eating in moderation, should first focus on improving individuals' awareness of their risk behaviour before targeting motivational factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Computational tools for exact conditional logistic regression.

PubMed

Corcoran, C; Mehta, C; Patel, N; Senchaudhuri, P

Logistic regression analyses are often challenged by the inability of unconditional likelihood-based approximations to yield consistent, valid estimates and p-values for model parameters. This can be due to sparseness or separability in the data. Conditional logistic regression, though useful in such situations, can also be computationally unfeasible when the sample size or number of explanatory covariates is large. We review recent developments that allow efficient approximate conditional inference, including Monte Carlo sampling and saddlepoint approximations. We demonstrate through real examples that these methods enable the analysis of significantly larger and more complex data sets. We find in this investigation that for these moderately large data sets Monte Carlo seems a better alternative, as it provides unbiased estimates of the exact results and can be executed in less CPU time than can the single saddlepoint approximation. Moreover, the double saddlepoint approximation, while computationally the easiest to obtain, offers little practical advantage. It produces unreliable results and cannot be computed when a maximum likelihood solution does not exist. Copyright 2001 John Wiley & Sons, Ltd.

Animal models of maternal high fat diet exposure and effects on metabolism in offspring: a meta-regression analysis.

PubMed

Ribaroff, G A; Wastnedge, E; Drake, A J; Sharpe, R M; Chambers, T J G

2017-06-01

Animal models of maternal high fat diet (HFD) demonstrate perturbed offspring metabolism although the effects differ markedly between models. We assessed studies investigating metabolic parameters in the offspring of HFD fed mothers to identify factors explaining these inter-study differences. A total of 171 papers were identified, which provided data from 6047 offspring. Data were extracted regarding body weight, adiposity, glucose homeostasis and lipidaemia. Information regarding the macronutrient content of diet, species, time point of exposure and gestational weight gain were collected and utilized in meta-regression models to explore predictive factors. Publication bias was assessed using Egger's regression test. Maternal HFD exposure did not affect offspring birthweight but increased weaning weight, final bodyweight, adiposity, triglyceridaemia, cholesterolaemia and insulinaemia in both female and male offspring. Hyperglycaemia was found in female offspring only. Meta-regression analysis identified lactational HFD exposure as a key moderator. The fat content of the diet did not correlate with any outcomes. There was evidence of significant publication bias for all outcomes except birthweight. Maternal HFD exposure was associated with perturbed metabolism in offspring but between studies was not accounted for by dietary constituents, species, strain or maternal gestational weight gain. Specific weaknesses in experimental design predispose many of the results to bias. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Treatment of moderate-to-high hyperopia with the WaveLight Allegretto 400 and EX500 excimer laser systems

PubMed Central

Motwani, Manoj; Pei, Ronald

2017-01-01

Purpose To evaluate the efficacy of treating patients with +3.00 diopters (D) to +6.00 D of hyperopia via laser-assisted in situ keratomileusis (LASIK) with the WaveLight Allegretto 400 and EX500 excimer laser systems. Setting Private clinical ophthalmology practice. Patients and methods This was a retrospective study of patients undergoing LASIK treatments of +3.00 to +6.00 D on two different WaveLight laser systems: 163 eyes on the 400 (Hertz) Hz system and 54 eyes on the 500 Hz system. The duration of follow-up was 6 months postoperation. Data were evaluated for uncorrected distance visual acuity, corrected distance visual acuity (CDVA), spherical equivalents (SEQs), and changes in these parameters (eg, loss of vision, regression over time). Results Treatment with both lasers was safe and effective, with loss of one line of CDVA in four of 162 eyes using the 400 Hz laser system, and none of the 54 eyes with the 500 Hz laser system. Overall, regression ≥0.75 D from goal at 6 months was observed in 11.7% (19/163) of eyes in the 400 Hz laser group and 9.26% (5/54) of eyes in the 500 Hz laser group (regression ≥0.50 D =77.9% [127/163] and 77.8% [42/54], respectively). The mean SEQ regressions for all eyes with moderate hyperopia were 0.10 and 0.18 D for those with high hyperopia. Conclusions Both the 400 and 500 Hz excimer laser systems were safe and effective for the LASIK treatment of moderate-to-high hyperopia. The overall rate of regression was low and the amount of regression was relatively small with both systems. PMID:28579751

Determinants of work ability and its predictive value for disability.

PubMed

Alavinia, S M; de Boer, A G E M; van Duivenbooden, J C; Frings-Dresen, M H W; Burdorf, A

2009-01-01

Maintaining the ability of workers to cope with physical and psychosocial demands at work becomes increasingly important in prolonging working life. To analyse the effects of work-related factors and individual characteristics on work ability and to determine the predictive value of work ability on receiving a work-related disability pension. A longitudinal study was conducted among 850 construction workers aged 40 years and older, with average follow-up period of 23 months. Disability was defined as receiving a disability pension, granted to workers unable to continue working in their regular job. Work ability was assessed using the work ability index (WAI). Associations between work-related factors and individual characteristics with work ability at baseline were evaluated using linear regression analysis, and Cox regression analysis was used to evaluate the predictive value of work ability for disability. Work-related factors were associated with a lower work ability at baseline, but had little prognostic value for disability during follow-up. The hazard ratios for disability among workers with a moderate and poor work ability at baseline were 8 and 32, respectively. All separate scales in the WAI had predictive power for future disability with the highest influence of current work ability in relation to job demands and lowest influence of diseases diagnosed by a physician. A moderate or poor work ability was highly predictive for receiving a disability pension. Preventive measures should facilitate a good balance between work performance and health in order to prevent quitting labour participation.

Organizational resilience and enrollment trends of independent, for-profit higher education institutions.

PubMed

Frisbie, Kathryn; Converso, Judith

2016-05-24

From 2010 to 2012, the for-profit sector of higher education in the United States (otherwise known as career colleges) existed in a turbulent environment, characterized by regulatory, media, and public scrutiny. While virtually all career colleges experienced enrollment declines during this period, by 2012 some colleges were starting to see this trend stabilize or reverse, whereas others did not. The purpose of this study was to determine if the differences in career colleges' enrollment trends could be attributed to organizational resilience. A quantitative correlation study using a multiple regression analysis was conducted to determine the nature of the relationship between organizational resilience and the enrollment fluctuations of 59 career colleges located throughout the United States. The correlation between organizational resilience levels and enrollment fluctuations was fair to moderate and significant, r = 0.40, p < 0.05. A multiple-regression analysis revealed that the model significantly explained the impact of the six organizational resilience factors on enrollment fluctuations, F = 4.15, p < 0.01. The R2 for the model was 0.32, and the adjusted R2 was 0.25. In terms of individual organizational resilience factors, two tested either significantly or moderately significantly: avoidance-skepticism and critical understanding or sensemaking. Recommendations for college leaders include monitoring the level of avoidance to ensure a healthy balance of skepticism regarding new situations and incorporating strategies to help organizational members increase their levels of critical understanding or sensemaking.

High depressive symptomatology among older community-dwelling Mexican Americans: the impact of immigration.

PubMed

Gerst, Kerstin; Al-Ghatrif, Majd; Beard, Holly A; Samper-Ternent, Rafael; Markides, Kyriakos S

2010-04-01

This analysis explores nativity differences in depressive symptoms among very old (75+) community-dwelling Mexican Americans. Cross-sectional analysis using the fifth wave (2004-2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE). The sample consisted of 1699 non-institutionalized Mexican American men and women aged 75 years and above. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Logistic regression was used to predict high depressive symptoms (CES-D score 16 or higher) and multinomial logistic regression was used to predict sub-threshold, moderate, and high depressive symptoms. Results showed that elders born in Mexico had higher odds of more depressive symptoms compared to otherwise similar Mexican Americans born in the US. Age of arrival, gender, and other covariates did not modify that risk. The findings suggest that older Mexican American immigrants are at higher risk of depressive symptomatology compared to persons born in the US, which has significant implications for research, policy, and clinical practice.

Risk Factors for Developing Scoliosis in Cerebral Palsy: A Cross-Sectional Descriptive Study.

PubMed

Bertoncelli, Carlo M; Solla, Federico; Loughenbury, Peter R; Tsirikos, Athanasios I; Bertoncelli, Domenico; Rampal, Virginie

2017-06-01

This study aims to identify the risk factors leading to the development of severe scoliosis among children with cerebral palsy. A cross-sectional descriptive study of 70 children (aged 12-18 years) with severe spastic and/or dystonic cerebral palsy treated in a single specialist unit is described. Statistical analysis included Fisher exact test and logistic regression analysis to identify risk factors. Severe scoliosis is more likely to occur in patients with intractable epilepsy ( P = .008), poor gross motor functional assessment scores ( P = .018), limb spasticity ( P = .045), a history of previous hip surgery ( P = .048), and nonambulatory patients ( P = .013). Logistic regression model confirms the major risk factors are previous hip surgery ( P = .001), moderate to severe epilepsy ( P = .007), and female gender ( P = .03). History of previous hip surgery, intractable epilepsy, and female gender are predictors of developing severe scoliosis in children with cerebral palsy. This knowledge should aid in the early diagnosis of scoliosis and timely referral to specialist services.

Discrimination between stages of Alzheimer's disease with subsets of Mini-Mental State Examination items. An analysis of Consortium to Establish a Registry for Alzheimer's Disease data.

PubMed

Fillenbaum, G G; Wilkinson, W E; Welsh, K A; Mohs, R C

1994-09-01

To identify minimal sets of Mini-Mental State Examination (MMSE) items that can distinguish normal control subjects from patients with mild Alzheimer's disease (AD), patients with mild from those with moderate AD, and those with moderate from those with severe AD. Two randomly selected equivalent half samples. Results of logistic regression analysis from data from the first half of the sample were confirmed by receiver operating characteristic curves on the second half. Memory disorders clinics at major medical centers in the United States affiliated with the Consortium to establish a Registry for Alzheimer's Disease (CERAD). White, normal control subjects (n = 412) and patients with AD (n = 621) who met CERAD criteria; nonwhite subjects (n = 165) and persons with missing data (n = 27) were excluded. Three four-item sets of MMSE items that discriminate, respectively, (1) normal controls from patients with mild AD, (2) patients with mild from those with moderate AD, and (3) patients with moderate from those with severe AD. The MMSE items discriminating normal controls from patients with mild AD were day, date, recall of apple, and recall of penny; those discriminating patients with mild from those with moderate AD were month, city, spelling world backward, and county, and those discriminating patients with moderate from those with severe AD were floor of building, repeating the word table, naming watch, and folding paper in half. Performance on the first two four-item sets was comparable with that of the full MMSE; the third set distinguished patients with moderate from those with severe AD better than chance. A minimum set of MMSE items can effectively discriminate normal controls from patients with mild AD and between successive levels of severity of AD. Data apply only to white patients with AD. Performance in minorities, more heterogeneous groups, or normal subjects with questionable cognitive status has not been assessed.

Postoperative sleep-disordered breathing in patients without preoperative sleep apnea.

PubMed

Chung, Frances; Liao, Pu; Yang, Yiliang; Andrawes, Maged; Kang, Weimin; Mokhlesi, Babak; Shapiro, Colin M

2015-06-01

Recently published data show that postoperative apnea-hypopnea index (AHI) is significantly increased in some patients without preoperative sleep apnea. These patients may be at risk of developing perioperative adverse events related to sleep-disordered breathing (SDB). The objective of this study was to investigate the incidence and predictors of postoperative moderate-to-severe SDB (AHI > 15 events/h) in patients without sleep apnea preoperatively. In a prospective observational fashion, patients were invited to undergo sleep studies with a portable device (Embletta X100) preoperatively at home and postoperatively on the first and third night after surgery in the hospital or at home. The primary outcome was the incidence of postoperative moderate-to-severe SDB (AHI > 15 events/h) in non-sleep apnea patients (preoperative AHI ≤ 5 events/h). Logistic regression was used to evaluate the association of clinical factors and preoperative sleep parameters with the occurrence of postoperative moderate-to-severe SDB. A total of 120 non-sleep apnea patients completed the study, of which 31 (25.8% [95% confidence interval: 18.3%-34.6%]) patients were found to have AHI > 15 events/h on postoperative night 1 and/or postoperative night 3 (postoperative SDB group), and 89 (74%) patients had an AHI ≤ 15 events/h on both postoperative night 1 and 3 (postoperative non-SDB group). The patients in the postoperative SDB group were older (60 ± 13 vs 53 ± 12 years, P = 0.008) with more smokers (32.3% vs 15.7%, P = 0.048) and had a greater increase in the obstructive apnea index (adjusted P = 0.0003), central apnea index (adjusted P = 0.0012), and hypopnea index (adjusted P = 0.0004). Multivariate logistic regression analysis found that age and preoperative respiratory disturbance index (RDI) were significantly associated with the occurrence of postoperative moderate-to-severe SDB, P = 0.018 and P = 0.006, respectively. The sensitivity privilege cutoff of RDI at 4.9 events/h identified 70.2% to 96.4%patients developing postoperative moderate-to-severe SDB. At least 18.3% of non-sleep apnea patients developed moderate-to-severe SDB after surgery. Age and preoperative RDI were associated with the occurrence of postoperative moderate-to-severe SDB.

Individual Differences in Toddlers' Prosociality: Experiences in Early Relationships Explain Variability in Prosocial Behavior.

PubMed

Newton, Emily K; Thompson, Ross A; Goodman, Miranda

2016-11-01

Latent class logistic regression analysis was used to investigate sources of individual differences in profiles of prosocial behavior. Eighty-seven 18-month-olds were observed in tasks assessing sharing with a neutral adult, instrumentally helping a neutral adult, and instrumentally helping a sad adult. Maternal mental state language (MSL) and maternal sensitivity were also assessed. Despite differing motivational demands across tasks, we found consistency in children's prosocial behavior with three latent classes: no prosocial behavior, moderate prosocial behavior, and frequent instrumental helping across emotional situations. Maternal sensitivity, MSL, and their interaction predicted toddlers' membership in the classes. These findings evidence moderate consistency in early prosocial behaviors and suggest that these capacities are motivated in early relationships with caregivers. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

[Role of self-leadership in the relationship between organizational culture and informatics competency].

PubMed

Kim, Myoung Soo

2009-10-01

The purpose of this study was to identify the moderating and mediating effects of self-leadership in the relationship between organizational culture and nurses' informatics competency. Participants in this study were 297 nurses from the cities of Busan and Ulsan. The scales of organizational culture, self-leadership and informatics competency for nurses were used in this study. Descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were used for data analysis. Nursing informatics competency of the participants was relatively low with a mean score 3.02. There were significant positive correlations between subcategories of perceived organizational culture, self-leadership and nursing informatics competency. Self-leadership was a moderator and a mediator between organizational culture and informatics competency. Based on the results of this study, self-leadership promotion strategies to improve nursing informatics competency are needed.

High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

PubMed

Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

2012-12-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

PubMed Central

Lee, Soon Min; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

2012-01-01

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively. PMID:23255857

Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies.

PubMed

Lally, John; Ajnakina, Olesya; Stubbs, Brendon; Cullinane, Michael; Murphy, Kieran C; Gaughran, Fiona; Murray, Robin M

2017-12-01

Background Remission and recovery rates for people with first-episode psychosis (FEP) remain uncertain. Aims To assess pooled prevalence rates of remission and recovery in FEP and to investigate potential moderators. Method We conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies with more than 1 year of follow-up data, and conducted meta-regression analyses to investigate potential moderators. Results Seventy-nine studies were included representing 19072 patients with FEP. The pooled rate of remission among 12301 individuals with FEP was 58% (60 studies, mean follow-up 5.5 years). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 38% (35 studies, mean follow-up 7.2 years). Recovery rates were higher in North America than in other regions. Conclusions Remission and recovery rates in FEP may be more favourable than previously thought. We observed stability of recovery rates after the first 2 years, suggesting that a progressive deteriorating course of illness is not typical. Although remission rates have improved over time recovery rates have not, raising questions about the effectiveness of services in achieving improved recovery. © The Royal College of Psychiatrists 2017.

Does aging make employees more resilient to job stress? Age as a moderator in the job stressor-well-being relationship in three Finnish occupational samples.

PubMed

Mauno, Saija; Ruokolainen, Mervi; Kinnunen, Ulla

2013-01-01

This study examined whether an employee's age moderates the relationships between job stressors (i.e. job insecurity, workload, work-family conflict) and self-rated well-being (i.e. work-family enrichment, life satisfaction, job satisfaction, vigor at work). Analysis of covariance and moderated hierarchical regression analysis were used to examine the cross-sectional Finnish data collected among service sector employees (N = 1037), nurses (N = 1719), and academic employees (N = 945). In a situation of high job insecurity, the younger nurses reported higher work-family enrichment, job satisfaction, and vigor compared to their older colleagues. A similar result was also found among the service sector workers in relation to vigor at work. Thus, young age buffered against negative outcomes related to job insecurity. Moreover, older age buffered against the negative effect of high workload on job satisfaction among the service sector and against high work-family conflict on life satisfaction among the academic employees. More attention should be paid to the ability of younger employees to manage problems related to work-family imbalance and high workload, and to older employees' ability to cope with job insecurity. The findings of this study recommend different stress management interventions for older and younger employees.

Social support as a moderator of the relationship between anxiety and depression: an empirical study with adult survivors of Wenchuan earthquake.

PubMed

Xu, Jiuping; Wei, Ying

2013-01-01

On May 12th 2008, an earthquake with a magnitude of 8.0 on the Richter scale struck China, causing a large number of casualties and significant economic losses. By interviewing 2080 survivors of Wenchuan earthquake, the objective of this study is to estimate the role of different types of social support as possible moderating factors between anxiety and depression. A stratified random sampling strategy about the cross-sectional study was adopted. The self-rating anxiety scale (SAS), Self-Rating Depression Scale (SDS) and Social Support Rating Scale (SSRS) were used. A total of 2080 adult survivors of the Wenchuan earthquake from 19 damaged countries participated in the survey. Correlation analysis and regression analysis were performed to evaluate the moderating role of social support on the relationship between anxiety and depression. One year after the Wenchuan earthquake, anxiety and depression were found to be 37.6% and 40.7%, respectively. Demographic characteristics were seen as significant in the cases of depression, except for age (p=0.599), while age and education level were not found to be significant for anxiety. The results showed that social support, especially subjective support could moderate the association between anxiety and depression. Social support should be particularly focused on female survivors, those of the Han ethnic group, and those with a lower level of education and a lower income. Psychological intervention and care for survivors should focus on those most disoriented by the disaster.

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

PubMed

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

2004-12-01

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

The dependence of PGA and PGV on distance and magnitude inferred from Northern California ShakeMap data

USGS Publications Warehouse

Boatwright, J.; Bundock, H.; Luetgert, J.; Seekins, L.; Gee, L.; Lombard, P.

2003-01-01

We analyze peak ground velocity (PGV) and peak ground acceleration (PGA) data from 95 moderate (3.5 ??? M 100 km, the peak motions attenuate more rapidly than a simple power law (that is, r-??) can fit. Instead, we use an attenuation function that combines a fixed power law (r-0.7) with a fitted exponential dependence on distance, which is estimated as expt(-0.0063r) and exp(-0.0073r) for PGV and PGA, respectively, for moderate earthquakes. We regress log(PGV) and log(PGA) as functions of distance and magnitude. We assume that the scaling of log(PGV) and log(PGA) with magnitude can differ for moderate and large earthquakes, but must be continuous. Because the frequencies that carry PGV and PGA can vary with earthquake size for large earthquakes, the regression for large earthquakes incorporates a magnitude dependence in the exponential attenuation function. We fix the scaling break between moderate and large earthquakes at M 5.5; log(PGV) and log(PGA) scale as 1.06M and 1.00M, respectively, for moderate earthquakes and 0.58M and 0.31M for large earthquakes.

Does substance misuse moderate the relationship between criminal thinking and recidivism?

PubMed Central

Caudy, Michael S.; Folk, Johanna B.; Stuewig, Jeffrey B.; Wooditch, Alese; Martinez, Andres; Maass, Stephanie; Tangney, June P.; Taxman, Faye S.

2014-01-01

Purpose Some differential intervention frameworks contend that substance use is less robustly related to recidivism outcomes than other criminogenic needs such as criminal thinking. The current study tested the hypothesis that substance use disorder severity moderates the relationship between criminal thinking and recidivism. Methods The study utilized two independent criminal justice samples. Study 1 included 226 drug-involved probationers. Study 2 included 337 jail inmates with varying levels of substance use disorder severity. Logistic regression was employed to test the main and interactive effects of criminal thinking and substance use on multiple dichotomous indicators of recidivism. Results Bivariate analyses revealed a significant correlation between criminal thinking and recidivism in the jail sample (r = .18, p < .05) but no significant relationship in the probation sample. Logistic regressions revealed that SUD symptoms moderated the relationship between criminal thinking and recidivism in the jail-based sample (B = −.58, p < .05). A significant moderation effect was not observed in the probation sample. Conclusions Study findings indicate that substance use disorder symptoms moderate the strength of the association between criminal thinking and recidivism. These findings demonstrate the need for further research into the interaction between various dynamic risk factors. PMID:25598559

Work Demands-Burnout and Job Engagement-Job Satisfaction Relationships: Teamwork as a Mediator and Moderator.

PubMed

Mijakoski, Dragan; Karadzinska-Bislimovska, Jovanka; Basarovska, Vera; Minov, Jordan; Stoleski, Sasho; Angeleska, Nada; Atanasovska, Aneta

2015-03-15

Few studies have examined teamwork as mediator and moderator of work demands-burnout and job engagement-job satisfaction relationships in healthcare workers (HCWs) in South-East Europe. To assess mediation and moderation effect of teamwork on the relationship between independent (work demands or job engagement) and dependent (burnout or job satisfaction) variables. Work demands, burnout, job engagement, and job satisfaction were measured with Hospital Experience Scale, Maslach Burnout Inventory, Utrecht Work Engagement Scale, and Job Satisfaction Survey, respectively. Hospital Survey on Patient Safety Culture was used for assessment of teamwork. In order to examine role of teamwork as a mediating variable we fit series of regression models for burnout and job satisfaction. We also fit regression models predicting outcome (burnout or job satisfaction) from predictor (work demands or job engagement) and moderator (teamwork) variable. Teamwork was partial mediator of work demands-burnout relationship and full mediator of job engagement-job satisfaction relationship. We found that only job engagement-job satisfaction relationship was moderated by teamwork. Occupational health services should target detection of burnout in HCWs and implementation of organizational interventions in hospitals, taking into account findings that teamwork predicted reduced burnout and higher job satisfaction.

Social Class as Moderator of the Relationship between (Dis)Empowering Processes and Psychological Empowerment

ERIC Educational Resources Information Center

Christens, Brian D.; Speer, Paul W.; Peterson, N. Andrew

2011-01-01

This study examined whether social class moderated the relationship between empowering and disempowering processes and psychological empowerment (PE) in a sample of individuals from five community organizing initiatives (N=490). Hierarchical regression analyses were used to test the relationship between community participation (CP) and alienation…

Social Capital and Homeownership in Low- to Moderate-Income Neighborhoods

ERIC Educational Resources Information Center

Grinstein-Weiss, Michal; Yeo, Yeong Hun; Manturuk, Kim R.; Despard, Mathieu R.; Holub, Krista A.; Greeson, Johanna K. P.; Quercia, Roberto G.

2013-01-01

This study examined the relationship between homeownership and social capital among low- and moderate-income (LMI) households. Using data from the Community Advantage Panel Study, the authors used propensity score weighting and regression analyses to explore the relationship between LMI homeownership, neighborhood conditions, and social capital.…

Neighborhood Disorder and the Sense of Personal Control: Which Factors Moderate the Association?

ERIC Educational Resources Information Center

Kim, Joongbaeck; Conley, Meghan E.

2011-01-01

This study examines whether and how select individual characteristics moderate the relationship between neighborhood disorder and a sense of personal control. Our findings show that neighborhood disorder is associated with a decreased sense of control. However, regression analyses including interaction terms of neighborhood disorder and some…

Severity of acidosis affects long-term survival in COPD patients with hypoxemia after intensive care unit discharge.

PubMed

Gungor, Sinem; Kargin, Feyza; Irmak, Ilim; Ciyiltepe, Fulya; Acartürk Tunçay, Eylem; Atagun Guney, Pinar; Aksoy, Emine; Ocakli, Birsen; Adiguzel, Nalan; Karakurt, Zuhal

2018-01-01

Patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) due to COPD have high mortality and morbidity. Acidosis has several harmful effects on hemodynamics and metabolism, and the current knowledge regarding the relationship between respiratory acidosis severity on the short- and long-term survival of COPD patients is limited. We hypothesized that COPD patients with severe acidosis would have a poorer short- and long-term prognosis compared with COPD patients with mild-to-moderate acidosis. This retrospective observational cohort study was conducted in a level III respiratory ICU of a tertiary teaching hospital for chest diseases between December 1, 2013, and December 30, 2014. Subject characteristics, comorbidities, ICU parameters, duration of mechanical ventilation, length of ICU stay, ICU mortality, use of domiciliary noninvasive mechanical ventilation (NIMV) and long-term oxygen therapy (LTOT), and short- and long-term mortality were recorded. Patients were grouped according to their arterial blood gas (ABG) values during ICU admission: severe acidotic (pH≤7.20) and mild-to-moderate acidotic (pH 7.21-7.35). These groups were compared with the recorded data. The mortality predictors were analyzed by logistic regression test in the ICU and the Cox regression test for long-term mortality predictors. During the study period, a total of 312 COPD patients admitted to the ICU with ARF, 69 (72.5% male) in the severe acidosis group and 243 (79% male) in the mild-to-moderate acidosis group, were enrolled. Group demographics, comorbidities, duration of mechanical ventilation, and length of ICU stay were similar in the two groups. The severe acidosis group had a significantly higher rate of NIMV failure (60.7% vs 40%) in the ICU. Mild-to-moderate acidotic COPD patients using LTOT had longer survival after ICU discharge than those without LTOT. On the other hand, severely acidotic COPD patients without LTOT showed shorter survival than those with LTOT. Kaplan-Meier cumulative survival analysis showed that the 28-day and 1-, 2-, and 3-year mortality rates were 12.2%, 36.2%, 52.6%, 63.3%, respectively ( p =0.09). The Cox regression analyses showed that older age, PaO 2 /FiO 2 <300 mmHg, and body mass index ≤20 kg/m 2 was associated with mortality of all patients after 3 years. Severely acidotic COPD patients had a poorer short- and long-term prognosis compared with mild-to-moderate acidotic COPD patients if acute and chronic hypoxemia was predominant.

Severity of acidosis affects long-term survival in COPD patients with hypoxemia after intensive care unit discharge

PubMed Central

Gungor, Sinem; Kargin, Feyza; Irmak, Ilim; Ciyiltepe, Fulya; Acartürk Tunçay, Eylem; Atagun Guney, Pinar; Aksoy, Emine; Ocakli, Birsen; Adiguzel, Nalan; Karakurt, Zuhal

2018-01-01

Background Patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) due to COPD have high mortality and morbidity. Acidosis has several harmful effects on hemodynamics and metabolism, and the current knowledge regarding the relationship between respiratory acidosis severity on the short- and long-term survival of COPD patients is limited. We hypothesized that COPD patients with severe acidosis would have a poorer short- and long-term prognosis compared with COPD patients with mild-to-moderate acidosis. Patients and methods This retrospective observational cohort study was conducted in a level III respiratory ICU of a tertiary teaching hospital for chest diseases between December 1, 2013, and December 30, 2014. Subject characteristics, comorbidities, ICU parameters, duration of mechanical ventilation, length of ICU stay, ICU mortality, use of domiciliary noninvasive mechanical ventilation (NIMV) and long-term oxygen therapy (LTOT), and short- and long-term mortality were recorded. Patients were grouped according to their arterial blood gas (ABG) values during ICU admission: severe acidotic (pH≤7.20) and mild-to-moderate acidotic (pH 7.21–7.35). These groups were compared with the recorded data. The mortality predictors were analyzed by logistic regression test in the ICU and the Cox regression test for long-term mortality predictors. Results During the study period, a total of 312 COPD patients admitted to the ICU with ARF, 69 (72.5% male) in the severe acidosis group and 243 (79% male) in the mild-to-moderate acidosis group, were enrolled. Group demographics, comorbidities, duration of mechanical ventilation, and length of ICU stay were similar in the two groups. The severe acidosis group had a significantly higher rate of NIMV failure (60.7% vs 40%) in the ICU. Mild-to-moderate acidotic COPD patients using LTOT had longer survival after ICU discharge than those without LTOT. On the other hand, severely acidotic COPD patients without LTOT showed shorter survival than those with LTOT. Kaplan–Meier cumulative survival analysis showed that the 28-day and 1-, 2-, and 3-year mortality rates were 12.2%, 36.2%, 52.6%, 63.3%, respectively (p=0.09). The Cox regression analyses showed that older age, PaO2/FiO2 <300 mmHg, and body mass index ≤20 kg/m2 was associated with mortality of all patients after 3 years. Conclusion Severely acidotic COPD patients had a poorer short- and long-term prognosis compared with mild-to-moderate acidotic COPD patients if acute and chronic hypoxemia was predominant. PMID:29780244

Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave

PubMed Central

2010-01-01

Introduction The prognostic value of cardiac troponin I (cTnI) in patients having a heat-related illness during a heat wave has been poorly documented. Methods In a post hoc analysis, we evaluated 514 patients admitted to emergency departments during the August 2003 heat wave in Paris, having a core temperature >38.5°C and who had analysis of cTnI levels. cTnI was considered as normal, moderately elevated (abnormality threshold to 1.5 ng.mL-1), or severely elevated (>1.5 ng.mL-1). Patients were classified according to our previously described risk score (high, intermediate, and low-risk of death). Results Mean age was 84 ± 12 years, mean body temperature 40.3 ± 1.2°C. cTnI was moderately elevated in 165 (32%) and severely elevated in 97 (19%) patients. One-year survival was significantly decreased in patients with moderate or severe increase in cTnI (24 and 46% vs 58%, all P < 0.05). Using logistic regression, four independent variables were associated with an elevated cTnI: previous coronary artery disease, Glasgow coma scale <12, serum creatinine >120 μmol.L-1, and heart rate >110 bpm. Using Cox regression, only severely elevated cTnI was an independent prognostic factor (hazard ratio 1.93, 95% confidence interval 1.35 to 2.77) when risk score was taken into account. One-year survival was decreased in patients with elevated cTnI only in high risk patients (17 vs 31%, P = 0.04). Conclusions cTnI is frequently elevated in patients with non-exertional heat-related illnesses during a heat wave and is an independent risk factor only in high risk patients where severe increase (>1.5 ng.mL-1) indicates severe myocardial damage. PMID:20507603

Screening of anxiety and quality of life in people with epilepsy.

PubMed

Gur-Ozmen, Selen; Leibetseder, Annette; Cock, Hannah R; Agrawal, Niruj; von Oertzen, Tim J

2017-02-01

Up to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety. Anxiety remains under recognized in PwE. This study investigates if screening tools validated for depression could be used to detect anxiety disorders in PWE. Additionally it analyses the effect of anxiety on QoL. 261 participants with a confirmed diagnosis of epilepsy were included. Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Emotional Thermometers (ET), both validated to screen for depression were used. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) with a cut off for moderate and severe anxiety was used as the reference standard. QoL was measured with EQ5-D. Sensitivity, specificity, positive and negative predictive value and ROC analysis as well as multivariate regression analysis were performed. Patients with depression (n=46) were excluded as multivariate regression analysis showed that depression was the only significant determinant of having anxiety in the group. Against HADS-A, NDDI-E and ET-7 showed highest level of accuracy in recognizing anxiety with ET7 being the most effective tool. QoL was significantly reduced in PwE and anxiety. Our study showed that reliable screening for moderate to severe anxiety in PwE without co-morbid depression is feasible with screening tools for depression. The cut off values for anxiety are different from those for depression in ET7 but very similar in NDDI-E. ET7 can be applied to screen simultaneously for depression and "pure" anxiety. Anxiety reduces significantly QoL. We recommend screening as an initial first step to rule out patients who are unlikely to have anxiety. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Association between fruit juice consumption and self-reported body mass index among adult Canadians.

PubMed

Akhtar-Danesh, N; Dehghan, M

2010-04-01

The prevalence of obesity and being overweight is rising among adult Canadians and diet is recognised as one of the main causes of obesity. The consumption of fruit and vegetables is shown to be protective against obesity and being overweight but little is known about the association of fruit juice consumption and obesity and being overweight. The present study aimed to investigate the association between fruit juice consumption and self-reported body mass index (BMI) among adult Canadians. This analysis is based on the Canadian Community Health Survey, Cycle 3.1. A regression method was used to assess the association of fruit juice consumption with self-reported BMI in 18-64-year-old Canadians who had been adjusted for sex, age, total household income, education, self-rated health, and daily energy expenditure. Because the analysis is based on a cross-sectional dataset, it does not imply a cause and effect relationship. Almost 38.6% of adult Canadians reported a fruit juice intake of 0.5-1.4 times per day and 18.2% consumed fruit juice more than 1.5 times per day. Participants with normal weight were likely to consume more fruit juice than obese individuals. Regression analysis showed a negative association between fruit juice consumption and BMI after adjusting for age, sex, education, marital status, income, total fruit and vegetable intake, daily energy expenditure, and self-rated health. On average, for each daily serving of fruit juice, a -0.22 unit (95% confidence interval = -0.33 to -0.11) decrease in BMI was observed. The results obtained showed a moderate negative association between fruit juice intake and BMI, which may suggest that a moderate daily consumption of fruit juice is associated with normal weight status.

Associations between psychological distress, workplace accidents, workplace failures and workplace successes.

PubMed

Hilton, Michael F; Whiteford, Harvey A

2010-12-01

This study investigates associations between psychological distress and workplace accidents, workplace failures and workplace successes. The Health and Work Performance Questionnaire (HPQ) was distributed to employees of 58 large employers. A total of 60,556 full-time employees were eligible for analysis. The HPQ probed whether the respondent had, in the past 30-days, a workplace accident, success or failure ("yes" or "no"). Psychological distress was quantified using the Kessler 6 (K6) scale and categorised into low, moderate and high psychological distress. Three binomial logistic regressions were performed with the dependent variables being workplace accident, success or failure. Covariates in the models were K6 category, gender, age, marital status, education level, job category, physical health and employment sector. Accounting for all other variables, moderate and high psychological distress significantly (P < 0.0001) increased the odds ratio (OR) for a workplace accident to 1.4 for both levels of distress. Moderate and high psychological distress significantly (P < 0.0001) increased the OR (OR = 2.3 and 2.6, respectively) for a workplace failure and significantly (P < 0.0001) decreased the OR for a workplace success (OR = 0.8 and 0.7, respectively). Moderate and high psychological distress increase the OR's for workplace accidents work failures and decrease the OR of workplace successes at similar levels. As the prevalence of moderate psychological distress is approximately double that of high psychological distress moderate distress consequentially has a greater workplace impact.

Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction.

PubMed

Inverso, Gino; Dodson, Thomas B; Gonzalez, Martin L; Chuang, Sung-Kiang

2016-03-01

To examine the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing third molar extraction and determine whether any differences in complication risks exist between the 2 levels of sedation. We performed a prospective study of the Oral and Maxillofacial Surgery Outcomes System from January 2001 to December 2010. The primary predictor variable was the level of sedation, divided into 2 groups: moderate sedation versus deep sedation/general anesthesia. The primary outcome was the incidence of adverse complications resulting from the sedation level. Differences in the cohort characteristics were analyzed using the independent samples t test, χ(2) test, and analysis of variance, as appropriate. Multivariable logistic regression was used to measure the effect the level of sedation had on the adverse complication rate. Patients in the moderate sedation group had a complication rate of 0.5%, and patients in the deep sedation/general anesthesia group had a complication rate of 0.9%. Compared with moderate sedation, deep sedation/general anesthesia did not pose a significantly increased risk of adverse anesthesia complications (adjusted odds ratio 1.63, 95% confidence interval 0.95 to 2.81; P = .077). The results of our study have shown that the risk of adverse anesthesia complications is not increased when choosing between moderate and deep sedation/general anesthesia for adolescent patients undergoing third molar extraction. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Eating disorder severity and functional impairment: moderating effects of illness duration in a clinical sample.

PubMed

Davidsen, Annika Helgadóttir; Hoyt, William T; Poulsen, Stig; Waaddegaard, Mette; Lau, Marianne

2017-09-01

The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.

Regression and Sentinel Lymph Node Status in Melanoma Progression

PubMed Central

Letca, Alina Florentina; Ungureanu, Loredana; Şenilă, Simona Corina; Grigore, Lavinia Elena; Pop, Ştefan; Fechete, Oana; Vesa, Ştefan Cristian

2018-01-01

Background The purpose of this study was to assess the role of regression and other clinical and histological features for the prognosis and the progression of cutaneous melanoma. Material/Methods Between 2005 and 2016, 403 patients with melanoma were treated and followed at our Department of Dermatology. Of the 403 patients, 173 patients had cutaneous melanoma and underwent sentinel lymph node (SLN) biopsy and thus were included in this study. Results Histological regression was found in 37 cases of melanoma (21.3%). It was significantly associated with marked and moderate tumor-infiltrating lymphocyte (TIL) and with negative SLN. Progression of the disease occurred in 42 patients (24.2%). On multivariate analysis, we found that a positive lymph node and a Breslow index higher than 2 mm were independent variables associated with disease free survival (DFS). These variables together with a mild TIL were significantly correlated with overall survival (OS). The presence of regression was not associated with DFS or OS. Conclusions We could not demonstrate an association between regression and the outcome of patients with cutaneous melanoma. Tumor thickness greater than 2 mm and a positive SLN were associated with recurrence. Survival was influenced by a Breslow thickness >2 mm, the presence of a mild TIL and a positive SLN status. PMID:29507279

The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.

PubMed

Antunes, Alberto A; Srougi, Miguel; Dall'oglio, Marcos F; Vicentini, Fabio; Paranhos, Mario; Freire, Geraldo C

2008-07-01

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in middle-aged and older men. Recently, epidemiologic studies have shown significant associations between severity of LUTS and male sexual dysfunction. We analyzed the role of prostate enlargement, LUTS, and prostate specific antigen (PSA) levels in the erectile function of Brazilian men who underwent prostate cancer (PCa) screening. We analyzed data from 1,008 consecutive patients enrolled in a PCa screening program. Benign prostatic hyperplasia (BPH) was defined as a prostate weight greater than 30 g as defined by digital rectal examination. For statistical analysis, we used the chi-squared and analysis of variance tests. The odds ratios (OR) for correlation of ED with prostate volume LUTS and PSA were estimated using logistic regression models. The American Urological Association (AUA) symptom score for LUTS and the International Index of Erectile Function. Mean patient age was 61.2 years (45-87) and median PSA value was 1.9 ng/mL. BPH was identified in 48.5% of patients. Mild, moderate, and severe LUTS were found in 52.3%, 30.9%, and 16.8% of cases, respectively. ED was classified as absent, mild, mild to moderate, moderate, and severe in 18.6%, 23.1%, 18.6%, 15.2%, and 24.5%, respectively. While only 5.4% of the patients with no ED presented severe LUTS, this finding was observed in 27.1% of patients with severe ED (P < 0.001). Univariate logistic regression analysis demonstrated that age, prostate volume, AUA symptom score, and PSA levels were significant predictors of ED. However, when controlled for patient age, only LUTS remained as an independent predictor of ED. Controlling for patient age, LUTS are independent risk factors for the development of ED among Brazilian men who undergo PCa screening. Antunes AA, Srougi M, Dall'Oglio MF, Vicentini F, Paranhos M, and Freire GC. The role of BPH, lower urinary tract symptoms, and PSA levels on erectile function of Brazilian men who undergo prostate cancer screening.

Comparative efficacy of fixed-dose combinations of long-acting muscarinic antagonists and long-acting β2-agonists: a systematic review and network meta-analysis

PubMed Central

Schlueter, Max; Gonzalez-Rojas, N; Baldwin, Michael; Groenke, Lars; Voss, Florian; Reason, Tim

2016-01-01

Background: A number of long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) fixed-dose combinations (FDCs) for treatment of moderate-to-very severe chronic obstructive pulmonary disease (COPD) have recently become available, but none have been directly compared in head-to-head randomized controlled trials (RCTs). The purpose of this study was to assess the relative clinical benefit of all currently available LAMA/LABA FDCs using a Bayesian network meta-analysis (NMA). Methods: A systematic literature review identified RCTs investigating the efficacy, safety and quality of life associated with licensed LAMA/LABA FDCs for the treatment of moderate-to-very severe COPD. RCTs were screened for inclusion in the NMA using prespecified eligibility criteria. Data were extracted for outcomes of interest, including change in trough forced expiratory volume in 1 second (tFEV1) from baseline, St. George Respiratory Questionnaire (SGRQ) percentage of responders, Transition Dyspnea Index (TDI) percentage of responders, change in SGRQ score from baseline, change in TDI focal score from baseline, moderate-to-severe exacerbations, all-cause discontinuation, and discontinuation due to adverse events. Results: Following screening, a total of 27 trials from 26 publications with 30,361 subjects were eligible for inclusion in the NMA. Nonsignificant results were seen in most analyses comparing efficacy, exacerbations and discontinuation rates of included LAMA/LABA FDCs (i.e. aclidinium/formoterol 400/12 µg, glycopyrronium/indacaterol 110/50 µg, tiotropium + olodaterol 5/5 µg, umeclidinium/vilanterol 62.5/25 µg). Meta-regression controlling for post-bronchodilator percentage of tFEV1 predicted at baseline as well as meta-regression adjusting for concomitant use of inhaled corticosteroids at baseline was performed to assess the magnitude of effect modification and produced similar results as observed in the base case analysis. Conclusion: All LAMA/LABA FDCs were found to have similar efficacy and safety. Definitive assessment of the relative efficacy of different treatments can only be performed through direct comparison in head-to-head RCTs. In the absence of such data, this indirect comparison may be of value in clinical and health economic decision-making. PMID:26746383

Vegetation placement for summer built surface temperature moderation in an urban microclimate.

PubMed

Millward, Andrew A; Torchia, Melissa; Laursen, Andrew E; Rothman, Lorne D

2014-06-01

Urban vegetation can mitigate increases in summer air temperature by reducing the solar gain received by buildings. To quantify the temperature-moderating influence of city trees and vine-covered buildings, a total of 13 pairs of temperature loggers were installed on the surfaces of eight buildings in downtown Toronto, Canada, for 6 months during the summer of 2008. One logger in each pair was shaded by vegetation while the other measured built surface temperature in full sunlight. We investigated the temperature-moderating benefits of solitary mature trees, clusters of trees, and perennial vines using a linear-mixed model and a multiple regression analysis of degree hour difference. We then assessed the temperature-moderating effect of leaf area, plant size and proximity to building, and plant location relative to solar path. During a period of high solar intensity, we measured an average temperature differential of 11.7 °C, with as many as 10-12 h of sustained cooler built surface temperatures. Vegetation on the west-facing aspect of built structures provided the greatest temperature moderation, with maximum benefit (peak temperature difference) occurring late in the afternoon. Large mature trees growing within 5 m of buildings showed the greatest ability to moderate built surface temperature, with those growing in clusters delivering limited additional benefit compared with isolated trees. Perennial vines proved as effective as trees at moderating rise in built surface temperature to the south and west sides of buildings, providing an attractive alternative to shade trees where soil volume and space are limited.

Vegetation Placement for Summer Built Surface Temperature Moderation in an Urban Microclimate

NASA Astrophysics Data System (ADS)

Millward, Andrew A.; Torchia, Melissa; Laursen, Andrew E.; Rothman, Lorne D.

2014-06-01

Urban vegetation can mitigate increases in summer air temperature by reducing the solar gain received by buildings. To quantify the temperature-moderating influence of city trees and vine-covered buildings, a total of 13 pairs of temperature loggers were installed on the surfaces of eight buildings in downtown Toronto, Canada, for 6 months during the summer of 2008. One logger in each pair was shaded by vegetation while the other measured built surface temperature in full sunlight. We investigated the temperature-moderating benefits of solitary mature trees, clusters of trees, and perennial vines using a linear-mixed model and a multiple regression analysis of degree hour difference. We then assessed the temperature-moderating effect of leaf area, plant size and proximity to building, and plant location relative to solar path. During a period of high solar intensity, we measured an average temperature differential of 11.7 °C, with as many as 10-12 h of sustained cooler built surface temperatures. Vegetation on the west-facing aspect of built structures provided the greatest temperature moderation, with maximum benefit (peak temperature difference) occurring late in the afternoon. Large mature trees growing within 5 m of buildings showed the greatest ability to moderate built surface temperature, with those growing in clusters delivering limited additional benefit compared with isolated trees. Perennial vines proved as effective as trees at moderating rise in built surface temperature to the south and west sides of buildings, providing an attractive alternative to shade trees where soil volume and space are limited.

Testing moderation in network meta-analysis with individual participant data.

PubMed

Dagne, Getachew A; Brown, C Hendricks; Howe, George; Kellam, Sheppard G; Liu, Lei

2016-07-10

Meta-analytic methods for combining data from multiple intervention trials are commonly used to estimate the effectiveness of an intervention. They can also be extended to study comparative effectiveness, testing which of several alternative interventions is expected to have the strongest effect. This often requires network meta-analysis (NMA), which combines trials involving direct comparison of two interventions within the same trial and indirect comparisons across trials. In this paper, we extend existing network methods for main effects to examining moderator effects, allowing for tests of whether intervention effects vary for different populations or when employed in different contexts. In addition, we study how the use of individual participant data may increase the sensitivity of NMA for detecting moderator effects, as compared with aggregate data NMA that employs study-level effect sizes in a meta-regression framework. A new NMA diagram is proposed. We also develop a generalized multilevel model for NMA that takes into account within-trial and between-trial heterogeneity and can include participant-level covariates. Within this framework, we present definitions of homogeneity and consistency across trials. A simulation study based on this model is used to assess effects on power to detect both main and moderator effects. Results show that power to detect moderation is substantially greater when applied to individual participant data as compared with study-level effects. We illustrate the use of this method by applying it to data from a classroom-based randomized study that involved two sub-trials, each comparing interventions that were contrasted with separate control groups. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Caregiver ratings of long-term executive dysfunction and attention problems after early childhood traumatic brain injury: family functioning is important.

PubMed

Kurowski, Brad G; Taylor, H Gerry; Yeates, Keith Owen; Walz, Nicolay C; Stancin, Terry; Wade, Shari L

2011-09-01

To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. A multicenter, prospective cohort study that included an orthopedic injury (OI) reference group. Three tertiary academic children's hospital medical centers and one general medical center. Children, ages 3-7 years, hospitalized for OI, moderate TBI, or severe TBI. METHODS AND OUTCOME MEASUREMENTS: Parental ratings of family functioning and parenting styles were obtained 18 months after the injury occurred. The main outcome measurements, which were parental ratings of children's executive function and attention, were performed at least 24 months after the injury occurred (mean, 39 months; range, 25-63 months). Group comparisons were conducted with use of t-tests, χ(2) analysis, analysis of variance, and Pearson and Spearman correlations. Regression analysis was used to examine associations of the outcomes with family functioning and parenting styles and to test moderating effects of these factors on group differences. Participants with severe TBI demonstrated increased executive dysfunction and attention problems compared with those who sustained moderate TBI or OI. Lower levels of family dysfunction were associated with better executive function and attention across groups but did not moderate group differences. However, attention deficits after severe TBI were exacerbated under conditions of more permissive parenting relative to attention deficits after OIs. Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood TBI could help target future interventions. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Perceived stress and life satisfaction: social network service use as a moderator.

PubMed

Niu, Qikun; Liu, Yihao; Sheng, Zitong; He, Yue; Shao, Xiaolin

2011-01-01

Social Network Service (SNS) has become a buzzword in recent media coverage with the development of the second generation of Web-based communities. In China, SNS has played an increasingly important role in its users' daily lives, especially among students. With a sample of 471 college students, we tested the direct relationship between perceived stress and life satisfaction using a regression analysis. Moreover, we found SNS use could buffer the negative effect of perceived stress. This study has practical implications on Internet users' SNS use.

Leadership and change commitment in the life insurance service context in Taiwan: the mediating-moderating role of job satisfaction.

PubMed

Yang, Yi-Feng

2011-06-01

The effects of transformational leadership and satisfaction were studied along with their interconnected effects (mediation and moderation) on commitment to change in the life insurance industry in two samples, sales managers and salespersons. A multiple mediated-moderated regression approach showed mediation and moderation to have statistically significant main effects on change commitment. Transformational leadership and satisfaction made a more important contribution to change commitment while job satisfaction had a mediating and moderating role that could enhance the relationships between leadership and change commitment. This information is of importance in building successful change commitment associations with customers.

Experiencing reproductive concerns as a female cancer survivor is associated with depression.

PubMed

Gorman, Jessica R; Su, H Irene; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L

2015-03-15

Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. This cross-sectional study included 200 female cancer survivors between the ages of 18 and 35 years who completed a Web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality-of-life indicators. The mean age of the participants was 28 years (standard deviation, 4.4 years), and almost two-thirds were diagnosed within 5 years of survey completion. A multivariate logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (odds ratio for each 5-unit increase in the Reproductive Concerns After Cancer [RCAC] score, 1.30; 95% confidence interval, 1.06-1.60). Among those with moderate to severe depression, 23% had high RCAC scores, whereas 6% of those with minimal to mild depression did (P < .001). A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention for improving the psychosocial health of young survivors. © 2014 American Cancer Society.

Gender Moderates Association Between Emotional-Behavioral Problems and Text Comprehension in Children with Both Reading Difficulties and Adhd.

PubMed

Mano, Quintino R; Jastrowski Mano, Kristen E; Denton, Carolyn A; Epstein, Jeffery N; Tamm, Leanne

2017-05-01

Evidence suggests that higher order linguistic functioning such as text comprehension is particularly vulnerable to emotional modulation. Gender has been identified as an important moderating variable in emotional expression such that girls tend toward internalizing emotions (e.g., sadness, anxiety) whereas boys tend toward externalizing emotions (e.g., anger, combativeness), which may influence the relationship between emotion and text comprehension. The present study examined whether gender moderates the relationship between emotional-behavioral problems and text comprehension among children ( n = 187; boys= 115, girls = 72) with both word reading difficulties (RD) and attention-deficit/hyperactivity disorder (ADHD), a sample widely acknowledged to be at increased risk for developing emotional-behavioral problems such as anxiety, poor academic self-concept, and delinquency. A moderated regression analysis tested for the significance of two separate interaction terms (i.e., gender × externalizing problems, gender × internalizing problems) after controlling for gender, IQ, basic reading skills, cognitive-linguistic processes closely related to reading, attentional problems, internalizing problems, and externalizing problems. Results indicated that gender significantly and uniquely moderates the relationship between emotional-behavioral problems and text comprehension. Specifically, text comprehension was relatively lower among girls with relatively higher externalizing problems, whereas no such association was observed among boys. These results contribute to our understanding of cognition-emotion interactions within reading development and raise important implications.

Gender Moderates Association Between Emotional-Behavioral Problems and Text Comprehension in Children with Both Reading Difficulties and Adhd

PubMed Central

Mano, Quintino R.; Jastrowski Mano, Kristen E.; Denton, Carolyn A.; Epstein, Jeffery N.; Tamm, Leanne

2017-01-01

Evidence suggests that higher order linguistic functioning such as text comprehension is particularly vulnerable to emotional modulation. Gender has been identified as an important moderating variable in emotional expression such that girls tend toward internalizing emotions (e.g., sadness, anxiety) whereas boys tend toward externalizing emotions (e.g., anger, combativeness), which may influence the relationship between emotion and text comprehension. The present study examined whether gender moderates the relationship between emotional-behavioral problems and text comprehension among children (n = 187; boys= 115, girls = 72) with both word reading difficulties (RD) and attention-deficit/hyperactivity disorder (ADHD), a sample widely acknowledged to be at increased risk for developing emotional-behavioral problems such as anxiety, poor academic self-concept, and delinquency. A moderated regression analysis tested for the significance of two separate interaction terms (i.e., gender × externalizing problems, gender × internalizing problems) after controlling for gender, IQ, basic reading skills, cognitive-linguistic processes closely related to reading, attentional problems, internalizing problems, and externalizing problems. Results indicated that gender significantly and uniquely moderates the relationship between emotional-behavioral problems and text comprehension. Specifically, text comprehension was relatively lower among girls with relatively higher externalizing problems, whereas no such association was observed among boys. These results contribute to our understanding of cognition-emotion interactions within reading development and raise important implications. PMID:28751795

Experiencing reproductive concerns as a female cancer survivor is associated with depression

PubMed Central

Gorman, Jessica R.; Su, H. Irene; Roberts, Samantha C.; Dominick, Sally A.; Malcarne, Vanessa L.

2014-01-01

Background Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. Methods This cross-sectional study includes 200 female cancer survivors between the ages of 18 and 35 years who completed a web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality of life indicators. Results The mean age of participants was 28 years (SD = 4.4) and almost two-thirds were diagnosed within 5 years of completing the survey. Multivariable logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (OR = 1.30, 95% CI = 1.06–1.60 for each 5 unit increase in RCAC score). Of those with moderate to severe depression, 23% had high RCAC scores as compared to 6% of those with minimal to mild depression (p < 0.001). Conclusion A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention to improve the psychosocial health of young survivors. PMID:25377593

Does emotion and its daily fluctuation correlate with depression? A cross-cultural analysis among six developing countries.

PubMed

Chan, Derwin K C; Zhang, Xin; Fung, Helene H; Hagger, Martin S

2015-03-01

Utilizing a World Health Organization (WHO) multi-national dataset, the present study examined the relationships between emotion, affective variability (i.e., the fluctuation of emotional status), and depression across six developing countries, including China (N=15,050); Ghana (N=5,573); India (N=12,198); Mexico (N=5,448); South Africa (N=4,227); and Russia (N=4,947). Using moderated logistic regression and hierarchical multiple regression, the effects of emotion, affective variability, culture, and their interactions on depression and depressive symptoms were examined when statistically controlling for a number of external factors (i.e., age, gender, marital status, education level, income, smoking, alcohol drinking, physical activity, sedentary behavior, and diet). The results revealed that negative emotion was a statistically significant predictor of depressive symptoms, but the strength of association was smaller in countries with a lower incidence of depression (i.e., China and Ghana). The association between negative affective variability and the risk of depression was higher in India and lower in Ghana. Findings suggested that culture not only was associated with the incidence of depression, but it could also moderate the effects of emotion and affective variability on depression or the experience of depressive symptoms. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Test-retest reliability of eye tracking in the visual world paradigm for the study of real-time spoken word recognition.

PubMed

Farris-Trimble, Ashley; McMurray, Bob

2013-08-01

Researchers have begun to use eye tracking in the visual world paradigm (VWP) to study clinical differences in language processing, but the reliability of such laboratory tests has rarely been assessed. In this article, the authors assess test-retest reliability of the VWP for spoken word recognition. Methods Participants performed an auditory VWP task in repeated sessions and a visual-only VWP task in a third session. The authors performed correlation and regression analyses on several parameters to determine which reflect reliable behavior and which are predictive of behavior in later sessions. Results showed that the fixation parameters most closely related to timing and degree of fixations were moderately-to-strongly correlated across days, whereas the parameters related to rate of increase or decrease of fixations to particular items were less strongly correlated. Moreover, when including factors derived from the visual-only task, the performance of the regression model was at least moderately correlated with Day 2 performance on all parameters ( R > .30). The VWP is stable enough (with some caveats) to serve as an individual measure. These findings suggest guidelines for future use of the paradigm and for areas of improvement in both methodology and analysis.

Elevated serum uric acid predicts the development of moderate coronary artery calcification independent of conventional cardiovascular risk factors.

PubMed

Jun, Ji Eun; Lee, You-Bin; Lee, Seung-Eun; Ahn, Ji Yeon; Kim, Gyuri; Jin, Sang-Man; Hur, Kyu Yeon; Lee, Moon-Kyu; Kang, Mi Ra; Kim, Jae Hyeon

2018-05-01

Hyperuricemia was frequently noted in subjects with a high risk of cardiovascular disease (CVD). This study aimed to elucidate whether serum uric acid (SUA) is associated with development of moderate coronary artery calcification in generally healthy adults. A total of 9297 subjects underwent multidetector CT for the evaluation of CAC at least two times during their annual health examinations. Among them, 4461 participants without CVD history and who had no (scores 0) or minimal CAC (scores 1-10) in their first examination were enrolled. The association between SUA as a continuous and categorical variable and development of moderate coronary artery calcification (CAC score > 100) was assessed by Cox regression analysis. Receiver-operating characteristic (ROC) curves were constructed to investigate the diagnostic efficacy of SUA. During a median follow-up of 4.1 years, 131 incident cases of moderate calcification developed. Baseline SUA concentration was significantly higher in subjects with progression to moderate coronary artery calcification (6.6 ± 1.3 vs. 5.8 ± 1.3 mg/dL, p < 0.001). SUA as a continuous variable (per 1 mg/dL) and divided into quartiles was positively associated with a higher risk of development of moderate calcification after adjustment for conventional CVD risk factors. The addition of SUA to the conventional CVD risk factors improved the predictive power for development of moderate coronary artery calcification. SUA was an independent predictor for development of moderate coronary artery calcification in subjects with no or minimal calcification. Copyright © 2018 Elsevier B.V. All rights reserved.

Excessive internet use in European adolescents: what determines differences in severity?

PubMed

Blinka, Lukas; Škařupová, Kateřina; Ševčíková, Anna; Wölfling, Klaus; Müller, Kai W; Dreier, Michael

2015-02-01

This study investigated the differences between non-excessive, moderately excessive, and highly excessive internet use among adolescents. These differences were explored in terms of personal characteristics, psychological difficulties, environmental factors, and manner of internet use. A representative sample was investigated, consisting of 18,709 adolescents aged 11-16 and their parents, from 25 European countries. Excessive internet use was measured using a five item scale covering following factors: salience, conflict, tolerance, withdrawal symptoms, and relapse and reinstatement. The main data analysis utilised multinomial and binary logistic regression models. The vast majority of respondents reported no signs of excessive internet use. Moderately excessive users (4.4%) reported higher emotional and behavioural difficulties, but also more sophisticated digital skills and a broader range of online activities. The highly excessive users (1.4%) differed from the non-excessive and moderately excessive users in their preference for online games and in having more difficulties with self-control. Adolescents who struggle with attention and self-control and who are inclined toward online gaming may be especially vulnerable to the otherwise uncommon phenomenon of excessive internet use.

The relationship between racial identity and self-esteem in African American college and high school students.

PubMed

Rowley, S J; Sellers, R M; Chavous, T M; Smith, M A

1998-03-01

The Multidimensional Model of Racial Identity was used to examine the relationship between racial identity and personal self-esteem (PSE) in a sample of African American college students (n = 173) and a sample of African American high school students (n = 72). Racial identity was assessed using the Centrality and Regard scales of the Multidimensional Inventory of Black Identity, whereas the Rosenberg Self-Esteem Scale was used to assess PSE. Four predictions were tested: (a) racial centrality is weakly but positively related to PSE; (b) private regard is moderately related to PSE; (c) public regard is unrelated to PSE; and (d) racial centrality moderates the relationship between private regard and PSE. Multiple regression analysis found that racial centrality and public racial regard were unrelated to PSE in both samples. Private regard was positively related to PSE in the college sample. Racial centrality moderated the relationship between private regard and PSE in both samples, such that the relationship was significant for those with high levels of centrality but nonsignificant for those with low levels.

Discrimination and distress among Afghan refugees in northern California: The moderating role of pre- and post-migration factors

PubMed Central

2018-01-01

This study investigates the effect of perceived discrimination on the mental health of Afghan refugees, and secondly, tests the distress moderating effects of pre-migration traumatic experiences and post-resettlement adjustment factors. In a cross-sectional design, 259 Afghans completed surveys assessing perceived discrimination and a number of other factors using scales developed through inductive techniques. Multivariable analyses consisted of a series of hierarchical regressions testing the effect of perceived discrimination on distress, followed by a sequential analysis of moderator variables. Perceived discrimination was significantly associated with higher distress, and this relationship was stronger among those with a strong intra-ethnic identity and high pre-resettlement traumatic experiences. The expected buffering effects of civic engagement, ethnic orientation (e.g. integration), and social support were not significant. Discrimination is a significant source of stress for Afghan refugees, which may exacerbate stresses associated with other pre- and post-migration stressors. Future research is needed to tailor interventions that can help mitigate the stress associated with discrimination among this highly vulnerable group. PMID:29782531

Adolescent gambling and impulsivity: Does employment during high school moderate the association?

PubMed

Canale, Natale; Scacchi, Luca; Griffiths, Mark D

2016-09-01

The aim of the present study was to examine the potential moderating relationships between adolescent gambling and impulsivity traits (negative urgency, positive urgency, lack of premeditation, lack of perseverance and sensation seeking) with employment status. High-school students (N=400; 69% male; mean age=18.35years; SD=1.16; past year gamblers) were surveyed to provide data on impulsivity and employment. Multiple linear regression analysis was applied to examine associations with gambling and related problems. Positive urgency was associated with stronger scores of both gambling frequency and problem gambling. Students in employment had substantially higher frequency of gambling and greater problem gambling. Moreover, the combination of having a job and low perseverance was associated with a particularly high frequency on gambling. These findings further support the importance of positive urgency and employment status in adolescent gambling. The study highlights unique moderating relationship between gambling and lack of perseverance with employment status. Youth with a low perseverance and having a job may have particular need for interventions to reduce gambling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interventions to Improve Medication Adherence in Hypertensive Patients: Systematic Review and Meta-analysis.

PubMed

Conn, Vicki S; Ruppar, Todd M; Chase, Jo-Ana D; Enriquez, Maithe; Cooper, Pamela S

2015-12-01

This systematic review applied meta-analytic procedures to synthesize medication adherence interventions that focus on adults with hypertension. Comprehensive searching located trials with medication adherence behavior outcomes. Study sample, design, intervention characteristics, and outcomes were coded. Random-effects models were used in calculating standardized mean difference effect sizes. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression to explore associations between effect sizes and sample, design, and intervention characteristics. Effect sizes were calculated for 112 eligible treatment-vs.-control group outcome comparisons of 34,272 subjects. The overall standardized mean difference effect size between treatment and control subjects was 0.300. Exploratory moderator analyses revealed interventions were most effective among female, older, and moderate- or high-income participants. The most promising intervention components were those linking adherence behavior with habits, giving adherence feedback to patients, self-monitoring of blood pressure, using pill boxes and other special packaging, and motivational interviewing. The most effective interventions employed multiple components and were delivered over many days. Future research should strive for minimizing risks of bias common in this literature, especially avoiding self-report adherence measures.

Introduction, comparison, and validation of Meta‐Essentials: A free and simple tool for meta‐analysis

PubMed Central

van Rhee, Henk; Hak, Tony

2017-01-01

We present a new tool for meta‐analysis, Meta‐Essentials, which is free of charge and easy to use. In this paper, we introduce the tool and compare its features to other tools for meta‐analysis. We also provide detailed information on the validation of the tool. Although free of charge and simple, Meta‐Essentials automatically calculates effect sizes from a wide range of statistics and can be used for a wide range of meta‐analysis applications, including subgroup analysis, moderator analysis, and publication bias analyses. The confidence interval of the overall effect is automatically based on the Knapp‐Hartung adjustment of the DerSimonian‐Laird estimator. However, more advanced meta‐analysis methods such as meta‐analytical structural equation modelling and meta‐regression with multiple covariates are not available. In summary, Meta‐Essentials may prove a valuable resource for meta‐analysts, including researchers, teachers, and students. PMID:28801932

Adoption of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline in Cardiology Practices Nationwide

PubMed Central

Pokharel, Yashashwi; Tang, Fengming; Jones, Philip G.; Nambi, Vijay; Bittner, Vera A.; Hira, Ravi S.; Nasir, Khurram; Chan, Paul S.; Maddox, Thomas M.; Oetgen, William J.; Heidenreich, Paul A.; Borden, William B.; Spertus, John A.; Petersen, Laura A.; Ballantyne, Christie M.

2017-01-01

Importance The 2013 American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Management Guideline recommends moderate-intensity to high-intensity statin therapy in eligible patients. Objective To examine adoption of the 2013 ACC/AHA guideline in US cardiology practices. Design, Setting, and Participants Among 161 cardiology practices, trends in the use of moderate-intensity to high-intensity statin and nonstatin lipid-lowering therapy (LLT) were analyzed before (September 1, 2012, to November 1, 2013) and after (February 1, 2014, to April 1, 2015) publication of the 2013 ACC/AHA guideline among 4 mutually exclusive risk groups within the ACC Practice Innovation and Clinical Excellence Registry. Interrupted time series analysis was used to evaluate for differences in trend in use of moderate-intensity to high-intensity statin and nonstatin LLT use in hierarchical logistic regression models. Participants were a population-based sample of 1 105 356 preguideline patients (2 431 192 patient encounters) and 1 116 472 postguideline patients (2 377 219 patient encounters). Approximately 97% of patients had atherosclerotic cardiovascular disease (ASCVD). Exposures Moderate-intensity to high-intensity statin and nonstatin LLT use before and after publication of the 2013 ACC/AHA guideline. Main Outcomes and Measures Time trend in the use of moderate-intensity to high-intensity statin and nonstatin LLT. Results In the study cohort, the mean (SD) age was 69.6 (12.1) years among 1 105 356 patients (40.2% female) before publication of the guideline and 70.0 (11.9) years among 1 116 472 patients (39.8% female) after publication of the guideline. Although there was a trend toward increasing use of moderate-intensity to high-intensity statins overall and in the ASCVD cohort, such a trend was already present before publication of the guideline. No significant difference in trend in the use of moderate-intensity to high-intensity statins was observed in other groups. The use of moderate-intensity to high-intensity statin therapy was 62.1% (before publication of the guideline) and 66.6% (after publication of the guideline) in the overall cohort, 62.7% (before publication) and 67.0% (after publication) in the ASCVD cohort, 50.6% (before publication) and 52.3% (after publication) in the cohort with elevated low-density lipoprotein cholesterol levels (ie, ≥190 mg/dL), 52.4% (before publication) and 55.2% (after publication) in the diabetes cohort, and 41.9% (before publication) and 46.9% (after publication) in the remaining group with 10-year ASCVD risk of 7.5% or higher. In hierarchical logistic regression models, there was a significant increase in the use of moderate-intensity to high-intensity statins in the overall cohort (4.8%) and in the ASCVD cohort (4.3%) (P < .01 for slope for both). There was no significant change for other risk cohorts. Nonstatin LLT use remained unchanged in the preguideline and postguideline periods in the hierarchical logistic regression models for all of the risk groups. Conclusions and Relevance Adoption of the 2013 ACC/AHA Cholesterol Management Guideline in cardiology practices was modest. Timely interventions are needed to improve guideline-concordant practice to reduce the burden of ASCVD. PMID:28249067

Income inequality as a moderator of the relationship between psychological job demands and sickness absence, in particular in men: an international comparison of 23 countries.

PubMed

Muckenhuber, Johanna; Burkert, Nathalie; Großschädl, Franziska; Freidl, Wolfgang

2014-01-01

The aim of this study was to investigate whether more sickness absence is reported in countries with higher income inequality than elsewhere, and whether the level of income inequality moderates the association between psycho-social job demands and sickness absence. Our analysis is based on the Fifth European Working Conditions Survey that compared 23 European countries. We performed multi-level regression analysis. On the macro-level of analysis we included the Gini-Index as measure of inequality. On the micro-level of analysis we followed the Karasek-Theorell model and included three scales for psychological job demands, physical job demands, and decision latitude in the model. The model was stratified by sex. We found that, in countries with high income inequality, workers report significantly more sickness absence than workers in countries with low income inequality. In addition we found that the level of income inequality moderates the relationship between psychological job demands and sickness absence. High psychological job demands are significantly more strongly related to more days of sickness absence in countries with low income inequality than in countries with high income inequality. As the nature and causal pathways of cross-level interaction effects still cannot be fully explained, we argue that future research should aim to explore such causal pathways. In accordance with WHO recommendations we argue that inequalities should be reduced. In addition we state that, particularly in countries with low levels of income inequality, policies should aim to reduce psychological job demands.

Income Inequality as a Moderator of the Relationship between Psychological Job Demands and Sickness Absence, in Particular in Men: An International Comparison of 23 Countries

PubMed Central

Muckenhuber, Johanna; Burkert, Nathalie; Großschädl, Franziska; Freidl, Wolfgang

2014-01-01

Objectives The aim of this study was to investigate whether more sickness absence is reported in countries with higher income inequality than elsewhere, and whether the level of income inequality moderates the association between psycho-social job demands and sickness absence. Methods Our analysis is based on the Fifth European Working Conditions Survey that compared 23 European countries. We performed multi-level regression analysis. On the macro-level of analysis we included the Gini-Index as measure of inequality. On the micro-level of analysis we followed the Karasek-Theorell model and included three scales for psychological job demands, physical job demands, and decision latitude in the model. The model was stratified by sex. Results We found that, in countries with high income inequality, workers report significantly more sickness absence than workers in countries with low income inequality. In addition we found that the level of income inequality moderates the relationship between psychological job demands and sickness absence. High psychological job demands are significantly more strongly related to more days of sickness absence in countries with low income inequality than in countries with high income inequality. Conclusions As the nature and causal pathways of cross-level interaction effects still cannot be fully explained, we argue that future research should aim to explore such causal pathways. In accordance with WHO recommendations we argue that inequalities should be reduced. In addition we state that, particularly in countries with low levels of income inequality, policies should aim to reduce psychological job demands. PMID:24505271

On the Misconception of Multicollinearity in Detection of Moderating Effects: Multicollinearity Is Not Always Detrimental

ERIC Educational Resources Information Center

Shieh, Gwowen

2010-01-01

Due to its extensive applicability and computational ease, moderated multiple regression (MMR) has been widely employed to analyze interaction effects between 2 continuous predictor variables. Accordingly, considerable attention has been drawn toward the supposed multicollinearity problem between predictor variables and their cross-product term.…

The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network

PubMed Central

Geller, Marilyn G.; Zylberberg, Haley M.; Green, Peter H. R.; Lebwohl, Benjamin

2018-01-01

Background: The prevalence of depression in celiac disease (CD) is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac®) to explore the effect that depression has on patients’ symptomatic response to a gluten-free diet (GFD). Methods: We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI)), GFD adherence (Celiac Dietary Adherence Test (CDAT)), and a 5-point, scaled question regarding depressive symptoms relating to patients’ celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT) in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Results: Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt “somewhat,” “quite a bit,” or “very much” depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence (r = 0.6, p < 0.0001). In those with a positive depression screen, there was a moderate correlation between worsening symptoms and worsening dietary adherence (r = 0.5, p < 0.0001) whereas in those without depression, the correlation was stronger (r = 0.64, p < 0.0001). We performed a linear regression analysis, which suggests that the relationship between CSI and CDAT is modified by depression. Conclusions: In patients with depressive symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may modify the effect of a GFD on celiac symptoms. Depressive symptoms may therefore mask the relationship between inadvertent gluten exposure and symptoms. Additional longitudinal and prospective studies are needed to further explore this potentially important finding. PMID:29701659

The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network.

PubMed

Joelson, Andrew M; Geller, Marilyn G; Zylberberg, Haley M; Green, Peter H R; Lebwohl, Benjamin

2018-04-26

The prevalence of depression in celiac disease (CD) is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac ® ) to explore the effect that depression has on patients' symptomatic response to a gluten-free diet (GFD). We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI)), GFD adherence (Celiac Dietary Adherence Test (CDAT)), and a 5-point, scaled question regarding depressive symptoms relating to patients' celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT) in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt "somewhat," "quite a bit," or "very much" depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence ( r = 0.6, p < 0.0001). In those with a positive depression screen, there was a moderate correlation between worsening symptoms and worsening dietary adherence ( r = 0.5, p < 0.0001) whereas in those without depression, the correlation was stronger ( r = 0.64, p < 0.0001). We performed a linear regression analysis, which suggests that the relationship between CSI and CDAT is modified by depression. In patients with depressive symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may modify the effect of a GFD on celiac symptoms. Depressive symptoms may therefore mask the relationship between inadvertent gluten exposure and symptoms. Additional longitudinal and prospective studies are needed to further explore this potentially important finding.

Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

PubMed

Altubasi, Ibrahim M

2018-06-07

Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

[Prediction of histological liver damage in asymptomatic alcoholic patients by means of clinical and laboratory data].

PubMed

Iturriaga, H; Hirsch, S; Bunout, D; Díaz, M; Kelly, M; Silva, G; de la Maza, M P; Petermann, M; Ugarte, G

1993-04-01

Looking for a noninvasive method to predict liver histologic alterations in alcoholic patients without clinical signs of liver failure, we studied 187 chronic alcoholics recently abstinent, divided in 2 series. In the model series (n = 94) several clinical variables and results of common laboratory tests were confronted to the findings of liver biopsies. These were classified in 3 groups: 1. Normal liver; 2. Moderate alterations; 3. Marked alterations, including alcoholic hepatitis and cirrhosis. Multivariate methods used were logistic regression analysis and a classification and regression tree (CART). Both methods entered gamma-glutamyltransferase (GGT), aspartate-aminotransferase (AST), weight and age as significant and independent variables. Univariate analysis with GGT and AST at different cutoffs were also performed. To predict the presence of any kind of damage (Groups 2 and 3), CART and AST > 30 IU showed the higher sensitivity, specificity and correct prediction, both in the model and validation series. For prediction of marked liver damage, a score based on logistic regression and GGT > 110 IU had the higher efficiencies. It is concluded that GGT and AST are good markers of alcoholic liver damage and that, using sample cutoffs, histologic diagnosis can be correctly predicted in 80% of recently abstinent asymptomatic alcoholics.

Lidocaine dose-response effect on postoperative cognitive deficit: meta-analysis and meta-regression.

PubMed

Habibi, Mohammad Reza; Habibi, Valiollah; Habibi, Ali; Soleimani, Aria

2018-04-01

The true influence of the perioperative intravenous lidocaine on the development of postoperative cognitive deficit (POCD) in coronary artery bypass grafting (CABG) remains controversial. The principal aim is to undertake a meta-regression to determine whether moderator variables mediate the relationship between lidocaine and POCD. Areas covered: We searched the Web of Science, PubMed database, Scopus and the Cochrane Library database (up to June 2017) and systematically reviewed a list of retrieved articles. Our final review includes only randomized controlled trials (RCTs) that compared infusion of lidocaine and placebo during cardiopulmonary bypass (CPB). Mantel-Haenszel risk ratio (MH RR) and corresponding 95% confidence interval (CI) was used to report the overall effect and meta-regression analysis. A total of 688 patients in five RCTs were included. POCD occurred in 34% of all cases. Perioperative lidocaine reduces POCD (MH RR 0.702 (95% CI: 0.541-0.909). Younger age, male gender, longer CPB and higher concentration of lidocaine significantly mediate the relationship between lidocaine and POCD in favour of the neuroprotective effect of lidocaine. Expert commentary: The neuroprotective effect of lidocaine on POCD is consistent in spite of longer CPB time. A higher concentration of lidocaine strengthened the neuroprotective effect of lidocaine.

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

PubMed

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

2013-04-01

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

High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis.

PubMed

Cooney, Laura G; Lee, Iris; Sammel, Mary D; Dokras, Anuja

2017-05-01

Do women with polycystic ovary syndrome (PCOS) have an increased prevalence of moderate and severe depressive and anxiety symptoms compared with control women, and do these symptoms correlate with age, BMI, testosterone, hirsutism or insulin resistance (IR)? Women with PCOS have significantly increased odds of moderate and severe depressive and anxiety symptoms, independent of obesity, and the symptoms are weakly associated with age, BMI, elevated testosterone, hirsutism and IR. Previous studies have reported that women with PCOS have an increased prevalence of mild depressive and anxiety symptoms or an increase in mean depression and anxiety scores, although these scores are usually within the normal range. Thus, it is therefore not clear whether these findings are clinically significant. The prevalence of moderate and severe depressive and anxiety symptoms, which require follow-up and would benefit from treatment, is not known in this population. A comprehensive systematic review (SR) was performed up to January 2016 and included 30 cross-sectional studies, representing 3050 subjects with PCOS and 3858 controls, from 10 different countries. The meta-analysis (MA) on depressive symptoms included 18 studies and the MA on anxiety symptoms included 9 studies. A separate SR identified 15 studies for the meta-regression examining the associations with PCOS-related symptoms or comorbidities. All studies included adult women with PCOS, defined by the National Institutes of Health or Rotterdam criteria, and a control group without PCOS. Ovid, Embase, PsychInfo and Cochrane were searched up to January 2016. Included studies used a validated screening tool to compare the prevalence or mean scores of depressive and/or anxiety symptoms. Random effects MA was used to estimate the pooled odds ratio (OR) of depressive and anxiety symptoms. Sensitivity analyses of methodological characteristics and a meta-regression of the pooled standardized mean difference (SMD) to evaluate PCOS-related clinical and laboratory associations were performed. Women with PCOS had increased odds of any depressive symptoms (OR: 3.78; 95% CI: 3.03-4.72; 18 studies) and of moderate/severe depressive symptoms (OR: 4.18; 95% CI: 2.68-6.52; 11 studies). Women with PCOS had increased odds of any anxiety symptoms (OR: 5.62; 95% CI: 3.22-9.80, nine studies) and of moderate/severe anxiety symptoms (OR: 6.55; 95% CI: 2.87, 14.93; five studies). When subjects were matched on BMI, women with PCOS still had higher odds of both depressive (OR: 3.25; 95% CI 1.73-6.09; four studies) and anxiety symptoms (OR: 6.30, 95% CI: 1.88-21.09; three studies). There was no substantial heterogeneity among studies in the overall MA on depressive symptoms (I2 = 22.4%, P = 0.19), but there was significant heterogeneity among studies in the analysis on anxiety symptoms (I2 = 59.6%, P= 0.01). In the meta-regression evaluating pooled SMDs between groups, women with PCOS and concurrent depression had higher mean values of age, BMI, hirsutism score and IR, while women with PCOS and concurrent anxiety had higher mean values of BMI, hirsutism score and free testosterone (P < 0.05 for all comparisons). All studies were cross-sectional, thus we can only hypothesize that the diagnosis of PCOS precedes the diagnosis of depression and anxiety. There were large variations in methodological characteristics especially in the studies screening for anxiety; however, they only partly explained effect size variation. This evidence-synthesis analysis shows that PCOS diagnosis is associated with an increased risk of moderate and severe depressive and anxiety symptoms and suggests that providers should consider screening women with PCOS for both depression and anxiety. Although age, obesity, hyperandrogenism and IR do not explain the entire association, well-designed studies are needed to assess the impact of treatment of these factors on depressive and anxiety symptoms in women with PCOS. No funding was used for this study. There are no conflicts of interest. N/A. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases

PubMed Central

Ali, Alaa M.G.; Schmidt, Marjanka K.; Bolla, Manjeet K.; Wang, Qin; Gago-Dominguez, M.; Castelao, J. Esteban; Carracedo, Angel; Garzón, Victor Muñoz; Bojesen, Stig E.; Nordestgaard, Børge G.; Flyger, Henrik; Chang-Claude, Jenny; Vrieling, Alina; Rudolph, Anja; Seibold, Petra; Nevanlinna, Heli; Muranen, Taru A.; Aaltonen, Kirsimari; Blomqvist, Carl; Matsuo, Keitaro; Ito, Hidemi; Iwata, Hiroji; Horio, Akiyo; John, Esther M.; Sherman, Mark; Lissowska, Jolanta; Figueroa, Jonine; Garcia-Closas, Montserrat; Anton-Culver, Hoda; Shah, Mitul; Hopper, John L.; Trichopoulou, Antonia; Bueno-de-Mesquita, Bas; Krogh, Vittorio; Weiderpass, Elisabete; Andersson, Anne; Clavel-Chapelon, Françoise; Dossus, Laure; Fagherazzi, Guy; Peeters, Petra H.; Olsen, Anja; Wishart, Gordon C.; Easton, Douglas F.; Borgquist, Signe; Overvad, Kim; Barricarte, Aurelio; González, Carlos A.; Sánchez, María-José; Amiano, Pilar; Riboli, Elio; Key, Tim; Pharoah, Paul D.

2015-01-01

Background Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts. Methods A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for “moderate drinkers” versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts. Results We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate post-diagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85–1.05], but there was some evidence of better survival associated with prediagnosis consumption (HR, 0.80; 95% CI, 0.73–0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer–specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer–specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease. Conclusion There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer–specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer–specific mortality in ER-negative disease. Impact Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer. PMID:24636975

Family Functioning and Dysfunctional Eating Among Italian Adolescents: The Moderating Role of Gender.

PubMed

Laghi, Fiorenzo; McPhie, Meghan L; Baumgartner, Emma; Rawana, Jennine S; Pompili, Sara; Baiocco, Roberto

2016-02-01

The first aim of this study was to examine the association between different dimensions of family functioning and dysfunctional eating in a sample of Italian adolescent boys and girls. The second aim was to investigate whether gender moderates the relationship between family functioning and dysfunctional eating. Seven hundred and twenty seven adolescents (500 boys and 227 girls) with ages ranging from 15 to 18 years completed a survey of self-report measures. Findings from hierarchical multiple regression analysis suggested that aspects of family functioning such as flexibility, cohesion, disengagement, enmeshment, rigidity and chaotic were related to dysfunctional eating in adolescents. Additionally the results indicated differences between boys and girls, in particular dysfunctional eating in adolescent boys seemed to be more affected by dimensions of enmeshment and disengagement than dysfunctional eating in girls. This research highlights the important role of various aspects of family functioning in relation to dysfunctional eating in adolescents.

The relationship between breast cancer anxiety and mammography: experiential avoidance as a moderator.

PubMed

Miller, Sarah J; O'Hea, Erin L; Lerner, Jennifer Block; Moon, Simon; Foran-Tuller, Kelly A

2011-10-01

Although mammography can aid in the early detection and prevention of breast cancer, many women do not receive annual mammograms. It remains unclear whether anxiety about breast cancer inhibits or promotes mammography rates. The way in which women regulate their anxiety (ie, level of experiential avoidance) may play a role in predicting mammography adherence. A community sample of women (N = 84) completed a questionnaire which assessed mammography rates, experiential avoidance, and breast cancer anxiety. The results suggest that, while controlling for breast cancer anxiety, experiential avoidance (β = .31, p < .01) significantly predicted mammography rates. When examining experiential avoidance as a moderator, a multiple regression analysis approached significance (R2 Δ = .04, p = .07), suggesting that a woman's level of experiential avoidance influences the relationship between anxiety and mammography. These findings will help enable health care practitioners to better identify women at risk of non-adherence to mammography recommendations.

The Influence of Social Structure on Cancer Pain and Quality of Life.

PubMed

Ham, Ok-Kyung; Chee, Wonshik; Im, Eun-Ok

2017-12-01

The aim of this study was to investigate whether social structure is associated with cancer pain and quality of life using the Social Structure and Personality Research Framework. This study was a secondary analysis of data from 480 cancer patients. The measurements included socioeconomic variables, self-reported cancer pain using the McGill Pain Questionnaire-Short Form (MPQ-SF), and quality of life measured using the Functional Assessment of Cancer Therapy Scale (FACT-G). The data were analyzed using moderated multiple regression. Cancer pain and quality of life differed significantly with income. The associations between income and pain and quality of life were significant only for the high education group (≥ partial college), and these associations were greater for Caucasians than for their counterparts ( p < .05). When developing interventions, nurses should consider the influence of socioeconomic variables on pain and quality of life while considering possible moderating factors such as education.

Impact of the Supervisor Feedback Environment on Creative Performance: A Moderated Mediation Model.

PubMed

Zhang, Jian; Gong, Zhenxing; Zhang, Shuangyu; Zhao, Yujia

2017-01-01

Studies on the relationship between feedback and creative performance have only focused on the feedback-self and have underestimated the value of the feedback environment. Building on Self Determined Theory, the purpose of this article is to examine the relationship among feedback environment, creative personality, goal self-concordance and creative performance. Hierarchical regression analysis of a sample of 162 supervisor-employee dyads from nine industry firms. The results indicate that supervisor feedback environment is positively related to creative performance, the relationship between the supervisor feedback environment and creative performance is mediated by goal self-concordance perfectly and moderated by creative personality significantly. The mediation effort of goal self-concordance is significantly influenced by creative personality. The implication of improving employees' creative performance is further discussed. The present study advances several perspectives of previous studies, echoes recent suggestions that organizations interested in stimulating employee creativity might profitably focus on developing work contexts that support it.

Horizontal and vertical dimensions of individualism-collectivism: a comparison of African Americans and European Americans.

PubMed

Komarraju, Meera; Cokley, Kevin O

2008-10-01

The current study examined ethnic differences in horizontal and vertical dimensions of individualism and collectivism among 96 African American and 149 European American college students. Participants completed the 32-item Singelis et al. (1995) Individualism/Collectivism Scale. Multivariate analyses of variance results yielded a main effect for ethnicity, with African Americans being significantly higher on horizontal individualism and European Americans being higher on horizontal collectivism and vertical individualism. A moderated multiple regression analysis indicated that ethnicity significantly moderated the relationship between individualism and collectivism. Individualism and collectivism were significantly and positively associated among African Americans, but not associated among European Americans. In addition, collectivism was related to grade point average for African Americans but not for European Americans. Contrary to the prevailing view of individualism-collectivism being unipolar, orthogonal dimensions, results provide support for individualism-collectivism to be considered as unipolar, related dimensions for African Americans.

The association between body mass index status and sick leave and the role of emotional exhaustion-a mediation analysis among a representative sample of dutch employees.

PubMed

Proper, Karin I; Koppes, Lando L J; Meijer, Sanne; Bemelmans, Wanda J E

2013-10-01

To investigate the associations between body mass index (BMI) and sick leave, and the mediating role of emotional exhaustion. Data were collected from a large survey among Dutch employees (n = 35,022). The causal pathway approach consisting of four regression analyses was applied. In women, moderate overweight and obesity were associated with higher sick leave; in men, obesity, but not moderate overweight, was associated with higher sick leave. Obese workers were at increased risk for emotional exhaustion. Emotional exhaustion was also associated with higher sick leave rates. Adjustment for emotional exhaustion in the association between BMI and sick leave hardly changed the effect size and significance remained. The association between BMI status and sick leave can be explained partially by the presence of emotional exhaustion. Workplace health promotion initiatives should take this into account.

Mean centering, multicollinearity, and moderators in multiple regression: The reconciliation redux.

PubMed

Iacobucci, Dawn; Schneider, Matthew J; Popovich, Deidre L; Bakamitsos, Georgios A

2017-02-01

In this article, we attempt to clarify our statements regarding the effects of mean centering. In a multiple regression with predictors A, B, and A × B (where A × B serves as an interaction term), mean centering A and B prior to computing the product term can clarify the regression coefficients (which is good) and the overall model fit R 2 will remain undisturbed (which is also good).

The burden of moderate-to-heavy soil-transmitted helminth infections among rural malaysian aborigines: an urgent need for an integrated control programme.

PubMed

Ahmed, Abdulhamid; Al-Mekhlafi, Hesham M; Choy, Seow Huey; Ithoi, Init; Al-Adhroey, Abdulelah H; Abdulsalam, Awatif M; Surin, Johari

2011-12-30

Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Almost half of the participants had heavy trichuriasis, one-quarter had heavy ascariasis whereas all hookworm infections were light infections. Overall, moderate-to-heavy STH infections accounted for 56.7% of the total infections. Univariate analysis revealed that those using untreated water supply (P = 0.013), living in houses without toilets (P = 0.027) and having domestic animals in the houses (P = 0.044) had significantly higher prevalence of moderate-to-heavy infections than others. Logistic regression analysis confirmed using untreated water for drinking (P = 0.001) and the absence of a toilet in the house (P = 0.003) as significant risk factors of moderate-to-heavy STH infections among these children. The high proportion of moderate-to-heavy STH infections further confirms the need for serious attention towards these devastating diseases that has put lives and the future of aboriginal children in jeopardy. Introduction of more poverty alleviation schemes, proper sanitation, provision of clean and safe drinking water, health education, as well as the introduction of periodic school-based deworming programmes are imperative among these communities in order to curtail the transmission and morbidity caused by STH.

The burden of moderate-to-heavy soil-transmitted helminth infections among rural malaysian aborigines: an urgent need for an integrated control programme

PubMed Central

2011-01-01

Background Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. Methods A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Results Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Almost half of the participants had heavy trichuriasis, one-quarter had heavy ascariasis whereas all hookworm infections were light infections. Overall, moderate-to-heavy STH infections accounted for 56.7% of the total infections. Univariate analysis revealed that those using untreated water supply (P = 0.013), living in houses without toilets (P = 0.027) and having domestic animals in the houses (P = 0.044) had significantly higher prevalence of moderate-to-heavy infections than others. Logistic regression analysis confirmed using untreated water for drinking (P = 0.001) and the absence of a toilet in the house (P = 0.003) as significant risk factors of moderate-to-heavy STH infections among these children. Conclusion The high proportion of moderate-to-heavy STH infections further confirms the need for serious attention towards these devastating diseases that has put lives and the future of aboriginal children in jeopardy. Introduction of more poverty alleviation schemes, proper sanitation, provision of clean and safe drinking water, health education, as well as the introduction of periodic school-based deworming programmes are imperative among these communities in order to curtail the transmission and morbidity caused by STH. PMID:22208559

The applied model of imagery use: Examination of moderation and mediation effects.

PubMed

Koehn, S; Stavrou, N A M; Young, J A; Morris, T

2016-08-01

The applied model of mental imagery use proposed an interaction effect between imagery type and imagery ability. This study had two aims: (a) the examination of imagery ability as a moderating variable between imagery type and dispositional flow, and (b) the testing of alternative mediation models. The sample consisted of 367 athletes from Scotland and Australia, who completed the Sport Imagery Questionnaire, Sport Imagery Ability Questionnaire, and Dispositional Flow Scale-2. Hierarchical regression analysis showed direct effects of imagery use and imagery ability on flow, but no significant interaction. Mediation analysis revealed a significant indirect path, indicating a partially mediated relationship (P = 0.002) between imagery use, imagery ability, and flow. Partial mediation was confirmed when the effect of cognitive imagery use and cognitive imagery ability was tested, and a full mediation model was found between motivational imagery use, motivational imagery ability, and flow. The results are discussed in conjunction with potential future research directions on advancing theory and applications. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adolescent pregnancy and depression: is there an association?

PubMed

Kamalak, Z; Köşüş, N; Köşüş, A; Hizli, D; Akçal, B; Kafali, H; Canbal, M; Isaoğlu, Ü

2016-01-01

The impact of being an adolescent and socio-demographic parameters on depression development during pregnancy were evaluated in this study. Between September 2010 and September 2011, 105 consecutive adolescent women ≤ 17 years of age were defined as the study group and 105 consecutive pregnant women over 18 years of age and matched for gestational age, were defined as the control group. Groups were compared according to depression development. The predictors of depression were analyzed by regression analysis. Median Beck Depression Inventory-II (BDI-II) scores in adolescent and control groups were 16 and 6, respectively. The difference was statistically significant. In the adolescent group, 39.0% of patients had mild depression, 37.1% moderate, and 10.5% had severe depression. Only 4.8% of patients in the control group had mild depression while none of the control cases had moderate or severe depression. Multivariate analysis showed that most important factor that was associated with depression development during pregnancy was being an adolescent. Depression risk was increased 18.2-fold in adolescent patients with pregnancy. Therefore psychiatric evaluation should be considered for these patients.

Cognitive performance predicts treatment decisional abilities in mild to moderate dementia.

PubMed

Gurrera, R J; Moye, J; Karel, M J; Azar, A R; Armesto, J C

2006-05-09

To examine the contribution of neuropsychological test performance to treatment decision-making capacity in community volunteers with mild to moderate dementia. The authors recruited volunteers (44 men, 44 women) with mild to moderate dementia from the community. Subjects completed a battery of 11 neuropsychological tests that assessed auditory and visual attention, logical memory, language, and executive function. To measure decision making capacity, the authors administered the Capacity to Consent to Treatment Interview, the Hopemont Capacity Assessment Interview, and the MacCarthur Competence Assessment Tool--Treatment. Each of these instruments individually scores four decisional abilities serving capacity: understanding, appreciation, reasoning, and expression of choice. The authors used principal components analysis to generate component scores for each ability across instruments, and to extract principal components for neuropsychological performance. Multiple linear regression analyses demonstrated that neuropsychological performance significantly predicted all four abilities. Specifically, it predicted 77.8% of the common variance for understanding, 39.4% for reasoning, 24.6% for appreciation, and 10.2% for expression of choice. Except for reasoning and appreciation, neuropsychological predictor (beta) profiles were unique for each ability. Neuropsychological performance substantially and differentially predicted capacity for treatment decisions in individuals with mild to moderate dementia. Relationships between elemental cognitive function and decisional capacity may differ in individuals whose decisional capacity is impaired by other disorders, such as mental illness.

Reward and punishment sensitivity and alcohol use: the moderating role of executive control.

PubMed

Jonker, Nienke C; Ostafin, Brian D; Glashouwer, Klaske A; van Hemel-Ruiter, Madelon E; de Jong, Peter J

2014-05-01

Reward sensitivity and to a lesser extent punishment sensitivity have been found to explain individual differences in alcohol use. Furthermore, many studies showed that addictive behaviors are characterized by impaired self-regulatory processes, and that individual differences related to alcohol use are moderated by executive control. This is the first study that explores the potential moderating role of executive control in the relation between reward and punishment sensitivity and alcohol use. Participants were 76 university students, selected on earlier given information about their alcohol use. Half of the participants indicated to drink little alcohol and half indicated to drink substantial amounts of alcohol. As expected, correlational analyses showed a positive relationship between reward sensitivity and alcohol use and a negative relation between punishment sensitivity and alcohol use. Regression analysis confirmed that reward sensitivity was a significant independent predictor of alcohol use. Executive control moderated the relation between punishment sensitivity and alcohol use, but not the relation between reward sensitivity and alcohol use. Only in individuals with weak executive control punishment sensitivity and alcohol use were negatively related. The results suggest that for individuals with weak executive control, punishment sensitivity might be a protective factor working against substantial alcohol use. Copyright © 2013 Elsevier Ltd. All rights reserved.

Subclinical hypothyroidism and diabetes as risk factors for postoperative stiff shoulder.

PubMed

Blonna, Davide; Fissore, Francesca; Bellato, Enrico; La Malfa, Marco; Calò, Michel; Bonasia, Davide Edoardo; Rossi, Roberto; Castoldi, Filippo

2017-07-01

Postoperative stiffness can be a disabling condition after arthroscopic shoulder surgery. The purpose of this study was to analyse the potential contribution of subclinical forms of hypothyroidism and diabetes in the development of postoperative shoulder stiffness. A prospective study was conducted on 65 consecutive patients scheduled for arthroscopic subacromial decompression or rotator cuff tear repair. Patients with preoperative stiffness were excluded. Preoperative measurements of free thyroxine, free triiodothyronine, thyroid-stimulating hormone and fasting glycaemia were taken in all patients to detect subclinical forms of diabetes and hypothyroidism. A follow-up was planned at 30, 60, 90 and 180 days after surgery. According to range of motion measurements, postoperative stiffness was classified as severe or moderate at follow-up. Univariate and logistic regression analyses were performed for the assessment of risk factors for stiffness. The overall incidence of postoperative stiffness was 29 % (19/65) in our cohort. Considering only the arthroscopic rotator cuff repairs, this incidence was 23 % (7/31). A new diagnosis of subclinical forms of diabetes or hypothyroidism was made in five cases. All five of these cases developed postoperative stiffness. The logistic regression analysis demonstrated that hypothyroidism was a risk factor for severe stiffness (RR = 25; p = 0.001) and that diabetes was a risk factor for moderate stiffness (RR = 5.7; p = 0.03). The postoperative stiffness in the majority of patients can be predicted by a careful analysis of past medical history and by detecting subclinical forms of hypothyroidism and diabetes. Prognostic study, Level II.

Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China.

PubMed

Lv, Bing; Zhou, Zhongliang; Xu, Guiping; Yang, Dingkun; Wu, Lina; Shen, Qian; Jiang, Minghuan; Wang, Xiao; Zhao, Guilan; Yang, Shimin; Fang, Yu

2014-07-01

To evaluate the knowledge, attitude and behaviours of university students on the use of antibiotics. A knowledge-attitude-practice questionnaire was developed and distributed to undergraduate students of Xi'an Jiaotong University, comprising 18 schools/colleges in Shaanxi Province, western China. Chi-square test and logistic regression analysis were applied to identify risk factors associated with self-medication with antibiotics. Of the 731 respondents (response rate = 73.1%), 294 (40.2%) had self-medicated with antibiotics in the past 6 months. Most of the antibiotics (59.2%) for self-medication were purchased without prescription in retail pharmacies. The median score of students' knowledge about antibiotics was 4 (IQR: 3-6) of a maximum possible score of 10. Students had moderately accurate beliefs towards antibiotics. More than half of the students (56.5%) were storing antibiotics frequently. During self-medication, 16.7% of students claimed to have experienced adverse reactions, and 30.6% had used antibiotics to prevent common colds. The majority preferred to use broad-spectrum antibiotics, and nearly half preferred intravenous antibiotics. Over 44% of students had changed antibiotic dosage, and 36.5% had switched to another antibiotic during the treatment course. Logistic regression analysis identified college and home town as independent risk factors for self-medication with antibiotics (P < 0.01). Undergraduate students had inadequate knowledge, moderately accurate beliefs and inappropriate practices concerning antibiotics, and a high rate of self-medication. This highlights the need for focused educational intervention and stricter governmental regulation concerning antibiotic use and sale in retail pharmacies. © 2014 John Wiley & Sons Ltd.

Do depression treatments reduce suicidal ideation? The effects of CBT, IPT, pharmacotherapy, and placebo on suicidality.

PubMed

Weitz, Erica; Hollon, Steven D; Kerkhof, Ad; Cuijpers, Pim

2014-01-01

Many well-researched treatments for depression exist. However, there is not yet enough evidence on whether these therapies, designed for the treatment of depression, are also effective for reducing suicidal ideation. This research provides valuable information for researchers, clinicians, and suicide prevention policy makers. Analysis was conducted on the Treatment for Depression Research Collaborative (TDCRP) sample, which included CBT, IPT, medication, and placebo treatment groups. Participants were included in the analysis if they reported suicidal ideation on the HRSD or BDI (score of ≥1). Multivariate linear regression indicated that both IPT (b=.41, p<.05) and medication (b =.47, p<.05) yielded a significant reduction in suicide symptoms compared to placebo on the HRSD. Multivariate linear regression indicated that after adjustment for change in depression these treatment effects were no longer significant. Moderate Cohen׳s d effect sizes from baseline to post-test differences in suicide score by treatment group are reported. These analyses were completed on a single suicide item from each of the measures. Moreover, the TDCRP excluded participants with moderate to severe suicidal ideation. This study demonstrates the specific effectiveness of IPT and medications in reducing suicidal ideation (relative to placebo), albeit largely as a consequence of their more general effects on depression. This adds to the growing body of evidence that depression treatments, specifically IPT and medication, can also reduce suicidal ideation and serves to further our understanding of the complex relationship between depression and suicide. Copyright © 2014 Elsevier B.V. All rights reserved.

Work Demands-Burnout and Job Engagement-Job Satisfaction Relationships: Teamwork as a Mediator and Moderator

PubMed Central

Mijakoski, Dragan; Karadzinska-Bislimovska, Jovanka; Basarovska, Vera; Minov, Jordan; Stoleski, Sasho; Angeleska, Nada; Atanasovska, Aneta

2015-01-01

BACKGROUND: Few studies have examined teamwork as mediator and moderator of work demands-burnout and job engagement-job satisfaction relationships in healthcare workers (HCWs) in South-East Europe. AIM: To assess mediation and moderation effect of teamwork on the relationship between independent (work demands or job engagement) and dependent (burnout or job satisfaction) variables. METHODS: Work demands, burnout, job engagement, and job satisfaction were measured with Hospital Experience Scale, Maslach Burnout Inventory, Utrecht Work Engagement Scale, and Job Satisfaction Survey, respectively. Hospital Survey on Patient Safety Culture was used for assessment of teamwork. In order to examine role of teamwork as a mediating variable we fit series of regression models for burnout and job satisfaction. We also fit regression models predicting outcome (burnout or job satisfaction) from predictor (work demands or job engagement) and moderator (teamwork) variable. RESULTS: Teamwork was partial mediator of work demands-burnout relationship and full mediator of job engagement-job satisfaction relationship. We found that only job engagement-job satisfaction relationship was moderated by teamwork. CONCLUSIONS: Occupational health services should target detection of burnout in HCWs and implementation of organizational interventions in hospitals, taking into account findings that teamwork predicted reduced burnout and higher job satisfaction. PMID:27275218

Optimism on quality of life in Portuguese chronic patients: moderator/mediator?

PubMed

Vilhena, Estela; Pais-Ribeiro, José; Silva, Isabel; Pedro, Luísa; Meneses, Rute F; Cardoso, Helena; Silva, António Martins da; Mendonça, Denisa

2014-07-01

optimism is an important variable that has consistently been shown to affect adjustment to quality of life in chronic diseases. This study aims to clarify if dispositional optimism exerts a moderating or a mediating influence on the personality traits-quality of life association, in Portuguese chronic patients. multiple regression models were used to test the moderation and mediation effects of dispositional optimism in quality of life. A sample of 729 patients was recruited in Portugal's main hospitals and completed self-reported questionnaires assessing socio-demographic and clinical variables, personality, dispositional optimism, quality of life (QoL) and subjective well-being (SWB). the results of the regression models showed that dispositional optimism did not moderate the relationships between personality traits and quality of life. After controlling for gender, age, education level and severity of disease perception, the effects of personality traits on QoL and in SWB were mediated by dispositional optimism (partially and completely), except for the links between neuroticism/openness to experience and physical health. dispositional optimism is more likely to play a mediating, rather than a moderating role in personality traits-quality of life pathway in Portuguese chronic patients, suggesting that "the expectation that good things will happen" contributes to a better quality of life and subjective well-being.

A Comparison of Methods for Estimating Quadratic Effects in Nonlinear Structural Equation Models

ERIC Educational Resources Information Center

Harring, Jeffrey R.; Weiss, Brandi A.; Hsu, Jui-Chen

2012-01-01

Two Monte Carlo simulations were performed to compare methods for estimating and testing hypotheses of quadratic effects in latent variable regression models. The methods considered in the current study were (a) a 2-stage moderated regression approach using latent variable scores, (b) an unconstrained product indicator approach, (c) a latent…

Inverse Association between Fruit and Vegetable Intake and BMI even after Controlling for Demographic, Socioeconomic and Lifestyle Factors

PubMed Central

Heo, Moonseong; Kim, Ryung S.; Wylie-Rosett, Judith; Allison, David B.; Heymsfield, Steve B.; Faith, Myles S.

2011-01-01

Objective To estimate fruit and vegetable (FV) intake levels of US adult population and evaluate the association between FV intake and BMI status after controlling for confounding demographic, socioeconomic and lifestyle factors. We also sought to identify moderating factors. Methods We used 2007 Behavior Risk Factors Surveillance System (N > 400,000) data. FV intake was dichotomized as ≥5 servings (FV5+) versus <5 servings/day. BMI status was categorized as normal, overweight, and obese. Identification of moderators was performed by testing interactions between BMI status and other variables using bivariate analyses followed by multiple logistic regression analysis incorporating complex survey sampling design features. Results Only 24.6% of US adults consumed ≥5 servings per day and less than 4% consumed 9 or more servings. Overweight (% FV5+ = 23.9%) and obese (21.9%) groups consumed significantly less FV than the normal-weight (27.4%) group (p < 0.0001). This inverse association remained significant even after controlling for potential confounding factors. Multivariate analysis identified five significant moderators (p < 0.0001) after controlling for all evaluated variables: race, sex, smoking status, health coverage, and physical activity. Notably, physically inactive obese males tended to consume the least FV (% FV5+ = 14.7%). Conclusion Current US population FV intake level is below recommended levels. The inverse association between FV intake and obesity was significant and was moderated by demographic, socioeconomic status, and lifestyle factors. These factors should be considered when developing policies and interventions to increase FV intake. PMID:22248995

Economic, Labor, and Regulatory Moderators of the Effect of Individual Placement and Support Among People With Severe Mental Illness: A Systematic Review and Meta-analysis.

PubMed

Metcalfe, Justin D; Drake, Robert E; Bond, Gary R

2018-01-13

As Individual Placement and Support (IPS) has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. This meta-analysis used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product (GDP), local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce. Regulatory moderators represent facilitators and barriers to employment that may reinforce or detract from the effectiveness of IPS. Across 30 sites drawn from 21 randomized controlled trials in 12 countries (33% in the United States), IPS recipients were 2.31 (95% CI 1.99-2.69) times more likely to find competitive employment than recipients of alternative vocational rehabilitation services. The significant competitive-employment rate advantage of IPS over control services increased in the presence of weaker employment protection legislation and integration efforts, and less generous disability benefits. Policy makers should recognize and account for the fact that labor and disability regulations can create an arrangement of incentives that reduces the relative efficacy of supported employment. © The Author(s) 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Evaluation of a reduced nicotine product standard: moderating effects of and impact on cannabis use*

PubMed Central

Pacek, Lauren R.; Vandrey, Ryan; Dermody, Sarah S.; Denlinger, Rachel L.; Lemieux, Andrine; Tidey, Jennifer W.; McClernon, F. Joseph; Bangdiwala, Ananta S.; Drobes, David J.; al'Absi, Mustafa; Strasser, Andrew A.; Koopmeiners, Joseph S.; Hatsukami, Dorothy K.; Donny, Eric C.

2016-01-01

Introduction The Family Smoking Prevention and Tobacco Control Act authorized the FDA to reduce the nicotine content in cigarettes. Research is needed to guide proposed regulations, including evaluation of consequences to public health. This study evaluated how a reduced nicotine product standard might be moderated by and impact cannabis use. Methods Secondary analysis of a controlled clinical trial examining the effects of nicotine content in cigarettes in adult daily smokers. Linear regression assessed whether baseline cannabis use moderated behavioral, subjective, or physiological effects of smoking very low nicotine content (VLNC) versus normal nicotine content (NNC) cigarettes. Repeated measures analysis of associations between nicotine condition and prevalence and frequency of cannabis use was completed using generalized estimating equations (GEE). Results Among cannabis users and non-users, smokers randomized to VLNC cigarettes reported lower nicotine dependence, cigarettes per day, biomarkers of nicotine exposure, and craving compared to smokers randomized to NNC cigarettes. Non-cannabis using smokers randomized to VLNC cigarettes also reported lower smoking dependence motives and had lower tobacco-specific nitrosamine exposure and total puff volume versus smokers randomized to NNC cigarettes. For cannabis users, smokers randomized to VLNC cigarettes reported decreased positive affect. Cannabis use did not moderate most effects of VLNC cigarettes. VLNC cigarette use did not impact the prevalence or frequency of cannabis use. Discussion Findings provide evidence that nicotine reduction in cigarettes could have beneficial effects on cigarette smoking regardless of cannabis use. Results suggest that transitioning to VLNC cigarettes is unlikely to alter current rates of cannabis use. PMID:27590743

Home environment, brain injury, & school performance in LBW survivors.

PubMed

Mahoney, Ashley Darcy; Pinto-Martin, Jennifer; Hanlon, Alexandra

2014-01-01

There has been substantial research on low birthweight (LBW) as a predictor of adverse educational and cognitive outcomes. LBW infants perform worse on cognitive battery tests compared to children born at normal birthweight; however, children exposed to similar risks do not all share the same experiences. The complex, interrelated factors responsible for poor cognitive and achievement performance vary for different populations, but researchers hypothesize that the home environment may influence the infants' long-term health outcomes. Examine the home environment as a moderator in the causal pathway from neonatal brain injury to school performance in a secondary analysis of a prospectively studied, geographically defined cohort from the Neonatal Brain Hemorrhage Study. The secondary analysis sample included 543 infants with birthweights of 501 to 2,000 g who were born consecutively in three community hospitals in New Jersey between 1984 and 1986. School performance at age 9 was measured by the Woodcock-Johnson Tests of Achievement. The home environment variables were tested and analyzed using multistep hierarchical regression modeling. A moderating effect between the variable neighborhood observations and brain injury was demonstrated for the outcome math score. The moderating relationship was found in the category of children without brain injury (β = 1.76, p = .005). There were statistically significant and potentially clinical meaningful models when looking at the home environmental variables as they relate to reading and math scores. The findings suggest that at least one variable within a LBW child's socio-environmental milieu can moderate the effects of perinatal brain injury on school performance outcomes.

Evaluation of a reduced nicotine product standard: Moderating effects of and impact on cannabis use.

PubMed

Pacek, Lauren R; Vandrey, Ryan; Dermody, Sarah S; Denlinger-Apte, Rachel L; Lemieux, Andrine; Tidey, Jennifer W; McClernon, F Joseph; Bangdiwala, Ananta S; Drobes, David J; al'Absi, Mustafa; Strasser, Andrew A; Koopmeiners, Joseph S; Hatsukami, Dorothy K; Donny, Eric C

2016-10-01

The Family Smoking Prevention and Tobacco Control Act authorized the FDA to reduce the nicotine content in cigarettes. Research is needed to guide proposed regulations, including evaluation of consequences to public health. This study evaluated how a reduced nicotine product standard might be moderated by and impact cannabis use. Secondary analysis of a controlled clinical trial examining the effects of nicotine content in cigarettes in adult daily smokers. Linear regression assessed whether baseline cannabis use moderated behavioral, subjective, or physiological effects of smoking very low nicotine content (VLNC) versus normal nicotine content (NNC) cigarettes. Repeated measures analysis of associations between nicotine condition and prevalence and frequency of cannabis use was completed using generalized estimating equations (GEE). Cannabis use did not moderate most of the following effects of VLNC cigarettes: Among cannabis users and non-users, smokers randomized to VLNC cigarettes reported lower nicotine dependence, cigarettes per day, biomarkers of nicotine exposure, and craving compared to smokers randomized to NNC cigarettes. Non-cannabis using smokers randomized to VLNC cigarettes also reported lower smoking dependence motives and had lower tobacco-specific nitrosamine exposure and total puff volume versus smokers randomized to NNC cigarettes. For cannabis users, smokers randomized to VLNC cigarettes reported decreased positive affect. VLNC cigarette use did not impact the prevalence or frequency of cannabis use. Findings provide evidence that nicotine reduction in cigarettes could have beneficial effects on cigarette smoking regardless of cannabis use. Results suggest that transitioning to VLNC cigarettes is unlikely to alter current rates of cannabis use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Role of depression severity and impulsivity in the relationship between hopelessness and suicidal ideation in patients with major depressive disorder.

PubMed

Wang, Yan-yu; Jiang, Neng-zhi; Cheung, Eric F C; Sun, Hong-wei; Chan, Raymond C K

2015-09-01

Hopelessness, depression and impulsivity all contribute to the development of suicidal ideation in patients with major depressive disorder, but the pathway of these factors to suicidal ideation is not clear. This study examined the meditating effect of depression severity on the relationship between hopelessness and suicidal ideation and explored how this mediating effect was moderated by impulsivity. A total of 162 patients with major depressive disorder (MDD) completed a structured clinical diagnostic interview and a battery of scales assessing depression severity, hopelessness, suicidal ideation, and impulsivity. Regression analyses with bootstrapping methods were used to examine the mediating and moderating effects of various risk factors. Mediation analysis revealed a significant indirect effect of hopelessness on suicidal ideation, and the effect was fully mediated through depression severity. On moderation analysis, the moderating effects of the relationship between depression severity and suicidal ideation were significant in both the medium and high impulsivity groups. The present study was limited by the assessment of trait impulsivity and observer-rated depression severity, which might not fully reflect momentary impulsivity and feeling of depression when suicidal ideation occurs. Depression severity plays a mediator role in the relationship between hopelessness and suicidal ideation and this mechanism is contingent on the levels of impulsivity. MDD patients with higher impulsivity appear to be more likely to have suicidal ideations even when they are less depressed. These findings highlight the importance of impulsivity assessment and alleviation of depressive symptoms to prevent suicidality in patients with MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

Using the Graded Response Model to Control Spurious Interactions in Moderated Multiple Regression

ERIC Educational Resources Information Center

Morse, Brendan J.; Johanson, George A.; Griffeth, Rodger W.

2012-01-01

Recent simulation research has demonstrated that using simple raw score to operationalize a latent construct can result in inflated Type I error rates for the interaction term of a moderated statistical model when the interaction (or lack thereof) is proposed at the latent variable level. Rescaling the scores using an appropriate item response…

Impact of Implantable Transvenous Device Lead Location on Severity of Tricuspid Regurgitation

PubMed Central

Addetia, Karima; Maffessanti, Francesco; Mediratta, Anuj; Yamat, Megan; Weinert, Lynn; Moss, Joshua D.; Nayak, Hemal M.; Burke, Martin C.; Patel, Amit R.; Kruse, Eric; Jeevanandam, Valluvan; Mor-Avi, Victor; Lang, Roberto M.

2015-01-01

Background Implantable device leads can cause tricuspid regurgitation (TR) when they interfere with leaflet motion. The aim of this study was to determine whether lead-leaflet interference is associated with TR severity, independent of other causative factors of functional TR. Methods A total of 100 patients who underwent transthoracic two-dimensional and three-dimensional (3D) echocardiography of the tricuspid valve before and after lead placement were studied. Lead position was classified on 3D echocardiography as leaflet-interfering or noninterfering. TR severity was estimated by vena contracta (VC) width. Logistic regression analysis was used to identify factors associated with postdevice TR, including predevice VC width, right ventricular end-diastolic and end-systolic areas, fractional area change, right atrial size, tricuspid annular diameter, TR gradient, device lead age, and presence or absence of lead interference. Odds ratios were used to describe the association with moderate (VC width ≥ 0.5 cm) or severe (VC width ≥ 0.7 cm) TR, separately, using bivariate and stepwise multivariate logistic regression analysis. Results Forty-five of 100 patients showed device lead tricuspid valve leaflet interference. The septal leaflet was the most commonly affected (23 patients). On bivariate analysis, preimplantation VC width, right atrial size, tricuspid annular diameter, and lead-leaflet interference were significantly associated with postdevice TR. On multivariate analysis, preimplantation VC width and the presence of an interfering lead were independently associated with postdevice TR. Furthermore, the presence of an interfering lead was the only factor associated with TR worsening, increasing the likelihood of developing moderate or severe TR by 15- and 11-fold, respectively. Conclusion Lead-leaflet interference as seen on 3D echocardiography is associated with TR after device lead placement, suggesting that 3D echocardiography should be used to assess for lead interference in patients with significant TR. PMID:25129393

LRP-1 polymorphism is associated with global and regional amyloid load in Alzheimer's disease in humans in-vivo

PubMed Central

Grimmer, Timo; Goldhardt, Oliver; Guo, Liang-Hao; Yousefi, Behrooz H.; Förster, Stefan; Drzezga, Alexander; Sorg, Christian; Alexopoulos, Panagiotis; Förstl, Hans; Kurz, Alexander; Perneczky, Robert

2014-01-01

Objective Impaired amyloid clearance has been proposed to contribute to β-amyloid deposition in sporadic late-onset Alzheimer's disease (AD). Low density lipoprotein receptor-related protein 1 (LRP-1) is involved in the active outward transport of β-amyloid across the blood–brain barrier (BBB). The C667T polymorphism (rs1799986) of the LRP-1 gene has been inconsistently associated with AD in genetic studies. We aimed to elucidate the association of this polymorphism with in-vivo brain amyloid load of AD patients using amyloid PET with [11C]PiB. Materials and methods 72 patients with very mild to moderate AD were examined with amyloid PET and C667T polymorphism was obtained using TaqMan PCR assays. The association of C667T polymorphism with global and regional amyloid load was calculated using linear regression and voxel based analysis, respectively. The effect of the previously identified modulator of amyloid uptake, the apolipoprotein E genotype, on this association was also determined. Results The regression analysis between amyloid load and C667T polymorphism was statistically significant (p = 0.046, β = 0.236). In an additional analysis ApoE genotype and gender were identified to explain further variability of amyloid load. Voxel based analysis revealed a significant (p < 0.05) association between C667T polymorphism and amyloid uptake in the temporo-parietal cortex bilaterally. ApoE did not interact significantly with the LRP-1 polymorphism. Discussion In conclusion, C667T polymorphism of LRP-1 is moderately but significantly associated with global and regional amyloid deposition in AD. The relationship appears to be independent of the ApoE genotype. This finding is compatible with the hypothesis that impaired amyloid clearance contributes to amyloid deposition in late-onset sporadic AD. PMID:24596678

2016 American College of Rheumatology/European League Against Rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative.

PubMed

Aggarwal, Rohit; Rider, Lisa G; Ruperto, Nicolino; Bayat, Nastaran; Erman, Brian; Feldman, Brian M; Oddis, Chester V; Amato, Anthony A; Chinoy, Hector; Cooper, Robert G; Dastmalchi, Maryam; Fiorentino, David; Isenberg, David; Katz, James D; Mammen, Andrew; de Visser, Marianne; Ytterberg, Steven R; Lundberg, Ingrid E; Chung, Lorinda; Danko, Katalin; García-De la Torre, Ignacio; Song, Yeong Wook; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A; Miller, Frederick W; Vencovsky, Jiri

2017-05-01

To develop response criteria for adult dermatomyositis (DM) and polymyositis (PM). Expert surveys, logistic regression, and conjoint analysis were used to develop 287 definitions using core set measures. Myositis experts rated greater improvement among multiple pairwise scenarios in conjoint analysis surveys, where different levels of improvement in 2 core set measures were presented. The PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) method determined the relative weights of core set measures and conjoint analysis definitions. The performance characteristics of the definitions were evaluated on patient profiles using expert consensus (gold standard) and were validated using data from a clinical trial. The nominal group technique was used to reach consensus. Consensus was reached for a conjoint analysis-based continuous model using absolute per cent change in core set measures (physician, patient, and extramuscular global activity, muscle strength, Health Assessment Questionnaire, and muscle enzyme levels). A total improvement score (range 0-100), determined by summing scores for each core set measure, was based on improvement in and relative weight of each core set measure. Thresholds for minimal, moderate, and major improvement were ≥20, ≥40, and ≥60 points in the total improvement score. The same criteria were chosen for juvenile DM, with different improvement thresholds. Sensitivity and specificity in DM/PM patient cohorts were 85% and 92%, 90% and 96%, and 92% and 98% for minimal, moderate, and major improvement, respectively. Definitions were validated in the clinical trial analysis for differentiating the physician rating of improvement (p<0.001). The response criteria for adult DM/PM consisted of the conjoint analysis model based on absolute per cent change in 6 core set measures, with thresholds for minimal, moderate, and major improvement. 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/.

Adaptive surrogate modeling by ANOVA and sparse polynomial dimensional decomposition for global sensitivity analysis in fluid simulation

NASA Astrophysics Data System (ADS)

Tang, Kunkun; Congedo, Pietro M.; Abgrall, Rémi

2016-06-01

The Polynomial Dimensional Decomposition (PDD) is employed in this work for the global sensitivity analysis and uncertainty quantification (UQ) of stochastic systems subject to a moderate to large number of input random variables. Due to the intimate connection between the PDD and the Analysis of Variance (ANOVA) approaches, PDD is able to provide a simpler and more direct evaluation of the Sobol' sensitivity indices, when compared to the Polynomial Chaos expansion (PC). Unfortunately, the number of PDD terms grows exponentially with respect to the size of the input random vector, which makes the computational cost of standard methods unaffordable for real engineering applications. In order to address the problem of the curse of dimensionality, this work proposes essentially variance-based adaptive strategies aiming to build a cheap meta-model (i.e. surrogate model) by employing the sparse PDD approach with its coefficients computed by regression. Three levels of adaptivity are carried out in this paper: 1) the truncated dimensionality for ANOVA component functions, 2) the active dimension technique especially for second- and higher-order parameter interactions, and 3) the stepwise regression approach designed to retain only the most influential polynomials in the PDD expansion. During this adaptive procedure featuring stepwise regressions, the surrogate model representation keeps containing few terms, so that the cost to resolve repeatedly the linear systems of the least-squares regression problem is negligible. The size of the finally obtained sparse PDD representation is much smaller than the one of the full expansion, since only significant terms are eventually retained. Consequently, a much smaller number of calls to the deterministic model is required to compute the final PDD coefficients.

Estimating top-of-atmosphere thermal infrared radiance using MERRA-2 atmospheric data

NASA Astrophysics Data System (ADS)

Kleynhans, Tania; Montanaro, Matthew; Gerace, Aaron; Kanan, Christopher

2017-05-01

Thermal infrared satellite images have been widely used in environmental studies. However, satellites have limited temporal resolution, e.g., 16 day Landsat or 1 to 2 day Terra MODIS. This paper investigates the use of the Modern-Era Retrospective analysis for Research and Applications, Version 2 (MERRA-2) reanalysis data product, produced by NASA's Global Modeling and Assimilation Office (GMAO) to predict global topof-atmosphere (TOA) thermal infrared radiance. The high temporal resolution of the MERRA-2 data product presents opportunities for novel research and applications. Various methods were applied to estimate TOA radiance from MERRA-2 variables namely (1) a parameterized physics based method, (2) Linear regression models and (3) non-linear Support Vector Regression. Model prediction accuracy was evaluated using temporally and spatially coincident Moderate Resolution Imaging Spectroradiometer (MODIS) thermal infrared data as reference data. This research found that Support Vector Regression with a radial basis function kernel produced the lowest error rates. Sources of errors are discussed and defined. Further research is currently being conducted to train deep learning models to predict TOA thermal radiance

Mathematical models application for mapping soils spatial distribution on the example of the farm from the North of Udmurt Republic of Russia

NASA Astrophysics Data System (ADS)

Dokuchaev, P. M.; Meshalkina, J. L.; Yaroslavtsev, A. M.

2018-01-01

Comparative analysis of soils geospatial modeling using multinomial logistic regression, decision trees, random forest, regression trees and support vector machines algorithms was conducted. The visual interpretation of the digital maps obtained and their comparison with the existing map, as well as the quantitative assessment of the individual soil groups detection overall accuracy and of the models kappa showed that multiple logistic regression, support vector method, and random forest models application with spatial prediction of the conditional soil groups distribution can be reliably used for mapping of the study area. It has shown the most accurate detection for sod-podzolics soils (Phaeozems Albic) lightly eroded and moderately eroded soils. In second place, according to the mean overall accuracy of the prediction, there are sod-podzolics soils - non-eroded and warp one, as well as sod-gley soils (Umbrisols Gleyic) and alluvial soils (Fluvisols Dystric, Umbric). Heavy eroded sod-podzolics and gray forest soils (Phaeozems Albic) were detected by methods of automatic classification worst of all.

Perceived risk associated with ecstasy use: a latent class analysis approach

PubMed Central

Martins, SS; Carlson, RG; Alexandre, PK; Falck, RS

2011-01-01

This study aims to define categories of perceived health problems among ecstasy users based on observed clustering of their perceptions of ecstasy-related health problems. Data from a community sample of ecstasy users (n=402) aged 18 to 30, in Ohio, was used in this study. Data was analyzed via Latent Class Analysis (LCA) and Regression. This study identified five different subgroups of ecstasy users based on their perceptions of health problems they associated with their ecstasy use. Almost one third of the sample (28.9%) belonged to a class with “low level of perceived problems” (Class 4). About one fourth (25.6%) of the sample (Class 2), had high probabilities of “perceiving problems on sexual-related items”, but generally low or moderate probabilities of perceiving problems in other areas. Roughly one-fifth of the sample (21.1%, Class 1) had moderate probabilities of perceiving ecstasy health-related problems in all areas. A small proportion of respondents (11.9%, Class 5) had high probabilities of reporting “perceived memory and cognitive problems, and of perceiving “ecstasy related-problems in all areas” (12.4%, Class 3). A large proportion of ecstasy users perceive either low or moderate risk associated with their ecstasy use. It is important to further investigate whether lower levels of risk perception are associated with persistence of ecstasy use. PMID:21296504

Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation.

PubMed

Rostagno, Carlo; Olivo, Giuseppe; Comeglio, Marco; Boddi, Vieri; Banchelli, Michela; Galanti, Giorgio; Gensini, Gian Franco

2003-06-01

The study was designed to evaluate the prognostic value of the 6-min walk test (6MWT) in patients with mild to moderate congestive heart failure (CHF). Two hundred and fourteen patients (119 men and 95 women, mean age 64 years) were followed for a mean period of 34 months to assess event-free survival (death, heart transplantation). Sixty-six patients (34%) died (63 cardiovascular causes, 2 cancer and 1 stroke) and five patients underwent heart transplantation. For patients who walked <300 m during the 6MWT, survival was 62% compared with 82% in patients who walked 300-450 m or>450 m. With univariate analysis, NYHA class was the strongest predictor of death. LVEF (P<0.0001), aetiology of heart failure (P<0.001), LV filling pattern (P=0.002) and 6MWT distance (P<0.01) were all significantly related to survival. No significant relationship was found between survival, peak oxygen consumption or anaerobic threshold. Multivariate analysis using the Cox-stepwise regression model showed that LV fractional shortening (P<0.009) and 6MWT distance (P<0.0005) were the strongest prognostic markers. A 6MWT distance of <300 m is a simple and useful prognostic marker of subsequent cardiac death in unselected patients with mild to moderate CHF.

Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal

PubMed Central

Wang, Daoyang; Li, Shuting; Hu, Mingming; Dong, Dan; Tao, Sha

2017-01-01

The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14–20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being. PMID:28824495

Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal.

PubMed

Wang, Daoyang; Li, Shuting; Hu, Mingming; Dong, Dan; Tao, Sha

2017-01-01

The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14-20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being.

Prevalence and characteristics of moderate-to-severe fatigue: a multicenter study in cancer patients and survivors

PubMed Central

Wang, Xin Shelley; Zhao, Fengmin; Fisch, Michael J.; O’Mara, Ann M.; Cella, David; Mendoza, Tito R.; Cleeland, Charles S.

2013-01-01

PURPOSE Effective management of fatigue in cancer patients requires a clear delineation of what constitutes nontrivial fatigue. We defined numeric cutpoints for fatigue severity based on functional interference and described fatigue’s prevalence and characteristics in cancer patients and survivors. METHODS In a multicenter study, outpatients with breast, prostate, colorectal, or lung cancer rated fatigue severity and symptom interference with functioning on the M. D. Anderson Symptom Inventory (MDASI) 0–10 scale. MDASI ratings of symptom interference guided selection of numeric rating cutpoints between mild, moderate, and severe fatigue levels. Regression analysis identified significant factors related to reporting moderate/severe fatigue. RESULTS The statistically optimal cutpoints were ≥4 for moderate fatigue and ≥7 for severe fatigue. Moderate/severe fatigue was reported by 45% (983/2177) of patients undergoing active treatment and was more likely to occur in patients taking strong opioids (odds ratio [OR], 3.00), had poor performance status (OR, 2.00), had >5% weight loss within 6 months (OR, 1.60), were taking >10 medications (OR, 1.58), had lung cancer (OR, 1.55), or had a history of depression (OR, 1.42). Among survivors (patients with complete remission or no evidence of disease, and no current cancer treatment), 29% (150/515) had moderate/severe fatigue that was associated with poor performance status (OR, 3.48) and a history of depression (OR, 2.21). CONCLUSION This study statistically defined fatigue-severity categories related to significantly increased symptom interference. The high prevalence of moderate/severe fatigue in both actively treated cancer patients and survivors warrants the promoting of routine assessment and management of patient-reported fatigue. PMID:24436136

A meta-regression analysis of 41 Australian problem gambling prevalence estimates and their relationship to total spending on electronic gaming machines.

PubMed

Markham, Francis; Young, Martin; Doran, Bruce; Sugden, Mark

2017-05-23

Many jurisdictions regularly conduct surveys to estimate the prevalence of problem gambling in their adult populations. However, the comparison of such estimates is problematic due to methodological variations between studies. Total consumption theory suggests that an association between mean electronic gaming machine (EGM) and casino gambling losses and problem gambling prevalence estimates may exist. If this is the case, then changes in EGM losses may be used as a proxy indicator for changes in problem gambling prevalence. To test for this association this study examines the relationship between aggregated losses on electronic gaming machines (EGMs) and problem gambling prevalence estimates for Australian states and territories between 1994 and 2016. A Bayesian meta-regression analysis of 41 cross-sectional problem gambling prevalence estimates was undertaken using EGM gambling losses, year of survey and methodological variations as predictor variables. General population studies of adults in Australian states and territory published before 1 July 2016 were considered in scope. 41 studies were identified, with a total of 267,367 participants. Problem gambling prevalence, moderate-risk problem gambling prevalence, problem gambling screen, administration mode and frequency threshold were extracted from surveys. Administrative data on EGM and casino gambling loss data were extracted from government reports and expressed as the proportion of household disposable income lost. Money lost on EGMs is correlated with problem gambling prevalence. An increase of 1% of household disposable income lost on EGMs and in casinos was associated with problem gambling prevalence estimates that were 1.33 times higher [95% credible interval 1.04, 1.71]. There was no clear association between EGM losses and moderate-risk problem gambling prevalence estimates. Moderate-risk problem gambling prevalence estimates were not explained by the models (I 2  ≥ 0.97; R 2  ≤ 0.01). The present study adds to the weight of evidence that EGM losses are associated with the prevalence of problem gambling. No patterns were evident among moderate-risk problem gambling prevalence estimates, suggesting that this measure is either subject to pronounced measurement error or lacks construct validity. The high degree of residual heterogeneity raises questions about the validity of comparing problem gambling prevalence estimates, even after adjusting for methodological variations between studies.

The role of social media use in improving cancer survivors' emotional well-being: a moderated mediation study.

PubMed

Jiang, Shaohai

2017-06-01

In the USA, levels of emotional well-being among cancer survivors remain low. Social media is recognized as important to improve their emotional well-being. However, little is known about social mechanisms that underlie the impact of health-related social media in cancer care. This study proposed a moderated mediation model to signify a pathway linking social media use to emotional well-being. Four-hundred and fifty-nine cancer survivors identified through the 2013 US-based Health Information National Trends Survey were included for data analysis. First, structural equation modeling was conducted to examine the path from social media use to emotional well-being, mediated by patient activation. Second, hierarchical regression was performed to test the moderation effect of emotion management. Last, a normal theory-based approach was used to explore the final moderated mediation model. The effect of health-related social media use on emotional well-being was completely mediated by patient activation. Also, emotion management positively moderated the effect of patient activation on emotional well-being. Last, emotion management positively moderated the mediation pathway from health-related social media use to patient activation, and finally, to emotional well-being. Health-related social media, by itself, is not sufficient to bring about improvement in cancer survivors' emotional well-being. Patient activation and emotion management play a significant role. In future interventions designed to improve cancer survivors' emotional health, health practitioners should not only encourage cancer survivors to use social media for health purposes, but also activate them in the course of care, and improve their emotion self-management skills.

Predictors and moderators in the randomized trial of multifamily psychoeducational psychotherapy for childhood mood disorders.

PubMed

MacPherson, Heather A; Algorta, Guillermo Perez; Mendenhall, Amy N; Fields, Benjamin W; Fristad, Mary A

2014-01-01

This study investigated predictors and moderators of mood symptoms in the randomized controlled trial (RCT) of Multi-Family Psychoeducational Psychotherapy (MF-PEP) for childhood mood disorders. Based on predictors and moderators in RCTs of psychosocial interventions for adolescent mood disorders, we hypothesized that children's greater functional impairment would predict worse outcome, whereas children's stress/trauma history and parental expressed emotion and psychopathology would moderate outcome. Exploratory analyses examined other demographic, functioning, and diagnostic variables. Logistic regression and linear mixed effects modeling were used in this secondary analysis of the MF-PEP RCT of 165 children, ages 8 to 12, with mood disorders, a majority of whom were male (73%) and White, non-Hispanic (90%). Treatment nonresponse was significantly associated with higher baseline levels of global functioning (i.e., less impairment; Cohen's d = 0.51) and lower levels of stress/trauma history (d = 0.56) in children and Cluster B personality disorder symptoms in parents (d = 0.49). Regarding moderators, children with moderately impaired functioning who received MF-PEP had significantly decreased mood symptoms (t = 2.10, d = 0.33) compared with waitlist control. MF-PEP had the strongest effect on severely impaired children (t = 3.03, d = 0.47). Comprehensive assessment of demographic, youth, parent, and familial variables should precede intervention. Treatment of mood disorders in high-functioning youth without stress/trauma histories and with parents with elevated Cluster B symptoms may require extra therapeutic effort, whereas severely impaired children may benefit most from MF-PEP.

Effect of candesartan on progression and regression of retinopathy in type 2 diabetes (DIRECT-Protect 2): a randomised placebo-controlled trial.

PubMed

Sjølie, Anne Katrin; Klein, Ronald; Porta, Massimo; Orchard, Trevor; Fuller, John; Parving, Hans Henrik; Bilous, Rudy; Chaturvedi, Nish

2008-10-18

Diabetic retinopathy remains a leading cause of visual loss in people of working age. We examined whether candesartan treatment could slow the progression and, secondly, induce regression of retinopathy in people with type 2 diabetes. We did a randomised, double-blind, parallel-group, placebo-controlled trial in 309 centres worldwide. We recruited normoalbuminuric, normotensive, or treated hypertensive people with type 2 diabetes with mild to moderately severe retinopathy and assigned them to candesartan 16 mg once a day or placebo. After a month, the dose was doubled to 32 mg once per day. Investigators and patients were unaware of the treatment allocation status. Progression of retinopathy was the primary endpoint, and regression was a secondary endpoint. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT00252694. 1905 participants (aged 37-75 years) were randomised to candesartan (n=951) or placebo (n=954). 161 (17%) patients in the candesartan group and 182 (19%) in the placebo group had progression of retinopathy by three steps or more on the Early Treatment Diabetic Retinopathy Study scale. The risk of progression of retinopathy was non-significantly reduced by 13% in patients on candesartan compared with those on placebo (hazard ratio [HR] 0.87, 95% CI 0.70-1.08, p=0.20). Regression on active treatment was increased by 34% (1.34, 1.08-1.68, p=0.009). HRs were not attenuated by adjustment for baseline risk factors or changes in blood pressure during the trial. An overall change towards less severe retinopathy by the end of the trial was observed in the candesartan group (odds 1.17, 95% CI 1.05-1.30, p=0.003). Adverse events did not differ between the treatment groups. Treatment with candesartan in type 2 diabetic patients with mild to moderate retinopathy might induce improvement of retinopathy.

A SYSTEMATIC REVIEW AND META-ANALYSIS OF DROPOUT RATES IN YOUTH SOCCER.

PubMed

Møllerløkken, Nina Elise; Lorås, Håvard; Pedersen, Arve Vorland

2015-12-01

Despite the many benefits of involvement in youth sports, participation in them declines throughout childhood and adolescence. The present study performed a systematic review and meta-analysis of 12 studies reporting dropout rates in youth soccer, involving a total of 724,036 youths ages 10-18 years from five countries. The mixed effects meta-regression analyses took into account age and sex as statistical moderators of dropout rate. Potential articles were identified through computerized searches of the databases PubMed, MedLine, Embase, and SportDiscus up until August 2014, without any further time limit. Based on results reported in the 10 included articles, the annual weighted mean dropout rate is 23.9% across the included cohorts. Meta-regression indicated that annual dropout rates are stable from the ages of 10-19 years, with higher rates for girls (26.8%) compared to boys (21.4%). The present study suggests that youth soccer players are prone to dropout rates in which close to one-fourth of players leave the sport annually, which appears to be a consistent finding across ages 10-18 years.

Estimating the price elasticity of beer: meta-analysis of data with heterogeneity, dependence, and publication bias.

PubMed

Nelson, Jon P

2014-01-01

Precise estimates of price elasticities are important for alcohol tax policy. Using meta-analysis, this paper corrects average beer elasticities for heterogeneity, dependence, and publication selection bias. A sample of 191 estimates is obtained from 114 primary studies. Simple and weighted means are reported. Dependence is addressed by restricting number of estimates per study, author-restricted samples, and author-specific variables. Publication bias is addressed using funnel graph, trim-and-fill, and Egger's intercept model. Heterogeneity and selection bias are examined jointly in meta-regressions containing moderator variables for econometric methodology, primary data, and precision of estimates. Results for fixed- and random-effects regressions are reported. Country-specific effects and sample time periods are unimportant, but several methodology variables help explain the dispersion of estimates. In models that correct for selection bias and heterogeneity, the average beer price elasticity is about -0.20, which is less elastic by 50% compared to values commonly used in alcohol tax policy simulations. Copyright © 2013 Elsevier B.V. All rights reserved.

Global Prevalence of Elder Abuse: A Meta-analysis and Meta-regression.

PubMed

Ho, C Sh; Wong, S Y; Chiu, M M; Ho, R Cm

2017-06-01

Elder abuse is increasingly recognised as a global public health and social problem. There has been limited inter-study comparison of the prevalence and risk factors for elder abuse. This study aimed to estimate the pooled and subtype prevalence of elder abuse worldwide and identify significant associated risk factors. We conducted a meta-analysis and meta-regression of 34 population-based and 17 non-population-based studies. The pooled prevalences of elder abuse were 10.0% (95% confidence interval, 5.2%-18.6%) and 34.3% (95% confidence interval, 22.9%-47.8%) in population-based studies and third party- or caregiver-reported studies, respectively. Being in a marital relationship was found to be a significant moderator using random-effects model. This meta-analysis revealed that third parties or caregivers were more likely to report abuse than older abused adults. Subgroup analyses showed that females and those resident in non-western countries were more likely to be abused. Emotional abuse was the most prevalent elder abuse subtype and financial abuse was less commonly reported by third parties or caregivers. Heterogeneity in the prevalence was due to the high proportion of married older adults in the sample. Subgroup analysis showed that cultural factors, subtypes of abuse, and gender also contributed to heterogeneity in the pooled prevalence of elder abuse.

Effect of endurance exercise training on left ventricular size and remodeling in older adults with hypertension.

PubMed

Turner, M J; Spina, R J; Kohrt, W M; Ehsani, A A

2000-04-01

It is not known whether exercise training can induce a reduction of blood pressure (BP) and a regression of left ventricular hypertrophy (LVH) in older hypertensive subjects. This study was designed to determine whether endurance exercise training, by lowering BP, can induce regression of LVH and left ventricular (LV) concentric remodeling in older hypertensive adults. We studied 11 older adults with mild to moderate hypertension (BP 152.0 +/- 2.5/91.3 +/- 1.5 mm Hg, mean +/- SE), 65.5 +/- 1.2 years old, who exercised for 6.8 +/- 3.8 months. Seven sedentary hypertensive (BP 153 +/- 3/89 +/- 2 mm Hg) subjects, 68.5 +/- 1 years old, served as controls. LV size and geometry and function were assessed with the use of two-dimensional echocardiography. Exercise training increased aerobic power by 16% (p < .001), and it decreased systolic (p < .05) and diastolic (p < .05) BP, LV wall thickness (from 12.8 +/- 0.4 mm to 11.3 +/- 0.3 mm; p < .05), and the wall thickness-to-radius (h/r) ratio (from 0.48 +/- 0.02 to 0.41 +/- 0.01; p < .05). There were no significant changes in the controls. The changes in LV mass index (deltaLVMI) were different between the two groups. LV mass index decreased in the exercise group (deltaLVMI - 14.3 +/- 3.3 g) but not in the controls (deltaLVMI 1.4 +/- 4.1 g; p = .009). A multiple stepwise regression analysis showed that among clinical and physiological variables including changes in resting systolic BP, aerobic power, body mass index, and systolic BP during submaximal and maximal exercise, only the reduction in resting systolic BP correlated significantly with a regression of concentric remodeling (delta h/r ratio r = .80; p = .003). The other variables did not add to the ability of the model to predict changes in the h/r ratio. The data suggest that exercise training can reduce BP and induce partial regression of LVH and LV concentric remodeling in older adults with mild or moderate hypertension.

Role of anthropometric data in the prediction of 4-stranded hamstring graft size in anterior cruciate ligament reconstruction.

PubMed

Ho, Sean Wei Loong; Tan, Teong Jin Lester; Lee, Keng Thiam

2016-03-01

To evaluate whether pre-operative anthropometric data can predict the optimal diameter and length of hamstring tendon autograft for anterior cruciate ligament (ACL) reconstruction. This was a cohort study that involved 169 patients who underwent single-bundle ACL reconstruction (single surgeon) with 4-stranded MM Gracilis and MM Semi-Tendinosus autografts. Height, weight, body mass index (BMI), gender, race, age and -smoking status were recorded pre-operatively. Intra-operatively, the diameter and functional length of the 4-stranded autograft was recorded. Multiple regression analysis was used to determine the relationship between the anthropometric measurements and the length and diameter of the implanted autografts. The strongest correlation between 4-stranded hamstring autograft diameter was height and weight. This correlation was stronger in females than males. BMI had a moderate correlation with the diameter of the graft in females. Females had a significantly smaller graft both in diameter and length when compared with males. Linear regression models did not show any significant correlation between hamstring autograft length with height and weight (p>0.05). Simple regression analysis demonstrated that height and weight can be used to predict hamstring graft diameter. The following regression equation was obtained for females: Graft diameter=0.012+0.034*Height+0.026*Weight (R2=0.358, p=0.004) The following regression equation was obtained for males: Graft diameter=5.130+0.012*Height+0.007*Weight (R2=0.086, p=0.002). Pre-operative anthropometric data has a positive correlation with the diameter of 4 stranded hamstring autografts but no significant correlation with the length. This data can be utilised to predict the autograft diameter and may be useful for pre-operative planning and patient counseling for graft selection.

Physical activity increases survival after heart valve surgery.

PubMed

Lund, K; Sibilitz, K L; Berg, S K; Thygesen, L C; Taylor, R S; Zwisler, A D

2016-09-01

Increased physical activity predicts survival and reduces risk of readmission in patients with coronary heart disease. However, few data show how physical activity is associated with survival and readmission after heart valve surgery. Objective were to assess the association between physical activity levels 6-12 months after heart valve surgery and (1) survival, (2) hospital readmission 18-24 months after surgery and (3) participation in exercise-based cardiac rehabilitation. Prospective cohort study with registry data from The CopenHeart survey, The Danish National Patient Register and The Danish Civil Registration System of 742 eligible patients. Physical activity was quantified with the International Physical Activity Questionnaire and analysed using Kaplan-Meier analysis and Cox regression and logistic regression methods. Patients with a moderate to high physical activity level had a reduced risk of mortality (3 deaths in 289 patients, 1%) compared with those with a low physical activity level (13 deaths in 235 patients, 5.5%) with a fully adjusted HR of 0.19 (95% CI 0.05 to 0.70). In contrast, physical activity level was not associated with the risk of hospital readmission. Patients who participated in exercise-based cardiac rehabilitation (n=297) were more likely than the non-participants (n=200) to have a moderate or high physical activity level than a low physical activity level (fully adjusted OR: 1.52, 95% CI 1.03 to 2.24). Moderate to high levels of physical activity after heart valve surgery are positively associated with higher survival rates and participation in cardiac rehabilitation. 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/

Problematic internet usage in US college students: a pilot study

PubMed Central

2011-01-01

Background Internet addiction among US college students remains a concern, but robust estimates of its prevalence are lacking. Methods We conducted a pilot survey of 307 college students at two US universities. Participants completed the Internet Addiction Test (IAT) as well as the Patient Health Questionnaire. Both are validated measures of problematic Internet usage and depression, respectively. We assessed the association between problematic Internet usage and moderate to severe depression using a modified Poisson regression approach. In addition, we examined the associations between individual items in the IAT and depression. Results A total of 224 eligible respondents completed the survey (73% response rate). Overall, 4% of students scored in the occasionally problematic or addicted range on the IAT, and 12% had moderate to severe depression. Endorsement of individual problematic usage items ranged from 1% to 70%. In the regression analysis, depressive symptoms were significantly associated with several individual items. Relative risk could not be estimated for three of the twenty items because of small cell sizes. Of the remaining 17 items, depressive symptoms were significantly associated with 13 of them, and three others had P values less than 0.10. There was also a significant association between problematic Internet usage overall and moderate to severe depression (relative risk 24.07, 95% confidence interval 3.95 to 146.69; P = 0.001). Conclusion The prevalence of problematic Internet usage among US college students is a cause for concern, and potentially requires intervention and treatment amongst the most vulnerable groups. The prevalence reported in this study is lower than that which has been reported in other studies, however the at-risk population is very high and preventative measures are also recommended. PMID:21696582

Alcohol Use at Time of Injury and Survival Following Traumatic Brain Injury: Results From the National Trauma Data Bank

PubMed Central

Chen, Chiung M.; Yi, Hsiao-Ye; Yoon, Young-Hee; Dong, Chuanhui

2012-01-01

Objective: Premised on biological evidence from animal research, recent clinical studies have, for the most part, concluded that elevated blood alcohol concentration levels are independently associated with higher survival or decreased mortality in patients with moderate to severe traumatic brain injury (TBI). This study aims to provide some counterevidence to this claim and to further future investigations. Method: Incident data were drawn from the largest U.S. trauma registry, the National Trauma Data Bank, for emergency department admission years 2002–2006. TBI was identified according to the National Trauma Data Bank’s definition using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes. To eliminate confounding, the exact matching method was used to match alcohol-positive with alcohol-negative incidents on sex, age, race/ethnicity, and facility. Logistic regression compared in-hospital mortality between 44,043 alcohol-positive and 59,817 matched alcohol-negative TBI incidents, with and without causes and intents of TBI and Injury Severity Score as covariates. A sensitivity analysis was performed within a subsample of isolated moderate to severe TBI incidents. Results: Alcohol use at the time of injury was found to be significantly associated with an increased risk for TBI. Including varied causes and intents of TBI and Injury Severity Score as potential confounders in the regression model explained away the statistical significance of the seemingly protective effect of alcohol against TBI mortality for all TBIs and for isolated moderate to severe TBIs. Conclusions: The null finding shows that the purported reduction in TBI mortality attributed to positive blood alcohol likely is attributable to residual confounding. Accordingly, the risk of TBI associated with alcohol use should not be overlooked. PMID:22630791

Alcohol use at time of injury and survival following traumatic brain injury: results from the National Trauma Data Bank.

PubMed

Chen, Chiung M; Yi, Hsiao-Ye; Yoon, Young-Hee; Dong, Chuanhui

2012-07-01

Premised on biological evidence from animal research, recent clinical studies have, for the most part, concluded that elevated blood alcohol concentration levels are independently associated with higher survival or decreased mortality in patients with moderate to severe traumatic brain injury (TBI). This study aims to provide some counterevidence to this claim and to further future investigations. Incident data were drawn from the largest U.S. trauma registry, the National Trauma Data Bank, for emergency department admission years 2002-2006. TBI was identified according to the National Trauma Data Bank's definition using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), codes. To eliminate confounding, the exact matching method was used to match alcohol-positive with alcohol-negative incidents on sex, age, race/ethnicity, and facility. Logistic regression compared in-hospital mortality between 44,043 alcohol-positive and 59,817 matched alcohol-negative TBI incidents, with and without causes and intents of TBI and Injury Severity Score as covariates. A sensitivity analysis was performed within a subsample of isolated moderate to severe TBI incidents. Alcohol use at the time of injury was found to be significantly associated with an increased risk for TBI. Including varied causes and intents of TBI and Injury Severity Score as potential confounders in the regression model explained away the statistical significance of the seemingly protective effect of alcohol against TBI mortality for all TBIs and for isolated moderate to severe TBIs. The null finding shows that the purported reduction in TBI mortality attributed to positive blood alcohol likely is attributable to residual confounding. Accordingly, the risk of TBI associated with alcohol use should not be overlooked.

Socioeconomic Disparities in Elementary School Practices and Children’s Physical Activity During School

PubMed Central

Carlson, Jordan A.; Mignano, Alexandra M.; Norman, Gregory J.; McKenzie, Thomas L.; Kerr, Jacqueline; Arredondo, Elva M.; Madanat, Hala; Cain, Kelli L.; Elder, John P.; Saelens, Brian E.; Sallis, James F.

2014-01-01

Purpose To examine school socioeconomic status (SES) in relation to school physical activity-related practices and children’s physical activity. Design A cross-sectional design was used for this study. Setting The study was set in 97 elementary schools (63% response rate) in two U.S. regions. Subjects Of the children taking part in this study, 172 were aged 10.2 (standard deviation (SD) = 1.5) years; 51.7% were girls, and 69.2% were White non-Hispanic. Measures School physical education (PE) teachers or principals responded to 15 yes/no questions on school physical activity-supportive practices. School SES (low, moderate, high) was derived from the percent of students eligible for free and reduced-price lunch. Children’s moderate to vigorous physical activity (MVPA) during school was measured with accelerometers. Analysis School level analyses involved linear and logistic regression; children’s MVPA analyses used mixed effects regression. Results Low-SES schools were less likely to have a PE teacher and had fewer physical activity-supportive PE practices than did high-SES schools (p < .05). Practices related to active travel to school were more favorable at low-SES schools (p < .05). Children attending high-SES schools had 4.4 minutes per day more of MVPA during school than did those at low-SES schools, but this finding was not statistically significant (p = .124). Conclusion These findings suggest that more low- and moderate-SES elementary schools need PE teachers in order to reduce disparities in school physical activity opportunities and that PE time needs to be supplemented by classroom teachers or other staff to meet guidelines. PMID:24380465

Role of maximal heart rate and arterial O2 saturation on the decrement of VO2max in moderate acute hypoxia in trained and untrained men.

PubMed

Mollard, P; Woorons, X; Letournel, M; Cornolo, J; Lamberto, C; Beaudry, M; Richalet, J-P

2007-03-01

We aimed to evaluate 1) the altitude where maximal heart rate (HR (max)) decreases significantly in both trained and untrained subjects in moderate acute hypoxia, and 2) if the HR (max) decrease could partly explain the drop of V.O (2max). Seventeen healthy males, nine trained endurance athletes (TS) and eight untrained individuals (US) were studied. Subjects performed incremental exercise tests at sea level and at 5 simulated altitudes (1000, 1500, 2500, 3500, 4500 meters). Power output (PO), heart rate (HR), arterial oxygen saturation (SaO (2)), oxygen uptake (V.O (2)), arterialized blood pH and lactate were measured. Both groups showed a progressive reduction in V.O (2max). The decrement in HR (max) (DeltaHR (max)) was significant from 1000 m for TS and 2500 m for US and more important in TS than US (at 1500 m and 3500 m). At maximal exercise, TS had a greater reduction in SaO (2) (DeltaSaO (2)) at each altitude. DeltaHR (max) observed in TS was correlated with DeltaSaO (2). When the two groups were pooled, simple regressions showed that DeltaV.O (2max) was correlated with both DeltaSaO (2) and DeltaHR (max). However, a multiple regression analysis demonstrated that DeltaSaO (2) alone may account for DeltaV.O (2max). Furthermore, in spite of a greater reduction in SaO (2) and HR (max) in TS, no difference was evidenced in relative DeltaV.O (2max) between groups. Thus, in moderate acute hypoxia, the reduction in SaO (2) is the primary factor to explain the drop of V.O (2max) in trained and untrained subjects.

Service collaboration and hospital cost performance: direct and moderating effects.

PubMed

Proenca, E Jose; Rosko, Michael D; Dismuke, Clara E

2005-12-01

Growing reliance on service provision through systems and networks creates the need to better understand the nature of the relationship between service collaboration and hospital performance and the conditions that affect this relationship. We examine 1) the effects of service provision through health systems and health networks on hospital cost performance and 2) the moderating effects of market conditions and service differentiation on the collaboration-cost relationship. We used moderated regression analysis to test the direct and moderating effects. Data on 1368 private hospitals came from the 1998 AHA Annual Survey, Medicare Cost Reports, and Solucient. Service collaboration was measured as the proportion of hospital services provided at the system level and at the network level. Market conditions were measured by the levels of managed care penetration and competition in the hospital's market. The proportion of hospital services provided at the system level had a negative relationship with hospital cost. The relationship was curvilinear for network use. Degree of managed care penetration moderated the relationship between network-based collaboration and hospital cost. The benefits of service collaboration through systems and networks, as measured by reduced cost, depend on degree of collaboration rather than mere membership. In loosely structured collaborations such as networks, costs reduce initially but increase later as the extent of collaboration increases. The effect of network-based collaboration is also tempered by managed care penetration. These effects are not seen in more tightly integrated forms such as systems.

Testing a Theoretical Model of the Stress Process in Alzheimer's Caregivers with Race as a Moderator

ERIC Educational Resources Information Center

Hilgeman, Michelle M.; Durkin, Daniel W.; Sun, Fei; DeCoster, Jamie; Allen, Rebecca S.; Gallagher-Thompson, Dolores; Burgio, Louis D.

2009-01-01

Purpose: The primary aim of this study was to test the stress process model (SPM; Pearlin, Mullan, Semple, & Skaff, 1990) in a racially diverse sample of Alzheimer's caregivers (CGs) using structural equation modeling (SEM) and regression techniques. A secondary aim was to examine race or ethnicity as a moderator of the relation between latent…

Does Parental Monitoring Moderate the Relation between Parent-Child Communication and Pre-Coital Sexual Behaviours among Urban, Minority Early Adolescents?

ERIC Educational Resources Information Center

Santa Maria, Diane; Markham, Christine; Swank, Paul; Baumler, Elizabeth; McCurdy, Sheryl; Tortolero, Susan

2014-01-01

This study examined parental monitoring (PM) as a potential moderator of the relation between parent-child communication (PCC) and pre-coital sexual behaviours (PCSB) in an urban, minority, early adolescent population. Seventh-grade students (n = 1609) reported PCC, PM and PCSB. Multivariable logistic regression was conducted to assess for…

Coping Self-Efficacy and Academic Stress among Hispanic First-Year College Students: The Moderating Role of Emotional Intelligence

ERIC Educational Resources Information Center

Watson, Joshua C.; Watson, April A.

2016-01-01

In this study, the authors examined the role that emotional intelligence plays in moderating the relationship between academic stress and coping self-efficacy among a sample of 125 Hispanic 1st-year college students enrolled at a medium-size, southern Hispanic-serving institution. Results of a 2-stage hierarchical multiple regression analysis…

Influence of Child Behavioral Problems and Parenting Stress on Parent-Child Conflict among Low-Income Families: The Moderating Role of Maternal Nativity

ERIC Educational Resources Information Center

Garcia, Aileen S.; Ren, Lixin; Esteraich, Jan M.; Raikes, Helen H.

2017-01-01

This study was designed to examine whether parenting stress and child behavioral problems are significant predictors of parent-child conflict in the context of low-income families and how these relations are moderated by maternal nativity. The authors conducted multiple regression analyses to examine relations between teachers' report of…

Mediator and Moderator Role of Loneliness in the Relationship between Peer Victimization and Depressive Symptoms

ERIC Educational Resources Information Center

Baker, Ozgur Erdur; Bugay, Asli

2011-01-01

The goal of this study was to examine the mediator and moderator roles of loneliness in the relationship between peer victimisation and depressive symptoms. The participants of the study were 144 adolescents (66 girls, 78 boys) ranging in age from 11 to 15 years. Hierarchical multiple regression analyses were conducted to test the relations of…

The Influence of Contextual Barriers and Coping Efficacy on the Career Interest/Choice Goal Relationship

ERIC Educational Resources Information Center

Kirkland, Amanda Netterville

2010-01-01

The purpose of this study was to examine (1) if barriers moderate the relation of career interests to career goals, (2) if coping efficacy moderates the relation of barriers to career goals, and (3) to what extent coping efficacy mediates the relation of barriers to career goals. Hierarchical regression analyses were used to examine these effects…

Prevalence of binge and loss of control eating among children and adolescents with overweight and obesity: An exploratory meta-analysis.

PubMed

He, Jinbo; Cai, Zhihui; Fan, Xitao

2017-02-01

Due to the inconsistency of the research findings in the current literature, the prevalence of binge and loss of control (LOC) eating among children and adolescents with overweight and obesity remains unclear. By using the meta-analytic approach, this article aimed at exploring the prevalence of binge/LOC eating among children and adolescents with overweight and obesity, and at identifying potential moderators, which may have contributed to the heterogeneity of the existing research findings. Four electronic databases (PubMed, Web of Science, EBSCOhost, and ProQuest Dissertations & Theses Global) were searched. The search period covered the research literature up to April 2016. A random-effects meta-analysis model was used to estimate the overall prevalence. Weighted random-effects model ANOVAs and univariate random-effects meta-regression were applied for the analysis of categorical moderators and continuous moderators, respectively. Thirty-six studies were identified. The overall prevalence of binge/LOC eating was estimated to be 26.3% (95% CI: 23.1-29.7%), with 22.2% (95% CI: 18.6-26.3%) and 31.2% (95% CI: 26.1-36.9%) for binge eating and LOC eating, respectively. Treatment status, binge eating vs. LOC eating and assessment methods appeared to be associated with the inconsistencies of the prevalence rates across the studies. The findings of this meta-analysis indicated that binge/LOC eating was prevalent among more than one quarter of children and adolescents with overweight and obesity. Considering the close relationship between disordered eating behaviors and obesity, future research concerning overweight and obesity among children and adolescents needs to take binge/LOC eating into consideration. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:91-103). © 2016 Wiley Periodicals, Inc.

Caries risk assessment in schoolchildren - a form based on Cariogram® software

PubMed Central

CABRAL, Renata Nunes; HILGERT, Leandro Augusto; FABER, Jorge; LEAL, Soraya Coelho

2014-01-01

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk. PMID:25466473

Associations between joint attention and language in autism spectrum disorder and typical development: A systematic review and meta-regression analysis.

PubMed

Bottema-Beutel, Kristen

2016-10-01

Using a structured literature search and meta-regression procedures, this study sought to determine whether associations between joint attention and language are moderated by group (autism spectrum disorder [ASD] vs. typical development [TD]), joint attention type (responding to joint attention [RJA] vs. other), and other study design features and participant characteristics. Studies were located using database searches, hand searches, and electronic requests for data from experts in the field. This resulted in 71 reports or datasets and 605 effect sizes, representing 1,859 participants with ASD and 1,835 TD participants. Meta-regression was used to answer research questions regarding potential moderators of the effect sizes of interest, which were Pearson's r values quantifying the association between joint attention and language variables. In the final models, conducted separately for each language variable, effect sizes were significantly higher for the ASD group as compared to the TD group, and for RJA as compared to non-RJA joint attention types. Approximate mental age trended toward significance for the expressive language model. Joint attention may be more tightly tied to language in children with ASD as compared to TD children because TD children exhibit joint attention at sufficient thresholds so that language development becomes untethered to variations in joint attention. Conversely, children with ASD who exhibit deficits in joint attention develop language contingent upon their joint attention abilities. Because RJA was more strongly related to language than other types of joint attention, future research should involve careful consideration of the operationalization and measurement of joint attention constructs. Autism Res 2016, 9: 1021-1035. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Optimal Dose of Perineural Dexamethasone to Prolong Analgesia After Brachial Plexus Blockade: A Systematic Review and Meta-analysis.

PubMed

Kirkham, Kyle Robert; Jacot-Guillarmod, Alain; Albrecht, Eric

2018-01-01

Perineural dexamethasone has gained popularity in regional anesthesia to prolong analgesia duration. However, uncertainty remains regarding the optimal perineural dose. Clarification of this characteristic is of significant importance as the administration of dexamethasone may lead to dose-dependent complications. The objective of this meta-analysis was to define the optimal perineural dexamethasone dose to prolong analgesia after brachial plexus blockade for adult patients undergoing upper limb surgery. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines and searched databases including MEDLINE, PubMed, and EMBASE until January 2017, without language restriction. Only trials comparing perineural dexamethasone and local anesthetics with local anesthetics alone for brachial plexus blocks were included in the present meta-analysis. The Cochrane Collaboration's Risk of Bias Tool was used to assess the methodological quality of each trial and meta-analyses were performed following a random effects model. The primary outcome was duration of analgesia for each type of local anesthetic (short-/intermediate-acting and long-acting local anesthetics). A meta-regression followed by a subgroup analysis were performed to assess the impact of different perineural dexamethasone doses on duration of analgesia; for the latter analysis, trials were grouped in low (1-4 mg) and moderate (5-10 mg) dexamethasone doses. Secondary outcomes included the rate of neurologic complication and resting pain scores and morphine consumption within the first 24 hours. Thirty-three controlled trials, including 2138 patients, were identified. The meta-regression revealed a ceiling effect with a perineural dexamethasone dose of 4 mg when combined with short-/intermediate-acting (8 trials; 366 participants) or long-acting local anesthetics (23 trials; 1869 participants). This finding was confirmed by subgroup analyses comparing low and moderate dexamethasone doses. With short-/intermediate-acting local anesthetics, the mean difference (95% confidence interval) of analgesia duration with low and moderate doses was 277 (234-322) minutes and 229 (161-297) minutes, respectively. With long-acting local anesthetics, the mean differences with low and moderate doses were 505 (342-669) minutes and 509 (443-575) minutes. Perineural dexamethasone did not increase the rate of neurologic complications (risk ratio [95% confidence interval], 1.40 [0.54-3.63]). The Grades of Recommendation, Assessment, Development, and Evaluation quality of evidence for the primary and secondary outcomes were very low, due mainly to limitations, inconsistency, indirectness, and publication bias. There is currently very low quality evidence that 4 mg of perineural dexamethasone represents a ceiling dose that prolongs analgesia duration by a mean period of 6 and 8 hours when combined with short-/intermediate- or long-acting local anesthetics, respectively. Additional data are needed to explore the threshold for this effect, particularly with doses below 4 mg. The risk of neurologic complications is probably not increased (very low evidence).

Which somatic symptoms are associated with an unfavorable course in Chinese patients with major depressive disorder?

PubMed

Novick, Diego; Montgomery, William S; Aguado, Jaume; Peng, Xiaomei; Brugnoli, Roberto; Haro, Josep Maria

2015-12-01

This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD). Data were extracted from a 3-month prospective observational study which enrolled 909 patients with MDD in psychiatric care settings; this analysis focused on the Chinese patients (n=300). Depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) and 17-item Hamilton Depression Rating Scale (HAMD-17); somatic symptoms were assessed using the patient-rated 28-item Somatic Symptom Inventory (SSI). Cluster analysis using baseline SSI scores grouped patients into three clusters with no/mild, moderate, or severe somatic symptoms. Four SSI factors (pain, autonomic symptoms, energy, and central nervous system) were defined, and regression analyses identified which factors were associated with remission at 3 months. More than 70% of the patients had moderate or severe somatic symptoms. Baseline depression severity (HAMD-17 and CGI-S scores) was associated with more severe somatic symptoms. Remission rates differed between clusters of patients: 84.1%, 72.0%, and 55.3% for no/mild, moderate, and severe somatic symptoms, respectively (P=0.0034). Pain symptoms were the somatic symptoms more strongly associated with lower remission rates at 3 months. Somatic symptoms are associated with greater clinical severity and lower remission rates. Among somatic symptoms, pain symptoms have the greatest prognostic value and should be taken into account when treating patients with depression. © 2015 Wiley Publishing Asia Pty Ltd.

Modern Attitudes Toward Older Adults in the Aging World: A Cross-Cultural Meta-Analysis.

PubMed

North, Michael S; Fiske, Susan T

2015-09-01

Prevailing beliefs suggest that Eastern cultures hold older adults in higher esteem than Western cultures do, due to stronger collectivist traditions of filial piety. However, in modern, industrialized societies, the strain presented by dramatic rises in population aging potentially threatens traditional cultural expectations. Addressing these competing hypotheses, a literature search located 37 eligible papers, comprising samples from 23 countries and 21,093 total participants, directly comparing Easterners and Westerners (as classified per U.N. conventions) in their attitudes toward aging and the aged. Contradicting conventional wisdom, a random-effects meta-analysis on these articles found such evaluations to be more negative in the East overall (standardized mean difference = -0.31). High heterogeneity in study comparisons suggested the presence of moderators; indeed, geographical region emerged as a significant moderating factor, with the strongest levels of senior derogation emerging in East Asia (compared with South and Southeast Asia) and non-Anglophone Europe (compared with North American and Anglophone Western regions). At the country level, multiple-moderator meta-regression analysis confirmed recent rises in population aging to significantly predict negative elder attitudes, controlling for industrialization per se over the same time period. Unexpectedly, these analyses also found that cultural individualism significantly predicted relative positivity-suggesting that, for generating elder respect within rapidly aging societies, collectivist traditions may backfire. The findings suggest the importance of demographic challenges in shaping modern attitudes toward elders-presenting considerations for future research in ageism, cross-cultural psychology, and even economic development, as societies across the globe accommodate unprecedented numbers of older citizens. (c) 2015 APA, all rights reserved).

Overview of the Impact of Depression and Anxiety in Chronic Obstructive Pulmonary Disease.

PubMed

Montserrat-Capdevila, Josep; Godoy, Pere; Marsal, Josep Ramon; Barbé, Ferran; Pifarré, Josep; Alsedà, Miquel; Ortega, Marta

2017-02-01

Anxiety and depression are common entities in patients diagnosed with COPD. However, the impact that they have on the exacerbation of illness is scarcely studied. To determine if the presence of anxiety and depression is associated with a greater risk of frequent exacerbation (≥2 per year) in patients diagnosed with COPD. A cohort study that analysed frequent exacerbation and associated factors in 512 patients monitored during 2 years. Exacerbations were defined as events that required antibiotic/s and/or systemic corticosteroids (moderate) or hospitalization (serious). Variables of interest were recorded for each patient, including anxiety and depression (Hospital Anxiety and Depression Scale), and we analysed their association with frequent exacerbation through the adjusted odds ratio (aOR) by means of a logistic regression model. The prevalence of anxiety/depression at the start of the study was of 15.6%. During the 2 years of monitoring, 77.9% of the patients suffered at least moderate-to-severe exacerbation. 54.1% were frequent exacerbators. Anxiety/depression were strongly associated with moderate-severe frequent exacerbation in the crude analysis (OR c  = 2.28). In the multivariate analysis, the risk factors also associated with frequent exacerbation were being overweight (aOR 2.78); obesity (aOR 3.02); diabetes (aOR 2.56) and the associated comorbidity (BODEx) (ORa = 1.45). The prevalence of anxiety/depression in COPD patients is high, and they are relevant risk factors in frequent exacerbation although the effect is lower in the multivariate analysis when adjusting for different variables strongly associated with exacerbation.

The Impact of Symptoms and Impairments on Overall Health in US National Health Data

PubMed Central

Stewart, Susan T.; Woodward, Rebecca M.; Rosen, Allison B.; Cutler, David M.

2015-01-01

Objective To assess the effects on overall self-rated health of the broad range of symptoms and impairments that are routinely asked about in national surveys. Data We use data from adults in the nationally representative Medical Expenditure Panel Survey (MEPS) 2002 with validation in an independent sample from MEPS 2000. Methods Regression analysis is used to relate impairments and symptoms to a 100-point self-rating of general health status. The effect of each impairment and symptom on health-related quality of life (HRQOL) is estimated from regression coefficients, accounting for interactions between them. Results Impairments and symptoms most strongly associated with overall health include pain, self-care limitations, and having little or no energy. The most prevalent are moderate pain, severe anxiety, moderate depressive symptoms, and low energy. Effects are stable across different waves of MEPS, and questions cover a broader range of impairments and symptoms than existing health measurement instruments. Conclusions This method makes use of the rich detail on impairments and symptoms in existing national data, quantifying their independent effects on overall health. Given the ongoing availability of these data and the shortcomings of traditional utility methods, it would be valuable to compare existing HRQOL measures to other methods, such as the one presented herein, for use in tracking population health over time. PMID:18725850

Quantifying ADHD classroom inattentiveness, its moderators, and variability: a meta-analytic review.

PubMed

Kofler, Michael J; Rapport, Mark D; Alderson, R Matt

2008-01-01

Most classroom observation studies have documented significant deficiencies in the classroom attention of children with attention-deficit/hyperactivity disorder (ADHD) compared to their typically developing peers. The magnitude of these differences, however, varies considerably and may be influenced by contextual, sampling, diagnostic, and observational differences. Meta-analysis of 23 between-group classroom observation studies using weighted regression, publication bias, goodness of fit, best case, and original metric analyses. Across studies, a large effect size (ES = .73) was found prior to consideration of potential moderators. Weighted regression, best case, and original metric estimation indicate that this effect may be an underestimation of the classroom visual attention deficits of children with ADHD. Several methodological factors-classroom environment, sample characteristics, diagnostic procedures, and observational coding schema-differentially affect observed rates of classroom attentive behavior for children with ADHD and typically developing children. After accounting for these factors, children with ADHD were on-task approximately 75% of the time compared to 88% for their classroom peers (ES = 1.40). Children with ADHD were also more variable in their attentive behavior across studies. The present study confirmed that children with ADHD exhibit deficient and more variable visual attending to required stimuli in classroom settings and provided an aggregate estimation of the magnitude of these deficits at the group level. It also demonstrated the impact of situational, sampling, diagnostic, and observational variables on observed rates of on-task behavior.

Differences in quality of life in home-dwelling persons and nursing home residents with dementia - a cross-sectional study.

PubMed

Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Jøranson, Nina; Calogiuri, Giovanna; Ihlebæk, Camilla

2016-07-11

Dementia often eventually leads to dependency on others and finally to residential care. However, in Norway about half of the dementia population lives at home, due to individual and political wishes. There is scarce and inconclusive knowledge of how living in a nursing home differs from living at home for persons with dementia (PWDs) with regard to their quality of life (QoL). The first aim of the study was therefore to compare QoL, cognitive and physical functions, social contacts, sleep patterns, physical activity levels, exposure to light, and medication of PWDs in nursing homes and home-dwelling PWDs, and whether living in nursing homes was associated with a lower QoL than living at home for PWDs. A second aim was to examine if possible differences between residencies in QoL were consistent over time. The cross-sectional study was based on baseline data from two RCT studies of PWDs. A total of 15 nursing homes with adapted units for PWDs and 23 adapted day care centres for home-dwelling PWDs recruited 78 and 115 participants respectively. Trained nurses scored sociodemographic data, level of dementia (on the Clinical Dementia Rating scale), amount of medication, and QoL (QUALID). Sleep patterns, physical activity levels, and light exposure were measured by actigraphy. A multiple regression analysis was used to test the association between residency and QoL. The association between residency and change in QoL over time was investigated by linear regression analysis of a subsample with follow-up data. Home-dwelling PWDs showed significantly higher QoL than PWDs in nursing homes. This difference was maintained even after stratifying on the severity of dementia. Home-dwelling PWDs with moderate dementia showed significantly less use of walking aids, more social contact, higher levels of activity and exposure to daylight, and less use of psychotropic medications. The regression model explained 28 % of the variance in QoL in persons with moderate dementia. However, only residency contributed significantly in the model. Residency also significantly predicted negative change over time in QoL. The study indicated that living at home as long as possible is not only desirable for economic or health political reasons but also is associated with higher QoL for persons with moderate dementia. More studies are needed to investigate how QoL could be increased for PWDs in nursing homes.

Resilience as a Moderator of Psychological Health in Situations of Chronic Stress (Burnout) in a Sample of Hospital Nurses.

PubMed

García-Izquierdo, Mariano; Meseguer de Pedro, Mariano; Ríos-Risquez, Mª Isabel; Sánchez, Mª Isabel Soler

2018-03-01

To analyze the role played by resilience in the dimensions that constitute burnout syndrome and, through that, the psychological health of a sample of nurses working at hospital centers. Cross-sectional design, with a questionnaire as the tool. The sample consisted of 537 nurses from three public hospitals in Murcia, Spain. The questionnaire contained measures of the following variables: resilience, the three dimensions of burnout (emotional exhaustion, cynicism, and professional efficacy), and general psychological health, as well as sociodemographic and employment information. The emotional exhaustion and cynicism dimensions of burnout were significantly linked to psychological health in the manner expected, but this was not the case for professional efficacy. A stepwise multiple regression analysis revealed the moderating role of resilience on the emotional exhaustion and cynicism dimensions, as well as on psychological health. This study highlights the moderating role of resilience on burnout and psychological health. The practical implications of the results are discussed for the implementation of measures to increase resilience as a personal resource in order to improve the health and work performance of these professionals. © 2017 Sigma Theta Tau International.

Unpacking personalized feedback: an exploratory study of the impact of its components and the reactions it elicits among problem drinking men who have sex with men.

PubMed

Kuerbis, Alexis Noel; Schaumberg, Katherine; Davis, Christine M; Hail, Lisa; Morgenstern, Jon

2014-03-01

Personalized feedback (PF) has demonstrated effectiveness in reducing drinking. Few studies have examined its effectiveness with adult problem drinkers or its potential mediators or moderators, including developing discrepancy. This study aimed to identify potential mediators and moderators of PF provided to adult problem drinking men who have sex with men (PDMSM). An exploratory analysis of PF provided to PDMSM in the context of modified behavioral self-control therapy (N = 90). The association of individual items of PF, severity of PF, and independently rated, in-session participant reactions to PF with drinking outcomes (mean drinks per drinking day, MDDD) were examined using correlations and logistic and linear regression. Significant pre-post differences in MDDD emerged. Other drug risk, family risk, and having an abnormal liver enzyme test result were significantly associated with proxies for developed discrepancy in expected directions; however, no PF item or reaction to PF predicted drinking outcomes. Severity of PF was not associated with participant reactions or drinking outcome. PF may be an effective intervention for PDMSM. Further research is needed to identify potential mediators and moderators of PF among adults.

Sexual communication, sexual satisfaction, and relationship quality in people with multiple sclerosis.

PubMed

Valvano, Abbey K; Rollock, Michael J D; Hudson, William H; Goodworth, Marie-Christine Rutter; Lopez, Eliot; Stepleman, Lara

2018-05-01

This study sought to explore relationships between sexual satisfaction, sexual communication and relationship satisfaction in people living with multiple sclerosis (MS). Specifically, sexual satisfaction was evaluated as a moderator between sexual communication and relationship satisfaction. Individuals diagnosed with MS and being treated in a hospital-based MS clinic in the southeastern United States (n = 58) completed measures of sexual satisfaction, sexual communication, sexual dysfunction, relationship quality, depression, level of disability, and frequency of sex-related communication and behaviors in a cross-sectional survey design. Sexual satisfaction moderated the relationship between quality of sexual communication and relationship quality, controlling for depression and frequency of sexual behavior and sexual communication. Directionality was examined in a 2nd regression analysis, in which the predictor and outcome variables were switched, which was also significant. Additionally, depression most strongly predicted relationship dissatisfaction. Findings help to establish sexual satisfaction as a moderator between sexual communication and relationship satisfaction, although directionality cannot be supported. Results also highlight the role of depression in overall relationship functioning and support the biopsychosocial model of care for treatment of sexual dysfunction in people living with MS. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Stress-Metabolic Syndrome Relationship in Adolescents: An Examination of the Moderating Potential of Physical Activity.

PubMed

Holmes, Megan E; Pivarnik, Jim; Pfeiffer, Karin; Maier, Kimberly S; Eisenmann, Joey C; Ewing, Martha

2016-10-01

The role of psychosocial stress in the development of obesity and metabolic syndrome is receiving increased attention and has led to examination of whether physical activity may moderate the stress-metabolic syndrome relationship. The current study examined relationships among physical activity, stress, and metabolic syndrome in adolescents. Participants (N = 126; 57 girls, 69 boys) were assessed for anthropometry, psychosocial stress, physical activity, and metabolic syndrome variables; t tests were used to examine sex differences, and regression analysis was used to assess relationships among variables controlling for sex and maturity status. Mean body mass index approached the 75th percentile for both sexes. Typical sex differences were observed for systolic blood pressure, time spent in moderate and vigorous physical activity, and perceived stress. Although stress was not associated with MetS (β = -.001, P = .82), a modest, positive relationship was observed with BMI (β = .20, P = .04). Strong relationships between physical activity and stress with MetS or BMI were not found in this sample. Results may be partially explained by overall good physical health status of the participants. Additional research in groups exhibiting varying degrees of health is needed.

Moral distress and burnout syndrome: are there relationships between these phenomena in nursing workers?

PubMed

Dalmolin, Graziele de Lima; Lunardi, Valéria Lerch; Lunardi, Guilherme Lerch; Barlem, Edison Luiz Devos; Silveira, Rosemary Silva da

2014-01-01

to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers?1

PubMed Central

Dalmolin, Graziele de Lima; Lunardi, Valéria Lerch; Lunardi, Guilherme Lerch; Barlem, Edison Luiz Devos; da Silveira, Rosemary Silva

2014-01-01

Objective to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. Methods this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. Results the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. Conclusion the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied. PMID:24553701

An EM-based semi-parametric mixture model approach to the regression analysis of competing-risks data.

PubMed

Ng, S K; McLachlan, G J

2003-04-15

We consider a mixture model approach to the regression analysis of competing-risks data. Attention is focused on inference concerning the effects of factors on both the probability of occurrence and the hazard rate conditional on each of the failure types. These two quantities are specified in the mixture model using the logistic model and the proportional hazards model, respectively. We propose a semi-parametric mixture method to estimate the logistic and regression coefficients jointly, whereby the component-baseline hazard functions are completely unspecified. Estimation is based on maximum likelihood on the basis of the full likelihood, implemented via an expectation-conditional maximization (ECM) algorithm. Simulation studies are performed to compare the performance of the proposed semi-parametric method with a fully parametric mixture approach. The results show that when the component-baseline hazard is monotonic increasing, the semi-parametric and fully parametric mixture approaches are comparable for mildly and moderately censored samples. When the component-baseline hazard is not monotonic increasing, the semi-parametric method consistently provides less biased estimates than a fully parametric approach and is comparable in efficiency in the estimation of the parameters for all levels of censoring. The methods are illustrated using a real data set of prostate cancer patients treated with different dosages of the drug diethylstilbestrol. Copyright 2003 John Wiley & Sons, Ltd.

Low triiodothyronine: A new facet of inflammation in acute ischemic stroke.

PubMed

Ma, Lili; Zhu, Dongliang; Jiang, Ying; Liu, Yingying; Ma, Xiaomeng; Liu, Mei; Chen, Xiaohong

2016-07-01

Patients with acute ischemic stroke (AIS) frequently experience low free triiodothyronine (fT3) concentrations. Inflammation is recognized as a key contributor to the pathophysiology of stroke. Previous studies, however, did not simultaneously evaluate fT3 and inflammation biomarkers in AIS patients. Markers of inflammation, including serum concentrations of C-reactive protein (CRP) and albumin, and fT3 were assessed retrospectively in 117 patients. Stroke severity was measured on the National Institutes of Health Stroke Scale (NIHSS). Regression analyses were performed to adjust for confounders. Serum fT3 concentrations were significantly lower in moderate AIS patients than those in mild AIS patients (P<0.001). fT3 concentration also positively correlated with serum albumin concentration (r=0.358, P<0.001) and negatively correlated with log10CRP concentration (r=-0.341, P<0.001), NIHSS score (r=-0.384, P<0.001). Multiple regression analysis showed that CRP, albumin concentrations and NIHSS score were independently correlated with fT3 concentration. Binary logistic regression analysis showed that fT3 concentration was an independent factor correlated with NIHSS score, the area under the receiver operating characteristic curve was 0.712 (95% CI, 0.618-0.805). Low fT3 concentrations may be involved in the pathogenic pathway linking inflammation to stroke severity in AIS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Systematic review and meta-analysis of dropout rates in individual psychotherapy for generalized anxiety disorder.

PubMed

Gersh, Elon; Hallford, David J; Rice, Simon M; Kazantzis, Nikolaos; Gersh, Hannah; Gersh, Benji; McCarty, Carolyn A

2017-12-01

Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates. A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD. Forty-five studies, involving 2224 participants, were identified for meta-analysis. The weighted mean dropout rate was 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator analysis and meta-regressions indicated no statistically significant effect of client age, sex, symptom severity, comorbidity, treatment type, study type (randomized trial or not), study quality, number of sessions or therapist experience. In research investigating psychotherapy for GAD, approximately one in six clients can be expected to drop out of treatment. Dropout rate was not significantly moderated by the client, therapist or treatment variables investigated. Future research should specify the definition of dropout, reasons for dropout and associated correlates to assist the field's progression. Copyright © 2017 Elsevier Ltd. All rights reserved.

A systematic review and meta-analysis of sleep architecture and chronic traumatic brain injury.

PubMed

Mantua, Janna; Grillakis, Antigone; Mahfouz, Sanaa H; Taylor, Maura R; Brager, Allison J; Yarnell, Angela M; Balkin, Thomas J; Capaldi, Vincent F; Simonelli, Guido

2018-02-02

Sleep quality appears to be altered by traumatic brain injury (TBI). However, whether persistent post-injury changes in sleep architecture are present is unknown and relatively unexplored. We conducted a systematic review and meta-analysis to assess the extent to which chronic TBI (>6 months since injury) is characterized by changes to sleep architecture. We also explored the relationship between sleep architecture and TBI severity. In the fourteen included studies, sleep was assessed with at least one night of polysomnography in both chronic TBI participants and controls. Statistical analyses, performed using Comprehensive Meta-Analysis software, revealed that chronic TBI is characterized by relatively increased slow wave sleep (SWS). A meta-regression showed moderate-severe TBI is associated with elevated SWS, reduced stage 2, and reduced sleep efficiency. In contrast, mild TBI was not associated with any significant alteration of sleep architecture. The present findings are consistent with the hypothesis that increased SWS after moderate-severe TBI reflects post-injury cortical reorganization and restructuring. Suggestions for future research are discussed, including adoption of common data elements in future studies to facilitate cross-study comparability, reliability, and replicability, thereby increasing the likelihood that meaningful sleep (and other) biomarkers of TBI will be identified. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

Tang, Kunkun, E-mail: ktg@illinois.edu; Inria Bordeaux – Sud-Ouest, Team Cardamom, 200 avenue de la Vieille Tour, 33405 Talence; Congedo, Pietro M.

The Polynomial Dimensional Decomposition (PDD) is employed in this work for the global sensitivity analysis and uncertainty quantification (UQ) of stochastic systems subject to a moderate to large number of input random variables. Due to the intimate connection between the PDD and the Analysis of Variance (ANOVA) approaches, PDD is able to provide a simpler and more direct evaluation of the Sobol' sensitivity indices, when compared to the Polynomial Chaos expansion (PC). Unfortunately, the number of PDD terms grows exponentially with respect to the size of the input random vector, which makes the computational cost of standard methods unaffordable formore » real engineering applications. In order to address the problem of the curse of dimensionality, this work proposes essentially variance-based adaptive strategies aiming to build a cheap meta-model (i.e. surrogate model) by employing the sparse PDD approach with its coefficients computed by regression. Three levels of adaptivity are carried out in this paper: 1) the truncated dimensionality for ANOVA component functions, 2) the active dimension technique especially for second- and higher-order parameter interactions, and 3) the stepwise regression approach designed to retain only the most influential polynomials in the PDD expansion. During this adaptive procedure featuring stepwise regressions, the surrogate model representation keeps containing few terms, so that the cost to resolve repeatedly the linear systems of the least-squares regression problem is negligible. The size of the finally obtained sparse PDD representation is much smaller than the one of the full expansion, since only significant terms are eventually retained. Consequently, a much smaller number of calls to the deterministic model is required to compute the final PDD coefficients.« less

Introduction, comparison, and validation of Meta-Essentials: A free and simple tool for meta-analysis.

PubMed

Suurmond, Robert; van Rhee, Henk; Hak, Tony

2017-12-01

We present a new tool for meta-analysis, Meta-Essentials, which is free of charge and easy to use. In this paper, we introduce the tool and compare its features to other tools for meta-analysis. We also provide detailed information on the validation of the tool. Although free of charge and simple, Meta-Essentials automatically calculates effect sizes from a wide range of statistics and can be used for a wide range of meta-analysis applications, including subgroup analysis, moderator analysis, and publication bias analyses. The confidence interval of the overall effect is automatically based on the Knapp-Hartung adjustment of the DerSimonian-Laird estimator. However, more advanced meta-analysis methods such as meta-analytical structural equation modelling and meta-regression with multiple covariates are not available. In summary, Meta-Essentials may prove a valuable resource for meta-analysts, including researchers, teachers, and students. © 2017 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.

Injuries among US adults with disabilities.

PubMed

Brophy, Megan; Zhang, Xiaofei; Xiang, Huiyun

2008-05-01

Injury prevention among individuals with disabilities is understudied. We compared the patterns of medically treated injuries among US adults with and without disabilities for clues to prevention. We used nationally representative data from the 2004-2005 National Health Interview Survey to compare medically attended injuries within the past 3 months among noninstitutionalized adults in the United States with no disabilities, moderate disabilities, and severe disabilities. The association between disability and injuries was examined in logistic regression analysis, taking into account sociodemographic factors. The 3-month cumulative incidence of injuries was 2.3% (95% confidence interval [CI] = 2.2%-2.4%) among adults with no disabilities, 3.8% (3.4%-4.2%) among adults with moderate disabilities, and 5.6% (4.9%-6.3%) among adults with severe disabilities. Falls were the leading mechanism of injury regardless of disability status, and were even more common in the severely or moderately disabled adults (68% and 47% respectively, compared with 28% among those without disabilities). The setting of the injury also differed with disability status. For the severely disabled, 57% (CI = 52%-62%) of injury episodes occurred at home, compared with only 32% (28%-37%) for the moderately disabled and 23% (21%-25%) for adults with no disabilities. Adults with disabilities are at an increased risk for injury. Programs specifically directed toward injury prevention may benefit adults with disabilities.

Association between Urinary Lactate to Creatinine Ratio and Neurodevelopmental Outcome in Term Infants with Hypoxic-Ischemic Encephalopathy

PubMed Central

Oh, William; Perritt, Rebecca; Shankaran, Seetha; Merritts, Matthew; Donovan, Edward F.; Ehrenkranz, Richard A.; O’Shea, T. Michael; Tyson, Jon E.; Laptook, Abbot R.; Das, Abhik; Higgins, Rosemary D.

2010-01-01

Objective To assess the association between urinary lactate to creatinine ratio (ULCR) and neurodevelopmental outcome in term infants with hypoxic ischemic encephalopathy and examine the effect of hypothermia on the change in ULCR. Study design Spot urine samples were collected in 58 term infants (28 hypothermia, 30 control subjects) with hypoxic ischemic encephalopathy. Urinary lactate and creatinine were measured by using 1H nuclear magnetic resonance spectroscopy and expressed as ULCR. Survivors were examined at 18 months of age. Results The ULCR was significantly higher in infants who died or had moderate/severe neurodevelopmental disability. Logistic regression analysis controlling for hypothermia and severity of encephalopathy confirmed the association (adjusted odds ratio, 5.52; 95% CI, 1.36, 22.42; P < .02). Considerable overlap in ULCR was observed between infants with normal/mild disability and those who died or survived with moderate/severe disability. ULCR fell significantly between 6 and 24 hours and 48 and 72 hours of age for all infants. The magnitude of decline did not differ between hypothermia and control groups. Conclusions High ULCR is associated with death or moderate/severe neurodevelopmental disability. Significant overlap in values between the normal/mild and moderate/severe disability groups limits predictive value of this measure. Whole-body hypothermia did not affect the decline in ULCR. PMID:18534246

Predictive factor of secondary tricuspid regurgitation after aortic valve replacement for aortic stenosis: the importance of myocardial hypertrophy and diastolic dysfunction.

PubMed

Igarashi, Takashi; Tanji, Masahiro; Takahashi, Koki; Ishida, Keiichi; Sasaki, Satomi; Yokoyama, Hitoshi

2017-05-01

The aim of this study is to determine the predictors of secondary tricuspid regurgitation after aortic valve replacement for aortic stenosis. Seventy-one patients, who underwent aortic valve replacement for aortic stenosis at our institute from January 2006 to July 2011, were divided into two groups: an STR group, which included 15 patients with moderate or greater than moderate secondary tricuspid regurgitation at a follow-up visit and a control group. Echocardiography was performed before surgery, at discharge, and at a late follow-up visit (mean follow-up 36 ± 19 months, range 0-77). Preoperatively, the number of women (p < .01), body surface area (p < .001), and relative wall thickness (0.60 ± 0.15 vs 0.71 ± 0.13, p = .022) showed significant differences between the two groups. At a follow-up visit, moderate or severe mitral regurgitation (p = .0001) and severe diastolic dysfunction (p = .003) showed significant differences between the two groups. In the Cox regression analysis, moderate or severe mitral regurgitation at follow-up (p = .038, hazard ratio 4.394, 95% CI 1.085-17.791) was the only independent predictor of secondary tricuspid regurgitation. This study suggested that preoperative concentric myocardial hypertrophy and diastolic dysfunction were associated with development of the secondary tricuspid regurgitation at late follow-up.

The relationships between perceived organizational support, affective commitment, psychological contract breach, organizational citizenship behaviour and work engagement.

PubMed

Gupta, Vishal; Agarwal, Upasna A; Khatri, Naresh

2016-11-01

This study examines the factors that mediate and moderate the relationships of perceived organizational support with work engagement and organization citizenship behaviour. Specifically, affective commitment is posited to mediate and psychological contract breach to moderate the above relationships. Nurses play a critical role in delivering exemplary health care. For nurses to perform at their best, they need to experience high engagement, which can be achieved by providing them necessary organizational support and proper working environment. Data were collected via a self-reported survey instrument. A questionnaire was administered to a random sample of 750 nurses in nine large hospitals in India during 2013-2014. Four hundred and seventy-five nurses (63%) responded to the survey. Hierarchical multiple regression was used for statistical analysis of the moderated-mediation model. Affective commitment was found to mediate the positive relationships between perceived organizational support and work outcomes (work engagement, organizational citizenship behaviour). The perception of unfulfilled expectations (psychological contract breach) was found to moderate the perceived organizational support-work outcome relationships adversely. The results of this study indicate that perceived organizational support exerts its influence on work-related outcomes and highlight the importance of taking organizational context, such as perceptions of psychological contract breach, into consideration when making sense of the influence of perceived organizational support on affective commitment, work engagement and citizenship behaviours of nurses. © 2016 John Wiley & Sons Ltd.

Internalizing and externalizing symptoms among Palestinian adolescents from Israel as consequences of their exposure to community violence: Are they moderated by their self-efficacy and collective efficacy?

PubMed

Darawshy, Neveen Ali-Saleh; Haj-Yahia, Muhammad M

2018-05-01

This article presents the findings of a study that examined the rates and the consequences of exposure to community violence (ECV) as reflected in witnessing and experiencing such violence, among Palestinian adolescents from Israel. In particular, it examined the extent to which these adolescents exhibit high levels of internalizing and externalizing symptoms as consequences of such exposure, and the extent to which self-efficacy and collective efficacy moderate these consequences. A systematic random sample of 760 Palestinian adolescents in Israel (320 boys, and 440 girls) filled out a self-administered questionnaire. The results show that most of the adolescents had witnessed community violence during the last year and during lifetime, and more than one third had directly experienced such violence during their lifetime compared with 19.6% during the last year. Boys were exposed to community violence more often than girls. Moreover, participants' ECV predicted high levels of externalizing and internalizing symptoms. Hierarchical regression analysis revealed that collective efficacy moderated the correlation between experiencing community violence and internalizing symptoms, whereas self-efficacy moderated the correlation between witnessing community violence and externalizing symptoms. There is a need for providing support for youth from close adults as well as from formal and informal resources in the community before and after their ECV. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cognitive performance predicts treatment decisional abilities in mild to moderate dementia

PubMed Central

Gurrera, R.J.; Moye, J.; Karel, M.J.; Azar, A.R.; Armesto, J.C.

2016-01-01

Objective To examine the contribution of neuropsychological test performance to treatment decision-making capacity in community volunteers with mild to moderate dementia. Methods The authors recruited volunteers (44 men, 44 women) with mild to moderate dementia from the community. Subjects completed a battery of 11 neuropsychological tests that assessed auditory and visual attention, logical memory, language, and executive function. To measure decision making capacity, the authors administered the Capacity to Consent to Treatment Interview, the Hopemont Capacity Assessment Interview, and the MacCarthur Competence Assessment Tool—Treatment. Each of these instruments individually scores four decisional abilities serving capacity: understanding, appreciation, reasoning, and expression of choice. The authors used principal components analysis to generate component scores for each ability across instruments, and to extract principal components for neuropsychological performance. Results Multiple linear regression analyses demonstrated that neuropsychological performance significantly predicted all four abilities. Specifically, it predicted 77.8% of the common variance for understanding, 39.4% for reasoning, 24.6% for appreciation, and 10.2% for expression of choice. Except for reasoning and appreciation, neuropsychological predictor (β) profiles were unique for each ability. Conclusions Neuropsychological performance substantially and differentially predicted capacity for treatment decisions in individuals with mild to moderate dementia. Relationships between elemental cognitive function and decisional capacity may differ in individuals whose decisional capacity is impaired by other disorders, such as mental illness. PMID:16682669

Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes.

PubMed

Kirk, Sara F L; Kuhle, Stefan; McIsaac, Jessie-Lee D; Williams, Patty L; Rossiter, Melissa; Ohinmaa, Arto; Veugelers, Paul J

2015-11-01

Food security (FS) exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their needs. The present research sought to determine whether students from households experiencing moderate or severe food insecurity (FI) had poorer diet quality, higher body weights and poorer psychosocial outcomes than students from households classed as having high FS or marginal FI status. Population-based survey conducted in schools. Multiple regression analysis was used to explore associations between FS status (high FS; marginal, moderate, severe FI), dietary behaviours and intake, and health-related outcomes (body weight, quality of life, mood, peer relationships, externalizing problems). Nova Scotia, Canada. Grade 5 students (n 5853), aged 10-11 years, with complete information on FS status and student outcomes. In this sample, rates of household FS were 73·5% (high FS), 8·3% (marginal FI) 10·2% (moderate FI) and 7·1% (severe FI status). Students living in households experiencing moderate or severe FI had poorer diet quality, higher BMI and poorer psychosocial outcomes than students classed as having high FS or marginal FI. These findings provide important evidence for policy makers on the prevalence of FI among families in Nova Scotia with grade 5 children and its relationship with childhood nutrition, psychosocial and quality of life factors, and weight status.

Do Barriers to Crime Prevention Moderate the Effects of Situational Crime Prevention Policies on Violent Crime in High Schools?

ERIC Educational Resources Information Center

Sevigny, Eric L.; Zhang, Gary

2018-01-01

This study investigates how barriers to school-based crime prevention programming moderate the effects of situational crime prevention (SCP) policies on levels of violent crime in U.S. public high schools. Using data from the 2008 School Survey on Crime and Safety, we estimate a series of negative binomial regression models with interactions to…

Unemployment, Parental Distress and Youth Emotional Well-Being: The Moderation Roles of Parent-Youth Relationship and Financial Deprivation.

PubMed

Frasquilho, Diana; de Matos, Margarida Gaspar; Marques, Adilson; Neville, Fergus G; Gaspar, Tânia; Caldas-de-Almeida, J M

2016-10-01

We investigated, in a sample of 112 unemployed parents of adolescents aged 10-19 years, the links between parental distress and change in youth emotional problems related to parental unemployment, and the moderation roles of parent-youth relationship and financial deprivation. Data were analyzed using descriptive statistics and correlations. Further, simple moderation, additive moderation, and moderated moderation models of regression were performed to analyze the effects of parental distress, parent-youth relationship and financial deprivation in predicting change in youth emotional problems related to parental unemployment. Results show that parental distress moderated by parent-youth relationship predicted levels of change in youth emotional problems related to parental unemployment. This study provides evidence that during job loss, parental distress is linked to youth emotional well-being and that parent-youth relationships play an important moderation role. This raises the importance of further researching parental distress impacts on youth well-being, especially during periods of high unemployment rates.

A Cluster Analytic Approach to Identifying Predictors and Moderators of Psychosocial Treatment for Bipolar Depression: Results from STEP-BD

PubMed Central

Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa G.; Gold, Alexandra K.; da Silva Magalhaes, Pedro Vieira; Henry, David B.; Frank, Ellen; Otto, Michael W.; Berk, Michael; Dougherty, Darin D.; Nierenberg, Andrew A.; Miklowitz, David J.

2016-01-01

Background We sought to address how predictors and moderators of psychotherapy for bipolar depression – identified individually in prior analyses – can inform the development of a metric for prospectively classifying treatment outcome in intensive psychotherapy (IP) versus collaborative care (CC) adjunctive to pharmacotherapy in the Systematic Treatment Enhancement Program (STEP-BD) study. Methods We conducted post-hoc analyses on 135 STEP-BD participants using cluster analysis to identify subsets of participants with similar clinical profiles and investigated this combined metric as a moderator and predictor of response to IP. We used agglomerative hierarchical cluster analyses and k-means clustering to determine the content of the clinical profiles. Logistic regression and Cox proportional hazard models were used to evaluate whether the resulting clusters predicted or moderated likelihood of recovery or time until recovery. Results The cluster analysis yielded a two-cluster solution: 1) “less-recurrent/severe” and 2) “chronic/recurrent.” Rates of recovery in IP were similar for less-recurrent/severe and chronic/recurrent participants. Less-recurrent/severe patients were more likely than chronic/recurrent patients to achieve recovery in CC (p = .040, OR = 4.56). IP yielded a faster recovery for chronic/recurrent participants, whereas CC led to recovery sooner in the less-recurrent/severe cluster (p = .034, OR = 2.62). Limitations Cluster analyses require list-wise deletion of cases with missing data so we were unable to conduct analyses on all STEP-BD participants. Conclusions A well-powered, parametric approach can distinguish patients based on illness history and provide clinicians with symptom profiles of patients that confer differential prognosis in CC vs. IP. PMID:27289316

Life Events Trajectories, Allostatic Load, and the Moderating Role of Age at Arrival from Puerto Rico to the US Mainland

PubMed Central

Arévalo, Sandra P.; Tucker, Katherine L; Falcon, Luis M

2014-01-01

Our aim was to examine the effects of trajectories of stressful life events on allostatic load, measured over a two year time period, and to investigate the roles of language acculturation and age at migration in this association, in a sample of Puerto Rican migrants. We used data from the Boston Puerto Rican Health Study; a population-based prospective cohort of older Puerto Ricans recruited between the ages of 45 and 75 years. The Institutional Review Boards at Tufts Medical Center and Northeastern University approved the study. We used latent growth mixture modeling (LGMM) to identify different classes of two-year trajectories of stressful life events; analysis of variance to examine group differences by stress trajectory; and linear regression to test for the modifying effects of age at arrival on the association of stress trajectory with allostatic load at follow-up. In LGMM analysis, we identified three distinct stress trajectories; low, moderate ascending, and high. Unexpectedly, participants in the low stress group had the highest allostatic load at follow-up (F=4.4, p=0.01) relative to the other two groups. Age at arrival had a statistically significant moderating effect on the association. A reported two year period of moderate but repetitive and increasingly bad life events was associated with increases in allostatic load for participants who arrived to the U.S. mainland after the age of 5 years, and was particularly strong for those arriving between 6–11 years, but not for those arriving earlier or later. Results from this study highlight the complex effects of stress during the life course, and point to certain vulnerable periods for immigrant children that could modify long term effects of stress. PMID:25265208

Match and mismatch between opening area and resistance in mild and moderate rheumatic mitral stenosis.

PubMed

El-Dosouky, Ibtesam Ibrahim

2016-12-01

Mitral valve resistance (MVR) is a hemodynamic consequence of mitral stenosis (MS), but it has no clear threshold with a shortage of data to be reliable. We aimed to investigate match and mismatch between opening area and resistance especially in patients with moderate and mild MS. This study comprised 88 patients with moderate and mild rheumatic MS. Transthoracic echocardiographic study estimated the following: mitral valve area (MVA) by both planimetry (2D) and pressure half-time (PHT), mitral valve score (MVS), mean transmitral pressure gradient (MPG), diastolic filling time (DFT), left ventricular out flow tract diameter (LVOTd) and velocity-time integral (LVOTvti), and MVR = MPG/aortic flow ratio [(LVOTd) (LVOTvti)/DFT] in dynes·s/cm 5 . Patients were classified into two groups: group 1 (51 patients) with matched MVR and group 2 (37 patients) with mismatched higher MVR. In the matched group, moderate MS showed MVR <105 dynes·s/cm 5 and <76dynes·s/cm 5 with mild MS. Group 2 compared to group 1 had higher NYHA class (1.4±0.6 vs 1.2±0.4, P<.05) and higher MVS (8.1±1.8 vs 7±0.9, P<.05). MVR showed positive correlation with MVS (r=.5, P<.05), and logistic regression analysis showed that MVS is the only independent predictor of the MVR severity in the mismatched group (i.e., with higher MVR compared to the ROC analysis results) (B±SE=6.997±2.826, t=2.476, 95% CI 1.241±12.752 with an odds ratio=0.412, P<.05). On investigating match and mismatch between opening area and resistance, the only independent predictor of mismatch is the mitral valve score. © 2016, Wiley Periodicals, Inc.

Association of Problem Gambling with Type of Gambling Among Italian General Population.

PubMed

Scalese, Marco; Bastiani, Luca; Salvadori, Stefano; Gori, Mercedes; Lewis, Isabella; Jarre, Paolo; Molinaro, Sabrina

2016-09-01

The origin of gambling disorders is uncertain; however, research has shown a tendency to focus on specific types of games as a potential important risk factor. The principal aim of this study is to examine the relationships between types of gambling practices and gambling disorder. The data were extracted from IPSAD-Italia(®) 2010-2011 (Italian Population Survey on Alcohol and other Drugs), a survey among the Italian general population which collects socio-cultural information, information about the use of drugs, legal substances and gambling habits. In order to identify the "problem gambler" we used the Problem Gambling Severity Index. Three groups are considered in this analysis: no-risk gamblers, low-risk gamblers, moderate-risk/problem gamblers. Type of gambling practice was considered among two types of gambler: one-game players and multi-games players. 1.9 % of multi-game players were considered problem gamblers, only 0.6 % of one-game players were problem gamblers (p < 0.001). The percentage of players who were low and moderate-risk gamblers was approximately double among multi-game players, with 14.4 % low-risk and 5.8 % moderate-risk; compared with 7.7 % low-risk and 2.5 % moderate risk among one-game players. Results of ordinal logistic regression analysis confirmed that higher level of gambling severity was associated with multi-game players (OR = 2.23, p < 0.0001). Video-poker/slot-machines show the highest association with gambling severity among both one-game players and multi-game players, with scores of OR equal to 4.3 and 4.5 respectively. These findings suggest a popular perception of risk associated with this type of gambling for the development of gambling problems.

Determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania: analysis of data from the 2010 Tanzania Demographic and Health Survey.

PubMed

Wilunda, Calistus; Massawe, Siriel; Jackson, Caroline

2013-12-01

To identify determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania. We included participants from the 2010 Tanzania Demographic and Health Survey, which collected data on socio-demographic and maternal health and determined haemoglobin levels from blood samples. We performed logistic regression to calculate adjusted odds ratios for associations between socio-demographic, contextual, reproductive and lifestyle factors, and moderate-to-severe anaemia and investigated interactions between certain risk factors. Of 9477 women, 20.1% were anaemic. Pregnancy was significantly associated with anaemia (adjusted OR 1.75, 95% CI 1.43-2.15), but the effect varied significantly by urban/rural residence, wealth and education. The effect of pregnancy was stronger in women without education and those who were in lower wealth groups, with significant interactions observed for each of these factors. Education was associated with a lower anaemia risk, particularly in the poorest group (OR 0.58, 95% CI 0.43-0.80), and in pregnant women. The risk of anaemia fell with rising iron supplementation coverage. Lack of toilet facilities increased anaemia risk (OR 1.26, 95% CI 1.00-1.60), whereas using hormonal contraception reduced it. There was no association with age, urban/rural residence, wealth or type of cooking fuel in adjusted analysis. Pregnant women in Tanzania are particularly at risk of moderate-to-severe anaemia, with the effect modified by urban/rural residence, education and wealth. Prevention interventions should target women with lower education or without proper sanitation facilities, and women who are pregnant, particularly if they are uneducated or in lower wealth groups. © 2013 John Wiley & Sons Ltd.

Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

PubMed

Fuller, Daniel; Cummins, Steven; Matthews, Stephen A

2013-01-01

A consistent body of research has shown that the neighborhood food environment is associated with fruit and vegetable (F&V) consumption and obesity in deprived neighborhoods in the United States. However, these studies have often neglected to consider how transportation can moderate associations between food accessibility and diet-related outcomes. This study examined associations between distance to primary food store, fruit and vegetable consumption, and BMI and whether mode of transportation to the primary food store moderates this relation. Cross-sectional data from the baseline wave of the Philadelphia Neighborhood Food Environment Study were used. A telephone survey of adult (≥18 y of age) household primary food shoppers residing in 2 Philadelphia neighborhoods was conducted (n = 1440). In a bivariate linear regression analysis, distance to primary food store did not predict F&V consumption (β = 0.04; 95% CI: -0.00, 0.09). Linear regression analysis stratified by transportation mode to the main F&V store showed no difference in F&V consumption between car, public, and multimodal transportation users. Compared with respondents using multimodal transportation, those using public transit had a significantly lower BMI (β = -1.31; 95% CI: -2.50, -0.10), whereas those using an automobile did not (β = -0.41; 95% CI: -1.36, 0.54). The assumption that using an automobile to access food stores results in increased F&V consumption was not confirmed. Significant associations were found for the relation between transportation mode and BMI. Theory-based mechanisms explaining relationships between the primary transportation mode used to access food stores and BMI should be further explored.

Low maternal sensitivity at 6 months of age predicts higher BMI in 48 month old girls but not boys.

PubMed

Wendland, Barbara E; Atkinson, Leslie; Steiner, Meir; Fleming, Alison S; Pencharz, Paul; Moss, Ellen; Gaudreau, Hélène; Silveira, Patricia P; Arenovich, Tamara; Matthews, Stephen G; Meaney, Michael J; Levitan, Robert D

2014-11-01

Large population-based studies suggest that systematic measures of maternal sensitivity predict later risk for overweight and obesity. More work is needed to establish the developmental timing and potential moderators of this association. The current study examined the association between maternal sensitivity at 6 months of age and BMI z score measures at 48 months of age, and whether sex moderated this association. Longitudinal Canadian cohort of children from birth (the MAVAN project). This analysis was based on a dataset of 223 children (115 boys, 108 girls) who had structured assessments of maternal sensitivity at 6 months of age and 48-month BMI data available. Mother-child interactions were videotaped and systematically scored using the Maternal Behaviour Q-Sort (MBQS)-25 items, a standardized measure of maternal sensitivity. Linear mixed-effects models and logistic regression examined whether MBQS scores at 6 months predicted BMI at 48 months, controlling for other covariates. After controlling for weight-relevant covariates, there was a significant sex by MBQS interaction (P=0.015) in predicting 48 month BMI z. Further analysis revealed a strong negative association between MBQS scores and BMI in girls (P=0.01) but not boys (P=0.72). Logistic regression confirmed that in girls only, low maternal sensitivity was associated with the higher BMI categories as defined by the WHO (i.e. "at risk for overweight" or above). A significant association between low maternal sensitivity at 6 months of age and high body mass indices was found in girls but not boys at 48 months of age. These data suggest for the first time that the link between low maternal sensitivity and early BMI z may differ between boys and girls. Copyright © 2014 Elsevier Ltd. All rights reserved.

Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use.

PubMed

Bohnert, Amy S B; German, Danielle; Knowlton, Amy R; Latkin, Carl A

2010-03-01

Social support is a multi-dimensional construct that is important to drug use cessation. The present study identified types of supportive friends among the social network members in a community-based sample and examined the relationship of supporter-type classes with supporter, recipient, and supporter-recipient relationship characteristics. We hypothesized that the most supportive network members and their support recipients would be less likely to be current heroin/cocaine users. Participants (n=1453) were recruited from low-income neighborhoods with a high prevalence of drug use. Participants identified their friends via a network inventory, and all nominated friends were included in a latent class analysis and grouped based on their probability of providing seven types of support. These latent classes were included as the dependent variable in a multi-level regression of supporter drug use, recipient drug use, and other characteristics. The best-fitting latent class model identified five support patterns: friends who provided Little/No Support, Low/Moderate Support, High Support, Socialization Support, and Financial Support. In bivariate models, friends in the High, Low/Moderate, and Financial Support were less likely to use heroin or cocaine and had less conflict with and were more trusted by the support recipient than friends in the Low/No Support class. Individuals with supporters in those same support classes compared to the Low/No Support class were less likely to use heroin or cocaine, or to be homeless or female. Multivariable models suggested similar trends. Those with current heroin/cocaine use were less likely to provide or receive comprehensive support from friends. Published by Elsevier Ireland Ltd.

The relationship between amount of soda consumed and intention to reduce soda consumption among adults exposed to the Choose Health LA 'Sugar Pack' health marketing campaign.

PubMed

Robles, Brenda; Blitstein, Jonathan L; Lieberman, Alicea J; Barragan, Noel C; Gase, Lauren N; Kuo, Tony

2015-10-01

To examine behavioural intention to reduce soda consumption after exposure to the Choose Health LA 'Sugar Pack' campaign in Los Angeles County, California, USA. A cross-sectional street-intercept survey was conducted to assess knowledge, attitudes, health behaviours and behavioural intentions after exposure to the 'Sugar Pack' campaign. A multivariable regression analysis was performed to examine the relationships between the amount of soda consumed and self-reported intention to reduce consumption of non-diet soda among adults who saw the campaign. Three pre-selected Los Angeles County Metro bus shelters and/or rail stops with the highest number of 'Sugar Pack' campaign advertisement placements. Riders of the region's Metro buses and railways who were the intended audience of the campaign advertisements. The overall survey response rate was 56 % (resulting n 1041). Almost 60 % of respondents were exposed to the advertisements (619/1041). The multivariable logistic regression analysis suggested that the odds of reporting intention to reduce soda consumption among moderate consumers (1-6 sodas/week) were 1·95 times greater than among heavy consumers (≥1 soda/d), after controlling for clustering and covariates. Respondents with less than a high-school education and who perceived sugary beverage consumption as harmful also had higher odds; in contrast, respondents aged ≥65 years had lower odds. Results suggest that future campaigns should be tailored differently for moderate v. heavy consumers of soda. Similar tailoring strategies are likely needed for younger groups, for those with less educational attainment and for those who do not perceive consumption of soda as harmful.

Acute care surgery: defining mortality in emergency general surgery in the state of Maryland.

PubMed

Narayan, Mayur; Tesoriero, Ronald; Bruns, Brandon R; Klyushnenkova, Elena N; Chen, Hegang; Diaz, Jose J

2015-04-01

Emergency general surgery (EGS) is a major component of acute care surgery, however, limited data exist on mortality with respect to trauma center (TC) designation. We hypothesized that mortality would be lower for EGS patients treated at a TC vs non-TC (NTC). A retrospective review of the Maryland Health Services Cost Review Commission database from 2009 to 2013 was performed. The American Association for the Surgery of Trauma EGS ICD-9 codes were used to identify EGS patients. Data collected included demographics, TC designation, emergency department admissions, and All Patients Refined Severity of Illness (APR_SOI). Trauma center designation was used as a marker of a formal acute care surgery program. Primary outcomes included in-hospital mortality. Multivariable logistic regression analysis was performed controlling for age. There were 817,942 EGS encounters. Mean ± SD age of patients was 60.1 ± 18.7 years, 46.5% were males; 71.1% of encounters were at NTCs; and 75.8% were emergency department admissions. Overall mortality was 4.05%. Mortality was calculated based on TC designation controlling for age across APR_SOI strata. Multivariable logistic regression analysis did not show statistically significant differences in mortality between hospital levels for minor APR_SOI. For moderate APR_SOI, mortality was significantly lower for TCs compared with NTCs (p < 0.001). Among TCs, the effect was strongest for Level I TC (odds ratio = 0.34). For extreme APR_SOI, mortality was higher at TCs vs NTCs (p < 0.001). Emergency general surgery patients treated at TCs had lower mortality for moderate APR_SOI, but increased mortality for extreme APR_SOI when compared with NTCs. Additional investigation is required to better evaluate this unexpected finding. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Prevalence and risk factors associated with pain 21 months following surgery for breast cancer.

PubMed

Moloney, Niamh; Sung, Jennie Man Wai; Kilbreath, Sharon; Dylke, Elizabeth

2016-11-01

This study investigated (1) the prevalence of pain following breast cancer treatment including moderate-to-severe persistent pain and (2) the association of risk factors, present 1 month following surgery, with pain at 21 months following surgery. This information may aid the development of clinical guidelines for early pain assessment and intervention in this population. This study was a retrospective analysis of core and breast modules of the European Organisation for Research and Treatment of Cancer (EORTC) questionnaire from 121 participants with early breast cancer. The relationships between potential risk factors (subscales derived from the EORTC), measured within 1 month following surgery, and pain at 21 months following surgery were analysed using univariable and multi-variable logistic regression. At 21 months following surgery, 46.3 % of participants reported pain, with 24 % categorised as having moderate or severe pain. Prevalence of pain was similar between those who underwent axillary lymph node dissection versus biopsy. Univariate logistic regression identified baseline pain (odds ratio (95 % CI): 2.7 (1.1 to 6.4)); baseline arm symptoms (11.2 (1.4 to 89.8)); emotional function (0.4 (0.1 to 0.8)) and insomnia (2.3 (1.1 to 4.7) as significantly associated with pain at 21 months. In multi-variable analysis, two factors were independently associated with pain at 21 months-baseline arm symptoms and emotional subscale scores. Pain is a significant problem following breast cancer treatment in both the early post-operative period and months following surgery. Risk factors for pain at long-term follow-up included arm symptoms and higher emotional subscale scores at baseline.

Effects of self-management health information technology on glycaemic control for patients with diabetes: a meta-analysis of randomized controlled trials.

PubMed

Tao, Da; Or, Calvin Kl

2013-04-01

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) which had evaluated self-management health information technology (SMHIT) for glycaemic control in patients with diabetes. A total of 43 RCTs was identified, which reported on 52 control-intervention comparisons. The glycosylated haemoglobin (HbA 1c ) data were pooled using a random effects meta-analysis method, followed by a meta-regression and subgroup analyses to examine the effects of a set of moderators. The meta-analysis showed that use of SMHITs was associated with a significant reduction in HbA 1c compared to usual care, with a pooled standardized mean difference of -0.30% (95% CI -0.39 to -0.21, P < 0.001). Sample size, age, study setting, type of application and method of data entry significantly moderated the effects of SMHIT use. The review supports the use of SMHITs as a self-management approach to improve glycaemic control. The effect of SMHIT use is significantly greater when the technology is a web-based application, when a mechanism for patients' health data entry is provided (manual or automatic) and when the technology is operated in the home or without location restrictions. Integrating these variables into the design of SMHITs may augment the effectiveness of the interventions. © SAGE Publications Ltd, 2013.

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial.

PubMed

Krampe, Henning; Salz, Anna-Lena; Kerper, Léonie F; Krannich, Alexander; Schnell, Tatjana; Wernecke, Klaus-Dieter; Spies, Claudia D

2017-12-29

Readiness to change is a pivotal construct for psychotherapy research and a major target of motivational interventions. Our primary objective was to examine whether pre-treatment readiness to change moderated therapy effects of Bridging Intervention in Anesthesiology (BRIA), an innovative psychotherapy approach for surgical patients. This stepped care program aims at motivating and supporting surgical patients with mental disorders to engage in psychosocial mental health care. The major steps of BRIA are two motivational interventions with different intensity. The first step of the program consists of preoperative computer-assisted psychosocial self-assessment including screening for psychological distress and automatically composed computerized brief written advice (BWA). In the second step, patients participate in postoperative psychotherapy sessions combining motivational interviewing with cognitive behavioural therapy (BRIA psychotherapy sessions). We performed regression-based moderator analyses on data from a recent randomized controlled trial published by our research group. The sample comprised 220 surgical patients with diverse comorbid mental disorders according to ICD-10. The most frequent disorders were mood, anxiety, substance use and adjustment disorders. The patients had a mean age of 43.31 years, and 60.90% were women. In a regression model adjusted for pre-treatment psychological distress, we investigated whether readiness to change moderated outcome differences between (1) the BRIA psychotherapy sessions and (2) no psychotherapy / BWA only. Multiple regression analyses showed that readiness to change moderated treatment effects regarding the primary outcomes "Participation in psychosocial mental health care options at month 6" (p = 0.03) and "Having approached psychosocial mental health care options at month 6" (p = 0.048) but not regarding the secondary outcome "Change of general psychological distress between baseline assessment and month 6" (p = 0.329). Probing the moderation effect with the Johnson-Neyman technique revealed that BRIA psychotherapy sessions were superior to BWA in patients with low to moderate readiness, but not in those with high readiness. Readiness to change may act as moderator of the efficacy of psychosocial therapy. Combinations of motivational interviewing and cognitive behavioural therapy may be effective particularly in patients with a variety of mental disorders and low readiness to change. clinicaltrials.gov Identifier: NCT01357694.

Social Desirability Trait Is Associated with Self-Reported Vegetable Intake among Women Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children.

PubMed

Di Noia, Jennifer; Cullen, Karen Weber; Monica, Dorothy

2016-12-01

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Fresh Start (WFS) is a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable (F/V) purchases and consumption among women enrolled in WIC. Using baseline data from WFS to examine associations between social desirability trait, the tendency to respond in a manner consistent with expected norms, and self-reported F/V intake and to determine whether associations, if found, are moderated by participant characteristics. Cross-sectional. Seven hundred forty-four women enrolled in WFS. The setting is a New Jersey-based WIC agency located in a densely populated urban area. Items assessing participant characteristics, a short form of the Marlowe-Crowne Social Desirability Scale, and validated measures of the frequency and quantity of F/V intake. Linear regression analysis to examine associations between social desirability trait and F/V intake and hierarchical regression analysis to test for moderation by participant characteristics of the associations between social desirability trait and F/V intake. Social desirability trait was significantly associated with times per day vegetables were reported to have been consumed (β=0.08, P=0.03). The association was moderated by breastfeeding status. Among breastfeeding women, social desirability trait was unrelated to reported intake, whereas among non-breastfeeding women, it was positively associated with intake (a 1-unit increase in the social desirability score was associated with a 0.12 increase in times per day vegetables were reported to have been consumed). Social desirability trait is associated with self-reported vegetable intake among WIC participants generally and non-breastfeeding participants in particular and should be assessed in these groups. Replication studies with comparative measures of "true intake" are needed to determine whether social desirability trait biases self-reports of vegetable intake or whether those with a high social desirability trait consume vegetables more often. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Midline Shift is Unrelated to Subjective Pupillary Reactivity Assessment on Admission in Moderate and Severe Traumatic Brain Injury.

PubMed

Nourallah, Basil; Menon, David K; Zeiler, Frederick A

2018-04-04

This study aims to determine the relationship between pupillary reactivity, midline shift and basal cistern effacement on brain computed tomography (CT) in moderate-to-severe traumatic brain injury (TBI). All are important diagnostic and prognostic measures, but their relationship is unclear. A total of 204 patients with moderate-to-severe TBI, documented pupillary reactivity, and archived neuroimaging were included. Extent of midline shift and basal cistern effacement were extracted from admission brain CT. Mean midline shift was calculated for each ordinal category of pupillary reactivity and basal cistern effacement. Sequential Chi-square analysis was used to calculate a threshold midline shift for pupillary abnormalities and basal cistern effacement. Univariable and multiple logistic regression analyses were performed. Pupils were bilaterally reactive in 163 patients, unilaterally reactive in 24, and bilaterally unreactive in 17, with mean midline shift (mm) of 1.96, 3.75, and 2.56, respectively (p = 0.14). Basal cisterns were normal in 118 patients, compressed in 45, and absent in 41, with mean midline shift (mm) of 0.64, 2.97, and 5.93, respectively (p < 0.001). Sequential Chi-square analysis identified a threshold for abnormal pupils at a midline shift of 7-7.25 mm (p = 0.032), compressed basal cisterns at 2 mm (p < 0.001), and completely effaced basal cisterns at 7.5 mm (p < 0.001). Logistic regression revealed no association between midline shift and pupillary reactivity. With effaced basal cisterns, the odds ratio for normal pupils was 0.22 (95% CI 0.08-0.56; p = 0.0016) and for at least one unreactive pupil was 0.061 (95% CI 0.012-0.24; p < 0.001). Basal cistern effacement strongly predicted midline shift (OR 1.27; 95% CI 1.17-1.40; p < 0.001). Basal cistern effacement alone is associated with pupillary reactivity and is closely associated with midline shift. It may represent a uniquely useful neuroimaging marker to guide intervention in traumatic brain injury.

Effects of Cerebral Blood Flow and Vessel Conditions on Speech Recognition in Patients With Postlingual Adult Cochlear Implant: Predictable Factors for the Efficacy of Cochlear Implant.

PubMed

Ishino, Takashi; Ragaee, Mahmoud Ali; Maruhashi, Tatsuya; Kajikawa, Masato; Higashi, Yukihito; Sonoyama, Toru; Takeno, Sachio; Hirakawa, Katsuhiro

Cochlear implantation (CI) has been the most successful procedure for restoring hearing in a patient with severe and profound hearing loss. However, possibly owing to the variable brain functions of each patient, its performance and the associated patient satisfaction are widely variable. The authors hypothesize that peripheral and cerebral circulation can be assessed by noninvasive and globally available methods, yielding superior presurgical predictive factors of the performance of CI in adult patients with postlingual hearing loss who are scheduled to undergo CI. Twenty-two adult patients with cochlear implants for postlingual hearing loss were evaluated using Doppler sonography measurement of the cervical arteries (reflecting cerebral blood flow), flow-mediated dilation (FMD; reflecting the condition of cerebral arteries), and their pre-/post-CI best score on a monosyllabic discrimination test (pre-/post-CI best monosyllabic discrimination [BMD] score). Correlations between post-CI BMD score and the other factors were examined using univariate analysis and stepwise multiple linear regression analysis. The prediction factors were calculated by examining the receiver-operating characteristic curve between post-CI BMD score and the significantly positively correlated factors. Age and duration of deafness had a moderately negative correlation. The mean velocity of the internal carotid arteries and FMD had a moderate-to-strong positive correlation with the post-CI BMD score in univariate analysis. Stepwise multiple linear regression analysis revealed that only FMD was significantly positively correlated with post-CI BMD score. Analysis of the receiver-operating characteristic curve showed that a FMD cutoff score of 1.8 significantly predicted post-CI BMD score. These data suggest that FMD is a convenient, noninvasive, and widely available tool for predicting the efficacy of cochlear implants. An FMD cutoff score of 1.8 could be a good index for determining whether patients will hear well with cochlear implants. It could also be used to predict whether cochlear implants will provide good speech recognition benefits to candidates, even if their speech discrimination is poor. This FMD index could become a useful predictive tool for candidates with poor speech discrimination to determine the efficacy of CI before surgery.

Premorbid personality characteristics and attachment style moderate the effect of injury severity on occupational outcome in traumatic brain injury: another aspect of reserve.

PubMed

Sela-Kaufman, Michal; Rassovsky, Yuri; Agranov, Eugenia; Levi, Yifat; Vakil, Eli

2013-01-01

The concept of "reserve" has been proposed to account for the mismatch between brain pathology and its clinical expression. Prior efforts to characterize this concept focused mostly on brain or cognitive reserve measures. The present study was a preliminary attempt to evaluate premorbid personality and emotional aspects as potential moderators in moderate-to-severe traumatic brain injury. Using structural equation modeling and multiple regression analyses, we found that premorbid personality characteristics provided the most robust moderator of injury severity on occupational outcome. Findings offer preliminary support for premorbid personality features as another relevant reserve construct in predicting outcome in this population.

Maternal hemoglobin concentration and adverse pregnancy outcomes at low and moderate altitudes in Peru.

PubMed

Gonzales, Gustavo F; Tapia, Vilma; Gasco, Manuel; Carrillo, Carlos E

2012-07-01

To identify associations of maternal hemoglobin (Hb) with perinatal outcomes at low and moderate altitudes in Peru. Study of records with sequential information using perinatal database system. The study included 295 651 pregnant women with their products. Using multiple logistic regression analysis, we estimated the probability of stillbirths, preterm and small for gestational age (SGA) births associated with maternal Hb levels at low (0-1999 m) and moderate altitudes (2000-2999 m). Maternal Hb decreased as pregnancy progressed from first to third trimester at both altitudes. Hb was higher at moderate than at low altitude (p < 0.001). Risks for stillbirths increased with low maternal Hb (odds ratio [OR]: 1.39 for Hb 9-9.9; OR: 1.84 for Hb 8-8.9; OR: 3.25 for Hb 7-7.9; and OR: 7.8 for Hb <7 g/dl); with Hb higher than 14.5 g/dl (OR: 1.31) and with altitudes ≥ 2000 m (OR: 1.2). High preterm rates were also observed with low Hbs (OR: 1.16 for Hb 9-9.9; OR: 1.64 for Hb 8-8.9; OR: 2.25 for Hb 7-7.9; and OR:2.87 for Hb<7 g/dl) and with Hb higher than 14.5 g/dl (OR: 1.14). High SGA rates were observed in neonates with maternal Hb of 7-7.9 (OR: 1.35) and <7 g/dl (OR:1.57), and higher than 14.5 g/dl (OR: 1.33), and with moderate altitudes (OR: 1.12). The cut-off points for lower risks of stillbirth and preterm births was 10 g/dl, and for SGA 9 g/dl of hemoglobin. Low and high maternal Hb levels and moderate altitude were independent risk factors for adverse perinatal outcomes.

Prevalence, correlates, and impact of coronary calcification on adverse events following PCI with newer-generation DES: Findings from a large multiethnic registry.

PubMed

Copeland-Halperin, Robert S; Baber, Usman; Aquino, Melissa; Rajamanickam, Anitha; Roy, Swathi; Hasan, Choudhury; Barman, Nitin; Kovacic, Jason C; Moreno, Pedro; Krishnan, Prakash; Sweeny, Joseph M; Mehran, Roxana; Dangas, George; Kini, Annapoorna S; Sharma, Samin K

2018-04-01

We sought to determine the prevalence, predictors, and clinical impact of target lesion calcification in patients undergoing percutaneous coronary intervention (PCI) with newer generation drug-eluting stents (DES) and devices. Coronary calcification is independently associated with adverse outcomes following PCI. While newer DES and contemporary devices are considered safer and more efficacious, their influence on outcomes following PCI of heavily calcified lesions is unknown. We performed a retrospective analysis of a large, multiethnic cohort of patients undergoing PCI with new generation DES at an academic center between 2009 and 2013. Coronary calcification was qualitatively assessed as none/mild, moderate, or severe. Independent demographic, clinical, and anatomic predictors of moderate/severe calcification were identified using logistic regression. Associations between coronary calcification and 1-year MACE (death, myocardial infarction, or target vessel revascularization) were examined using Cox modeling. Compared to patients with none/mild (n = 10,180; 82.0%), those with moderate (n = 1,271; 10.0%) or severe (n = 994; 8.0%) calcification were older, more often Caucasian, had more complex target lesions, and worse renal function. The strongest demographic, clinical, and anatomic correlates of moderate/severe calcification were age, Caucasian race, renal dysfunction, lesion length, and left main location. Unadjusted MACE rates among those with none/mild, moderate, and severe calcification were 8.3, 14.6, and 17.8%, respectively (P < 0.001). After multivariable adjustment, the hazard ratio (95% CI) for MACE associated with moderate or severe coronary calcification was 1.63. Target lesion calcification remains independently associated with adverse outcomes in patients treated with newer generation DES and modern devices. © 2017 Wiley Periodicals, Inc.

Association between aortic valve calcification measured on non-contrast computed tomography and aortic valve stenosis in the general population.

PubMed

Paulsen, Niels Herluf; Carlsen, Bjarke Bønløkke; Dahl, Jordi Sanchez; Carter-Storch, Rasmus; Christensen, Nicolaj Lyhne; Khurrami, Lida; Møller, Jacob Eifer; Lindholt, Jes Sandal; Diederichsen, Axel Cosmus Pyndt

2016-01-01

Aortic valve calcification (AVC) measured on non-contrast computed tomography (CT) has shown correlation to severity of aortic valve stenosis (AS) and mortality in patients with known AS. The aim of this study was to determine the association of CT verified AVC and subclinical AS in a general population undergoing CT. CT scans from 566 randomly selected male participants (age 65-74) in the Danish cardiovascular screening study (DANCAVAS) were analyzed for AVC. All participants with a moderately or severely increased AVC score (≥300 arbitrary units (AU)) and a matched control group were invited for a supplementary echocardiography. AS was graded by indexed aortic valve area (AVAi) on echocardiography as moderate 0.6-0.85 cm(2)/m(2) and severe < 0.6 cm(2)/m(2), respectively. ROC- and regression analyses were performed. Due to prior valve surgery, and artifacts from ICD leads 16 individuals were excluded from the AVC scoring. Moderate or severe increased AVC was observed in 10.7% (95% CI: 8.4-13.7). Echocardiography was performed in 101 individuals; 32.7% (95% CI: 21.8 to 46.0) with moderate or high AVC score had moderate or severe AS, while none with no or low AVC. A ROC analysis defined an AVC score ≥588 AU to be suggestive of moderate or severe AS (AUC 0.89 ± 0.04, sensitivity 83% and specificity 87%). In the univariate analyses, AVC was the only variable significantly associated with AS. This study indicates an association between CT verified AVC and subclinical AS. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Retail Tobacco Exposure: Using Geographic Analysis to Identify Areas With Excessively High Retail Density

PubMed Central

2014-01-01

Introduction: There is great disparity in tobacco outlet density (TOD), with density highest in low-income areas and areas with greater proportions of minority residents, and this disparity may affect cancer incidence. We sought to better understand the nature of this disparity by assessing how these socio-demographic factors relate to TOD at the national level. Methods: Using mixture regression analysis and all of the nearly 65,000 census tracts in the contiguous United States, we aimed to determine the number of latent disparity classes by modeling the relations of proportions of Blacks, Hispanics, and families living in poverty with TOD, controlling for urban/rural status. Results: We identified six disparity classes. There was considerable heterogeneity in relation to TOD for Hispanics in rural settings. For Blacks, there was no relation to TOD in an urban moderate disparity class, and for rural census tracts, the relation was highest in a moderate disparity class. Conclusions: We demonstrated the utility of classifying census tracts on heterogeneity of tobacco risk exposure. This approach provides a better understanding of the complexity of socio-demographic influences of tobacco retailing and creates opportunities for policy makers to more efficiently target areas in greatest need. PMID:23999651

Retail tobacco exposure: using geographic analysis to identify areas with excessively high retail density.

PubMed

Rodriguez, Daniel; Carlos, Heather A; Adachi-Mejia, Anna M; Berke, Ethan M; Sargent, James

2014-02-01

There is great disparity in tobacco outlet density (TOD), with density highest in low-income areas and areas with greater proportions of minority residents, and this disparity may affect cancer incidence. We sought to better understand the nature of this disparity by assessing how these socio-demographic factors relate to TOD at the national level. Using mixture regression analysis and all of the nearly 65,000 census tracts in the contiguous United States, we aimed to determine the number of latent disparity classes by modeling the relations of proportions of Blacks, Hispanics, and families living in poverty with TOD, controlling for urban/rural status. We identified six disparity classes. There was considerable heterogeneity in relation to TOD for Hispanics in rural settings. For Blacks, there was no relation to TOD in an urban moderate disparity class, and for rural census tracts, the relation was highest in a moderate disparity class. We demonstrated the utility of classifying census tracts on heterogeneity of tobacco risk exposure. This approach provides a better understanding of the complexity of socio-demographic influences of tobacco retailing and creates opportunities for policy makers to more efficiently target areas in greatest need.

Interventions for caregivers of someone with an eating disorder: a meta-analysis.

PubMed

Hibbs, Rebecca; Rhind, Charlotte; Leppanen, Jenni; Treasure, Janet

2015-05-01

A variety of interventions have been developed for caregivers of people with an eating disorder either to help them cope with the burden and distress that commonly accompanies this role or to make them more effective at providing support. The aim of the study is to perform a meta-analysis of quantitative studies that have described the impact of these interventions on caregivers. Electronic databases were searched between September 2001 and September 2013. Thirteen studies were finally selected for inclusion. Pooled effect size estimates were summarized. Meta-regressions were used to determine whether type of intervention, team, measure used or risk of bias were effect modifiers of the relationship. We also summarized the content and form (amount of professional help) of the interventions. Most interventions produced a moderate sized reduction in carer distress and a small/moderate reduction in carer burden and expressed emotion post treatment and these changes were maintained over follow-up. Carer distress, burden and expressed emotion can be reduced by a variety of psychoeducational interventions and these changes are sustainable over time. The interventions themselves are easy to disseminate and deliver. © 2014 Wiley Periodicals, Inc.

Reduced dopamine receptors and transporters but not synthesis capacity in normal aging adults: a meta-analysis.

PubMed

Karrer, Teresa M; Josef, Anika K; Mata, Rui; Morris, Evan D; Samanez-Larkin, Gregory R

2017-09-01

Many theories of cognitive aging are based on evidence that dopamine (DA) declines with age. Here, we performed a systematic meta-analysis of cross-sectional positron emission tomography and single-photon emission-computed tomography studies on the average effects of age on distinct DA targets (receptors, transporters, or relevant enzymes) in healthy adults (N = 95 studies including 2611 participants). Results revealed significant moderate to large, negative effects of age on DA transporters and receptors. Age had a significantly larger effect on D1- than D2-like receptors. In contrast, there was no significant effect of age on DA synthesis capacity. The average age reductions across the DA system were 3.7%-14.0% per decade. A meta-regression found only DA target as a significant moderator of the age effect. This study precisely quantifies prior claims of reduced DA functionality with age. It also identifies presynaptic mechanisms (spared synthesis capacity and reduced DA transporters) that may partially account for previously unexplained phenomena whereby older adults appear to use dopaminergic resources effectively. Recommendations for future studies including minimum required samples sizes are provided. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Obstructive sleep apnea combined dyslipidemia render additive effect on increasing atherosclerotic cardiovascular diseases prevalence.

PubMed

Cao, Zhiyong; Zhang, Ping; He, Zhiqing; Yang, Jing; Liang, Chun; Ren, Yusheng; Wu, Zonggui

2016-05-26

Current study was designed to investigate the effects of obstructive sleep apnea (OSA) combined dyslipidemia on the prevalence of atherosclerotic cardiovascular diseases (ASCVD). This was a cross-sectional study and subjects with documented dyslipidemia and without previous diagnosis of OSA were enrolled. Polysomnography was applied to evaluate apnea-hypopnea index (AHI). Based on AHI value, subjects were classified into four groups: without OSA, mild, moderate and severe OSA groups. Clinical characteristics and laboratory examination data were recorded. Relationship between AHI event and lipid profiles was analyzed, and logistic regression analysis was used to evaluate the effects of OSA combined dyslipidemia on ASCVD prevalence. Totally 248 subjects with dyslipidemia were enrolled. Compared to the other 3 groups, subjects with severe OSA were older, male predominant and had higher smoking rate. In addition, subjects with severe OSA had higher body mass index, waist-hip ratio, blood pressure, and higher rates of overweight and obesity. Serum levels of fasting plasma glucose, glycated hemoglobin, LDL-C and CRP were all significantly higher. ASCVD prevalence was considerably higher in subjects with severe OSA. AHI event in the severe OSA group was up to 35.4 ± 5.1 events per hour which was significantly higher than the other groups (P < 0.05 for trend). Pearson correlation analysis showed that only LDL-C was positively correlated with AHI events (r = 0.685, P < 0.05). Logistic regression analysis revealed that in unadjusted model, compared to dyslipidemia plus no-OSA group (reference group), OSA enhanced ASCVD risk in subjects with dyslipidemia, regardless of OSA severity. After extensively adjusted for confounding variables, the odds of dyslipidemia plus mild-OSA was reduced to insignificance. While the effects of moderate- and severe-OSA on promoting ASCVD risk in subjects with dyslipidemia remained significant, with severe-OSA most prominent (odds ratio: 1.52, 95% confidence interval: 1.13-2.02). OSA combined dyslipidemia conferred additive adverse effects on cardiovascular system, with severe-OSA most prominent.

Placebo effects in trials evaluating 12 selected minimally invasive interventions: a systematic review and meta-analysis

PubMed Central

Holtedahl, Robin; Brox, Jens Ivar; Tjomsland, Ole

2015-01-01

Objectives To analyse the impact of placebo effects on outcome in trials of selected minimally invasive procedures and to assess reported adverse events in both trial arms. Design A systematic review and meta-analysis. Data sources and study selection We searched MEDLINE and Cochrane library to identify systematic reviews of musculoskeletal, neurological and cardiac conditions published between January 2009 and January 2014 comparing selected minimally invasive with placebo (sham) procedures. We searched MEDLINE for additional randomised controlled trials published between January 2000 and January 2014. Data synthesis Effect sizes (ES) in the active and placebo arms in the trials’ primary and pooled secondary end points were calculated. Linear regression was used to analyse the association between end points in the active and sham groups. Reported adverse events in both trial arms were registered. Results We included 21 trials involving 2519 adult participants. For primary end points, there was a large clinical effect (ES≥0.8) after active treatment in 12 trials and after sham procedures in 11 trials. For secondary end points, 7 and 5 trials showed a large clinical effect. Three trials showed a moderate difference in ES between active treatment and sham on primary end points (ES ≥0.5) but no trials reported a large difference. No trials showed large or moderate differences in ES on pooled secondary end points. Regression analysis of end points in active treatment and sham arms estimated an R2 of 0.78 for primary and 0.84 for secondary end points. Adverse events after sham were in most cases minor and of short duration. Conclusions The generally small differences in ES between active treatment and sham suggest that non-specific mechanisms, including placebo, are major predictors of the observed effects. Adverse events related to sham procedures were mainly minor and short-lived. Ethical arguments frequently raised against sham-controlled trials were generally not substantiated. PMID:25636794

Prediction of Early Childhood Outcome of Term Infants using Apgar Scores at 10 Minutes following Hypoxic-Ischemic Encephalopathy

PubMed Central

Laptook, Abbot R.; Shankaran, Seetha; Ambalavanan, Namasivayam; Carlo, Waldemar A.; McDonald, Scott A.; Higgins, Rosemary D.; Das, Abhik

2010-01-01

Context Death or severe disability is so common following an Apgar score of 0 at 10 minutes in observational studies that the Neonatal Resuscitation Program suggests considering discontinuation of resuscitation after 10 minutes of effective CPR. Objective To determine if Apgar scores at 10 minutes are associated with death or disability in early childhood following perinatal hypoxic-ischemic encephalopathy (HIE). Design, Setting, and Patients This is a secondary analysis of infants enrolled in the NICHD Neonatal Research Network hypothermia trial. Infants ≥ 36 weeks gestation had clinical and/or biochemical abnormalities at birth, and encephalopathy at < 6 hours. Logistic regression and classification and regression tree (CART) analysis was used to determine associations between Apgar scores at 10 minutes and neurodevelopmental outcome adjusting for covariates. Associations are expressed as odds ratios (OR) and 95% confidence interval (CI). Main Outcome Measure Death or disability (moderate or severe) at 18–22 months of age. Results Twenty of 208 infants were excluded (missing data). More than 90% of infants had Apgar scores of 0–2 at 1 minute and Apgars at 5 and 10 minutes shifted to progressively higher values; at 10 minutes 27% of infants had Apgar scores of 0–2. After adjustment each point decrease in Apgar score at 10 minutes was associated with a 45% increase in the odds of death or disability (OR 1.45, CI 1.22–1.72). Death or disability occurred in 76, 82 and 80% of infants with Apgar scores at 10 minutes of 0, 1 and 2, respectively. CART analysis indicated that Apgar scores at 10 minutes were discriminators of outcome. Conclusion Apgar scores at 10 minutes provide useful prognostic data before other evaluations are available for infants with HIE. Death or moderate/severe disability is common but not uniform with Apgar scores < 3; caution is needed before adopting a specific time interval to guide duration of resuscitation. PMID:19948631

Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation.

PubMed

Jeong, Junhui; Jung, Jinsei; Lee, Jeon Mi; Suh, Michelle J; Kwak, Sang Hyun; Kim, Sung Huhn

2017-08-01

We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis. Retrospective analysis. Tertiary referral center. Forty-six patients with acute unilateral vestibular neuritis were included. Diagnostic, therapeutic, and rehabilitative. All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed. After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p < 0.001). After multiple regression analysis of those factors, initial DHI score and absent cervical vestibular-evoked myogenic potential response were identified as being associated with higher postrehabilitation DHI score. Saccular dysfunction in acute vestibular neuritis can contribute to persistent subjective dizziness, even after the objective parameters of vestibular function tests have been improved by vestibular rehabilitation.

Effect of low-to-moderate-dose corticosteroids on mortality of hospitalized adolescents and adults with influenza A(H1N1)pdm09 viral pneumonia.

PubMed

Li, Hui; Yang, Shi-Gui; Gu, Li; Zhang, Yao; Yan, Xi-Xin; Liang, Zong-An; Zhang, Wei; Jia, Hong-Yu; Chen, Wei; Liu, Meng; Yu, Kai-Jiang; Xue, Chun-Xue; Hu, Ke; Zou, Qi; Li, Lan-Juan; Cao, Bin; Wang, Chen

2017-07-01

The effect of corticosteroids on influenza A(H1N1)pdm09 viral pneumonia patients remains controversial, and the impact of dosage has never been studied. Using data of hospitalized adolescent and adult patients with influenza A(H1N1)pdm09 viral pneumonia, prospectively collected from 407 hospitals in mainland China, the effects of low-to-moderate-dose (25-150 mg d -1 ) and high-dose (>150 mg d -1 ) corticosteroids on 30-day mortality, 60-day mortality, and nosocomial infection were assessed with multivariate Cox regression and propensity score-matched case-control analysis. In total, 2141 patients (median age: 34 years; morality rate: 15.9%) were included. Among them, 1160 (54.2%) had PaO 2 /FiO 2 <300 mm Hg on admission, and 1055 (49.3%) received corticosteroids therapy. Corticosteroids, without consideration of dose, did not influence either 30-day or 60-day mortality. Further analysis revealed that, as compared with the no-corticosteroid group, low-to-moderate-dose corticosteroids were related to reduced 30-day mortality (adjusted hazard ratio [aHR] 0.64 [95% CI 0.43-0.96, P=.033]). In the subgroup analysis among patients with PaO 2 /FiO 2 <300 mm Hg, low-to-moderate-dose corticosteroid treatment significantly reduced both 30-day mortality (aHR 0.49 [95% CI 0.32-0.77]) and 60-day mortality (aHR 0.51 [95% CI 0.33-0.78]), while high-dose corticosteroid therapy yielded no difference. For patients with PaO 2 /FiO 2 ≥300 mm Hg, corticosteroids (irrespective of dose) showed no benefit and even increased 60-day mortality (aHR 3.02 [95% CI 1.06-8.58]). Results were similar in the propensity model analysis. Low-to-moderate-dose corticosteroids might reduce mortality of influenza A(H1N1)pdm09 viral pneumonia patients with PaO 2 /FiO 2 <300 mm Hg. Mild patients with PaO 2 /FiO 2 ≥300 mm Hg could not benefit from corticosteroid therapy. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Clothing adjustments for concealed soft body armor during moderate physical exertion.

PubMed

Ryan, Greg A; Bishop, Stacy H; Herron, Robert L; Katica, Charles P; Elbon, Bre'anna L; Bosak, Andrew M; Bishop, Phillip

2015-01-01

Previous research has studied the impact of Level II concealed soft body armor (SBA) on the augmentation of heat storage in a hot environment simulating a typical summer day in the southeastern United States (wet bulb globe temperature [WBGT] = 30°C) and noted a significant difference between macro- and micro-WBGTs. The purpose of this study was to characterize the microclimate (micro-WBGT) under a concealed Level II SBA during 60 min of moderately intense work at two separate macro-WBGTs (26°C and 30°C), and to establish WBGT corrections to allow prediction of heat strain in an individual wearing a concealed Level II SBA. A single trial was performed with nine volunteers (27 ± 4 years) outfitted with a simulated standard law enforcement uniform and a traditional concealed Level II SBA, in a moderately warm environment (WBGT = 26°C). Each participant performed cycles of 12 min of walking (1.25 L · min(-1)) and 3 min of arm curls (14.3 kg, 0.6 L · min(-1)) with a 5 min rest after every other cycle, for a total of 60 minutes. This trial was compared to an identical previously completed 60-min work bout at 30°C. A two-way repeated measures ANOVA with Post hoc Bonferroni and paired samples t-test analysis was conducted. A greater difference between macro- micro-WBGTs existed at 26°C compared to the 30°C macro-WBGT. Under these conditions, a moderate work in Level II SBA requires a WBGT correction of 8.9°C and 6.2°C at macro-WBGTs of 26°C and 30°C, respectively. A modified simple linear regression prediction model was established for mean Micro-WBGT for each macro-WBGTs after the plateau point at the 30 min mark. The derivation regressions at 26°C (R(2) = 0.99), and 30°C (R(2) = 0.99) indicate that micro-WBGT could be predicted for each 15 minutes time at both macro-WBGTs tested for individuals doing moderate intensity (300 Kcals · hr(-1)) work wearing concealed Level II SBA.

[The role of parental support in the relationship between homophobic bullying, internalized homophobia and psychological distress among sexual-minority youths (SMY): a moderated mediation approach].

PubMed

Bergeron, Félix-Antoine; Blais, Martin; Hébert, Martine

Introduction Sexual-minority youths (SMY) report high rates of psychological distress such as depression, anxiety and suicidal ideation (Burton, Marshal, Chisolm, Sucato et Friedman, 2013; Williams & Chapman, 2011). Several studies confirm that the poor mental health outcomes are partly related to their high likelihood of experiencing homophobic victimization (Blais, Gervais, Boucher, Hébert & Lavoie, 2013; Taylor & Peter, 2011; Hughes, McCabe, Wilsnack, West & Boyd, 2010; Chamberland, Richard & Bernier, 2013). Whereas the development of a positive sexual minority identity is crucial for the mental health of SMY (Chamberland, Richard & Chevrier, 2011; Rosario, Schrimshaw & Hunter, 2011; Luhtanen, 2002), the victimization they experience put them at risk of internalizing societal homophobia and heterosexism (Meyer, 2003; Hatzenbuehler, 2009). It is important to identify variables that may influence the impact of distal and proximal factors that impact SMY's mental health.Objectives The objectives of this paper are 1) to document different forms of homophobic victimization experienced by SMY, according to gender and age, and 2) to test the potential moderating effect of parental support in the relationship between homophobic victimization, internalized homophobia and psychological distress.Method Data come from 228 SMY aged 14 to 22 years old recruited through online means as part of the Quebec Youth's Romantic Relationships Survey. The impact of homophobic victimization, parental support, and internalized homophobia on psychological distress is explored by a linear regression model including moderated mediation effects.Results Results show the relationship between homophobic victimization and psychological distress as well as indirect significant relationship through internalized homophobia. The moderated mediation analysis also confirms the moderating role of parental support in the relationship between homophobic victimization and psychological distress. Thus, at equal level of victimization, participants with low parental support experienced more psychological distress. However, parental support did not lessen the impact of victimization on internalized homophobia. The linear regression model explains 22.5% of the variance in psychological distress and 6.6% of the variance of internalized homophobia.Conclusion The results emphasize the importance of continuing efforts to prevent homophobic behaviors and attitudes among school staff, parents as well as employers and colleagues in the workplace. Given their key role, parents must also be educated and trained to support their gay, lesbian, bisexual or questioning children.

Development and evaluation of an electromagnetic hypersensitivity questionnaire for Japanese people

PubMed Central

Tokiya, Mikiko; Mizuki, Masami; Miyata, Mikio; Kanatani, Kumiko T.; Takagi, Airi; Tsurikisawa, Naomi; Kame, Setsuko; Katoh, Takahiko; Tsujiuchi, Takuya; Kumano, Hiroaki

2016-01-01

The purpose of the present study was to evaluate the validity and reliability of a Japanese version of an electromagnetic hypersensitivity (EHS) questionnaire, originally developed by Eltiti et al. in the United Kingdom. Using this Japanese EHS questionnaire, surveys were conducted on 1306 controls and 127 self‐selected EHS subjects in Japan. Principal component analysis of controls revealed eight principal symptom groups, namely, nervous, skin‐related, head‐related, auditory and vestibular, musculoskeletal, allergy‐related, sensory, and heart/chest‐related. The reliability of the Japanese EHS questionnaire was confirmed by high to moderate intraclass correlation coefficients in a test–retest analysis, and high Cronbach's α coefficients (0.853–0.953) from each subscale. A comparison of scores of each subscale between self‐selected EHS subjects and age‐ and sex‐matched controls using bivariate logistic regression analysis, Mann–Whitney U‐ and χ 2 tests, verified the validity of the questionnaire. This study demonstrated that the Japanese EHS questionnaire is reliable and valid, and can be used for surveillance of EHS individuals in Japan. Furthermore, based on multiple logistic regression and receiver operating characteristic analyses, we propose specific preliminary criteria for screening EHS individuals in Japan. Bioelectromagnetics. 37:353–372, 2016. © 2016 The Authors. Bioelectromagnetics Published by Wiley Periodicals, Inc. PMID:27324106

Computer-delivered interventions for reducing alcohol consumption: meta-analysis and meta-regression using behaviour change techniques and theory.

PubMed

Black, Nicola; Mullan, Barbara; Sharpe, Louise

2016-09-01

The current aim was to examine the effectiveness of behaviour change techniques (BCTs), theory and other characteristics in increasing the effectiveness of computer-delivered interventions (CDIs) to reduce alcohol consumption. Included were randomised studies with a primary aim of reducing alcohol consumption, which compared self-directed CDIs to assessment-only control groups. CDIs were coded for the use of 42 BCTs from an alcohol-specific taxonomy, the use of theory according to a theory coding scheme and general characteristics such as length of the CDI. Effectiveness of CDIs was assessed using random-effects meta-analysis and the association between the moderators and effect size was assessed using univariate and multivariate meta-regression. Ninety-three CDIs were included in at least one analysis and produced small, significant effects on five outcomes (d+ = 0.07-0.15). Larger effects occurred with some personal contact, provision of normative information or feedback on performance, prompting commitment or goal review, the social norms approach and in samples with more women. Smaller effects occurred when information on the consequences of alcohol consumption was provided. These findings can be used to inform both intervention- and theory-development. Intervention developers should focus on, including specific, effective techniques, rather than many techniques or more-elaborate approaches.

[Multivariate ordinal logistic regression analysis on the association between consumption of fried food and both esophageal cancer and precancerous lesions].

PubMed

Guo, L W; Liu, S Z; Zhang, M; Chen, Q; Zhang, S K; Sun, X B

2017-12-10

Objective: To investigate the effect of fried food intake on the pathogenesis of esophageal cancer and precancerous lesions. Methods: From 2005 to 2013, all the residents aged 40-69 years from 11 counties (cities) where cancer screening of upper gastrointestinal cancer had been conducted in rural areas of Henan province, were recruited as the subjects of study. Information on demography and lifestyle was collected. The residents under study were screened with iodine staining endoscopic examination and biopsy samples were diagnosed pathologically, under standardized criteria. Subjects with high risk were divided into the groups based on their different pathological degrees. Multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and esophageal cancer and precancerous lesions. Results: A total number of 8 792 cases with normal esophagus, 3 680 with mild hyperplasia, 972 with moderate hyperplasia, 413 with severe hyperplasia carcinoma in situ, and 336 cases of esophageal cancer were recruited. Results from multivariate logistic regression analysis showed that, when compared with those who did not eat fried food, the intake of fried food (<2 times/week: OR =1.60, 95% CI : 1.40-1.83; ≥2 times/week: OR =2.58, 95% CI : 1.98-3.37) appeared a risk factor for both esophageal cancer or precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index, smoking and alcohol intake. Conclusion: The intake of fried food appeared a risk factor for both esophageal cancer and precancerous lesions.

Automating annotation of information-giving for analysis of clinical conversation.

PubMed

Mayfield, Elijah; Laws, M Barton; Wilson, Ira B; Penstein Rosé, Carolyn

2014-02-01

Coding of clinical communication for fine-grained features such as speech acts has produced a substantial literature. However, annotation by humans is laborious and expensive, limiting application of these methods. We aimed to show that through machine learning, computers could code certain categories of speech acts with sufficient reliability to make useful distinctions among clinical encounters. The data were transcripts of 415 routine outpatient visits of HIV patients which had previously been coded for speech acts using the Generalized Medical Interaction Analysis System (GMIAS); 50 had also been coded for larger scale features using the Comprehensive Analysis of the Structure of Encounters System (CASES). We aggregated selected speech acts into information-giving and requesting, then trained the machine to automatically annotate using logistic regression classification. We evaluated reliability by per-speech act accuracy. We used multiple regression to predict patient reports of communication quality from post-visit surveys using the patient and provider information-giving to information-requesting ratio (briefly, information-giving ratio) and patient gender. Automated coding produces moderate reliability with human coding (accuracy 71.2%, κ=0.57), with high correlation between machine and human prediction of the information-giving ratio (r=0.96). The regression significantly predicted four of five patient-reported measures of communication quality (r=0.263-0.344). The information-giving ratio is a useful and intuitive measure for predicting patient perception of provider-patient communication quality. These predictions can be made with automated annotation, which is a practical option for studying large collections of clinical encounters with objectivity, consistency, and low cost, providing greater opportunity for training and reflection for care providers.

Small-Sample Adjustments for Tests of Moderators and Model Fit in Robust Variance Estimation in Meta-Regression

ERIC Educational Resources Information Center

Tipton, Elizabeth; Pustejovsky, James E.

2015-01-01

Randomized experiments are commonly used to evaluate the effectiveness of educational interventions. The goal of the present investigation is to develop small-sample corrections for multiple contrast hypothesis tests (i.e., F-tests) such as the omnibus test of meta-regression fit or a test for equality of three or more levels of a categorical…

The economic burden of depression in Switzerland.

PubMed

Tomonaga, Yuki; Haettenschwiler, Josef; Hatzinger, Martin; Holsboer-Trachsler, Edith; Rufer, Michael; Hepp, Urs; Szucs, Thomas D

2013-03-01

Despite the high prevalence of depression, information about the burden of this disease in Switzerland is scarce. A better knowledge of the costs of depression may provide important information for future national preventive programmes, optimizing cost-effective budgeting. The estimates of national costs may improve the public's awareness of depression and depression-related costs, breaking down the taboo of depression as an illness. The aims of this study were to analyse the annual cost for different levels of depression and to investigate the annual economic burden of depression in Switzerland. A retrospective, multicentre, non-interventional study in psychiatrist practices was carried out. Outpatients who had been diagnosed with depression in the last 3 years were included. Patient demographics and information on clinical characteristics and resource utilization in the first 12 months after diagnosis were collected. Costs analysis, subdivided into direct and indirect costs, was performed for three depression severity classes (mild, moderate and severe), according to the 17-item Hamilton Depression Rating Scale (HDRS-17). Costs were also extrapolated to a national level. Regression analysis was performed to control for factors that may have an impact on the cost of depression. A total of 556 patients were included. Hospitalization and hospitalization days were directly correlated with disease severity (p < 0.001). Medical resource utilization linked to depression and antidepressant treatments was also correlated to the disease status. Severely depressed patients reported a significantly higher number of workdays lost and were significantly more often on disability insurance. The mean total direct costs per person per year, mainly due to hospitalization costs, were 3,561 for mild, 9,744 for moderate and 16,240 for severe depression. The mean indirect costs per person per year, mainly due to workdays lost, were 8,730 for mild, 12,675 for moderate and 16,669 for severe depression (year 2007/2008 values). Regression analysis showed that hospitalization days, psychiatrist visits in hospital, disability insurance, workdays lost and the HDRS-17 score were significantly correlated to the total costs. Extrapolation at a national level resulted in a total burden of about 8.1-8.3 billion per year. The burden of depression in Switzerland was estimated to be about 8 billion per year. The costs of depression were directly related to disease severity. However, since many cases of depression remain unreported and since this analysis only included individuals between 18 and 65 years of age, it is reasonable to suppose that the total burden of depression may be even higher.

A Nasal Brush-based Classifier of Asthma Identified by Machine Learning Analysis of Nasal RNA Sequence Data.

PubMed

Pandey, Gaurav; Pandey, Om P; Rogers, Angela J; Ahsen, Mehmet E; Hoffman, Gabriel E; Raby, Benjamin A; Weiss, Scott T; Schadt, Eric E; Bunyavanich, Supinda

2018-06-11

Asthma is a common, under-diagnosed disease affecting all ages. We sought to identify a nasal brush-based classifier of mild/moderate asthma. 190 subjects with mild/moderate asthma and controls underwent nasal brushing and RNA sequencing of nasal samples. A machine learning-based pipeline identified an asthma classifier consisting of 90 genes interpreted via an L2-regularized logistic regression classification model. This classifier performed with strong predictive value and sensitivity across eight test sets, including (1) a test set of independent asthmatic and control subjects profiled by RNA sequencing (positive and negative predictive values of 1.00 and 0.96, respectively; AUC of 0.994), (2) two independent case-control cohorts of asthma profiled by microarray, and (3) five cohorts with other respiratory conditions (allergic rhinitis, upper respiratory infection, cystic fibrosis, smoking), where the classifier had a low to zero misclassification rate. Following validation in large, prospective cohorts, this classifier could be developed into a nasal biomarker of asthma.

Digital Games, Design, and Learning

PubMed Central

Clark, Douglas B.; Tanner-Smith, Emily E.; Killingsworth, Stephen S.

2016-01-01

In this meta-analysis, we systematically reviewed research on digital games and learning for K–16 students. We synthesized comparisons of game versus nongame conditions (i.e., media comparisons) and comparisons of augmented games versus standard game designs (i.e., value-added comparisons). We used random-effects meta-regression models with robust variance estimates to summarize overall effects and explore potential moderator effects. Results from media comparisons indicated that digital games significantly enhanced student learning relative to nongame conditions (g¯ = 0.33, 95% confidence interval [0.19, 0.48], k = 57, n = 209). Results from value-added comparisons indicated significant learning benefits associated with augmented game designs (g¯ = 0.34, 95% confidence interval [0.17, 0.51], k = 20, n = 40). Moderator analyses demonstrated that effects varied across various game mechanics characteristics, visual and narrative characteristics, and research quality characteristics. Taken together, the results highlight the affordances of games for learning as well as the key role of design beyond medium. PMID:26937054

Social representations of genetically modified foods and public willingness to consume such foods in Taiwan.

PubMed

Chen, Mei-Fang

2018-04-20

This study highlighted the relevance of how social representations of genetically modified (GM) foods influence the Taiwanese public's willingness to consume GM foods. Moderated regression analysis results revealed that the social representation dimensions of adherence to technology and food as a necessity positively influenced the public's willingness to consume GM foods; however, the dimension of resistance to and suspicion of novelties had a negative influence. Food technology neophobia played a role in predicting people's willingness to consume GM foods and exerted moderating effects to enhance the negative relationship between the respondents' resistance to and suspicion of novelties and their willingness to consume GM foods. This neophobia also changed the positive relationship between food as a necessity and willingness to consume GM foods into negative. One-way ANOVA results revealed that food technology neophobia influences the public's specific social representations of GM foods, personal domain-specific innovativeness, and willingness to consume GM foods. This article is protected by copyright. All rights reserved.

The Exchange Relationship between Work-Family Enrichment and Affective Commitment: the Moderating Role of Gender.

PubMed

Marques, António Manuel; Chambel, Maria José; Pinto, Inês

2015-06-03

Workers' perception that their job experience enriches their family life has been considered a mechanism that explains their positive attitudes toward the organization where they work. However, because women and men live their work and family differently, gender may condition this relationship between the work-family enrichment and workers' attitudes. With a sample of 1885 workers from one Portuguese bank, with 802 women, the current study investigated the relationship between work-family enrichment and organizational affective commitment as well as the role of sex as a moderator of this relationship. The hypotheses were tested by using regression analysis. The results indicated that the perception held by workers that their work enriches their family is positively correlated with their affective commitment toward the organization. Furthermore, the data revealed that this relationship is stronger for women than for men. Study results have implications for management, particularly for human resource management, enhancing their knowledge about the relationship of work-family enrichment and workers' affective commitment toward organization.

Examining spiritual support among African American and Caucasian Alzheimer's caregivers: A risk and resilience study.

PubMed

Wilks, Scott E; Spurlock, Wanda R; Brown, Sandra C; Teegen, Bettina C; Geiger, Jennifer R

2018-05-25

Research shows African Americans at greater risk of developing Alzheimer's disease (AD) compared to the Caucasian population, suggesting African American AD caregivers are rising in numbers at a greater rate than Caucasian counterparts. Over a decade ago, an article in Geriatric Nursing revealed spiritual well-being differences among these caregiver groups. The purpose of this study was a quasi-follow-up, utilizing a larger caregiver sample to test spiritual support as a moderator via a risk-and-resilience framework. Secondary data analysis from a sample of 691 AD caregivers examined data on demographics and standardized measures of spiritual support, caregiver burden, and psychological resilience. One-third of the sample reported as African American. Resilience negatively regressed, though not significantly, on caregiving burden among both groups. Spiritual support positively, significantly impacted resilience among both groups, slightly stronger among African Americans. Spiritual support did not significantly moderate risk with either group. Implications for professional healthcare practice are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Genetic and environmental influences on separation anxiety disorder symptoms and their moderation by age and sex.

PubMed

Feigon, S A; Waldman, I D; Levy, F; Hay, D A

2001-09-01

We estimated genetic and environmental influences on mother-rated DSM-III-R separation anxiety disorder (SAD) symptoms in 2043 3 to 18-year-old male and female twin pairs and their siblings (348 pairs) recruited from the Australian NH&MRC Twin Registry. Using DeFries and Fulker's (1985) multiple regression analysis, we found that genetic and shared environmental influences both contributed appreciably to variation in SAD symptoms (h2 = .47, SE = .07; c2 = .21, SE = .05) and were significantly moderated by both sex and age. Genetic influences were greater for girls than boys (h2 = .50 and .14, respectively), whereas shared environmental influences were greater for boys than girls (c2 = .51 and .21, respectively). Genetic influences increased with age. whereas shared environmental influences decreased with age. Shared environmental influences were greater in magnitude for twins than for nontwin siblings (c2 = .28 versus .13, respectively). Implications of these findings for theories of the cause of separation anxiety are discussed.

Can community consciousness be a bad thing? A moderated mediation analysis of heterosexism, mental health, and body appreciation in sexual minority men

PubMed Central

Simpson, Courtney C.; Sutter, Megan; Perrin, Paul B.

2016-01-01

This study examined the connections among heterosexism, mental health, body appreciation, and community consciousness in sexual minority men. Participants (N = 89) completed a national online survey. Simultaneous multiple regression found that heterosexism explained 9.4% of the variance in body appreciation and 25.8% of the variance in mental health; mental health accounted for 28.0% of the variance in body appreciation. Within these models, harassment/rejection heterosexism was a unique positive predictor of mental health and a unique negative predictor of body appreciation; depression was a unique negative predictor of body appreciation. A moderated mediational model found that depression mediated the relationship between harassment/rejection heterosexism and body appreciation, but only in men who endorsed high community consciousness. Intervention research might benefit from helping sexual minority men explore the ways in which body image is affected by heterosexism and mental health, as well as the ways that contemporary Western gay communities might contribute to these connections. PMID:27210047

Orphan Status, HIV Risk Behavior, and Mental Health Among Adolescents in Rural Kenya

PubMed Central

Drabkin, Anya S.; Stashko, Allison L.; Broverman, Sherryl A.; Ogwang-Odhiambo, Rose A.; Sikkema, Kathleen J.

2012-01-01

Objective To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya. Methods Randomly selected adolescents aged 10–18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver–child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk. Results Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver–youth communication were more strongly associated with lower sex-related self-efficacy for orphans. Conclusions Orphans are at higher risk for psychosocial problems. These problems may affect orphans’ self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans. PMID:22728899

Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya.

PubMed

Puffer, Eve S; Drabkin, Anya S; Stashko, Allison L; Broverman, Sherryl A; Ogwang-Odhiambo, Rose A; Sikkema, Kathleen J

2012-09-01

To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya. Randomly selected adolescents aged 10-18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver-child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk. Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver-youth communication were more strongly associated with lower sex-related self-efficacy for orphans. Orphans are at higher risk for psychosocial problems. These problems may affect orphans' self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans.

Length of Residence and Vehicle Ownership in Relation to Physical Activity Among U.S. Immigrants.

PubMed

Terasaki, Dale; Ornelas, India; Saelens, Brian

2017-04-01

Physical activity among U.S. immigrants over time is not well understood. Transportation may affect this trajectory. Using a survey of documented immigrants (N = 7240), we performed simple, then multivariable logistic regression to calculate ORs and 95 % CIs between length of residence (LOR) and both light-to-moderate (LPA) and vigorous (VPA) activity. We adjusted for demographic variables, then vehicle ownership to assess changes in ORs. Compared to new arrivals, all four LOR time-intervals were associated with lower odds of LPA and higher odds of VPA in simple analysis. All ORs for LPA remained significant after including demographics, but only one remained significant after adding vehicle ownership. Two ORs for VPA remained significant after including demographics and after adding vehicle ownership. Immigrants lower their light-to-moderate activity the longer they reside in the U.S., partly from substituting driving for walking. Efforts to maintain walking for transportation among immigrants are warranted.

The Association Between 25 Hydroxyvitamin D and Airway Obstruction in Asthma.

PubMed

Hutchinson, K; Kerley, C; Cormican, L; Rochev, Y; Faul, J

2016-03-10

Since Vitamin D has anti-inflammatory effects we wondered whether the association between low serum 25OHD and airway obstruction in moderate persistent asthma might be explained by inflammatory pathways that worsen asthma. All subjects examined were Irish Caucasians with moderate persistent asthma and none took systemic steroid therapy. In addition to computerized spirometry, we measured BMI, serum 25-hydroxyvitamin D (25OHD), total IgE, Eosinophil Cationic Protein (ECP), and high sensitive C- reactive protein (hs-CRP). One hundred (47 male) subjects completed the testing. Within single level of asthma severity, 25OHD levels were related to post-bronchodilator FEV1/FVC (r = 0.26, p< 0.01), but multiple linear regression analysis demonstrated that the association was not explained by obesity or inflammatory markers. We find a relationship exists between airway obstruction and 25OHD levels in asthmatic adults, and the effect is not explained by the presence of potential confounders such as obesity, allergy and systemic inflammation.

Divorce, approaches to learning, and children's academic achievement: a longitudinal analysis of mediated and moderated effects.

PubMed

Anthony, Christopher J; DiPerna, James Clyde; Amato, Paul R

2014-06-01

Data from the Early Childhood Longitudinal Study--Kindergarten Cohort (ECLS-K) were used to test the hypothesis that approaches to learning (ATL) mediates the link between parental divorce and academic achievement. Fixed effects regression was utilized to test for mediation, and subsequent moderation analyses examining gender and age at time of divorce also were conducted. Results indicated that divorce was associated with less growth in test scores and that ATL mediated 18% and 12% of this association in reading and mathematics respectively. Parental divorce also was associated with larger negative effects for children who experienced divorce at an older age as well as for girls' mathematics test scores. These findings contribute to the understanding of the impact of parental divorce on children's academic achievement and underscore the importance of focusing on the variability of child outcomes following parental divorce. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

An Accurate Mass Determination for Kepler-1655b, a Moderately Irradiated World with a Significant Volatile Envelope

NASA Astrophysics Data System (ADS)

Haywood, Raphaëlle D.; Vanderburg, Andrew; Mortier, Annelies; Giles, Helen A. C.; López-Morales, Mercedes; Lopez, Eric D.; Malavolta, Luca; Charbonneau, David; Collier Cameron, Andrew; Coughlin, Jeffrey L.; Dressing, Courtney D.; Nava, Chantanelle; Latham, David W.; Dumusque, Xavier; Lovis, Christophe; Molinari, Emilio; Pepe, Francesco; Sozzetti, Alessandro; Udry, Stéphane; Bouchy, François; Johnson, John A.; Mayor, Michel; Micela, Giusi; Phillips, David; Piotto, Giampaolo; Rice, Ken; Sasselov, Dimitar; Ségransan, Damien; Watson, Chris; Affer, Laura; Bonomo, Aldo S.; Buchhave, Lars A.; Ciardi, David R.; Fiorenzano, Aldo F.; Harutyunyan, Avet

2018-05-01

We present the confirmation of a small, moderately irradiated (F = 155 ± 7 F ⊕) Neptune with a substantial gas envelope in a P = 11.8728787 ± 0.0000085 day orbit about a quiet, Sun-like G0V star Kepler-1655. Based on our analysis of the Kepler light curve, we determined Kepler-1655b’s radius to be 2.213 ± 0.082 R ⊕. We acquired 95 high-resolution spectra with Telescopio Nazionale Galileo/HARPS-N, enabling us to characterize the host star and determine an accurate mass for Kepler-1655b of 5.0{+/- }2.83.1 {M}\\oplus via Gaussian-process regression. Our mass determination excludes an Earth-like composition with 98% confidence. Kepler-1655b falls on the upper edge of the evaporation valley, in the relatively sparsely occupied transition region between rocky and gas-rich planets. It is therefore part of a population of planets that we should actively seek to characterize further.

Impact of the Supervisor Feedback Environment on Creative Performance: A Moderated Mediation Model

PubMed Central

Zhang, Jian; Gong, Zhenxing; Zhang, Shuangyu; Zhao, Yujia

2017-01-01

Studies on the relationship between feedback and creative performance have only focused on the feedback-self and have underestimated the value of the feedback environment. Building on Self Determined Theory, the purpose of this article is to examine the relationship among feedback environment, creative personality, goal self-concordance and creative performance. Hierarchical regression analysis of a sample of 162 supervisor–employee dyads from nine industry firms. The results indicate that supervisor feedback environment is positively related to creative performance, the relationship between the supervisor feedback environment and creative performance is mediated by goal self-concordance perfectly and moderated by creative personality significantly. The mediation effort of goal self-concordance is significantly influenced by creative personality. The implication of improving employees’ creative performance is further discussed. The present study advances several perspectives of previous studies, echoes recent suggestions that organizations interested in stimulating employee creativity might profitably focus on developing work contexts that support it. PMID:28275362

Can community consciousness be a bad thing? A moderated mediation analysis of heterosexism, mental health and body appreciation in sexual minority men.

PubMed

Simpson, Courtney C; Sutter, Megan; Perrin, Paul B

2016-11-01

This study examined the connections between heterosexism, mental health, body appreciation and community consciousness in sexual minority men (SMM). Participants (n = 89) completed a national online survey. Simultaneous multiple regressions found that heterosexism explained 9.4% of the variance in body appreciation and 25.8% of the variance in mental health; mental health accounted for 28.0% of the variance in body appreciation. Within these models, harassment/rejection heterosexism was a unique positive predictor of mental health problems and a unique negative predictor of body appreciation; depression was a unique negative predictor of body appreciation. A moderated mediational model found that depression mediated the relationship between harassment/rejection heterosexism and body appreciation, but only in men who endorsed high community consciousness. Intervention research might benefit from helping SMM explore the ways in which body image is affected by heterosexism and mental health, as well as the ways that contemporary Western gay communities might contribute to these connections.

Expression of Glut-1 is a prognostic marker for oral squamous cell carcinoma patients.

PubMed

Eckert, A W; Lautner, M H W; Taubert, H; Schubert, J; Bilkenroth, U

2008-12-01

Oral squamous cell carcinoma (OSCC) is among the tenth most common human cancers worldwide with evidence of an increase in incidence rate and mortality. Despite advances in treatment modalities, the prognosis of this cancer is still very poor and has not changed over the past two decades. This study is based on samples collected from 42 patients with a primary OSCC. Immunohistochemical staining for Glut-1 was carried out and compared with the clinicopathological data. Thirty-two patients showed in their tumors a weak or undetectable Glut-1 expression, whereas in tumors of 10 patients a moderate to strong Glut-1 expression was detected. In multivariate Cox's regression hazard analysis, patients whose tumors had a moderate to strong Glut-1 expression possessed a 4.9-fold increased risk of tumor-related death compared to the other patients. Our results suggest that Glut-1 expression is an independent prognostic marker for routine assessment of OSCC.

The Impact of Additional Weekdays of Active Commuting to School on Children Achieving a Criterion of 300+ Minutes of Moderate-to-Vigorous Physical Activity

ERIC Educational Resources Information Center

Daly-Smith, Andy J. W.; McKenna, Jim; Radley, Duncan; Long, Jonathan

2011-01-01

Objective: To investigate the value of additional days of active commuting for meeting a criterion of 300+ minutes of moderate-to-vigorous physical activity (MVPA; 60+ mins/day x 5) during the school week. Methods: Based on seven-day diaries supported by teachers, binary logistic regression analyses were used to predict achievement of MVPA…

Searching for moderators and mediators of pharmacological treatment effects in children and adolescents with anxiety disorders.

PubMed

Walkup, John T; Labellarte, Michael J; Riddle, Mark A; Pine, Daniel; Greenhill, Laurence; Klein, Rachel; Davies, Mark; Sweeney, Michael; Fu, Caifeng; Abikoff, Howard; Hack, Sabine; Klee, Brain; McCracken, James; Bergman, Lindsey; Piacentini, John; March, John; Compton, Scott; Robinson, James; O'Hara, Thomas; Baker, Sheryl; Vitiello, Benedetto; Ritz, Louise; Roper, Margaret

2003-01-01

To examine whether age, gender, ethnicity, type of anxiety disorder, severity of illness, comorbidity, intellectual level, family income, or parental education may function as moderators and whether treatment adherence, medication dose, adverse events, or blinded rater's guess of treatment assignment may function as mediators of pharmacological treatment effect in children and adolescents with anxiety disorders. The database of a recently reported double-blind placebo-controlled trial of fluvoxamine in 128 youths was analyzed. With a mixed-model random-effects regression analysis of the Pediatric Anxiety Rating Scale total score, moderators and mediators were searched by testing for a three-way interaction (strata by treatment by time). A two-way interaction (strata by time) identified predictors of treatment outcome. No significant moderators of efficacy were identified, except for lower baseline depression scores, based on parent's (but not child's) report, being associated with greater improvement (p < .001). Patients with social phobia (p < .05) and greater severity of illness (p < .001) were less likely to improve, independently of treatment assignment. Blinded rater's guess of treatment assignment acted as a possible mediator (p < .001), but improvement was attributed to fluvoxamine, regardless of actual treatment assignment. Treatment adherence tended to be associated (p = .05) with improvement. In this exploratory study, patient demographics, illness characteristics, family income, and parental education did not function as moderators of treatment effect. Social phobia and severity of illness predicted less favorable outcome. Attribution analyses indicated that study blindness remained intact. The presence of concomitant depressive symptoms deserves attention in future treatment studies of anxious children.

Understanding Who Benefits from Parenting Interventions for Children's Conduct Problems: an Integrative Data Analysis.

PubMed

Leijten, Patty; Raaijmakers, Maartje; Wijngaards, Leoniek; Matthys, Walter; Menting, Ankie; Hemink-van Putten, Maud; Orobio de Castro, Bram

2018-05-01

Parenting interventions are an effective strategy to reduce children's conduct problems. For some families, that is, not all families benefit equally. Individual trials tend to be underpowered and often lack variability to differentiate between families how benefit less or more. Integrating individual family level data across trials, we aimed to provide more conclusive results about often presumed key family (parental education and ethnic background) and child characteristics (problem severity, ADHD symptoms and emotional problems) as putative moderators of parenting intervention effects. We included data from 786 families (452 intervention; 334 control) from all four trials on the Incredible Years parenting intervention in The Netherlands (three randomized; one matched control). Children ranged between 2 and 10 years (M = 5.79; SD = 1.66). Of the families, 31% had a lower educational level and 29% had an ethnic minority background. Using multilevel regression, we tested whether each of the putative moderators affected intervention effects. Incredible Years reduced children's conduct problems (d = - .34). There were no differential effects by families' educational or ethnic background, or by children's level of ADHD symptoms. Children with more severe conduct problems and those with more emotional problems benefited more. Post hoc sensitivity analyses showed that for the two trials with longer-term data, moderation effects disappeared at 4 or 12 months follow-up. Often assumed moderators have some, but limited abilities to explain who benefits from parenting interventions. This suggests the need for studying theoretically more precise moderators in prevention research, other than relatively static family characteristics alone.

Trait Mindfulness as a Limiting Factor for Residual Depressive Symptoms: An Explorative Study Using Quantile Regression

PubMed Central

Radford, Sholto; Eames, Catrin; Brennan, Kate; Lambert, Gwladys; Crane, Catherine; Williams, J. Mark G.; Duggan, Danielle S.; Barnhofer, Thorsten

2014-01-01

Mindfulness has been suggested to be an important protective factor for emotional health. However, this effect might vary with regard to context. This study applied a novel statistical approach, quantile regression, in order to investigate the relation between trait mindfulness and residual depressive symptoms in individuals with a history of recurrent depression, while taking into account symptom severity and number of episodes as contextual factors. Rather than fitting to a single indicator of central tendency, quantile regression allows exploration of relations across the entire range of the response variable. Analysis of self-report data from 274 participants with a history of three or more previous episodes of depression showed that relatively higher levels of mindfulness were associated with relatively lower levels of residual depressive symptoms. This relationship was most pronounced near the upper end of the response distribution and moderated by the number of previous episodes of depression at the higher quantiles. The findings suggest that with lower levels of mindfulness, residual symptoms are less constrained and more likely to be influenced by other factors. Further, the limiting effect of mindfulness on residual symptoms is most salient in those with higher numbers of episodes. PMID:24988072

The global prevalence and correlates of skin bleaching: a meta-analysis and meta-regression analysis.

PubMed

Sagoe, Dominic; Pallesen, Ståle; Dlova, Ncoza C; Lartey, Margaret; Ezzedine, Khaled; Dadzie, Ophelia

2018-06-11

To estimate and investigate the global lifetime prevalence and correlates of skin bleaching. A meta-analysis and meta-regression analysis was performed based on a systematic and comprehensive literature search conducted in Google Scholar, ISI Web of Science, ProQuest, PsycNET, PubMed, and other relevant websites and reference lists. A total of 68 studies (67,665 participants) providing original data on the lifetime prevalence of skin bleaching were included. Publication bias was corrected using the trim and fill procedure. The pooled (imputed) lifetime prevalence of skin bleaching was 27.7% (95% CI: 19.6-37.5, I 2  = 99.6, P < 0.01). The highest significant prevalences were associated with: males (28.0%), topical corticosteroid use (51.8%), Africa (27.1%), persons aged ≤30 years (55.9%), individuals with only primary school education (31.6%), urban or semiurban residents (74.9%), patients (21.3%), data from 2010-2017 (26.8%), dermatological evaluation and testing-based assessment (24.9%), random sampling methods (29.2%), and moderate quality studies (32.3%). The proportion of females in study samples was significantly related to skin bleaching prevalence. Despite some limitations, our results indicate that the practice of skin bleaching is a serious global public health issue that should be addressed through appropriate public health interventions. © 2018 The International Society of Dermatology.

Cross-cultural examination of the five-factor model of drinking motives in Spanish and Canadian undergraduates.

PubMed

Mezquita, Laura; Stewart, Sherry H; Kuntsche, Emmanuel; Grant, Valerie V

2016-06-14

This study aims to test the cross-cultural suitability of Modified Drinking Motives Questionnaire-Revised (M DMQ-R) (Grant, Stewart, O'Connor, Blackwell, & Conrod, 2007). The sample included 571 Spanish and 571 Canadian undergraduates between the ages of 18 and 22 (65.8% women). The confirmatory factor analysis demonstrated factorial invariance between samples. The regression analysis showed that social, enhancement and low conformity motives were related to drinking frequency and drinking quantity in the total sample. No moderation effect of country on predicting alcohol consumption was found. The results suggest that M DMQ-R is a suitable instrument for comparing drinking motives across Spanish and Canadian undergraduates, and that motives-focused prevention and treatment programmes developed in one country could be generalised to another.

Cortisol reactivity is positively related to executive function in preschool children attending head start.

PubMed

Blair, Clancy; Granger, Douglas; Peters Razza, Rachel

2005-01-01

This study examined relations among cortisol reactivity and measures of cognitive function and social behavior in 4- to 5-year-old children (N = 169) attending Head Start. Saliva samples for the assay of cortisol were collected at the beginning, middle, and end of an approximately 45-min testing session. Moderate increase in cortisol followed by down-regulation of this increase was positively associated with measures of executive function, self-regulation, and letter knowledge but not with measures of receptive vocabulary, emotion knowledge, or false belief understanding. Regression analysis indicates that executive function accounted for the association between cortisol reactivity and self-regulation and letter knowledge.

Authoritative school climate and high school dropout rates.

PubMed

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

2016-06-01

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

An integrated model of feedback-seeking behavior: disposition, context, and cognition.

PubMed

VandeWalle, D; Ganesan, S; Challagalla, G N; Brown, S P

2000-12-01

This study replicates, integrates, and extends prior research on the dispositional, contextual, and cognitive antecedents of feedback-seeking behavior. Regression analysis was used to analyze data collected from a sample of salespeople (N = 310) from 2 Fortune 500 companies. The study hypotheses were supported with the following results. First, the individual disposition of learning goal orientation and the contextual factors of leader consideration and leader initiation of structure influenced cognitions about the perceived cost and value of feedback seeking. Second, the strength of the relationship of learning goal orientation with the cost and value perceptions was moderated by the leadership style of the supervisor.

Barriers perceived by teachers at work, coping strategies, self-efficacy and burnout.

PubMed

Doménech Betoret, Fernando; Gómez Artiga, Amparo

2010-11-01

This study examines the relationships among stressors, coping strategies, self-efficacy and burnout in a sample of 724 Spanish primary and secondary teachers. We understood stressors as barriers perceived by teachers that interfere with their work meeting learning objectives and which cause them stress and burnout. An analysis of teacher responses using hierarchical regression revealed that pedagogical barriers had significant positive effects on the burnout dimensions. Furthermore, the results show not only the moderator role played by coping strategies in the pedagogical barriers-burnout dimensions relationship, but also the association between self-efficacy and the coping strategies used by teachers. Practical implications are discussed.

"The home infusion patient": patient profiles for the home infusion therapy market.

PubMed

Westbrook, K W; Powers, T

1999-01-01

The authors review the relevant literature regarding home health care patient profiles. An empirical analysis is provided from archival data for a home infusion company servicing patients in urban and rural areas. The results are provided as a 2 x 2 matrix for patients in urban and rural areas seeing either a specialist or primary care physicians. A series of moderated regressions indicate that type of treating physician, patient's gender, geographic residence and level of acuity are cogent in predicting the complexity of prescribed infusion therapies. Managerial implications are provided for the home care marketer in segmenting patient markets for infusion services.

Prevalence of preoperative anemia, abnormal mean corpuscular volume and red cell distribution width among surgical patients in Singapore, and their influence on one year mortality

PubMed Central

Wee, Hide Elfrida; Ang, Ai Leen; Ranjakunalan, Niresh; Ong, Biauw Chi; Abdullah, Hairil Rizal

2017-01-01

Introduction Preoperative anemia and high red cell distribution width (RDW) are associated with higher perioperative mortality. Conditions with high RDW levels can be categorized by mean corpuscular volume (MCV). The relationship between RDW, anemia and MCV may explain causality between high RDW levels and outcomes. We aim to establish the prevalence of preoperative anemia and distribution of RDW and MCV among pre-surgical patients in Singapore. In addition, we aim to investigate the association between preoperative anemia, RDW and MCV levels with one-year mortality after surgery. Methods Retrospective review of 97,443 patients aged > = 18 years who underwent cardiac and non-cardiac surgeries under anesthesia between January 2012 and October 2016. Patient demographics, comorbidities, priority of surgery, surgical risk classification, perioperative transfusion, preoperative hemoglobin, RDW, MCV were collected. WHO anemia classification was used. High RDW was defined as >15.7%. Multivariate regression analyses were done to identify independent risk factors for mild or moderate/severe anemia and high RDW (>15.7). Multivariate cox regression analysis was done to determine the effect of preoperative anemia, abnormal RDW and MCV values on 1-year mortality. Results Our cohort comprised of 94.7% non-cardiac and 5.3% cardiac surgeries. 88.7% of patients achieved 1 year follow-up. Anemia prevalence was 27.8%—mild anemia 15.3%, moderate anemia 12.0% and severe anemia 0.5%. One-year mortality was 3.5%. Anemia increased with age in males, while in females, anemia was more prevalent between 18–49 years and > = 70 years. Most anemics were normocytic. Normocytosis and macrocytosis increased with age, while microcytosis decreased with age. Older age, male gender, higher ASA-PS score, anemia (mild- aHR 1.98; moderate/severe aHR 2.86), macrocytosis (aHR 1.47), high RDW (aHR 2.34), moderate-high risk surgery and emergency surgery were associated with higher hazard ratios of one-year mortality. Discussion Preoperative anemia is common. Anemia, macrocytosis and high RDW increases one year mortality. PMID:28777814

Effects of enamel fluorosis and dental caries on quality of life.

PubMed

Onoriobe, U; Rozier, R G; Cantrell, J; King, R S

2014-10-01

The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health-related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students (n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ8-10 in grades 4-5; CPQ11-14 in grades 6-12). All students were examined for fluorosis (Dean's index) and caries experience (d2-3fs or D2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d2-3fs and D2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d2-3fs and D2-3MFS scores was positively associated with CPQ11-14 (B = 0.240, p < .001), ECOHIS (B = 0.252, p ≤ .001), and FIS (B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child's caries experience negatively affects OHRQoL, while fluorosis has little impact. © International & American Associations for Dental Research.

Leisure-time physical activity at moderate and high intensity is associated with parameters of body composition, muscle strength and sarcopenia in aged adults with obesity and metabolic syndrome from the PREDIMED-Plus study.

PubMed

Rosique-Esteban, Nuria; Babio, Nancy; Díaz-López, Andrés; Romaguera, Dora; Alfredo Martínez, J; Sanchez, Vicente Martin; Schröder, Helmut; Estruch, Ramón; Vidal, Josep; Buil-Cosiales, Pilar; Konieczna, Jadwiga; Abete, Itziar; Salas-Salvadó, Jordi

2018-06-06

We aimed to examine the associations of leisure-time physical activity (PA) and sedentary behavior (SB) with the prevalence of sarcopenia, body composition and muscle strength among older adults having overweight/obesity and metabolic syndrome, from the PREDIMED-Plus trial. Cross-sectional baseline analysis including 1539 men and women (65 ± 5 y). Sarcopenia was defined as low muscle mass (according to FNIH cut-offs) plus low muscle strength (lowest sex-specific tertile for 30-s chair-stand test). We applied multivariable-adjusted Cox regression with robust variance and constant time (given the cross-sectional design) for the associations of self-reported leisure-time PA and SB with sarcopenia; and multivariable-linear regression for the associations with dual-energy X-ray absorptiometry (DXA)-derived bone mass, fat mass, lean mass and lower-limb muscle strength. Inverse associations were observed between sarcopenia and each hourly increment in total [prevalence ratio 0.81 (95% confidence interval, 0.70, 0.93)], moderate [0.80 (0.66, 0.97)], vigorous [0.51 (0.32, 0.84)], and moderate-vigorous PA (MVPA) [0.74 (0.62, 0.89)]. Incrementing 1-h/day total-PA and MVPA was inversely associated with body-mass-index, waist circumference (WC), fat mass, and positively associated with bone mass and lower-limb muscle strength (all P <.05). One h/day increase in total SB, screen-based SB and TV-viewing was positively associated with body-mass-index, WC and fat mass. Light-PA was not significantly associated with any outcome. Total-PA and PA at moderate and high intensities may protect against the prevalence of sarcopenia, have a beneficial role on body composition and prevent loss of muscle strength. SB, particularly TV-viewing, may have detrimental effects on body composition in older adults at high cardiovascular risk. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Body mass index: accounting for full time sedentary occupation and 24-hr self-reported time use.

PubMed

Tudor-Locke, Catrine; Schuna, John M; Katzmarzyk, Peter T; Liu, Wei; Hamrick, Karen S; Johnson, William D

2014-01-01

We used linked existing data from the 2006-2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities? We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20-29, 30-39, 40-49, and 50-64 years. BMI groups were defined by 18.5-24.9, 25.0-27.4, 27.5-29.9, 30.0-34.9, and ≥35.0 kg/m2. Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income. The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20-64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income. We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships.

Body Mass Index: Accounting for Full Time Sedentary Occupation and 24-Hr Self-Reported Time Use

PubMed Central

Tudor-Locke, Catrine; Schuna, John M.; Katzmarzyk, Peter T.; Liu, Wei; Hamrick, Karen S.; Johnson, William D.

2014-01-01

Objectives We used linked existing data from the 2006–2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities? Methods We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20–29, 30–39, 40–49, and 50–64 years. BMI groups were defined by 18.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, and ≥35.0 kg/m2. Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income. Results The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20–64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income. Conclusions We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships. PMID:25295601

Impaired IQ and academic skills in adults who experienced moderate to severe infantile malnutrition: a 40-year study.

PubMed

Waber, Deborah P; Bryce, Cyralene P; Girard, Jonathan M; Zichlin, Miriam; Fitzmaurice, Garrett M; Galler, Janina R

2014-02-01

To evaluate IQ and academic skills in adults who experienced an episode of moderate-to-severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. IQ and academic skills were assessed in 77 previously malnourished adults (mean age = 38.4 years; 53% male) and 59 controls (mean age = 38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (P < 0.0001). IQ scores in the intellectual disability range (< 70) were nine times more prevalent in the previously malnourished group (odds ratio = 9.18; 95% confidence interval = 3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Moderate-to-severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity.

Physical activity and selected cardiovascular risk factors in middle-aged male personnel of self-defense forces.

PubMed

Sakuta, Hidenari; Suzuki, Takashi

2006-01-01

We cross-sectionally analyzed the association between duration of physical activity and the presence of selected cardiovascular risk factors in the middle-aged male personnel of the Self-Defense Forces who underwent retirement check-up (n = 974). In a univariate regression analysis, duration of high intensity physical activity but not that of moderate or low intensity physical activity inversely correlated with body mass index (BMI), triglyceride, fasting plasma glucose, white blood cell (WBC) count and systolic blood pressure. No intensity categories of physical activity correlated with total cholesterol. In a multivariate logistic regression analysis adjusted for lifestyle factors and the rank, the odds ratio per 1 h/wk increase in high intensity physical activity was .88 (95% confidence interval (CI) .80-.97; P=.007) for the presence of obesity (BMI 25.0 kg/m2), .88 (95% CI .81-.95; P = .002) for hypertrigly ceridemia, .87 (95% CI .76-.99; P=.034) for type 2 diabetes, and .90 (95% CI .82-.99; P=.037) for hypertension. Neither hypercholesterolemia nor high WBC count (> or = 6,900/microl) was associated with high intensity physical activity. High intensity physical activity inversely correlated with traditional cardiovascular risk factors in the middle-aged men.

Prediction of Return-to-original-work after an Industrial Accident Using Machine Learning and Comparison of Techniques

PubMed Central

2018-01-01

Background Many studies have tried to develop predictors for return-to-work (RTW). However, since complex factors have been demonstrated to predict RTW, it is difficult to use them practically. This study investigated whether factors used in previous studies could predict whether an individual had returned to his/her original work by four years after termination of the worker's recovery period. Methods An initial logistic regression analysis of 1,567 participants of the fourth Panel Study of Worker's Compensation Insurance yielded odds ratios. The participants were divided into two subsets, a training dataset and a test dataset. Using the training dataset, logistic regression, decision tree, random forest, and support vector machine models were established, and important variables of each model were identified. The predictive abilities of the different models were compared. Results The analysis showed that only earned income and company-related factors significantly affected return-to-original-work (RTOW). The random forest model showed the best accuracy among the tested machine learning models; however, the difference was not prominent. Conclusion It is possible to predict a worker's probability of RTOW using machine learning techniques with moderate accuracy. PMID:29736160

Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors.

PubMed

Rudaz, Myriam; Ledermann, Thomas; Grzywacz, Joseph G

2018-06-05

This study examined the moderating role of spiritual mindfulness on the association between spiritual coping and perceived growth in individuals with and without current treatment for cancer. Adults with a cancer history (N = 534) from the Midlife in the United States study completed a telephone interview and self-administered questionnaires. Moderated regression analyses, controlled for age and educational attainment, showed that mindfulness moderated the effect of spiritual coping on personal growth and on positive reinterpretation. High mindfulness amplified the effect of spiritual coping on both personal growth and positive reinterpretation. Further, this moderating effect was significantly different for adults with versus without current treatment for cancer for positive reinterpretation but not for personal growth. These findings highlight the potential amplifying effect of spiritual mindfulness on the effect of spiritual coping on perceived growth in cancer survivors.

How the study of online collaborative learning can guide teachers and predict students' performance in a medical course.

PubMed

Saqr, Mohammed; Fors, Uno; Tedre, Matti

2018-02-06

Collaborative learning facilitates reflection, diversifies understanding and stimulates skills of critical and higher-order thinking. Although the benefits of collaborative learning have long been recognized, it is still rarely studied by social network analysis (SNA) in medical education, and the relationship of parameters that can be obtained via SNA with students' performance remains largely unknown. The aim of this work was to assess the potential of SNA for studying online collaborative clinical case discussions in a medical course and to find out which activities correlate with better performance and help predict final grade or explain variance in performance. Interaction data were extracted from the learning management system (LMS) forum module of the Surgery course in Qassim University, College of Medicine. The data were analyzed using social network analysis. The analysis included visual as well as a statistical analysis. Correlation with students' performance was calculated, and automatic linear regression was used to predict students' performance. By using social network analysis, we were able to analyze a large number of interactions in online collaborative discussions and gain an overall insight of the course social structure, track the knowledge flow and the interaction patterns, as well as identify the active participants and the prominent discussion moderators. When augmented with calculated network parameters, SNA offered an accurate view of the course network, each user's position, and level of connectedness. Results from correlation coefficients, linear regression, and logistic regression indicated that a student's position and role in information relay in online case discussions, combined with the strength of that student's network (social capital), can be used as predictors of performance in relevant settings. By using social network analysis, researchers can analyze the social structure of an online course and reveal important information about students' and teachers' interactions that can be valuable in guiding teachers, improve students' engagement, and contribute to learning analytics insights.

The moderating role of safety-specific trust on the relation between safety-specific leadership and safety citizenship behaviors.

PubMed

Conchie, Stacey M; Donald, Ian J

2009-04-01

The authors examined whether safety-specific trust moderates or mediates the relationship between safety-specific transformational leadership and subordinates' safety citizenship behavior. Data from 139 subordinate-supervisor dyads were collected from the United Kingdom construction industry and analyzed using hierarchical regression models. Results showed that safety-specific trust moderated rather than mediated the effects of safety-specific transformational leaders on subordinates' behavior. Specifically, in conditions of high and moderate safety-specific trust, leaders had a significant effect on subordinates' safety citizenship behavior. However, in conditions of low safety-specific trust, leaders did not significantly influence subordinates' safety citizenship behavior. The implications of these findings for general safety theory and practice are discussed.

Land use patterns and SO2 and NO2 pollution in Ulaanbaatar, Mongolia.

PubMed

Huang, Yu-Kai; Luvsan, Munkh-Erdene; Gombojav, Enkhjargal; Ochir, Chimedsuren; Bulgan, Jargal; Chan, Chang-Chuan

2013-07-01

We proposed to study spatial distribution and source contribution of SO2 and NO2 pollution in Ulaanbaatar, Mongolia. We collected 2-week ambient SO2 and NO2 concentration samples at 38 sites, which were classified by major sources of air pollution such as ger areas and/or major roads, in three seasons as warm (September, 2011), cold (November-December, 2011), and moderate (March, 2012) in Ulaanbaatar. The SO2 and NO2 concentrations were collected by Ogawa ambient air passive samplers and analyzed by ion chromatography and spectrophotometry methods, respectively. Stepwise regression models were used to estimate the contribution of emission proxies, such as the distance to major roads, ger areas, power plants, and city center, to the ambient concentrations of SO2 and NO2. We found that the SO2 and NO2 concentrations were significantly higher in the cold season than in the warm and moderate seasons at all 38 ambient sampling sites. The SO2 concentrations in 20 ger sites (46.60 ppb in the cold season and 17.82 ppb in the moderate season) were significantly higher than in 18 non-ger sites (23.35 ppb in the cold season and 12.53 ppb in the moderate season). The NO2 concentrations at 19 traffic/road sites (12.85 ppb in the warm season and 20.48 ppb in the moderate season) were significantly higher than those at 19 urban sites (7.60 ppb and 14.39 ppb in the moderate season). Multiple regression models show that SO2 concentrations decreased by 23% in the cold and 17% in the moderate seasons at 0.70 km from the ger areas, an average of all sampling sites, and by 29% in the moderate season at 4.83 km from the city center, an average of all sampling sites. Multiple regression models show that the NO2 concentrations at 4.83 km from the city center decreased by 38% in the warm and 29% in the moderate seasons. Our models also report that NO2 concentrations at 0.16 km from the main roads decreased by 15% and 9% in the warm and the moderate seasons, respectively, and by 16% in the cold season decreased at the location 0.70 km from the ger area. The NO2 concentration at the location 4.83 km from the city center was decreased by 18% and at the location 4.79 km from the power plants by 21%. Our study concludes that SO2 and NO2 concentrations are very high in Ulaanbaatar, especially in the winter, and can be explained by several land use variables, including the distance to the ger areas, the city center, the main roads, and the power plants. Copyright © 2013 Elsevier Inc. All rights reserved.

Gluten-free is not enough--perception and suggestions of celiac consumers.

PubMed

do Nascimento, Amanda Bagolin; Fiates, Giovanna Medeiros Rataichesck; dos Anjos, Adilson; Teixeira, Evanilda

2014-06-01

The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ² tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.

Hierarchical Bayesian spatial models for predicting multiple forest variables using waveform LiDAR, hyperspectral imagery, and large inventory datasets

USGS Publications Warehouse

Finley, Andrew O.; Banerjee, Sudipto; Cook, Bruce D.; Bradford, John B.

2013-01-01

In this paper we detail a multivariate spatial regression model that couples LiDAR, hyperspectral and forest inventory data to predict forest outcome variables at a high spatial resolution. The proposed model is used to analyze forest inventory data collected on the US Forest Service Penobscot Experimental Forest (PEF), ME, USA. In addition to helping meet the regression model's assumptions, results from the PEF analysis suggest that the addition of multivariate spatial random effects improves model fit and predictive ability, compared with two commonly applied modeling approaches. This improvement results from explicitly modeling the covariation among forest outcome variables and spatial dependence among observations through the random effects. Direct application of such multivariate models to even moderately large datasets is often computationally infeasible because of cubic order matrix algorithms involved in estimation. We apply a spatial dimension reduction technique to help overcome this computational hurdle without sacrificing richness in modeling.

Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores.

PubMed

Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

2016-01-01

To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Data from 392 admitted students in the graduating classes of 2010-2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson's correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1.

Linking Anger Trait with Somatization in Low-Grade College Students: Moderating Roles of Family Cohesion and Adaptability.

PubMed

Liu, Liang; Liu, Cuilian; Zhao, Xudong

2017-02-25

Between 22% and 58% of patients in primary care settings complain of somatic symptoms. Previous research has found that somatization was associated with anger traits and family functions. However, studies that specifically assess the moderating effect of family function in how anger traits become somatic complaints are lacking. This study was designed to examine whether the variances in family cohesion and family adaptability moderated the strength of the relationship between anger traits and somatization. A cross-section design was conducted and 2008 college students were recruited from a comprehensive university in Shanghai. All participants finished questionnaires including Symptom Check List- 90 (SCL-90), State-Trait Anger Expression Inventory 2 (STAXI-2, Chinese version) and Family Adaptability and Cohesion Scale, second edition (FACES II, Chinese Version) to assess their degree of current somatization, anger trait and family function. Hierarchical linear regression analysis (Enter) was conducted respectively for men and women to examine the moderation effect of family cohesion and family adaptability in the association between anger and somatization. Somatic symptoms were significantly linked in the expected directions with depression and anger trait for both genders. Family cohesion and family adaptability were negatively associated with somatic symptoms. For female college students family cohesion was found to moderate the link between anger trait and somatization, but for male college students the moderation effect of family cohesion was marginally significant. The moderating role of family adaptability was significant for neither male nor female after current depressive symptoms were accounted for. Proneness to anger is an independent predictor of somatization. For women, a high level of family cohesion was a protective factor which could reduce the influence of anger trait on somatic symptoms. Without comorbidity of current depression, family adaptability to some degree exempted individuals with anger proneness from developing somatic complaints. Interventions that integrate family cohesion cultivation, family flexibility fostering and depression treatment might be more effective for somatic patients high in anger trait.

Profile of the elderly in physical therapy and its relation to functional disability.

PubMed

Rossi, Ana L S; Pereira, Vanessa S; Driusso, Patrícia; Rebelatto, José R; Ricci, Natalia A

2013-01-01

As the population ages, changes occur in the epidemiological profile towards the current predominance of chronic degenerative diseases which, when untreated, lead to loss of functional capacity and require long-term assistance. To describe the profile of the elderly attending the geriatric physical therapy service and to identify factors associated with functional disability. A cross-sectional descriptive analytical study was conducted. The medical records of elderly individuals were analyzed using the first physical therapy assessment, which included sociodemographic, clinical and mobility data. To determine the degree of disability (mild/moderate), the Brazilian Multidimensional Functional Assessment Questionnaire (BOMFAQ) was used. Descriptive analysis and univariate logistic regression were performed, followed by multivariate logistic regression. The sample comprised 130 elderly patients with a mean age of 73.3 [standar deviation (SD)=7.2] years-old, predominantly female (63.9%), sedentary (71.5%) and presenting three to four diseases (47.7%). The mean of activities with difficulty in the BOMFAQ was 6.7 (SD=4.8), 35 (26.9%) individuals presented mild disability and 95 (73.1%) moderate. The participant characteristic that presented a greatest risk of disability was self-reporting of poor health (OR=12.4). The factors identified, which together can determine functional decline, were sedentary lifestyle, presence of dizziness, polypharmacy and high pain intensity. Elderly individuals attended by the geriatric physical therapy service showed a profile associated with disability, characterized by potentially modifiable factors. This profile also reinforces the demand for long-term care for this population.

Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.

PubMed

Ehrlich, S F; Hedderson, M M; Brown, S D; Sternfeld, B; Chasan-Taber, L; Feng, J; Adams, J; Ching, J; Crites, Y; Quesenberry, C P; Ferrara, A

2017-10-01

To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical Activity Questionnaire assessing moderate and vigorous intensity sports and exercise in the past 3 months. Self-monitored capillary glucose values were obtained for the 6-week period following the questionnaire, with optimal glycaemic control defined≥80% values meeting the targets<5.3mmol/L for fasting and <7.8mmol/L 1-hour after meals. Logistic regression estimated the odds of achieving optimal control; linear regression estimated activity level-specific least square mean glucose, as well as between-level mean glucose differences. For volume of moderate intensity sports and exercise ([MET×hours]/week), the highest quartile, compared to the lowest, had significantly increased odds of optimal control (OR=1.82 [95% CI: 1.06-3.14] P=0.03). There were significant trends for decreasing mean 1-hour post breakfast, lunch and dinner glycaemia with increasing quartile of moderate activity (all P<0.05). Any participation in vigorous intensity sports and exercise was associated with decreased mean 1-hour post breakfast and lunch glycaemia (both P<0.05). No associations were observed for fasting. Higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control. Clinicians should be aware that unsupervised moderate intensity sports and exercise performed in mid-pregnancy aids in subsequent glycaemic control among women with GDM. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Trust, confidence, procedural fairness, outcome fairness, moral conviction, and the acceptance of GM field experiments.

PubMed

Siegrist, Michael; Connor, Melanie; Keller, Carmen

2012-08-01

In 2005, Swiss citizens endorsed a moratorium on gene technology, resulting in the prohibition of the commercial cultivation of genetically modified crops and the growth of genetically modified animals until 2013. However, scientific research was not affected by this moratorium, and in 2008, GMO field experiments were conducted that allowed us to examine the factors that influence their acceptance by the public. In this study, trust and confidence items were analyzed using principal component analysis. The analysis revealed the following three factors: "economy/health and environment" (value similarity based trust), "trust and honesty of industry and scientists" (value similarity based trust), and "competence" (confidence). The results of a regression analysis showed that all the three factors significantly influenced the acceptance of GM field experiments. Furthermore, risk communication scholars have suggested that fairness also plays an important role in the acceptance of environmental hazards. We, therefore, included measures for outcome fairness and procedural fairness in our model. However, the impact of fairness may be moderated by moral conviction. That is, fairness may be significant for people for whom GMO is not an important issue, but not for people for whom GMO is an important issue. The regression analysis showed that, in addition to the trust and confidence factors, moral conviction, outcome fairness, and procedural fairness were significant predictors. The results suggest that the influence of procedural fairness is even stronger for persons having high moral convictions compared with persons having low moral convictions. © 2012 Society for Risk Analysis.

Self-reported interoceptive deficits in eating disorders: A meta-analysis of studies using the eating disorder inventory.

PubMed

Jenkinson, Paul M; Taylor, Lauren; Laws, Keith R

2018-07-01

An impairment of the ability to sense the physiological condition of the body - interoception - has long been proposed as central to the onset and maintenance of eating disorders. More recent attention to this topic has generally indicated the presence of interoceptive deficits in individuals with an eating disorder diagnosis; however, possible links with specific diagnosis, BMI, age, illness duration, depression, and alexithymia remain unclear from individual studies. This meta-analysis aimed to provide a necessary quantitative overview of self-reported interoceptive deficits in eating disorder populations, and the relationship between these deficits and the previously mentioned factors. Using a random effects model, our meta-analysis assessed the magnitude of differences in interoceptive abilities as measured using the Eating Disorder Inventory in 41 samples comparing people with eating disorders (n = 4308) and healthy controls (n = 3459). Follow-up and moderator analysis was conducted, using group comparisons and meta-regressions. We report a large pooled effect size of 1.62 for eating disorders with some variation between diagnostic groups. Further moderator analysis showed that BMI, age and alexithymia were significant predictors of overall effect size. This meta-analysis is the first to confirm that large interoceptive deficits occur in a variety of eating disorders and crucially, in those who have recovered. These deficits may be useful in identifying and distinguishing eating disorders. Future research needs to consider both objective and subjective measures of interoception across different types of eating disorders and may fruitfully examine interoception as a possible endophenotype and target for treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

Cognitive-Affective Correlates of Suicide Ideation and Attempt: Mindfulness is Negatively Associated with Suicide Attempt History but Not State Suicidality.

PubMed

Chesin, Megan; Cascardi, Michele

2018-06-11

To test whether three cognitive-affective correlates, mindfulness, emotion reactivity, and depressive symptom severity, have different associations with current suicidal ideation (SI), a history of suicide attempt (SA) and SA+SI among emerging adults. To test whether impulsive-aggression (IA) moderates associations between cognitive-affective correlates of suicidal behavior and suicidality. Survey data on current SI, SA history, mindfulness, emotion reactivity, depressive symptom severity, and IA were collected from 780 emerging adults. Results from multinomial logistic regression analysis showed greater depressive symptom severity among emerging adults with current SI, regardless of SA history. Those with a history of SA reported greater depressive symptom severity and less mindfulness than controls. IA did not moderate relationships of SI and/or SA and mindfulness, emotion reactivity, or depressive symptom severity. Mindfulness is a marker of SA, and depressive symptom severity is associated with current SI and SA history in emerging adults. IA does not moderate these associations. To the extent that a history of SA is indicative of elevated trait-like suicide risk and SI indicates state suicidality, our findings suggest that mindfulness protects against longer-term vulnerability to SA while depressive symptom severity increases with increasing suicide state-trait risk.

Perceived organizational support-burnout-satisfaction relationship in workers with disabilities: The moderation of family support.

PubMed

Alcover, Carlos-María; Chambel, Maria José; Fernández, Juan José; Rodríguez, Fernando

2018-05-02

Our study tests the perceived organizational support-burnout-satisfaction relationship based on stressor-strain-outcome model of stress (Koeske & Koeske, ) and on the conservation of resources theory (Hobfoll, ) in workers with disabilities employed in ordinary or competitive jobs (open labor market), analyzing the relationship between perceived organizational support, family support, job satisfaction and burnout. We use a sample of 246 workers with physical, motor, sensory and psychological disabilities working in ordinary jobs. To test our proposed model we used a regression-based path analysis using PROCESS software, which is a computational tool for estimating and probing interactions and the conditional indirect effects of moderated mediation models. We find that the positive relationship between organizational support and job satisfaction was partially mediated by the levels of cynicism and the relationship between burnout and job satisfaction was moderated by family support. Employees with low support from family had identical job satisfaction with high burnout or low burnout, but employees with high support from family when they had high burnout had lower job satisfaction than when they had low burnout, indicating that the support outside work could have a negative effect in workers' life. Practical implications and future research are discussed and proposed. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Is outcome responsibility at work emotionally exhausting? Investigating employee proactivity as a moderator.

PubMed

Schmitt, Antje; Den Hartog, Deanne N; Belschak, Frank D

2015-10-01

This study investigates the relationship between outcome responsibility and employees' well-being in terms of emotional exhaustion. Outcome responsibility is a job demand implying that employees' decisions at work have high material and/or nonmaterial consequences. Previous research indicates that outcome responsibility can have both positive and negative effects on employee well-being. Based on the person-job fit approach we hypothesize that whether or not outcome responsibility is positively or negatively related to emotional exhaustion depends on whether employees' behavioral style fits with this job demand. We investigate the role of proactive behavior as a personal resource that fits with high responsibility. We test our hypothesis in a multisource study among 138 employee-colleague dyads. Results of hierarchical moderated regression analysis reveal that peer-rated proactive behavior moderates the relationship between outcome responsibility and emotional exhaustion, such that the relationship is negative for employees showing high and nonsignificant for employees showing low proactivity. This finding holds also when controlling for trait positive and negative affect. The current study contributes to previous research on job design, proactivity, and occupational well-being and offers practical implications in terms of selection and training of employees for jobs high in outcome responsibility. (c) 2015 APA, all rights reserved).

Outdoor activities and depressive symptoms in displaced older adults following natural disaster: community cohesion as mediator and moderator.

PubMed

Chao, Shiau-Fang

2016-09-01

This investigation examined whether community cohesion mediates or moderates the relationship between outdoor activities and depressive symptoms in older adults displaced by Typhoon Morakot in Taiwan. This cross-sectional study included 292 adults aged 65 years or older who were relocated to permanent houses after Typhoon Morakot damaged their homes on 8th August 2009. Multiple regression analysis was applied to test the role of community cohesion on the association between outdoor activities and depressive symptoms. The sample of displaced older adults displayed higher prevalence of depressive symptoms than the average for community dwelling older people in Taiwan. Community cohesion fully mediated the relationship between outdoor activities and depressive symptoms. Community cohesion also moderated the relationship between outdoor activities and depressive symptoms. Community cohesion occupies a key role on the link between outdoor activities and depressive symptoms. Participation in outdoor activities was associated positively with community cohesion, while high community cohesion was related negatively to depressive symptoms. Additionally, the benefit of outdoor activities to fewer depressive symptoms only manifested in older adults with high community cohesion. Programs and services should be designed to enhance community cohesion in order to maximize the benefit of outdoor activities to the mental health of displaced older adults after natural disasters.

The interactive effect of the MAOA-VNTR genotype and childhood abuse on aggressive behaviors in Chinese male adolescents.

PubMed

Zhang, Yun; Ming, Qingsen; Wang, Xiang; Yao, Shuqiao

2016-06-01

Gene-environment interactions that moderate aggressive behavior have been identified in association with the MAOA (monoamine oxidase A) gene. The present study examined the moderating effect of MAOA-VNTR (variable number of tandem repeats) on aggression behavior relating to child abuse among Chinese adolescents. A sample of 507 healthy Chinese male adolescents completed the Child Trauma Questionnaire-Short Form (CTQ-SF) and Youth Self-report of the Child Behavior Checklist. The participants' buccal cells were sampled and subjected to DNA analysis. The effects of childhood abuse (CTQ-SF scores), MAOA-VNTR [high-activity allele (H) versus low-activity allele (L)], and their interaction in aggressive behaviors were analyzed by linear regression. Child maltreatment was found to be a significant independent factor in the manifestation of aggressive behavior, whereas MAOA activity was not. There was a significant interaction between MAOA-VNTR and childhood maltreatment in the exhibition of aggressive behaviors. In the context of physical or emotional abuse, boys in the MAOA-L group showed a greater tendency toward aggression than those in the MAOA-H group. Aggressive behavior arising from childhood maltreatment is moderated by MAOA-VNTR, which may be differentially sensitive to the subtype of childhood maltreatment experienced, among Chinese adolescents.

Relationship between incivility experiences and nursing professional values among nursing students: Moderating effects of coping strategies.

PubMed

Kim, Ji-Soo

2018-06-01

During clinical practice, nursing students develop their professional role and internalize the values of the nursing profession. Unfortunately, it also often exposes them uncivil behaviors from nurses. To identify the relationship between incivility experiences and nursing professional values, and investigate the potential moderating effects of coping strategies in this relationship. This was a descriptive, cross-sectional study. Data were collected from 203 nursing students using questionnaires. The questionnaire comprised sections assessing participant characteristics, incivility experiences, coping strategies, and nursing professional values. Multiple regression analysis was used to identify the relationship between incivility experiences and nursing professional values, as well as the interaction effect of incivility experiences and coping strategies on nursing professional values. Incivility experiences were negatively related to nursing professional values. Furthermore, seeking support moderated the relationship between incivility experiences and nursing professional values. In other words, as incivility experiences increased, nursing students who used more seeking social support tended to have stronger nursing professional values than did those who used this coping strategy less. To improve the nursing professional values of nursing students, educators must inform nursing managers when nurses direct uncivil behaviors towards students. Educators should also listen to students' experiences, support them emotionally, and encourage students to engage in seeking social support. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pharmacokinetics of Diclofenac and Hydroxypropyl‐β‐Cyclodextrin (HPβCD) Following Administration of Injectable HPβCD‐Diclofenac in Subjects With Mild to Moderate Renal Insufficiency or Mild Hepatic Impairment

PubMed Central

Hamilton, Douglas A.; Ernst, Cynthia C.; Kramer, William G.; Madden, Donna; Lang, Eric; Liao, Edward; Lacouture, Peter G.; Ramaiya, Atulkumar

2017-01-01

Abstract Given their established analgesic properties, nonsteroidal anti‐inflammatory drugs (NSAIDs) represent an important postoperative pain management option. This study investigated: (1) the effects of mild or moderate renal insufficiency and mild hepatic impairment on the pharmacokinetics (PK) of diclofenac and hydroxypropyl‐β‐cyclodextrin (HPβCD) following administration of the injectable NSAID HPβCD‐diclofenac; and (2) the PK of HPβCD following administration of HPβCD‐diclofenac and intravenous itraconazole formulated with HPβCD in healthy adults. Diclofenac clearance (CL) and volume of distribution (Vz) tended to increase with decreasing renal function (moderate insufficiency versus mild insufficiency or healthy controls). Regression analysis demonstrated a significant relationship between Vz (but not CL or elimination half‐life, t½) and renal function. HPβCD CL was significantly decreased in subjects with renal insufficiency, with a corresponding increase in t½. There were no significant differences in diclofenac or HPβCD PK in subjects with mild hepatic impairment versus healthy subjects. Exposure to HPβCD in healthy subjects following HPβCD‐diclofenac administration was ∼12% of that with intravenous itraconazole, after adjusting for dosing schedule and predicted accumulation (<5% without adjustment). With respect to PK properties, these results suggest that HPβCD‐diclofenac might be administered to patients with mild or moderate renal insufficiency or mild hepatic impairment without dose adjustment (NCT00805090). PMID:29197175

Relationship between diastolic ventricular dysfunction and subclinical sleep-disordered breathing in atrial fibrillation ablation candidates.

PubMed

Kaitani, Kazuaki; Kondo, Hirokazu; Hanazawa, Koji; Onishi, Naoaki; Hayama, Yukiko; Tsujimura, Akira; Kuroda, Maiko; Nishimura, Shunsuke; Yoshikawa, Yusuke; Takahashi, Yusuke; Amano, Masashi; Imamura, Sari; Tamaki, Yodo; Enomoto, Soichiro; Miyake, Makoto; Tamura, Toshihiro; Motooka, Makoto; Izumi, Chisato; Nakagawa, Yoshihisa

2016-07-01

Sleep-disordered breathing (SDB) is recognized as a primary factor or mediator of atrial fibrillation (AF). We hypothesized that the severity of SDB among AF ablation candidates would be associated with left ventricular diastolic dysfunction (LVDD) even for subclinical SDB. A total of 246 patients hospitalized for initial pulmonary vein isolation (PVI) were analyzed. Known SDB cases were excluded. We measured the oxygen desaturation index (ODI) by pulse oximetry overnight as an indicator of SDB, and classified SDB severity by 3 % ODI as normal (ODI < 5 events/h), mild (ODI ≤ 5 to <15 events/h), or moderate-to-severe (ODI ≥15 events/h). The LVDD was assessed by echocardiography using combined categories with tissue Doppler imaging and left atrial (LA) volume measurement. Among the participants, 42 patients (17.1 %) had LVDD. The prevalence of LVDD increased with the SDB severity from 8.6 % (normal) to 12.7 % (mild) to 40.0 % (moderate-to-severe SDB) (p < 0.0001). In the multivariate logistic regression analysis, the odds ratio of having LVDD in the moderate-to-severe SDB group (ODI ≥ 15) vs. normal group (ODI < 5) was 5.96 (95 % CI, 2.10-19.00, P = 0.006). The presence of moderate-to-severe SDB in AF ablation candidates adversely affected LV diastolic function even during a subclinical state of SDB.

Race and Ethnicity, Religion Involvement, Church-based Social Support and Subjective Health in United States: A Case of Moderated Mediation.

PubMed

Assari, Shervin

2013-02-01

To test if social support and ethnicity mediate/moderate the association between religion involvement and subjective health in the United States. This is a secondary analysis of National Survey of American Life, 2003. Hierarchical regression was fit to a national household probability sample of adult African Americans (n = 3570), Caribbean Blacks (n = 1621), and Whites (n = 891). Frequency of church attendance, positive/negative church-based social support, ethnicity, and subjective health (overall life satisfaction and self-rated mental health) were considered as predictor, mediator, moderator and outcome, respectively. Frequency of church attendance had a significant and positive association with mental health and life satisfaction among all ethnic groups. Frequency of church attendance was also correlated with positive and negative social support among all ethnic groups. Church-based social support fully mediated the association between frequency of church attendance and overall life satisfaction among African Americans but not among Caribbean Blacks, or Whites. Church-based social support, however, partially mediated the association between frequency of church attendance and overall mental health among African Americans but not among Caribbean Blacks or Whites. Ethnicity shapes how church-based social support mediates the association between religious involvement and subjective health. Our results showed a moderating mediation effect of ethnicity and social support on the religious involvement-subjective health linkage, in a way that it is only among African Americans that social support is a pathway for the beneficial health effect of religious involvement.

Resource Loss Moderates the Association Between Child Abuse and Current PTSD Symptoms Among Women in Primary-Care Settings.

PubMed

Costa, Eleonora C V; Guimarães, Sara; Ferreira, Domingos; Pereira, M Graça

2016-09-01

This study examined if abuse during childhood, rape in adulthood, and loss of resources predict a woman's probability of reporting symptoms of posttraumatic stress disorder (PTSD), and whether resource loss moderates the association between reporting childhood abuse and PTSD symptoms. The sample included 767 women and was collected in publicly funded primary-care settings. Women who reported having been abused during childhood also reported more resource loss, more acute PTSD symptoms, and having suffered more adult rape than those who reported no childhood abuse. Hierarchical logistic regression yielded a two-variable additive model in which child abuse and adult rape predict the probability of reporting or not any PTSD symptoms, explaining 59.7% of the variance. Women abused as children were 1 to 2 times more likely to report PTSD symptoms, with sexual abuse during childhood contributing most strongly to this result. Similarly, women reporting adult rape were almost twice as likely to report symptoms of PTSD as those not reporting it. Resource loss was unexpectedly not among the predictors but a moderation analysis showed that such loss moderated the association between child abuse and current PTSD symptoms, with resource loss increasing the number and severity of PTSD symptoms in women who also reported childhood abuse. The findings highlight the importance of early assessment and intervention in providing mental health care to abused, neglected, and impoverished women to help them prevent and reverse resource loss and revictimization.

Risk perception and intention to quit among a tri-ethnic sample of nondaily, light daily, and moderate/heavy daily smokers.

PubMed

Savoy, Elaine; Reitzel, Lorraine R; Scheuermann, Taneisha S; Agarwal, Mohit; Mathur, Charu; Choi, Won S; Ahluwalia, Jasjit S

2014-10-01

Although the relationship between risk perceptions and quit intentions has been established, few studies explore the potential impact of smoking level on these associations, and none have done so among diversely-aged samples of multiple ethnicities. Participants, ranging in age from 25 to 81, were 1133 nondaily smokers (smoked ≥1 cigarette on 4 to 24days in the past 30days), 556 light daily smokers (≤10 cigarettes per day), and 585 moderate to heavy daily smokers (>10 cigarettes per day). Each smoking level comprised approximately equal numbers of African Americans, Latinos, and Whites. A logistic regression analysis, adjusted for sociodemographics, self-rated health, time to the first cigarette of the day and smoking level, was used to examine the association between risk perception (perceived risk of acquiring lung cancer, lung disease, and heart disease) and intention to quit (≤6months versus >6months/never). A second adjusted model tested moderation by smoking level with an interaction term. Greater risk perception was associated with a higher odds of planning to quit within 6months (AOR=1.34, CI.95=1.24, 1.45). Smoking level did not moderate this association (p=.85). Results suggest that educating all smokers, irrespective of their smoking level, about increased risk of developing smoking-related diseases might be a helpful strategy to enhance their intention to make a smoking quit attempt. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reallocating sedentary time to moderate-to-vigorous physical activity but not to light-intensity physical activity is effective to reduce adiposity among youths: a systematic review and meta-analysis.

PubMed

García-Hermoso, A; Saavedra, J M; Ramírez-Vélez, R; Ekelund, U; Del Pozo-Cruz, B

2017-09-01

The aim of the study was to summarize the evidence of the effects of reallocating time spent in sedentary behaviours in different activity intensities on youth's adiposity. Five databases were searched. Studies that reported the effects of replacing sedentary behaviour with light-intensity physical activity (LIPA) and/or moderate-to-vigorous physical activity (MVPA) on at least one adiposity parameter. The estimated regression coefficients (β) and 95% CIs were combined and meta-analysed. Data from 7,351 youths and five studies were analysed. Pooled analysis from cross-sectional studies shows that replacing sedentary time with LIPA showed no significant associations with any adiposity-related outcomes. Replacing sedentary time with MVPA was statistically associated with total body fat percentage (β = -2.512; p = 0.003), but not with body mass index or waist circumference. In subgroup analysis, the greatest magnitude of association was observed from studies where 60 min of sedentary behaviour was reallocated to 60 min of MVPA (β = -4.535; p < 0.001). Our results highlight the importance of promoting MVPA, which may improve body composition phenotypes in young people. This information can be used to develop more effective lifestyle interventions. © 2017 World Obesity Federation.

An improved portmanteau test for autocorrelated errors in interrupted time-series regression models.

PubMed

Huitema, Bradley E; McKean, Joseph W

2007-08-01

A new portmanteau test for autocorrelation among the errors of interrupted time-series regression models is proposed. Simulation results demonstrate that the inferential properties of the proposed Q(H-M) test statistic are considerably more satisfactory than those of the well known Ljung-Box test and moderately better than those of the Box-Pierce test. These conclusions generally hold for a wide variety of autoregressive (AR), moving averages (MA), and ARMA error processes that are associated with time-series regression models of the form described in Huitema and McKean (2000a, 2000b).

Organizational culture, intersectoral collaboration and mental health care.

PubMed

Mitchell, Penelope Fay; Pattison, Philippa Eleanor

2012-01-01

This study aims to investigate whether and how organizational culture moderates the influence of other organizational capacities on the uptake of new mental health care roles by non-medical primary health and social care services. Using a cross-sectional survey design, data were collected in 2004 from providers in 41 services in Victoria, Australia, recruited using purposeful sampling. Respondents within each service worked as a group to complete a structured interview that collected quantitative and qualitative data simultaneously. Five domains of organizational capacity were analyzed: leadership, moral support and participation; organizational culture; shared concepts, policies, processes and structures; access to resource support; and social model of health. A principal components analysis explored the structure of data about roles and capacities, and multiple regression analysis examined relationships between them. The unit of analysis was the service (n = 41). Organizational culture was directly associated with involvement in two types of mental health care roles and moderated the influence of factors in the inter-organizational environment on role involvement. Congruence between the values embodied in organizational culture, communicated in messages from the environment, and underlying particular mental health care activities may play a critical role in shaping the emergence of intersectoral working and the uptake of new roles. This study is the first to demonstrate the importance of organizational culture to intersectoral collaboration in health care, and one of very few to examine organizational culture as a predictor of performance, compared with other organizational-level factors, in a multivariate analysis. Theory is developed to explain the findings.

Does equity sensitivity moderate the relationship between effort-reward imbalance and burnout.

PubMed

Oren, Lior; Littman-Ovadia, Hadassah

2013-01-01

The model of effort-reward imbalance (ERI) received considerable research attention in the job stress literature. However, very scarce research investigated individual differences as moderators between ERI and stress. The present study is aimed at examining the combined effects of ERI, overcommitment (OVC), and the interaction between ERI and overcommitment on burnout (i.e., emotional exhaustion, cynicism, and inefficacy) and the moderating role of equity sensitivity. A questionnaire measuring ERI, burnout, and equity sensitivity was administered to 159 employees. Regression analyses were conducted to test the proposed relations and moderating hypotheses. ERI was negatively related to inefficacy and overcommitment was positively related to emotional exhaustion and cynicism. In addition, equity sensitivity was found to moderate the effect of overcommitment on emotional exhaustion and inefficacy. The findings emphasize the detrimental effect overcommitment may have on employee's mental health and suggest that the ERI model components may be closely related to perceptions of organizational justice.

Physical activity, sedentary behavior, and vitamin D metabolites.

PubMed

Hibler, Elizabeth A; Sardo Molmenti, Christine L; Dai, Qi; Kohler, Lindsay N; Warren Anderson, Shaneda; Jurutka, Peter W; Jacobs, Elizabeth T

2016-02-01

Physical activity is associated with circulating 25-hydroxyvitamin D (25(OH)D). However, the influence of activity and/or sedentary behavior on the biologically active, seco-steroid hormone 1α,25-dihydroxyvitamin D (1,25(OH)2D) is unknown. We conducted a cross-sectional analysis among ursodeoxycholic acid (UDCA) randomized trial participants (n=876) to evaluate associations between physical activity, sedentary behavior, and circulating vitamin D metabolite concentrations. Continuous vitamin D metabolite measurements and clinical thresholds were evaluated using multiple linear and logistic regression models, mutually adjusted for either 1,25(OH)2D or 25(OH)D and additional confounding factors. A statistically significant linear association between 1,25(OH)2D and moderate-vigorous physical activity per week was strongest among women (β (95% CI): 3.10 (1.51-6.35)) versus men (β (95% CI): 1.35 (0.79-2.29)) in the highest tertile of activity compared to the lowest (p-interaction=0.003). Furthermore, 25(OH)D was 1.54ng/ml (95% CI 1.09-1.98) higher per hour increase in moderate-vigorous activity (p=0.001) and odds of sufficient 25(OH)D status was higher among physically active participants (p=0.001). Sedentary behavior was not significantly associated with either metabolite in linear regression models, nor was a statistically significant interaction by sex identified. The current study identified novel associations between physical activity and serum 1,25(OH)2D levels, adjusted for 25(OH)D concentrations. These results identify the biologically active form of vitamin D as a potential physiologic mechanism related to observed population-level associations between moderate-vigorous physical activity with bone health and chronic disease risk. However, future longitudinal studies are needed to further evaluate the role of physical activity and vitamin D metabolites in chronic disease prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

Increased tea consumption is associated with decreased arterial stiffness in a Chinese population.

PubMed

Li, Chung-Hao; Yang, Yi-Ching; Wu, Jin-Shang; Huang, Ying-Hsiang; Lee, Chih-Ting; Lu, Feng-Hwa; Chang, Chih-Jen

2014-01-01

Tea has attracted considerable attention for its potential cardioprotective effects. The primary chemical components of tea are thought to have a beneficial effect by reducing arterial stiffness. The objective of this study was to assess the association between tea consumption and brachial-ankle pulse wave velocity (baPWV) in a relatively healthy Chinese population. We enrolled 3,135 apparently healthy subjects from October 2006 to August 2009. Subjects taking medication for diabetes, hypertension, or hyperlipidemia, or with a history of cardiovascular disease, were excluded from the study. The subjects were categorized into three groups according to their tea-drinking habits: (1) none to low (n = 1615), defined as non-habitual tea drinkers, or drinking for <1 year, or drinking ≤150 mL per day for ≥1 year ; (2) moderate tea consumption, defined as drinking for ≥1 year and consumption between 151 and 450 mL per day; and (3) heavy tea consumption, defined as a drinking for ≥1 year and consumption >450 mL per day. Multiple logistic regression was used to determine whether different levels of consumption were independently associated with the highest quartile of baPWV values, defined as ≥1428.5 cm/s. Of the 3,135 subjects, 48.5% had drunk >150 mL of tea per day for at least 1 year. In multivariate regression analysis with adjustment for co-variables, including, age, sex, current smoking, alcohol use, habitual exercise, total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio >5, obesity, newly diagnosed hypertension and diabetes, subjects with high tea consumption had a decreased risk of highest quartile of baPWV by 22% (odds ratio = 0.78, 95% confidence interval = 0.62-0.98, p = 0.032), while subjects with moderate tea consumption did not (p = 0.742), as compared subjects with none to low tea consumption. High, but not moderate, habitual tea consumption may decrease arterial stiffness.

Increased Tea Consumption Is Associated with Decreased Arterial Stiffness in a Chinese Population

PubMed Central

Li, Chung-Hao; Yang, Yi-Ching; Huang, Ying-Hsiang; Lee, Chih-Ting; Lu, Feng-Hwa

2014-01-01

Background Tea has attracted considerable attention for its potential cardioprotective effects. The primary chemical components of tea are thought to have a beneficial effect by reducing arterial stiffness. The objective of this study was to assess the association between tea consumption and brachial–ankle pulse wave velocity (baPWV) in a relatively healthy Chinese population. Methods We enrolled 3,135 apparently healthy subjects from October 2006 to August 2009. Subjects taking medication for diabetes, hypertension, or hyperlipidemia, or with a history of cardiovascular disease, were excluded from the study. The subjects were categorized into three groups according to their tea-drinking habits: (1) none to low (n = 1615), defined as non-habitual tea drinkers, or drinking for <1 year, or drinking ≤150 mL per day for ≥1 year ; (2) moderate tea consumption, defined as drinking for ≥1 year and consumption between 151 and 450 mL per day; and (3) heavy tea consumption, defined as a drinking for ≥1 year and consumption >450 mL per day. Multiple logistic regression was used to determine whether different levels of consumption were independently associated with the highest quartile of baPWV values, defined as ≥1428.5 cm/s. Results Of the 3,135 subjects, 48.5% had drunk >150 mL of tea per day for at least 1 year. In multivariate regression analysis with adjustment for co-variables, including, age, sex, current smoking, alcohol use, habitual exercise, total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio >5, obesity, newly diagnosed hypertension and diabetes, subjects with high tea consumption had a decreased risk of highest quartile of baPWV by 22% (odds ratio = 0.78, 95% confidence interval = 0.62–0.98, p = 0.032), while subjects with moderate tea consumption did not (p = 0.742), as compared subjects with none to low tea consumption. Conclusions High, but not moderate, habitual tea consumption may decrease arterial stiffness. PMID:24465848

The Association between Nocturnal Cardiac Arrhythmias and Sleep-Disordered Breathing: The DREAM Study.

PubMed

Selim, Bernardo J; Koo, Brian B; Qin, Li; Jeon, Sangchoon; Won, Christine; Redeker, Nancy S; Lampert, Rachel J; Concato, John P; Bravata, Dawn M; Ferguson, Jared; Strohl, Kingman; Bennett, Adam; Zinchuk, Andrey; Yaggi, Henry K

2016-06-15

To determine whether sleep-disordered breathing (SDB) is associated with cardiac arrhythmia in a clinic-based population with multiple cardiovascular comorbidities and severe SDB. This was a cross-sectional analysis of 697 veterans who underwent polysomnography for suspected SDB. SDB was categorized according to the apnea-hypopnea index (AHI): none (AHI < 5), mild (5 ≥ AHI < 15), and moderate-severe (AHI ≥ 15). Nocturnal cardiac arrhythmias consisted of: (1) complex ventricular ectopy, (CVE: non-sustained ventricular tachycardia, bigeminy, trigeminy, or quadrigeminy), (2) combined supraventricular tachycardia, (CST: atrial fibrillation or supraventricular tachycardia), (3) intraventricular conduction delay (ICD), (4) tachyarrhythmias (ventricular and supraventricular), and (5) any cardiac arrhythmia. Unadjusted, adjusted logistic regression, and Cochran-Armitage testing examined the association between SDB and cardiac arrhythmias. Linear regression models explored the association between hypoxia, arousals, and cardiac arrhythmias. Compared to those without SDB, patients with moderate-severe SDB had almost three-fold unadjusted odds of any cardiac arrhythmia (2.94; CI 95%, 2.01-4.30; p < 0.0001), two-fold odds of tachyarrhythmias (2.16; CI 95%,1.47-3.18; p = 0.0011), two-fold odds of CVE (2.01; 1.36-2.96; p = 0.003), and two-fold odds of ICD (2.50; 1.58-3.95; p = 0.001). A linear trend was identified between SDB severity and all cardiac arrhythmia subtypes (p value linear trend < 0.0001). After adjusting for age, BMI, gender, and cardiovascular diseases, moderate-severe SDB patients had twice the odds of having nocturnal cardiac arrhythmias (2.24; 1.48-3.39; p = 0.004). Frequency of obstructive respiratory events and hypoxia were strong predictors of arrhythmia risk. SDB is independently associated with nocturnal cardiac arrhythmias. Increasing severity of SDB was associated with an increasing risk for any cardiac arrhythmia. © 2016 American Academy of Sleep Medicine.

Does Smoke from Biomass Fuel Contribute to Anemia in Pregnant Women in Nagpur, India? A Cross-Sectional Study

PubMed Central

Page, Charlotte M.; Patel, Archana; Hibberd, Patricia L.

2015-01-01

Background Anemia affects upwards of 50% of pregnant women in developing countries and is associated with adverse outcomes for mother and child. We hypothesized that exposure to smoke from biomass fuel – which is widely used for household energy needs in resource-limited settings – could exacerbate anemia in pregnancy, possibly as a result of systemic inflammation. Objective To evaluate whether exposure to smoke from biomass fuel (wood, straw, crop residues, or dung) as opposed to clean fuel (electricity, liquefied petroleum gas, natural gas, or biogas) is an independent risk factor for anemia in pregnancy, classified by severity. Methods A secondary analysis was performed using data collected from a rural pregnancy cohort (N = 12,782) in Nagpur, India in 2011-2013 as part of the NIH-funded Maternal and Newborn Health Registry Study. Multinomial logistic regression was used to estimate the effect of biomass fuel vs. clean fuel use on anemia in pregnancy, controlling for maternal age, body mass index, education level, exposure to household tobacco smoke, parity, trimester when hemoglobin was measured, and receipt of prenatal iron and folate supplements. Results The prevalence of any anemia (hemoglobin < 11 g/dl) was 93% in biomass fuel users and 88% in clean fuel users. Moderate-to-severe anemia (hemoglobin < 10 g/dl) occurred in 53% and 40% of the women, respectively. Multinomial logistic regression showed higher relative risks of mild anemia in pregnancy (hemoglobin 10-11 g/dl; RRR = 1.38, 95% CI = 1.19-1.61) and of moderate-to-severe anemia in pregnancy (RRR = 1.79, 95% CI = 1.53-2.09) in biomass fuel vs. clean fuel users, after adjusting for covariates. Conclusion In our study population, exposure to biomass smoke was associated with higher risks of mild and moderate-to-severe anemia in pregnancy, independent of covariates. Trial Registration ClinicalTrials.gov NCT 01073475 PMID:26024473

Obstetric complications and mild to moderate intellectual disability.

PubMed

Sussmann, Jessika E; McIntosh, Andrew M; Lawrie, Stephen M; Johnstone, Eve C

2009-03-01

Mild to moderate intellectual disability affects 2.5% of the general population and is associated with an increased risk of several psychiatric disorders. Most cases are of unknown aetiology although genetic factors have an important role. To investigate the role of obstetric and neonatal complications in the aetiology of mild to moderate intellectual disability. Obstetric and neonatal complications recorded at the time of pregnancy and delivery were compared between participants with mild to moderate intellectual disability, age-matched siblings and unrelated controls using logistic regression. Admission to a special care baby unit and not being breastfed on discharge were more common in people with mild to moderate intellectual disability. Not being breastfed on discharge was also more common in those with intellectual disability than unaffected siblings. Foetal distress was more common among controls than among those with mild to moderate intellectual disability. Admission to a special care baby unit and not being breastfed on discharge may be related to the aetiology of intellectual disability, although the direction of this association is unclear.

Self-concept clarity buffers the impact of societal threat to safety on right-wing authoritarianism.

PubMed

Russo, Silvia; Manzi, Claudia; Roccato, Michele

2017-01-01

Exposure to societal threat can elicit an increase in right-wing authoritarianism (RWA). In this study, using a quasi-experimental vignette design (Italian community sample, N = 86), we tested the moderating role of self-concept clarity (SCC). A moderated regression showed that manipulated societal threat to safety fostered RWA only among low SCC scorers. It is concluded that SCC is an important resource for individuals facing threat conditions.

Volunteering predicts happiness among older Māori and non-Māori in the New Zealand health, work, and retirement longitudinal study.

PubMed

Dulin, Patrick L; Gavala, Jhanitra; Stephens, Christine; Kostick, Marylynne; McDonald, Jennifer

2012-01-01

This study sought to understand the relationship between volunteer activity and happiness among a sample of older adult New Zealanders. It specifically sought to determine if ethnicity (Māori vs. non-Māori) and economic living standards (ELS) functioned as moderators of the relationship between volunteering and happiness. Data were garnered from the 2008 administration of the New Zealand Health, Work, and Retirement Longitudinal Study. Correlational and multiple regression procedures were employed to examine study hypotheses. Results from multiple regression analyses showed that the amount of volunteering per week was a unique predictor of the overall level of happiness. Moderation analyses indicated that ethnicity did not function as a moderator of the relationship between volunteering and happiness, but ELS did. Those with low ELS evidenced a stronger relationship between volunteering and happiness than those with high ELS. Results also indicated that Maori and those with low ELS volunteered more frequently than non-Māori and those with high ELS. This study provides evidence that volunteering is related to increased happiness, irrespective of ethnicity. It also provides further evidence that the relationship between volunteering and happiness is moderated by economic resources. Older individuals at the low end of the economic spectrum are likely to benefit more from volunteering than those at the high end.

Cardiac Computed Tomography versus Echocardiography in the Assessment of Stenotic Rheumatic Mitral Valve.

PubMed

Unal Aksu, Hale; Gorgulu, Sevket; Diker, Mustafa; Celik, Omer; Aksu, Huseyin; Ozturk, Derya; Kırıs, Adem; Kalkan, Ali Kemal; Erturk, Mehmet; Bakır, İhsan

2016-03-01

There are different clinical cardiac applications of dual source computed tomography (DSCT). Here, we aimed to compare the DSCT with the transthoracic echocardiography (TTE) for evaluating the Wilkins score and planimetric mitral valve area (MVA) of a rheumatic stenotic mitral valve. We prospectively evaluated mitral valvular structure and function in 31 patients with known mitral stenosis undergoing electrocardiogram-gated, second-generation DSCT, in our heart center for different indications. Mitral valve was evaluated using Wilkins score, and also, the planimetric MVA was assessed. We found a significant difference between MVAs determined by DSCT (average 1.42 ± 0.44 cm2) and MVAs determined by TTE (average 1.35 ± 0.43 cm2 ; difference 0.07 ± 0.16 cm2; P = 0.018). Linear regression analysis revealed a good correlation between the two techniques (r = 0.934; P < 0.0001). The limits of agreement for DSCT and TTE in the Bland-Altman analysis were ±0.31 cm2 . DSCT using TTE as the reference enabled good discrimination between mild and moderate-to-severe stenosis and had an area under the ROC curve of 0.967 (CI 0.912-1.023; P < 0.0001). Wilkins scores obtained by DSCT (7.51 ± 1.17, range 5-10) and TTE (8.16 ± 1.27, range 6-10) had a moderate correlation (r = 0.686; P < 0.0001). We found that planimetric MVA measurements assessed by DSCT were closely correlated with MVA calculations by TTE. The moderate correlation was observed for the Wilkins score. © 2015, Wiley Periodicals, Inc.

Depression and Alcohol Use in a National Sample of Hispanic Adolescents.

PubMed

Merianos, Ashley L; Swoboda, Christopher M; Oluwoye, Oladunni A; Gilreath, Tamika D; Unger, Jennifer B

2018-04-16

Underage alcohol use and depression remain public health concerns for Hispanic adolescents nationwide. The study purpose was to identify the profiles of depression among Hispanic adolescents who reported experiencing depressive symptoms in their lifetime and classify them into groups based on their symptoms. Based on classifications, we examined the relationship between past year alcohol use and severity of depressive symptoms while controlling for sex and age. A secondary analysis of the 2013 NSDUH was conducted among Hispanic adolescents from 12 to 17 years of age (n = 585) who reported experiencing depressive symptoms. Latent class analysis was used to identify latent classes of depressive symptoms among Hispanic adolescents. A zero-inflated negative-binomial regression model was used to examine the relationship between alcohol use and depressive symptoms. "High depressive" and "moderate depressive" classes were formed. The items that highly differentiated among the groups were felt worthless nearly every day, others noticed they were restless or lethargic, and had changes in appetite or weight. There was a significant difference (p = 0.03) between the classes based on alcohol use; those in the moderate depressive class were 1.71 times more likely to be identified as not reporting past alcohol use. Results indicated the high depressive class was estimated to have 1.62 more days of past year alcohol use than those in the moderate depressive class for adolescents who used alcohol (p < 0.001). Conclusions/Importance: Study findings can be used to address these significant public health issues impacting Hispanic adolescents. Recommendations are included.

Trust in the health care professional and health outcome: A meta-analysis.

PubMed

Birkhäuer, Johanna; Gaab, Jens; Kossowsky, Joe; Hasler, Sebastian; Krummenacher, Peter; Werner, Christoph; Gerger, Heike

2017-01-01

To examine whether patients' trust in the health care professional is associated with health outcomes. We searched 4 major electronic databases for studies that reported quantitative data on the association between trust in the health care professional and health outcome. We screened the full-texts of 400 publications and included 47 studies in our meta-analysis. We conducted random effects meta-analyses and meta-regressions and calculated correlation coefficients with corresponding 95% confidence intervals. Two interdependent researchers assessed the quality of the included studies using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Overall, we found a small to moderate correlation between trust and health outcomes (r = 0.24, 95% CI: 0.19-0.29). Subgroup analyses revealed a moderate correlation between trust and self-rated subjective health outcomes (r = 0.30, 0.24-0.35). Correlations between trust and objective (r = -0.02, -0.08-0.03) as well as observer-rated outcomes (r = 0.10, -0.16-0.36) were non-significant. Exploratory analyses showed a large correlation between trust and patient satisfaction and somewhat smaller correlations with health behaviours, quality of life and symptom severity. Heterogeneity was small to moderate across the analyses. From a clinical perspective, patients reported more beneficial health behaviours, less symptoms and higher quality of life and to be more satisfied with treatment when they had higher trust in their health care professional. There was evidence for upward bias in the summarized results. Prospective studies are required to deepen our understanding of the complex interplay between trust and health outcomes.

Service with a smile: do emotional intelligence, gender, and autonomy moderate the emotional labor process?

PubMed

Johnson, Hazel-Anne M; Spector, Paul E

2007-10-01

This survey study of 176 participants from eight customer service organizations investigated how individual factors moderate the impact of emotional labor strategies on employee well-being. Hierarchical regression analyses indicated that gender and autonomy were significant moderators of the relationships between emotional labor strategies and the personal outcomes of emotional exhaustion, affective well-being, and job satisfaction. Females were more likely to experience negative consequences when engaging in surface acting. Autonomy served to alleviate negative outcomes for individuals who used emotional labor strategies often. Contrary to our hypotheses, emotional intelligence did not moderate the relationship between the emotional labor strategies and personal outcomes. Results demonstrated how the emotional labor process can influence employee well-being. (c) 2007 APA, all rights reserved.

Do medical students like communication? Validation of the German CSAS (Communication Skills Attitude Scale).

PubMed

Busch, Anne-Kathrin; Rockenbauch, Katrin; Schmutzer, Gabriele; Brähler, Elmar

2015-01-01

Attitudes towards communication skills of medical undergraduates can be gathered using the Communication Skills Attitude Scale (CSAS). We aimed to develop a German version of the CSAS (CSAS-G) in order to explore attitudes towards communication skills in a German cohort. Additionally the potential influence of demographic factors was examined. We realized the CSAS-G and conducted a survey with 529 participants from 3 different years of study. We then carried out an explorative as well as confirmatory factor analysis and compared the attitudinal scores. Multiple regression analysis was performed. The confirmatory analysis confirmed the two-subscale system revealed by the explorative factor analysis. Students indicate low levels of negative attitudes and moderate levels of positive attitudes. Attitudinal scores differ significantly in relation to gender. The CSAS-G can be used in German cohorts to evaluate attitudes towards communication skills. Medical students in our study show basically a positive approach. Further investigation is necessary to explore and understand attitudes towards communication skills of German medical students.

The impact of depression on fatigue in patients with haemodialysis: a correlational study.

PubMed

Bai, Yu-Ling; Lai, Liu-Yuan; Lee, Bih-O; Chang, Yong-Yuan; Chiou, Chou-Ping

2015-07-01

To investigate the fatigue levels and important fatigue predictors for patients undergoing haemodialysis. Fatigue is a common symptom for haemodialysis patients. With its debilitating and distressing effects, it impacts patients in terms of their quality of life while also increasing their mortality rate. A descriptive correlational study. Convenience sampling was conducted at six chosen haemodialysis centres in Southern Taiwan. Data were collected via a structured questionnaire from 193 haemodialysis patients. The scales involved in this study were socio-demographic details, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Scale for haemodialysis patients. Data analysis included percentages, means, standard deviations and hierarchical multiple regression analysis. The fatigue level for haemodialysis patients was in the moderate range. Results from the hierarchical multiple regression analysis indicated that age, employment status, types of medications, physical activity and depression were significant. Of those variables, depression had the greatest impact on the patients' fatigue level, accounting for up to 30·6% of the explanatory power. The total explanatory power of the regression model was 64·2%. This study determined that for haemodialysis patients, unemployment, increased age, taking more medications or lower exercise frequencies resulted in more severe depression, which translated in turn to higher levels of fatigue. Among all these factors, depression had the greatest impact on the patients' fatigue levels. Not only is this finding beneficial to future studies on fatigue as a source of reference, it is also helpful in our understanding of important predictors relating to fatigue in the everyday lives of haemodialysis patients. It is recommended that when caring for fatigued patients, more care should be dedicated to their psychological states, and assistance should be provided in a timely way so as to reduce the amount of fatigue suffered. © 2015 John Wiley & Sons Ltd.

Cell cycle-related genes as modifiers of age of onset of colorectal cancer in Lynch syndrome: a large-scale study in non-Hispanic white patients.

PubMed

Chen, Jinyun; Pande, Mala; Huang, Yu-Jing; Wei, Chongjuan; Amos, Christopher I; Talseth-Palmer, Bente A; Meldrum, Cliff J; Chen, Wei V; Gorlov, Ivan P; Lynch, Patrick M; Scott, Rodney J; Frazier, Marsha L

2013-02-01

Heterogeneity in age of onset of colorectal cancer in individuals with mutations in DNA mismatch repair genes (Lynch syndrome) suggests the influence of other lifestyle and genetic modifiers. We hypothesized that genes regulating the cell cycle influence the observed heterogeneity as cell cycle-related genes respond to DNA damage by arresting the cell cycle to provide time for repair and induce transcription of genes that facilitate repair. We examined the association of 1456 single nucleotide polymorphisms (SNPs) in 128 cell cycle-related genes and 31 DNA repair-related genes in 485 non-Hispanic white participants with Lynch syndrome to determine whether there are SNPs associated with age of onset of colorectal cancer. Genotyping was performed on an Illumina GoldenGate platform, and data were analyzed using Kaplan-Meier survival analysis, Cox regression analysis and classification and regression tree (CART) methods. Ten SNPs were independently significant in a multivariable Cox proportional hazards regression model after correcting for multiple comparisons (P < 5 × 10(-4)). Furthermore, risk modeling using CART analysis defined combinations of genotypes for these SNPs with which subjects could be classified into low-risk, moderate-risk and high-risk groups that had median ages of colorectal cancer onset of 63, 50 and 42 years, respectively. The age-associated risk of colorectal cancer in the high-risk group was more than four times the risk in the low-risk group (hazard ratio = 4.67, 95% CI = 3.16-6.92). The additional genetic markers identified may help in refining risk groups for more tailored screening and follow-up of non-Hispanic white patients with Lynch syndrome.

Cell cycle–related genes as modifiers of age of onset of colorectal cancer in Lynch syndrome: a large-scale study in non-Hispanic white patients

PubMed Central

Chen, Jinyun; Pande, Mala

2013-01-01

Heterogeneity in age of onset of colorectal cancer in individuals with mutations in DNA mismatch repair genes (Lynch syndrome) suggests the influence of other lifestyle and genetic modifiers. We hypothesized that genes regulating the cell cycle influence the observed heterogeneity as cell cycle–related genes respond to DNA damage by arresting the cell cycle to provide time for repair and induce transcription of genes that facilitate repair. We examined the association of 1456 single nucleotide polymorphisms (SNPs) in 128 cell cycle–related genes and 31 DNA repair–related genes in 485 non-Hispanic white participants with Lynch syndrome to determine whether there are SNPs associated with age of onset of colorectal cancer. Genotyping was performed on an Illumina GoldenGate platform, and data were analyzed using Kaplan–Meier survival analysis, Cox regression analysis and classification and regression tree (CART) methods. Ten SNPs were independently significant in a multivariable Cox proportional hazards regression model after correcting for multiple comparisons (P < 5×10–4). Furthermore, risk modeling using CART analysis defined combinations of genotypes for these SNPs with which subjects could be classified into low-risk, moderate-risk and high-risk groups that had median ages of colorectal cancer onset of 63, 50 and 42 years, respectively. The age-associated risk of colorectal cancer in the high-risk group was more than four times the risk in the low-risk group (hazard ratio = 4.67, 95% CI = 3.16–6.92). The additional genetic markers identified may help in refining risk groups for more tailored screening and follow-up of non-Hispanic white patients with Lynch syndrome. PMID:23125224

Discrepancies Between Perceptions of the Parent-Adolescent Relationship and Early Adolescent Depressive Symptoms: An Illustration of Polynomial Regression Analysis.

PubMed

Nelemans, S A; Branje, S J T; Hale, W W; Goossens, L; Koot, H M; Oldehinkel, A J; Meeus, W H J

2016-10-01

Adolescence is a critical period for the development of depressive symptoms. Lower quality of the parent-adolescent relationship has been consistently associated with higher adolescent depressive symptoms, but discrepancies in perceptions of parents and adolescents regarding the quality of their relationship may be particularly important to consider. In the present study, we therefore examined how discrepancies in parents' and adolescents' perceptions of the parent-adolescent relationship were associated with early adolescent depressive symptoms, both concurrently and longitudinally over a 1-year period. Our sample consisted of 497 Dutch adolescents (57 % boys, M age = 13.03 years), residing in the western and central regions of the Netherlands, and their mothers and fathers, who all completed several questionnaires on two occasions with a 1-year interval. Adolescents reported on depressive symptoms and all informants reported on levels of negative interaction in the parent-adolescent relationship. Results from polynomial regression analyses including interaction terms between informants' perceptions, which have recently been proposed as more valid tests of hypotheses involving informant discrepancies than difference scores, suggested the highest adolescent depressive symptoms when both the mother and the adolescent reported high negative interaction, and when the adolescent reported high but the father reported low negative interaction. This pattern of findings underscores the need for a more sophisticated methodology such as polynomial regression analysis including tests of moderation, rather than the use of difference scores, which can adequately address both congruence and discrepancies in perceptions of adolescents and mothers/fathers of the parent-adolescent relationship in detail. Such an analysis can contribute to a more comprehensive understanding of risk factors for early adolescent depressive symptoms.

Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery

PubMed Central

Tucker, Jalie A.; Cheong, JeeWon; Chandler, Susan D.; Lambert, Brice H.; Pietrzak, Brittney; Kwok, Heather; Davies, Susan L.

2016-01-01

Background As interventions have expanded beyond clinical treatment to include brief interventions for persons with less severe alcohol problems, predicting who can achieve stable moderation drinking has gained importance. Recent behavioral economic (BE) research on natural recovery has shown that active problem drinkers who allocate their monetary expenditures on alcohol and saving for the future over longer time horizons tend to have better subsequent recovery outcomes, including maintenance of stable moderation drinking. The present study compared the predictive utility of this money-based “Alcohol-Savings Discretionary Expenditure” (ASDE) index with multiple BE analogue measures of behavioral impulsivity and self-control, which have seldom been investigated together, to predict outcomes of natural recovery attempts. Methods Community-dwelling problem drinkers, enrolled shortly after stopping abusive drinking without treatment, were followed prospectively for up to a year (N = 175 [75.4% male], M age = 50.65 years). They completed baseline assessments of pre-resolution drinking practices and problems; analogue behavioral choice tasks (Delay Discounting, Melioration-Maximization, and Alcohol Purchase Tasks); and a Timeline Followback interview including expenditures on alcohol compared to voluntary savings (ASDE index) during the pre-resolution year. Results Multinomial logistic regression models showed that, among the BE measures, only the ASDE index predicted stable moderation drinking compared to stable abstinence or unstable resolutions involving relapse. As hypothesized, stable moderation was associated with more balanced pre-resolution allocations to drinking and savings (OR = 1.77, 95% CI = 1.02 ∼ 3.08, p < .05), suggesting it is associated with longer term behavior regulation processes than abstinence. Conclusions The ASDE's unique predictive utility may rest on its comprehensive representation of contextual elements to support this patterning of behavioral allocation. Stable low risk drinking, but not abstinence, requires such regulatory processes. PMID:27775161

Depression's moderation of the effectiveness of intensive case management with substance-dependent women on temporary assistance for needy families: outpatient substance use disorder treatment utilization and outcomes.

PubMed

Kuerbis, Alexis N; Neighbors, Charles J; Morgenstern, Jon

2011-03-01

Intensive case management (ICM) is effective for facilitating entry into and retention in outpatient substance use disorder treatment (OSUDT) for low-income substance-dependent women; however, no studies have specifically examined the moderating impact of depressive symptoms on ICM. The purpose of this study was to investigate whether depressive symptoms moderated ICM's effect on OSUDT engagement, attendance, and outcomes for substance-dependent women on Temporary Assistance for Needy Families (TANF). It was hypothesized that highly depressed women would demonstrate worse outcomes on all indicators. Logistic regression and generalized estimating equations were used to determine depression's moderating impact on ICM in a secondary analysis of data from a randomized controlled trial comparing the effectiveness of ICM to usual care provided by local public assistance offices in Essex County, NJ. Substance-dependent women (N = 294) were recruited while being screened for TANF eligibility and were followed for 24 months. Findings revealed that high levels of depressive symptoms moderated the effectiveness of ICM in unexpected directions for two outcome variables. Subjects with high levels of depressive symptoms in ICM were (a) significantly more likely to engage in at least one treatment program than those in usual care and (b) associated with the fewest mean drinks per drinking day across the 24-month follow-up period. Independent effects for high levels of depressive symptoms and ICM were also found to positively influence engagement, attendance, and percentage days abstinent. ICM is effective for substance-dependent women with a broad spectrum of depressive symptoms in enhancing OSUDT utilization and outcomes.

[A cross-sectional study of moderate or severe visual impairment and blindness in residents with type 2 diabetes living in Xinjing Town, Shanghai].

PubMed

Bai, X L; Xu, X; Lu, M; He, J N; Xu, X; Du, X; Zhang, B; He, X G; Lu, L N; Zhu, J F; Zou, H D; Zhao, J L

2016-11-11

Objective: To investigate the prevalence, underlying causes and risk factors of moderate or severe visual impairment and blindness in a population with type 2 diabetes in Xinjing Town, Shanghai, China. Methods: A cross-sectional survey among local Han adult residents, who were previously diagnosed as type 2 diabetes, was conducted between October 2014 and January 2015. The survey was preceded by a pilot study; operational methods were refined and quality assurance evaluation was carried out. The best corrected visual acuity was recorded and classified following the modified World Health Organization grading system. Assigned ophthalmic doctors assured the leading causes of every blind or visually impaired eye. Binary logistic regression analysis was used to determine the related factors of blindness and moderate or severe visual impairment. Results: A total of 2 216 type 2 diabetic residents were enrolled, and 166 eyes (3.7%, 166/4 432) were blind. Cataract was the leading cause of blindness (39.8%); macular degeneration (18.0%) and eyeball atrophy (11.4%) were the second and third leading causes of blindness, respectively. Moderate or severe visual impairment was found in 376 eyes (8.5%, 376/4 432), and the most frequent cause was cataract (65.7%), followed by diabetic retinopathy (9.8%) and macular degeneration (9.4% ). Older age, female gender, earlier onset diabetes and a lower spherical equivalent in the better eye were associated with best corrected visual acuity<20/63 in the better eye. Conclusion: The prevalences of moderate or severe visual impairment and blindness in our population with type 2 diabetes were high. (Chin J Ophthalmol, 2016, 52: 825-830) .

Intracultural accusations of assimilation and alcohol use severity among Hispanic emerging adults: Moderating effects of acculturation, enculturation, and gender.

PubMed

Cano, Miguel Ángel

2016-12-01

Individuals, including Hispanics, tend to drink most heavily during emerging adulthood (ages 18-25 years old). Research has suggested that intercultural stressors (e.g., ethnic discrimination) may increase levels of alcohol use among Hispanics. However, the relationship between intracultural stressors (e.g., accusations of assimilation-when Hispanics accuse a member of their heritage group of acculturating to U.S. culture) and alcohol use has been examined to a lesser extent. Accordingly, the present study aimed to (a) examine the association between family accusations of assimilation and alcohol use severity; and (b) examine if acculturation domains, enculturation domains, and gender moderated that association. A hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 181 Hispanic emerging adults. Results indicated that higher family accusations of assimilation were associated with higher levels of alcohol use severity (β = .18, p < .05), and all variables entered in the model accounted for ΔR2 = 15.1% of the variance of alcohol use severity. A moderation analysis indicated that higher family accusations of assimilation were associated with higher alcohol use severity among men, but not women. Of the four acculturation/enculturation domains, none had a moderation effect. However, there was a statistically significant three-way interaction among family accusations of assimilation, gender, and affective enculturation. This three-way interaction suggests that among men, higher family accusations of assimilation were associated with higher alcohol use severity at lower levels of affective enculturation. This study addresses a literature gap on intracultural stressors and substance use among Hispanics, and discusses recommendations for future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Dancing Participation and Cardiovascular Disease Mortality: A Pooled Analysis of 11 Population-Based British Cohorts.

PubMed

Merom, Dafna; Ding, Ding; Stamatakis, Emmanuel

2016-06-01

Little is known about whether cardiovascular benefits vary by activity type. Dance is a multidimensional physical activity of psychosocial nature. The study aimed to examine the association between dancing and cardiovascular disease mortality. A cohort study pooled 11 independent population surveys in the United Kingdom from 1995 to 2007, analyzed in 2014. Participants were 48,390 adults aged ≥40 years who were free of cardiovascular disease at baseline and consented to be linked to the National Death Registry. Respondents reported participation in light- or moderate-intensity dancing and walking in the past 4 weeks. Physical activity amount was calculated based on frequency, duration, and intensity of participation in various types of exercise. The main outcome was cardiovascular disease mortality based on ICD-9 codes 390-459 or ICD-10 codes I01-I99. During 444,045 person-years, 1,714 deaths caused by cardiovascular disease were documented. Moderate-intensity, but not light-intensity, dancing and walking were both inversely associated with cardiovascular disease mortality. In Cox regression models, the hazard ratios for cardiovascular disease mortality, adjusted for age, sex, SES, smoking, alcohol, BMI, chronic illness, psychosocial distress, and total physical activity amount, were 0.54 (95% CI=0.34, 0.87) for moderate-intensity dancing and 0.67 (95% CI=0.52, 0.87) for moderate-intensity walking. Moderate-intensity dancing was associated with a reduced risk for cardiovascular disease mortality to a greater extent than walking. The association between dance and cardiovascular disease mortality may be explained by high-intensity bouts during dancing, lifelong adherence, or psychosocial benefits. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Cross-sectional analysis of food choice frequency, sleep confounding beverages, and psychological distress predictors of sleep quality.

PubMed

Knowlden, Adam P; Burns, Maranda; Harcrow, Andy; Shewmake, Meghan E

2016-03-16

Poor sleep quality is a significant public health problem. The role of nutrition in predicting sleep quality is a relatively unexplored area of inquiry. The purpose of this study was to evaluate the capacity of 10 food choice categories, sleep confounding beverages, and psychological distress to predict the sleep quality of college students. A logistic regression model comprising 10 food choice variables (healthy proteins, unhealthy proteins, healthy dairy, unhealthy dairy, healthy grains, unhealthy grains, healthy fruits and vegetables, unhealthy empty calories, healthy beverages, unhealthy beverages), sleep confounding beverages (caffeinated/alcoholic beverages), as well as psychological distress (low, moderate, serious distress) was computed to determine the capacity of the variables to predict sleep quality (good/poor). The odds of poor sleep quality were 32.4% lower for each unit of increased frequency of healthy proteins consumed (p<0.001; OR=0.676), 14.1% lower for each unit of increased frequency of healthy dairy food choices consumed (p=0.024; OR=0.859), 13.1% higher for each unit of increased frequency of empty calorie food choices consumed (p=0.003; OR=1.131), and 107.3% higher for those classified in the moderate psychological distress (p=0.016; OR=2.073). Collectively, healthy proteins, healthy dairy, unhealthy empty calories, and moderate psychological distress were moderately predictive of sleep quality in the sample (Nagelkerke R2=23.8%). Results of the study suggested higher frequency of consumption of healthy protein and healthy dairy food choices reduced the odds of poor sleep quality, while higher consumption of empty calories and moderate psychological distress increased the odds of poor sleep quality.

Individual patient data meta-analysis of combined treatments versus psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for adult depression: a protocol.

PubMed

Weitz, Erica; Kleiboer, Annet; van Straten, Annemieke; Hollon, Steven D; Cuijpers, Pim

2017-02-13

There are many proven treatments (psychotherapy, pharmacotherapy or their combination) for the treatment of depression. Although there is growing evidence for the effectiveness of combination treatment (psychotherapy + pharmacotherapy) over pharmacotherapy alone, psychotherapy alone or psychotherapy plus pill placebo, for depression, little is known about which specific groups of patients may respond best to combined treatment versus monotherapy. Conventional meta-analyses techniques have limitations when tasked with examining whether specific individual characteristics moderate the effect of treatment on depression. Therefore, this protocol outlines an individual patient data (IPD) meta-analysis to explore which patients, with which clinical characteristics, have better outcomes in combined treatment compared with psychotherapy (alone or with pill placebo), pharmacotherapy and pill placebo. Study searches are completed using an established database of randomised controlled trials (RCTs) on the psychological treatment of adult depression that has previously been reported. Searches were conducted in PubMed, PsycInfo, Embase and the Cochrane Central Register of Controlled Trials. RCTs comparing combination treatment (psychotherapy + pharmacotherapy) with psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for the treatment of adult depression will be included. Study authors of eligible trials will be contacted and asked to contribute IPD. Conventional meta-analysis techniques will be used to examine differences between studies that have contributed data and those that did not. Then, IPD will be harmonised and analysis using multilevel regression will be conducted to examine effect moderators of treatment outcomes. Study results outlined above will be published in peer-reviewed journals. Study results will contribute to better understanding whether certain patients respond best to combined treatment or other depression treatments and provide new information on moderators of treatment outcome that can be used by patients, clinicians and researchers. CRD42016039028. 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/.

Stressors, social support, and tests of the buffering hypothesis: effects on psychological responses of injured athletes.

PubMed

Mitchell, Ian; Evans, Lynne; Rees, Tim; Hardy, Lew

2014-09-01

The purpose of this article was to examine the main and stress-buffering effect relationships between social support and psychological responses to injury. The article presents two studies, both of which matched social support types with injury stressors. Study 1 used measures of stressors, perception of social support availability, and psychological responses of injured athletes. Study 2 utilized measures of stressors, received social support, and psychological responses of injured athletes. During physiotherapy clinic visits, injured athletes (Study 1, N = 319; Study 2, N = 302) completed measures of stressors, social support, and psychological responses to injury. Confirmatory factor analysis (CFA) and moderated hierarchical regression were used to analyse the data. In both studies, CFA suggested adequate model fit for measures of social support and psychological responses to injury. Moderated hierarchical regression analyses in Study 1 revealed significant (p < .05) stress-buffering effects for the perception of available esteem support in relation to restlessness, isolation, and feeling cheated, and the perception of emotional support in relation to isolation. In both studies, moderated hierarchical regression analyses revealed significant (p < .05) main effects for esteem, emotional, and tangible support in relation to restlessness, isolation, and feeling cheated. The findings of the current studies enhance our understanding of the stress-buffering effects of social support in relation to injury stressors and psychological responses; that is, the relationships between social support, stressors, and psychological responses to sport injury may differ with regard to received or perceived available support. The findings have important implications for the design of social support interventions with injured athletes aimed at alleviating the detrimental effects of injury stressors. What is already known on this subject? The health, social, and sport-injury related research suggests that social support has the potential to moderate (i.e., buffer) those psychological responses to stress that are detrimental to health and well-being. Despite what is a growing body of empirical research that has explored the role of social support in a sport injury context, there has been a paucity of research that has examined how social support functions in relation to injury-related stressors and psychological responses, particularly with regard to the effect of perceived and received support. In addition, there has been limited regard for current conceptualizations of social support as well as injured athletes, psychological responses in the measurement strategies adopted and measures employed. What does this study add? Enhances our understanding of the stress-buffering effects of perceived and received social support in sport. Provides support for the functional aspects of perceived support when dealing with injury-related stressors. Has important implications for the design of social support interventions that aim to expedite injured athletes successful return to sport. © 2013 The British Psychological Society.

The relationship between organizational leadership for safety and learning from patient safety events.

PubMed

Ginsburg, Liane R; Chuang, You-Ta; Berta, Whitney Blair; Norton, Peter G; Ng, Peggy; Tregunno, Deborah; Richardson, Julia

2010-06-01

To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs). Forty-nine general acute care hospitals in Ontario, Canada. A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety. Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined. Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds). We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.

Pulmonary arterial enlargement predicts long-term survival in COPD patients.

PubMed

de-Torres, Juan P; Ezponda, Ana; Alcaide, Ana B; Campo, Arantza; Berto, Juan; Gonzalez, Jessica; Zulueta, Javier J; Casanova, Ciro; Rodriguez-Delgado, Luisa Elena; Celli, Bartolome R; Bastarrika, Gorka

2018-01-01

Pulmonary artery enlargement (PAE) is associated with exacerbations in Chronic Obstructive Pulmonary Disease (COPD) and with survival in moderate to severe patients. The potential role of PAE in survival prediction has not been compared with other clinical and physiological prognostic markers. In 188 patients with COPD, PA diameter was measured on a chest CT and the following clinical and physiological parameters registered: age, gender, smoking status, pack-years history, dyspnea, lung function, exercise capacity, Body Mass Index, BODE index and history of exacerbations in year prior to enrolment. Proportional Cox regression analysis determined the best predictor of all cause survival. During 83 months (±42), 43 patients died. Age, pack-years history, smoking status, BMI, FEV1%, six minute walking distance, Modified Medical Research Council dyspnea scale, BODE index, exacerbation rate prior to enrollment, PA diameter and PAE (diameter≥30mm) were associated with survival. In the multivariable analysis, age (HR: 1.08; 95%CI: 1.03-1.12, p<0.001) and PAE (HR: 2.78; 95%CI: 1.35-5.75, p = 0.006) were the most powerful parameters associated with all-cause mortality. In this prospective observational study of COPD patients with mild to moderate airflow limitation, PAE was the best predictor of long-term survival along with age.

Interactions of age and cognitive functions in predicting decision making under risky conditions over the life span.

PubMed

Brand, Matthias; Schiebener, Johannes

2013-01-01

Little is known about how normal healthy aging affects decision-making competence. In this study 538 participants (age 18-80 years) performed the Game of Dice Task (GDT). Subsamples also performed the Iowa Gambling Task as well as tasks measuring logical thinking and executive functions. In a moderated regression analysis, the significant interaction between age and executive components indicates that older participants with good executive functioning perform well on the GDT, while older participants with reduced executive functions make more risky choices. The same pattern emerges for the interaction of age and logical thinking. Results demonstrate that age and cognitive functions act in concert in predicting the decision-making performance.

An Exploratory Investigation of the Role of Openness in Relationship Quality among Emerging Adult Chinese Couples

PubMed Central

Zhou, Yixin; Wang, Kexin; Chen, Shuang; Zhang, Jianxin; Zhou, Mingjie

2017-01-01

This study tested emerging adult couples’ openness and its fit effect on their romantic relationship quality using quadratic polynomial regression and response surface analysis. Participants were 260 emerging adult dyads. Both dyads’ openness and relationship quality were measured. The result showed that (1) female and male openness contribute differently to relationship quality; (2) couples with similar high openness could experience better relationship quality than those with similar low openness traits; and (3) when dyadic openness is dissimilar, it is better to be either relatively high or relatively low than to be moderate. These findings highlight the role of openness in emerging adults’ romantic relationships from a dyadic angle. PMID:28360875

Future-oriented tweets predict lower county-level HIV prevalence in the United States.

PubMed

Ireland, Molly E; Schwartz, H Andrew; Chen, Qijia; Ungar, Lyle H; Albarracín, Dolores

2015-12-01

Future orientation promotes health and well-being at the individual level. Computerized text analysis of a dataset encompassing billions of words used across the United States on Twitter tested whether community-level rates of future-oriented messages correlated with lower human immunodeficiency virus (HIV) rates and moderated the association between behavioral risk indicators and HIV. Over 150 million tweets mapped to U.S. counties were analyzed using 2 methods of text analysis. First, county-level HIV rates (cases per 100,000) were regressed on aggregate usage of future-oriented language (e.g., will, gonna). A second data-driven method regressed HIV rates on individual words and phrases. Results showed that counties with higher rates of future tense on Twitter had fewer HIV cases, independent of strong structural predictors of HIV such as population density. Future-oriented messages also appeared to buffer health risk: Sexually transmitted infection rates and references to risky behavior on Twitter were associated with higher HIV prevalence in all counties except those with high rates of future orientation. Data-driven analyses likewise showed that words and phrases referencing the future (e.g., tomorrow, would be) correlated with lower HIV prevalence. Integrating big data approaches to text analysis and epidemiology with psychological theory may provide an inexpensive, real-time method of anticipating outbreaks of HIV and etiologically similar diseases. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Future-Oriented Tweets Predict Lower County-Level HIV Prevalence in the United States

PubMed Central

Ireland, Molly E.; Schwartz, Hansen A.; Chen, Qijia; Ungar, Lyle; Albarracín, Dolores

2016-01-01

Objective Future orientation promotes health and well-being at the individual level. Computerized text analysis of a dataset encompassing billions of words used across the United States on Twitter tested whether community-level rates of future-oriented messages correlated with lower HIV rates and moderated the association between behavioral risk indicators and HIV. Method Over 150 million Tweets mapped to US counties were analyzed using two methods of text analysis. First, county-level HIV rates (cases per 100,000) were regressed on aggregate usage of future-oriented language (e.g., will, gonna). A second data-driven method regressed HIV rates on individual words and phrases. Results Results showed that counties with higher rates of future tense on Twitter had fewer HIV cases, independent of strong structural predictors of HIV such as population density. Future-oriented messages also appeared to buffer health risk: Sexually transmitted infection rates and references to risky behavior on Twitter were associated with higher HIV prevalence in all counties except those with high rates of future orientation. Data-driven analyses likewise showed that words and phrases referencing the future (e.g., tomorrow, would be) correlated with lower HIV prevalence. Conclusion Integrating big data approaches to text analysis and epidemiology with psychological theory may provide an inexpensive, real-time method of anticipating outbreaks of HIV and etiologically similar diseases. PMID:26651466

A multilateral modelling of Youth Soccer Performance Index (YSPI)

NASA Astrophysics Data System (ADS)

Bisyri Husin Musawi Maliki, Ahmad; Razali Abdullah, Mohamad; Juahir, Hafizan; Abdullah, Farhana; Ain Shahirah Abdullah, Nurul; Muazu Musa, Rabiu; Musliha Mat-Rasid, Siti; Adnan, Aleesha; Azura Kosni, Norlaila; Muhamad, Wan Siti Amalina Wan; Afiqah Mohamad Nasir, Nur

2018-04-01

This study aims to identify the most dominant factors that influencing performance of soccer player and to predict group performance for soccer players. A total of 184 of youth soccer players from Malaysia sport school and six soccer academy encompasses as respondence of the study. Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were computed to identify the most dominant factors whereas reducing the initial 26 parameters with recommended >0.5 of factor loading. Meanwhile, prediction of the soccer performance was predicted by regression model. CFA revealed that sit and reach, vertical jump, VO2max, age, weight, height, sitting height, calf circumference (cc), medial upper arm circumference (muac), maturation, bicep, triceps, subscapular, suprailiac, 5M, 10M, and 20M speed were the most dominant factors. Further index analysis forming Youth Soccer Performance Index (YSPI) resulting by categorizing three groups namely, high, moderate, and low. The regression model for this study was significant set as p < 0.001 and R2 is 0.8222 which explained that the model contributed a total of 82% prediction ability to predict the whole set of the variables. The significant parameters in contributing prediction of YSPI are discussed. As a conclusion, the precision of the prediction models by integrating a multilateral factor reflecting for predicting potential soccer player and hopefully can create a competitive soccer games.

Functional disability and its predictors in systemic sclerosis: a study from the DeSScipher project within the EUSTAR group.

PubMed

Jaeger, Veronika K; Distler, Oliver; Maurer, Britta; Czirják, Laszlo; Lóránd, Veronika; Valentini, Gabriele; Vettori, Serena; Del Galdo, Francesco; Abignano, Giuseppina; Denton, Christopher; Nihtyanova, Svetlana; Allanore, Yannick; Avouac, Jerome; Riemekasten, Gabriele; Siegert, Elise; Huscher, Dörte; Matucci-Cerinic, Marco; Guiducci, Serena; Frerix, Marc; Tarner, Ingo H; Garay Toth, Beata; Fankhauser, Beat; Umbricht, Jörg; Zakharova, Anastasia; Mihai, Carina; Cozzi, Franco; Yavuz, Sule; Hunzelmann, Nicolas; Rednic, Simona; Vacca, Alessandra; Schmeiser, Tim; Riccieri, Valeria; García de la Peña Lefebvre, Paloma; Gabrielli, Armando; Krummel-Lorenz, Brigitte; Martinovic, Duska; Ancuta, Codrina; Smith, Vanessa; Müller-Ladner, Ulf; Walker, Ulrich A

2018-03-01

The multisystem manifestations of SSc can greatly impact patients' quality of life. The aim of this study was to identify factors associated with disability in SSc. SSc patients from the prospective DeSScipher cohort who had completed the scleroderma health assessment questionnaire (SHAQ), a disability score that combines the health assessment questionnaire and five visual analogue scales, were included in this analysis. The effect of factors possibly associated with disability was analysed with multiple linear regressions. The mean SHAQ and HAQ scores of the 944 patients included were 0.87 (s.d. = 0.66) and 0.92 (s.d. = 0.78); 59% of the patients were in the mild to moderate difficulty SHAQ category (0 ⩽ SHAQ < 1), 34% in the moderate to severe disability category (1 ⩽ SHAQ < 2) and 7% in the severe to very severe disability category (2 ⩽ SHAQ ⩽ 3). The means of the visual analogue scales scores were in order of magnitude: overall disease severity (37 mm), RP (31 mm), pulmonary symptoms (24 mm), gastrointestinal symptoms (20 mm) and digital ulcers (19 mm). In multiple regression, the main factors associated with high SHAQ scores were the presence of dyspnoea [modified New York Heart Association (NYHA) class IV (regression coefficient B = 0.62), modified NYHA class III (B = 0.53) and modified NYHA class II (B = 0.21; all vs modified NYHA class I)], FM (B = 0.37), muscle weakness (B = 0.27), digital ulcers (B = 0.20) and gastrointestinal symptoms (oesophageal symptoms, B = 0.16; stomach symptoms, B = 0.15; intestinal symptoms, B = 0.15). SSc patients perceive dyspnoea, pain, digital ulcers, muscle weakness and gastrointestinal symptoms as the main factors driving their level of disability, unlike physicians who emphasize objective measures of disability. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research.

PubMed

Allen, Mark S; Walter, Emma E

2018-04-01

Sexual dysfunction is a common problem among men and women and is associated with negative individual functioning, relationship difficulties, and lower quality of life. To determine the magnitude of associations between 6 health-related lifestyle factors (cigarette smoking, alcohol intake, physical activity, diet, caffeine, and cannabis use) and 3 common sexual dysfunctions (erectile dysfunction, premature ejaculation, and female sexual dysfunction). A comprehensive literature search of 10 electronic databases identified 89 studies that met the inclusion criteria (452 effect sizes; N = 348,865). Pooled mean effects (for univariate, age-adjusted, and multivariable-adjusted estimates) were computed using inverse-variance weighted random-effects meta-analysis and moderation by study and population characteristics were tested using random-effects meta-regression. Mean effect sizes from 92 separate meta-analyses provided evidence that health-related lifestyle factors are important for sexual dysfunction. Cigarette smoking (past and current), alcohol intake, and physical activity had dose-dependent associations with erectile dysfunction. Risk of erectile dysfunction increased with greater cigarette smoking and decreased with greater physical activity. Alcohol had a curvilinear association such that moderate intake was associated with a lower risk of erectile dysfunction. Participation in physical activity was associated with a lower risk of female sexual dysfunction. There was some evidence that a healthy diet was related to a lower risk of erectile dysfunction and female sexual dysfunction, and caffeine intake was unrelated to erectile dysfunction. Publication bias appeared minimal and findings were similar for clinical and non-clinical samples. Modification of lifestyle factors would appear to be a useful low-risk approach to decreasing the risk of erectile dysfunction and female sexual dysfunction. Strengths include the testing of age-adjusted and multivariable-adjusted models and tests of potential moderators using meta-regression. Limitations include low statistical power in models testing diet, caffeine, and cannabis use as risk factors. Results provide compelling evidence that cigarette smoking, alcohol, and physical activity are important for sexual dysfunction. Insufficient research was available to draw conclusions regarding risk factors for premature ejaculation or for cannabis use as a risk factor. These findings should be of interest to clinicians treating men and women with complaints relating to symptoms of sexual dysfunction. Allen MS, Walter EE. Health-Related Lifestyle Factors and Sexual Dysfunction: A Meta-Analysis of Population-Based Research. J Sex Med 2018;15:458-475. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Impaired IQ and Academic Skills in Adults Who Experienced Moderate to Severe Infantile Malnutrition: A Forty-Year Study

PubMed Central

Waber, Deborah P.; Bryce, Cyralene P.; Girard, Jonathan M.; Zichlin, Miriam; Fitzmaurice, Garrett M.; Galler, Janina R.

2013-01-01

Objectives To evaluate IQ and academic skills in adults who experienced an episode of moderate to severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. Methods IQ and academic skills were assessed in 77 previously malnourished adults (mean age=38.4 years; 53% male) and 59 controls (mean age=38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. Results The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (p<0.0001). IQ scores in the Intellectual Disability range (< 70) were 9 times more prevalent in the previously malnourished group (OR=9.18; 95% CI=3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Discussion Moderate to severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity. PMID:23484464

Personal growth, symptoms, and uncertainty in community-residing adults with heart failure.

PubMed

Overbaugh, Kristen J; Parshall, Mark B

Personal growth has not been studied extensively in heart failure (HF). To characterize personal growth in HF and its relationships with symptom burden, uncertainty, and demographic and clinical factors. Associations among personal growth, uncertainty, symptom burden, and clinical and demographic variables were examined in adult outpatients with HF using bivariate correlations and multiple regressions. Participants (N = 103; 76% male, mean age = 74 years, 97% New York Heart Association classes II and III) reported moderate levels of personal growth, uncertainty, and symptom burden. Personal growth was weakly correlated with age and symptom burden but not with other study variables. In a regression model, age, sex, ethnicity, disease severity, time since diagnosis, symptom burden, and uncertainty were not significant independent correlates of personal growth. Community-residing patients with HF report moderate personal growth that is not explained by uncertainty, symptom burden, or demographic and clinical variables. Copyright © 2016 Elsevier Inc. All rights reserved.

Bias-motivated bullying and psychosocial problems: implications for HIV risk behaviors among young men who have sex with men.

PubMed

Li, Michael Jonathan; Distefano, Anthony; Mouttapa, Michele; Gill, Jasmeet K

2014-02-01

The present study aimed to determine whether the experience of bias-motivated bullying was associated with behaviors known to increase the risk of HIV infection among young men who have sex with men (YMSM) aged 18-29, and to assess whether the psychosocial problems moderated this relationship. Using an Internet-based direct marketing approach in sampling, we recruited 545 YMSM residing in the USA to complete an online questionnaire. Multiple linear regression analyses tested three regression models where we controlled for sociodemographics. The first model indicated that bullying during high school was associated with unprotected receptive anal intercourse within the past 12 months, while the second model indicated that bullying after high school was associated with engaging in anal intercourse while under the influence of drugs or alcohol in the past 12 months. In the final regression model, our composite measure of HIV risk behavior was found to be associated with lifetime verbal harassment. None of the psychosocial problems measured in this study - depression, low self-esteem, and internalized homonegativity - moderated any of the associations between bias-motivated bullying victimization and HIV risk behaviors in our regression models. Still, these findings provide novel evidence that bullying prevention programs in schools and communities should be included in comprehensive approaches to HIV prevention among YMSM.

Marital and sexual satisfaction in Chinese families: exploring the moderating effects.

PubMed

Guo, Baorong; Huang, Jin

2005-01-01

This study examines the relationship between marital satisfaction and sexual satisfaction in Chinese families. Hierarchical multiple regression using data from the 1993 China Housing Survey indicates that, when controlling for the other variables, sexual satisfaction has considerable impact on marital satisfaction. We also found that the effects of sexual satisfaction on marital satisfaction are moderated by gender and education. The study suggests that marriage counseling, with an emphasis on promoting awareness of sexual quality, would be helpful in addressing marital problems in Chinese families.

Comparison of 3 Methods for Identifying Dietary Patterns Associated With Risk of Disease

PubMed Central

DiBello, Julia R.; Kraft, Peter; McGarvey, Stephen T.; Goldberg, Robert; Campos, Hannia

2008-01-01

Reduced rank regression and partial least-squares regression (PLS) are proposed alternatives to principal component analysis (PCA). Using all 3 methods, the authors derived dietary patterns in Costa Rican data collected on 3,574 cases and controls in 1994–2004 and related the resulting patterns to risk of first incident myocardial infarction. Four dietary patterns associated with myocardial infarction were identified. Factor 1, characterized by high intakes of lean chicken, vegetables, fruit, and polyunsaturated oil, was generated by all 3 dietary pattern methods and was associated with a significantly decreased adjusted risk of myocardial infarction (28%–46%, depending on the method used). PCA and PLS also each yielded a pattern associated with a significantly decreased risk of myocardial infarction (31% and 23%, respectively); this pattern was characterized by moderate intake of alcohol and polyunsaturated oil and low intake of high-fat dairy products. The fourth factor derived from PCA was significantly associated with a 38% increased risk of myocardial infarction and was characterized by high intakes of coffee and palm oil. Contrary to previous studies, the authors found PCA and PLS to produce more patterns associated with cardiovascular disease than reduced rank regression. The most effective method for deriving dietary patterns related to disease may vary depending on the study goals. PMID:18945692

Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem.

PubMed

Picco, Louisa; Pang, Shirlene; Lau, Ying Wen; Jeyagurunathan, Anitha; Satghare, Pratika; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Lim, Susan; Poh, Chee Lien; Chong, Siow Ann; Subramaniam, Mythily

2016-12-30

This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.