Sample records for statistically significant predictor

  1. A comparison of risk factors associated with suicide ideation/attempts in American Indian and White youth in Montana.

    PubMed

    Manzo, Karen; Tiesman, Hope; Stewart, Jera; Hobbs, Gerald R; Knox, Sarah S

    2015-01-01

    We examined racial/ethnic and gender-specific associations between suicide ideation/attempts and risky behaviors, sadness/hopelessness, and victimization in Montana American Indian and White youth using 1999-2011 Youth Risk Behavior Survey data. Logistic regression was used to calculate odds ratios and 95% confidence intervals in stratified racial/ethnic-gender groups. The primary results of this study show that although the American Indian youth had more statistically significant suicidal thoughts and attempts than the White youth, they had fewer statistically significant predictors compared to the White youth. Sadness/hopelessness was the strongest, and the only statistically significant, predictor of suicide ideation/attempts common across all four groups. The unhealthy weight control cluster was a significant predictor for the White youth and the American Indian/Alaska Native girls; the alcohol/tobacco/marijuana cluster was a significant predictor for the American Indian boys only. Results show important differences across the groups and indicate directions for future research targeting prevention and intervention.

  2. Relationship between academic motivation and mathematics achievement among Indian adolescents in Canada and India.

    PubMed

    Areepattamannil, Shaljan

    2014-01-01

    This study examined the relationships between academic motivation-intrinsic motivation, extrinsic motivation, amotivation-and mathematics achievement among 363 Indian adolescents in India and 355 Indian immigrant adolescents in Canada. Results of hierarchical multiple regression analyses showed that intrinsic motivation, extrinsic motivation, and amotivation were not statistically significantly related to mathematics achievement among Indian adolescents in India. In contrast, both intrinsic motivation and extrinsic motivation were statistically significantly related to mathematics achievement among Indian immigrant adolescents in Canada. While intrinsic motivation was a statistically significant positive predictor of mathematics achievement among Indian immigrant adolescents in Canada, extrinsic motivation was a statistically significant negative predictor of mathematics achievement among Indian immigrant adolescents in Canada. Amotivation was not statistically significantly related to mathematics achievement among Indian immigrant adolescents in Canada. Implications of the findings for pedagogy and practice are discussed.

  3. 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.

  4. Student performance on levels 1 and 2-CE of COMLEX-USA: do elective upper-level undergraduate science courses matter?

    PubMed

    Wong, Stanley K; Ramirez, Juan R; Helf, Scott C

    2009-11-01

    The effect of a variety of preadmission variables, including the number of elective preadmission upper-level science courses, on academic achievement is not well established. To investigate the relationship between number of preadmission variables and overall student academic achievement in osteopathic medical school. Academic records of osteopathic medical students in the 2008 and 2009 graduating classes of Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, California, were analyzed. Multivariate linear regression analyses were performed to identify predictors of academic achievement based on Medical College Admission Test (MCAT) subscores, undergraduate grade point average (GPA), GPA in medical school basic science (preclinical GPA) and clinical clerkship (clinical GPA), and scores on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE). Records of 358 osteopathic medical students were evaluated. Analysis of beta coefficients suggested that undergraduate science GPA was the most important predictor of overall student academic achievement (P<.01). Biological sciences MCAT subscore was a more modest but still statistically significant predictor of preclinical GPA and COMLEX-USA Level 1 score (P<.01). Physical sciences MCAT subscore was also a statistically significant predictor of preclinical GPA, and verbal reasoning MCAT subscore was a statistically significant predictor of COMLEX-USA Level 2-CE score (both P<.01). Women had statistically significantly higher preclinical GPA and COMLEX-USA Level 2-CE scores than men (P<.05). Differences in some outcome variables were also associated with racial-ethnic background and age. Number of preadmission elective upper-level science courses taken by students before matriculation was not significantly correlated with any academic achievement variable. Although undergraduate science GPA and MCAT biological sciences subscore were significant predictors of overall academic achievement for osteopathic medical students, the number of elective upper-level science courses taken preadmission had no predictive value.

  5. On the Identification of Associations between Five World Health Organization Water, Sanitation and Hygiene Phenotypes and Six Predictors in Low and Middle-Income Countries.

    PubMed

    Ellis, Hugh; Schoenberger, Erica

    2017-01-01

    According to the most recent estimates, 842,000 deaths in low- to middle-income countries were attributable to inadequate water, sanitation and hygiene in 2012. Despite billions of dollars and decades of effort, we still lack a sound understanding of which kinds of WASH interventions are most effective in improving public health outcomes, and an important corollary-whether the right things are being measured. The World Health Organization (WHO) has made a concerted effort to compile comprehensive data on drinking water quality and sanitation in the developing world. A recent 2014 report provides information on three phenotypes (responses): Unsafe Water Deaths, Unsafe Sanitation Deaths, Unsafe Hygiene Deaths; two grouped phenotypes: Unsafe Water and Sanitation Deaths and Unsafe Water, Sanitation and Hygiene Deaths; and six explanatory variables (predictors): Improved Sanitation, Unimproved Water Source, Piped Water To Premises, Other Improved Water Source, Filtered and Bottled Water in the Household and Handwashing. Regression analyses were performed to identify statistically significant associations between these mortality responses and predictors. Good fitted-model performance required: (1) the use of population-normalized death fractions as opposed to number of deaths; (2) transformed response (logit or power); and (3) square-root predictor transformation. Given the complexity and heterogeneity of the relationships and countries being studied, these models exhibited remarkable performance and explained, for example, about 85% of the observed variance in population-normalized Unsafe Sanitation Death fraction, with a high F-statistic and highly statistically significant predictor p-values. Similar performance was found for all other responses, which was an unexpected result (the expected associations between responses and predictors-i.e., water-related with water-related, etc. did not occur). The set of statistically significant predictors remains the same across all responses. That is, Unsafe Water Source (UWS), Improved Sanitation (IS) and Filtered and Bottled Water in the Household (FBH) were the only statistically significant predictors whether the response was Unsafe Sanitation Death Fraction, Unsafe Hygiene Death Fraction or Unsafe Water Death Fraction. Moreover, the fraction of variance explained for all fitted models remained relatively high (adjusted R2 ranges from 0.7605 to 0.8533). We find that two of the statistically significant predictors-Improved Sanitation and Unimproved Water Sources-are particularly influential. We also find that some predictors (Piped Water to Premises, Other Improved Water Sources) have very little explanatory power for predicting mortality and one (Other Improved Water Sources) has a counterintuitive effect on response (Unsafe Sanitary Death Fraction increases with increases in OIWS) and one predictor (Hand Washing) to have essentially no explanatory usefulness. Our results suggest that a higher priority may need to be given to improved sanitation than has been the case. Nevertheless, while our focus in this paper is mortality, morbidity is a staggering consequence of inadequate water, sanitation and hygiene, and lower impact on mortality may not mean a similarly low impact on morbidity. More specifically, those predictors that we found uninfluential for predicting mortality-related responses may indeed be important when morbidity is the response.

  6. Predictors of workplace violence among female sex workers in Tijuana, Mexico.

    PubMed

    Katsulis, Yasmina; Durfee, Alesha; Lopez, Vera; Robillard, Alyssa

    2015-05-01

    For sex workers, differences in rates of exposure to workplace violence are likely influenced by a variety of risk factors, including where one works and under what circumstances. Economic stressors, such as housing insecurity, may also increase the likelihood of exposure. Bivariate analyses demonstrate statistically significant associations between workplace violence and selected predictor variables, including age, drug use, exchanging sex for goods, soliciting clients outdoors, and experiencing housing insecurity. Multivariate regression analysis shows that after controlling for each of these variables in one model, only soliciting clients outdoors and housing insecurity emerge as statistically significant predictors for workplace violence. © The Author(s) 2014.

  7. Self-efficacy, stress, and acculturation as predictors of first year science success among Latinos at a South Texas university

    NASA Astrophysics Data System (ADS)

    McNamara, Mark W.

    The study tested the hypothesis that self-efficacy, stress, and acculturation are useful predictors of academic achievement in first year university science, independent of high school GPA and SAT scores, in a sample of Latino students at a South Texas Hispanic serving institution of higher education. The correlational study employed a mixed methods explanatory sequential model. The non-probability sample consisted of 98 university science and engineering students. The study participants had high science self-efficacy, low number of stressors, and were slightly Anglo-oriented bicultural to strongly Anglo-oriented. As expected, the control variables of SAT score and high school GPA were statistically significant predictors of the outcome measures. Together, they accounted for 19.80% of the variation in first year GPA, 13.80% of the variation in earned credit hours, and 11.30% of the variation in intent to remain in the science major. After controlling for SAT scores and high school GPAs, self-efficacy was a statistically significant predictor of credit hours earned and accounted for 5.60% of the variation; its unique contribution in explaining the variation in first year GPA and intent to remain in the science major was not statistically significant. Stress and acculturation were not statistically significant predictors of any of the outcome measures. Analysis of the qualitative data resulted in six themes (a) high science self-efficacy, (b) stressors, (c) positive role of stress, (d) Anglo-oriented, (e) bicultural, and (f) family. The quantitative and qualitative results were synthesized and practical implications were discussed.

  8. A Statistical Analysis of the Economic Drivers of Battery Energy Storage in Commercial Buildings: Preprint

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

    Long, Matthew; Simpkins, Travis; Cutler, Dylan

    There is significant interest in using battery energy storage systems (BESS) to reduce peak demand charges, and therefore the life cycle cost of electricity, in commercial buildings. This paper explores the drivers of economic viability of BESS in commercial buildings through statistical analysis. A sample population of buildings was generated, a techno-economic optimization model was used to size and dispatch the BESS, and the resulting optimal BESS sizes were analyzed for relevant predictor variables. Explanatory regression analyses were used to demonstrate that peak demand charges are the most significant predictor of an economically viable battery, and that the shape ofmore » the load profile is the most significant predictor of the size of the battery.« less

  9. A Statistical Analysis of the Economic Drivers of Battery Energy Storage in Commercial Buildings

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

    Long, Matthew; Simpkins, Travis; Cutler, Dylan

    There is significant interest in using battery energy storage systems (BESS) to reduce peak demand charges, and therefore the life cycle cost of electricity, in commercial buildings. This paper explores the drivers of economic viability of BESS in commercial buildings through statistical analysis. A sample population of buildings was generated, a techno-economic optimization model was used to size and dispatch the BESS, and the resulting optimal BESS sizes were analyzed for relevant predictor variables. Explanatory regression analyses were used to demonstrate that peak demand charges are the most significant predictor of an economically viable battery, and that the shape ofmore » the load profile is the most significant predictor of the size of the battery.« less

  10. Fish communities of fixed sites in the Western Lake Michigan Drainages, Wisconsin and Michigan, 1993-95

    USGS Publications Warehouse

    Sullivan, D.J.

    1997-01-01

    Canonical correspondence analysis (CCA) revealed that soil credibility was a significant predictor of species composition. Though not statistically significant, land use, soil permeability, and bedrock permeability also were indicated as predictors of fish-species composition by CCA.

  11. Most Likely to Succeed: Exploring Predictor Variables for the Counselor Preparation Comprehensive Examination

    ERIC Educational Resources Information Center

    Hartwig, Elizabeth Kjellstrand; Van Overschelde, James P.

    2016-01-01

    The authors investigated predictor variables for the Counselor Preparation Comprehensive Examination (CPCE) to examine whether academic variables, demographic variables, and test version were associated with graduate counseling students' CPCE scores. Multiple regression analyses revealed all 3 variables were statistically significant predictors of…

  12. Quantitatively measured tremor in hand-arm vibration-exposed workers.

    PubMed

    Edlund, Maria; Burström, Lage; Hagberg, Mats; Lundström, Ronnie; Nilsson, Tohr; Sandén, Helena; Wastensson, Gunilla

    2015-04-01

    The aim of the present study was to investigate the possible increase in hand tremor in relation to hand-arm vibration (HAV) exposure in a cohort of exposed and unexposed workers. Participants were 178 male workers with or without exposure to HAV. The study is cross-sectional regarding the outcome of tremor and has a longitudinal design with respect to exposure. The dose of HAV exposure was collected via questionnaires and measurements at several follow-ups. The CATSYS Tremor Pen(®) was used for measuring postural tremor. Multiple linear regression methods were used to analyze associations between different tremor variables and HAV exposure, along with predictor variables with biological relevance. There were no statistically significant associations between the different tremor variables and cumulative HAV or current exposure. Age was a statistically significant predictor of variation in tremor outcomes for three of the four tremor variables, whereas nicotine use was a statistically significant predictor of either left or right hand or both hands for all four tremor variables. In the present study, there was no evidence of an exposure-response association between HAV exposure and measured postural tremor. Increase in age and nicotine use appeared to be the strongest predictors of tremor.

  13. Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery.

    PubMed

    von Arx, Thomas; Jensen, Simon Storgård; Hänni, Stefan

    2007-02-01

    This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

  14. Physical Activity and Perceived Self-Efficacy in Older Adults.

    ERIC Educational Resources Information Center

    Langan, Mary E.; Marotta, Sylvia A.

    2000-01-01

    The purpose of this study was to examine predictors of self-efficacy in older adults, with physical activity, age, and sex as the predictor variables. Regression analyses revealed physical activity to be the only statistically significant predictor of self-efficacy. These findings may be of interest to counselors who work with older people.…

  15. Publication of statistically significant research findings in prosthodontics & implant dentistry in the context of other dental specialties.

    PubMed

    Papageorgiou, Spyridon N; Kloukos, Dimitrios; Petridis, Haralampos; Pandis, Nikolaos

    2015-10-01

    To assess the hypothesis that there is excessive reporting of statistically significant studies published in prosthodontic and implantology journals, which could indicate selective publication. The last 30 issues of 9 journals in prosthodontics and implant dentistry were hand-searched for articles with statistical analyses. The percentages of significant and non-significant results were tabulated by parameter of interest. Univariable/multivariable logistic regression analyses were applied to identify possible predictors of reporting statistically significance findings. The results of this study were compared with similar studies in dentistry with random-effects meta-analyses. From the 2323 included studies 71% of them reported statistically significant results, with the significant results ranging from 47% to 86%. Multivariable modeling identified that geographical area and involvement of statistician were predictors of statistically significant results. Compared to interventional studies, the odds that in vitro and observational studies would report statistically significant results was increased by 1.20 times (OR: 2.20, 95% CI: 1.66-2.92) and 0.35 times (OR: 1.35, 95% CI: 1.05-1.73), respectively. The probability of statistically significant results from randomized controlled trials was significantly lower compared to various study designs (difference: 30%, 95% CI: 11-49%). Likewise the probability of statistically significant results in prosthodontics and implant dentistry was lower compared to other dental specialties, but this result did not reach statistical significant (P>0.05). The majority of studies identified in the fields of prosthodontics and implant dentistry presented statistically significant results. The same trend existed in publications of other specialties in dentistry. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. The role of enamel thickness and refractive index on human tooth colour.

    PubMed

    Oguro, Rena; Nakajima, Masatoshi; Seki, Naoko; Sadr, Alireza; Tagami, Junji; Sumi, Yasunori

    2016-08-01

    To investigate the role of enamel thickness and refractive index (n) on tooth colour. The colour and enamel thickness of fifteen extracted human central incisors were determined according to CIELab colour scale using spectrophotometer (Crystaleye) and swept-source optical coherence tomography (SS-OCT), respectively. Subsequently, labial enamel was trimmed by approximately 100μm, and the colour and remaining enamel thickness were investigated again. This cycle was repeated until dentin appeared. Enamel blocks were prepared from the same teeth and their n were obtained using SS-OCT. Multiple regression analysis was performed to reveal any effects of enamel thickness and n on colour difference (ΔE00) and differences in colour parameters with CIELCh and CIELab colour scales. Multiple regression analysis revealed that enamel thickness (p=0.02) and n of enamel (p<0.001) were statistically significant predictors of ΔE00 after complete enamel trimming. The n was also a significant predictor of ΔH' (p=0.01). Enamel thickness and n were not statistically significant predictors of ΔL', ΔC', Δa* and Δb*. Enamel affected tooth colour, in which n was a statistically significant predictor for tooth colour change. Understanding the role of enamel in tooth colour could contribute to development of aesthetic restorative materials that mimic the colour of natural tooth with minimal reduction of the existing enamel. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Factors influencing teamwork and collaboration within a tertiary medical center

    PubMed Central

    Chien, Shu Feng; Wan, Thomas TH; Chen, Yu-Chih

    2012-01-01

    AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton’s Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R2 = 0.59) and in collaboration (R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled. CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive to intra-organizational collaboration. PMID:25237612

  18. Uncertainties of statistical downscaling from predictor selection: Equifinality and transferability

    NASA Astrophysics Data System (ADS)

    Fu, Guobin; Charles, Stephen P.; Chiew, Francis H. S.; Ekström, Marie; Potter, Nick J.

    2018-05-01

    The nonhomogeneous hidden Markov model (NHMM) statistical downscaling model, 38 catchments in southeast Australia and 19 general circulation models (GCMs) were used in this study to demonstrate statistical downscaling uncertainties caused by equifinality to and transferability. That is to say, there could be multiple sets of predictors that give similar daily rainfall simulation results for both calibration and validation periods, but project different amounts (or even directions of change) of rainfall changing in the future. Results indicated that two sets of predictors (Set 1 with predictors of sea level pressure north-south gradient, u-wind at 700 hPa, v-wind at 700 hPa, and specific humidity at 700 hPa and Set 2 with predictors of sea level pressure north-south gradient, u-wind at 700 hPa, v-wind at 700 hPa, and dewpoint temperature depression at 850 hPa) as inputs to the NHMM produced satisfactory results of seasonal rainfall in comparison with observations. For example, during the model calibration period, the relative errors across the 38 catchments ranged from 0.48 to 1.76% with a mean value of 1.09% for the predictor Set 1, and from 0.22 to 2.24% with a mean value of 1.16% for the predictor Set 2. However, the changes of future rainfall from NHMM projections based on 19 GCMs produced projections with a different sign for these two different sets of predictors: Set 1 predictors project an increase of future rainfall with magnitudes depending on future time periods and emission scenarios, but Set 2 predictors project a decline of future rainfall. Such divergent projections may present a significant challenge for applications of statistical downscaling as well as climate change impact studies, and could potentially imply caveats in many existing studies in the literature.

  19. Determining the Statistical Significance of Relative Weights

    ERIC Educational Resources Information Center

    Tonidandel, Scott; LeBreton, James M.; Johnson, Jeff W.

    2009-01-01

    Relative weight analysis is a procedure for estimating the relative importance of correlated predictors in a regression equation. Because the sampling distribution of relative weights is unknown, researchers using relative weight analysis are unable to make judgments regarding the statistical significance of the relative weights. J. W. Johnson…

  20. Can Money Buy Happiness? A Statistical Analysis of Predictors for User Satisfaction

    ERIC Educational Resources Information Center

    Hunter, Ben; Perret, Robert

    2011-01-01

    2007 data from LibQUAL+[TM] and the ACRL Library Trends and Statistics database were analyzed to determine if there is a statistically significant correlation between library expenditures and usage statistics and library patron satisfaction across 73 universities. The results show that users of larger, better funded libraries have higher…

  1. Does transport time help explain the high trauma mortality rates in rural areas? New and traditional predictors assessed by new and traditional statistical methods

    PubMed Central

    Røislien, Jo; Lossius, Hans Morten; Kristiansen, Thomas

    2015-01-01

    Background Trauma is a leading global cause of death. Trauma mortality rates are higher in rural areas, constituting a challenge for quality and equality in trauma care. The aim of the study was to explore population density and transport time to hospital care as possible predictors of geographical differences in mortality rates, and to what extent choice of statistical method might affect the analytical results and accompanying clinical conclusions. Methods Using data from the Norwegian Cause of Death registry, deaths from external causes 1998–2007 were analysed. Norway consists of 434 municipalities, and municipality population density and travel time to hospital care were entered as predictors of municipality mortality rates in univariate and multiple regression models of increasing model complexity. We fitted linear regression models with continuous and categorised predictors, as well as piecewise linear and generalised additive models (GAMs). Models were compared using Akaike's information criterion (AIC). Results Population density was an independent predictor of trauma mortality rates, while the contribution of transport time to hospital care was highly dependent on choice of statistical model. A multiple GAM or piecewise linear model was superior, and similar, in terms of AIC. However, while transport time was statistically significant in multiple models with piecewise linear or categorised predictors, it was not in GAM or standard linear regression. Conclusions Population density is an independent predictor of trauma mortality rates. The added explanatory value of transport time to hospital care is marginal and model-dependent, highlighting the importance of exploring several statistical models when studying complex associations in observational data. PMID:25972600

  2. Multicollinearity and Regression Analysis

    NASA Astrophysics Data System (ADS)

    Daoud, Jamal I.

    2017-12-01

    In regression analysis it is obvious to have a correlation between the response and predictor(s), but having correlation among predictors is something undesired. The number of predictors included in the regression model depends on many factors among which, historical data, experience, etc. At the end selection of most important predictors is something objective due to the researcher. Multicollinearity is a phenomena when two or more predictors are correlated, if this happens, the standard error of the coefficients will increase [8]. Increased standard errors means that the coefficients for some or all independent variables may be found to be significantly different from In other words, by overinflating the standard errors, multicollinearity makes some variables statistically insignificant when they should be significant. In this paper we focus on the multicollinearity, reasons and consequences on the reliability of the regression model.

  3. Orthotopic bladder substitution in men revisited: identification of continence predictors.

    PubMed

    Koraitim, M M; Atta, M A; Foda, M K

    2006-11-01

    We determined the impact of the functional characteristics of the neobladder and urethral sphincter on continence results, and determined the most significant predictors of continence. A total of 88 male patients 29 to 70 years old underwent orthotopic bladder substitution with tubularized ileocecal segment (40) and detubularized sigmoid (25) or ileum (23). Uroflowmetry, cystometry and urethral pressure profilometry were performed at 13 to 36 months (mean 19) postoperatively. The correlation between urinary continence and 28 urodynamic variables was assessed. Parameters that correlated significantly with continence were entered into a multivariate analysis using a logistic regression model to determine the most significant predictors of continence. Maximum urethral closure pressure was the only parameter that showed a statistically significant correlation with diurnal continence. Nocturnal continence had not only a statistically significant positive correlation with maximum urethral closure pressure, but also statistically significant negative correlations with maximum contraction amplitude, and baseline pressure at mid and maximum capacity. Three of these 4 parameters, including maximum urethral closure pressure, maximum contraction amplitude and baseline pressure at mid capacity, proved to be significant predictors of continence on multivariate analysis. While daytime continence is determined by maximum urethral closure pressure, during the night it is the net result of 2 forces that have about equal influence but in opposite directions, that is maximum urethral closure pressure vs maximum contraction amplitude plus baseline pressure at mid capacity. Two equations were derived from the logistic regression model to predict the probability of continence after orthotopic bladder substitution, including Z1 (diurnal) = 0.605 + 0.0085 maximum urethral closure pressure and Z2 (nocturnal) = 0.841 + 0.01 [maximum urethral closure pressure - (maximum contraction amplitude + baseline pressure at mid capacity)].

  4. Epidemiological predictors of metabolic syndrome in urban West Bengal, India.

    PubMed

    Chakraborty, Sasthi Narayan; Roy, Sunetra Kaviraj; Rahaman, Md Abdur

    2015-01-01

    Metabolic syndrome is one of the emerging health problems of the world. Its prevalence is high in urban areas. Though pathogenesis is complex, but the interaction of obesity, sedentary lifestyle, dietary, and genetic factors are known as contributing factors. Community-based studies were very few to find out the prevalence or predictors of the syndrome. To ascertain the prevalence and epidemiological predictors of metabolic syndrome. A total of 690 study subjects were chosen by 30 clusters random sampling method from 43 wards of Durgapur city. Data were analyzed in SPSS version 20 software and binary logistic regression was done to find out statistical significance of the predictors. Among 32.75% of the study population was diagnosed as metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III definition with a modification for Asia Pacific cut-off of waist circumference. Odds were more among females (2.43), upper social class (14.89), sedentary lifestyle (17.00), and positive family history. The overall prevalence of metabolic syndrome was high in urban areas of Durgapur. Increased age, female gender, higher social status, sedentary lifestyle, positive family history, and higher education were the statistically significant predictors of metabolic syndrome.

  5. Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis.

    PubMed

    Lewis, G N; Rice, D A; McNair, P J; Kluger, M

    2015-04-01

    Several studies have identified clinical, psychosocial, patient characteristic, and perioperative variables that are associated with persistent postsurgical pain; however, the relative effect of these variables has yet to be quantified. The aim of the study was to provide a systematic review and meta-analysis of predictor variables associated with persistent pain after total knee arthroplasty (TKA). Included studies were required to measure predictor variables prior to or at the time of surgery, include a pain outcome measure at least 3 months post-TKA, and include a statistical analysis of the effect of the predictor variable(s) on the outcome measure. Counts were undertaken of the number of times each predictor was analysed and the number of times it was found to have a significant relationship with persistent pain. Separate meta-analyses were performed to determine the effect size of each predictor on persistent pain. Outcomes from studies implementing uni- and multivariable statistical models were analysed separately. Thirty-two studies involving almost 30 000 patients were included in the review. Preoperative pain was the predictor that most commonly demonstrated a significant relationship with persistent pain across uni- and multivariable analyses. In the meta-analyses of data from univariate models, the largest effect sizes were found for: other pain sites, catastrophizing, and depression. For data from multivariate models, significant effects were evident for: catastrophizing, preoperative pain, mental health, and comorbidities. Catastrophizing, mental health, preoperative knee pain, and pain at other sites are the strongest independent predictors of persistent pain after TKA. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Temperature and Humidity Effects on Hospital Morbidity in Darwin, Australia.

    PubMed

    Goldie, James; Sherwood, Steven C; Green, Donna; Alexander, Lisa

    2015-01-01

    Many studies have explored the relationship between temperature and health in the context of a changing climate, but few have considered the effects of humidity, particularly in tropical locations, on human health and well-being. To investigate this potential relationship, this study assessed the main and interacting effects of daily temperature and humidity on hospital admission rates for selected heat-relevant diagnoses in Darwin, Australia. Univariate and bivariate Poisson generalized linear models were used to find statistically significant predictors and the admission rates within bins of predictors were compared to explore nonlinear effects. The analysis indicated that nighttime humidity was the most statistically significant predictor (P < 0.001), followed by daytime temperature and average daily humidity (P < 0.05). There was no evidence of a significant interaction between them or other predictors. The nighttime humidity effect appeared to be strongly nonlinear: Hot days appeared to have higher admission rates when they were preceded by high nighttime humidity. From this analysis, we suggest that heat-health policies in tropical regions similar to Darwin need to accommodate the effects of temperature and humidity at different times of day. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Exercise and Bone Mineral Density in Premenopausal Women: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Kelley, George A.; Kelley, Kristi S.; Kohrt, Wendy M.

    2013-01-01

    Objective. Examine the effects of exercise on femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) in premenopausal women. Methods. Meta-analysis of randomized controlled exercise trials ≥24 weeks in premenopausal women. Standardized effect sizes (g) were calculated for each result and pooled using random-effects models, Z score alpha values, 95% confidence intervals (CIs), and number needed to treat (NNT). Heterogeneity was examined using Q and I 2. Moderator and predictor analyses using mixed-effects ANOVA and simple metaregression were conducted. Statistical significance was set at P ≤ 0.05. Results. Statistically significant improvements were found for both FN (7g's, 466 participants, g = 0.342, 95%  CI = 0.132, 0.553, P = 0.001, Q = 10.8, P = 0.22, I 2 = 25.7%, NNT = 5) and LS (6g's, 402 participants, g = 0.201, 95%  CI = 0.009, 0.394, P = 0.04, Q = 3.3, P = 0.65, I 2 = 0%, NNT = 9) BMD. A trend for greater benefits in FN BMD was observed for studies published in countries other than the United States and for those who participated in home versus facility-based exercise. Statistically significant, or a trend for statistically significant, associations were observed for 7 different moderators and predictors, 6 for FN BMD and 1 for LS BMD. Conclusions. Exercise benefits FN and LS BMD in premenopausal women. The observed moderators and predictors deserve further investigation in well-designed randomized controlled trials. PMID:23401684

  8. Exercise and bone mineral density in premenopausal women: a meta-analysis of randomized controlled trials.

    PubMed

    Kelley, George A; Kelley, Kristi S; Kohrt, Wendy M

    2013-01-01

    Objective. Examine the effects of exercise on femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) in premenopausal women. Methods. Meta-analysis of randomized controlled exercise trials ≥24 weeks in premenopausal women. Standardized effect sizes (g) were calculated for each result and pooled using random-effects models, Z score alpha values, 95% confidence intervals (CIs), and number needed to treat (NNT). Heterogeneity was examined using Q and I(2). Moderator and predictor analyses using mixed-effects ANOVA and simple metaregression were conducted. Statistical significance was set at P ≤ 0.05. Results. Statistically significant improvements were found for both FN (7g's, 466 participants, g = 0.342, 95%  CI = 0.132, 0.553, P = 0.001, Q = 10.8, P = 0.22, I(2) = 25.7%, NNT = 5) and LS (6g's, 402 participants, g = 0.201, 95%  CI = 0.009, 0.394, P = 0.04, Q = 3.3, P = 0.65, I(2) = 0%, NNT = 9) BMD. A trend for greater benefits in FN BMD was observed for studies published in countries other than the United States and for those who participated in home versus facility-based exercise. Statistically significant, or a trend for statistically significant, associations were observed for 7 different moderators and predictors, 6 for FN BMD and 1 for LS BMD. Conclusions. Exercise benefits FN and LS BMD in premenopausal women. The observed moderators and predictors deserve further investigation in well-designed randomized controlled trials.

  9. Lymph node ratio may predict relapse free survival and overall survival in patients with stage II & III colorectal carcinoma.

    PubMed

    Zekri, Jamal; Ahmad, Imran; Fawzy, Ehab; Elkhodary, Tawfik R; Al-Gahmi, Aboelkhair; Hassouna, Ashraf; El Sayed, Mohamed E; Ur Rehman, Jalil; Karim, Syed M; Bin Sadiq, Bakr

    2015-01-01

    Lymph node ratio (LNR) defined as the number of lymph nodes (LNs) involved with metastases divided by number of LNs examined, has been shown to be an independent prognostic factor in breast, stomach and various other solid tumors. Its significance as a prognostic determinant in colorectal cancer (CRC) is still under investigation. This study investigated the prognostic value of LNR in patients with resected CRC. We retrospectively ex- amined 145 patients with stage II & III CRC diagnosed and treated at a single institution during 9 years pe- riod. Patients were grouped according to LNR in three groups. Group 1; LNR < 0.05, Group 2; LNR = 0.05-0.19 & Group 3 > 0.19. Chi square, life table analysis and multivariate Cox regression were used for statistical analysis. On multivariate analysis, number of involved LNs (NILN) (HR = 1.15, 95% CI 1.055-1.245; P = 0.001) and pathological T stage (P = 0.002) were statistically significant predictors of relapse free survival (RFS). LNR as a continuous variable (but not as a categorical variable) was statistically significant predictor of RFS (P = 0.02). LNR was also a statistically significant predictor of overall survival (OS) (P = 0.02). LNR may predict RFS and OS in patients with resected stage II & III CRC. Studies with larger cohorts and longer follow up are needed to further examine and validate theprognostic value of LNR.

  10. Prognostic significance of electrical alternans versus signal averaged electrocardiography in predicting the outcome of electrophysiological testing and arrhythmia-free survival

    NASA Technical Reports Server (NTRS)

    Armoundas, A. A.; Rosenbaum, D. S.; Ruskin, J. N.; Garan, H.; Cohen, R. J.

    1998-01-01

    OBJECTIVE: To investigate the accuracy of signal averaged electrocardiography (SAECG) and measurement of microvolt level T wave alternans as predictors of susceptibility to ventricular arrhythmias. DESIGN: Analysis of new data from a previously published prospective investigation. SETTING: Electrophysiology laboratory of a major referral hospital. PATIENTS AND INTERVENTIONS: 43 patients, not on class I or class III antiarrhythmic drug treatment, undergoing invasive electrophysiological testing had SAECG and T wave alternans measurements. The SAECG was considered positive in the presence of one (SAECG-I) or two (SAECG-II) of three standard criteria. T wave alternans was considered positive if the alternans ratio exceeded 3.0. MAIN OUTCOME MEASURES: Inducibility of sustained ventricular tachycardia or fibrillation during electrophysiological testing, and 20 month arrhythmia-free survival. RESULTS: The accuracy of T wave alternans in predicting the outcome of electrophysiological testing was 84% (p < 0.0001). Neither SAECG-I (accuracy 60%; p < 0.29) nor SAECG-II (accuracy 71%; p < 0.10) was a statistically significant predictor of electrophysiological testing. SAECG, T wave alternans, electrophysiological testing, and follow up data were available in 36 patients while not on class I or III antiarrhythmic agents. The accuracy of T wave alternans in predicting the outcome of arrhythmia-free survival was 86% (p < 0.030). Neither SAECG-I (accuracy 65%; p < 0.21) nor SAECG-II (accuracy 71%; p < 0.48) was a statistically significant predictor of arrhythmia-free survival. CONCLUSIONS: T wave alternans was a highly significant predictor of the outcome of electrophysiological testing and arrhythmia-free survival, while SAECG was not a statistically significant predictor. Although these results need to be confirmed in prospective clinical studies, they suggest that T wave alternans may serve as a non-invasive probe for screening high risk populations for malignant ventricular arrhythmias.

  11. Is parenting style a predictor of suicide attempts in a representative sample of adolescents?

    PubMed

    Donath, Carolin; Graessel, Elmar; Baier, Dirk; Bleich, Stefan; Hillemacher, Thomas

    2014-04-26

    Suicidal ideation and suicide attempts are serious but not rare conditions in adolescents. However, there are several research and practical suicide-prevention initiatives that discuss the possibility of preventing serious self-harm. Profound knowledge about risk and protective factors is therefore necessary. The aim of this study is a) to clarify the role of parenting behavior and parenting styles in adolescents' suicide attempts and b) to identify other statistically significant and clinically relevant risk and protective factors for suicide attempts in a representative sample of German adolescents. In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was conducted. In this survey, the lifetime prevalence of suicide attempts was investigated as well as potential predictors including parenting behavior. A three-step statistical analysis was carried out: I) As basic model, the association between parenting and suicide attempts was explored via binary logistic regression controlled for age and sex. II) The predictive values of 13 additional potential risk/protective factors were analyzed with single binary logistic regression analyses for each predictor alone. Non-significant predictors were excluded in Step III. III) In a multivariate binary logistic regression analysis, all significant predictor variables from Step II and the parenting styles were included after testing for multicollinearity. Three parental variables showed a relevant association with suicide attempts in adolescents - (all protective): mother's warmth and father's warmth in childhood and mother's control in adolescence (Step I). In the full model (Step III), Authoritative parenting (protective: OR: .79) and Rejecting-Neglecting parenting (risk: OR: 1.63) were identified as significant predictors (p < .001) for suicidal attempts. Seven further variables were interpreted to be statistically significant and clinically relevant: ADHD, female sex, smoking, Binge Drinking, absenteeism/truancy, migration background, and parental separation events. Parenting style does matter. While children of Authoritative parents profit, children of Rejecting-Neglecting parents are put at risk - as we were able to show for suicide attempts in adolescence. Some of the identified risk factors contribute new knowledge and potential areas of intervention for special groups such as migrants or children diagnosed with ADHD.

  12. Incidence of workers compensation indemnity claims across socio-demographic and job characteristics.

    PubMed

    Du, Juan; Leigh, J Paul

    2011-10-01

    We hypothesized that low socioeconomic status, employer-provided health insurance, low wages, and overtime were predictors of reporting workers compensation indemnity claims. We also tested for gender and race disparities. Responses from 17,190 (person-years) Americans participating in the Panel Study of Income Dynamics, 1997-2005, were analyzed with logistic regressions. The dependent variable indicated whether the subject collected benefits from a claim. Odds ratios for men and African-Americans were relatively large and strongly significant predictors of claims; significance for Hispanics was moderate and confounded by education. Odds ratios for variables measuring education were the largest for all statistically significant covariates. Neither low wages nor employer-provided health insurance was a consistent predictor. Due to confounding from the "not salaried" variable, overtime was not a consistently significant predictor. Few studies use nationally representative longitudinal data to consider which demographic and job characteristics predict reporting workers compensation indemnity cases. This study did and tested some common hypotheses about predictors. Copyright © 2011 Wiley-Liss, Inc.

  13. Psychosocial Predictors for Cancer Prevention Behaviors in Workplace Using Protection Motivation Theory.

    PubMed

    Zare Sakhvidi, Mohammad Javad; Zare, Maryam; Mostaghaci, Mehrdad; Mehrparvar, Amir Houshang; Morowatisharifabad, Mohammad Ali; Naghshineh, Elham

    2015-01-01

    Backgrounds. The aim of this study was to describe the preventive behaviors of industrial workers and factors influencing occupational cancer prevention behaviors using protection motivation theory. Methods. A self-administered questionnaire was completed by 161 petrochemical workers in Iran in 2014 which consisted of three sections: background information, protection motivation theory measures, and occupational cancers preventive behaviors. Results. A statistically significant positive correlation was found between PM and self-efficacy, response efficacy, and the cancer preventive behaviors. Meanwhile, statistically significant negative correlations were found between PM, cost, and reward. Conclusions. Among available PMT constructs, only self-efficacy and cost were significant predictors of preventive behaviors. Protection motivation model based health promotion interventions with focus on self-efficacy and cost would be desirable in the case of occupational cancers prevention.

  14. Psychosocial Predictors for Cancer Prevention Behaviors in Workplace Using Protection Motivation Theory

    PubMed Central

    Zare Sakhvidi, Mohammad Javad; Zare, Maryam; Mehrparvar, Amir Houshang; Morowatisharifabad, Mohammad Ali; Naghshineh, Elham

    2015-01-01

    Backgrounds. The aim of this study was to describe the preventive behaviors of industrial workers and factors influencing occupational cancer prevention behaviors using protection motivation theory. Methods. A self-administered questionnaire was completed by 161 petrochemical workers in Iran in 2014 which consisted of three sections: background information, protection motivation theory measures, and occupational cancers preventive behaviors. Results. A statistically significant positive correlation was found between PM and self-efficacy, response efficacy, and the cancer preventive behaviors. Meanwhile, statistically significant negative correlations were found between PM, cost, and reward. Conclusions. Among available PMT constructs, only self-efficacy and cost were significant predictors of preventive behaviors. Protection motivation model based health promotion interventions with focus on self-efficacy and cost would be desirable in the case of occupational cancers prevention. PMID:26543649

  15. Estimating the color of maxillary central incisors based on age and gender

    PubMed Central

    Gozalo-Diaz, David; Johnston, William M.; Wee, Alvin G.

    2008-01-01

    Statement of problem There is no scientific information regarding the selection of the color of teeth for edentulous patients. Purpose The purpose of this study was to evaluate linear regression models that may be used to predict color parameters for central incisors of edentulous patients based on some characteristics of dentate subjects. Material and methods A spectroradiometer and an external light source were set in a noncontacting 45/0 degree (45-degree illumination and 0-degree observer) optical configuration to measure the color of subjects’ vital craniofacial structures (maxillary central incisor, attached gingiva, and facial skin). The subjects (n=120) were stratified into 5 age groups with 4 racial groups and balanced for gender. Linear first-order regression was used to determine the significant factors (α=.05) in the prediction model for each color direction of the color of the maxillary central incisor. Age, gender, and color of the other craniofacial structures were studied as potential predictors. Final predictions in each color direction were based only on the statistically significant factors, and then the color differences between observed and predicted CIELAB values for the central incisors were calculated and summarized. Results The statistically significant predictors of age and gender accounted for 36% of the total variability in L*. The statistically significant predictor of age accounted for 16% of the total variability in a*. The statistically significant predictors of age and gender accounted for 21% of the variability in b*. The mean ΔE (SD) between predicted and observed CIELAB values for the central incisor was 5.8 (3.2). Conclusions Age and gender were found to be statistically significant determinants in predicting the natural color of central incisors. Although the precision of these predictions was less than the median color difference found for all pairs of teeth studied, and may be considered an acceptable precision, further study is needed to reduce this precision to the limit of detection. Clinical Implications Age is highly correlated with the natural color of the central incisors. When age increases, the central incisor becomes darker, more reddish, and more yellow. Also, the women subjects in this study had lighter and less yellow central incisors than the men. PMID:18672125

  16. Paroxysmal atrial fibrillation prediction method with shorter HRV sequences.

    PubMed

    Boon, K H; Khalil-Hani, M; Malarvili, M B; Sia, C W

    2016-10-01

    This paper proposes a method that predicts the onset of paroxysmal atrial fibrillation (PAF), using heart rate variability (HRV) segments that are shorter than those applied in existing methods, while maintaining good prediction accuracy. PAF is a common cardiac arrhythmia that increases the health risk of a patient, and the development of an accurate predictor of the onset of PAF is clinical important because it increases the possibility to stabilize (electrically) and prevent the onset of atrial arrhythmias with different pacing techniques. We investigate the effect of HRV features extracted from different lengths of HRV segments prior to PAF onset with the proposed PAF prediction method. The pre-processing stage of the predictor includes QRS detection, HRV quantification and ectopic beat correction. Time-domain, frequency-domain, non-linear and bispectrum features are then extracted from the quantified HRV. In the feature selection, the HRV feature set and classifier parameters are optimized simultaneously using an optimization procedure based on genetic algorithm (GA). Both full feature set and statistically significant feature subset are optimized by GA respectively. For the statistically significant feature subset, Mann-Whitney U test is used to filter non-statistical significance features that cannot pass the statistical test at 20% significant level. The final stage of our predictor is the classifier that is based on support vector machine (SVM). A 10-fold cross-validation is applied in performance evaluation, and the proposed method achieves 79.3% prediction accuracy using 15-minutes HRV segment. This accuracy is comparable to that achieved by existing methods that use 30-minutes HRV segments, most of which achieves accuracy of around 80%. More importantly, our method significantly outperforms those that applied segments shorter than 30 minutes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Is parenting style a predictor of suicide attempts in a representative sample of adolescents?

    PubMed Central

    2014-01-01

    Background Suicidal ideation and suicide attempts are serious but not rare conditions in adolescents. However, there are several research and practical suicide-prevention initiatives that discuss the possibility of preventing serious self-harm. Profound knowledge about risk and protective factors is therefore necessary. The aim of this study is a) to clarify the role of parenting behavior and parenting styles in adolescents’ suicide attempts and b) to identify other statistically significant and clinically relevant risk and protective factors for suicide attempts in a representative sample of German adolescents. Methods In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was conducted. In this survey, the lifetime prevalence of suicide attempts was investigated as well as potential predictors including parenting behavior. A three-step statistical analysis was carried out: I) As basic model, the association between parenting and suicide attempts was explored via binary logistic regression controlled for age and sex. II) The predictive values of 13 additional potential risk/protective factors were analyzed with single binary logistic regression analyses for each predictor alone. Non-significant predictors were excluded in Step III. III) In a multivariate binary logistic regression analysis, all significant predictor variables from Step II and the parenting styles were included after testing for multicollinearity. Results Three parental variables showed a relevant association with suicide attempts in adolescents – (all protective): mother’s warmth and father’s warmth in childhood and mother’s control in adolescence (Step I). In the full model (Step III), Authoritative parenting (protective: OR: .79) and Rejecting-Neglecting parenting (risk: OR: 1.63) were identified as significant predictors (p < .001) for suicidal attempts. Seven further variables were interpreted to be statistically significant and clinically relevant: ADHD, female sex, smoking, Binge Drinking, absenteeism/truancy, migration background, and parental separation events. Conclusions Parenting style does matter. While children of Authoritative parents profit, children of Rejecting-Neglecting parents are put at risk – as we were able to show for suicide attempts in adolescence. Some of the identified risk factors contribute new knowledge and potential areas of intervention for special groups such as migrants or children diagnosed with ADHD. PMID:24766881

  18. Quality of life in breast cancer patients--a quantile regression analysis.

    PubMed

    Pourhoseingholi, Mohamad Amin; Safaee, Azadeh; Moghimi-Dehkordi, Bijan; Zeighami, Bahram; Faghihzadeh, Soghrat; Tabatabaee, Hamid Reza; Pourhoseingholi, Asma

    2008-01-01

    Quality of life study has an important role in health care especially in chronic diseases, in clinical judgment and in medical resources supplying. Statistical tools like linear regression are widely used to assess the predictors of quality of life. But when the response is not normal the results are misleading. The aim of this study is to determine the predictors of quality of life in breast cancer patients, using quantile regression model and compare to linear regression. A cross-sectional study conducted on 119 breast cancer patients that admitted and treated in chemotherapy ward of Namazi hospital in Shiraz. We used QLQ-C30 questionnaire to assessment quality of life in these patients. A quantile regression was employed to assess the assocciated factors and the results were compared to linear regression. All analysis carried out using SAS. The mean score for the global health status for breast cancer patients was 64.92+/-11.42. Linear regression showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant. In spite of linear regression, financial difficulties were not significant in quantile regression analysis and dyspnea was only significant for first quartile. Also emotion functioning and duration of disease statistically predicted the QOL score in the third quartile. The results have demonstrated that using quantile regression leads to better interpretation and richer inference about predictors of the breast cancer patient quality of life.

  19. Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

    PubMed Central

    2013-01-01

    Background Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. Methods The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. Results The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. Conclusions Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh. PMID:23297699

  20. Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

    PubMed

    Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

    2017-11-01

    Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity and mortality. Epidemiologic/Prognostic, level IV.

  1. The Relationship of Performance on the Dental Admission Test and Performance on Part I of the National Board Dental Examinations.

    ERIC Educational Resources Information Center

    De Ball, Suzanne; Sullivan, Kathleen; Horine, Julie; Duncan, William K.; Replogle, William

    2002-01-01

    Comapred University of Mississippi dental student scores on the Dental Admission Test (DAT) and Part I of the National Board Dental Examinations (NBDE) and found that DAT reading comprehension was a statistically significant predictor of all four subtests of the NBDE. Also found that DAT biology and organic chemistry scores were predictors of NBDE…

  2. Hostility and Learning: A Follow-Up Note

    ERIC Educational Resources Information Center

    Costin, Frank

    1971-01-01

    Hostility scores, as measured by the Scrambled Sentence Test, were found to be statistically significant negative predictors of course achievement in a meteorology course at a military installation. (MS)

  3. Teacher Quality Indicators as Predictors of Instructional Assessment Practices in Science Classrooms in Secondary Schools in Barbados

    NASA Astrophysics Data System (ADS)

    Ogunkola, Babalola J.; Archer-Bradshaw, Ramona E.

    2013-02-01

    This study investigated the self-reported instructional assessment practices of a selected sample of secondary school science teachers in Barbados. The study sought to determine if there were statistically significant differences in the instructional assessment practices of teachers based on their sex and teacher quality (teaching experience, professional qualification and teacher academic qualification). It also sought to determine the extent to which each of these four selected variables individually and jointly affected the teachers' report of their instructional assessment practices. A sample of 55 science teachers from nine secondary schools in Barbados was randomly selected to participate in this study. Data was collected by means of a survey and was analyzed using the means and standard deviations of the instructional assessment practices scores and linear, multiple and binary logistic regression. The results of the study were such that the majority of the sample reported good overall instructional assessment practices while only a few participants reported moderate assessment practices. The instructional assessment practices in the area of student knowledge were mostly moderate as indicated by the sample. There were no statistically significant differences between or among the mean scores of the teachers' reported instructional assessment practices based on sex ( t = 0.10; df = 53; p = 0.992), teaching experience ( F[4,50] = 1.766; p = 0.150), the level of professional qualification (F[3,45] = 0.2117; p = 0.111) or the level of academic qualification (F[2,52] = 0.504; p = 0.607). The independent variables (teacher sex, teaching experience, teacher professional qualification or teacher academic qualification) were not significant predictors of the instructional assessment practices scores. However, teacher sex was a significant predictor of the teachers' report of good instructional assessment practices. The study also found that the joint effect of the variables teacher sex, teaching experience, teacher professional qualification and teacher academic qualification was not significant in predicting the instructional assessment practices scores of the science teachers. However, the joint effect of these variables was statistically significant ( X 2 = 18.482; df = 10; p = 0.047) in predicting the teachers' reported use of good instructional assessment practices. The best predictor of teachers' report of good instructional assessment practices, though not statistically significant, was the diploma in education professional qualification.

  4. Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010.

    PubMed

    Molla, Azaher Ali; Chi, Chunhuei; Mondaca, Alicia Lorena Núñez

    2017-01-31

    Predictors of high out-of-pocket household healthcare expenditure are essential for creating effective health system finance policy. In Bangladesh, 63.3% of health expenditure is out-of-pocket and born by households. It is imperative to know what determines household health expenditure. This study aims to investigate the predicting factors of high out-of-pocket household healthcare expenditure targeting to put forward policy recommendations on equity in financial burden. Bangladesh household income and expenditure survey 2010 provides data for this study. Predictors of high out-of-pocket household healthcare expenditure were analyzed using multiple linear regressions. We have modeled non-linear relationship using logarithmic form of linear regression. Heteroscedasticity and multicollinearity were checked using Breusch-Pagan/Cook-Weishberg and VIF tests. Normality of the residuals was checked using Kernel density curve. We applied required adjustment for survey data, so that standard errors and parameters estimation are valid. Presence of chronic disease and household income were found to be the most influential and statistically significant (p < 0.001) predictors of high household healthcare expenditure. Households in rural areas spend 7% less than urban dwellers. The results show that a 100% increase in female members in a family leads to a 2% decrease in household health expenditure. Household income, health shocks in families, and family size are other statistically significant predictors of household healthcare expenditure. Proportion of elderly and under-five members in the family show some positive influence on health expenditure, though statistically nonsignificant. The findings call for emphasizing prevention of chronic diseases, as it is a strong predictor of household health expenditure. Innovative insurance scheme needs to be devised to prevent household from being impoverished due to health shocks in the family. Policy makers are urged to design an alternative source of healthcare financing in Bangladesh to minimize the burden of high OOP healthcare expenditure.

  5. Antecedents of students' achievement in statistics

    NASA Astrophysics Data System (ADS)

    Awaludin, Izyan Syazana; Razak, Ruzanna Ab; Harris, Hezlin; Selamat, Zarehan

    2015-02-01

    The applications of statistics in most fields have been vast. Many degree programmes at local universities require students to enroll in at least one statistics course. The standard of these courses varies across different degree programmes. This is because of students' diverse academic backgrounds in which some comes far from the field of statistics. The high failure rate in statistics courses for non-science stream students had been concerning every year. The purpose of this research is to investigate the antecedents of students' achievement in statistics. A total of 272 students participated in the survey. Multiple linear regression was applied to examine the relationship between the factors and achievement. We found that statistics anxiety was a significant predictor of students' achievement. We also found that students' age has significant effect to achievement. Older students are more likely to achieve lowers scores in statistics. Student's level of study also has a significant impact on their achievement in statistics.

  6. Impact of Coal Mining on Self-Rated Health among Appalachian Residents

    PubMed Central

    Woolley, Shannon M.; Bear, Todd M.; Balmert, Lauren C.; Talbott, Evelyn O.; Buchanich, Jeanine M.

    2015-01-01

    Objective. To determine the impact of coal mining, measured as the number of coal mining-related facilities nearby one's residence or employment in an occupation directly related to coal mining, on self-rated health in Appalachia. Methods. Unadjusted and adjusted ordinal logistic regression models calculated odds ratio estimates and associated 95% confidence intervals for the probability of having an excellent self-rated health response versus another response. Covariates considered in the analyses included number of coal mining-related facilities nearby one's residence and employment in an occupation directly related to coal mining, as well as potential confounders age, sex, BMI, smoking status, income, and education. Results. The number of coal mining facilities near the respondent's residence was not a statistically significant predictor of self-rated health. Employment in a coal-related occupation was a statistically significant predictor of self-rated health univariably; however, after adjusting for potential confounders, it was no longer a significant predictor. Conclusions. Self-rated health does not seem to be associated with residential proximity to coal mining facilities or employment in the coal industry. Future research should consider additional measures for the impact of coal mining. PMID:26240577

  7. Relation between myocardial infarction, depression, hostility, and death.

    PubMed

    Kaufmann, M W; Fitzgibbons, J P; Sussman, E J; Reed, J F; Einfalt, J M; Rodgers, J K; Fricchione, G L

    1999-09-01

    To examine the independent impact of major depression and hostility on mortality rate at 6 months and 12 months after discharge from the hospital in patients with a myocardial infarction. Three hundred thirty-one patients were prospectively evaluated for depression with a modified version of the National Institute of Mental Health Diagnostic Interview Schedule for major depressive episode. The Cook Medley Hostility Scale data were analyzed by chi(2) procedures for nominal and categoric data, and Student t test was used for continuous data types. Depression was a significant predictor of death at 12 months (P =. 04) but not at 6 months (P =.08). Hostility was not found to be a predictor of death at 6 months or 12 months. Major depression in patients hospitalized after myocardial infarction is a significant univariable predictor of death at 12 months, although it was not a statistically significant predictor after adjusting for other variables. Hostility is not a predictor of death. Prospective studies are needed to determine the impact of aggressive treatment of depression on post-myocardial infarction survival.

  8. Latinos in science: Identifying factors that influence the low percentage of Latino representation in the sciences

    NASA Astrophysics Data System (ADS)

    Miranda, Susan Jennifer

    A mixed methods approach was used to identify factors that influence the underrepresentation of Latinos in the domain of science. The researcher investigated the role of family influences, academic preparation, and personal motivations to determine science-related career choices by Latinos. Binary logistic regression analyses were conducted using information from Latinos gathered from the National Education Longitudinal Study of 1988 (NELS: 88) administered by the National Center for Education Statistics. For the present study, data were analyzed using participants' responses as high school seniors, college students, and post-baccalaureates. Students responded to questions on school, work, parental academic influences, personal aspirations, and self-perception. To provide more insight into the experiences of Latinos in science and support the statistical analyses, nine students majoring in science in a private, urban university located in the northeastern part of the country were interviewed. Eleven variables related to parents' academic support and students' perceptions of parental support were taken together as predictors for two separate criteria from the survey. These results identified parents' level of education and the importance of academics to parents in their teen's college choice as significant predictors in determining college major in science. When the criterion was degree in science, the significant predictor was the frequency parents contacted high school as volunteers. Student interviews supported this information, demonstrating the importance of parental support in attaining a degree in science. Academic preparation was also analyzed. Students' reasons for taking science classes in high school was a significant predictor for science major; significant predictors for science degree were the emphasis placed on objectives in math and science classes and number of courses in biology and physics. Student interviews supported this information and demonstrated the influence their own motivation placed on their goals. Survey data were also obtained about the students' test scores and academic achievement. Data collected from the statistical and interview components of the study developed a greater understanding for the lack of Latinos in the sciences as influenced by personal and familial factors.

  9. A SIGNIFICANCE TEST FOR THE LASSO1

    PubMed Central

    Lockhart, Richard; Taylor, Jonathan; Tibshirani, Ryan J.; Tibshirani, Robert

    2014-01-01

    In the sparse linear regression setting, we consider testing the significance of the predictor variable that enters the current lasso model, in the sequence of models visited along the lasso solution path. We propose a simple test statistic based on lasso fitted values, called the covariance test statistic, and show that when the true model is linear, this statistic has an Exp(1) asymptotic distribution under the null hypothesis (the null being that all truly active variables are contained in the current lasso model). Our proof of this result for the special case of the first predictor to enter the model (i.e., testing for a single significant predictor variable against the global null) requires only weak assumptions on the predictor matrix X. On the other hand, our proof for a general step in the lasso path places further technical assumptions on X and the generative model, but still allows for the important high-dimensional case p > n, and does not necessarily require that the current lasso model achieves perfect recovery of the truly active variables. Of course, for testing the significance of an additional variable between two nested linear models, one typically uses the chi-squared test, comparing the drop in residual sum of squares (RSS) to a χ12 distribution. But when this additional variable is not fixed, and has been chosen adaptively or greedily, this test is no longer appropriate: adaptivity makes the drop in RSS stochastically much larger than χ12 under the null hypothesis. Our analysis explicitly accounts for adaptivity, as it must, since the lasso builds an adaptive sequence of linear models as the tuning parameter λ decreases. In this analysis, shrinkage plays a key role: though additional variables are chosen adaptively, the coefficients of lasso active variables are shrunken due to the l1 penalty. Therefore, the test statistic (which is based on lasso fitted values) is in a sense balanced by these two opposing properties—adaptivity and shrinkage—and its null distribution is tractable and asymptotically Exp(1). PMID:25574062

  10. Seasonal drought predictability in Portugal using statistical-dynamical techniques

    NASA Astrophysics Data System (ADS)

    Ribeiro, A. F. S.; Pires, C. A. L.

    2016-08-01

    Atmospheric forecasting and predictability are important to promote adaption and mitigation measures in order to minimize drought impacts. This study estimates hybrid (statistical-dynamical) long-range forecasts of the regional drought index SPI (3-months) over homogeneous regions from mainland Portugal, based on forecasts from the UKMO operational forecasting system, with lead-times up to 6 months. ERA-Interim reanalysis data is used for the purpose of building a set of SPI predictors integrating recent past information prior to the forecast launching. Then, the advantage of combining predictors with both dynamical and statistical background in the prediction of drought conditions at different lags is evaluated. A two-step hybridization procedure is performed, in which both forecasted and observed 500 hPa geopotential height fields are subjected to a PCA in order to use forecasted PCs and persistent PCs as predictors. A second hybridization step consists on a statistical/hybrid downscaling to the regional SPI, based on regression techniques, after the pre-selection of the statistically significant predictors. The SPI forecasts and the added value of combining dynamical and statistical methods are evaluated in cross-validation mode, using the R2 and binary event scores. Results are obtained for the four seasons and it was found that winter is the most predictable season, and that most of the predictive power is on the large-scale fields from past observations. The hybridization improves the downscaling based on the forecasted PCs, since they provide complementary information (though modest) beyond that of persistent PCs. These findings provide clues about the predictability of the SPI, particularly in Portugal, and may contribute to the predictability of crops yields and to some guidance on users (such as farmers) decision making process.

  11. Prevalence of High Blood Pressure, Heart Disease, Thalassemia, Sickle-Cell Anemia, and Iron-Deficiency Anemia among the UAE Adolescent Population

    PubMed Central

    Barakat-Haddad, Caroline

    2013-01-01

    This study examined the prevalence of high blood pressure, heart disease, and medical diagnoses in relation to blood disorders, among 6,329 adolescent students (age 15 to 18 years) who reside in the United Arab Emirates (UAE). Findings indicated that the overall prevalence of high blood pressure and heart disease was 1.8% and 1.3%, respectively. Overall, the prevalence for thalassemia, sickle-cell anemia, and iron-deficiency anemia was 0.9%, 1.6%, and 5%, respectively. Bivariate analysis revealed statistically significant differences in the prevalence of high blood pressure among the local and expatriate adolescent population in the Emirate of Sharjah. Similarly, statistically significant differences in the prevalence of iron-deficiency anemia were observed among the local and expatriate population in Abu Dhabi city, the western region of Abu Dhabi, and Al-Ain. Multivariate analysis revealed the following significant predictors of high blood pressure: residing in proximity to industry, nonconventional substance abuse, and age when smoking or exposure to smoking began. Ethnicity was a significant predictor of heart disease, thalassemia, sickle-cell anemia, and iron-deficiency anemia. In addition, predictors of thalassemia included gender (female) and participating in physical activity. Participants diagnosed with sickle-cell anemia and iron-deficiency anemia were more likely to experience different physical activities. PMID:23606864

  12. Accounting for disease modifying therapy in models of clinical progression in multiple sclerosis.

    PubMed

    Healy, Brian C; Engler, David; Gholipour, Taha; Weiner, Howard; Bakshi, Rohit; Chitnis, Tanuja

    2011-04-15

    Identifying predictors of clinical progression in patients with relapsing-remitting multiple sclerosis (RRMS) is complicated in the era of disease modifying therapy (DMT) because patients follow many different DMT regimens. To investigate predictors of progression in a treated RRMS sample, a cohort of RRMS patients was prospectively followed in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB). Enrollment criteria were exposure to either interferon-β (IFN-β, n=164) or glatiramer acetate (GA, n=114) for at least 6 months prior to study entry. Baseline demographic and clinical features were used as candidate predictors of longitudinal clinical change on the Expanded Disability Status Scale (EDSS). We compared three approaches to account for DMT effects in statistical modeling. In all approaches, we analyzed all patients together and stratified based on baseline DMT. Model 1 used all available longitudinal EDSS scores, even those after on-study DMT changes. Model 2 used only clinical observations prior to changing DMT. Model 3 used causal statistical models to identify predictors of clinical change. When all patients were considered using Model 1, patients with a motor symptom as the first relapse had significantly larger change in EDSS scores during follow-up (p=0.04); none of the other clinical or demographic variables significantly predicted change. In Models 2 and 3, results were generally unchanged. DMT modeling choice had a modest impact on the variables classified as predictors of EDSS score change. Importantly, however, interpretation of these predictors is dependent upon modeling choice. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Predictors of asymptomatic bacteriuria among obstetric population in Ibadan.

    PubMed

    Awonuga, D O; Awonuga, D A; Fawole, A O; Dada-Adegbola, H O; Dada-Adegbola, H A; Olola, F A; Awonuga, O M

    2010-01-01

    Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended. The general objective of the study was to determine the pattern as well as possible predictors of asymptomatic bacteriuria at the University College Hospital, Ibadan. The study was a descriptive, cross sectional, exploratory survey of the pattern of asymptomatic bacteriuria among all consecutive patients presenting for the first antenatal visit at the University College Hospital, Ibadan during the study period. The prevalence of asymptomatic bacteriuria was 10.7%. Although no statistically significant association was found, the prevalence was higher among women aged between 26 - 35 years (11.5%) and those with only secondary education (14.6%). Other demographic parameters characterized by high rates of bacteriuria were Christian women (12.7% compared to 4.3% among Muslims) and genotypes AS and AC (16.4% and 16.7% respectively). Low parity (para 1-2), 2nd and 3rd trimesters of pregnancy were the identified possible obstetric predictors of bacteriuria in pregnancy. Staphylococcus species constitute the predominant isolates in 3rd trimester and among Muslim pregnant women. Since no statistically significant predictors for bacteriuria in pregnancy were found, routine screening of all our pregnant women for this condition in 2nd trimester is recommended.

  14. Predictors of effects of lifestyle intervention on diabetes mellitus type 2 patients.

    PubMed

    Jacobsen, Ramune; Vadstrup, Eva; Røder, Michael; Frølich, Anne

    2012-01-01

    The main aim of the study was to identify predictors of the effects of lifestyle intervention on diabetes mellitus type 2 patients by means of multivariate analysis. Data from a previously published randomised clinical trial, which compared the effects of a rehabilitation programme including standardised education and physical training sessions in the municipality's health care centre with the same duration of individual counseling in the diabetes outpatient clinic, were used. Data from 143 diabetes patients were analysed. The merged lifestyle intervention resulted in statistically significant improvements in patients' systolic blood pressure, waist circumference, exercise capacity, glycaemic control, and some aspects of general health-related quality of life. The linear multivariate regression models explained 45% to 80% of the variance in these improvements. The baseline outcomes in accordance to the logic of the regression to the mean phenomenon were the only statistically significant and robust predictors in all regression models. These results are important from a clinical point of view as they highlight the more urgent need for and better outcomes following lifestyle intervention for those patients who have worse general and disease-specific health.

  15. Predictors, Moderators, and Mediators of Treatment Outcome Following Manualised Cognitive-Behavioural Therapy for Eating Disorders: A Systematic Review.

    PubMed

    Linardon, Jake; de la Piedad Garcia, Xochitl; Brennan, Leah

    2017-01-01

    This systematic review synthesised the literature on predictors, moderators, and mediators of outcome following Fairburn's CBT for eating disorders. Sixty-five articles were included. The relationship between individual variables and outcome was synthesised separately across diagnoses and treatment format. Early change was found to be a consistent mediator of better outcomes across all eating disorders. Moderators were mostly tested in binge eating disorder, and most moderators did not affect cognitive-behavioural treatment outcome relative to other treatments. No consistent predictors emerged. Findings suggest that it is unclear how and for whom this treatment works. More research testing mediators and moderators is needed, and variables selected for analyses need to be empirically and theoretically driven. Future recommendations include the need for authors to (i) interpret the clinical and statistical significance of findings; (ii) use a consistent definition of outcome so that studies can be directly compared; and (iii) report null and statistically significant findings. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  16. Exploring self-efficacy as a predictor of disease management.

    PubMed

    Clark, N M; Dodge, J A

    1999-02-01

    Self-efficacy is posited in social cognitive theory as fundamental to behavior change. Few health behavior studies have examined self-efficacy prospectively, viewed it as part of a reciprocal behavioral process, or compared self-efficacy beliefs in the same population across different behaviors. This article first discusses self-efficacy in its theoretical context and reviews the available prospective studies. Second, it explores self-efficacy as a predictor of disease management behaviors in 570 older women with heart disease. Although the R2 statistics in each case were modest, the construct is shown to be a statistically significant (p<.05) predictor at both 4 and 12 months postbaseline of several disease management behaviors: using medicine as prescribed, getting adequate exercise, managing stress, and following a recommended diet. Building self-efficacy is likely a reasonable starting point for interventions aiming to enhance heart disease management behaviors of mature female patients.

  17. Change in quality of life and their predictors in the long-term follow-up after group cognitive behavioral therapy for social anxiety disorder: a prospective cohort study

    PubMed Central

    2010-01-01

    Background Social anxiety disorder (SAD) is one of the most common anxiety disorders. The efficacy of cognitive behaviour therapy (CBT) has been examined but to date its effects on Quality of Life (QoL) have not been appropriately evaluated especially in the long term. The study aimed to examine, in the long term, what aspects of Quality of Life (QoL) changed among social anxiety disorder (SAD) patients treated with group cognitive behaviour therapy (CBT) and what predictors at baseline were associated with QoL. Methods Outpatients diagnosed with SAD were enrolled into group CBT, and assessed at follow-ups for up to 12 months in a typical clinical setting. QoL was evaluated using the Short Form 36. Various aspects of SAD symptomatology were also assessed. Each of the QoL domains and scores on symptomatology were quantified and compared with those at baseline. Baseline predictors of QoL outcomes at follow-up were investigated. Results Fifty-seven outpatients were enrolled into group CBT for SAD, 48 completed the whole program, and 44 and 40 completed assessments at the 3-month and 12-month follow-ups, respectively. All aspects of SAD symptomatology and psychological subscales of the QoL showed statistically significant improvement throughout follow-ups for up to 12 months. In terms of social functioning, no statistically significant improvement was observed at either follow-up point except for post-treatment. No consistently significant pre-treatment predictors were observed. Conclusions After group CBT, SAD symptomatology and some aspects of QoL improved and this improvement was maintained for up to 12 months, but the social functioning domain did not prove any significant change statistically. Considering the limited effects of CBT on QoL, especially for social functioning, more powerful treatments are needed. PMID:20942980

  18. The Impact of Individual Differences on E-Learning System Behavioral Intention

    NASA Astrophysics Data System (ADS)

    Liao, Peiwen; Yu, Chien; Yi, Chincheh

    This study investigated the impact of contingent variables on the relationship between four predictors and employees' behavioral intention with e-learning. Seven hundred and twenty-two employees in online training and education were asked to answer questionnaires about their learning styles, perceptions of the quality of the proposed predictors and behavioral intention with e-learning systems. The results of analysis showed that three contingent variables, gender, job title and industry, significantly influenced the perceptions of predictors and employees' behavioral intention with the e-learning system. This study also found a statistically significant moderating effect of two contingent variables, gender, job title and industry, on the relationship between predictors and e-learning system behavioral intention. The results suggest that a serious consideration of contingent variables is crucial for improving e-learning system behavioral intention. The implications of these results for the management of e-learning systems are discussed.

  19. A twelve-year profile of students' SAT scores, GPAs, and MCAT scores from a small university's premedical program.

    PubMed

    Montague, J R; Frei, J K

    1993-04-01

    To determine whether significant correlations existed among quantitative and qualitative predictors of students' academic success and quantitative outcomes of such success over a 12-year period in a small university's premedical program. A database was assembled from information on the 199 graduates who earned BS degrees in biology from Barry University's School of Natural and Health Sciences from 1980 through 1991. The quantitative variables were year of BS degree, total score on the Scholastic Aptitude Test (SAT), various measures of undergraduate grade-point averages (GPAs), and total score on the Medical College Admission Test (MCAT); and the qualitative variables were minority (54% of the students) or majority status and transfer (about one-third of the students) or nontransfer status. The statistical methods were multiple analysis of variance and stepwise multiple regression. Statistically significant positive correlations were found among SAT total scores, final GPAs, biology GPAs versus nonbiology GPAs, and MCAT total scores. These correlations held for transfer versus nontransfer students and for minority versus majority students. Over the 12-year period there were significant fluctuations in mean MCAT scores. The students' SAT scores and GPAs proved to be statistically reliable predictors of MCAT scores, but the minority or majority status and the transfer or nontransfer status of the students were statistically insignificant.

  20. Reading Ability as a Predictor of Academic Procrastination among African American Graduate Students

    ERIC Educational Resources Information Center

    Collins, Kathleen M. T.; Onwuegbuzie, Anthony J.; Jiao, Qun G.

    2008-01-01

    The present study examined the relationship between reading ability (i.e., reading comprehension and reading vocabulary) and academic procrastination among 120 African American graduate students. A canonical correlation analysis revealed statistically significant and practically significant multivariate relationships between these two reading…

  1. Influence of Family Structure on Health among Youths with Diabetes.

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  2. Demographics as predictors of suicidal thoughts and behaviors: A meta-analysis

    PubMed Central

    Huang, Xieyining; Ribeiro, Jessica D.; Musacchio, Katherine M.; Franklin, Joseph C.

    2017-01-01

    Background Certain demographic factors have long been cited to confer risk or protection for suicidal thoughts and behaviors. However, many studies have found weak or non-significant effects. Determining the effect strength and clinical utility of demographics as predictors is crucial for suicide risk assessment and theory development. As such, we conducted a meta-analysis to determine the effect strength and clinical utility of demographics as predictors. Methods We searched PsycInfo, PubMed, and GoogleScholar for studies published before January 1st, 2015. Inclusion criteria required that studies use at least one demographic factor to longitudinally predict suicide ideation, attempt, or death. The initial search yielded 2,541 studies, 159 of which were eligible. A total of 752 unique statistical tests were included in analysis. Results Suicide death was the most commonly studied outcome, followed by attempt and ideation. The average follow-up length was 9.4 years. The overall effects of demographic factors studied in the field as risk factors were significant but weak, and that of demographic factors studied as protective factors were non-significant. Adjusting for publication bias further reduced effect estimates. No specific demographic factors appeared to be strong predictors. The effects were consistent across multiple moderators. Conclusions At least within the narrow methodological constraints of the existing literature, demographic factors were statistically significant risk factors, but not protective factors. Even as risk factors, demographics offer very little improvement in predictive accuracy. Future studies that go beyond the limitations of the existing literature are needed to further understand the effects of demographics. PMID:28700728

  3. Reducing Xerostomia After Chemo-IMRT for Head and Neck Cancer: Beyond Sparing the Parotid Glands

    PubMed Central

    Little, Michael; Schipper, Matthew; Feng, Felix Y.; Vineberg, Karen; Cornwall, Craig; Murdoch-Kinch, Carol-Anne; Eisbruch, Avraham

    2011-01-01

    Purpose To assess whether in addition to sparing parotid glands (PGs), xerostomia after chemo-IMRT of head and neck cancer is affected by reducing doses to other salivary glands. Methods Prospective study: 78 patients with stages III/IV oropharynx/nasopharynx cancers received chemo-IMRT aiming to spare the parts outside the targets of bilateral PGs, oral cavity (OC) containing the minor salivary glands, and contralateral submandibular gland (SMG) (when contralateral level I was not a target). Pretherapy and periodically through 24 months, validated patient-reported xerostomia questionnaires (XQ) scores and observer-graded xerostomia were recorded, and stimulated and unstimulated saliva measured selectively from each of the PGs and SMGs. Mean OC doses served as surrogates of minor salivary glands dysfunction. Regression models assessed XQ and observer-graded xerostomia predictors. Results Statistically significant predictors of the XQ score in univariate analysis included OC, PG, and SMG mean doses, as well as baseline XQ score, time since RT, and both stimulated and unstimulated PG saliva flow rates. Similar factors were statistically significant predictors of observer-graded xerostomia. OC, PG and SMG mean doses were moderately inter-correlated (r=0.47–0.55). In multivariate analyses, after adjusting for PG and SMG doses, OC mean dose (p < 0.0001), time from RT (p < 0.0001), and stimulated PG saliva (p < 0.0025) were significant predictors for XQ scores, and OC mean dose and time for observer-graded xerostomia. While scatter plots showed no thresholds, OC mean doses <40 Gy and contralateral SMG mean <50 Gy were each associated with low patient-reported and observer-rated xerostomia at almost all post-therapy time points. Conclusion PG, SMG and OC mean doses were significant predictors of both patient-reported and observer-rated xerostomia after chemo-IMRT, with OC doses remaining significant after adjusting for PG and SMG doses. These results support efforts to spare all salivary glands by IMRT, beyond the PGs alone. PMID:22056067

  4. Binary recursive partitioning: background, methods, and application to psychology.

    PubMed

    Merkle, Edgar C; Shaffer, Victoria A

    2011-02-01

    Binary recursive partitioning (BRP) is a computationally intensive statistical method that can be used in situations where linear models are often used. Instead of imposing many assumptions to arrive at a tractable statistical model, BRP simply seeks to accurately predict a response variable based on values of predictor variables. The method outputs a decision tree depicting the predictor variables that were related to the response variable, along with the nature of the variables' relationships. No significance tests are involved, and the tree's 'goodness' is judged based on its predictive accuracy. In this paper, we describe BRP methods in a detailed manner and illustrate their use in psychological research. We also provide R code for carrying out the methods.

  5. Age-related variation and predictors of long-term quality of life in germ cell tumor survivors.

    PubMed

    Hartung, Tim J; Mehnert, Anja; Friedrich, Michael; Hartmann, Michael; Vehling, Sigrun; Bokemeyer, Carsten; Oechsle, Karin

    2016-02-01

    To compare long-term health-related quality of life (QoL) in germ cell tumor survivors (GCTS) and age-adjusted men and to identify predictors of variation in long-term QoL in GCTS. We used the Short-Form Health Survey to measure QoL in a cross-sectional sample of 164 survivors of germ cell tumors from Hamburg, Germany. QoL was compared with age-adjusted German norm data. Sociodemographic and medical data from questionnaires and medical records were used to find predictors of QoL. On average, patients were 44.4 years old (standard deviation = 9.6 y) and average time since first germ cell tumor diagnosis was 11.6 years (standard deviation = 7.3 y). We found significantly lower mental component scores in GCTS when compared with norm data (Hedges g =-0.44, P<0.001). An exploratory analysis by age group showed the largest difference in mental QoL in survivors aged 31 to 40 years (Hedges g =-0.67). Linear regression analysis revealed age (β =-0.46, P<0.001), marital status (β = 0.20, P = 0.024), advanced secondary qualifications (β =-0.25, P = 0.001), time since diagnosis (β = 0.17, P = 0.031), and tumor stage (β = 0.17, P = 0.024) as statistically significant predictors of the physical component score, accounting for 22% of the variance. Statistically significant predictors of the mental component score were higher secondary qualifications (β = 0.17, P = 0.033) and unemployment (β =-0.21, P = 0.009), accounting for 6% of the variance. Survivors of germ cell tumors can expect an overall long-term QoL similar to that of other men of their age. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cognitive predictors of balance in Parkinson's disease.

    PubMed

    Fernandes, Ângela; Mendes, Andreia; Rocha, Nuno; Tavares, João Manuel R S

    2016-06-01

    Postural instability is one of the most incapacitating symptoms of Parkinson's disease (PD) and appears to be related to cognitive deficits. This study aims to determine the cognitive factors that can predict deficits in static and dynamic balance in individuals with PD. A sociodemographic questionnaire characterized 52 individuals with PD for this work. The Trail Making Test, Rule Shift Cards Test, and Digit Span Test assessed the executive functions. The static balance was assessed using a plantar pressure platform, and dynamic balance was based on the Timed Up and Go Test. The results were statistically analysed using SPSS Statistics software through linear regression analysis. The results show that a statistically significant model based on cognitive outcomes was able to explain the variance of motor variables. Also, the explanatory value of the model tended to increase with the addition of individual and clinical variables, although the resulting model was not statistically significant The model explained 25-29% of the variability of the Timed Up and Go Test, while for the anteroposterior displacement it was 23-34%, and for the mediolateral displacement it was 24-39%. From the findings, we conclude that the cognitive performance, especially the executive functions, is a predictor of balance deficit in individuals with PD.

  7. Explaining Math Achievement: Personality, Motivation, and Trust

    ERIC Educational Resources Information Center

    Kilic-Bebek, Ebru

    2009-01-01

    This study investigated the statistical significance of student trust next to the well-tested constructs of personality and motivation to determine whether trust is a significant predictor of course achievement in college math courses. Participants were 175 students who were taking undergraduate math courses in an urban public university. The…

  8. Exploring Statistics Anxiety: Contrasting Mathematical, Academic Performance and Trait Psychological Predictors

    ERIC Educational Resources Information Center

    Bourne, Victoria J.

    2018-01-01

    Statistics anxiety is experienced by a large number of psychology students, and previous research has examined a range of potential correlates, including academic performance, mathematical ability and psychological predictors. These varying predictors are often considered separately, although there may be shared variance between them. In the…

  9. Public attitudes toward euthanasia and suicide for terminally ill persons: 1977 and 1996.

    PubMed

    DeCesare, M A

    2000-01-01

    This study replicates Singh's (1979) "classic" examination of correlates of euthanasia and suicide attitudes. The purposes of the current study were to assess (1) changes in public attitudes toward these voluntary termination of life practices, and (2) changes in the effects on attitudes of selected independent variables. I found Americans' approval of both euthanasia and suicide in 1996 to be higher than that in 1977. The increase in the approval of suicide, however, far outstripped that of euthanasia. Results of OLS regressions indicated that race, religious commitment, religious attendance, political identification, and suicide approval were statistically significant predictors of euthanasia approval. Only religious attendance and euthanasia approval were statistically significant predictors of suicide approval in both 1977 and 1996. The findings regarding euthanasia approval support those of Singh (1979); those regarding suicide approval do not. Triangulation of methods in future research is necessary to illuminate other aspects of these multifaceted issues.

  10. Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program.

    PubMed

    Güngen, Belma Doğan; Tunç, Abdulkadir; Aras, Yeşim Güzey; Gündoğdu, Aslı Aksoy; Güngen, Adil Can; Bal, Serdar

    2017-07-11

    The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients. One-hundred patients participated in the pulmonary rehabilitation program, 81 of whom served as a control group. Statistically, one- and three-month mortality was associated with NIHSS and MRS scores at admission and three months (p<0.001; r=0.440, r=0.432, r=0.339 and r=0.410, respectively). One and three months mortality- ICU admission had a statistically significant relationship with parenteral nutrition (p<0.001; r=0.346, r=0.300, respectively; r=0.294 and r=0.294, respectively). Similarly, there was also a statistically significant relationship between pneumonia onset and one- and three-month mortality- ICU admission (p<0.05; r=0.217, r=0.127, r=0.185 and r=0.185, respectively). A regression analysis showed that parenteral nutrition (odds ratio [OR] =13.434, 95% confidence interval [CI] =1.148-157.265, p=0.038) was a significant predictor of ICU admission. The relationship between pulmonary physiotherapy (PPT) and ICU admission- pneumonia onset at the end of three months was statistically significant (p=0.04 and p=0.043, respectively). This study showed that PPT improved the prognosis of ischemic stroke patients. We believe that a pulmonary rehabilitation program, in addition to general stroke rehabilitation programs, can play a critical role in improving survival and functional outcomes. NCT03195907 . Trial registration date: 21.06.2017 'Retrospectively registered'.

  11. Predictors of surgeons' efficiency in the operating rooms.

    PubMed

    Nakata, Yoshinori; Watanabe, Yuichi; Narimatsu, Hiroto; Yoshimura, Tatsuya; Otake, Hiroshi; Sawa, Tomohiro

    2017-02-01

    The sustainability of the Japanese healthcare system is questionable because of a huge fiscal debt. One of the solutions is to improve the efficiency of healthcare. The purpose of this study is to determine what factors are predictive of surgeons' efficiency scores. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30 in 2013-2015. Output-oriented Charnes-Cooper-Rhodes model of data envelopment analysis was employed to calculate each surgeon's efficiency score. Seven independent variables that may predict their efficiency scores were selected: experience, medical school, surgical volume, gender, academic rank, surgical specialty, and the surgical fee schedule. Multiple regression analysis using random-effects Tobit model was used for our panel data. The data from total 8722 surgical cases were obtained in 18-month study period. The authors analyzed 134 surgeons. The only statistically significant coefficients were surgical specialty and surgical fee schedule (p = 0.000 and p = 0.016, respectively). Experience had some positive association with efficiency scores but did not reach statistical significance (p = 0.062). The other coefficients were not statistically significant. These results demonstrated that the surgical reimbursement system, not surgeons' personal characteristics, is a significant predictor of surgeons' efficiency.

  12. Speech and communication in Parkinson’s disease: a cross-sectional exploratory study in the UK

    PubMed Central

    Barnish, Maxwell S; Horton, Simon M C; Butterfint, Zoe R; Clark, Allan B; Atkinson, Rachel A; Deane, Katherine H O

    2017-01-01

    Objective To assess associations between cognitive status, intelligibility, acoustics and functional communication in PD. Design Cross-sectional exploratory study of functional communication, including a within-participants experimental design for listener assessment. Setting A major academic medical centre in the East of England, UK. Participants Questionnaire data were assessed for 45 people with Parkinson’s disease (PD), who had self-reported speech or communication difficulties and did not have clinical dementia. Acoustic and listener analyses were conducted on read and conversational speech for 20 people with PD and 20 familiar conversation partner controls without speech, language or cognitive difficulties. Main outcome measures Functional communication assessed by the Communicative Participation Item Bank (CPIB) and Communicative Effectiveness Survey (CES). Results People with PD had lower intelligibility than controls for both the read (mean difference 13.7%, p=0.009) and conversational (mean difference 16.2%, p=0.04) sentences. Intensity and pause were statistically significant predictors of intelligibility in read sentences. Listeners were less accurate identifying the intended emotion in the speech of people with PD (14.8% point difference across conditions, p=0.02) and this was associated with worse speaker cognitive status (16.7% point difference, p=0.04). Cognitive status was a significant predictor of functional communication using CPIB (F=8.99, p=0.005, η2 = 0.15) but not CES. Intelligibility in conversation sentences was a statistically significant predictor of CPIB (F=4.96, p=0.04, η2 = 0.19) and CES (F=13.65, p=0.002, η2 = 0.43). Read sentence intelligibility was not a significant predictor of either outcome. Conclusions Cognitive status was an important predictor of functional communication—the role of intelligibility was modest and limited to conversational and not read speech. Our results highlight the importance of focusing on functional communication as well as physical speech impairment in speech and language therapy (SLT) for PD. Our results could inform future trials of SLT techniques for PD. PMID:28554918

  13. Effects of perceived social support and family demands on college students' mental well-being: A cross-cultural investigation.

    PubMed

    Khallad, Yacoub; Jabr, Fares

    2016-10-01

    The effects of perceived social support and family demands on college students' mental well-being (perceived stress and depression) were assessed in 2 samples of Jordanian and Turkish college students. Statistically significant negative correlations were found between perceived support and mental well-being. Multiple regression analyses showed that perceived family support was a better predictor of mental well-being for Jordanian students, while perceived support from friends was a better predictor of mental well-being for Turkish students. Perceived family demands were stronger predictors of mental well-being for participants from both ethnic groups. Jordanian and Turkish participants who perceived their families to be too demanding were more likely to report higher depression and stress levels. None of the interactions between social support or family demands and either of the 2 demographic variables were statistically significant. These findings provide a more nuanced view of the relationship between social support and mental health among college students, and point to the relevance of some cultural and situational factors. They also draw further attention to the detrimental effects of unrealistic family demands and pressures on the mental health of college youths. © 2015 International Union of Psychological Science.

  14. [The clinical predictors of heteroaggressive behaviour of the women serving sentence in penitentiary].

    PubMed

    Shaklein, K N; Bardenshtein, L M; Demcheva, N K

    To identify clinical predictors of heteroaggressive behavior. Three hundreds and three women serving sentence in a penal colony were examined using clinical, neurologic and statistical methods. The main group consisted of 225 women with heteroaggressive behavior, the control group included 78 women without aggressive behavior. Differences between the main and control groups in the structure of mental disorders and key syndromes were revealed. The authors conclude that the states with elements of dysphoria, dysthymia, decompensation of personality disorders, which are defined in the various forms of mental pathology, are the most significant predictors of heteroaggressive behavior in women in the penal colony.

  15. First-Grade Cognitive Abilities as Long-Term Predictors of Reading Comprehension and Disability Status

    PubMed Central

    Fuchs, Douglas; Compton, Donald L.; Fuchs, Lynn S.; Bryant, V. Joan; Hamlett, Carol L.; Lambert, Warren

    2012-01-01

    In a sample of 195 first graders selected for poor reading performance, the authors explored four cognitive predictors of later reading comprehension and reading disability (RD) status. In fall of first grade, the authors measured the children’s phonological processing, rapid automatized naming (RAN), oral language comprehension, and nonverbal reasoning. Throughout first grade, they also modeled the students’ reading progress by means of weekly Word Identification Fluency (WIF) tests to derive December and May intercepts. The authors assessed their reading comprehension in the spring of Grades 1–5. With the four cognitive variables and the WIF December intercept as predictors, 50.3% of the variance in fifth-grade reading comprehension was explained: 52.1% of this 50.3% was unique to the cognitive variables, 13.1% to the WIF December intercept, and 34.8% was shared. All five predictors were statistically significant. The same four cognitive variables with the May (rather than December) WIF intercept produced a model that explained 62.1% of the variance. Of this amount, the cognitive variables and May WIF intercept accounted for 34.5% and 27.7%, respectively; they shared 37.8%. All predictors in this model were statistically significant except RAN. Logistic regression analyses indicated that the accuracy with which the cognitive variables predicted end-of-fifth-grade RD status was 73.9%. The May WIF intercept contributed reliably to this prediction; the December WIF intercept did not. Results are discussed in terms of a role for cognitive abilities in identifying, classifying, and instructing students with severe reading problems. PMID:22539057

  16. First-grade cognitive abilities as long-term predictors of reading comprehension and disability status.

    PubMed

    Fuchs, Douglas; Compton, Donald L; Fuchs, Lynn S; Bryant, V Joan; Hamlett, Carol L; Lambert, Warren

    2012-01-01

    In a sample of 195 first graders selected for poor reading performance, the authors explored four cognitive predictors of later reading comprehension and reading disability (RD) status. In fall of first grade, the authors measured the children's phonological processing, rapid automatized naming (RAN), oral language comprehension, and nonverbal reasoning. Throughout first grade, they also modeled the students' reading progress by means of weekly Word Identification Fluency (WIF) tests to derive December and May intercepts. The authors assessed their reading comprehension in the spring of Grades 1-5. With the four cognitive variables and the WIF December intercept as predictors, 50.3% of the variance in fifth-grade reading comprehension was explained: 52.1% of this 50.3% was unique to the cognitive variables, 13.1% to the WIF December intercept, and 34.8% was shared. All five predictors were statistically significant. The same four cognitive variables with the May (rather than December) WIF intercept produced a model that explained 62.1% of the variance. Of this amount, the cognitive variables and May WIF intercept accounted for 34.5% and 27.7%, respectively; they shared 37.8%. All predictors in this model were statistically significant except RAN. Logistic regression analyses indicated that the accuracy with which the cognitive variables predicted end-of-fifth-grade RD status was 73.9%. The May WIF intercept contributed reliably to this prediction; the December WIF intercept did not. Results are discussed in terms of a role for cognitive abilities in identifying, classifying, and instructing students with severe reading problems.

  17. Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study.

    PubMed

    Esterman, Adrian J; Fountaine, Tim; McDermott, Robyn

    2016-01-18

    To determine whether certain characteristics of general practices are associated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC). Our cross-sectional analysis used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. Practice characteristics were self-reported. Characteristics of the patients that were assessed included glycaemic control (HbA1c level ≤ 53 mmol/mol), age, sex, duration of diabetes, socio-economic disadvantage (SEIFA) score, the complexity of the patient's condition, and whether the patient had completed an ACC for diabetes in the past 18 months. Clustered logistic regression was used to establish predictors of glycaemic control and a completed ACC. Data were available from 147 general practices and 5455 patients with established type 1 or type 2 diabetes in three Australian states. After adjustment for other patient characteristics, only the patient completing an ACC was statistically significant as a predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having complete an ACC. Patient characteristics are moderately good predictors of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patients completing an ACC. The ACC is an established indicator of good diabetes management. This is the first study to report a positive association between having completed an ACC and the patient being in glycaemic control.

  18. [Effects of occupational stress on serum tumor necrosis factor-α and interleukins].

    PubMed

    Zhou, Wen-Hui; Yu, Shan-Fa; Jiang, Kai-You

    2010-12-01

    To explore the effect of occupational stress on serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-2 and IL-4. A cross-sectional epidemiological study was conducted in 200 workers from the refrigerator assembly line in Henan province in China. Psychosocial work conditions were measured by using the job demand-control model, the effort-reward imbalance model questionnaires and occupational stress measurement scale. Serum TNF-α, IL-1β, IL-2, and IL-4 concentrations were measured by radioimmunoassay or immunoradiometric assay method respectively. Serum TNF-α concentration was statistically significantly different between workers with higher affective balance level and control groups [(1.947 ± 0.173) and (2.029 ± 0.240) fmol/ml] (P < 0.05). Serum IL-1β concentration was statistically significantly different between workers with higher effort level and control groups [(0.133 ± 0.034) and (0.118 ± 0.031) ng/ml] (P < 0.05). Serum IL-2 concentration was statistically significantly different between workers with higher role ambiguity level [(1.658 ± 0.376) and (1.491 ± 0.033) ng/ml] and control groups (P < 0.05), as well as between workers with higher role conflict level and control groups [(1.774 ± 0.311) and (1.589 ± 0.380) ng/ml] (P < 0.05), between workers with higher daily life stress level and control groups [(1.759 ± 0.361) and (1.606 ± 0.381) ng/ml] (P < 0.05). Serum IL-4 concentration was statistically significantly different between workers with higher reward level and control groups [(1.449 ± 0.025) and (1.466 ± 0.041) pg/ml] (P < 0.05). Stepwise regression analysis indicated that affective balance was the predictor of serum TNF-α (R(2) = 0.029). Effort and mental health were the predictors of serum IL-1β (R(2) was 0.029 and 0.055, respectively). Role conflict, daily life stress and role ambiguity were the predictors of serum IL-2 (R(2) was 0.040, 0.078 and 0.104, respectively). Reward was the predictor of serum IL-4 (R(2) = 0.030). Unhealthy psychological stress factor might be induce a marked increase in the concentrations of serum TNF-α, IL-1β, IL-2, as well as IL-4.

  19. The Relationship Among Sexual Attitudes, Sexual Fantasy, and Religiosity

    PubMed Central

    Ahrold, Tierney K.; Farmer, Melissa; Trapnell, Paul D.; Meston, Cindy M.

    2015-01-01

    Recent research on the impact of religiosity on sexuality has highlighted the role of the individual, and suggests that the effects of religious group and sexual attitudes and fantasy may be mediated through individual differences in spirituality. The present study investigated the role of religion in an ethnically diverse young adult sample (N = 1413, 69% women) using religious group as well as several religiosity domains: spirituality, intrinsic religiosity, paranormal beliefs, and fundamentalism. Differences between religious groups in conservative sexual attitudes were statistically significant but small; as predicted, spirituality mediated these effects. In contrast to the weak effects of religious group, spirituality, intrinsic religiosity, and fundamentalism were strong predictors of women’s conservative sexual attitudes; for men, intrinsic religiosity predicted sexual attitude conservatism but spirituality predicted attitudinal liberalism. For women, both religious group and religiosity domains were significant predictors of frequency of sexual fantasies while, for men, only religiosity domains were significant predictors. These results indicate that individual differences in religiosity domains were better predictors of sexual attitudes and fantasy than religious group and that these associations are moderated by gender. PMID:20364304

  20. Predicting early signs of dyslexia at a preliterate age by combining behavioral assessment with structural MRI.

    PubMed

    Kraft, Indra; Schreiber, Jan; Cafiero, Riccardo; Metere, Riccardo; Schaadt, Gesa; Brauer, Jens; Neef, Nicole E; Müller, Bent; Kirsten, Holger; Wilcke, Arndt; Boltze, Johannes; Friederici, Angela D; Skeide, Michael A

    2016-12-01

    Recent studies suggest that neurobiological anomalies are already detectable in pre-school children with a family history of developmental dyslexia (DD). However, there is a lack of longitudinal studies showing a direct link between those differences at a preliterate age and the subsequent literacy difficulties seen in school. It is also not clear whether the prediction of DD in pre-school children can be significantly improved when considering neurobiological predictors, compared to models based on behavioral literacy precursors only. We recruited 53 pre-reading children either with (N=25) or without a family risk of DD (N=28). Quantitative T1 MNI data and literacy precursor abilities were assessed at kindergarten age. A subsample of 35 children was tested for literacy skills either one or two years later, that is, either in first or second grade. The group comparison of quantitative T1 measures revealed significantly higher T1 intensities in the left anterior arcuate fascicle (AF), suggesting reduced myelin concentration in preliterate children at risk of DD. A logistic regression showed that DD can be predicted significantly better (p=.024) when neuroanatomical differences between groups are used as predictors (80%) compared to a model based on behavioral predictors only (63%). The Wald statistic confirmed that the T1 intensity of the left AF is a statistically significant predictor of DD (p<.05). Our longitudinal results provide evidence for the hypothesis that neuroanatomical anomalies in children with a family risk of DD are related to subsequent problems in acquiring literacy. Particularly, solid white matter organization in the left anterior arcuate fascicle seems to play a pivotal role. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma.

    PubMed

    Chua, Felicia H Z; Thien, Ady; Ng, Lee Ping; Seow, Wan Tew; Low, David C Y; Chang, Kenneth T E; Lian, Derrick W Q; Loh, Eva; Low, Sharon Y Y

    2017-03-01

    Posterior fossa syndrome (PFS) is a serious complication faced by neurosurgeons and their patients, especially in paediatric medulloblastoma patients. The uncertain aetiology of PFS, myriad of cited risk factors and therapeutic challenges make this phenomenon an elusive entity. The primary objective of this study was to identify associative factors related to the development of PFS in medulloblastoma patient post-tumour resection. This is a retrospective study based at a single institution. Patient data and all related information were collected from the hospital records, in accordance to a list of possible risk factors associated with PFS. These included pre-operative tumour volume, hydrocephalus, age, gender, extent of resection, metastasis, ventriculoperitoneal shunt insertion, post-operative meningitis and radiological changes in MRI. Additional variables included molecular and histological subtypes of each patient's medulloblastoma tumour. Statistical analysis was employed to determine evidence of each variable's significance in PFS permanence. A total of 19 patients with appropriately complete data was identified. Initial univariate analysis did not show any statistical significance. However, multivariate analysis for MRI-specific changes reported bilateral DWI restricted diffusion changes involving both right and left sides of the surgical cavity was of statistical significance for PFS permanence. The authors performed a clinical study that evaluated possible risk factors for permanent PFS in paediatric medulloblastoma patients. Analysis of collated results found that post-operative DWI restriction in bilateral regions within the surgical cavity demonstrated statistical significance as a predictor of PFS permanence-a novel finding in the current literature.

  2. Costs and cost containment in nursing homes.

    PubMed Central

    Smith, H L; Fottler, M D

    1981-01-01

    The study examines the impact of structural and process variables on the cost of nursing home care and the utilization of various cost containment methods in 43 california nursing homes. Several predictors were statistically significant in their relation to cost per patient day. A diverse range of cost containment techniques was discovered along with strong predictors of the utilization of these techniques by nursing home administrators. The trade-off between quality of care and cost of care is discussed. PMID:7228713

  3. How Does One Assess the Accuracy of Academic Success Predictors? ROC Analysis Applied to University Entrance Factors

    ERIC Educational Resources Information Center

    Vivo, Juana-Maria; Franco, Manuel

    2008-01-01

    This article attempts to present a novel application of a method of measuring accuracy for academic success predictors that could be used as a standard. This procedure is known as the receiver operating characteristic (ROC) curve, which comes from statistical decision techniques. The statistical prediction techniques provide predictor models and…

  4. Childhood Predictors of Adolescent Competence and Self-Worth in Rural Youth

    PubMed Central

    Rew, Lynn; Grady, Matthew W.; Spoden, Micajah

    2012-01-01

    Problem Urban children who become competent adults despite circumstances that place their development and mental health at risk are considered to be resilient. Less is known about the risk and protective factors that characterize resilience among Hispanic/Latinos living in rural areas. Methods Data for regression analyses were collected when children (N = 603; 54% Hispanic/Latino) enrolled in the study in fifth grade, (M=10.4 years of age) and again five years later when they were in high school (M=15 years of age). Findings Statistically significant predictors of competence and self-worth in high schoolers included gender, ethnicity, and mother’s education, as well as stress, temperament (task persistence), and competences measured in grade school. Conclusions Parents’ perceptions of child’s temperament is a significant predictor of future competence and self-worth among rural adolescents. PMID:23121139

  5. Childhood predictors of adolescent competence and self-worth in rural youth.

    PubMed

    Rew, Lynn; Grady, Matthew W; Spoden, Micajah

    2012-11-01

    Urban children who become competent adults despite circumstances that place their development and mental health at risk are considered to be resilient. Less is known about the risk and protective factors that characterize resilience among Hispanic/Latinos living in rural areas. Data for regression analyses were collected when children (n = 603; 54% Hispanic/Latino) enrolled in the study in fifth grade (M = 10.4 years of age), and again 5 years later when they were in high school (M = 15 years of age). Statistically significant predictors of competence and self-worth in high schoolers included gender, ethnicity, and mother's education, as well as stress, temperament (task persistence), and competences measured in grade school. Parents' perception of child's temperament is a significant predictor of future competence and self-worth among rural adolescents. © 2012 Wiley Periodicals, Inc.

  6. The clinical implications of myocardial perfusion abnormalities in patients with esophageal or lung cancer after chemoradiation therapy.

    PubMed

    Gayed, Isis; Gohar, Salman; Liao, Zhongxing; McAleer, Mary; Bassett, Roland; Yusuf, Syed Wamique

    2009-06-01

    This study aims to identify the clinical implications of myocardial perfusion defects after chemoradiation therapy (CRT) in patients with esophageal and lung cancer. We retrospectively compared myocardial perfusion imaging (MPI) results before and after CRT in 16 patients with esophageal cancer and 24 patients with lung cancer. New MPI defects in the radiation therapy (RT) fields were considered related to RT. Follow-up to evaluate for cardiac complications and their relation with the results of MPI was performed. Statistical analysis identified predictors of cardiac morbidities. Eleven females and twenty nine males at a mean age of 66.7 years were included. Five patients (31%) with esophageal cancer and seven patients (29%) with lung cancer developed myocardial ischemia in the RT field at mean intervals of 7.0 and 8.4 months after RT. The patients were followed-up for mean intervals of 15 and 23 months in the esophageal and lung cancer groups, respectively. Seven patients in each of the esophageal (44%) and lung (29%) cancer patients (P = 0.5) developed cardiac complications of which one patient with esophageal cancer died of complete heart block. Six out of the fourteen patients (43%) with cardiac complication had new ischemia on MPI after CRT of which only one developed angina. The remaining eight patients with cardiac complications had normal MPI results. MPI result was not a statistically significant predictor of future cardiac complications after CRT. A history of congestive heart failure (CHF) (P = 0.003) or arrhythmia (P = 0.003) is a significant predictor of cardiac morbidity after CRT in univariate analysis but marginal predictors when multivariate analysis was performed (P = 0.06 and 0.06 for CHF and arrhythmia, respectively). Cardiac complications after CRT are more common in esophageal than lung cancer patients but the difference is not statistically significant. MPI abnormalities are frequently seen after CRT but are not predictive of future cardiac complications. A history of arrhythmia or CHF is significantly associated with cardiac complications after CRT.

  7. Factors predictive of the onset and duration of action of local anesthesia in mandibular third-molar surgery: a prospective study.

    PubMed

    Al-Shayyab, Mohammad H; Baqain, Zaid H

    2018-04-01

    The aim of this study was to assess the influence of patients' and surgical variables on the onset and duration of action of local anesthesia (LA) in mandibular third-molar (M3) surgery. Patients scheduled for mandibular M3 surgery were considered for inclusion in this prospective cohort study. Patients' and surgical variables were recorded. Two per cent (2%) lidocaine with 1:100,000 epinephrine was used to block the nerves for extraction of mandibular M3. Then, the onset of action and duration of LA were monitored. Univariate analysis and multivariate regression analysis were used to analyze the data. The final cohort included 88 subjects (32 men and 56 women; mean age ± SD = 29.3 ± 12.3 yr). With univariate analysis, age, gender, body mass index (BMI), smoking quantity and duration, operation time, and 'volume of local anesthetic needed' significantly influenced the onset of action and duration of LA. Multivariate regression revealed that age and smoking quantity were the only statistically significant predictors of the onset of action of LA, whereas age, smoking quantity, and 'volume of local anesthetic needed' were the only statistically significant predictors of duration of LA. Further studies are recommended to uncover other predictors of the onset of action and duration of LA. © 2018 Eur J Oral Sci.

  8. Comparison of potential fecundity models for walleye pollock Gadus chalcogrammus in the Pacific waters off Hokkaido, Japan.

    PubMed

    Tanaka, H; Hamatsu, T; Mori, K

    2017-01-01

    Potential fecundity models of walleye or Alaska pollock Gadus chalcogrammus in the Pacific waters off Hokkaido, Japan, were developed. They were compared using a generalized linear model with using either standard body length (L S ) or total body mass (M T ) as a main covariate along with Fulton's condition factor (K) and mean diameter of oocytes (D O ) as additional potential covariates to account for maternal conditions and maturity stage. The results of model selection showed that M T was a better single predictor of potential fecundity (F P ) than L S . The biological importance of K on F P was obscure, because it was statistically significant when used in the predictor with L S (i.e. length-based model), but not significant when used with M T (i.e. mass-based model). Meanwhile, D O was statistically significant in both length and mass-based models, suggesting the importance of downregulation on the number of oocytes with advancing maturation. Among all candidate models, the model with M T and D O in the predictor had the lowest Akaike's information criterion value, suggesting its better predictive power. These newly developed models will improve future comparisons of the potential fecundity within and among stocks by excluding potential biases other than body size. © 2016 The Fisheries Society of the British Isles.

  9. Radiographic assessment of lower third molar eruption in different anteroposterior skeletal patterns and age-related groups.

    PubMed

    Jakovljevic, Aleksandar; Lazic, Emira; Soldatovic, Ivan; Nedeljkovic, Nenad; Andric, Miroslav

    2015-07-01

    To analyze radiographic predictors for lower third molar eruption among subjects with different anteroposterior skeletal relations and of different age groups. In total, 300 lower third molars were recorded on diagnostic digital orthopantomograms (DPTs) and lateral cephalograms (LCs). The radiographs were grouped according to sagittal intermaxillary angle (ANB), subject age, and level of lower third molar eruption. The DPT was used to analyze retromolar space, mesiodistal crown width, space/width ratio, third and second molar angulation (α, γ), third molar inclination (β), and gonion angle. The LC was used to determine ANB, angles of maxillar and mandibular prognathism (SNA, SNB), mandibular plane angle (SN/MP), and mandibular lengths. A logistic regression model was created using the statistically significant predictors. The logistic regression analysis revealed a statistically significant impact of β angle and distance between gonion and gnathion (Go-Gn) on the level of lower third molar eruption (P < .001 and P < .015, respectively). The retromolar space was significantly increased in the adult subgroup for all skeletal classes. The lower third molar impaction rate was significantly higher in the adult subgroup with the Class II (62.3%) compared with Class III subjects (31.7%; P < .013). The most favorable values of linear and angular predictors of mandibular third molar eruption were measured in Class III subjects. For valid estimation of mandibular third molar eruption, certain linear and angular measures (β angle, Go-Gn), as well as the size of the retromolar space, need to be considered.

  10. Combining clinical and angiographic variables for estimating risk of target lesion revascularization after drug eluting stent placement.

    PubMed

    Stolker, Joshua M; Cohen, David J; Kennedy, Kevin F; Pencina, Michael J; Arnold, Suzanne V; Kleiman, Neal S; Spertus, John A

    Drug-eluting stents (DES) reduce restenosis but require prolonged antiplatelet therapy, when compared with bare metal stents. Ideally, the patient should be involved in this risk:benefit assessment prior to selecting DES, to maximize the benefits and cost-effectiveness of care, and to improve medication adherence. However, accurate estimation of restenosis risk may require angiographic factors identified at cardiac catheterization. In a large PCI registry, we used logistic regression to identify clinical and angiographic predictors of clinically-driven target lesion revascularization (TLR) over the first year after stent placement. Discrimination c-statistic and integrated discrimination improvement (IDI) were used to calculate the incremental utility of angiographic variables when added to clinical predictors. Of 8501 PCI patients, TLR occurred in 4.5%. After adjusting for DES use, clinical TLR predictors were younger age, female sex, diabetes, prior PCI, and prior bypass surgery (model c-statistic 0.630). Angiographic predictors were vein graft PCI, in-stent restenosis lesion, longer stent length, and smaller stent diameter (c-statistic 0.650). After adding angiographic factors to the clinical model, c-statistic improved to 0.680 and the average separation in TLR risk among patients with and without TLR improved by 1% (IDI=0.010, 95% CI 0.009-0.014), primarily driven by those experiencing TLR (from 5.9% to 6.9% absolute risk). Among unselected PCI patients, the incidence of clinically-indicated TLR is <5% at 1-year, and standard clinical variables only moderately discriminate who will and will not experience TLR. Angiographic variables significantly improve TLR risk assessment, suggesting that stent selection may be best performed after coronary anatomy has been delineated. Although several recent studies have challenged traditional expectations regarding the duration of dual antiplatelet therapy, current guidelines recommend at least 6 to 12months of treatment after implantation of a drug eluting stent, with a shorter course for bare metal stents. Stent selection ideally should involve input from the patient receiving these stents, but multiple studies have suggested that angiographic factors - obtained after the patient has received sedation during the diagnostic catheterization - are important predictors of repeat revascularization. In this analysis from a large registry of patients receiving coronary stents, angiographic characteristics were found to significantly improve risk assessment for target lesion revascularization, when added to clinical variables alone. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Perceived difficulty quitting predicts enrollment in a smoking-cessation program for patients with head and neck cancer.

    PubMed

    Duffy, Sonia A; Scheumann, Angela L; Fowler, Karen E; Darling-Fisher, Cynthia; Terrell, Jeffrey E

    2010-05-01

    To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention. Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers' participation in an intervention study. Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. Oncology nurses are in an opportune position to assess patients' perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population.

  12. A clinical prediction rule for detecting major depressive disorder in primary care: the PREDICT-NL study.

    PubMed

    Zuithoff, Nicolaas P A; Vergouwe, Yvonne; King, Michael; Nazareth, Irwin; Hak, Eelko; Moons, Karel G M; Geerlings, Mirjam I

    2009-08-01

    Major depressive disorder often remains unrecognized in primary care. Development of a clinical prediction rule using easily obtainable predictors for major depressive disorder in primary care patients. A total of 1046 subjects, aged 18-65 years, were included from seven large general practices in the center of The Netherlands. All subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. Major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Text Revision edition criteria was assessed with the Composite International Diagnostic Interview. Candidate predictors were gender, age, educational level, being single, number of presented complaints, presence of non-somatic complaints, whether a diagnosis was assigned, consultation rate in past 12 months, presentation of depressive complaints or prescription of antidepressants in past 12 months, number of life events in past 6 months and any history of depression. The first multivariable logistic regression model including only predictors that require no confronting depression-related questions had a reasonable degree of discrimination (area under the receiver operating characteristic curve or concordance-statistic (c-statistic) = 0.71; 95% Confidence Interval (CI): 0.67-0.76). Addition of three simple though more depression-related predictors, number of life events and history of depression, significantly increased the c-statistic to 0.80 (95% CI: 0.76-0.83). After transforming this second model to an easily to use risk score, the lowest risk category (sum score < 5) showed a 1% risk of depression, which increased to 49% in the highest category (sum score > or = 30). A clinical prediction rule allows GPs to identify patients-irrespective of their complaints-in whom diagnostic workup for major depressive disorder is indicated.

  13. Sensitivity and specificity of memory and naming tests for identifying left temporal-lobe epilepsy.

    PubMed

    Umfleet, Laura Glass; Janecek, Julie K; Quasney, Erin; Sabsevitz, David S; Ryan, Joseph J; Binder, Jeffrey R; Swanson, Sara J

    2015-01-01

    The sensitivity and specificity of the Selective Reminding Test (SRT) Delayed Recall, Wechsler Memory Scale (WMS) Logical Memory, the Boston Naming Test (BNT), and two nonverbal memory measures for detecting lateralized dysfunction in association with side of seizure focus was examined in a sample of 143 patients with left or right temporal-lobe epilepsy (TLE). Scores on the SRT and BNT were statistically significantly lower in the left TLE group compared with the right TLE group, whereas no group differences emerged on the Logical Memory subtest. No significant group differences were found with nonverbal memory measures. When the SRT and BNT were both entered as predictors in a logistic regression, the BNT, although significant, added minimal value to the model beyond the variance accounted for by the SRT Delayed Recall. Both variables emerged as significant predictors of side of seizure focus when entered into separate regressions. Sensitivity and specificity of the SRT and BNT ranged from 56% to 65%. The WMS Logical Memory and nonverbal memory measures were not significant predictors of the side of seizure focus.

  14. Clinical predictors of oral leukoplakia recurrence following CO₂ laser vaporization.

    PubMed

    Chainani-Wu, Nita; Lee, Dustin; Madden, Erin; Sim, Chelsia; Collins, Kornelia; Silverman, Sol

    2015-11-01

    The objective of this study was to determine whether risk of early leukoplakia recurrence (within 3 months) following carbon dioxide (CO2) laser removal varies by clinical characteristics including lesion size, site and accessibility of margins. A retrospective cohort study included patients with oral leukoplakia who had their first CO2 laser surgery for removal of oral leukoplakia between 2005 and 2010 at the UCSF oral medicine clinic. Twenty-six patients with 32 separate lesions met the eligibility criteria after a clinic database search was followed by review of clinical notes and biopsy reports from existing patient charts. Data analysis included computation of summary statistics, and logistic regression analyses to evaluate recurrence of leukoplakia by clinical characteristics of the lesions. Patient data and the characteristics of lesions were evaluated as possible predictors of early recurrence following laser removal; these included age, sex, duration, size, appearance and histopathology of the lesion. The only one that reached statistical significance was poor accessibility of the margins of the lesion (vs. good accessibility, OR = 24.57 (95% CI: 1.59-16.68), p = 0.016); the probability for trend for good, questionable, and poor accessibility was 0.0028. This finding remained significant after controlling for age, sex, duration and size of lesion. Four out of five lesions with poor accessibility showed recurrence at 3 months. Of these, three involved the gingiva and one the lateral tongue. This study has identified poor accessibility of the lesion margins as a predictor for early recurrence of leukoplakia following laser removal. Other variables evaluated did not reach statistical significance, possibly due to lack of power. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Trends in Mortality After Primary Cytoreductive Surgery for Ovarian Cancer: A Systematic Review and Metaregression of Randomized Clinical Trials and Observational Studies.

    PubMed

    Di Donato, Violante; Kontopantelis, Evangelos; Aletti, Giovanni; Casorelli, Assunta; Piacenti, Ilaria; Bogani, Giorgio; Lecce, Francesca; Benedetti Panici, Pierluigi

    2017-06-01

    Primary cytoreductive surgery (PDS) followed by platinum-based chemotherapy is the cornerstone of treatment and the absence of residual tumor after PDS is universally considered the most important prognostic factor. The aim of the present analysis was to evaluate trend and predictors of 30-day mortality in patients undergoing primary cytoreduction for ovarian cancer. Literature was searched for records reporting 30-day mortality after PDS. All cohorts were rated for quality. Simple and multiple Poisson regression models were used to quantify the association between 30-day mortality and the following: overall or severe complications, proportion of patients with stage IV disease, median age, year of publication, and weighted surgical complexity index. Using the multiple regression model, we calculated the risk of perioperative mortality at different levels for statistically significant covariates of interest. Simple regression identified median age and proportion of patients with stage IV disease as statistically significant predictors of 30-day mortality. When included in the multiple Poisson regression model, both remained statistically significant, with an incidence rate ratio of 1.087 for median age and 1.017 for stage IV disease. Disease stage was a strong predictor, with the risk estimated to increase from 2.8% (95% confidence interval 2.02-3.66) for stage III to 16.1% (95% confidence interval 6.18-25.93) for stage IV, for a cohort with a median age of 65 years. Metaregression demonstrated that increased age and advanced clinical stage were independently associated with an increased risk of mortality, and the combined effects of both factors greatly increased the risk.

  16. A cross-national analysis of how economic inequality predicts biodiversity loss.

    PubMed

    Holland, Tim G; Peterson, Garry D; Gonzalez, Andrew

    2009-10-01

    We used socioeconomic models that included economic inequality to predict biodiversity loss, measured as the proportion of threatened plant and vertebrate species, across 50 countries. Our main goal was to evaluate whether economic inequality, measured as the Gini index of income distribution, improved the explanatory power of our statistical models. We compared four models that included the following: only population density, economic footprint (i.e., the size of the economy relative to the country area), economic footprint and income inequality (Gini index), and an index of environmental governance. We also tested the environmental Kuznets curve hypothesis, but it was not supported by the data. Statistical comparisons of the models revealed that the model including both economic footprint and inequality was the best predictor of threatened species. It significantly outperformed population density alone and the environmental governance model according to the Akaike information criterion. Inequality was a significant predictor of biodiversity loss and significantly improved the fit of our models. These results confirm that socioeconomic inequality is an important factor to consider when predicting rates of anthropogenic biodiversity loss.

  17. Exploratory study of emergency physicians' use of a prescription monitoring program using a framework of technology acceptance.

    PubMed

    Fleming, Marc L; Hatfield, Mark D; Wattana, Monica K; Todd, Knox H

    2014-03-01

    Emergency physicians (EPs) are faced with significant challenges regarding pain management, while preventing abuse of prescription opioids. Prescription monitoring programs (PMPs) are increasingly used to help allay the abuse of controlled substances. The objective of this study was to determine EPs' intention to use the Texas PMP within the framework of the Technology Acceptance Model. A cross-sectional, 24-item survey instrument was developed and distributed to EPs attending an emergency medicine conference. PMP nonusers reported a positive intention to use the PMP in the future, with attitude (β = 0.61, p < 0.01) as the only statistically significant predictor of intention. PMP users reported a positive intention to use the PMP, with perceived usefulness (β = 0.62, p < 0.01) as the only statistically significant predictor of intention for PMP users. This exploratory study provides a basis for understanding EPs' intention to use a PMP. The use of PMPs by EPs may lead to a decrease in prescription opioid abuse and improve patient safety related to opioid prescribing in the emergency department setting.

  18. Gender Trends in the Career Patterns of Recent Dental Graduates.

    ERIC Educational Resources Information Center

    Dolan, Teresa A.; Lewis, Charles E.

    1987-01-01

    The gender differences among recent dental graduates' professional commitment, choice of practice arrangements, and income were examined. Gender remained as a statistically significant predictor of income when controlling for practice ownership, hours per week worked, background, and family/social variables. (Author/MLW)

  19. National trends in occupational injuries before and after 1992 and predictors of workers' compensation costs.

    PubMed

    Bhushan, Abhinav; Leigh, J Paul

    2011-01-01

    Numbers and costs of occupational injuries and illnesses are significant in terms of morbidity and dollars, yet our understanding of time trends is minimal. We investigated trends and addressed some common hypotheses regarding causes of fluctuations. We pulled data on incidence rates (per 100 full-time employed workers) for injuries and illnesses from the U.S. Bureau of Labor Statistics and on costs and benefits from the National Academy of Social Insurance for 1973 through 2007. Rates reflected all injury and illness cases, lost work-time cases, and cases resulting in at least 31 days away from work. We adjusted dollar costs (premiums) and benefits for inflation and measured them per employed worker. We plotted data in time-trend charts and ran linear regressions. From 1973 to 1991, there was a weak to nonexistent downward trend for injury and illness rates, and rates were strongly and negatively correlated with the unemployment rate. From 1992 to 2007, there were strong, consistent downward trends, but no longer were there statistically significant correlations with unemployment. Significant predictors (and signs) of workers' compensation premiums for 1973-2007 included medical price inflation (positive), number of lost-time injuries (positive), the Dow Jones Industrial Average (negative), and inflation-adjusted interest rate on U.S. Treasury bonds (negative). Dollars of benefits were positively and significantly predicted by medical inflation and number of lost-time cases. For 1992-2007, the Dow Jones variable was the only robust predictor of premiums; the number of injuries was not a significant positive predictor. We had two major conclusions. First, the year 1992 marked a sharp contrast in trends and correlations between unemployment and incidence rates for occupational injuries and illnesses. Second, for the entire time period (1973-2007), insurance carriers' premiums were strongly associated with returns on investments.

  20. National Trends in Occupational Injuries Before and After 1992 and Predictors of Workers' Compensation Costs

    PubMed Central

    Bhushan, Abhinav; Leigh, J. Paul

    2011-01-01

    Objective Numbers and costs of occupational injuries and illnesses are significant in terms of morbidity and dollars, yet our understanding of time trends is minimal. We investigated trends and addressed some common hypotheses regarding causes of fluctuations. Methods We pulled data on incidence rates (per 100 full-time employed workers) for injuries and illnesses from the U.S. Bureau of Labor Statistics and on costs and benefits from the National Academy of Social Insurance for 1973 through 2007. Rates reflected all injury and illness cases, lost work-time cases, and cases resulting in at least 31 days away from work. We adjusted dollar costs (premiums) and benefits for inflation and measured them per employed worker. We plotted data in time-trend charts and ran linear regressions. Results From 1973 to 1991, there was a weak to nonexistent downward trend for injury and illness rates, and rates were strongly and negatively correlated with the unemployment rate. From 1992 to 2007, there were strong, consistent downward trends, but no longer were there statistically significant correlations with unemployment. Significant predictors (and signs) of workers' compensation premiums for 1973–2007 included medical price inflation (positive), number of lost-time injuries (positive), the Dow Jones Industrial Average (negative), and inflation-adjusted interest rate on U.S. Treasury bonds (negative). Dollars of benefits were positively and significantly predicted by medical inflation and number of lost-time cases. For 1992–2007, the Dow Jones variable was the only robust predictor of premiums; the number of injuries was not a significant positive predictor. Conclusion We had two major conclusions. First, the year 1992 marked a sharp contrast in trends and correlations between unemployment and incidence rates for occupational injuries and illnesses. Second, for the entire time period (1973–2007), insurance carriers' premiums were strongly associated with returns on investments. PMID:21886322

  1. Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep.

    PubMed

    Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

    2015-06-01

    Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% "frequently or always") were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% "frequently or always") were statistically significant predictors of sleep quality. Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken.

  2. Insight, rumination, and self-reflection as predictors of well-being.

    PubMed

    Harrington, Rick; Loffredo, Donald A

    2011-01-01

    Dispositional private self-focused attention variables such as insight, internal self-awareness (ISA), and self-reflectiveness (SR) have been found to relate to well-being. The present study sought to determine which dispositional private self-focused attention variables have the most predictive power for subjective well-being as measured by the Satisfaction With Life Scale (E. Diener, R. A. Emmons, R. J. Larsen, & S. Griffin, 1985) and for a eudaemonic form of well-being as measured by the Psychological Well-Being Scale (C. D. Ryff, 1989). A total of 121 college student participants completed an online version of the Self-Consciousness Scale-Revised, the Rumination-Reflection Questionnaire, the Self-Reflection and Insight Scale, the Satisfaction With Life Scale, and the Psychological WellBeing Scale. Results of a multivariate regression analysis using the Self-Consciousness Scale-Revised's (M. F. Scheier & C. S. Carver, 1985) subfactors of SR and ISA, the Rumination-Reflection Questionnaire's (P. D. Trapnell & J. D. Campbell, 1999) subscales of Rumination and Reflection, and the Self-Reflection and Insight Scale's (A. M. Grant, J. Franklin, & P. Langford, 2002) Self-Reflection and Insight subscales revealed that the Insight subscale was the only statistically significant predictor (a positive predictor) for all 6 dimensions of psychological well-being. Insight was also the only significant positive predictor for satisfaction with life. The Rumination subscale was a significant negative predictor for 3 dimensions of psychological well-being, and the Reflection subscale was a significant positive predictor for 1 dimension. Implications of dispositional self-awareness variables and their relation to dimensions of well-being are discussed.

  3. Tract-Based Spatial Statistics in Preterm-Born Neonates Predicts Cognitive and Motor Outcomes at 18 Months.

    PubMed

    Duerden, E G; Foong, J; Chau, V; Branson, H; Poskitt, K J; Grunau, R E; Synnes, A; Zwicker, J G; Miller, S P

    2015-08-01

    Adverse neurodevelopmental outcome is common in children born preterm. Early sensitive predictors of neurodevelopmental outcome such as MR imaging are needed. Tract-based spatial statistics, a diffusion MR imaging analysis method, performed at term-equivalent age (40 weeks) is a promising predictor of neurodevelopmental outcomes in children born very preterm. We sought to determine the association of tract-based spatial statistics findings before term-equivalent age with neurodevelopmental outcome at 18-months corrected age. Of 180 neonates (born at 24-32-weeks' gestation) enrolled, 153 had DTI acquired early at 32 weeks' postmenstrual age and 105 had DTI acquired later at 39.6 weeks' postmenstrual age. Voxelwise statistics were calculated by performing tract-based spatial statistics on DTI that was aligned to age-appropriate templates. At 18-month corrected age, 166 neonates underwent neurodevelopmental assessment by using the Bayley Scales of Infant Development, 3rd ed, and the Peabody Developmental Motor Scales, 2nd ed. Tract-based spatial statistics analysis applied to early-acquired scans (postmenstrual age of 30-33 weeks) indicated a limited significant positive association between motor skills and axial diffusivity and radial diffusivity values in the corpus callosum, internal and external/extreme capsules, and midbrain (P < .05, corrected). In contrast, for term scans (postmenstrual age of 37-41 weeks), tract-based spatial statistics analysis showed a significant relationship between both motor and cognitive scores with fractional anisotropy in the corpus callosum and corticospinal tracts (P < .05, corrected). Tract-based spatial statistics in a limited subset of neonates (n = 22) scanned at <30 weeks did not significantly predict neurodevelopmental outcomes. The strength of the association between fractional anisotropy values and neurodevelopmental outcome scores increased from early-to-late-acquired scans in preterm-born neonates, consistent with brain dysmaturation in this population. © 2015 by American Journal of Neuroradiology.

  4. Expression of thymidylate synthase (TS) and its prognostic significance in patients with cutaneous angiosarcoma.

    PubMed

    Shimizu, A; Kaira, K; Okubo, Y; Utsumi, D; Bolag, A; Yasuda, M; Takahashi, K; Ishikawa, O

    2017-01-01

    Cutaneous angiosarcoma (CA) is extremely rare, and little is known about the biological significance of possible biomarkers for chemotherapeutic agents. Thymidylate synthase (TS) is an attractive target for cancer treatment in various human neoplasms. It remains unclear whether the expression of TS is associated with the clinicopathological features of CA patients. The aim of this study was to elucidate the relationship between TS expression and the clinicopathological significance in CA patients. Fifty-one patients with CA were included in this study. TS expression and Ki-67 labeling index were examined using immunohistochemical analysis. TS was positively expressed in 39% (20/51) of CA patients. No statistically significant prognostic factor was identified as a predictor of overall survival (OS) for all patients by univariate analysis, whereas a significant prognostic variable for progression free survival (PFS) was found to be the clinical stage. In addition, both univariate and multivariate analyses confirmed that positive expression of TS was a significant predictor of worse PFS in CA patients of clinical stage 1. Positive TS expression in CA was identified as a significant predictor of worse outcome in patients of clinical stage 1.

  5. Predictors of matching in an ophthalmology residency program.

    PubMed

    Loh, Allison R; Joseph, Damien; Keenan, Jeremy D; Lietman, Thomas M; Naseri, Ayman

    2013-04-01

    To examine the characteristics of US medical students applying for ophthalmology residency and to determine the predictors of matching. A retrospective case series. A total of 3435 medical students from the United States who applied to an ophthalmology residency program from 2003 to 2008 were included. Matched and unmatched applicants were compared and stratified by predictor variables, including United States Medical Licensing Examination (USMLE) Step 1 score, Alpha Omega Alpha (AOA) status, medical school reputation, and medical school geographic region. Differences in proportions were analyzed using the Fisher exact test. Logistic regression was used to determine the predictors of successful matching. Successful matching to an ophthalmology program. The majority of applicants (72%, 2486/3435) matched in ophthalmology. In multivariate analysis, AOA membership (odds ratio [OR], 2.6, P<0.0001), USMLE score (OR, 1.6; P<0.0001), presence of an ophthalmology residency at medical school (OR, 1.4; P = 0.01), top 25 medical school (OR, 1.4; P<0.03), top 10 medical school (OR, 1.6; P<0.02), and allopathic degree (OR, 4.0; P<0.0001) were statistically significant predictors of matching. Approximately 60% (1442/2486) of applicants matched to the same geographic region as their medical school. Applicants were more likely to match at a program in the same geographic region as their medical school than would be predicted by chance alone (P<0.0001). In multivariate analysis, higher USMLE score (OR, 0.9; P<0.0001) and top 10 medical school (OR, 0.7; P = 0.027) were statistically significant predictors of matching to outside the geographic region as one's medical school. The majority of applicants applying for an ophthalmology residency position match successfully. Higher performance on quantitative metrics seems to confer an advantage for matching. The majority of applicants match at a residency program within the same geographic region as one's medical school. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  6. Predictive importance of anthropometric and training data in recreational male Ironman triathletes and marathon runners: comment on the study by Gianoli, et al. (2012).

    PubMed

    Burtscher, Martin; Gatterer, Hannes

    2013-04-01

    Anthropometric and training data have been reported as statistically significant predictors of race performance in endurance events. However, it is well established that physiological characteristics, i.e., maximal oxygen uptake (VO2max), the use of a high percentage of VO2max during sustained exercise, and work efficiency are predominant predictors of performance in those events. Thus, the essential issue is whether the anthropometric and training data give additional predictive power beyond these other measures.

  7. Digital literacy of youth and young adults with intellectual disability predicted by support needs and social maturity.

    PubMed

    Seok, Soonhwa; DaCosta, Boaventura

    2017-01-01

    This study investigated relationships between digital propensity and support needs as well as predictors of digital propensity in the context of support intensity, age, gender, and social maturity. A total of 118 special education teachers rated the support intensity, digital propensity, and social maturity of 352 students with intellectual disability. Leveraging the Digital Propensity Index, Supports Intensity Scale, and the Social Maturity Scale, descriptive statistics, correlations, multiple regressions, and regression analyses were employed. The findings revealed significant relationships between digital propensity and support needs. In addition, significant predictors of digital propensity were found with regard to support intensity, age, gender, and social maturity.

  8. Self-Efficacy and Multicultural Competence of School Counselors

    ERIC Educational Resources Information Center

    Owens, Delila; Bodenhorn, Nancy; Bryant, Rhonda M.

    2010-01-01

    The study examined the relationship between school counselor self efficacy and perceived multicultural competence self efficacy in a sample of 157 school counselors. Results reveal School Counselor Self-Efficacy (SCSE) cultural acceptance subscale was a statistically significant predictor of all three multicultural competencies (MCC: Terminology,…

  9. Daily Spiritual Experiences and Prosocial Behavior

    ERIC Educational Resources Information Center

    Einolf, Christopher J.

    2013-01-01

    This paper examines how the Daily Spiritual Experiences Scale (DSES) relates to range of prosocial behaviors, using a large, nationally representative U.S. data set. It finds that daily spiritual experiences are a statistically and substantively significant predictor of volunteering, charitable giving, and helping individuals one knows personally.…

  10. What Is the Ideal Tumor Regression Grading System in Rectal Cancer Patients after Preoperative Chemoradiotherapy?

    PubMed Central

    Kim, Soo Hee; Chang, Hee Jin; Kim, Dae Yong; Park, Ji Won; Baek, Ji Yeon; Kim, Sun Young; Park, Sung Chan; Oh, Jae Hwan; Yu, Ami; Nam, Byung-Ho

    2016-01-01

    Purpose Tumor regression grade (TRG) is predictive of therapeutic response in rectal cancer patients after chemoradiotherapy (CRT) followed by curative resection. However, various TRG systems have been suggested, with subjective categorization, resulting in interobserver variability. This study compared the prognostic validity of four different TRG systems in order to identify the most ideal TRG system. Materials and Methods This study included 933 patients who underwent preoperative CRT and curative resection. Primary tumors alone were graded according to the American Joint Committee on Cancer (AJCC), Dworak, and Ryan TRG systems, and both primary tumors and regional lymph nodes were graded according to a modified Dworak TRG system. The ability of each TRG system to predict recurrence-free survival (RFS) and overall survival (OS) was analyzed using chi-square and C statistics. Results All four TRG systems were significantly predictive of both RFS and OS (p < 0.001 each), however none was a better predictor of prognosis than ypStage. Among the four TRGs, the mDworak TRG system was a better predictor of RFS and OS than the AJCC, Dworak, and Ryan TRG systems, and both the chi-square and C statistics were higher for the former, although the differences were not statistically significant. The combination of ypStage and the modified Dworak TRG better predicted RFS and OS than ypStage alone. Conclusion The modified Dworak TRG system for evaluation of entire tumors including regional lymph nodes is a better predictor of survival than current TRG systems for evaluation of the primary tumor alone. PMID:26511803

  11. Comparison of ISS, NISS, and RTS score as predictor of mortality in pediatric fall.

    PubMed

    Soni, Kapil Dev; Mahindrakar, Santosh; Gupta, Amit; Kumar, Subodh; Sagar, Sushma; Jhakal, Ashish

    2017-01-01

    Studies to identify an ideal trauma score tool representing prediction of outcomes of the pediatric fall patient remains elusive. Our study was undertaken to identify better predictor of mortality in the pediatric fall patients. Data was retrieved from prospectively maintained trauma registry project at level 1 trauma center developed as part of Multicentric Project-Towards Improving Trauma Care Outcomes (TITCO) in India. Single center data retrieved from a prospectively maintained trauma registry at a level 1 trauma center, New Delhi, for a period ranging from 1 October 2013 to 17 February 2015 was evaluated. Standard anatomic scores Injury Severity Score (ISS) and New Injury Severity Score (NISS) were compared with physiologic score Revised Trauma Score (RTS) using receiver operating curve (ROC). Heart rate and RTS had a statistical difference among the survivors to nonsurvivors. ISS, NISS, and RTS were having 50, 50, and 86% of area under the curve on ROCs, and RTS was statistically significant among them. Physiologically based trauma score systems (RTS) are much better predictors of inhospital mortality in comparison to anatomical based scoring systems (ISS and NISS) for unintentional pediatric falls.

  12. Statistical-dynamical modeling of the cloud-to-ground lightning activity in Portugal

    NASA Astrophysics Data System (ADS)

    Sousa, J. F.; Fragoso, M.; Mendes, S.; Corte-Real, J.; Santos, J. A.

    2013-10-01

    The present study employs a dataset of cloud-to-ground discharges over Portugal, collected by the Portuguese lightning detection network in the period of 2003-2009, to identify dynamically coherent lightning regimes in Portugal and to implement a statistical-dynamical modeling of the daily discharges over the country. For this purpose, the high-resolution MERRA reanalysis is used. Three lightning regimes are then identified for Portugal: WREG, WREM and SREG. WREG is a typical cold-core cut-off low. WREM is connected to strong frontal systems driven by remote low pressure systems at higher latitudes over the North Atlantic. SREG is a combination of an inverted trough and a mid-tropospheric cold-core nearby Portugal. The statistical-dynamical modeling is based on logistic regressions (statistical component) developed for each regime separately (dynamical component). It is shown that the strength of the lightning activity (either strong or weak) for each regime is consistently modeled by a set of suitable dynamical predictors (65-70% of efficiency). The difference of the equivalent potential temperature in the 700-500 hPa layer is the best predictor for the three regimes, while the best 4-layer lifted index is still important for all regimes, but with much weaker significance. Six other predictors are more suitable for a specific regime. For the purpose of validating the modeling approach, a regional-scale climate model simulation is carried out under a very intense lightning episode.

  13. HIV/AIDS information by African companies: an empirical analysis.

    PubMed

    Barako, Dulacha G; Taplin, Ross H; Brown, Alistair M

    2010-01-01

    This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

  14. Factors influencing perceived effectiveness in dealing with self-harming patients in a sample of emergency department staff.

    PubMed

    Egan, Rachel; Sarma, Kiran M; O'Neill, Meena

    2012-12-01

    Past self-harming behavior is one of the most significant predictors of future suicide. Each year in Ireland there are approximately 11,000 presentations of self-harm to emergency departments (EDs) across the country. This study examines predictors of perceived personal effectiveness in dealing with self-harming patients as reported by ED staff. The predictors are derived from past research and are influenced by Bandura's Social Cognitive Theory. One hundred twenty-five ED medical staff (28 doctors and 97 nurses) from five EDs in the West and South of Ireland completed a questionnaire. Predictor variables included in the design, and informed by past research, included knowledge of self-harm and suicidal behavior and confidence in dealing with incidents of self-harm. Standard multiple regression suggested a statistically significant model fit between the two predictors and the criterion variable, accounting for 24% of total variance. Knowledge and Confidence were significant contributors to perceived personal effectiveness in dealing with self-harming patients. Little is known regarding specific factors that influence perceived effectiveness in dealing with self-harming patients in the ED setting. These findings have implications for psycho-education and training content for staff. The findings suggest that increasing knowledge of self-harm and confidence in dealing with self-harming patients can lead to more positive perceived personal effectiveness in responding to clients' needs. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population.

    PubMed

    He, Steven Y; McCulloch, Charles E; Boscardin, W John; Chren, Mary-Margaret; Linos, Eleni; Arron, Sarah T

    2014-10-01

    Fitzpatrick skin phototype (FSPT) is the most common method used to assess sunburn risk and is an independent predictor of skin cancer risk. Because of a conventional assumption that FSPT is predictable based on pigmentary phenotypes, physicians frequently estimate FSPT based on patient appearance. We sought to determine the degree to which self-reported race and pigmentary phenotypes are predictive of FSPT in a large, ethnically diverse population. A cross-sectional survey collected responses from 3386 individuals regarding self-reported FSPT, pigmentary phenotypes, race, age, and sex. Univariate and multivariate logistic regression analyses were performed to determine variables that significantly predict FSPT. Race, sex, skin color, eye color, and hair color are significant but weak independent predictors of FSPT (P<.0001). A multivariate model constructed using all independent predictors of FSPT only accurately predicted FSPT to within 1 point on the Fitzpatrick scale with 92% accuracy (weighted kappa statistic 0.53). Our study enriched for responses from ethnic minorities and does not fully represent the demographics of the US population. Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by FSPT. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Gastroschisis: antenatal sonographic predictors of adverse neonatal outcome.

    PubMed

    Page, Rachael; Ferraro, Zachary Michael; Moretti, Felipe; Fung, Karen Fung Kee

    2014-01-01

    The aim of this review was to identify clinically significant ultrasound predictors of adverse neonatal outcome in fetal gastroschisis. A quasi-systematic review was conducted in PubMed and Ovid using the key terms "gastroschisis," "predictors," "outcome," and "ultrasound." A total of 18 papers were included. The most common sonographic predictors were intra-abdominal bowel dilatation (IABD), intrauterine growth restriction (IUGR), and bowel dilatation not otherwise specified (NOS). Three ultrasound markers were consistently found to be statistically insignificant with respect to predicting adverse outcome including abdominal circumference, stomach herniation and dilatation, and extra-abdominal bowel dilatation (EABD). Gastroschisis is associated with several comorbidities, yet there is much discrepancy in the literature regarding which specific ultrasound markers best predict adverse neonatal outcomes. Future research should include prospective trials with larger sample sizes and use well-defined and consistent definitions of the adverse outcomes investigated with consideration given to IABD.

  17. Impulse oscillometry at preschool age is a strong predictor of lung function by flow-volume spirometry in adolescence.

    PubMed

    Lauhkonen, Eero; Riikonen, Riikka; Törmänen, Sari; Koponen, Petri; Nuolivirta, Kirsi; Helminen, Merja; Toikka, Jyri; Korppi, Matti

    2018-05-01

    The transition from early childhood wheezing to persistent asthma is linked to lung function impairment over time. Little is known how the methods used to study lung function at different ages correlate longitudinally. Sixty-four children with a history of hospitalization for bronchiolitis before 6 months of age were prospectively studied with impulse oscillometry (IOS) at the mean age of 6.3 years and these preschool IOS results were compared with flow-volume spirometry (FVS) measurements at mean age of 11.4 years. The baseline respiratory system resistance at 5 Hz (Rrs5) showed a modest statistically significant correlation with all baseline FVS parameters except FVC. The post-bronchodilator (post-BD) Rrs5 showed a modest statistically significant correlation with post-BD FEV 1 and FEV 1 /FVC. The bronchodilator-induced decrease in Rrs5 showed a modest statistically significant correlation with the percent increase in FEV 1 . Baseline and post-BD respiratory reactance at 5 Hz (Xrs5) showed a modest statistically significant correlation with baseline and post-BD FVS parameters except post-BD FEV 1 /FVC, respectively, and post-BD Xrs5 showed a strong correlation with post-BD FVC (ρ = 0.61) and post-BD FEV 1 (ρ = 0.59). In adjusted linear regression, preschool Xrs5 remained as a statistically significant independent predictor of FVS parameters in adolescence; the one-unit decrease in the Z-score of preschool post-BD Xrs5 predicted 9.6% lower post-BD FEV 1 , 9.3% lower post-BD FVC, and 9.7% lower post-BD MEF 50 when expressed as %-predicted parameters. Persistent post-BD small airway impairment in children with a history of bronchiolitis detected with IOS at preschool age predicted FVS results measured in early adolescence. © 2018 Wiley Periodicals, Inc.

  18. Perceived Difficulty Quitting Predicts Enrollment in a Smoking-Cessation Program for Patients With Head and Neck Cancer

    PubMed Central

    Duffy, Sonia A.; Scheumann, Angela L.; Fowler, Karen E.; Darling-Fisher, Cynthia; Terrell, Jeffrey E.

    2013-01-01

    Purpose/Objectives To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. Design This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers’ participation in a cessation intervention. Setting Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. Sample 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. Methods Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers’ participation in an intervention study. Main Research Variables Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. Findings Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. Conclusions Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. Implications for Nursing Oncology nurses are in an opportune position to assess patients’ perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population. PMID:20439219

  19. Technology Acceptance Predictors among Student Teachers and Experienced Classroom Teachers

    ERIC Educational Resources Information Center

    Smarkola, Claudia

    2007-01-01

    This study investigated 160 student teachers' and 158 experienced teachers' self-reported computer usage and their future intentions to use computer applications for school assignments. The Technology Acceptance Model (TAM) was used as the framework to determine computer usage and intentions. Statistically significant results showed that after…

  20. Predicting Teacher Job Satisfaction Based on Principals' Instructional Supervision Behaviours: A Study of Turkish Teachers

    ERIC Educational Resources Information Center

    Ilgan, Abdurrahman; Parylo, Oksana; Sungu, Hilmi

    2015-01-01

    This quantitative research examined instructional supervision behaviours of school principals as a predictor of teacher job satisfaction through the analysis of Turkish teachers' perceptions of principals' instructional supervision behaviours. There was a statistically significant difference found between the teachers' job satisfaction level and…

  1. Gender Inequality and Rates of Female Homicide Victimization across U.S. Cities.

    ERIC Educational Resources Information Center

    Brewer, Victoria E.; Smith, M. Dwayne

    1995-01-01

    Explores the possibility that female victimization rates are influenced by conditions of sex-based inequality. No single inequality variable was found to be a statistically significant predictor of female homicide rates when controlling for social structural effects. Found little support for gender inequality/female homicide connection. (JBJ)

  2. Discrimination History, Backlash Fear, and Ethnic Identity among Arab Americans: Post-9/11 Snapshots

    ERIC Educational Resources Information Center

    Nassar-McMillan, Sylvia C.; Lambert, Richard G.; Hakim-Larson, Julie

    2011-01-01

    The authors examined discrimination history, backlash fear, and ethnic identity of Arab Americans nationally at 3 times, beginning shortly after September 11, 2001. Relations between variables were moderate, and discrimination history and backlash fear were statistically significant predictors of ethnic identity. Implications for acculturation and…

  3. Single and Multiple Indicators of Physical Attractiveness and Psychosocial Behaviors among Young Adolescents.

    ERIC Educational Resources Information Center

    Perkins, Daniel F.; Lerner, Richard M.

    1995-01-01

    Examined relations among several indicators of physical attractiveness (PA): height, weight, and triceps skinfold thickness. Appraised whether multiple PA indicators accounted for more variation in measures of psychosocial functioning than did single PA indexes. Facial attractiveness was the most frequent statistically significant predictor of…

  4. Clinical significance of preoperative carcinoembryonic antigen level in patients with clinical stage IA non-small cell lung cancer.

    PubMed

    Maeda, Ryo; Suda, Takashi; Hachimaru, Ayumi; Tochii, Daisuke; Tochii, Sachiko; Takagi, Yasushi

    2017-01-01

    The objective of this study was to assess the preoperative serum carcinoembryonic antigen (CEA) level in patients with clinical stage IA non-small cell lung cancer (NSCLC) and to evaluate its clinical significance. Between January 2005 and December 2014, a total of 378 patients with clinical stage IA NSCLC underwent complete resection with systematic node dissection. The survival rate was estimated starting from the date of surgery to the date of either death or the last follow-up by the Kaplan-Meier method. Univariate analyses by log-rank tests were used to determine prognostic factors. Cox proportional hazards ratios were used to identify independent predictors of poor prognosis. Clinicopathological predictors of lymph node metastases were evaluated by logistic regression analyses. The 5-year survival rate of patients with an elevated preoperative serum CEA level was significantly lower than that of patients with a normal CEA level (75.5% vs. 87.7%; P=0.02). However, multivariate analysis did not show the preoperative serum CEA level to be an independent predictor of poor prognosis. Postoperative pathological factors, including lymphatic permeation, visceral pleural invasion, and lymph node metastases, tended to be positive in patients with an elevated preoperative serum CEA level. In addition, the CEA level was a statistically significant independent clinical predictor of lymph node metastases. The preoperative serum CEA level was not an independent predictor of poor prognosis in patients with pathological stage IA NSCLC but was an important clinical predictor of tumor invasiveness and lymph node metastases in patients with clinical stage IA NSCLC. Therefore, measurement of the preoperative serum CEA level should be considered even for patients with early-stage NSCLC.

  5. Towards an automatic statistical model for seasonal precipitation prediction and its application to Central and South Asian headwater catchments

    NASA Astrophysics Data System (ADS)

    Gerlitz, Lars; Gafurov, Abror; Apel, Heiko; Unger-Sayesteh, Katy; Vorogushyn, Sergiy; Merz, Bruno

    2016-04-01

    Statistical climate forecast applications typically utilize a small set of large scale SST or climate indices, such as ENSO, PDO or AMO as predictor variables. If the predictive skill of these large scale modes is insufficient, specific predictor variables such as customized SST patterns are frequently included. Hence statistically based climate forecast models are either based on a fixed number of climate indices (and thus might not consider important predictor variables) or are highly site specific and barely transferable to other regions. With the aim of developing an operational seasonal forecast model, which is easily transferable to any region in the world, we present a generic data mining approach which automatically selects potential predictors from gridded SST observations and reanalysis derived large scale atmospheric circulation patterns and generates robust statistical relationships with posterior precipitation anomalies for user selected target regions. Potential predictor variables are derived by means of a cellwise correlation analysis of precipitation anomalies with gridded global climate variables under consideration of varying lead times. Significantly correlated grid cells are subsequently aggregated to predictor regions by means of a variability based cluster analysis. Finally for every month and lead time, an individual random forest based forecast model is automatically calibrated and evaluated by means of the preliminary generated predictor variables. The model is exemplarily applied and evaluated for selected headwater catchments in Central and South Asia. Particularly the for winter and spring precipitation (which is associated with westerly disturbances in the entire target domain) the model shows solid results with correlation coefficients up to 0.7, although the variability of precipitation rates is highly underestimated. Likewise for the monsoonal precipitation amounts in the South Asian target areas a certain skill of the model could be detected. The skill of the model for the dry summer season in Central Asia and the transition seasons over South Asia is found to be low. A sensitivity analysis by means on well known climate indices reveals the major large scale controlling mechanisms for the seasonal precipitation climate of each target area. For the Central Asian target areas, both, the El Nino Southern Oscillation and the North Atlantic Oscillation are identified as important controlling factors for precipitation totals during moist spring season. Drought conditions are found to be triggered by a warm ENSO phase in combination with a positive phase of the NAO. For the monsoonal summer precipitation amounts over Southern Asia, the model suggests a distinct negative response to El Nino events.

  6. A Review of the Study Designs and Statistical Methods Used in the Determination of Predictors of All-Cause Mortality in HIV-Infected Cohorts: 2002–2011

    PubMed Central

    Otwombe, Kennedy N.; Petzold, Max; Martinson, Neil; Chirwa, Tobias

    2014-01-01

    Background Research in the predictors of all-cause mortality in HIV-infected people has widely been reported in literature. Making an informed decision requires understanding the methods used. Objectives We present a review on study designs, statistical methods and their appropriateness in original articles reporting on predictors of all-cause mortality in HIV-infected people between January 2002 and December 2011. Statistical methods were compared between 2002–2006 and 2007–2011. Time-to-event analysis techniques were considered appropriate. Data Sources Pubmed/Medline. Study Eligibility Criteria Original English-language articles were abstracted. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports and any other ineligible articles were excluded. Results A total of 189 studies were identified (n = 91 in 2002–2006 and n = 98 in 2007–2011) out of which 130 (69%) were prospective and 56 (30%) were retrospective. One hundred and eighty-two (96%) studies described their sample using descriptive statistics while 32 (17%) made comparisons using t-tests. Kaplan-Meier methods for time-to-event analysis were commonly used in the earlier period (n = 69, 76% vs. n = 53, 54%, p = 0.002). Predictors of mortality in the two periods were commonly determined using Cox regression analysis (n = 67, 75% vs. n = 63, 64%, p = 0.12). Only 7 (4%) used advanced survival analysis methods of Cox regression analysis with frailty in which 6 (3%) were used in the later period. Thirty-two (17%) used logistic regression while 8 (4%) used other methods. There were significantly more articles from the first period using appropriate methods compared to the second (n = 80, 88% vs. n = 69, 70%, p-value = 0.003). Conclusion Descriptive statistics and survival analysis techniques remain the most common methods of analysis in publications on predictors of all-cause mortality in HIV-infected cohorts while prospective research designs are favoured. Sophisticated techniques of time-dependent Cox regression and Cox regression with frailty are scarce. This motivates for more training in the use of advanced time-to-event methods. PMID:24498313

  7. Post Hoc Analysis of Potential Predictors of Response to Atomoxetine for the Treatment of Adults with Attention-Deficit/Hyperactivity Disorder using an Integrated Database.

    PubMed

    Bushe, Chris; Sobanski, Esther; Coghill, David; Berggren, Lovisa; De Bruyckere, Katrien; Leppämäki, Sami

    2016-04-01

    Responses to atomoxetine vary for individual patients with attention-deficit/hyperactivity disorder (ADHD). However, we do not know whether any factors can be used to reliably predict how individuals with ADHD will respond to treatment. Our objective was to evaluate background variables that facilitate early identification of those adults with ADHD who are likely to respond to treatment with atomoxetine. We pooled data for atomoxetine-treated adults with ADHD from 12 clinical trials for a short-term (10-week) analysis, and from 11 clinical trials for a long-term (24-week) analysis. Patients not meeting a response definition [≥30 % reduction in Conners' Adult ADHD Rating Scales-Investigator Rated: Screening Version (CAARS-Inv:SV) total score and Clinical Global Impressions of ADHD Severity Scale (CGI-S) score ≤3 at endpoint], or who discontinued, were defined as non-responders. Another definition of response (≥30 % reduction in CAARS-Inv:SV total score at endpoint) was also used in these analyses; only the results with the former definition are shown in this abstract, as the same conclusions were gained with both definitions. A treatment-specified subgroup detection tool (a resampling-based ensemble tree method) was used to identify predictors of response. Of 1945 adults in the long-term analysis, 548 (28.2 %) were responders to atomoxetine at week 24; 65.2 % of 1397 non-responders had discontinued. Of 4524 adults in the short-term analysis, 1490 (32.9 %) were responders at week 10; 33.2 % of 1006 non-responders had discontinued. No analyzed baseline parameters (age, sex, prior stimulant use, ADHD subtype, CAARS-Inv:SV, CGI-S) were statistically significant predictors of response. Reductions in CAARS-Inv:SV total, CAARS-Inv:SV subscores, and CGI-S at week 4 in the short-term analysis, and at weeks 4 or 10 in the long-term analysis, were statistically significant predictors of response, i.e., patients with versus without these reductions early in treatment were more likely to be clinical responders at later time points. Sensitivity ranged from 28.6 to 85.9 %, and specificity ranged from 23.8 to 86.7 %. Predictors with higher sensitivity had lower specificity, and vice versa. Reductions in CAARS-Inv:SV and CGI-S scores at weeks 4 and 10 are statistically significant predictors of response to atomoxetine at later time points in adults with ADHD. However, the predictors identified by these analyses are not reliable enough for use in clinical practice. The only currently available method to judge whether individuals with ADHD will respond to atomoxetine is to start treatment and assess the response over an extended period, sometimes longer than 10 weeks.

  8. Early prediction of olanzapine-induced weight gain for schizophrenia patients.

    PubMed

    Lin, Ching-Hua; Lin, Shih-Chi; Huang, Yu-Hui; Wang, Fu-Chiang; Huang, Chun-Jen

    2018-05-01

    The aim of this study was to determine whether weight changes at week 2 or other factors predicted weight gain at week 6 for schizophrenia patients receiving olanzapine. This study was the secondary analysis of a six-week trial for 94 patients receiving olanzapine (5 mg/d) plus trifluoperazine (5 mg/d), or olanzapine (10 mg/d) alone. Patients were included in analysis only if they had completed the 6-week trial (per protocol analysis). Weight gain was defined as a 7% or greater increase of the patient's baseline weight. The receiver operating characteristic curve was employed to determine the optimal cutoff points of statistically significant predictors. Eleven of the 67 patients completing the 6-week trial were classified as weight gainers. Weight change at week 2 was the statistically significant predictor for ultimate weight gain at week 6. A weight change of 1.0 kg at week 2 appeared to be the optimal cutoff point, with a sensitivity of 0.92, a specificity of 0.75, and an AUC of 0.85. Using weight change at week 2 to predict weight gain at week 6 is favorable in terms of both specificity and sensitivity. Weight change of 1.0 kg or more at 2 weeks is a reliable predictor. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. MULTIVARIATE STATISTICAL MODELS FOR EFFECTS OF PM AND COPOLLUTANTS IN A DAILY TIME SERIES EPIDEMIOLOGY STUDY

    EPA Science Inventory

    Most analyses of daily time series epidemiology data relate mortality or morbidity counts to PM and other air pollutants by means of single-outcome regression models using multiple predictors, without taking into account the complex statistical structure of the predictor variable...

  10. Predictors of Adolescents’ Health- promoting Behaviors Guided by Primary Socialization Theory

    PubMed Central

    Rew, Lynn; Arheart, Kristopher L.; Thompson, Sanna; Johnson, Karen

    2013-01-01

    Purpose The purpose of this study was to determine the influence of parents and peers on adolescents’ health-promoting behaviors, framed by Primary Socialization Theory. Design and Method Longitudinal data collected annually from 1,081 rural youth (mean age = 17 ±.7; 43.5% males; 44% Hispanic) and once from their parents were analyzed using generalized linear models. Results Parental monitoring and adolescent’s religious commitment significantly predicted all health-promoting behaviors (nutrition, physical activity, safety, health practices awareness, stress management). Other statistically significant predictors were parent’s responsiveness and health-promoting behaviors. Peer influence predicted safety and stress management. Practice Implications Nurses may facilitate adolescents’ development of health-promoting behaviors through family-focused interventions. PMID:24094123

  11. Increased Energy Drink Use as a Predictor of Illicit Prescription Stimulant Use.

    PubMed

    Woolsey, Conrad L; Williams, Ronald D; Jacobson, Bert H; Housman, Jeff M; McDonald, Jason D; Swartz, Julie H; Evans, Marion W; Sather, Thomas E; Barry, Adam E; Davidson, Robert T

    2015-01-01

    The purpose of this study was to examine energy drink usage patterns and to investigate the relationship between energy drink use and illicit use of prescription stimulants among college students. A sample of 605 undergraduate and graduate students (mean age±SD: 21.96±4.216) from a large midwestern university voluntarily participated in the study. Of the participants, 48.9% (n=296) reported using energy drinks in the past 30 days, whereas 25.3% (n=153) reported using prescription stimulant drugs in the past 30 days. Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of energy drink consumption was a significant predictor of illicit prescription stimulant use, with the odds for use increasing by 14% with each additional day of energy drink use (odds ratio for using=1.143, P≤.001). Analyses revealed statistically significant differences (P<.05) between prescription stimulant users and nonusers for all energy drink use variables, with the strongest predictors of prescription stimulant use being the number of days using energy drinks in the past 30 days and number of energy drink binges in the past 30 days. Results indicate that the frequency of energy drink use was a significant predictor of the illicit use of prescription stimulants.

  12. Statistical downscaling rainfall using artificial neural network: significantly wetter Bangkok?

    NASA Astrophysics Data System (ADS)

    Vu, Minh Tue; Aribarg, Thannob; Supratid, Siriporn; Raghavan, Srivatsan V.; Liong, Shie-Yui

    2016-11-01

    Artificial neural network (ANN) is an established technique with a flexible mathematical structure that is capable of identifying complex nonlinear relationships between input and output data. The present study utilizes ANN as a method of statistically downscaling global climate models (GCMs) during the rainy season at meteorological site locations in Bangkok, Thailand. The study illustrates the applications of the feed forward back propagation using large-scale predictor variables derived from both the ERA-Interim reanalyses data and present day/future GCM data. The predictors are first selected over different grid boxes surrounding Bangkok region and then screened by using principal component analysis (PCA) to filter the best correlated predictors for ANN training. The reanalyses downscaled results of the present day climate show good agreement against station precipitation with a correlation coefficient of 0.8 and a Nash-Sutcliffe efficiency of 0.65. The final downscaled results for four GCMs show an increasing trend of precipitation for rainy season over Bangkok by the end of the twenty-first century. The extreme values of precipitation determined using statistical indices show strong increases of wetness. These findings will be useful for policy makers in pondering adaptation measures due to flooding such as whether the current drainage network system is sufficient to meet the changing climate and to plan for a range of related adaptation/mitigation measures.

  13. 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.

  14. Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program

    PubMed Central

    Tejada, Frederick R.; Lang, Lynn A.; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

    2015-01-01

    Objective. To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Methods. Statistical analyses included two sample t tests, multiple regression and Pearson’s correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. Results. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Conclusion. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion. PMID:26430273

  15. Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program.

    PubMed

    Parmar, Jayesh R; Tejada, Frederick R; Lang, Lynn A; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

    2015-08-25

    To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Statistical analyses included two sample t tests, multiple regression and Pearson's correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion.

  16. Using Sisterhood Networks to Cultivate Ethnic Identity and Enhance School Engagement

    ERIC Educational Resources Information Center

    Jones, Janine M.; Lee, Lisa H.; Matlack, Alexa; Zigarelli, Julia

    2018-01-01

    School engagement has been found to be a statistically significant predictor of academic success. Education researchers are particularly interested in exploring the factors that influence the ways in which students are engaged in the classroom. As the population of students in the United States has become increasingly multicultural, it is…

  17. Prediction of Growth and Mortality of Oregon White Oak in the Pacific Northwest

    Treesearch

    Peter J. Gould; David D. X. Marshall; Constance A. Harrington

    2008-01-01

    We developed new equations to predict Oregon white oak (Quercus garryano Dougl. ex Hook.) development within ORGANON, a stand-development model that is widely used in the Pacific Northwest. Tree size, competitive status, crown ratio, and site productivity were statistically significant predictors of growth and mortality. Three...

  18. Prediction of growth and mortality of Oregon White Oak in the Pacific Northwest.

    Treesearch

    Peter J. Gould; David D. Marshall; Constance A. Harrington

    2008-01-01

    We developed new equations to predict Oregon white oak (Quercus garryana Dougl. ex Hook.) development with ORGANON, a stand-development model that is widely used in the Pacific Northwest. Tree size, competitive status, crown ratio, and site productivity were statistically significant predictors of growth and mortality. Three scenarios were...

  19. Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep

    PubMed Central

    Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

    2015-01-01

    Background Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Methods Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Results Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% “frequently or always”) were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% “frequently or always”) were statistically significant predictors of sleep quality. Conclusion Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken. PMID:26106509

  20. Predictor of increase in caregiver burden for disabled elderly at home.

    PubMed

    Okamoto, Kazushi; Harasawa, Yuko

    2009-01-01

    In order to classify the caregivers at high risk of increase in their burden early, linear discriminant analysis was performed to obtain an effective discriminant model for differentiation of the presence or absence of increase in caregiver burden. The data obtained by self-administered questionnaire from 193 caregivers of frail elderly from January to February of 2005 were used. The discriminant analysis yielded a statistically significant function explaining 35.0% (Rc=0.59; d.f.=6; p=0.0001). The configuration indicated that the psychological predictors of change in caregiver burden with much perceived stress (1.47), high caregiver burden at baseline (1.28), emotional control (0.75), effort to achieve (-0.28), symptomatic depression (0.20) and "ikigai" (purpose in life) (0.18) made statistically significant contributions to the differentiation between no increase and increase in caregiver burden. The discriminant function showed a sensitivity of 86% and specificity of 81%, and successfully classified 83% of the caregivers. The function at baseline is a simple and useful method for screening of an increase in caregiver burden among caregivers for the frail elderly at home.

  1. Age, Body Mass Index, and Daytime and Nocturnal Hypoxia as Predictors of Hypertension in Patients With Obstructive Sleep Apnea.

    PubMed

    Natsios, Georgios; Pastaka, Chaido; Vavougios, Georgios; Zarogiannis, Sotirios G; Tsolaki, Vasiliki; Dimoulis, Andreas; Seitanidis, Georgios; Gourgoulianis, Konstantinos I

    2016-02-01

    A growing body of evidence links obstructive sleep apnea (OSA) with hypertension. The authors performed a retrospective cohort study using the University Hospital of Larissa Sleep Apnea Database (1501 patients) to determine predictors of in-laboratory diagnosed OSA for development of hypertension. Differences in continuous variables were assessed via independent samples t test, whereas discrete variables were compared by Pearson's chi-square test. Multivariate analysis was performed via discriminant function analysis. There were several significant differences between hypertensive and normotensive patients. Age, body mass index, comorbidity, daytime oxygen saturation, and indices of hypoxia during sleep were deemed the most accurate predictors of hypertension, whereas apnea-hypopnea index and desaturation index were not. The single derived discriminant function was statistically significant (Wilk's lambda=0.771, χ(2) =289.070, P<.0001). Daytime and nocturnal hypoxia as consequences of chronic intermittent hypoxia play a central role in OSA-related hypertension and should be further evaluated as possible severity markers in OSA. ©2015 Wiley Periodicals, Inc.

  2. American Sign Language and Academic English: Factors Influencing the Reading of Bilingual Secondary School Deaf and Hard of Hearing Students.

    PubMed

    Scott, Jessica A; Hoffmeister, Robert J

    2017-01-01

    For many years, researchers have sought to understand the reading development of deaf and hard of hearing (DHH) students. Guided by prior research on DHH and hearing students, in this study we investigate the hypothesis that for secondary school DHH students enrolled in American Sign Language (ASL)/English bilingual schools for the deaf, academic English proficiency would be a significant predictor of reading comprehension alongside ASL proficiency. Using linear regression, we found statistically significant interaction effects between academic English knowledge and word reading fluency in predicting the reading comprehension scores of the participants. However, ASL remained the strongest and most consistent predictor of reading comprehension within the sample. Findings support a model in which socio-demographic factors, ASL proficiency, and word reading fluency are primary predictors of reading comprehension for secondary DHH students. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@.com.

  3. Verification of relationships between anthropometric variables among ureteral stents recipients and ureteric lengths: a challenge for Vitruvian-da Vinci theory.

    PubMed

    Acelam, Philip A

    2015-01-01

    To determine and verify how anthropometric variables correlate to ureteric lengths and how well statistical models approximate the actual ureteric lengths. In this work, 129 charts of endourological patients (71 females and 58 males) were studied retrospectively. Data were gathered from various research centers from North and South America. Continuous data were studied using descriptive statistics. Anthropometric variables (age, body surface area, body weight, obesity, and stature) were utilized as predictors of ureteric lengths. Linear regressions and correlations were used for studying relationships between the predictors and the outcome variables (ureteric lengths); P-value was set at 0.05. To assess how well statistical models were capable of predicting the actual ureteric lengths, percentages (or ratios of matched to mismatched results) were employed. The results of the study show that anthropometric variables do not correlate well to ureteric lengths. Statistical models can partially estimate ureteric lengths. Out of the five anthropometric variables studied, three of them: body frame, stature, and weight, each with a P<0.0001, were significant. Two of the variables: age (R (2)=0.01; P=0.20) and obesity (R (2)=0.03; P=0.06), were found to be poor estimators of ureteric lengths. None of the predictors reached the expected (match:above:below) ratio of 1:0:0 to qualify as reliable predictors of ureteric lengths. There is not sufficient evidence to conclude that anthropometric variables can reliably predict ureteric lengths. These variables appear to lack adequate specificity as they failed to reach the expected (match:above:below) ratio of 1:0:0. Consequently, selections of ureteral stents continue to remain a challenge. However, height (R (2)=0.68) with the (match:above:below) ratio of 3:3:4 appears suited for use as estimator, but on the basis of decision rule. Additional research is recommended for stent improvements and ureteric length determinations.

  4. Verification of relationships between anthropometric variables among ureteral stents recipients and ureteric lengths: a challenge for Vitruvian-da Vinci theory

    PubMed Central

    Acelam, Philip A

    2015-01-01

    Objective To determine and verify how anthropometric variables correlate to ureteric lengths and how well statistical models approximate the actual ureteric lengths. Materials and methods In this work, 129 charts of endourological patients (71 females and 58 males) were studied retrospectively. Data were gathered from various research centers from North and South America. Continuous data were studied using descriptive statistics. Anthropometric variables (age, body surface area, body weight, obesity, and stature) were utilized as predictors of ureteric lengths. Linear regressions and correlations were used for studying relationships between the predictors and the outcome variables (ureteric lengths); P-value was set at 0.05. To assess how well statistical models were capable of predicting the actual ureteric lengths, percentages (or ratios of matched to mismatched results) were employed. Results The results of the study show that anthropometric variables do not correlate well to ureteric lengths. Statistical models can partially estimate ureteric lengths. Out of the five anthropometric variables studied, three of them: body frame, stature, and weight, each with a P<0.0001, were significant. Two of the variables: age (R2=0.01; P=0.20) and obesity (R2=0.03; P=0.06), were found to be poor estimators of ureteric lengths. None of the predictors reached the expected (match:above:below) ratio of 1:0:0 to qualify as reliable predictors of ureteric lengths. Conclusion There is not sufficient evidence to conclude that anthropometric variables can reliably predict ureteric lengths. These variables appear to lack adequate specificity as they failed to reach the expected (match:above:below) ratio of 1:0:0. Consequently, selections of ureteral stents continue to remain a challenge. However, height (R2=0.68) with the (match:above:below) ratio of 3:3:4 appears suited for use as estimator, but on the basis of decision rule. Additional research is recommended for stent improvements and ureteric length determinations. PMID:26317082

  5. Using High Resolution Model Data to Improve Lightning Forecasts across Southern California

    NASA Astrophysics Data System (ADS)

    Capps, S. B.; Rolinski, T.

    2014-12-01

    Dry lightning often results in a significant amount of fire starts in areas where the vegetation is dry and continuous. Meteorologists from the USDA Forest Service Predictive Services' program in Riverside, California are tasked to provide southern and central California's fire agencies with fire potential outlooks. Logistic regression equations were developed by these meteorologists several years ago, which forecast probabilities of lightning as well as lightning amounts, out to seven days across southern California. These regression equations were developed using ten years of historical gridded data from the Global Forecast System (GFS) model on a coarse scale (0.5 degree resolution), correlated with historical lightning strike data. These equations do a reasonably good job of capturing a lightning episode (3-5 consecutive days or greater of lightning), but perform poorly regarding more detailed information such as exact location and amounts. It is postulated that the inadequacies in resolving the finer details of episodic lightning events is due to the coarse resolution of the GFS data, along with limited predictors. Stability parameters, such as the Lifted Index (LI), the Total Totals index (TT), Convective Available Potential Energy (CAPE), along with Precipitable Water (PW) are the only parameters being considered as predictors. It is hypothesized that the statistical forecasts will benefit from higher resolution data both in training and implementing the statistical model. We have dynamically downscaled NCEP FNL (Final) reanalysis data using the Weather Research and Forecasting model (WRF) to 3km spatial and hourly temporal resolution across a decade. This dataset will be used to evaluate the contribution to the success of the statistical model of additional predictors in higher vertical, spatial and temporal resolution. If successful, we will implement an operational dynamically downscaled GFS forecast product to generate predictors for the resulting statistical lightning model. This data will help fire agencies be better prepared to pre-deploy resources in advance of these events. Specific information regarding duration, amount, and location will be especially valuable.

  6. Single nucleotide polymorphisms in CETP, SLC46A1, SLC19A1, CD36, BCOM1, APOA5, and ABCA1 are significant predictors of plasma HDL in healthy adults

    USDA-ARS?s Scientific Manuscript database

    In a marker-trait association study we estimated the statistical significance of 65 single nucleotide polymorphisms (SNP) in 23 candidate genes on HDL levels of two independent Caucasian populations. Each population consisted of men and women and their HDL levels were adjusted for gender and body we...

  7. Migraine with aura: a predictor of patent foramen ovale in children and adolescents.

    PubMed

    Choi, Deok Young; Shin, Dong Hoon; Cho, Kang Ho; Lee, Sang Pyo; Park, Sanghui

    2013-05-01

    The prevalence of patent foramen ovale (PFO) is higher among adult migraine patients. The purpose of this study was to determine the frequency of PFO in children and adolescent migraine patients. A total of 32 patients with migraine (divided into two subgroups, the migraine with aura subgroup and the migraine without aura subgroup) and 31 normal control subjects were enrolled in this study. All of the participants underwent transthoracic echocardiography with an agitated saline test. We compared the prevalence of PFO and the severity of right-to-left shunt (RLS) in each group. No statistical difference in age and sex ratio was observed in either group. The prevalence of PFO was higher in the migraine group than in the control group, but without statistical significance (46.9% vs. 25.8%, P = 0.084). The prevalence of PFO was significantly higher in the migraine with aura subgroup than in the migraine without aura subgroup ( P = 0.031) and the normal control group ( P = 0.0074). Migraine with aura was the only significant factor showing an association with PFO (<0.01). RLS size did not have an influence on migraine. Considering the significantly high prevalence of PFO in pediatric migraine with aura patients, migraine with aura is a clear predictor of PFO among children and adolescents.

  8. Clinical and imaging predictors of management in retained products of conception.

    PubMed

    Kamaya, Aya; Krishnarao, Priya Menon; Nayak, Nita; Jeffrey, R Brooke; Maturen, Katherine E

    2016-12-01

    To determine if clinical and ultrasound (US) imaging features help predict management in clinically suspected retained products of conception (RPOC). 334 patients sonographically evaluated for RPOC were included in this IRB-approved retrospective study. Of the 334 patients, 176 had sonographic diagnosis of RPOC and comprised the final study group. Patients were managed expectantly, medically, or surgically in accordance with clinical judgment of treating physicians. Pelvic sonograms were retrospectively reviewed for endometrial stripe thickness and vascularity was graded on a 0-3 scale based on appearance relative to myometrium (Grade 0: no vascularity, Grade 1: minimal vascularity, Grade 2: moderate vascularity, Grade 3: marked vascularity). Clinical and imaging predictors of management were evaluated in univariate and multivariate analysis. Mean patient age was 29.6 years and mean gestational age was 17.4 weeks. Most (74.4%) women presented with vaginal bleeding. 83 patients (47.2%) were treated conservatively with expectant management, 42 (23.8%) were treated medically, and 51 (29.0%) required surgical intervention. Mean endometrial stripe thickness was 21.3 mm. 47 women (26.7%) had vascularity score of 0; 50 (28.4%) had score 1; 52 (29.6%) had score 2; and 27 (15.3%) had score 3. In univariate analysis, serum hemoglobin (Hb) (p < 0.0001), endometrial stripe thickness on US (p < 0.005), presenting symptoms (p = 0.03), and US vascularity score (p < 0.005) were statistically significant predictors of final management. In multivariate logistic regression, serum Hb (OR 0.69, 95% CI 0.55-0.86, p < 0.0009), endometrial stripe thickness (OR 1.08, 95% CI 1.04-1.12, p < 0.0001), and US vascularity score (OR 1.77, 95% CI 1.16-2.70, p < 0.01) were statistically significant predictors of need for surgery. Serum Hb, endometrial stripe thickness, and US vascularity score were significant predictors of clinical management, particularly the need for surgical intervention, in women with clinically suspected RPOC.

  9. Relationship between burnout and occupational stress among nurses in China.

    PubMed

    Wu, Siying; Zhu, Wei; Wang, Zhiming; Wang, Mianzhen; Lan, Yajia

    2007-08-01

    This article is a report of a study of occupational burnout among nurses in China. Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. It is well-known that burnout is a major problem for many professions. Nurses are considered to be particularly susceptible to this. Measuring burnout among nurses is important because their well-being has implications for stability in the healthcare workforce and for the quality of care provided. The sample consisted of 495 nurses from three provincial hospitals in China. The Maslach Burnout Inventory -- General Survey (MBI-GS) was used to measure burnout, and the Occupational Stress Inventory -- Revised edition was used to measure two dimensions of occupational adjustment (occupational stress and coping resources). After statistical testing for validity and reliability of the MBI-GS with nurses in China, participants' scores were evaluated and analysed. Scores for burnout of surgical and medical nurses were statistically significantly higher than those of other nurses (P < 0.05). Lower educational status was associated with lower professional efficacy, and younger nurses reported higher levels of burnout. The most significant predictors of emotional exhaustion were role overload, responsibility, role insufficiency and self-care (P < 0.05). The most significant predictors of cynicism were role insufficiency, role boundary, responsibility and self-care (P < 0.05). The most significant predictors of professional efficacy were role insufficiency, social support and rational/cognitive coping (P < 0.05). It is important to reduce occupational stress in nurses and to strengthen their coping resources to prevent burnout. This could be achieved with job redesign, modification of shiftwork systems, and by offering occupational health education.

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

    PubMed

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

    2016-04-01

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

  11. An interactive Bayesian model for prediction of lymph node ratio and survival in pancreatic cancer patients.

    PubMed

    Smith, Brian J; Mezhir, James J

    2014-10-01

    Regional lymph node status has long been used as a dichotomous predictor of clinical outcomes in cancer patients. More recently, interest has turned to the prognostic utility of lymph node ratio (LNR), quantified as the proportion of positive nodes examined. However, statistical tools for the joint modeling of LNR and its effect on cancer survival are lacking. Data were obtained from the NCI SEER cancer registry on 6400 patients diagnosed with pancreatic ductal adenocarcinoma from 2004 to 2010 and who underwent radical oncologic resection. A novel Bayesian statistical approach was developed and applied to model simultaneously patients' true, but unobservable, LNR statuses and overall survival. New web development tools were then employed to create an interactive web application for individualized patient prediction. Histologic grade and T and M stages were important predictors of LNR status. Significant predictors of survival included age, gender, marital status, grade, histology, T and M stages, tumor size, and radiation therapy. LNR was found to have a highly significant, non-linear effect on survival. Furthermore, predictive performance of the survival model compared favorably to those from studies with more homogeneous patients and individualized predictors. We provide a new approach and tool set for the prediction of LNR and survival that are generally applicable to a host of cancer types, including breast, colon, melanoma, and stomach. Our methods are illustrated with the development of a validated model and web applications for the prediction of survival in a large set of pancreatic cancer patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. SCD-HeFT: Use of RR Interval Statistics for Long-term Risk Stratification for Arrhythmic Sudden Cardiac Death

    PubMed Central

    Au-yeung, Wan-tai M.; Reinhall, Per; Poole, Jeanne E.; Anderson, Jill; Johnson, George; Fletcher, Ross D.; Moore, Hans J.; Mark, Daniel B.; Lee, Kerry L.; Bardy, Gust H.

    2015-01-01

    Background In the SCD-HeFT a significant fraction of the congestive heart failure (CHF) patients ultimately did not die suddenly from arrhythmic causes. CHF patients will benefit from better tools to identify if ICD therapy is needed. Objective To identify predictor variables from baseline SCD-HeFT patients’ RR intervals that correlate to arrhythmic sudden cardiac death (SCD) and mortality and to design an ICD therapy screening test. Methods Ten predictor variables were extracted from pre-randomization Holter data from 475 patients enrolled in the SCD-HeFT ICD arm using novel and traditional heart rate variability methods. All variables were correlated to SCD using Mann Whitney-Wilcoxon test and receiver operating characteristic analysis. ICD therapy screening tests were designed by minimizing the cost of false classifications. Survival analysis, including log-rank test and Cox models, was also performed. Results α1 and α2 from detrended fluctuation analysis, the ratio of low to high frequency power, the number of PVCs per hour and heart rate turbulence slope are all statistically significant for predicting the occurrences of SCD (p<0.001) and survival (log-rank p<0.01). The most powerful multivariate predictor tool using the Cox Proportional Hazards was α2 with a hazard ratio of 0.0465 (95% CI: 0.00528 – 0.409, p<0.01). Conclusion Predictor variables from RR intervals correlate to the occurrences of SCD and distinguish survival among SCD-HeFT ICD patients. We believe SCD prediction models should incorporate Holter based RR interval analysis to refine ICD patient selection especially in removing patients who are unlikely to benefit from ICD therapy. PMID:26096609

  13. Effectiveness of Tongue-lip Adhesion for Obstructive Sleep Apnea in Infants With Robin Sequence Measured by Polysomnography.

    PubMed

    Resnick, Cory M; Dentino, Kelley; Katz, Eliot; Mulliken, John B; Padwa, Bonnie L

    2016-09-01

    Tongue-lip adhesion (TLA) is commonly used to relieve obstructive sleep apnea (OSA) in infants with Robin sequence (RS), but few studies have evaluated its efficacy with objective measures. The purpose of this study was to measure TLA outcomes using polysomnography. Our hypothesis was that TLA relieves OSA in most infants. This is a retrospective study of infants with RS who underwent TLA from 2011 to 2014 and had at least a postoperative polysomnogram. Predictor variables included demographic and birth characteristics, surgeon, syndromic diagnosis, GILLS score, preoperative OSA severity, and clinical course. A successful outcome was defined as minimal OSA (apnea-hypopnea index score < 5) on postoperative polysomnogram and no need for additional airway intervention. Descriptive, bivariate, and regression statistics were computed, and statistical significance was set at P < .05. Eighteen subjects who had TLA at a mean age of 28 ± 4.7 days were included. Thirteen (72.2%) had a confirmed or suspected syndrome, and the mean GILLS score was 3 ± 0.3. All parameters trended toward improvement from the preoperative to postoperative polysomnograms, and improvement in OSA severity, oxygen saturation nadir, and arousals per hour was statistically significant (P < .02). This effect was significant across categories of surgeon, syndrome, and GILLS score. Nine subjects (50%) met the criteria for a successful outcome. Bivariate and regression analyses did not demonstrate a significant relationship between success and any predictor variable. TLA improved airway obstruction in all infants with RS but resolved OSA in only nine patients, and success was unpredictable.

  14. Predictors of transformational leadership of nurse managers.

    PubMed

    Echevarria, Ilia M; Patterson, Barbara J; Krouse, Anne

    2017-04-01

    The aim of this study was to examine the relationships among education, leadership experience, emotional intelligence and transformational leadership of nurse managers. Nursing leadership research provides limited evidence of predictors of transformational leadership style in nurse managers. A predictive correlational design was used with a sample of nurse managers (n = 148) working in varied health care settings. Data were collected using the Genos Emotional Intelligence Inventory, the Multi-factor Leadership Questionnaire and a demographic questionnaire. Simple linear and multiple regression analyses were used to examine relationships. A statistically significant relationship was found between emotional intelligence and transformational leadership (r = 0.59, P < 0.001) explaining 34% variance in transformational leadership. Nurse managers should be well informed of the predictors of transformational leadership in order to pursue continuing education and development opportunities related to those predictors. The results of this study emphasise the need for emotional intelligence continuing education, leadership development and leader assessment programmes. © 2016 John Wiley & Sons Ltd.

  15. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

    PubMed

    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = < .007), a Christian man should not get circumcised (OR = 2.47; p < .001), and circumcision makes penetration more painful and difficult (OR = 2.44; p = .007). Several beliefs about enhanced sexual performance, normative beliefs (parents, sexual partner, and friends), and non-TRA-related factors (e.g., importance of plowing season to daily schedule) were also statistically significant predictors. TRA proved a useful theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC.

  16. Can we predict 4-year graduation in podiatric medical school using admission data?

    PubMed

    Sesodia, Sanjay; Molnar, David; Shaw, Graham P

    2012-01-01

    This study examined the predictive ability of educational background and demographic variables, available at the admission stage, to identify applicants who will graduate in 4 years from podiatric medical school. A logistic regression model was used to identify two predictors of 4-year graduation: age at matriculation and total Medical College Admission Test score. The model was cross-validated using a second independent sample from the same population. Cross-validation gives greater confidence that the results could be more generally applied. Total Medical College Admission Test score was the strongest predictor of 4-year graduation, with age at matriculation being a statistically significant but weaker predictor. Despite the model's capacity to predict 4-year graduation better than random assignment, a sufficient amount of error in prediction remained, suggesting that important predictors are missing from the model. Furthermore, the high rate of false-positives makes it inappropriate to use age and Medical College Admission Test score as admission screens in an attempt to eliminate attrition by not accepting at-risk students.

  17. Characterizing multivariate decoding models based on correlated EEG spectral features

    PubMed Central

    McFarland, Dennis J.

    2013-01-01

    Objective Multivariate decoding methods are popular techniques for analysis of neurophysiological data. The present study explored potential interpretative problems with these techniques when predictors are correlated. Methods Data from sensorimotor rhythm-based cursor control experiments was analyzed offline with linear univariate and multivariate models. Features were derived from autoregressive (AR) spectral analysis of varying model order which produced predictors that varied in their degree of correlation (i.e., multicollinearity). Results The use of multivariate regression models resulted in much better prediction of target position as compared to univariate regression models. However, with lower order AR features interpretation of the spectral patterns of the weights was difficult. This is likely to be due to the high degree of multicollinearity present with lower order AR features. Conclusions Care should be exercised when interpreting the pattern of weights of multivariate models with correlated predictors. Comparison with univariate statistics is advisable. Significance While multivariate decoding algorithms are very useful for prediction their utility for interpretation may be limited when predictors are correlated. PMID:23466267

  18. Self-Concept, Early Childhood Depression and School Retention as Predictors of Adolescent Depression in Urban Hispanic Adolescents

    ERIC Educational Resources Information Center

    Robles-Pina, Rebecca A.; Defrance, Emily; Cox, Deborah L.

    2008-01-01

    The role that early school retention, early childhood depression and self-concept had on levels of depression in 191 urban Hispanic adolescents was investigated. This exploratory study used a purposeful sample to study relationships and thus causality cannot be inferred. Statistically significant gender differences were found for depression with…

  19. Applying Ajzen's Theory of Planned Behavior to a Study of Online Course Adoption in Public Relations Education

    ERIC Educational Resources Information Center

    Knabe, Ann Peru

    2012-01-01

    This study used Icek Ajzen's Theory of Planned Behavior to research public relations faculty intentions of teaching online. All of the main predictor variables (Subjective Norms, Attitude toward the Act and Perceived Behavioral Control) were statistically significant at varying degrees in predicting intent to teach public relations online. Of the…

  20. Scores on the 16 Personality Factor Test and Success in College Calculus 1.

    ERIC Educational Resources Information Center

    Shaughnessy, Michael F.; And Others

    This study explored personality variables measured by the 16 Personality Factor (16PF) test and their relevance to success, as defined by the final course grade, in college calculus courses with 94 students. Two personality variables were significant predictors of success as determined by the final course grade. A Statistical Analysis System…

  1. Predictors of Working Alliance Efficacy among State VR Counselors as a Function of Ex-Offender Status

    ERIC Educational Resources Information Center

    Bates, Julie K.

    2012-01-01

    The purpose of this study was to determine if statistically significant relationships existed between burnout, stigma, flourishing, caseload size, experience, and working alliance self-efficacy and to assess the predictive power of these variables on levels of working alliance self-efficacy with clients with disabilities alone and clients with…

  2. The Predictive Validity of a Computer-Adaptive Assessment of Kindergarten and First-Grade Reading Skills

    ERIC Educational Resources Information Center

    Clemens, Nathan H.; Hagan-Burke, Shanna; Luo, Wen; Cerda, Carissa; Blakely, Alane; Frosch, Jennifer; Gamez-Patience, Brenda; Jones, Meredith

    2015-01-01

    This study examined the predictive validity of a computer-adaptive assessment for measuring kindergarten reading skills using the STAR Early Literacy (SEL) test. The findings showed that the results of SEL assessments administered during the fall, winter, and spring of kindergarten were moderate and statistically significant predictors of year-end…

  3. Hand Movements and Braille Reading Efficiency: Data from the Alphabetic Braille and Contracted Braille Study

    ERIC Educational Resources Information Center

    Wright, Tessa; Wormsley, Diane P.; Kamei-Hannan, Cheryl

    2009-01-01

    Using a subset of data from the Alphabetic Braille and Contracted Braille Study, researchers analyzed the patterns and characteristics of hand movements as predictors of reading performance. Statistically significant differences were found between one- and two-handed readers and between patterns of hand movements and reading rates. (Contains 6…

  4. How Effective Are Military Academy Admission Standards

    DTIC Science & Technology

    2016-07-22

    curriculum) 60 Leadership Composite Called the extracurricular composite; includes activities , leadership, and résumé 20 Selection Panel Score Consists of...score 60 Community Leadership Score Composite of the athletic activities score, the extracurricular activities score, and the faculty appraisal...promotion. Both the candidate fitness assessment and the athletic activities score are statistically significant predictors of graduation. The candidate

  5. Teacher Quality Indicators as Predictors of Instructional Assessment Practices in Science Classrooms in Secondary Schools in Barbados

    ERIC Educational Resources Information Center

    Ogunkola, Babalola J.; Archer-Bradshaw, Ramona E.

    2013-01-01

    This study investigated the self-reported instructional assessment practices of a selected sample of secondary school science teachers in Barbados. The study sought to determine if there were statistically significant differences in the instructional assessment practices of teachers based on their sex and teacher quality (teaching experience,…

  6. Acute posttraumatic stress symptoms and depression after exposure to the 2005 Saskatchewan Centennial Air Show disaster: prevalence and predictors.

    PubMed

    Taylor, Steven; Asmundson, Gordon J G; Carleton, R Nicholas; Brundin, Peter

    2007-01-01

    The purpose of this study was to determine the prevalence of acute distress-that is, clinically significant posttraumatic stress symptoms (PTSS) and depression-and to identify predictors of each in a sample of people who witnessed a fatal aircraft collision at the 2005 Saskatchewan Centennial Air Show. Air Show attendees (N = 157) were recruited by advertisements in the local media and completed an Internet-administered battery of questionnaires. Based on previously established cut-offs, 22 percent respondents had clinically significant PTSS and 24 percent had clinically significant depressive symptoms. Clinically significant symptoms were associated with posttrauma impairment in social and occupational functioning. Acute distress was associated with several variables, including aspects of Air Show trauma exposure, severity of prior trauma exposure, low posttrauma social support (ie, negative responses by others), indices of poor coping (eg, intolerance of uncertainty, rumination about the trauma), and elevated scores on anxiety sensitivity, the personality trait of absorption, and dissociative tendencies. Results suggest that clinically significant acute distress is common in the aftermath of witnessed trauma. The statistical predictors (correlates) of acute distress were generally consistent with the results of studies of other forms of trauma. People with elevated scores on theoretical vulnerability factors (eg, elevated anxiety sensitivity) were particularly likely to develop acute distress.

  7. Predictors of anemia among pregnant women in Westmoreland, Jamaica

    PubMed Central

    Charles, Alyson M.; Campbell-Stennett, Dianne; Yatich, Nelly; Jolly, Pauline E.

    2010-01-01

    Anemia in pregnancy is a worldwide problem, but it is most prevalent in the developing world. This research project was conducted to determine the predictors of anemia in pregnant women in Westmoreland, Jamaica. A cross-sectional study design was conducted and descriptive, bivariate, and multiple logistic regression analyses were used. Body mass index, Mid-upper arm circumference, and the number of antenatal care visits showed a statistically significant association with anemia. Based on the results, we believe that maintaining a healthy body weight, and frequently visiting an antenatal clinic, will help to lower the prevalence of anemia among pregnant women in Westmoreland. PMID:20526925

  8. SU-F-T-386: Analysis of Three QA Methods for Predicting Dose Deviation Pass Percentage for Lung SBRT VMAT Plans

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

    Hardin, M; To, D; Giaddui, T

    2016-06-15

    Purpose: To investigate the significance of using pinpoint ionization chambers (IC) and RadCalc (RC) in determining the quality of lung SBRT VMAT plans with low dose deviation pass percentage (DDPP) as reported by ScandiDos Delta4 (D4). To quantify the relationship between DDPP and point dose deviations determined by IC (ICDD), RadCalc (RCDD), and median dose deviation reported by D4 (D4DD). Methods: Point dose deviations and D4 DDPP were compiled for 45 SBRT VMAT plans. Eighteen patients were treated on Varian Truebeam linear accelerators (linacs); the remaining 27 were treated on Elekta Synergy linacs with Agility collimators. A one-way analysis ofmore » variance (ANOVA) was performed to determine if there were any statistically significant differences between D4DD, ICDD, and RCDD. Tukey’s test was used to determine which pair of means was statistically different from each other. Multiple regression analysis was performed to determine if D4DD, ICDD, or RCDD are statistically significant predictors of DDPP. Results: Median DDPP, D4DD, ICDD, and RCDD were 80.5% (47.6%–99.2%), −0.3% (−2.0%–1.6%), 0.2% (−7.5%–6.3%), and 2.9% (−4.0%–19.7%), respectively. The ANOVA showed a statistically significant difference between D4DD, ICDD, and RCDD for a 95% confidence interval (p < 0.001). Tukey’s test revealed a statistically significant difference between two pairs of groups, RCDD-D4DD and RCDD-ICDD (p < 0.001), but no difference between ICDD-D4DD (p = 0.485). Multiple regression analysis revealed that ICDD (p = 0.04) and D4DD (p = 0.03) are statistically significant predictors of DDPP with an adjusted r{sup 2} of 0.115. Conclusion: This study shows ICDD predicts trends in D4 DDPP; however this trend is highly variable as shown by our low r{sup 2}. This work suggests that ICDD can be used as a method to verify DDPP in delivery of lung SBRT VMAT plans. RCDD may not validate low DDPP discovered in D4 QA for small field SBRT treatments.« less

  9. First-cycle blood counts and subsequent neutropenia, dose reduction, or delay in early-stage breast cancer therapy.

    PubMed

    Silber, J H; Fridman, M; DiPaola, R S; Erder, M H; Pauly, M V; Fox, K R

    1998-07-01

    If patients could be ranked according to their projected need for supportive care therapy, then more efficient and less costly treatment algorithms might be developed. This work reports on the construction of a model of neutropenia, dose reduction, or delay that rank-orders patients according to their need for costly supportive care such as granulocyte growth factors. A case series and consecutive sample of patients treated for breast cancer were studied. Patients had received standard-dose adjuvant chemotherapy for early-stage nonmetastatic breast cancer and were treated by four medical oncologists. Using 95 patients and validated with 80 additional patients, development models were constructed to predict one or more of the following events: neutropenia (absolute neutrophil count [ANC] < or = 250/microL), dose reduction > or = 15% of that scheduled, or treatment delay > or = 7 days. Two approaches to modeling were attempted. The pretreatment approach used only pretreatment predictors such as chemotherapy regimen and radiation history; the conditional approach included, in addition, blood count information obtained in the first cycle of treatment. The pretreatment model was unsuccessful at predicting neutropenia, dose reduction, or delay (c-statistic = 0.63). Conditional models were good predictors of subsequent events after cycle 1 (c-statistic = 0.87 and 0.78 for development and validation samples, respectively). The depth of the first-cycle ANC was an excellent predictor of events in subsequent cycles (P = .0001 to .004). Chemotherapy plus radiation also increased the risk of subsequent events (P = .0011 to .0901). Decline in hemoglobin (HGB) level during the first cycle of therapy was a significant predictor of events in the development study (P = .0074 and .0015), and although the trend was similar in the validation study, HGB decline failed to reach statistical significance. It is possible to rank patients according to their need of supportive care based on blood counts observed in the first cycle of therapy. Such rankings may aid in the choice of appropriate supportive care for patients with early-stage breast cancer.

  10. US female college students' breast health knowledge, attitudes, and determinants of screening practices: new implications for health education.

    PubMed

    Early, Jody; Armstrong, Shelley Nicole; Burke, Sloane; Thompson, Doris Lee

    2011-01-01

    This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population. A convenience sample of 1,074 college women from 3 universities participated in the research. Respondents completed an online version of the Toronto Breast Self-examination Instrument as well as questions developed by the authors. Descriptive statistics showed gaps in college women's knowledge of breast health and negative attitudes toward screening that were relative to age. Multiple linear and logistic regression analyses revealed that knowledge, attitudes, and copay were significant predictors of screening, whereas family history and ethnicity were not. This study supported previous smaller-sample studies that showed college women to be a priority population for breast health education and revealed new significant factors that should be addressed in health education for this group.

  11. Perceptions of Prostate Cancer Fatalism and Screening Behavior Between United States-Born and Caribbean-Born Black Males

    PubMed Central

    Cobran, Ewan K.; Wutoh, Anthony K.; Lee, Euni; Odedina, Folakemi T.; Ragin, Camille; Aiken, William; Godley, Paul A.

    2013-01-01

    Cancer fatalism is believed to be a major barrier for cancer screening in Black males. Therefore, the purpose of this study was to compare perceptions of prostate cancer (CaP) fatalism and predictors of CaP screening with Prostate Specific Antigen (PSA) testing between U.S.-born and Caribbean-born Black males. The Powe Fatalism Inventory and the Personal Integrative Model of CaP Disparity Survey were used to collect the following data from males in South Florida. Multivariate logistic regression models were constructed to examine the statistically significant predictors of CaP screening. A total of 211 U.S.-born and Caribbean-born Black males between ages 39–75 were recruited. Nativity was not a significant predictor of CaP screening with PSA testing within the last year (Odds ratio [OR] = 0.80, 95 % confidence interval [CI] = 0.26, 2.48, p = 0.70). Overall, higher levels of CaP fatalism were not a significant predictor of CaP screening with PSA testing within the last year (OR = 1.37, 95 % CI = 0.48, 3.91, p = 0.56). The study results suggest that nativity did not influence CaP screening with PSA testing. However, further studies are needed to evaluate the association between CaP screening behavior and levels of CaP fatalism. PMID:23576029

  12. Social and organizational factors affecting implementation of evidence-informed practice in a public health department in Ontario: a network modelling approach

    PubMed Central

    2014-01-01

    Objective The objective of this study is to develop a statistical model to assess factors associated with information seeking in a Canadian public health department. Methods Managers and professional consultants of a public health department serving a large urban population named whom they turned to for help, whom they considered experts in evidence-informed practice, and whom they considered friends. Multilevel regression analysis and exponential random graph modeling were used to predict the formation of information seeking and expertise-recognition connections by personal characteristics of the seeker and source, and the structural attributes of the social networks. Results The respondents were more likely to recognize the members of the supervisory/administrative division as experts. The extent to which an individual implemented evidence-based practice (EBP) principles in daily practice was a significant predictor of both being an information source and being recognized as expert by peers. Friendship was a significant predictor of both information seeking and expertise-recognition connections. Conclusion The analysis showed a communication network segregated by organizational divisions. Managers were identified frequently as information sources, even though this is not a part of their formal role. Self-perceived implementation of EBP in practice was a significant predictor of being an information source or an expert, implying a positive atmosphere towards implementation of evidence-informed decision making in this public health organization. Results also implied that the perception of accessibility and trust were significant predictors of expertise recognition. PMID:24565228

  13. Gender interactions and success.

    PubMed

    Wiggins, Carla; Peterson, Teri

    2004-01-01

    Does gender by itself, or does gender's interaction with career variables, better explain the difference between women and men's careers in healthcare management? US healthcare managers were surveyed regarding career and personal experiences. Gender was statistically interacted with explanatory variables. Multiple regression with backwards selection systematically removed non-significant variables. All gender interaction variables were non-significant. Much of the literature proposes that work and career factors impact working women differently than working men. We find that while gender alone is a significant predictor of income, it does not significantly interact with other career variables.

  14. Predicting driving performance in older adults: we are not there yet!

    PubMed

    Bédard, Michel; Weaver, Bruce; Darzins, Peteris; Porter, Michelle M

    2008-08-01

    We set up this study to determine the predictive value of approaches for which a statistical association with driving performance has been documented. We determined the statistical association (magnitude of association and probability of occurrence by chance alone) between four different predictors (the Mini-Mental State Examination, Trails A test, Useful Field of View [UFOV], and a composite measure of past driving incidents) and driving performance. We then explored the predictive value of these measures with receiver operating characteristic (ROC) curves and various cutoff values. We identified associations between the predictors and driving performance well beyond the play of chance (p < .01). Nonetheless, the predictors had limited predictive value with areas under the curve ranging from .51 to .82. Statistical associations are not sufficient to infer adequate predictive value, especially when crucial decisions such as whether one can continue driving are at stake. The predictors we examined have limited predictive value if used as stand-alone screening tests.

  15. Use of generalised additive models to categorise continuous variables in clinical prediction

    PubMed Central

    2013-01-01

    Background In medical practice many, essentially continuous, clinical parameters tend to be categorised by physicians for ease of decision-making. Indeed, categorisation is a common practice both in medical research and in the development of clinical prediction rules, particularly where the ensuing models are to be applied in daily clinical practice to support clinicians in the decision-making process. Since the number of categories into which a continuous predictor must be categorised depends partly on the relationship between the predictor and the outcome, the need for more than two categories must be borne in mind. Methods We propose a categorisation methodology for clinical-prediction models, using Generalised Additive Models (GAMs) with P-spline smoothers to determine the relationship between the continuous predictor and the outcome. The proposed method consists of creating at least one average-risk category along with high- and low-risk categories based on the GAM smooth function. We applied this methodology to a prospective cohort of patients with exacerbated chronic obstructive pulmonary disease. The predictors selected were respiratory rate and partial pressure of carbon dioxide in the blood (PCO2), and the response variable was poor evolution. An additive logistic regression model was used to show the relationship between the covariates and the dichotomous response variable. The proposed categorisation was compared to the continuous predictor as the best option, using the AIC and AUC evaluation parameters. The sample was divided into a derivation (60%) and validation (40%) samples. The first was used to obtain the cut points while the second was used to validate the proposed methodology. Results The three-category proposal for the respiratory rate was ≤ 20;(20,24];> 24, for which the following values were obtained: AIC=314.5 and AUC=0.638. The respective values for the continuous predictor were AIC=317.1 and AUC=0.634, with no statistically significant differences being found between the two AUCs (p =0.079). The four-category proposal for PCO2 was ≤ 43;(43,52];(52,65];> 65, for which the following values were obtained: AIC=258.1 and AUC=0.81. No statistically significant differences were found between the AUC of the four-category option and that of the continuous predictor, which yielded an AIC of 250.3 and an AUC of 0.825 (p =0.115). Conclusions Our proposed method provides clinicians with the number and location of cut points for categorising variables, and performs as successfully as the original continuous predictor when it comes to developing clinical prediction rules. PMID:23802742

  16. A meta-analysis of predictors of offender treatment attrition and its relationship to recidivism.

    PubMed

    Olver, Mark E; Stockdale, Keira C; Wormith, J Stephen

    2011-02-01

    The failure of offenders to complete psychological treatment can pose significant concerns, including increased risk for recidivism. Although a large literature identifying predictors of offender treatment attrition has accumulated, there has yet to be a comprehensive quantitative review. A meta-analysis of the offender treatment literature was conducted to identify predictors of offender treatment attrition and examine its relationship to recidivism. The review covered 114 studies representing 41,438 offenders. Sex offender and domestic violence programs were also examined separately given their large independent literatures. The overall attrition rate was 27.1% across all programs (k = 96), 27.6% from sex offender programs (k = 34), and 37.8% from domestic violence programs (k = 35). Rates increased when preprogram attrition was considered. Significant predictors included demographic characteristics (e.g., age, rw = -.10), criminal history and personality variables (e.g., prior offenses, rw = .14; antisocial personality, rw = .14), psychological concerns (e.g., intelligence, rw = -.14), risk assessment measures (e.g., Statistical Information on Recidivism scale, rw =.18), and treatment-related attitudes and behaviors (e.g., motivation, rw = -.13). Results indicated that treatment noncompleters were higher risk offenders and attrition from all programs significantly predicted several recidivism outcomes ranging from rw = .08 to .23. The clients who stand to benefit the most from treatment (i.e., high-risk, high-needs) are the least likely to complete it. Offender treatment attrition can be managed and clients can be retained through an awareness of, and attention to, key predictors of attrition and adherence to responsivity considerations.

  17. Impact of referral source and study applicants' preference for randomly assigned service on research enrollment, service engagement, and evaluative outcomes.

    PubMed

    Macias, Cathaleene; Barreira, Paul; Hargreaves, William; Bickman, Leonard; Fisher, William; Aronson, Elliot

    2005-04-01

    The inability to blind research participants to their experimental conditions is the Achilles' heel of mental health services research. When one experimental condition receives more disappointed participants, or more satisfied participants, research findings can be biased in spite of random assignment. The authors explored the potential for research participants' preference for one experimental program over another to compromise the generalizability and validity of randomized controlled service evaluations as well as cross-study comparisons. Three Cox regression analyses measured the impact of applicants' service assignment preference on research project enrollment, engagement in assigned services, and a service-related outcome, competitive employment. A stated service preference, referral by an agency with a low level of continuity in outpatient care, and willingness to switch from current services were significant positive predictors of research enrollment. Match to service assignment preference was a significant positive predictor of service engagement, and mismatch to assignment preference was a significant negative predictor of both service engagement and employment outcome. Referral source type and service assignment preference should be routinely measured and statistically controlled for in all studies of mental health service effectiveness to provide a sound empirical base for evidence-based practice.

  18. Sociodemographic predictors of elderly's psychological well-being in Malaysia.

    PubMed

    Momtaz, Yadollah A; Ibrahim, Rahimah; Hamid, Tengku A; Yahaya, Nurizan

    2011-05-01

    Psychological well-being as one of the most important indicators of successful aging has received substantial attention in the gerontological literature. Prior studies show that sociodemographic factors influencing elderly's psychological well-being are multiple and differ across cultures. The aim of this study was to identify significant sociodemographic predictors of psychological well-being among Malay elders. The study included 1415 older Malays (60-100 years, 722 women), randomly selected through a multistage stratified random method from Peninsular Malaysia. WHO-Five well-being index was used to measure psychological well-being. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 13.0. Using multiple regression analysis a significant model emerged (F(7, 1407) = 20.14, p ≤ 0.001), where age, sex, marital status, and household income were significant predictor variables of psychological well-being among Malay elders. However, level of education, employment status, and place of residence failed to predict psychological well-being. This study showed that the oldest old, elderly women, unmarried, and the poor elderly people are at risk for experiencing low psychological well-being. Therefore, they need special attention from family, policy makers, and those who work with elderly people.

  19. Identifying predictors of time-inhomogeneous viral evolutionary processes.

    PubMed

    Bielejec, Filip; Baele, Guy; Rodrigo, Allen G; Suchard, Marc A; Lemey, Philippe

    2016-07-01

    Various factors determine the rate at which mutations are generated and fixed in viral genomes. Viral evolutionary rates may vary over the course of a single persistent infection and can reflect changes in replication rates and selective dynamics. Dedicated statistical inference approaches are required to understand how the complex interplay of these processes shapes the genetic diversity and divergence in viral populations. Although evolutionary models accommodating a high degree of complexity can now be formalized, adequately informing these models by potentially sparse data, and assessing the association of the resulting estimates with external predictors, remains a major challenge. In this article, we present a novel Bayesian evolutionary inference method, which integrates multiple potential predictors and tests their association with variation in the absolute rates of synonymous and non-synonymous substitutions along the evolutionary history. We consider clinical and virological measures as predictors, but also changes in population size trajectories that are simultaneously inferred using coalescent modelling. We demonstrate the potential of our method in an application to within-host HIV-1 sequence data sampled throughout the infection of multiple patients. While analyses of individual patient populations lack statistical power, we detect significant evidence for an abrupt drop in non-synonymous rates in late stage infection and a more gradual increase in synonymous rates over the course of infection in a joint analysis across all patients. The former is predicted by the immune relaxation hypothesis while the latter may be in line with increasing replicative fitness during the asymptomatic stage.

  20. 2012 Workplace and Gender Relations Survey of Active Duty Members: Nonresponse Bias Analysis Report

    DTIC Science & Technology

    2014-01-01

    Control and Prevention ), or command climate surveys (e.g., DEOCS). 6 Table 1. Comparison of Trends in WGRA and SOFS-A Response Rates (Shown in...DMDC draws optimized samples to reduce survey burden on members as well as produce high levels of precision for important domain estimates by using...statistical significance at α= .05 Because paygrade is a significant predictor of survey response, we next examined the odds ratio of each paygrade levels

  1. Socio-Demographic and Clinical Characteristics are Not Clinically Useful Predictors of Refill Adherence in Patients with Hypertension

    PubMed Central

    Steiner, John F.; Ho, P. Michael; Beaty, Brenda L.; Dickinson, L. Miriam; Hanratty, Rebecca; Zeng, Chan; Tavel, Heather M.; Havranek, Edward P.; Davidson, Arthur J.; Magid, David J.; Estacio, Raymond O.

    2009-01-01

    Background Although many studies have identified patient characteristics or chronic diseases associated with medication adherence, the clinical utility of such predictors has rarely been assessed. We attempted to develop clinical prediction rules for adherence with antihypertensive medications in two health care delivery systems. Methods and Results Retrospective cohort studies of hypertension registries in an inner-city health care delivery system (N = 17176) and a health maintenance organization (N = 94297) in Denver, Colorado. Adherence was defined by acquisition of 80% or more of antihypertensive medications. A multivariable model in the inner-city system found that adherent patients (36.3% of the total) were more likely than non-adherent patients to be older, white, married, and acculturated in US society, to have diabetes or cerebrovascular disease, not to abuse alcohol or controlled substances, and to be prescribed less than three antihypertensive medications. Although statistically significant, all multivariate odds ratios were 1.7 or less, and the model did not accurately discriminate adherent from non-adherent patients (C-statistic = 0.606). In the health maintenance organization, where 72.1% of patients were adherent, significant but weak associations existed between adherence and older age, white race, the lack of alcohol abuse, and fewer antihypertensive medications. The multivariate model again failed to accurately discriminate adherent from non-adherent individuals (C-statistic = 0.576). Conclusions Although certain socio-demographic characteristics or clinical diagnoses are statistically associated with adherence to refills of antihypertensive medications, a combination of these characteristics is not sufficiently accurate to allow clinicians to predict whether their patients will be adherent with treatment. PMID:20031876

  2. Predictors of Latina/o Community College Student Vocational Choice of STEM Fields: Testing of the STEM-Vocational Choice Model

    ERIC Educational Resources Information Center

    Johnson, Joel D.

    2013-01-01

    This study confirmed appropriate measurement model fit for a theoretical model, the STEM vocational choice (STEM-VC) model. This model identifies exogenous factors that successfully predicted, at a statistically significant level, a student's vocational choice decision to pursue a STEM degree at transfer. The student population examined for this…

  3. Predictors of Postpartum Depression in Dubai, a Rapidly Growing Multicultural Society in the United Arab Emirates.

    PubMed

    Alhammadi, Salwa M; Hashem, Lien Abou; Abusbeih, Zainah R; Alzaabi, Fatima S; Alnuaimi, Salama N; Jalabi, Ala F; Nair, Satish C; Carrick, Frederick R; Abdulrahman, Mahera

    2017-09-01

    Postpartum depression (PPD) is a significant public health problem adversely affecting mothers, their newborns, and other members of the family. Although PPD is common and potentially dangerous, only a minority of the cases are identified in primary health care settings during routine care, and the majority of depressed mothers in the community lies unrecognized and therefore untreated. In this study, a total of 1500 mothers were approached randomly, 808 accepted to participate, and 504 were within the inclusion criteria (women who had a birth of a singleton full-term healthy infant, had an uncomplicated pregnancy, and were within their one week to six months postpartum). The participants completed the Edinburgh Postnatal Depression Scale. A total of 168 women had an EPDS score ≥10, yielding a crude prevalence rate of 33%. The prevalence of suicidal ideation was 14 out of 504 (3%), among which 11 (79%) had EPDS score of ≥10. We fitted multiple linear regression models to evaluate the predictors of variables measured on the EPDS scale. This model was statistically significant p<0.0001 in predicting the total EPDS score. Women's employment status, baby's birth weight, stressful life event and marital conflict were statistically significant predictors. The findings of this study are anticipated to entail the government and policy makers in the region to pay more attention to the apparently high prevalence of unrevealed PPD in the community. It is crucial to enhance screening mechanisms for early detection, providing interventions to manage symptoms, and at the same time mandating local guidelines to address the PPD pathology as a high priority for the UAE population.

  4. Pediatric outcomes data collection instrument scores in ambulatory children with cerebral palsy: an analysis by age groups and severity level.

    PubMed

    Barnes, Douglas; Linton, Judith L; Sullivan, Elroy; Bagley, Anita; Oeffinger, Donna; Abel, Mark; Damiano, Diane; Gorton, George; Nicholson, Diane; Romness, Mark; Rogers, Sarah; Tylkowski, Chester

    2008-01-01

    The Pediatric Outcomes Data Collection Instrument (PODCI) was developed in 1994 as a patient-based tool for use across a broad age range and wide array of musculoskeletal disorders, including children with cerebral palsy (CP). The purpose of this study was to establish means and SDs of the Parent PODCI measures by age groups and Gross Motor Function Classification System (GMFCS) levels for ambulatory children with CP. This instrument was one of several studied in a prospective, multicenter project of ambulatory patients with CP between the aged 4 and 18 years and GMFCS levels I through III. Participants included 338 boys and 221 girls at a mean age of 11.1 years, with 370 diplegic, 162 hemiplegic, and 27 quadriplegic. Both baseline and follow-up data sets of the completed Parent PODCI responses were statistically analyzed. Age was identified as a significant predictor of the PODCI measures of Upper Extremity Function, Transfers and Basic Mobility, Global Function, and Happiness With Physical Condition. Gross Motor Function Classification System levels was a significant predictor of Transfers and Basic Mobility, Sports and Physical Function, and Global Function. Pattern of involvement, sex, and prior orthopaedic surgery were not statistically significant predictors for any of the Parent PODCI measures. Mean and SD scores were calculated for age groups stratified by GMFCS levels. Analysis of the follow-up data set validated the findings derived from the baseline data. Linear regression equations were derived, with age as a continuous variable and GMFCS levels as a categorical variable, to be used for Parent PODCI predicted scores. The results of this study provide clinicians and researchers with a set of Parent PODCI values for comparison to age- and severity-matched populations of ambulatory patients with CP.

  5. Predictors of Long-term Success After Concomitant Surgical Ablation for Atrial Fibrillation.

    PubMed

    Pecha, Simon; Ghandili, Susanne; Hakmi, Samer; Willems, Stephan; Reichenspurner, Hermann; Wagner, Florian Mathias

    2017-01-01

    According to guidelines, atrial fibrillation (AF) ablation success should be measured by 24-hour Holter electrocardiogram (ECG). However, information on long-term success, especially obtained by 24-hour Holter ECG, is rare. We therefore analyzed rhythm course and long-term outcomes of our patients undergoing concomitant surgical AF ablation. Between January 2003 and April 2011, 486 patients underwent concomitant surgical AF ablation in our institution. Patients with 24-hour Holter ECG rhythm status available between 5 and 10 years postoperatively were included in this retrospective data analysis (n = 155). Ablation lesions were limited to either a pulmonary vein isolation (n = 31, 20%), a more complex left atrial lesion set (n = 89, 57%), or biatrial lesions (n = 35, 23%). Primary end point of the study was freedom from AF during long-term follow-up. Mean patient age was 68.1 ± 8.4 years; 57.4% were male. Mean follow-up time was 5.9 years. Surgical AF ablation provided freedom from AF rate of 56.6% during long-term follow-up, with significantly better results in patients with paroxysmal than in those with persistent AF (67.2% vs 51.8% P = 0.03). A stable rhythm course was observed during follow-up, without statistically significant differences between 12 months and latest follow-up (63.2% vs 56.6%; P = 0.25). In multivariate analysis, preoperative paroxysmal AF, duration of AF, and left atrial diameter were predictors of long-term ablation success. Surgical AF ablation provided freedom from AF rate of 56.6% during long-term follow-up. Statistically significant predictors of ablation success at latest follow-up were preoperative paroxysmal AF, duration of AF, and a preoperative smaller left atrial diameter. Copyright © 2017. Published by Elsevier Inc.

  6. Fast Recognition of BCI-Inefficient Users Using Physiological Features from EEG Signals: A Screening Study of Stroke Patients.

    PubMed

    Shu, Xiaokang; Chen, Shugeng; Yao, Lin; Sheng, Xinjun; Zhang, Dingguo; Jiang, Ning; Jia, Jie; Zhu, Xiangyang

    2018-01-01

    Motor imagery (MI) based brain-computer interface (BCI) has been developed as an alternative therapy for stroke rehabilitation. However, experimental evidence demonstrates that a significant portion (10-50%) of subjects are BCI-inefficient users (accuracy less than 70%). Thus, predicting BCI performance prior to clinical BCI usage would facilitate the selection of suitable end-users and improve the efficiency of stroke rehabilitation. In the current study, we proposed two physiological variables, i.e., laterality index (LI) and cortical activation strength (CAS), to predict MI-BCI performance. Twenty-four stroke patients and 10 healthy subjects were recruited for this study. Each subject was required to perform two blocks of left- and right-hand MI tasks. Linear regression analyses were performed between the BCI accuracies and two physiological predictors. Here, the predictors were calculated from the electroencephalography (EEG) signals during paretic hand MI tasks (5 trials; approximately 1 min). LI values exhibited a statistically significant correlation with two-class BCI (left vs. right) performance (r = -0.732, p < 0.001), and CAS values exhibited a statistically significant correlation with brain-switch BCI (task vs. idle) performance ( r = 0.641, p < 0.001). Furthermore, the BCI-inefficient users were successfully recognized with a sensitivity of 88.2% and a specificity of 85.7% in the two-class BCI. The brain-switch BCI achieved a sensitivity of 100.0% and a specificity of 87.5% in the discrimination of BCI-inefficient users. These results demonstrated that the proposed BCI predictors were promising to promote the BCI usage in stroke rehabilitation and contribute to a better understanding of the BCI-inefficiency phenomenon in stroke patients.

  7. Fast Recognition of BCI-Inefficient Users Using Physiological Features from EEG Signals: A Screening Study of Stroke Patients

    PubMed Central

    Shu, Xiaokang; Chen, Shugeng; Yao, Lin; Sheng, Xinjun; Zhang, Dingguo; Jiang, Ning; Jia, Jie; Zhu, Xiangyang

    2018-01-01

    Motor imagery (MI) based brain-computer interface (BCI) has been developed as an alternative therapy for stroke rehabilitation. However, experimental evidence demonstrates that a significant portion (10–50%) of subjects are BCI-inefficient users (accuracy less than 70%). Thus, predicting BCI performance prior to clinical BCI usage would facilitate the selection of suitable end-users and improve the efficiency of stroke rehabilitation. In the current study, we proposed two physiological variables, i.e., laterality index (LI) and cortical activation strength (CAS), to predict MI-BCI performance. Twenty-four stroke patients and 10 healthy subjects were recruited for this study. Each subject was required to perform two blocks of left- and right-hand MI tasks. Linear regression analyses were performed between the BCI accuracies and two physiological predictors. Here, the predictors were calculated from the electroencephalography (EEG) signals during paretic hand MI tasks (5 trials; approximately 1 min). LI values exhibited a statistically significant correlation with two-class BCI (left vs. right) performance (r = −0.732, p < 0.001), and CAS values exhibited a statistically significant correlation with brain-switch BCI (task vs. idle) performance (r = 0.641, p < 0.001). Furthermore, the BCI-inefficient users were successfully recognized with a sensitivity of 88.2% and a specificity of 85.7% in the two-class BCI. The brain-switch BCI achieved a sensitivity of 100.0% and a specificity of 87.5% in the discrimination of BCI-inefficient users. These results demonstrated that the proposed BCI predictors were promising to promote the BCI usage in stroke rehabilitation and contribute to a better understanding of the BCI-inefficiency phenomenon in stroke patients. PMID:29515363

  8. Predictors of Colorectal Cancer Knowledge among Adults in the United Arab Emirates

    PubMed

    Al-Sharbatti, Shatha; Muttappallymyalil, Jayakumary; Sreedharan, Jayadevan; Almosawy, Yasien

    2017-09-27

    Objective: To assess knowledge regarding colorectal cancer (CRC) and to identify its predictors in the UAE. Materials and Methods: A cross sectional study was conducted among subjects ≥ 50 years-old, using a validated self-administered questionnaire. Awareness of CRC risk factors, warning signs/symptoms (S/S), and screening methods was evaluated with a level of knowledge score for various areas. Low (poor) knowledge was defined as a score below the corresponding average value. The Chi-square test and logistic regression were used in the statistical analysis. Results: The percentage of respondents who had poor knowledge score concerning risk factors, warning S/S and screening were 81.7%, 84.7% and 94.1% respectively. Male and lower education level subjects had significantly higher probability of low knowledge related to risk factors and warning S/S. Also respondents without a family history of CRC or personal history of polyps had a significantly higher probability of low knowledge concerning warning S/S compared to those who had a positive history. Significantly higher probability of low knowledge concerning screening methods was noted among non-Arabs and subjects with a lower education level. Conclusion: Most of the respondents had poor knowledge. Gender, education level, family and personal history and ethnicity were found to be significant predictors of CRC knowledge. Creative Commons Attribution License

  9. Predictors of Colorectal Cancer Knowledge among Adults in the United Arab Emirates

    PubMed Central

    Al-Sharbatti, Shatha; Muttappallymyalil, Jayakumary; Sreedharan, Jayadevan; Almosawy, Yasien

    2017-01-01

    Objective: To assess knowledge regarding colorectal cancer (CRC) and to identify its predictors in the UAE. Materials and Methods: A cross sectional study was conducted among subjects ≥ 50 years-old, using a validated self-administered questionnaire. Awareness of CRC risk factors, warning signs/symptoms (S/S), and screening methods was evaluated with a level of knowledge score for various areas. Low (poor) knowledge was defined as a score below the corresponding average value. The Chi-square test and logistic regression were used in the statistical analysis. Results: The percentage of respondents who had poor knowledge score concerning risk factors, warning S/S and screening were 81.7%, 84.7% and 94.1% respectively. Male and lower education level subjects had significantly higher probability of low knowledge related to risk factors and warning S/S. Also respondents without a family history of CRC or personal history of polyps had a significantly higher probability of low knowledge concerning warning S/S compared to those who had a positive history. Significantly higher probability of low knowledge concerning screening methods was noted among non-Arabs and subjects with a lower education level. Conclusion: Most of the respondents had poor knowledge. Gender, education level, family and personal history and ethnicity were found to be significant predictors of CRC knowledge. PMID:28950678

  10. Groundwater nitrate contamination: Factors and indicators

    PubMed Central

    Wick, Katharina; Heumesser, Christine; Schmid, Erwin

    2012-01-01

    Identifying significant determinants of groundwater nitrate contamination is critical in order to define sensible agri-environmental indicators that support the design, enforcement, and monitoring of regulatory policies. We use data from approximately 1200 Austrian municipalities to provide a detailed statistical analysis of (1) the factors influencing groundwater nitrate contamination and (2) the predictive capacity of the Gross Nitrogen Balance, one of the most commonly used agri-environmental indicators. We find that the percentage of cropland in a given region correlates positively with nitrate concentration in groundwater. Additionally, environmental characteristics such as temperature and precipitation are important co-factors. Higher average temperatures result in lower nitrate contamination of groundwater, possibly due to increased evapotranspiration. Higher average precipitation dilutes nitrates in the soil, further reducing groundwater nitrate concentration. Finally, we assess whether the Gross Nitrogen Balance is a valid predictor of groundwater nitrate contamination. Our regression analysis reveals that the Gross Nitrogen Balance is a statistically significant predictor for nitrate contamination. We also show that its predictive power can be improved if we account for average regional precipitation. The Gross Nitrogen Balance predicts nitrate contamination in groundwater more precisely in regions with higher average precipitation. PMID:22906701

  11. The Impact of State Legislation and Model Policies on Bullying in Schools.

    PubMed

    Terry, Amanda

    2018-04-01

    The purpose of this study was to determine the impact of the coverage of state legislation and the expansiveness ratings of state model policies on the state-level prevalence of bullying in schools. The state-level prevalence of bullying in schools was based on cross-sectional data from the 2013 High School Youth Risk Behavior Survey. Multiple regression was conducted to determine whether the coverage of state legislation and the expansiveness rating of a state model policy affected the state-level prevalence of bullying in schools. The purpose and definition category of components in state legislation and the expansiveness rating of a state model policy were statistically significant predictors of the state-level prevalence of bullying in schools. The other 3 categories of components in state legislation-District Policy Development and Review, District Policy Components, and Additional Components-were not statistically significant predictors in the model. Extensive coverage in the purpose and definition category of components in state legislation and a high expansiveness rating of a state model policy may be important in efforts to reduce bullying in schools. Improving these areas may reduce the state-level prevalence of bullying in schools. © 2018, American School Health Association.

  12. Determinants of Low Cloud Properties - An Artificial Neural Network Approach Using Observation Data Sets

    NASA Astrophysics Data System (ADS)

    Andersen, Hendrik; Cermak, Jan

    2015-04-01

    This contribution studies the determinants of low cloud properties based on the application of various global observation data sets in machine learning algorithms. Clouds play a crucial role in the climate system as their radiative properties and precipitation patterns significantly impact the Earth's energy balance. Cloud properties are determined by environmental conditions, as cloud formation requires the availability of water vapour ("precipitable water") and condensation nuclei in sufficiently saturated conditions. A main challenge in the research of aerosol-cloud interactions is the separation of aerosol effects from meteorological influence. To gain understanding of the processes that govern low cloud properties in order to increase accuracy of climate models and predictions of future changes in the climate system is thus of great importance. In this study, artificial neural networks are used to relate a selection of predictors (meteorological parameters, aerosol loading) to a set of predictands (cloud microphysical and optical properties). As meteorological parameters, wind direction and velocity, sea level pressure, static stability of the lower troposphere, atmospheric water vapour and temperature at the surface are used (re-analysis data by the European Centre for Medium-Range Weather Forecasts). In addition to meteorological conditions, aerosol loading is used as a predictor of cloud properties (MODIS collection 6 aerosol optical depth). The statistical model reveals significant relationships between predictors and predictands and is able to represent the aerosol-cloud-meteorology system better than frequently used bivariate relationships. The most important predictors can be identified by the additional error when excluding one predictor at a time. The sensitivity of each predictand to each of the predictors is analyzed.

  13. Socio-environmental predictors of Barmah forest virus transmission in coastal areas, Queensland, Australia.

    PubMed

    Naish, Suchithra; Hu, Wenbiao; Nicholls, Neville; Mackenzie, John S; Dale, Pat; McMichael, Anthony J; Tong, Shilu

    2009-02-01

    To assess the socio-environmental predictors of Barmah forest virus (BFV) transmission in coastal areas, Queensland, Australia. Data on BFV notified cases, climate, tidal levels and socioeconomic index for area (SEIFA) in six coastal cities, Queensland, for the period 1992-2001 were obtained from the relevant government agencies. Negative binomial regression models were used to assess the socio-environmental predictors of BFV transmission. The results show that maximum and minimum temperature, rainfall, relative humidity, high and low tide were statistically significantly associated with BFV incidence at lags 0-2 months. The fitted negative binomial regression models indicate a significant independent association of each of maximum temperature (beta = 0.139, P = 0.000), high tide (beta = 0.005, P = 0.000) and SEIFA index (beta = -0.010, P = 0.000) with BFV transmission after adjustment for confounding variables. The transmission of BFV disease in Queensland coastal areas seemed to be determined by a combination of local social and environmental factors. The model developed in this study may have applications in the control and prevention of BFV disease in these areas.

  14. Empirical-statistical downscaling of reanalysis data to high-resolution air temperature and specific humidity above a glacier surface (Cordillera Blanca, Peru)

    NASA Astrophysics Data System (ADS)

    Hofer, Marlis; MöLg, Thomas; Marzeion, Ben; Kaser, Georg

    2010-06-01

    Recently initiated observation networks in the Cordillera Blanca (Peru) provide temporally high-resolution, yet short-term, atmospheric data. The aim of this study is to extend the existing time series into the past. We present an empirical-statistical downscaling (ESD) model that links 6-hourly National Centers for Environmental Prediction (NCEP)/National Center for Atmospheric Research (NCAR) reanalysis data to air temperature and specific humidity, measured at the tropical glacier Artesonraju (northern Cordillera Blanca). The ESD modeling procedure includes combined empirical orthogonal function and multiple regression analyses and a double cross-validation scheme for model evaluation. Apart from the selection of predictor fields, the modeling procedure is automated and does not include subjective choices. We assess the ESD model sensitivity to the predictor choice using both single-field and mixed-field predictors. Statistical transfer functions are derived individually for different months and times of day. The forecast skill largely depends on month and time of day, ranging from 0 to 0.8. The mixed-field predictors perform better than the single-field predictors. The ESD model shows added value, at all time scales, against simpler reference models (e.g., the direct use of reanalysis grid point values). The ESD model forecast 1960-2008 clearly reflects interannual variability related to the El Niño/Southern Oscillation but is sensitive to the chosen predictor type.

  15. Perceived Nurse-Physician Communication in Patient Care and Associated Factors in Public Hospitals of Jimma Zone, South West Ethiopia: Cross Sectional Study.

    PubMed

    Hailu, Fikadu Balcha; Kassahun, Chanyalew Worku; Kerie, Mirkuzie Woldie

    2016-01-01

    Nurse-physician communication has been shown to have a significant impact on the job satisfaction and retention of staff. In areas where it has been studied, communication failure between nurses and physicians was found to be one of the leading causes of preventable patient injuries, complications, death and medical malpractice claims. The objective of this study is to determine perception of nurses and physicians towards nurse-physician communication in patient care and associated factors in public hospitals of Jimma zone, southwest Ethiopia. Institution based cross-sectional survey was conducted from March 10 to April 16, 2014 among 341 nurses and 168 physicians working in public hospitals in Jimma zone. Data was collected using a pre-tested self-administered questionnaire; entered into EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 16.0 for analysis. Factor analysis was carried out. Descriptive statistics, independent sample t-test, linear regression and one way analysis of variance were used. Variables with P-value < 0.05 were considered as statistically significant. The response rate of the study was 91.55%. The mean perceived nurse-physician communication scores were 50.88±19.7% for perceived professional respect and satisfaction, and 48.52±19.7% for perceived openness and sharing of patient information on nurse-physician communication. Age, salary and organizational factors were statistically significant predictors for perceived respect and satisfaction. Whereas sex, working hospital, work attitude individual factors and organizational factors were significant predictors of perceived openness and sharing of patient information in nurse-physician communication during patient care. Perceived level of nurse-physician communication mean score was low among nurses than physicians and it is attention seeking gap. Hence, the finding of our study suggests the need for developing and implementing nurse-physician communication improvement strategies to solve communication mishaps in patient care.

  16. Perceived Nurse—Physician Communication in Patient Care and Associated Factors in Public Hospitals of Jimma Zone, South West Ethiopia: Cross Sectional Study

    PubMed Central

    Hailu, Fikadu Balcha; Kassahun, Chanyalew Worku; Kerie, Mirkuzie Woldie

    2016-01-01

    Background Nurse–physician communication has been shown to have a significant impact on the job satisfaction and retention of staff. In areas where it has been studied, communication failure between nurses and physicians was found to be one of the leading causes of preventable patient injuries, complications, death and medical malpractice claims. Objective The objective of this study is to determine perception of nurses and physicians towards nurse-physician communication in patient care and associated factors in public hospitals of Jimma zone, southwest Ethiopia. Methods Institution based cross-sectional survey was conducted from March 10 to April 16, 2014 among 341 nurses and 168 physicians working in public hospitals in Jimma zone. Data was collected using a pre-tested self-administered questionnaire; entered into EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 16.0 for analysis. Factor analysis was carried out. Descriptive statistics, independent sample t-test, linear regression and one way analysis of variance were used. Variables with P-value < 0.05 were considered as statistically significant. Results The response rate of the study was 91.55%. The mean perceived nurse-physician communication scores were 50.88±19.7% for perceived professional respect and satisfaction, and 48.52±19.7% for perceived openness and sharing of patient information on nurse-physician communication. Age, salary and organizational factors were statistically significant predictors for perceived respect and satisfaction. Whereas sex, working hospital, work attitude individual factors and organizational factors were significant predictors of perceived openness and sharing of patient information in nurse-physician communication during patient care. Conclusion Perceived level of nurse-physician communication mean score was low among nurses than physicians and it is attention seeking gap. Hence, the finding of our study suggests the need for developing and implementing nurse-physician communication improvement strategies to solve communication mishaps in patient care. PMID:27632162

  17. Digit Span as a measure of everyday attention: a study of ecological validity.

    PubMed

    Groth-Marnat, Gary; Baker, Sonya

    2003-12-01

    This study investigated the effectiveness of the WAIS-III Digit Span subtest to predict the everyday attention of 75 participants with heterogeneous neurological conditions who were administered the Digit Span subtest as well as the ecologically valid Test of Everyday Attention. In addition, the more visually oriented Picture Completion subtest along with the verbally loaded National Adult Reading Test were administered. Analysis indicated that, although Digit Span was a weak but statistically significant predictor of attentional ability (accounting for 12.7% of the unique variance). Picture Completion was a somewhat stronger predictor (accounting for 19% of the unique variance). The weak association of Digit Span and the Test of Everyday Attention, along with the finding that Picture Completion was a better predictor of performance on the Test of Everyday Attention, question the clinical utility of using Digit Span as a measure of everyday attention.

  18. Peer Status in Boys With and Without Attention-Deficit Hyperactivity Disorder: Predictions from Overt and Covert Antisocial Behavior, Social Isolation, and Authoritative Parenting Beliefs.

    PubMed

    Hinshaw, Stephen P; Zupan, Brian A; Simmel, Cassandra; Nigg, Joel T; Melnick, Sharon

    1997-10-01

    Because of the centrality of peer relationship difficulties for children with attentiondeficit hyperactivity disorder (ADHD), we investigated behavioral (overt and covert antisocial activity), internalizing (self-reports and observed social isolation), and familial (authoritative, authoritarian, and permissive parenting beliefs) predictors of peer sociometric nominations among previously unfamiliar, ethnically diverse ADHD (N=73) and comparison (N=60) boys, aged 6-12 years. Authoritative maternal parenting beliefs and negatively weighted social isolation explained significant variance in positive peer regard; aggression, covert behavior, and authoritative parenting beliefs were the independent predictors of both negative peer status and peer social preference. We extended such predictions with statistical control of (1) child cognitive variables, (2) maternal psychopathology, and (3) ADHD boys, but authoritative parenting beliefs were stronger predictors in ADHD than in comparison youth. We discuss family-peer linkages regarding peer competence.

  19. Predictors of parent-child agreement on child anxiety diagnoses on the ADIS-IV-C/P.

    PubMed

    Hamblin, Rebecca J; Salloum, Alison; Andel, Ross; Nadeau, Joshua M; McBride, Nicole M; Lewin, Adam B; Storch, Eric A

    2016-11-30

    Diagnostic agreement between parents' and children's reports on children's anxiety problems is notoriously poor; however, very few investigations have examined specific predictors of inter-rater agreement on child anxiety diagnoses. This study examined predictors of categories of parent and child diagnostic endorsement on the Anxiety Disorders Interview Schedule for Children-IV. One hundred eight children (ages 7-13) and their parents completed structured diagnostic interviews for non-OCD/PTSD anxiety diagnoses and paper and pencil measures of functioning and impairment in a variety of domains. Parent-child agreement was statistically significant for social phobia and separation anxiety disorder, but was overall poor for all anxiety diagnoses. Externalizing disorder status, family accommodation frequency, and child rated impairment in various domains differentially predicted informant discrepancies for different anxiety disorders. These data are among the first to suggest variables that may explain parent-child concordance. Copyright © 2016. Published by Elsevier Ireland Ltd.

  20. Predictors of Wellness and American Indians

    PubMed Central

    Hodge, Felicia S.; Nandy, Karabi

    2012-01-01

    Wellness is an important American Indian (AI) concept, understood as being in balance with one’s body, mind, and environment. Wellness predictors are reported in this paper within the context of health. A cross-sectional randomized household survey of 457 AI adults at 13 rural health care sites in California was conducted. Measures included wellness perceptions, barriers, health status/health conditions, spirituality, cultural connectivity, high-risk behaviors and abuse history. Statistical analysis obtained the best predictive model for wellness. Predictors of wellness were general health status perception, participation in AI cultural practices and suicide ideation. Significant differences in wellness status were observed depending on experience of adverse events in childhood and adulthood (neglect, physical abuse, and sexual abuse). Cultural connectivity (speaking tribal language, participating in AI practices, and feeling connected to community) was also associated with perceptions of wellness. Recommendations are for culturally-appropriate education and interventions emphasizing community and cultural connectivity for improving wellness status. PMID:21841279

  1. Introduction to statistical modelling 2: categorical variables and interactions in linear regression.

    PubMed

    Lunt, Mark

    2015-07-01

    In the first article in this series we explored the use of linear regression to predict an outcome variable from a number of predictive factors. It assumed that the predictive factors were measured on an interval scale. However, this article shows how categorical variables can also be included in a linear regression model, enabling predictions to be made separately for different groups and allowing for testing the hypothesis that the outcome differs between groups. The use of interaction terms to measure whether the effect of a particular predictor variable differs between groups is also explained. An alternative approach to testing the difference between groups of the effect of a given predictor, which consists of measuring the effect in each group separately and seeing whether the statistical significance differs between the groups, is shown to be misleading. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. The Relationship Between Body Mass Index and Fatty Infiltration in the Shoulder Musculature.

    PubMed

    Dow, David F; Mehta, Kaushal; Xu, Yuanfang; England, Eric

    Fatty infiltration in the rotator cuff muscles has been well studied in the setting of rotator cuff tendon tears to help predict outcomes of surgical repair. Fatty infiltration in the rotator cuff has also been independently correlated to the variables of age and sex. The purpose of our study was to determine if there is a relationship between body mass index and fatty infiltration in patients with no imaging evidence of rotator cuff tendinosis or tear. Radiology reports of all magnetic resonance imaging examinations of the shoulder were searched over a 2-year period. Studies with imaging findings of rotator cuff tendinosis, partial tear, or full thickness tear were excluded from the study, resulting in a total of 143 patients with normal rotator cuffs who were included in the study. These studies were reviewed by consensus by 2 fellowship-trained musculoskeletal radiologists who used the Goutallier 5-stage scoring system to grade the supraspinatus, infraspinatus, subscapularis, teres minor, teres major, and deltoid muscles. Sex was shown not to be significantly associated with fatty infiltration with the exception of the deltoid muscle, which showed a statistically significant increase in fatty infiltration associated with female sex (P = 0.038). Age was shown to be a statistically significant predictor of fatty infiltration for all 6 muscles (P < 0.05). Body mass index was shown to be a statistically significant predictor of fatty infiltration for all of the evaluated shoulder musculature (P < 0.05) with the exception of the teres minor. Our results suggest that increased body mass index is associated with increased fatty infiltration in the supraspinatus, infraspinatus, subscapularis, teres major, and deltoid muscles. This relationship could help guide the decisions of orthopedic surgeons when considering rotator cuff repair.

  3. Health Status and Working Condition of Migrant Workers: Major Public Health Problems.

    PubMed

    Bener, Abdulbari

    2017-01-01

    Very little research and survey have been performed on the occupational health, hazards, and working condition of urban and rural of workers in Qatar. The aim of the current study is to identify the health status, lifestyle condition, working-related problems, and accidents experienced by Indian subcontinental migrants (ISCM) in Qatar and their access to health-care facilities. This is a cross-sectional study based on a representative sample of 1186 workers and study covering sociodemographic characteristics, medical conditions, and health-seeking behaviors and personal experience. There were statistically significant differences between semi-urban and urban migrant workers in terms of educational, occupation, income, working hours, and accommodation type ( P < 0.001). Furthermore, there were statistically significant differences between migrant workers in terms of body mass index, delay in receiving salary, the right to medical insurance and sick day entitlement, cigarettes and shisha smoking, amenities, having on-site safety measure, and sleeping hours ( P < 0.01). Moreover, there were statistically significant differences between semi-urban and urban migrant workers in terms of pain, cardiopulmonary, gastrointestinal, and pseudoneurologic and medical symptoms ( P < 0.01). Multiple logistic regression was used for predictors' health problems in migrant workers such as the absence of drinking water, tap water availability, safety facility tools, occupational status, shisha smoking, toilet facility, working hours, and accommodation type were considered the strong predictors. The current study revealed that there is a lack of insufficient information for the migrants about their lifestyle, medical conditions, health risks, injury, and rights privilege in relation to legal working condition and health services.

  4. Comparison of transform coding methods with an optimal predictor for the data compression of digital elevation models

    NASA Technical Reports Server (NTRS)

    Lewis, Michael

    1994-01-01

    Statistical encoding techniques enable the reduction of the number of bits required to encode a set of symbols, and are derived from their probabilities. Huffman encoding is an example of statistical encoding that has been used for error-free data compression. The degree of compression given by Huffman encoding in this application can be improved by the use of prediction methods. These replace the set of elevations by a set of corrections that have a more advantageous probability distribution. In particular, the method of Lagrange Multipliers for minimization of the mean square error has been applied to local geometrical predictors. Using this technique, an 8-point predictor achieved about a 7 percent improvement over an existing simple triangular predictor.

  5. Statistical Downscaling of General Circulation Model Outputs to Precipitation Accounting for Non-Stationarities in Predictor-Predictand Relationships

    PubMed Central

    Sachindra, D. A.; Perera, B. J. C.

    2016-01-01

    This paper presents a novel approach to incorporate the non-stationarities characterised in the GCM outputs, into the Predictor-Predictand Relationships (PPRs) in statistical downscaling models. In this approach, a series of 42 PPRs based on multi-linear regression (MLR) technique were determined for each calendar month using a 20-year moving window moved at a 1-year time step on the predictor data obtained from the NCEP/NCAR reanalysis data archive and observations of precipitation at 3 stations located in Victoria, Australia, for the period 1950–2010. Then the relationships between the constants and coefficients in the PPRs and the statistics of reanalysis data of predictors were determined for the period 1950–2010, for each calendar month. Thereafter, using these relationships with the statistics of the past data of HadCM3 GCM pertaining to the predictors, new PPRs were derived for the periods 1950–69, 1970–89 and 1990–99 for each station. This process yielded a non-stationary downscaling model consisting of a PPR per calendar month for each of the above three periods for each station. The non-stationarities in the climate are characterised by the long-term changes in the statistics of the climate variables and above process enabled relating the non-stationarities in the climate to the PPRs. These new PPRs were then used with the past data of HadCM3, to reproduce the observed precipitation. It was found that the non-stationary MLR based downscaling model was able to produce more accurate simulations of observed precipitation more often than conventional stationary downscaling models developed with MLR and Genetic Programming (GP). PMID:27997609

  6. Statistical Downscaling of General Circulation Model Outputs to Precipitation Accounting for Non-Stationarities in Predictor-Predictand Relationships.

    PubMed

    Sachindra, D A; Perera, B J C

    2016-01-01

    This paper presents a novel approach to incorporate the non-stationarities characterised in the GCM outputs, into the Predictor-Predictand Relationships (PPRs) in statistical downscaling models. In this approach, a series of 42 PPRs based on multi-linear regression (MLR) technique were determined for each calendar month using a 20-year moving window moved at a 1-year time step on the predictor data obtained from the NCEP/NCAR reanalysis data archive and observations of precipitation at 3 stations located in Victoria, Australia, for the period 1950-2010. Then the relationships between the constants and coefficients in the PPRs and the statistics of reanalysis data of predictors were determined for the period 1950-2010, for each calendar month. Thereafter, using these relationships with the statistics of the past data of HadCM3 GCM pertaining to the predictors, new PPRs were derived for the periods 1950-69, 1970-89 and 1990-99 for each station. This process yielded a non-stationary downscaling model consisting of a PPR per calendar month for each of the above three periods for each station. The non-stationarities in the climate are characterised by the long-term changes in the statistics of the climate variables and above process enabled relating the non-stationarities in the climate to the PPRs. These new PPRs were then used with the past data of HadCM3, to reproduce the observed precipitation. It was found that the non-stationary MLR based downscaling model was able to produce more accurate simulations of observed precipitation more often than conventional stationary downscaling models developed with MLR and Genetic Programming (GP).

  7. Predictors for early introduction of solid food among Danish mothers and infants: an observational study.

    PubMed

    Kronborg, Hanne; Foverskov, Else; Væth, Michael

    2014-10-01

    Early introduction of complementary feeding may interfere with breastfeeding and the infant's self-controlled appetite resulting in increased growth. The aim of the present study was to investigate predictors for early introduction of solid food. In an observational study Danish mothers filled in a self-administered questionnaire approximately six months after birth. The questionnaire included questions about factors related to the infant, the mother, attachment and feeding known to influence time for introduction of solid food. The study population consisted of 4503 infants. Data were analysed using ordered logistic regression models. Outcome variable was time for introduction to solid food. Almost all of the included infants 4386 (97%) initiated breastfeeding. At weeks 16, 17-25, 25+, 330 infants (7%); 2923 (65%); and 1250 (28%), respectively had been introduced to solid food. Full breastfeeding at five weeks was the most influential predictor for later introduction of solid food (OR = 2.52 CI: 1.93-3.28). Among infant factors male gender, increased gestational age at birth, and higher birth weight were found to be statistically significant predictors. Among maternal factors, lower maternal age, higher BMI, and being primipara were significant predictors, and among attachment factors mother's reported perception of the infant as being temperamental, and not recognising early infant cues of hunger were significant predictors for earlier introduction of solid food. Supplementary analyses of interactions between the predictors showed that the association of maternal perceived infant temperament on early introduction was restricted to primiparae, that the mother's pre-pregnancy BMI had no impact if the infant was fully breastfed at week five, and that birth weight was only associated if the mother had reported early uncertainty in recognising infant's cues of hunger. Breastfeeding was the single most powerful indicator for preventing early introduction to solid food. Modifiable predictors pointed to the importance of supporting breastfeeding and educating primipara and mothers with low birth weight infants to be able to read and respond to their infants' cues to prevent early introduction to solid food.

  8. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    PubMed

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data statistically improve the performance of predicting ILI-related ED visits in Douglas County, and this result can be generalized to other communities. Timely and accurate estimates of ED volume during the influenza season, as well as during pandemic outbreaks, can help hospitals plan their ED resources accordingly and lower their costs by optimizing supplies and staffing and can improve service quality by decreasing ED wait times and overcrowding. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Predictors of self-reported negative mood following a depressive mood induction procedure across previously depressed, currently anxious, and control individuals.

    PubMed

    Scherrer, Martin C; Dobson, Keith S; Quigley, Leanne

    2014-09-01

    This study identified and examined a set of potential predictors of self-reported negative mood following a depressive mood induction procedure (MIP) in a sample of previously depressed, clinically anxious, and control participants. The examined predictor variables were selected on the basis of previous research and theories of depression, and included symptoms of depression and anxiety, negative and positive affect, negative and positive automatic thoughts, dysfunctional beliefs, rumination, self-concept, and occurrence and perceived unpleasantness of recent negative events. The sample consisted of 33 previously depressed, 22 currently anxious, and 26 non-clinical control participants, recruited from community sources. Participant group status was confirmed through structured diagnostic interviews. Participants completed the Velten negative self-statement MIP as well as self-report questionnaires of affective, cognitive, and psychosocial variables selected as potential predictors of mood change. Symptoms of anxiety were associated with increased self-reported negative mood shift following the MIP in previously depressed participants, but not clinically anxious or control participants. Increased occurrence of recent negative events was a marginally significant predictor of negative mood shift for the previously depressed participants only. None of the other examined variables was significant predictors of MIP response for any of the participant groups. These results identify factors that may increase susceptibility to negative mood states in previously depressed individuals, with implications for theory and prevention of relapse to depression. The findings also identify a number of affective, cognitive, and psychosocial variables that do not appear to influence mood change following a depressive MIP in previously depressed, currently anxious, and control individuals. Limitations of the study and directions for future research are discussed. Current anxiety symptomatology was a significant predictor and occurrence of recent negative events was a marginally significant predictor of greater negative mood shift following the depressive mood induction for previously depressed individuals. None of the examined variables predicted change in mood following the depressive mood induction for currently anxious or control individuals. These results suggest that anxiety symptoms and experience with negative events may increase risk for experiencing depressive mood states among individuals with a vulnerability to depression. The generalizability of the present results to individuals with comorbid depression and anxiety is limited. Future research employing appropriate statistical approaches for confirmatory research is needed to test and confirm the present results. © 2014 The British Psychological Society.

  10. Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia.

    PubMed

    Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Martinsen, Egil; Gude, Tore; Hedley, Liv Margaret; Abrahamsen, Gun

    2010-01-01

    We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

  11. Breast Cancer and Mammography Screening: Knowledge, Beliefs and Predictors for Asian Immigrant Women Attending a Specialized Clinic in British Columbia, Canada.

    PubMed

    Hippman, Catriona; Moshrefzadeh, Arezu; Lohn, Zoe; Hodgson, Zoë G; Dewar, Kathryn; Lam, Melanie; Albert, Arianne Y K; Kwong, Juliet

    2016-12-01

    Screening mammography (MMG) reduces breast cancer mortality; however, Asian immigrant women underutilize MMG. The Asian Women's Health Clinic (AWHC) was established to promote women's cancer screening amongst this population. This study evaluated the rate, and predictors, of MMG amongst women attending the AWHC. Women (N = 98) attending the AWHC completed a questionnaire. Descriptive statistics and multivariable logistic regression evaluated rate and predictors of MMG. Most participants (87 %, n = 85) reported having had a mammogram. Significant MMG predictors were: lower perceived MMG barriers [lifetime: OR (CI) 1.19 (1.01-1.49); past 2 years: OR (CI) 1.11 (1.01-1.25)], and knowing someone with breast cancer [past year: OR (CI) 3.42 (1.25-9.85); past 2 years: OR (CI) 4.91 (1.32-2.13)]. Even amongst women using preventive medicine, 13 % report never having had a mammogram. More research is needed into innovative interventions, e.g. the AWHC, and breast cancer-related outcomes amongst Asian immigrant women.

  12. CWD prevalence, perceived human health risks, and state influences on deer hunting participation.

    PubMed

    Vaske, Jerry J; Lyon, Katie M

    2011-03-01

    This study examined factors predicted by previous research to influence hunters' decisions to stop hunting deer in a state. Data were obtained from mail surveys of resident and nonresident deer hunters in Arizona, North Dakota, South Dakota, and Wisconsin (n = 3,518). Hunters were presented with six scenarios depicting hypothetical CWD prevalence levels and human health risks from the disease (e.g., death), and asked if they would continue or stop hunting deer in the state. Bivariate analyses examined the influence of five predictor variables: (a) CWD prevalence, (b) hypothetical human death from CWD, (c) perceived human health risks from CWD, (d) state, and (e) residency. In the bivariate analyses, prevalence was the strongest predictor of quitting hunting in the state followed by hypothetical human death and perceived risk. The presence of CWD in a state and residency were weak, but statistically significant, predictors. Interactions among these predictors increased the potential for stopping hunting in the state. Multivariate analyses suggested that 64% of our respondents would quit hunting in the worst-case scenario. © 2010 Society for Risk Analysis.

  13. Burn Injuries and Their Impact on Cognitive-Communication Skills in the Inpatient Rehabilitation Setting.

    PubMed

    Hendricks, Carla Tierney; Camara, Kristin; Violick Boole, Kathryn; Napoli, Maureen F; Goldstein, Richard; Ryan, Colleen M; Schneider, Jeffrey C

    The prevalence and extent of cognitive-communication disorders and factors that have impact on outcomes are examined in the burn population within an inpatient rehabilitation facility. A retrospective data analysis was conducted on adults diagnosed with burn injury (n = 144). Descriptive statistics were used to identify the prevalence of cognitive-communication deficits on admission and discharge. The main outcomes were cognitive-communication ratings on discharge from inpatient rehabilitation as measured by the memory and problem-solving domains of the Functional Independence Measure (FIM) and composite score of the Functional Communication Measure (FCM). Medical, demographic and rehabilitation predictors of the main outcomes were assessed using regression analyses. On admission to inpatient rehabilitation, 79% of the total population presented with cognitive-communication impairments, and of them, 27% presented with persistent deficits on discharge. Admission FIM memory score, marital status, and age were significant predictors of discharge FIM memory score. Admission FIM problem-solving score, age, marital status, and prehospital living-with were significant predictors of discharge FIM problem-solving score. Admission FCM score and age were significant predictors of discharge FCM cognitive score. Persons with burn injuries are at risk for cognitive-communication impairments, which may persist after inpatient rehabilitation. FIM data obtained on admission can be used as a screening tool to identify these at-risk patients. Future work is needed to assess the efficacy of speech-language pathologist intervention for cognitive-communication deficits within the burn injury population.

  14. Contemporary model for cardiovascular risk prediction in people with type 2 diabetes.

    PubMed

    Kengne, Andre Pascal; Patel, Anushka; Marre, Michel; Travert, Florence; Lievre, Michel; Zoungas, Sophia; Chalmers, John; Colagiuri, Stephen; Grobbee, Diederick E; Hamet, Pavel; Heller, Simon; Neal, Bruce; Woodward, Mark

    2011-06-01

    Existing cardiovascular risk prediction equations perform non-optimally in different populations with diabetes. Thus, there is a continuing need to develop new equations that will reliably estimate cardiovascular disease (CVD) risk and offer flexibility for adaptation in various settings. This report presents a contemporary model for predicting cardiovascular risk in people with type 2 diabetes mellitus. A 4.5-year follow-up of the Action in Diabetes and Vascular disease: preterax and diamicron-MR controlled evaluation (ADVANCE) cohort was used to estimate coefficients for significant predictors of CVD using Cox models. Similar Cox models were used to fit the 4-year risk of CVD in 7168 participants without previous CVD. The model's applicability was tested on the same sample and another dataset. A total of 473 major cardiovascular events were recorded during follow-up. Age at diagnosis, known duration of diabetes, sex, pulse pressure, treated hypertension, atrial fibrillation, retinopathy, HbA1c, urinary albumin/creatinine ratio and non-HDL cholesterol at baseline were significant predictors of cardiovascular events. The model developed using these predictors displayed an acceptable discrimination (c-statistic: 0.70) and good calibration during internal validation. The external applicability of the model was tested on an independent cohort of individuals with type 2 diabetes, where similar discrimination was demonstrated (c-statistic: 0.69). Major cardiovascular events in contemporary populations with type 2 diabetes can be predicted on the basis of routinely measured clinical and biological variables. The model presented here can be used to quantify risk and guide the intensity of treatment in people with diabetes.

  15. What's in a Teacher Test? Assessing the Relationship between Teacher Test Scores and Student Secondary STEM Achievement. CEDR Working Paper. WP #2016-4

    ERIC Educational Resources Information Center

    Goldhaber, Dan; Gratz, Trevor; Theobald, Roddy

    2016-01-01

    We investigate the predictive validity of teacher credential test scores for student performance in secondary STEM classrooms in Washington state. After replicating earlier findings that teacher basic skills licensure test scores are a modest and statistically significant predictor of student math test score gains in elementary grades, we focus on…

  16. Research utilisation and critical thinking among newly graduated nurses: predictors for research use. A quantitative cross-sectional study.

    PubMed

    Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun

    2011-09-01

    The aim was to describe research utilisation among newly graduated nurses and to explore critical thinking dispositions and other individual and contextual factors as possible predictors for research use. Nurses are expected to be research users, and variations in research utilisation are explained by individual and contextual factors. To our knowledge, critical thinking dispositions have not earlier been explored as predictors for research use. A cross-sectional design was chosen. Data collection was carried out from October 2006 to April 2007 using the Research Utilization Questionnaire (RUQ) and the California Critical Thinking Disposition Inventory (CCTDI). The response rate was 33% (n =617). Pearson's chi-square test and regression analyses were used for statistical calculations. The respondents reported a positive attitude towards research, but only 24% (n = 148) were defined as research users. A significantly higher proportion of research users reported high critical thinking scores. Critical thinking explained 20% of the variance in attitude towards research and 11% of the variance in research use. Availability and support to implement research findings was the second strongest predictor for research use. Critical thinking, a significant predictor for attitude towards research and for the use of research, should be recognised and strengthened in nursing education and clinical practice. Contextual factors seem to be important for newly graduated nurses' use of research. Nurse leaders play an important role in nurturing newly graduated nurses' critical thinking and assisting them in transferring their positive attitude towards research into research use. Nurse educators play a significant role in supporting, challenging and supervising nursing students to be critical thinkers and strong believers in research utilisation. © 2011 Blackwell Publishing Ltd.

  17. Predictors and moderators of response to cognitive behavioral therapy and medication for the treatment of binge eating disorder.

    PubMed

    Grilo, Carlos M; Masheb, Robin M; Crosby, Ross D

    2012-10-01

    To examine predictors and moderators of response to cognitive behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout, and posttreatment. Demographic factors, psychiatric and personality disorder comorbidity, eating disorder psychopathology, psychological features, and 2 subtyping methods (negative affect, overvaluation of shape/weight) were tested as predictors and moderators for the primary outcome of remission from binge eating and 4 secondary dimensional outcomes (binge-eating frequency, eating disorder psychopathology, depression, and body mass index). Mixed-effects models analyzed all available data for each outcome variable. In each model, effects for baseline value and treatment were included with tests of both prediction and moderator effects. Several demographic and clinical variables significantly predicted and/or moderated outcomes. One demographic variable signaled a statistical advantage for medication only (younger participants had greater binge-eating reductions), whereas several demographic and clinical variables (lower self-esteem, negative affect, and overvaluation of shape/weight) signaled better improvements if receiving CBT. Overvaluation was the most salient predictor/moderator of outcomes. Overvaluation significantly predicted binge-eating remission (29% of participants with vs. 57% of participants without overvaluation remitted). Overvaluation was especially associated with lower remission rates if receiving medication only (10% vs. 42% for participants without overvaluation). Overvaluation moderated dimensional outcomes: Participants with overvaluation had significantly greater reductions in eating disorder psychopathology and depression levels if receiving CBT. Overvaluation predictor/moderator findings persisted after controlling for negative affect. Our findings have clinical utility for prescription of CBT and medication and implications for refinement of the BED diagnosis. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  18. Predictors and Moderators of Response to Cognitive Behavioral Therapy and Medication for the Treatment of Binge Eating Disorder

    PubMed Central

    Grilo, Carlos. M.; Masheb, Robin M.; Crosby, Ross D.

    2012-01-01

    Objective To examine predictors and moderators of response to cognitive-behavioral therapy (CBT) and medication treatments for binge-eating disorder (BED). Method 108 BED patients in a randomized double-blind placebo-controlled trial testing CBT and fluoxetine treatments were assessed prior, throughout-, and post-treatment. Demographic factors, psychiatric and personality-disorder co-morbidity, eating-disorder psychopathology, psychological features, and two sub-typing methods (negative-affect, overvaluation of shape/weight) were tested as predictors and moderators for the primary outcome of remission from binge-eating and four secondary dimensional outcomes (binge-eating frequency, eating-disorder psychopathology, depression, and body mass index). Mixed-effects-models analyzed all available data for each outcome variable. In each model, effects for baseline value and treatment were included with tests of both prediction and moderator effects. Results Several demographic and clinical variables significantly predicted and/or moderated outcomes. One demographic variable signaled a statistical advantage for medication-only (younger participants had greater binge-eating reductions) whereas several demographic and clinical variables (lower self-esteem, negative-affect, and overvaluation of shape/weight) signaled better improvements if receiving CBT. Overvaluation was the most salient predictor/moderator of outcomes. Overvaluation significantly predicted binge-eating remission (29% of participants with versus 57% of participants without overvaluation remitted). Overvaluation was especially associated with lower remission rates if receiving medication-only (10% versus 42% for participants without overvaluation). Overvaluation moderated dimensional outcomes: participants with overvaluation had significantly greater reductions in eating-disorder psychopathology and depression levels if receiving CBT. Overvaluation predictor/moderator findings persisted after controlling for negative-affect. Conclusions Our findings have clinical utility for prescription of CBT and medication and implications for refinement of the BED diagnosis. PMID:22289130

  19. Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity.

    PubMed

    Armijo-Olivo, Susan; Woodhouse, Linda J; Steenstra, Ivan A; Gross, Douglas P

    2016-12-01

    To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity. A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability. The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34). The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score. 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/.

  20. Influence of anthropometric parameters on ultrasound measurements of Os calcis.

    PubMed

    Hans, D; Schott, A M; Arlot, M E; Sornay, E; Delmas, P D; Meunier, P J

    1995-01-01

    Few data have been published concerning the influence of height, weight and body mass index (BMI) on broadband ultrasound attenuation (BUA), speed of sound (SOS) and Lunar "stiffness" index, and always in small population samples. The first ain of the present cross-sectional study was to determine whether anthropometric factors have a significant influence on ultrasound measurements. The second objective was to establish whether these parameters have real effect on whether their influence is due only to measurement errors. We measured, in 271 healthy French women (mean age 77 +/- 11 years; range 31-97 years), the following parameters: age, height, weight, lean and fat body mass, heel width, foot length, knee height and external malleolus (HEM). Simple linear regression analyses between ultrasound and anthropometric parameters were performed. Age, height, and heel width were significant predictors of SOS; age, height, weight, foot length, heel width, HEM, fat mass and lean mass were significant predictors of BUA; age, height, weight, heel width, HEM, fat mass and lean mass were significant predictors of stiffness. In the multiple regression analysis, once the analysis had been adjusted for age, only heel width was a significant predictor for SOS (p = 0.0007), weight for BUA (p = 0.0001), and weight (p = 0.0001) and heel width (p = 0.004) for the stiffness index. Besides their statistical meaning, the regression coefficients have a more clinically relevant interpretation which is developed in the text. These results confirm the influence of anthropometric factors on the ultrasonic parameter values, because BUA and SOS were in part dependent on heel width and weight. The influence of the position of the transducer on the calcaneus should be taken into account to optimize the methods of measurement using ultrasound.

  1. Statistical modelling of grapevine yield in the Port Wine region under present and future climate conditions

    NASA Astrophysics Data System (ADS)

    Santos, João A.; Malheiro, Aureliano C.; Karremann, Melanie K.; Pinto, Joaquim G.

    2011-03-01

    The impact of projected climate change on wine production was analysed for the Demarcated Region of Douro, Portugal. A statistical grapevine yield model (GYM) was developed using climate parameters as predictors. Statistically significant correlations were identified between annual yield and monthly mean temperatures and monthly precipitation totals during the growing cycle. These atmospheric factors control grapevine yield in the region, with the GYM explaining 50.4% of the total variance in the yield time series in recent decades. Anomalously high March rainfall (during budburst, shoot and inflorescence development) favours yield, as well as anomalously high temperatures and low precipitation amounts in May and June (May: flowering and June: berry development). The GYM was applied to a regional climate model output, which was shown to realistically reproduce the GYM predictors. Finally, using ensemble simulations under the A1B emission scenario, projections for GYM-derived yield in the Douro Region, and for the whole of the twenty-first century, were analysed. A slight upward trend in yield is projected to occur until about 2050, followed by a steep and continuous increase until the end of the twenty-first century, when yield is projected to be about 800 kg/ha above current values. While this estimate is based on meteorological parameters alone, changes due to elevated CO2 may further enhance this effect. In spite of the associated uncertainties, it can be stated that projected climate change may significantly benefit wine yield in the Douro Valley.

  2. Validity of the modified Charlson Comorbidity Index as predictor of short-term outcome in older stroke patients.

    PubMed

    Denti, Licia; Artoni, Andrea; Casella, Monica; Giambanco, Fabiola; Scoditti, Umberto; Ceda, Gian Paolo

    2015-02-01

    The modified Charlson Comorbidity Index (MCCI) has been proposed as a tool for adjusting the outcomes of stroke for comorbidity, but its validity in such a context has been evaluated in only a few studies and needs to be further explored, especially in elderly patients. We aimed to retrospectively assess the validity of the MCCI as a predictor of the short-term outcomes in a cohort of 297 patients with first-ever ischemic stroke, older than 60 years, and managed according to a clinical pathway. The poor outcome (PO) at 1 month, defined as a modified Rankin Scale score of 3-6, was the primary end point. Furthermore, a new comorbidity index has been developed, specific to our cohort, according to the same statistical approach used for the original CCI. The MCCI showed a positive association with PO (odds ratio [OR] 1.62; 95% confidence interval [CI] .98-2.68) and mortality (hazard ratio [HR] 1.85; 95% CI .94-3.61), not statistically significant and totally dependent on its association with the severity of neurologic impairment at onset. The new comorbidity index showed, as expected, a significant association with the PO and mortality with higher point estimates of OR (2.74; 95% CI 1.64-4.59) and HR (2.73; 95% CI 1.51-4.94), but this association was also dependent on stroke severity and premorbid disability. Our results do not support the validity of the MCCI as a predictor of the short-term outcomes in elderly stroke patients nor could we develop a more valid index from the available data. This suggests the need for development of disease- and age-specific indexes, possibly according to a prospective design. In any case, initial stroke severity, a strong predictor of outcome, is associated with the degree of comorbidity. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2016-01-01

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

  4. Evidence-based rules from family practice to inform family practice; the learning healthcare system case study on urinary tract infections.

    PubMed

    Soler, Jean K; Corrigan, Derek; Kazienko, Przemyslaw; Kajdanowicz, Tomasz; Danger, Roxana; Kulisiewicz, Marcin; Delaney, Brendan

    2015-05-16

    Analysis of encounter data relevant to the diagnostic process sourced from routine electronic medical record (EMR) databases represents a classic example of the concept of a learning healthcare system (LHS). By collecting International Classification of Primary Care (ICPC) coded EMR data as part of the Transition Project from Dutch and Maltese databases (using the EMR TransHIS), data mining algorithms can empirically quantify the relationships of all presenting reasons for encounter (RfEs) and recorded diagnostic outcomes. We have specifically looked at new episodes of care (EoC) for two urinary system infections: simple urinary tract infection (UTI, ICPC code: U71) and pyelonephritis (ICPC code: U70). Participating family doctors (FDs) recorded details of all their patient contacts in an EoC structure using the ICPC, including RfEs presented by the patient, and the FDs' diagnostic labels. The relationships between RfEs and episode titles were studied using probabilistic and data mining methods as part of the TRANSFoRm project. The Dutch data indicated that the presence of RfE's "Cystitis/Urinary Tract Infection", "Dysuria", "Fear of UTI", "Urinary frequency/urgency", "Haematuria", "Urine symptom/complaint, other" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection" . The Maltese data indicated that the presence of RfE's "Dysuria", "Urinary frequency/urgency", "Haematuria" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection". The Dutch data indicated that the presence of RfE's "Flank/axilla symptom/complaint", "Dysuria", "Fever", "Cystitis/Urinary Tract Infection", "Abdominal pain/cramps general" are all strong, reliable, predictors for the diagnosis "Pyelonephritis" . The Maltese data set did not present any clinically and statistically significant predictors for pyelonephritis. We describe clinically and statistically significant diagnostic associations observed between UTIs and pyelonephritis presenting as a new problem in family practice, and all associated RfEs, and demonstrate that the significant diagnostic cues obtained are consistent with the literature. We conclude that it is possible to generate clinically meaningful diagnostic evidence from electronic sources of patient data.

  5. Prognostic models for predicting posttraumatic seizures during acute hospitalization, and at 1 and 2 years following traumatic brain injury.

    PubMed

    Ritter, Anne C; Wagner, Amy K; Szaflarski, Jerzy P; Brooks, Maria M; Zafonte, Ross D; Pugh, Mary Jo V; Fabio, Anthony; Hammond, Flora M; Dreer, Laura E; Bushnik, Tamara; Walker, William C; Brown, Allen W; Johnson-Greene, Doug; Shea, Timothy; Krellman, Jason W; Rosenthal, Joseph A

    2016-09-01

    Posttraumatic seizures (PTS) are well-recognized acute and chronic complications of traumatic brain injury (TBI). Risk factors have been identified, but considerable variability in who develops PTS remains. Existing PTS prognostic models are not widely adopted for clinical use and do not reflect current trends in injury, diagnosis, or care. We aimed to develop and internally validate preliminary prognostic regression models to predict PTS during acute care hospitalization, and at year 1 and year 2 postinjury. Prognostic models predicting PTS during acute care hospitalization and year 1 and year 2 post-injury were developed using a recent (2011-2014) cohort from the TBI Model Systems National Database. Potential PTS predictors were selected based on previous literature and biologic plausibility. Bivariable logistic regression identified variables with a p-value < 0.20 that were used to fit initial prognostic models. Multivariable logistic regression modeling with backward-stepwise elimination was used to determine reduced prognostic models and to internally validate using 1,000 bootstrap samples. Fit statistics were calculated, correcting for overfitting (optimism). The prognostic models identified sex, craniotomy, contusion load, and pre-injury limitation in learning/remembering/concentrating as significant PTS predictors during acute hospitalization. Significant predictors of PTS at year 1 were subdural hematoma (SDH), contusion load, craniotomy, craniectomy, seizure during acute hospitalization, duration of posttraumatic amnesia, preinjury mental health treatment/psychiatric hospitalization, and preinjury incarceration. Year 2 significant predictors were similar to those of year 1: SDH, intraparenchymal fragment, craniotomy, craniectomy, seizure during acute hospitalization, and preinjury incarceration. Corrected concordance (C) statistics were 0.599, 0.747, and 0.716 for acute hospitalization, year 1, and year 2 models, respectively. The prognostic model for PTS during acute hospitalization did not discriminate well. Year 1 and year 2 models showed fair to good predictive validity for PTS. Cranial surgery, although medically necessary, requires ongoing research regarding potential benefits of increased monitoring for signs of epileptogenesis, PTS prophylaxis, and/or rehabilitation/social support. Future studies should externally validate models and determine clinical utility. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  6. Stratification of Recanalization for Patients with Endovascular Treatment of Intracranial Aneurysms

    PubMed Central

    Ogilvy, Christopher S.; Chua, Michelle H.; Fusco, Matthew R.; Reddy, Arra S.; Thomas, Ajith J.

    2015-01-01

    Background With increasing utilization of endovascular techniques in the treatment of both ruptured and unruptured intracranial aneurysms, the issue of obliteration efficacy has become increasingly important. Objective Our goal was to systematically develop a comprehensive model for predicting retreatment with various types of endovascular treatment. Methods We retrospectively reviewed medical records that were prospectively collected for 305 patients who received endovascular treatment for intracranial aneurysms from 2007 to 2013. Multivariable logistic regression was performed on candidate predictors identified by univariable screening analysis to detect independent predictors of retreatment. A composite risk score was constructed based on the proportional contribution of independent predictors in the multivariable model. Results Size (>10 mm), aneurysm rupture, stent assistance, and post-treatment degree of aneurysm occlusion were independently associated with retreatment while intraluminal thrombosis and flow diversion demonstrated a trend towards retreatment. The Aneurysm Recanalization Stratification Scale was constructed by assigning the following weights to statistically and clinically significant predictors. Aneurysm-specific factors: Size (>10 mm), 2 points; rupture, 2 points; presence of thrombus, 2 points. Treatment-related factors: Stent assistance, -1 point; flow diversion, -2 points; Raymond Roy 2 occlusion, 1 point; Raymond Roy 3 occlusion, 2 points. This scale demonstrated good discrimination with a C-statistic of 0.799. Conclusion Surgical decision-making and patient-centered informed consent require comprehensive and accessible information on treatment efficacy. We have constructed the Aneurysm Recanalization Stratification Scale to enhance this decision-making process. This is the first comprehensive model that has been developed to quantitatively predict the risk of retreatment following endovascular therapy. PMID:25621984

  7. Exploring patient satisfaction predictors in relation to a theoretical model.

    PubMed

    Grøndahl, Vigdis Abrahamsen; Hall-Lord, Marie Louise; Karlsson, Ingela; Appelgren, Jari; Wilde-Larsson, Bodil

    2013-01-01

    The aim is to describe patients' care quality perceptions and satisfaction and to explore potential patient satisfaction predictors as person-related conditions, external objective care conditions and patients' perception of actual care received ("PR") in relation to a theoretical model. A cross-sectional design was used. Data were collected using one questionnaire combining questions from four instruments: Quality from patients' perspective; Sense of coherence; Big five personality trait; and Emotional stress reaction questionnaire (ESRQ), together with questions from previous research. In total, 528 patients (83.7 per cent response rate) from eight medical, three surgical and one medical/surgical ward in five Norwegian hospitals participated. Answers from 373 respondents with complete ESRQ questionnaires were analysed. Sequential multiple regression analysis with ESRQ as dependent variable was run in three steps: person-related conditions, external objective care conditions, and PR (p < 0.05). Step 1 (person-related conditions) explained 51.7 per cent of the ESRQ variance. Step 2 (external objective care conditions) explained an additional 2.4 per cent. Step 3 (PR) gave no significant additional explanation (0.05 per cent). Steps 1 and 2 contributed statistical significance to the model. Patients rated both quality-of-care and satisfaction highly. The paper shows that the theoretical model using an emotion-oriented approach to assess patient satisfaction can explain 54 per cent of patient satisfaction in a statistically significant manner.

  8. Neonatal chemical hypoglycemia in newborns from pregnancies complicated by type 2 and gestational diabetes mellitus - the importance of neonatal ponderal index.

    PubMed

    Ramos, Gladys A; Hanley, Alethea A; Aguayo, Jennifer; Warshak, Carri R; Kim, Jae H; Moore, Thomas R

    2012-03-01

    To determine the frequency and risk factors associated with neonatal chemical hypoglycemia in neonates of mothers with type 2 diabetes and gestational diabetes mellitus (GDM). A retrospective cohort study of women with type 2 diabetes or GDM and their singleton neonates. The primary outcome measure was the presence of neonatal chemical hypoglycemia (capillary plasma equivalent glucose <45 mg/dl) within 1 h of birth. Statistical methods included bivariate and multivariate analyses. 242 mother infant dyads were identified. Sixty-eight (28%) were treated with diet, 110 (46%) with glyburide, and 64 (26%) with insulin. The incidence of neonatal chemical hypoglycemia was 18% (44/242). The incidence was significantly higher in those requiring pharmacotherapy (25% vs. 3%, p < 0.001). The frequency of neonatal chemical hypoglycemia between the glyburide and insulin-treated pregnancies did not differ significantly (23% vs. 27%, p = 0.58). The frequency of neonatal chemical hypoglycemia was statistically associated with birth weight, macrosomia and ponderal index (p < 0.001). Neonatal ponderal index was the strongest predictor of hypoglycemia (adjusted Odds ratio 5.59). Neonatal chemical hypoglycemia occurs more frequently in infants from women with type 2 diabetes and GDM treated with glyburide or insulin. An increased neonatal ponderal index is a strong predictor of significant neonatal chemical hypoglycemia.

  9. Certolizumab pegol in a heterogeneous population of patients with moderate-to-severe rheumatoid arthritis

    PubMed Central

    Soriano, Enrique R; Dellepiane, Analia; Salvatierra, Gabriela; Benítez, Cristian Alejandro; Salinas, Rodrigo Garcia; Baruzzo, Carlos

    2018-01-01

    Aim: To determine the efficacy and safety of certolizumab pegol for the treatment of rheumatoid arthritis in a real-world setting. Materials & methods: Patients with moderate-to-severe rheumatoid arthritis who initiated therapy with certolizumab were followed for 12 weeks. Response was assessed with Disease Activity Score of 28 joints, European Ligue Against Rheumatism criteria and Simplified Disease Activity Index. Predictors of response were analyzed with binary logistic regression models. Results: Statistically significant decreases in tender and swollen joint counts, laboratory parameters and use of corticosteroids and disease-modifying antirheumatic drugs were found. Disease activity also significantly diminished. Higher Disease Activity Score of 28 joints at baseline was the main predictor of response. No severe adverse events were reported. Conclusion: Certolizumab was effective and well tolerated, particularly in the subpopulation with higher inflammatory burden at baseline. PMID:29682324

  10. Recurrent Childhood Animal Cruelty and Its Link to Recurrent Adult Interpersonal Violence.

    PubMed

    Trentham, Caleb E; Hensley, Christopher; Policastro, Christina

    2018-06-01

    In the early 1960s, researchers began to examine the potential link between childhood animal cruelty and future interpersonal violence. Findings since then have been inconsistent in establishing a relationship between the two. This may be due to researchers failing to measure the recurrency of childhood animal abuse and the recurrency of later violent acts committed in adulthood. The current study, using data from 257 inmates at a medium-security prison in a Southern state, is a replication of research conducted by Tallichet and Hensley, and Hensley, Tallichet, and Dutkiewicz, which examined this recurrency issue. The only statistically significant predictor of recurrent adult interpersonal violence in this study was recurrent childhood animal cruelty. Inmates who engaged in recurrent childhood animal cruelty were more likely to commit recurrent adult interpersonal violence. Respondents' race, education, and childhood residence were not significant predictors of the outcome variable.

  11. Binary logistic regression modelling: Measuring the probability of relapse cases among drug addict

    NASA Astrophysics Data System (ADS)

    Ismail, Mohd Tahir; Alias, Siti Nor Shadila

    2014-07-01

    For many years Malaysia faced the drug addiction issues. The most serious case is relapse phenomenon among treated drug addict (drug addict who have under gone the rehabilitation programme at Narcotic Addiction Rehabilitation Centre, PUSPEN). Thus, the main objective of this study is to find the most significant factor that contributes to relapse to happen. The binary logistic regression analysis was employed to model the relationship between independent variables (predictors) and dependent variable. The dependent variable is the status of the drug addict either relapse, (Yes coded as 1) or not, (No coded as 0). Meanwhile the predictors involved are age, age at first taking drug, family history, education level, family crisis, community support and self motivation. The total of the sample is 200 which the data are provided by AADK (National Antidrug Agency). The finding of the study revealed that age and self motivation are statistically significant towards the relapse cases..

  12. Predictor sort sampling and one-sided confidence bounds on quantiles

    Treesearch

    Steve Verrill; Victoria L. Herian; David W. Green

    2002-01-01

    Predictor sort experiments attempt to make use of the correlation between a predictor that can be measured prior to the start of an experiment and the response variable that we are investigating. Properly designed and analyzed, they can reduce necessary sample sizes, increase statistical power, and reduce the lengths of confidence intervals. However, if the non- random...

  13. Assessment of single-item literacy questions, age, and education level in the prediction of low health numeracy.

    PubMed

    Johnson, Tim V; Abbasi, Ammara; Kleris, Renee S; Ehrlich, Samantha S; Barthwaite, Echo; DeLong, Jennifer; Master, Viraj A

    2013-08-01

    Determining a patient's health literacy is important to optimum patient care. Single-item questions exist for screening written health literacy. We sought to assess the predictive potential of three common screening questions, along with patient age and education level, in the prediction of low health numerical literacy (numeracy). After demographic and educational information was obtained, 441 patients were administered three health literacy screening questions. The three-item Schwartz-Woloshin Numeracy Scale was then administered to assess for low health numeracy (score of 0 out of 3). This score served as the reference standard for Receiver Operating Characteristics (ROC) curve analysis. ROC curves were constructed and used to determine the area under the curve (AUC); a higher AUC suggests increased statistical significance. None of the three screening questions were significant predictors of low health numeracy. However, education level was a significant predictor of low health numeracy, with an AUC (95% CI) of 0.811 (0.720-0.902). This measure had a specificity of 95.3% at the cutoff of 12 years of education (<12 versus > or = 12 years of education) but was non-sensitive. Common single-item questions used to screen for written health literacy are ineffective screening tools for health numeracy. However, low education level is a specific predictor of low health numeracy.

  14. Impact of Referral Source and Study Applicants’ Preference for Randomly Assigned Service on Research Enrollment, Service Engagement, and Evaluative Outcomes

    PubMed Central

    Macias, Cathaleene; Barreira, Paul; Hargreaves, William; Bickman, Leonard; Fisher, William; Aronson, Elliot

    2009-01-01

    Objective The inability to blind research participants to their experimental conditions is the Achilles’ heel of mental health services research. When one experimental condition receives more disappointed participants, or more satisfied participants, research findings can be biased in spite of random assignment. The authors explored the potential for research participants’ preference for one experimental program over another to compromise the generalizability and validity of randomized controlled service evaluations as well as cross-study comparisons. Method Three Cox regression analyses measured the impact of applicants’ service assignment preference on research project enrollment, engagement in assigned services, and a service-related outcome, competitive employment. Results A stated service preference, referral by an agency with a low level of continuity in outpatient care, and willingness to switch from current services were significant positive predictors of research enrollment. Match to service assignment preference was a significant positive predictor of service engagement, and mismatch to assignment preference was a significant negative predictor of both service engagement and employment outcome. Conclusions Referral source type and service assignment preference should be routinely measured and statistically controlled for in all studies of mental health service effectiveness to provide a sound empirical base for evidence-based practice. PMID:15800153

  15. Scoring and staging systems using cox linear regression modeling and recursive partitioning.

    PubMed

    Lee, J W; Um, S H; Lee, J B; Mun, J; Cho, H

    2006-01-01

    Scoring and staging systems are used to determine the order and class of data according to predictors. Systems used for medical data, such as the Child-Turcotte-Pugh scoring and staging systems for ordering and classifying patients with liver disease, are often derived strictly from physicians' experience and intuition. We construct objective and data-based scoring/staging systems using statistical methods. We consider Cox linear regression modeling and recursive partitioning techniques for censored survival data. In particular, to obtain a target number of stages we propose cross-validation and amalgamation algorithms. We also propose an algorithm for constructing scoring and staging systems by integrating local Cox linear regression models into recursive partitioning, so that we can retain the merits of both methods such as superior predictive accuracy, ease of use, and detection of interactions between predictors. The staging system construction algorithms are compared by cross-validation evaluation of real data. The data-based cross-validation comparison shows that Cox linear regression modeling is somewhat better than recursive partitioning when there are only continuous predictors, while recursive partitioning is better when there are significant categorical predictors. The proposed local Cox linear recursive partitioning has better predictive accuracy than Cox linear modeling and simple recursive partitioning. This study indicates that integrating local linear modeling into recursive partitioning can significantly improve prediction accuracy in constructing scoring and staging systems.

  16. The relationship between procrastination, learning strategies and statistics anxiety among Iranian college students: a canonical correlation analysis.

    PubMed

    Vahedi, Shahrum; Farrokhi, Farahman; Gahramani, Farahnaz; Issazadegan, Ali

    2012-01-01

    Approximately 66-80%of graduate students experience statistics anxiety and some researchers propose that many students identify statistics courses as the most anxiety-inducing courses in their academic curriculums. As such, it is likely that statistics anxiety is, in part, responsible for many students delaying enrollment in these courses for as long as possible. This paper proposes a canonical model by treating academic procrastination (AP), learning strategies (LS) as predictor variables and statistics anxiety (SA) as explained variables. A questionnaire survey was used for data collection and 246-college female student participated in this study. To examine the mutually independent relations between procrastination, learning strategies and statistics anxiety variables, a canonical correlation analysis was computed. Findings show that two canonical functions were statistically significant. The set of variables (metacognitive self-regulation, source management, preparing homework, preparing for test and preparing term papers) helped predict changes of statistics anxiety with respect to fearful behavior, Attitude towards math and class, Performance, but not Anxiety. These findings could be used in educational and psychological interventions in the context of statistics anxiety reduction.

  17. [An evaluation of clinical characteristics and prognosis of brain-stem infarction in diabetics].

    PubMed

    Lu, Zheng-qi; Li, Hai-yan; Hu, Xue-qiang; Zhang, Bing-jun

    2011-01-01

    To analyze the relationship between diabetics and the onset, clinical outcomes and prognosis of brainstem infarction, and to evaluate the impact of diabetes on brainstem infarction. Compare 172 cases of acute brainstem infarction in patients with or without diabetes. Analyze the associated risk factors of patients with brain-stem infarction in diabetics by multi-variate logistic regression analysis. Compare the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin scale (mRS) Score, pathogenetic condition and the outcome of the two groups in different times. The systolic blood pressure (SBP), TG, LDL-C, apolipoprotein B (Apo B), glutamyl transpeptidase (γ-GT), fibrinogen (Fb), fasting blood glucose (FPG) and glycosylated hemoglobin(HbA1c)in diabetic group were higher than those in non-diabetic group, which was statistically significant (P < 0.05). From multi-variate logistic regression analysis, γ-GT, Apo B and FPG were the risk predictors of diabetes with brainstem infarction(OR = 1.017, 4.667 and 3.173, respectively), while HDL-C was protective (OR = 0.288). HbA1c was a risk predictor of severity for acute brainstem infarction (OR = 1.299), while Apo A was beneficial (OR = 0.212). Compared with brain-stem infarction in non-diabetic group, NIHSS score and intensive care therapy of diabetic groups on the admission had no statistically significance, while the NIHSS score on discharge and the outcome at 6 months' of follow-up were statistically significant. Diabetes is closely associated with brainstem infarction. Brainstem infarction with diabetes cause more rapid progression, poorer prognosis, higher rates of mortality as well as disability and higher recurrence rate of cerebral infarction.

  18. Job satisfaction and horizontal violence in hospital staff registered nurses: the mediating role of peer relationships.

    PubMed

    Purpora, Christina; Blegen, Mary A

    2015-08-01

    To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined. Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between horizontal violence and job satisfaction. Cross-sectional mediational model testing. An anonymous four-part survey of a random sample of 175 hospital staff registered nurses working in California provided the data. Data about horizontal violence, peer relationships, job satisfaction, and nurse and work characteristics were collected between March-August 2010. A statistically significant negative relationship was found between horizontal violence and peer relationships, job satisfaction and a statistically significant positive relationship was found between peer relationships and job satisfaction. Peer relationships mediated the association between horizontal violence and job satisfaction. Job satisfaction was reported as higher by nurses who worked in teaching hospitals. There were no statistically significant differences in job satisfaction based on gender, ethnicity, basic registered nurse education, highest degree held, size of hospital or clinical area. The results suggest that peer relationships can attenuate the negative relationship between horizontal violence and job satisfaction. This adds to the extant literature on the relationship between horizontal violence and job satisfaction. The findings highlight peer relationships as an important factor when considering effective interventions that foster hospital staff registered nurses' job satisfaction in the presence of horizontal violence. © 2015 John Wiley & Sons Ltd.

  19. Risk of mortality associated to chronic kidney disease in patients with type 2 diabetes mellitus: a 13-year follow-up.

    PubMed

    Gimeno-Orna, José Antonio; Blasco-Lamarca, Yolanda; Campos-Gutierrez, Belén; Molinero-Herguedas, Edmundo; Lou-Arnal, Luis Miguel; García-García, Blanca

    2015-01-01

    Our aim was to assess the usefulness of glomerular filtration rate (GFR) and urinary albumin excretion (UAE) to predict the risk of mortality in patients with type 2 diabetes mellitus. This is a prospective cohort study in patients with type 2 diabetes mellitus. Clinical end-point was mortality rate. GFR was measured in ml/min/1.73 m2 and stratified in 3 categories (≥60; 45-59; <45); UAE was measured in mg/24hours and was also stratified in 3 categories (<30; 30-300; >300). Mortality rates were reported per 1000 patient-years. Cox regression models were used to predict mortality risk associated with combined GFR and UAE. The predictive power was estimated with C-Harrell statistic. A total of 453 patients (39.3% males), aged 64.9 (SD 9.3) years were included; mean diabetes duration was 10.4 (SD 7.5) years. Median follow-up was 13 years. Total mortality rate was 39.5/1000. The progressive increase in mortality in the successive categories of GFR and UAE was statistically significant (P<.001). In a multivariable analysis, UAE (HR30-300=1.02 and HR>300=2.83; X2=11.6; P =.003) and GFR (HR45-59=1.34 and HR<45=1.84; X2=6.4; P =.041) were independent predictors for mortality, with no significant interaction. Simultaneous inclusion of GFR and UAE improved the predictive power of models (C-Harrell 0.741 vs. 0.726; P =.045). GFR and UAE are independent predictors for mortality in type 2 diabetic patients and do not show a statistically significant interaction. Copyright © 2015 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

  20. Neighborhood Effects on PND Symptom Severity for Women Enrolled in a Home Visiting Program.

    PubMed

    Jones, David E; Tang, Mei; Folger, Alonzo; Ammerman, Robert T; Hossain, Md Monir; Short, Jodie; Van Ginkel, Judith B

    2018-05-01

    The aim of this study was to investigate the association between postnatal depression (PND) symptoms severity and structural neighborhood characteristics among women enrolled in a home visiting program. The sample included 295 mothers who were at risk for developing PND, observed as 3-month Edinburgh Postnatal Depression Scale (EPDS) scores ≥ 10. Two neighborhood predictor components (residential stability and social disadvantage) were analyzed as predictors of PND symptom severity using a generalized estimating equation. Residential stability was negatively associated with PND symptom severity. Social disadvantage was not found to be statistically significantly. The findings suggest that residential stability is associated with a reduction in PND symptom severity for women enrolled in home visiting program.

  1. Fasting triglycerides as a predictor of incident diabetes, insulin resistance and β-cell function in a Canadian First Nation.

    PubMed

    Riediger, Natalie D; Clark, Kirsten; Lukianchuk, Virginia; Roulette, Joanne; Bruce, Sharon

    2017-01-01

    Diabetes prevalence is substantially higher among Canadian First Nations populations than the non-First Nation population. Fasting serum triglycerides have been found to be an important predictor of incident diabetes among non-indigenous populations. However, there is a great need to understand diabetes progression within specific ethnic groups, particularly First Nations populations. The purpose of this study was to test for an association between fasting serum triglycerides and incident diabetes, changes in insulin resistance and changes in β-cell function in a Manitoba First Nation cohort. Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples and anthropometric, health and demographic data were collected. A generalised linear model with Poisson distribution was used to test for an association between fasting triglycerides and incident diabetes. There were 35 incident cases of diabetes among 128 persons without diabetes at baseline. Participants who developed incident type 2 diabetes were significantly older and had significantly higher body mass index (BMI; p=0.012), total cholesterol (p=0.007), fasting triglycerides (p<0.001), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p<0.001). Fasting triglyceride level was found to be a statistically significant positive predictor of incident diabetes independent of age, sex and waist circumference at baseline. Participants with triglycerides in the highest tertile (≥2.11 mmol/l) had a 4.0-times higher risk of developing incident diabetes compared to those in the lowest tertile (p=0.03). Notably, neither waist circumference nor BMI were significant predictors of incident diabetes independent of age, sex and triglycerides. Fasting triglycerides may be useful as a clinical predictor of insulin resistance and diabetes development among First Nations populations. Unlike other ethnic groups, BMI and waist circumference may be less important factors in diabetes development.

  2. IRB Process Improvements: A Machine Learning Analysis.

    PubMed

    Shoenbill, Kimberly; Song, Yiqiang; Cobb, Nichelle L; Drezner, Marc K; Mendonca, Eneida A

    2017-06-01

    Clinical research involving humans is critically important, but it is a lengthy and expensive process. Most studies require institutional review board (IRB) approval. Our objective is to identify predictors of delays or accelerations in the IRB review process and apply this knowledge to inform process change in an effort to improve IRB efficiency, transparency, consistency and communication. We analyzed timelines of protocol submissions to determine protocol or IRB characteristics associated with different processing times. Our evaluation included single variable analysis to identify significant predictors of IRB processing time and machine learning methods to predict processing times through the IRB review system. Based on initial identified predictors, changes to IRB workflow and staffing procedures were instituted and we repeated our analysis. Our analysis identified several predictors of delays in the IRB review process including type of IRB review to be conducted, whether a protocol falls under Veteran's Administration purview and specific staff in charge of a protocol's review. We have identified several predictors of delays in IRB protocol review processing times using statistical and machine learning methods. Application of this knowledge to process improvement efforts in two IRBs has led to increased efficiency in protocol review. The workflow and system enhancements that are being made support our four-part goal of improving IRB efficiency, consistency, transparency, and communication.

  3. Environmental and social-demographic predictors of the southern house mosquito Culex quinquefasciatus in New Orleans, Louisiana.

    PubMed

    Moise, Imelda K; Riegel, Claudia; Muturi, Ephantus J

    2018-04-17

    Understanding the major predictors of disease vectors such as mosquitoes can guide the development of effective and timely strategies for mitigating vector-borne disease outbreaks. This study examined the influence of selected environmental, weather and sociodemographic factors on the spatial and temporal distribution of the southern house mosquito Culex quinquefasciatus Say in New Orleans, Louisiana, USA. Adult mosquitoes were collected over a 4-year period (2006, 2008, 2009 and 2010) using CDC gravid traps. Socio-demographic predictors were obtained from the United States Census Bureau, 2005-2009 American Community Survey and the City of New Orleans Department of Code Enforcement. Linear mixed effects models and ERDAS image processing software were used for statistical analysis and image processing. Only two of the 22 predictors examined were significant predictors of Cx. quinquefasciatus abundance. Mean temperature during the week of mosquito collection was positively associated with Cx. quinquefasciatus abundance while developed high intensity areas were negatively associated with Cx. quinquefasciatus abundance. The findings of this study illustrate the power and utility of integrating biophysical and sociodemographic data using GIS analysis to identify the biophysical and sociodemographic processes that increase the risk of vector mosquito abundance. This knowledge can inform development of accurate predictive models that ensure timely implementation of mosquito control interventions.

  4. Predictors of Traditional and Cyber-Bullying Victimization: A Longitudinal Study of Australian Secondary School Students.

    PubMed

    Hemphill, Sheryl A; Tollit, Michelle; Kotevski, Aneta; Heerde, Jessica A

    2015-09-01

    The purpose of the present article is to compare the individual, peer, family, and school risk and protective factors for both traditional and cyber-bullying victimization. This article draws on data from 673 students from Victoria, Australia, to examine Grade 7 (aged 12-13 years) predictors of traditional and cyber-bullying victimization in Grade 9 (aged 14-15 years). Participants completed a modified version of the Communities That Care youth survey. There were few similarities and important differences in the predictors of traditional and cyber-bullying victimization. For Grade 9 cyber-bullying victimization, in the fully adjusted model, having been a victim of traditional bullying in Grade 7 and emotional control in Grade 7 were predictors. For Grade 9 traditional bullying victimization, predictors were Grade 7 traditional bullying victimization, association with antisocial peers, and family conflict, with family attachment and emotional control marginally statistically significant. The use of evidence-based bullying prevention programs is supported to reduce experiences of both traditional and cyber-bullying victimization, as is the implementation of programs to assist students to regulate their emotions effectively. In addition, traditional bullying victimization may be reduced by addressing association with antisocial friends, family conflict, and bonding to families. © The Author(s) 2014.

  5. Predictors for gut colonization of carbapenem-resistant Enterobacteriaceae in neonates in a neonatal intensive care unit.

    PubMed

    Singh, Narendra Pal; Choudhury, Debapriya Das; Gupta, Kavita; Rai, Sumit; Batra, Prerna; Manchanda, Vikas; Saha, Rituparna; Kaur, I R

    2018-06-01

    With the emergence of carbapenem-resistant isolates, the therapeutic alternatives have become limited. Various factors are responsible for carbapenem-resistant Enterobacteriaceae (CRE) gut colonization. This study was conducted to determine predictors for CRE gut colonization in neonates who were hospital delivered and admitted in a neonatal intensive care unit (NICU). Three rectal swabs were collected from 300 hospital-delivered and NICU-admitted neonates (likely to stay for >3 days). The data collected for the possible risk factors for CRE gut colonization were namely mode of delivery, prolonged rupture of membrane >18 hours, period of gestation, birth weight, meconium-stained liquor, ventilation, intravenous catheter, nasogastric (NG) tube, NG feeding, breastfeeding, katori spoon feeding, top feeding, expressed breastmilk, antibiotics administration, and duration of hospitalization. P < .05 was considered as statistically significant. A total of 26 cases of CRE were isolated from 300 neonates. Statistically significant risk factors were found to be NG tube, breastfeeding, NG feeding, top feeding, expressed breastmilk, ventilation, antibiotic administration, and duration of hospitalization. Top feeding and antibiotics administration were identified as 2 independent risk factors by multiple logistic regression. Active surveillance of cultures from hospitalized patients and implementation of preventive efforts can reduce the risk of CRE. Copyright © 2018. Published by Elsevier Inc.

  6. A combination of routine blood analytes predicts fitness decrement in elderly endurance athletes.

    PubMed

    Haslacher, Helmuth; Ratzinger, Franz; Perkmann, Thomas; Batmyagmar, Delgerdalai; Nistler, Sonja; Scherzer, Thomas M; Ponocny-Seliger, Elisabeth; Pilger, Alexander; Gerner, Marlene; Scheichenberger, Vanessa; Kundi, Michael; Endler, Georg; Wagner, Oswald F; Winker, Robert

    2017-01-01

    Endurance sports are enjoying greater popularity, particularly among new target groups such as the elderly. Predictors of future physical capacities providing a basis for training adaptations are in high demand. We therefore aimed to estimate the future physical performance of elderly marathoners (runners/bicyclists) using a set of easily accessible standard laboratory parameters. To this end, 47 elderly marathon athletes underwent physical examinations including bicycle ergometry and a blood draw at baseline and after a three-year follow-up period. In order to compile a statistical model containing baseline laboratory results allowing prediction of follow-up ergometry performance, the cohort was subgrouped into a model training (n = 25) and a test sample (n = 22). The model containing significant predictors in univariate analysis (alanine aminotransferase, urea, folic acid, myeloperoxidase and total cholesterol) presented with high statistical significance and excellent goodness of fit (R2 = 0.789, ROC-AUC = 0.951±0.050) in the model training sample and was validated in the test sample (ROC-AUC = 0.786±0.098). Our results suggest that standard laboratory parameters could be particularly useful for predicting future physical capacity in elderly marathoners. It hence merits further research whether these conclusions can be translated to other disciplines or age groups.

  7. Insights into body composition adaptation: should we reconsider the use of Body Mass Index in some sports?

    PubMed

    Durmić, Tijana; Djelić, Marina; Suzić Lazić, Jelena; Lazović Popović, Biljana; Dekleva, Milica; Soldatovic, Ivan; Mazić, Sanja

    2016-11-01

    The purposes of this study were to indentify the under/overweight/obese frequencies by Body Mass Index (BMI) and body fat percentage (BF%) in athletes within groups of sport and to investigate the accuracy of the BMI as a measure of BF%. Cross-sectional design study on elite male athletes (N.=2234, aged 22±4 years) from 51 sports disciplines who were classified according to two different sport classifications: predominant characteristic of training (four group model) and type and intensity of exercise (nine group model). All athletes underwent full anthropometric testing. After stratification, the majority of athletes were in normal weight category. According to 4 group model, BMI is showed as statistically significant, reliable and independent predictor of BF% in all groups of sports. In nine groups model all correlated parameters were positive for athletes being statistically significant (P<0.001) with exception of group LSMD, MSMD and HSMD (P>0.05). The highest positive correlation between BMI and BF% was in group MSLD (r=0.53; P<0.001) and in power sports group (r=0.24; P<0.001). BMI could be an accurate predictor of BF% in athletes but that depends on group of sport. Our results suggest the BMI could use only in power and MSLD groups of sport.

  8. Self-concept and the perception of facial appearance in children and adolescents seeking orthodontic treatment.

    PubMed

    Phillips, Ceib; Beal, Kimberly N Edwards

    2009-01-01

    To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need-Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients' diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. The self-perceived level of the attractiveness or "positive" feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion.

  9. A combination of routine blood analytes predicts fitness decrement in elderly endurance athletes

    PubMed Central

    Ratzinger, Franz; Perkmann, Thomas; Batmyagmar, Delgerdalai; Nistler, Sonja; Scherzer, Thomas M.; Ponocny-Seliger, Elisabeth; Pilger, Alexander; Gerner, Marlene; Scheichenberger, Vanessa; Kundi, Michael; Endler, Georg; Wagner, Oswald F.; Winker, Robert

    2017-01-01

    Endurance sports are enjoying greater popularity, particularly among new target groups such as the elderly. Predictors of future physical capacities providing a basis for training adaptations are in high demand. We therefore aimed to estimate the future physical performance of elderly marathoners (runners/bicyclists) using a set of easily accessible standard laboratory parameters. To this end, 47 elderly marathon athletes underwent physical examinations including bicycle ergometry and a blood draw at baseline and after a three-year follow-up period. In order to compile a statistical model containing baseline laboratory results allowing prediction of follow-up ergometry performance, the cohort was subgrouped into a model training (n = 25) and a test sample (n = 22). The model containing significant predictors in univariate analysis (alanine aminotransferase, urea, folic acid, myeloperoxidase and total cholesterol) presented with high statistical significance and excellent goodness of fit (R2 = 0.789, ROC-AUC = 0.951±0.050) in the model training sample and was validated in the test sample (ROC-AUC = 0.786±0.098). Our results suggest that standard laboratory parameters could be particularly useful for predicting future physical capacity in elderly marathoners. It hence merits further research whether these conclusions can be translated to other disciplines or age groups. PMID:28475643

  10. Situational leadership style as a predictor of success and productivity among Taiwanese business organizations.

    PubMed

    Silverthorne, C; Wang, T H

    2001-07-01

    The present study was an evaluation of the impact of Taiwanese leadership styles on the productivity of Taiwanese business organizations. Specifically, it looked at the impact that both adaptive and nonadaptive leaders have on 6 measures of productivity: absenteeism, turnover rate, quality of work, reject rates, profitability, and units produced. The results indicated that the greater the level of adaptability, the more productive the organization is likely to be. Although not all of the computed correlations were statistically significant, they were all in the predicted directions. In particular, the findings for units produced and reject rates were consistently statistically significant. The study was also an examination of the usefulness of the Leadership Effectiveness and Adaptability Description (LEAD) questionnaire (P. Hersey & K. Blanchard, 1988), which appeared to be an accurate predictor of adaptability and valid for use in Taiwan. The final part of this study was an investigation of whether successful companies were more likely to have a greater percentage of adaptive leaders than unsuccessful companies. The data supported this expectation, although it is suggested that caution be used in the interpretation of this particular finding because it could have several different explanations. Overall, the evidence supported the value of adaptive leadership styles in high-technology industries in Taiwan.

  11. Predictors of non- hookah smoking among high-school students based on prototype/willingness model.

    PubMed

    Abedini, Sedigheh; MorowatiSharifabad, MohammadAli; Chaleshgar Kordasiabi, Mosharafeh; Ghanbarnejad, Amin

    2014-01-01

    The aim of the study was to determine predictors of refraining from hookah smoking among high-school students in Bandar Abbas, southern Iran based on Prototype/Willingness model. This cross- sectional with analytic approach was performed on 240 high-school students selected by a cluster random sampling. The data of demographic and Prototype-Willingness Model constructs were acquired via a self-administrated questionnaire. Data were analyzed by mean, frequency, correlation, liner and logistic regression statistical tests. Statistically significant determinants of the intention to refrain from hookah smoking were subjective norms, willingness, and attitude. Regression model indicated that the three items together explained 46.9% of the non-smoking hookah intention variance. Attitude and subjective norms predicted 36.0% of the non-smoking hookah intention variance. There was a significant relationship between the participants' negative prototype about the hookah smokers and the willingness to avoid from hookah smoking (P=0.002). Also willingness predicted non-smoking hookah better than the intention (P<0.001). Deigning intervention to increase negative prototype about the hookah smokers and reducing situations and conditions which facilitate hookah smoking, such as easy access to tobacco products in the cafés, beaches can be useful results among adolescents to hookah smoking prevention.

  12. Predictors of work-related sensitisation, allergic rhinitis and asthma in early work life.

    PubMed

    Kellberger, Jessica; Peters-Weist, Astrid S; Heinrich, Sabine; Pfeiffer, Susanne; Vogelberg, Christian; Roller, Diana; Genuneit, Jon; Weinmayr, Gudrun; von Mutius, Erika; Heumann, Christian; Nowak, Dennis; Radon, Katja

    2014-09-01

    Although work-related asthma and allergies are a huge burden for society, investigation of occupational exposures in early work life using an unexposed reference group is rare. Thus, the present analyses aimed to assess the potential impact of occupational exposure and other risk factors on the prevalence of work-related sensitisation and incidence of allergic rhinitis/asthma using a population-based approach and taking into account an unexposed reference group. In SOLAR (Study on Occupational Allergy Risks) II, German participants of ISAAC (International Study of Asthma and Allergies in Childhood) phase II were followed from childhood (9-11 years) until early adulthood (19-24 years). Data on 1570 participants were available to fit predictive models. Occupational exposure was not statistically significantly associated with disease prevalence/incidence. Sensitisation in childhood, parental asthma, environmental tobacco smoke exposure during puberty, sex and study location were statistically significant predictors of outcome. Our results indicate that occupational exposure is of little relevance for work-related sensitisation prevalence and allergic rhinitis/asthma incidence in early work life, while other risk factors can be used to improve career guidance for adolescents. Further research on the role of a potential healthy hire effect and the impact of longer exposure duration is needed. ©ERS 2014.

  13. Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss.

    PubMed

    Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

    2016-01-01

    To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. © 2016 S. Karger GmbH, Freiburg.

  14. Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss

    PubMed Central

    Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

    2016-01-01

    Objective To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. PMID:26745715

  15. Do statistical segmentation abilities predict lexical-phonological and lexical-semantic abilities in children with and without SLI?

    PubMed Central

    Mainela-Arnold, Elina; Evans, Julia L.

    2014-01-01

    This study tested the predictions of the procedural deficit hypothesis by investigating the relationship between sequential statistical learning and two aspects of lexical ability, lexical-phonological and lexical-semantic, in children with and without specific language impairment (SLI). Participants included 40 children (ages 8;5–12;3), 20 children with SLI and 20 with typical development. Children completed Saffran’s statistical word segmentation task, a lexical-phonological access task (gating task), and a word definition task. Poor statistical learners were also poor at managing lexical-phonological competition during the gating task. However, statistical learning was not a significant predictor of semantic richness in word definitions. The ability to track statistical sequential regularities may be important for learning the inherently sequential structure of lexical-phonology, but not as important for learning lexical-semantic knowledge. Consistent with the procedural/declarative memory distinction, the brain networks associated with the two types of lexical learning are likely to have different learning properties. PMID:23425593

  16. Interdisciplinary treatment of patients with fibromyalgia: improvement of their health-related quality of life.

    PubMed

    Martín, Josune; Torre, Fernando; Padierna, Angel; Aguirre, Urko; González, Nerea; Matellanes, Begoña; Quintana, José M

    2014-11-01

    To assess whether an interdisciplinary intervention is more effective than usual care for improving the health-related quality of life (HRQoL) among patients with fibromyalgia (FM), and to identify variables that were predictors of improvement in HRQoL. In a randomized controlled clinical trial carried out on an outpatient basis in a hospital pain management unit, 153 patients with FM were randomly allocated to an experimental group (EG) or a control group (CG). Participants completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6 months after the intervention. The EG received an interdisciplinary treatment (12 sessions for 6 weeks) which consisted of coordinated psychological, medical, educational, and physiotherapeutic interventions while the CG received standard-of-care pharmacologic treatment. Descriptive statistics, ANOVA, Chi square and Fisher tests and generalized linear models were used for data analysis. Six months after the intervention, statistically significant improvements in HRQoL were observed in physical functioning (P = 0.01), pain (P = 0.03) and total FIQ score (P = 0.04) in the EG compared to the CG. The number of physical illnesses was identified as a predictor for improvement. This interdisciplinary intervention has shown effectiveness in improving the HRQoL of this sample of patients with FM. The number of physical illnesses was identified as a predictor of that improvement. © 2013 World Institute of Pain.

  17. Predictors of comorbid personality disorders in patients with panic disorder with agoraphobia.

    PubMed

    Latas, M; Starcevic, V; Trajkovic, G; Bogojevic, G

    2000-01-01

    The aim of this study was to ascertain predictors of comorbid personality disorders in patients with panic disorder with agoraphobia (PDAG). Sixty consecutive outpatients with PDAG were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) for the purpose of diagnosing personality disorders. Logistic regressions were used to identify predictors of any comorbid personality disorder, any DSM-IV cluster A, cluster B, and cluster C personality disorder. Independent variables in these regressions were gender, age, duration of panic disorder (PD), severity of PDAG, and scores on self-report instruments that assess the patient's perception of their parents, childhood separation anxiety, and traumatic experiences. High levels of parental protection on the Parental Bonding Instrument (PBI), indicating a perception of the parents as overprotective and controlling, emerged as the only statistically significant predictor of any comorbid personality disorder. This finding was attributed to the association between parental overprotection and cluster B personality disorders, particularly borderline personality disorder. The duration of PD was a significant predictor of any cluster B and any cluster C personality disorder, suggesting that some of the cluster B and cluster C personality disorders may be a consequence of the long-lasting PDAG. Any cluster B personality disorder was also associated with younger age. In conclusion, despite a generally nonspecific nature of the relationship between parental overprotection in childhood and adult psychopathology, the findings of this study suggest some specificity for the association between parental overprotection in childhood and personality disturbance in PDAG patients, particularly cluster B personality disorders.

  18. Predictors of length of stay after urogynecological surgery at a tertiary referral center.

    PubMed

    Gagnon, Louise-Helene; Tang, Selphee; Brennand, Erin

    2017-02-01

    The primary objective of this study was to determine significant predictors of length of stay (LOS) beyond the first postoperative day after urogynecological surgery. A single-center retrospective cohort study was conducted in 2015. Our study population included women who underwent inpatient pelvic reconstructive surgery. The primary outcome was LOS beyond the first postoperative day. A logistic regression analysis explored the relationship between 11 selected predictor variables [age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, distance from home to hospital, length of surgery, anesthesia during surgery, route of surgical approach, trial of void recordings, choice of bladder protocol, presence of concomitant sling, surgeon], and LOS. Two hundred and sixty-three patients were included in this study. A logistic regression analysis identified route of surgery and trial of void recordings as the two statistically significant predictors of stay beyond the first postoperative day. The odds of LOS after laparoscopic or open surgery compared with vaginal surgery increased more than fivefold [laparoscopic vs. vaginal approach odds ratio (OR) 5.04, 95 % confidence interval (CI) 1.95-13.03; laparotomy vs. vaginal OR 15.56, 95 % CI 1.77-136.77] and more than threefold for a prolonged pass of the bladder protocol compared with an immediate pass (OR 3.25, 95 % CI 1.54-6.87). Our study identified route of surgery and trial of void recordings as the two predictors with the greatest impact on LOS beyond the first postoperative day. Our results warrant a larger follow-up study.

  19. Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis.

    PubMed

    Adams, Rebecca N; Mosher, Catherine E; Blair, Cindy K; Snyder, Denise C; Sloane, Richard; Demark-Wahnefried, Wendy

    2015-01-01

    The health benefits of diet and exercise interventions for cancer survivors are well documented. However, little is known regarding demographic and medical predictors of survivors' willingness to participate in diet and exercise intervention trials, study enrollment, intervention adherence, and study completion. To assist in interpreting the generalizability of trial findings and to improve the design of future trials, this study examined predictors of these process measures. An integrative data analysis was performed on data from 3 of the largest home-based diet and exercise intervention trials for cancer survivors (n = 23,841). Demographic and medical factors (ie, sex, race, age, time since diagnosis, and cancer type) were examined as predictors of willingness to participate, study enrollment, intervention adherence, and study completion in the pooled sample. A 99% confidence interval was used to determine statistical significance. Across trials, 11.1% of contacted survivors were willing to participate, and 5.7% were eligible and enrolled. Among enrollees, 53.4% demonstrated ≥75% adherence to the intervention, and 91.1% completed the study. Race (Caucasian vs others), age, time since diagnosis, and cancer type predicted survivors' willingness to participate (P < .01). All examined predictors were associated with the likelihood of study enrollment (P < .01). No significant predictors of intervention adherence or study completion were found among study enrollees (P ≥ .01). Cancer survivors' demographic and medical characteristics predicted their interest and participation in diet and exercise intervention trials. These findings have implications for the generalizability of results and can help to guide procedures used in future trials to enhance patient representation. © 2014 American Cancer Society.

  20. Age at menarche and its socioeconomic determinants among female students in an urban area in Bangladesh.

    PubMed

    Islam, Md Serajul; Hussain, Md Altaf; Islam, Saimul; Mahumud, Rashidul Alam; Biswas, Tuhin; Islam, Sheikh Mohammed Shariful

    2017-06-01

    This cross-sectional study aimed to determine the age at menarche and its socioeconomic determinants among urban female students (n=680) in Bangladesh. The mean age of the respondents was 14±1.43years. Majority of the respondents were unmarried (98.4%). The mean age at menarche was 11.6±3.6years, median 12years. Almost one-third (35.7%) of the participants had menarche at the age of 12years. There was no statistically significant difference between age at menarche before and after 12years with the socio-economic characteristics, except education (p=<0.001). In the multivariate model, only higher education was statistically significant predictor of age at menarche. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Plasma Glucose Level Is Predictive of Serum Ammonia Level After Retrograde Occlusion of Portosystemic Shunts.

    PubMed

    Ishikawa, Tsuyoshi; Aibe, Yuki; Matsuda, Takashi; Iwamoto, Takuya; Takami, Taro; Sakaida, Isao

    2017-09-01

    The purpose of this study was to evaluate predictors of reduction in ammonia levels by occlusion of portosystemic shunts (PSS) in patients with cirrhosis. Forty-eight patients with cirrhosis (21 women, 27 men; mean age, 67.8 years) with PSS underwent balloon-occluded retrograde transvenous obliteration (BRTO) at one institution between February 2008 and June 2014. The causes of cirrhosis were hepatitis B in one case, hepatitis C in 20 cases, alcohol in 15 cases, nonalcoholic steatohepatitis in eight cases, and other conditions in four cases. The Child-Pugh classes were A in 24 cases, B in 23 cases, and C in one case. The indication for BRTO was gastric varices in 40 cases and hepatic encephalopathy in eight cases. Testing was conducted before and 1 month after the procedure. Statistical analyses were performed to identify predictors of a clinically significant decline in ammonia levels after BRTO. Occlusion of PSS resulted in a clinically significant decrease in ammonia levels accompanied by increased portal venous flow and improved Child-Pugh score. Univariate analyses showed that a reduction in ammonia levels due to BRTO was significantly related to lower plasma glucose levels, higher RBC counts, and higher hemoglobin concentration before the treatment. Furthermore, multivariate logistic regression identified preoperative plasma glucose level as the strongest independent predictor of a significant ammonia reduction in response to BRTO. In addition, although BRTO resulted in significantly declined ammonia levels in patients with normal glucose tolerance before the procedure, ammonia levels were not significantly decreased after shunt occlusion in patients with diabetes mellitus or impaired glucose tolerance before BRTO, according to 75-g oral glucose tolerance test results. Preoperative plasma glucose level is a useful predictor of clinically significant ammonia reduction resulting from occlusion of PSS in patients with cirrhosis. Even if PSS are present, control of blood ammonia levels by BRTO alone may be difficult in patients with glucose intolerance.

  2. Prevalence, risk factors, and predictors of nonalcoholic fatty liver disease among schoolchildren: a hospital-based study in Alexandria, Egypt.

    PubMed

    Alkassabany, Yasmine M; Farghaly, Azza G; El-Ghitany, Engy M

    2014-06-01

    Nonalcoholic fatty liver disease (NAFLD) is an emerging problem in children and adolescents worldwide. This study was done to investigate the prevalence of NAFLD in children and adolescents as well as to determine the associated risk factors of fatty liver and to explore the ability of some obesity indices to predict and consequently be used as a screening method of fatty liver disease at certain cutoff points in schoolchildren. A cross-sectional, nested case-control study was carried out. Cases and controls were randomly selected from outpatient schoolchildren aged 6-18years attending the radiology clinic at Sporting Health Insurance Paediatric Hospital in Alexandria. They were subjected to ultrasonic examination as well as complete anthropometric and laboratory measurements including fasting plasma glucose (FPG) level, fasting insulin, alanine aminotransferase (ALT) level, and lipid profile. Fatty liver was prevalent in schoolchildren (15.8%) and increased significantly with age (p=0.004). Positive family history of diabetes mellitus (DM), hypertension (HTN), obesity, and liver disease were all statistically significant risk factors for fatty liver. Waist circumference (WC), body mass index (BMI) and its Z-score were significantly sensitive predictors. BMI was considered the best predictor of paediatric NAFLD at a cutoff=22.9. NAFLD was significantly associated with high triglycerides (TGs), low high-density lipoprotein cholesterol (HDL), homoeostatic model assessment (HOMA) percentile, and the number of metabolic syndrome (MS) components. Paediatric NAFLD is a substantial problem in schoolchildren and has a close relationship with obesity, dyslipidaemia, insulin resistance (IR), and consequently MS. BMI and WC can be used as useful predictors and screening tools for NAFLD in schoolchildren. Copyright © 2014 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  3. Predicting the onset of smoking in boys and girls.

    PubMed

    Charlton, A; Blair, V

    1989-01-01

    The problem of the high prevalence of smoking among girls and young women is of great concern. In an attempt to identify the factors which influence girls and boys respectively to attempt smoking, the study examines social background, advertising and brand awareness, knowledge, teaching and personal beliefs in conjunction as predictors of smoking. In this study which involved the administration of identical pre- and post-test questionnaires to a sample of boys and girls aged 12 and 13 years, nine variables expressed by never-smokers at pre-test stage were assessed as predictors of immediate future smoking. The two tests were administered 4 months apart to 1125 boys and 1213 girls in northern England. The nine variables included were parental smoking, best friends' smoking, perceived positive values of smoking, perceived negative values of smoking, correct health knowledge, cigarette-brand awareness, having a favourite cigarette advertisement, having a cigarette-brand sponsored sport in four top favourites on television. One group received teaching about smoking between the pre- and post-tests and this was also included as a variable. For boys, no variable investigated had any consistently statistically significant correlation with the uptake of smoking. The most important predictor of smoking for boys, having a best friend who smoked, was significant on application of the chi 2 test (P 0.037), although it was non-significant when included singly in a logistic regression model (0.094); the discrepancy was probably due to the small number of best friends known to smoke. For girls, four variables were found to be significant predictors of smoking when included singly in a logistic regression.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Modifiable risk factors of ecstasy use: risk perception, current dependence, perceived control, and depression

    PubMed Central

    Leung, Kit Sang; Ben Abdallah, Arbi; Cottler, Linda B.

    2009-01-01

    Risk perception, perceived behavioral control of obtaining ecstasy (PBC-obtaining), current ecstasy dependence, and recent depression have been associated with past ecstasy use, however, their utility in predicting ecstasy use has not been demonstrated. This study aimed to determine whether these four modifiable risk factors could predict ecstasy use after controlling for socio-demographic covariates and recent polydrug use. Data from 601 ecstasy users in the National Institute on Drug Abuse funded TriCity Study of Club Drug Use, Abuse and Dependence were analyzed using multivariate logistic regression. Participants were interviewed twice within a 2-week period using standardized instruments. Thirteen percent (n=80) of the participants reported using ecstasy between the two interviews. Low risk perception, high PBC-obtaining (an estimated ecstasy procurement time < 24 hours), and current ecstasy dependence were statistically associated with ecstasy use between the two interviews. Recent depression was not a significant predictor. Despite not being a target predictor, recent polydrug use was also statistically associated with ecstasy use. The present findings may inform the development of interventions targeting ecstasy users. PMID:19880258

  5. Acculturation and changes in body mass index, waist circumference, and waist-hip ratio among Filipino Americans with hypertension.

    PubMed

    Serafica, Reimund; Angosta, Alona D

    2016-09-01

    The purpose of this research study was to examine whether level of acculturation is a predictor of body mass index, waist circumference, and waist-hip ratio in Filipino Americans with hypertension in the United States. The Filipino Americans (N = 108) were recruited from a primary care clinic in the United States. Two instruments were used to collect and operationalize the variables, specifically: (1) Socioeconomic/Demographic Questionnaire and (2) A Short Acculturation Scale for Filipino Americans. Descriptive statistics and partial least squares were used to calculate the results. The partial least square path model identified acculturation as a predictor of body mass index, wait circumference, and waist-hip ratio among Filipino Americans. The positive path coefficient (β = 0.384) was statistically significant (t = 5.92, P < .001). Health care providers need to stress the importance of the degree of acculturation when developing culturally appropriate lifestyle and health promotion interventions among immigrant patients with hypertension. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  6. Sex differences in educational encouragement and academic achievement.

    PubMed

    Khan, Aqeel

    2012-08-01

    Sex differences in educational encouragement and their predictiveness of academic achievement were examined among 442 secondary school students (M age = 13.2 yr., SD = 1.9). Education-related encouragement received from mothers, fathers, friends, and teachers was assessed. Academic achievement was based on student self-reports and grades. Female adolescents reported receiving statistically significantly more educational encouragement from their mothers, fathers, friends, and teachers than did male adolescents. In regression, sex and educational encouragement from parents, friends, and teachers were found to be significant predictors of academic achievement.

  7. [Predictors of Resilience in Adolescents with Leukemia].

    PubMed

    Hong, Sung Sil; Park, Ho Ran

    2015-08-01

    The purpose of this study was to identify the factors relating to resilience for adolescents with leukemia and examine the relationship between these factors. From June to September in 2014, 199 adolescents aged 11 to 21 participated in the study as they visited the out-patient clinic at C university hospital for follow-up care. To verify the predictors and the effects of resilience, uncertainty, symptom distress, perceived social support, spiritual perspective, defensive coping, courageous coping, hope, and self-transcendence were measured. Collected data were analyzed using hierarchical regression analysis with the SAS statistics program. The final regression model showed that courageous coping, hope, and self-transcendence were significant predictors related to resilience in adolescents with leukemia and explained for 63% of the variance in resilience. The findings indicate that adolescent-oriented intervention programs enhancing courageous coping, hope, and self-transcendence should be provide for adolescents with leukemia in order to overcome illness-related stress and support physical, psychological and social adjustment.

  8. Analysis of forecasting malaria case with climatic factors as predictor in Mandailing Natal Regency: a time series study

    NASA Astrophysics Data System (ADS)

    Aulia, D.; Ayu, S. F.; Matondang, A.

    2018-01-01

    Malaria is the most contagious global concern. As a public health problem with outbreaks, affect the quality of life and economy, also could lead to death. Therefore, this research is to forecast malaria cases with climatic factors as predictors in Mandailing Natal Regency. The total number of positive malaria cases on January 2008 to December 2016 were taken from health department of Mandailing Natal Regency. Climates data such as rainfall, humidity, and temperature were taken from Center of Statistic Department of Mandailing Natal Regency. E-views ver. 9 is used to analyze this study. Autoregressive integrated average, ARIMA (0,1,1) (1,0,0)12 is the best model to explain the 67,2% variability data in time series study. Rainfall (P value = 0.0005), temperature (P value = 0,0029) and humidity (P value = 0.0001) are significant predictors for malaria transmission. Seasonal adjusted factor (SAF) in November and March shows peak for malaria cases.

  9. Hostility as a predictor of survival in patients with coronary artery disease.

    PubMed

    Boyle, Stephen H; Williams, Redford B; Mark, Daniel B; Brummett, Beverly H; Siegler, Ilene C; Helms, Michael J; Barefoot, John C

    2004-01-01

    This article presents a reanalysis of an earlier study that reported a nonsignificant relation between the 50-item Cook-Medley Hostility Scale (CMHS) and survival in a sample of coronary patients. Since publication of those results, there have been significant developments in the measurement of hostility that suggest that an abbreviated scale may be a better predictor of health outcomes. This study examined the ability of the total CMHS and an abbreviated form of the CMHS (ACM) to predict survival in a sample of patients with documented coronary artery disease (CAD) with increased statistical power. Nine hundred thirty-six patients (83% were male; mean age = 51.48) with CAD who were followed for an average of 14.9 years. The ACM consisted of the combination of the cynicism, hostile attribution, hostile affect, and aggressive responding subscales that were identified in an earlier study (Barefoot et al. [1989]) by a rational analysis of the item content. The relation between hostility and survival was examined with Cox proportional hazard models (hazard ratios [HRs] based on a two standard deviation difference). Controlling for disease severity, the ACM was a significant predictor for both CHD mortality (HR = 1.33, p <.009) and total mortality (HR = 1.28, p <.02). The total CMHS was only a marginally significant predictor of either outcome (p values < 0.06). The results of this study suggest that hostility is associated with poorer survival in CAD patients, and it may be possible to refine measures of hostility in order to improve prediction of health outcomes.

  10. A comparison of logistic regression analysis and an artificial neural network using the BI-RADS lexicon for ultrasonography in conjunction with introbserver variability.

    PubMed

    Kim, Sun Mi; Han, Heon; Park, Jeong Mi; Choi, Yoon Jung; Yoon, Hoi Soo; Sohn, Jung Hee; Baek, Moon Hee; Kim, Yoon Nam; Chae, Young Moon; June, Jeon Jong; Lee, Jiwon; Jeon, Yong Hwan

    2012-10-01

    To determine which Breast Imaging Reporting and Data System (BI-RADS) descriptors for ultrasound are predictors for breast cancer using logistic regression (LR) analysis in conjunction with interobserver variability between breast radiologists, and to compare the performance of artificial neural network (ANN) and LR models in differentiation of benign and malignant breast masses. Five breast radiologists retrospectively reviewed 140 breast masses and described each lesion using BI-RADS lexicon and categorized final assessments. Interobserver agreements between the observers were measured by kappa statistics. The radiologists' responses for BI-RADS were pooled. The data were divided randomly into train (n = 70) and test sets (n = 70). Using train set, optimal independent variables were determined by using LR analysis with forward stepwise selection. The LR and ANN models were constructed with the optimal independent variables and the biopsy results as dependent variable. Performances of the models and radiologists were evaluated on the test set using receiver-operating characteristic (ROC) analysis. Among BI-RADS descriptors, margin and boundary were determined as the predictors according to stepwise LR showing moderate interobserver agreement. Area under the ROC curves (AUC) for both of LR and ANN were 0.87 (95% CI, 0.77-0.94). AUCs for the five radiologists ranged 0.79-0.91. There was no significant difference in AUC values among the LR, ANN, and radiologists (p > 0.05). Margin and boundary were found as statistically significant predictors with good interobserver agreement. Use of the LR and ANN showed similar performance to that of the radiologists for differentiation of benign and malignant breast masses.

  11. A neuroergonomic quasi-experiment: Predictors of situation awareness and display usability while performing complex tasks

    NASA Astrophysics Data System (ADS)

    Harbour, Steven D.; Christensen, James C.

    2015-05-01

    Situation awareness (SA) is the ability and capacity to perceive information and act on it acceptably. Head Up Display (HUD) versus Head Down Display (HDD) manipulation induced variation in task difficulty. HUD and HDD cockpit displays or display designs promoted or impaired SA. The quantitative research presented in this paper examines basic neurocognitive factors in order to identify their specific contributions to the formation of SA, while studying display usability and the effects on SA. Visual attentiveness (Va), perceptiveness (Vp), and spatial working memory (Vswm) were assessed as predictors of SA under varying task difficulty. The study participants were 19 tactical airlift pilots, selected from the Ohio Air National Guard. Neurocognitive tests were administered to the participants prior to flight. In-flight SA was objectively and subjectively assessed for 24 flights. At the completion of this field experiment, the data were analyzed and the tests were statistically significant for the three predictor visual abilities Vp, Va, and Vswm as task difficulty was varied, F(3,11) = 8.125, p = .008. In addition, multiple regression analyses revealed that the visual abilities together predicted a majority of the variance in SA, R2 = 0.753, p = .008. As validated and verified by ECG and EEG data, the HUD yielded a full ability and capacity to anticipate and accommodate trends were as the HDD yielded a saturated ability to anticipate and accommodate trends. Post-hoc tests revealed a Cohen's f2 = 3.05 yielding statistical power to be 0.98. This work results in a significant contribution to the field by providing an improved understanding of SA and path to safer travel for society worldwide. PA 88ABW-2015-1282.

  12. Assessing the role of pavement macrotexture in preventing crashes on highways.

    PubMed

    Pulugurtha, Srinivas S; Kusam, Prasanna R; Patel, Kuvleshay J

    2010-02-01

    The objective of this article is to assess the role of pavement macrotexture in preventing crashes on highways in the State of North Carolina. Laser profilometer data obtained from the North Carolina Department of Transportation (NCDOT) for highways comprising four corridors are processed to calculate pavement macrotexture at 100-m (approximately 330-ft) sections according to the American Society for Testing and Materials (ASTM) standards. Crash data collected over the same lengths of the corridors were integrated with the calculated pavement macrotexture for each section. Scatterplots were generated to assess the role of pavement macrotexture on crashes and logarithm of crashes. Regression analyses were conducted by considering predictor variables such as million vehicle miles of travel (as a function of traffic volume and length), the number of interchanges, the number of at-grade intersections, the number of grade-separated interchanges, and the number of bridges, culverts, and overhead signs along with pavement macrotexture to study the statistical significance of relationship between pavement macrotexture and crashes (both linear and log-linear) when compared to other predictor variables. Scatterplots and regression analysis conducted indicate a more statistically significant relationship between pavement macrotexture and logarithm of crashes than between pavement macrotexture and crashes. The coefficient for pavement macrotexture, in general, is negative, indicating that the number of crashes or logarithm of crashes decreases as it increases. The relation between pavement macrotexture and logarithm of crashes is generally stronger than between most other predictor variables and crashes or logarithm of crashes. Based on results obtained, it can be concluded that maintaining pavement macrotexture greater than or equal to 1.524 mm (0.06 in.) as a threshold limit would possibly reduce crashes and provide safe transportation to road users on highways.

  13. Validation of use of the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) for impairment rating: a transversal retrospective study of 120 patients.

    PubMed

    Timmermans, Luc; Falez, Freddy; Mélot, Christian; Wespes, Eric

    2013-09-01

    A urinary incontinence impairment rating must be a highly accurate, non-invasive exploration of the condition using International Classification of Functioning (ICF)-based assessment tools. The objective of this study was to identify the best evaluation test and to determine an impairment rating model of urinary incontinence. In performing a cross-sectional study comparing successive urodynamic tests using both the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and the 1-hr pad-weighing test in 120 patients, we performed statistical likelihood ratio analysis and used logistic regression to calculate the probability of urodynamic incontinence using the most significant independent predictors. Subsequently, we created a template that was based on the significant predictors and the probability of urodynamic incontinence. The mean ICIQ-UI-SF score was 13.5 ± 4.6, and the median pad test value was 8 g. The discrimination statistic (receiver operating characteristic) described how well the urodynamic observations matched the ICIQ-UI-SF scores (under curve area (UDA):0.689) and the pad test data (UDA: 0.693). Using logistic regression analysis, we demonstrated that the best independent predictors of urodynamic incontinence were the patient's age and the ICIQ-UI-SF score. The logistic regression model permitted us to construct an equation to determine the probability of urodynamic incontinence. Using these tools, we created a template to generate a probability index of urodynamic urinary incontinence. Using this probability index, relative to the patient and to the maximum impairment of the whole person (MIWP) relative to urinary incontinence, we were able to calculate a patient's permanent impairment. Copyright © 2012 Wiley Periodicals, Inc.

  14. How do repeat suicide attempters differ from first timers? An exploratory record based analysis

    PubMed Central

    Menon, Vikas; Kattimani, Shivanand; Sarkar, Siddharth; Mathan, Kaliaperumal

    2016-01-01

    Background: Evidence indicates that repeat suicide attempters, as a group, may differ from 1st time attempters. The identification of repeat attempters is a powerful but underutilized clinical variable. Aims: In this research, we aimed to compare individuals with lifetime histories of multiple attempts with 1st time attempters to identify factors predictive of repeat attempts. Setting and Design: This was a retrospective record based study carried out at a teaching cum Tertiary Care Hospital in South India. Methods: Relevant data was extracted from the clinical records of 1st time attempters (n = 362) and repeat attempters (n = 61) presenting to a single Tertiary Care Center over a 4½ year period. They were compared on various sociodemographic and clinical parameters. The clinical measures included Presumptive Stressful Life Events Scale, Beck Hopelessness Scale, Coping Strategies Inventory – Short Form, and the Global Assessment of Functioning Scale. Statistical Analysis Used: First time attempters and repeaters were compared using appropriate inferential statistics. Logistic regression was used to identify independent predictors of repeat attempts. Results: The two groups did not significantly differ on sociodemographic characteristics. Repeat attempters were more likely to have given prior hints about their act (χ2 = 4.500, P = 0.034). In the final regression model, beck hopelessness score emerged as a significant predictor of repeat suicide attempts (odds ratio = 1.064, P = 0.020). Conclusion: Among suicide attempters presenting to the hospital, the presence of hopelessness is a predictor of repeat suicide attempts, independent of clinical depression. This highlights the importance of considering hopelessness in the assessment of suicidality with a view to minimize the risk of future attempts. PMID:26933353

  15. Merging digital rectal exam, family history, age and prostate-specific antigen to create a decision-making tool.

    PubMed

    Ankerst, Donna Pauler; Thompson, Ian M

    2006-12-01

    In this paper, we report on risk factors for prostate cancer detection on biopsy as found in the Prostate Cancer Prevention Trial (PCPT), with special emphasis on the independent contribution of prostate-specific antigen (PSA) velocity to prostate cancer risk over that provided by PSA. For this study, we used a subset of PCPT placebo arm participants who had had at least one prostate biopsy and a digital rectal examination (DRE) and PSA measured within 1 year prior to biopsy. In order to evaluate PSA velocity, we also required an additional PSA measurement within 3 years prior to biopsy, yielding 5,519 PCPT placebo arm participants for inclusion in the analysis. The risk of prostate cancer rose from 11.1% for PSA values less than 1 ng/mL to 43.3% for PSA values greater than 6 ng/mL and the risk of high-grade disease rose from 1.0% to 22.0% across these two PSA intervals. It was in fact no longer statistically significant as soon as the single predictor PSA was added to the risk equation, whereas PSA remained statistically significant even when velocity was in the risk equation. Furthermore, in a head-to-head comparison of predictive strength as a single predictor in a model, assessed by maximized log likelihood, PSA was more predictive than PSA velocity. These findings occurred for every definition of velocity that was considered and hence we concluded that velocity did not add independent prognostic information to prostate cancer risk over that provided by PSA. Similarly, age, which is also a predictor of prostate cancer in the absence of other factors, did not add independent prognostic information to PSA, DRE, family history, and prior biopsy.

  16. Domestic violence and its predictors among married women in reproductive age in Fagitalekoma Woreda, Awi zone, Amhara regional state, North Western Ethiopia

    PubMed Central

    2013-01-01

    Background Violence against women is one of the most systematic and prevalent human rights abuses in the world. It is a form of discrimination and deeply rooted in power imbalances and structural inequality between women and men. Documenting the extent of the problem and associated factors is essential to develop public health interventions to tackle violence against women. Therefore, the objective of this study was to determine magnitude of domestic violence and identify its predictors among married women in the reproductive age in north western Ethiopia. Methods Community-based cross-sectional study was conducted from February 15 to March 15, 2011 among 682 married women and 46 key informants. Systematic sampling technique was used to select respondents for the quantitative method. Purposive sampling was used to select in-depth interview key informants for and focus group discussants. Data were analyzed using SPSS window version 16.0. Binary logistic regression and multivariable logistic regression analysis were carried out to determine the prevalence and identify independent predictors of domestic violence against women. Statistical association was measured by adjusted odds ratios and 95% confidence intervals. Statistical significance was declared at P < 0.05. Result The prevalence of domestic violence was 78.0%. About 73.3%, 58.4% and 49.1% of women reported different forms of psychological, physical and sexual violence, respectively. Alcohol consumption by husband (AOR = 1.9, 95%CI = 1.3, 2.8), being pregnant (AOR = 2.1, 95% CI = 1.4, 3.4), decision making power (AOR = 2.3, 95% CI = 1.5, 3.4) and annual income (AOR = 1.9, 95% CI = 1.1, 3.3) were predictors of domestic violence. Conclusion The prevalence of domestic violence was very high as compared to other studies. Women’s husband alcohol consumption, decision making power annual household income and being pregnant are some of the predictors of domestic violence against women. PMID:24308763

  17. Functional Status Outperforms Comorbidities as a Predictor of 30-Day Acute Care Readmissions in the Inpatient Rehabilitation Population.

    PubMed

    Shih, Shirley L; Zafonte, Ross; Bates, David W; Gerrard, Paul; Goldstein, Richard; Mix, Jacqueline; Niewczyk, Paulette; Greysen, S Ryan; Kazis, Lewis; Ryan, Colleen M; Schneider, Jeffrey C

    2016-10-01

    Functional status is associated with patient outcomes, but is rarely included in hospital readmission risk models. The objective of this study was to determine whether functional status is a better predictor of 30-day acute care readmission than traditionally investigated variables including demographics and comorbidities. Retrospective database analysis between 2002 and 2011. 1158 US inpatient rehabilitation facilities. 4,199,002 inpatient rehabilitation facility admissions comprising patients from 16 impairment groups within the Uniform Data System for Medical Rehabilitation database. Logistic regression models predicting 30-day readmission were developed based on age, gender, comorbidities (Elixhauser comorbidity index, Deyo-Charlson comorbidity index, and Medicare comorbidity tier system), and functional status [Functional Independence Measure (FIM)]. We hypothesized that (1) function-based models would outperform demographic- and comorbidity-based models and (2) the addition of demographic and comorbidity data would not significantly enhance function-based models. For each impairment group, Function Only Models were compared against Demographic-Comorbidity Models and Function Plus Models (Function-Demographic-Comorbidity Models). The primary outcome was 30-day readmission, and the primary measure of model performance was the c-statistic. All-cause 30-day readmission rate from inpatient rehabilitation facilities to acute care hospitals was 9.87%. C-statistics for the Function Only Models were 0.64 to 0.70. For all 16 impairment groups, the Function Only Model demonstrated better c-statistics than the Demographic-Comorbidity Models (c-statistic difference: 0.03-0.12). The best-performing Function Plus Models exhibited negligible improvements in model performance compared to Function Only Models, with c-statistic improvements of only 0.01 to 0.05. Readmissions are currently used as a marker of hospital performance, with recent financial penalties to hospitals for excessive readmissions. Function-based readmission models outperform models based only on demographics and comorbidities. Readmission risk models would benefit from the inclusion of functional status as a primary predictor. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  18. Prevalence and clinical significance of nonorgan specific antibodies in patients with autoimmune thyroiditis as predictor markers for rheumatic diseases.

    PubMed

    Elnady, Basant M; Kamal, Naglaa M; Shaker, Raneyah H M; Soliman, Amal F; Hasan, Waleed A; Alghamdi, Hamed A; Algethami, Mohammed M; Jajah, Mohamed Bilal

    2016-09-01

    Autoimmune diseases are considered the 3rd leading cause of morbidity and mortality in the industrialized countries. Autoimmune thyroid diseases (ATDs) are associated with high prevalence of nonorgan-specific autoantibodies, such as antinuclear antibodies (ANA), antidouble-stranded deoxyribonucleic acid (anti-dsDNA), antiextractable-nuclear antigens (anti-ENAs), rheumatoid factor (RF), and anticyclic-citrullinated peptides (anti-CCP) whose clinical significance is unknown.We aimed to assess the prevalence of various nonorgan-specific autoantibodies in patients with ATD, and to investigate the possible association between these autoantibodies and occurrence of rheumatic diseases and, if these autoantibodies could be considered as predictor markers for autoimmune rheumatic diseases in the future.This study had 2 phases: phase 1; in which 61 ATD patients free from rheumatic manifestations were assessed for the presence of these nonorgan-specific autoantibodies against healthy 61 control group, followed by 2nd phase longitudinal clinical follow-up in which cases are monitored systematically to establish occurrence and progression of any rheumatic disease in association to these autoantibodies with its influences and prognosis.Regarding ATD patients, ANA, anti-dsDNA, Anti-ENA, and RF were present in a percentage of (50.8%), (18%), (21.3%), and (34.4%), respectively, with statistically significance difference (P < 0.5) rather than controls. Nearly one third of the studied group (32.8%) developed the rheumatic diseases, over 2 years follow-up. It was obvious that those with positive anti-dsDNA had higher risk (2.45 times) to develop rheumatic diseases than those without. There was a statistically significant positive linear relationship between occurrence of disease in months and (age, anti-dsDNA, anti-CCP, RF, and duration of thyroiditis). Anti-dsDNA and RF are the most significant predictors (P < 0.0001).ATD is more associated with rheumatic diseases than previously thought. Anti-dsDNA, RF, and anti-CCP antibodies may be used as predictive screening markers of systemic lupus erythematosus and RA, with early referral to rheumatologists for close follow-up and early diagnoses for appropriate disease management of the disease, as early disease control will allow better quality of life.

  19. Predicting adolescents' intake of fruits and vegetables.

    PubMed

    Lytle, Leslie A; Varnell, Sherri; Murray, David M; Story, Mary; Perry, Cheryl; Birnbaum, Amanda S; Kubik, Martha Y

    2003-01-01

    To explore potential predictors of adolescents' fruit and vegetable intake by expanding on current theory and drawing from other adolescent research. This research reports on baseline and interim data from a school-based intervention study. Data were collected through surveys administered to students at the beginning and end of their 7th grade year. The students attended 16 public schools in Minnesota. Data were collected on 3878 students; approximately half were female and 67% were white. All students in the 7th grade cohort were invited to participate in the surveys and over 94% completed both surveys. Our dependent variable, fruit and vegetable intake, was assessed by a validated fruit and vegetable food frequency scale. Predictive factors assessed included parenting style, spirituality/religiosity, depressive symptoms, and other commonly assessed predictors. Generalized linear mixed model regression. Omnibus test of association using P <.05 is reported. Subjective norms, barriers, knowledge, usual food choice, parenting style, spirituality/religiosity, and depressive symptoms were statistically significant predictors of intake. The model explained about 31% of the variance in fruit and vegetable consumption. To better understand adolescents' fruit and vegetable intake, we must explore novel predictors. Our results need to be replicated, and more exploratory research in this field is needed.

  20. Social support is a primary influence on home fruit, 100% juice, and vegetable availability.

    PubMed

    Baranowski, Tom; Watson, Kathy; Missaghian, Mariam; Broadfoot, Alison; Cullen, Karen; Nicklas, Theresa; Fisher, Jennifer; Baranowski, Janice; O'Donnell, Sharon

    2008-07-01

    Children tend to eat more fruit and vegetables when more are available in the home. We proposed and tested a model that predicts the availability at home (hereinafter termed "home availability") of fruit, 100% juice, and vegetables, using new measures of frequency of food shopping, purchase, and comparative purchase outcome expectancies (ie, the perceived benefits and costs of purchasing fruit and vegetables), home food pantry management practices, family social support for purchasing fruit and vegetables, food shopping practices, and body mass index (BMI). Participants (N=98) were recruited in 2004 in front of grocery stores and completed two telephone interviews. Cross-sectional hierarchical regression was employed with backward deletion of nonsignificant variables. Despite many statistically significant bivariate correlations between the new variables and home fruit, 100% juice, and vegetable availability, social support was the primary predictor of home fruit availability in multivariate regression. BMI and home 100% juice pantry management were the primary predictors of home 100% juice availability. Social support, BMI, and shopping practices were the primary predictors of home vegetable availability. Social support for purchasing fruit, 100% juice, and vegetables was an important, consistent predictor of home availability. These findings need to be replicated in larger samples.

  1. Statistical downscaling of IPCC sea surface wind and wind energy predictions for U.S. east coastal ocean, Gulf of Mexico and Caribbean Sea

    NASA Astrophysics Data System (ADS)

    Yao, Zhigang; Xue, Zuo; He, Ruoying; Bao, Xianwen; Song, Jun

    2016-08-01

    A multivariate statistical downscaling method is developed to produce regional, high-resolution, coastal surface wind fields based on the IPCC global model predictions for the U.S. east coastal ocean, the Gulf of Mexico (GOM), and the Caribbean Sea. The statistical relationship is built upon linear regressions between the empirical orthogonal function (EOF) spaces of a cross- calibrated, multi-platform, multi-instrument ocean surface wind velocity dataset (predictand) and the global NCEP wind reanalysis (predictor) over a 10 year period from 2000 to 2009. The statistical relationship is validated before applications and its effectiveness is confirmed by the good agreement between downscaled wind fields based on the NCEP reanalysis and in-situ surface wind measured at 16 National Data Buoy Center (NDBC) buoys in the U.S. east coastal ocean and the GOM during 1992-1999. The predictand-predictor relationship is applied to IPCC GFDL model output (2.0°×2.5°) of downscaled coastal wind at 0.25°×0.25° resolution. The temporal and spatial variability of future predicted wind speeds and wind energy potential over the study region are further quantified. It is shown that wind speed and power would significantly be reduced in the high CO2 climate scenario offshore of the mid-Atlantic and northeast U.S., with the speed falling to one quarter of its original value.

  2. Linguistic Strategies for Improving Informed Consent in Clinical Trials Among Low Health Literacy Patients.

    PubMed

    Krieger, Janice L; Neil, Jordan M; Strekalova, Yulia A; Sarge, Melanie A

    2017-03-01

    Improving informed consent to participate in randomized clinical trials (RCTs) is a key challenge in cancer communication. The current study examines strategies for enhancing randomization comprehension among patients with diverse levels of health literacy and identifies cognitive and affective predictors of intentions to participate in cancer RCTs. Using a post-test-only experimental design, cancer patients (n = 500) were randomly assigned to receive one of three message conditions for explaining randomization (ie, plain language condition, gambling metaphor, benign metaphor) or a control message. All statistical tests were two-sided. Health literacy was a statistically significant moderator of randomization comprehension (P = .03). Among participants with the lowest levels of health literacy, the benign metaphor resulted in greater comprehension of randomization as compared with plain language (P = .04) and control (P = .004) messages. Among participants with the highest levels of health literacy, the gambling metaphor resulted in greater randomization comprehension as compared with the benign metaphor (P = .04). A serial mediation model showed a statistically significant negative indirect effect of comprehension on behavioral intention through personal relevance of RCTs and anxiety associated with participation in RCTs (P < .001). The effectiveness of metaphors for explaining randomization depends on health literacy, with a benign metaphor being particularly effective for patients at the lower end of the health literacy spectrum. The theoretical model demonstrates the cognitive and affective predictors of behavioral intention to participate in cancer RCTs and offers guidance on how future research should employ communication strategies to improve the informed consent processes. © The Author 2016. Published by Oxford University Press.

  3. Linguistic Strategies for Improving Informed Consent in Clinical Trials Among Low Health Literacy Patients

    PubMed Central

    Neil, Jordan M.; Strekalova, Yulia A.; Sarge, Melanie A.

    2017-01-01

    Abstract Background: Improving informed consent to participate in randomized clinical trials (RCTs) is a key challenge in cancer communication. The current study examines strategies for enhancing randomization comprehension among patients with diverse levels of health literacy and identifies cognitive and affective predictors of intentions to participate in cancer RCTs. Methods: Using a post-test-only experimental design, cancer patients (n = 500) were randomly assigned to receive one of three message conditions for explaining randomization (ie, plain language condition, gambling metaphor, benign metaphor) or a control message. All statistical tests were two-sided. Results: Health literacy was a statistically significant moderator of randomization comprehension (P = .03). Among participants with the lowest levels of health literacy, the benign metaphor resulted in greater comprehension of randomization as compared with plain language (P = .04) and control (P = .004) messages. Among participants with the highest levels of health literacy, the gambling metaphor resulted in greater randomization comprehension as compared with the benign metaphor (P = .04). A serial mediation model showed a statistically significant negative indirect effect of comprehension on behavioral intention through personal relevance of RCTs and anxiety associated with participation in RCTs (P < .001). Conclusions: The effectiveness of metaphors for explaining randomization depends on health literacy, with a benign metaphor being particularly effective for patients at the lower end of the health literacy spectrum. The theoretical model demonstrates the cognitive and affective predictors of behavioral intention to participate in cancer RCTs and offers guidance on how future research should employ communication strategies to improve the informed consent processes. PMID:27794035

  4. Health and human rights: a statistical measurement framework using household survey data in Uganda.

    PubMed

    Wesonga, Ronald; Owino, Abraham; Ssekiboobo, Agnes; Atuhaire, Leonard; Jehopio, Peter

    2015-05-03

    Health is intertwined with human rights as is clearly reflected in the right to life. Promotion of health practices in the context of human rights can be accomplished if there is a better understanding of the level of human rights observance. In this paper, we evaluate and present an appraisal for a possibility of applying household survey to study the determinants of health and human rights and also derive the probability that human rights are observed; an important ingredient into the national planning framework. Data from the Uganda National Governance Baseline Survey were used. A conceptual framework for predictors of a hybrid dependent variable was developed and both bivariate and multivariate statistical techniques employed. Multivariate post estimation computations were derived after evaluations of the significance of coefficients of health and human rights predictors. Findings, show that household characteristics of respondents considered in this study were statistically significant (p < 0.05) to provide a reliable assessment of human rights observance. For example, a unit increase of respondents' schooling levels results in an increase of about 34% level of positively assessing human rights observance. Additionally, the study establishes, through the three models presented, that household assessment of health and human rights observance was 20% which also represents how much of the entire continuum of human rights is demanded. Findings propose important evidence for monitoring and evaluation of health in the context human rights using household survey data. They provide a benchmark for health and human rights assessments with a focus on international and national development plans to achieve socio-economic transformation and health in society.

  5. Predictors of psychological distress after diagnosis in breast cancer patients and patients with benign breast problems.

    PubMed

    Ando, Noriko; Iwamitsu, Yumi; Kuranami, Masaru; Okazaki, Shigemi; Nakatani, Yuki; Yamamoto, Kenji; Watanabe, Masahiko; Miyaoka, Hitoshi

    2011-01-01

    The objective of this study was to determine how age and psychological characteristics assessed prior to diagnosis could predict psychological distress in outpatients immediately after disclosure of their diagnosis. This is a longitudinal and prospective study, and participants were breast cancer patients and patients with benign breast problems (BBP). Patients were asked to complete questionnaires to determine levels of the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood Status) prior to diagnosis. They were asked to complete a questionnaire measuring psychological distress after being told their diagnosis. We analyzed a total of 38 women diagnosed with breast cancer and 95 women diagnosed with a BBP. A two-way analysis of variance (prior to, after diagnosis × cancer, benign) showed that psychological distress after diagnosis among breast cancer patients was significantly higher than in patients with a BBP. The multiple regression model accounted for a significant amount of variance in the breast cancer group (model adjusted R(2) = 0.545, p < 0.001), and only trait anxiety was statistically significant (β = 0.778, p < 0.001). In the BBP group, the multiple regression analysis yielded a significant result (model adjusted R(2) = 0.462, p < 0.001), with trait anxiety and negative life changes as statistically significant factors (β = 0.449 and 0.324 respectively; p < 0.01). In both groups, trait anxiety assessed prior to diagnosis was the significant predictor of psychological distress after diagnosis, and might have prospects as a screening method for psychologically vulnerable women. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  6. Genetic and environmental predictors of serum 25(OH)D concentrations among middle-aged and elderly Chinese in Singapore

    PubMed Central

    Robien, Kim; Butler, Lesley M.; Wang, Renwei; Beckman, Kenneth B.; Walek, Dinesha; Koh, Woon-Puay; Yuan, Jian-Min

    2012-01-01

    Vitamin D is known for maintaining calcium homeostasis and bone structure, and may also decrease susceptibility to chronic and infectious diseases. However, data on vitamin D status and its predictors among Southeast Asian populations is limited. We evaluated the distribution and determinants (genetic and environmental) of serum 25-hydroxyvitamin D (25(OH)D) concentrations among 504 middle-aged and elderly participants (aged 45–74 years) in the Singapore Chinese Health Study. Data on dietary and other lifestyle factors were collected by trained interviewers. Serum 25(OH)D concentrations and genetic polymorphisms in vitamin D metabolism pathway enzymes [cytochrome P450 (CYP) 2R1, 3A4, 27B1, 24A1; vitamin D binding protein (GC); and vitamin D receptor (VDR)] were measured using stored biospecimens. Mean 25(OH)D concentration was 68.8 nmol/L. Serum 25(OH)D concentrations were positively associated with dietary vitamin D intake, and inversely associated with hours sitting at work. BMI was not associated with 25(OH)D concentrations. CYP2R1 rs10741657, rs12794714, rs1993116; CYP3A4 rs2242480; and GC rs4588, rs7041, rs16847015, rs2298849 were statistically significantly associated with 25(OH)D concentrations. Individuals with the Gc2-2 haplotype (rs4588AA/rs7041TT) had statistically significantly lower 25(OH)D concentrations compared to all other Gc haplotypes (p-trend<0.001). The majority of participants (86%) had 25(OH)D concentrations ≥50 nmol/L, which is consistent with the 2011 Institute of Medicine (United States) recommendation for bone health, and 32% had concentrations of ≥75 nmol/L that are thought to be required for broader health effects. Dietary vitamin D intake, hours spent indoors at work, and genetic variation in CYP2R1, CYP3A4 and GC are significant predictors of 25(OH)D concentrations among Singapore Chinese. PMID:22583563

  7. Genetic and environmental predictors of serum 25-hydroxyvitamin D concentrations among middle-aged and elderly Chinese in Singapore.

    PubMed

    Robien, Kim; Butler, Lesley M; Wang, Renwei; Beckman, Kenneth B; Walek, Dinesha; Koh, Woon-Puay; Yuan, Jian-Min

    2013-02-14

    Vitamin D is known for maintaining Ca homeostasis and bone structure, and may also decrease susceptibility to chronic and infectious diseases. However, data on vitamin D status and its predictors among Southeast Asian populations are limited. We evaluated the distribution and determinants (genetic and environmental) of serum 25-hydroxyvitamin D (25(OH)D) concentrations among 504 middle-aged and elderly participants (aged 45-74 years) in the Singapore Chinese Health Study. Data on dietary and other lifestyle factors were collected by trained interviewers. Serum 25(OH)D concentrations and genetic polymorphisms in vitamin D metabolism pathway enzymes (cytochrome P450 (CYP) 2R1, 3A4, 27B1, 24A1; vitamin D binding protein (also known as group-specific component, GC); and vitamin D receptor) were measured using stored biospecimens. Mean 25(OH)D concentration was 68·8 nmol/l. Serum 25(OH)D concentrations were positively associated with dietary vitamin D intake, and inversely associated with hours spent sitting at work. BMI was not associated with 25(OH)D concentrations. CYP2R1 rs10741657, rs12794714, rs1993116; CYP3A4 rs2242480; and GC rs4588, rs7041, rs16847015, rs2298849 were statistically significantly associated with 25(OH)D concentrations. Individuals with the Gc2-2 haplotype (rs4588AA/rs7041TT) had statistically significantly lower 25(OH)D concentrations compared to all other Gc haplotypes (P-trend < 0·001). The majority of participants (86 %) had 25(OH)D concentrations ≥ 50 nmol/l, which is consistent with the 2011 Institute of Medicine (US) recommendation for bone health, and 32 % had concentrations of ≥ 75 nmol/l that are thought to be required for broader health effects. Dietary vitamin D intake, hours spent indoors at work and genetic variation in CYP2R1, CYP3A4 and GC are significant predictors of 25(OH)D concentrations among Singapore Chinese.

  8. The Simulation of Daily Temperature Time Series from GCM Output. Part II: Sensitivity Analysis of an Empirical Transfer Function Methodology.

    NASA Astrophysics Data System (ADS)

    Winkler, Julie A.; Palutikof, Jean P.; Andresen, Jeffrey A.; Goodess, Clare M.

    1997-10-01

    Empirical transfer functions have been proposed as a means for `downscaling' simulations from general circulation models (GCMs) to the local scale. However, subjective decisions made during the development of these functions may influence the ensuing climate scenarios. This research evaluated the sensitivity of a selected empirical transfer function methodology to 1) the definition of the seasons for which separate specification equations are derived, 2) adjustments for known departures of the GCM simulations of the predictor variables from observations, 3) the length of the calibration period, 4) the choice of function form, and 5) the choice of predictor variables. A modified version of the Climatological Projection by Model Statistics method was employed to generate control (1 × CO2) and perturbed (2 × CO2) scenarios of daily maximum and minimum temperature for two locations with diverse climates (Alcantarilla, Spain, and Eau Claire, Michigan). The GCM simulations used in the scenario development were from the Canadian Climate Centre second-generation model (CCC GCMII).Variations in the downscaling methodology were found to have a statistically significant impact on the 2 × CO2 climate scenarios, even though the 1 × CO2 scenarios for the different transfer function approaches were often similar. The daily temperature scenarios for Alcantarilla and Eau Claire were most sensitive to the decision to adjust for deficiencies in the GCM simulations, the choice of predictor variables, and the seasonal definitions used to derive the functions (i.e., fixed seasons, floating seasons, or no seasons). The scenarios were less sensitive to the choice of function form (i.e., linear versus nonlinear) and to an increase in the length of the calibration period.The results of Part I, which identified significant departures of the CCC GCMII simulations of two candidate predictor variables from observations, together with those presented here in Part II, 1) illustrate the importance of detailed comparisons of observed and GCM 1 × CO2 series of candidate predictor variables as an initial step in impact analysis, 2) demonstrate that decisions made when developing the transfer functions can have a substantial influence on the 2 × CO2 scenarios and their interpretation, 3) highlight the uncertainty in the appropriate criteria for evaluating transfer function approaches, and 4) suggest that automation of empirical transfer function methodologies is inappropriate because of differences in the performance of transfer functions between sites and because of spatial differences in the GCM's ability to adequately simulate the predictor variables used in the functions.

  9. The Objective Assessment of Cough Frequency in Bronchiectasis.

    PubMed

    Spinou, Arietta; Lee, Kai K; Sinha, Aish; Elston, Caroline; Loebinger, Michael R; Wilson, Robert; Chung, Kian Fan; Yousaf, Nadia; Pavord, Ian D; Matos, Sergio; Garrod, Rachel; Birring, Surinder S

    2017-10-01

    Cough in bronchiectasis is associated with significant impairment in health status. This study aimed to quantify cough frequency objectively with a cough monitor and investigate its relationship with health status. A secondary aim was to identify clinical predictors of cough frequency. Fifty-four patients with bronchiectasis were compared with thirty-five healthy controls. Objective 24-h cough, health status (cough-specific: Leicester Cough Questionnaire LCQ and bronchiectasis specific: Bronchiectasis Health Questionnaire BHQ), cough severity and lung function were measured. The clinical predictors of cough frequency in bronchiectasis were determined in a multivariate analysis. Objective cough frequency was significantly raised in patients with bronchiectasis compared to healthy controls [geometric mean (standard deviation)] 184.5 (4.0) vs. 20.6 (3.2) coughs/24-h; mean fold-difference (95% confidence interval) 8.9 (5.2, 15.2); p < 0.001 and they had impaired health status. There was a significant correlation between objective cough frequency and subjective measures; LCQ r = -0.52 and BHQ r = -0.62, both p < 0.001. Sputum production, exacerbations (between past 2 weeks to 12 months) and age were significantly associated with objective cough frequency in multivariate analysis, explaining 52% of the variance (p < 0.001). There was no statistically significant association between cough frequency and lung function. Cough is a common and significant symptom in patients with bronchiectasis. Sputum production, exacerbations and age, but not lung function, were independent predictors of cough frequency. Ambulatory objective cough monitoring provides novel insights and should be further investigated as an outcome measure in bronchiectasis.

  10. On use of the multistage dose-response model for assessing laboratory animal carcinogenicity

    PubMed Central

    Nitcheva, Daniella; Piegorsch, Walter W.; West, R. Webster

    2007-01-01

    We explore how well a statistical multistage model describes dose-response patterns in laboratory animal carcinogenicity experiments from a large database of quantal response data. The data are collected from the U.S. EPA’s publicly available IRIS data warehouse and examined statistically to determine how often higher-order values in the multistage predictor yield significant improvements in explanatory power over lower-order values. Our results suggest that the addition of a second-order parameter to the model only improves the fit about 20% of the time, while adding even higher-order terms apparently does not contribute to the fit at all, at least with the study designs we captured in the IRIS database. Also included is an examination of statistical tests for assessing significance of higher-order terms in a multistage dose-response model. It is noted that bootstrap testing methodology appears to offer greater stability for performing the hypothesis tests than a more-common, but possibly unstable, “Wald” test. PMID:17490794

  11. Modeling Predictors of Duties Not Including Flying Status.

    PubMed

    Tvaryanas, Anthony P; Griffith, Converse

    2018-01-01

    The purpose of this study was to reuse available datasets to conduct an analysis of potential predictors of U.S. Air Force aircrew nonavailability in terms of being in "duties not to include flying" (DNIF) status. This study was a retrospective cohort analysis of U.S. Air Force aircrew on active duty during the period from 2003-2012. Predictor variables included age, Air Force Specialty Code (AFSC), clinic location, diagnosis, gender, pay grade, and service component. The response variable was DNIF duration. Nonparametric methods were used for the exploratory analysis and parametric methods were used for model building and statistical inference. Out of a set of 783 potential predictor variables, 339 variables were identified from the nonparametric exploratory analysis for inclusion in the parametric analysis. Of these, 54 variables had significant associations with DNIF duration in the final model fitted to the validation data set. The predicted results of this model for DNIF duration had a correlation of 0.45 with the actual number of DNIF days. Predictor variables included age, 6 AFSCs, 7 clinic locations, and 40 primary diagnosis categories. Specific demographic (i.e., age), occupational (i.e., AFSC), and health (i.e., clinic location and primary diagnosis category) DNIF drivers were identified. Subsequent research should focus on the application of primary, secondary, and tertiary prevention measures to ameliorate the potential impact of these DNIF drivers where possible.Tvaryanas AP, Griffith C Jr. Modeling predictors of duties not including flying status. Aerosp Med Hum Perform. 2018; 89(1):52-57.

  12. An Adaptive Prediction-Based Approach to Lossless Compression of Floating-Point Volume Data.

    PubMed

    Fout, N; Ma, Kwan-Liu

    2012-12-01

    In this work, we address the problem of lossless compression of scientific and medical floating-point volume data. We propose two prediction-based compression methods that share a common framework, which consists of a switched prediction scheme wherein the best predictor out of a preset group of linear predictors is selected. Such a scheme is able to adapt to different datasets as well as to varying statistics within the data. The first method, called APE (Adaptive Polynomial Encoder), uses a family of structured interpolating polynomials for prediction, while the second method, which we refer to as ACE (Adaptive Combined Encoder), combines predictors from previous work with the polynomial predictors to yield a more flexible, powerful encoder that is able to effectively decorrelate a wide range of data. In addition, in order to facilitate efficient visualization of compressed data, our scheme provides an option to partition floating-point values in such a way as to provide a progressive representation. We compare our two compressors to existing state-of-the-art lossless floating-point compressors for scientific data, with our data suite including both computer simulations and observational measurements. The results demonstrate that our polynomial predictor, APE, is comparable to previous approaches in terms of speed but achieves better compression rates on average. ACE, our combined predictor, while somewhat slower, is able to achieve the best compression rate on all datasets, with significantly better rates on most of the datasets.

  13. Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

    PubMed

    Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

    2012-05-01

    Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.

  14. A pilot study on predictors of brainstem raphe abnormality in patients with major depressive disorder.

    PubMed

    Kostić, Milutin; Munjiza, Ana; Pesic, Danilo; Peljto, Amir; Novakovic, Ivana; Dobricic, Valerija; Tosevski, Dusica Lecic; Mijajlovic, Milija

    2017-02-01

    Hypo/anechogenicity of the brainstem raphe (BR) structures has been suggested as a possible transcranial parenchymal sonography (TCS) marker associated with depression. The aim of this study was to analyze possible association of the abnormal BR echogenicity in patients with major depression when compared to healthy controls, and to evaluate its clinical and genetic correlates. TCS was performed in 53 patients diagnosed as major depressive disorder (MDD) without psychotic symptoms and in 54 healthy matched controls. The TCS detected BR abnormalities were significantly more frequent in MDD patients (35 out of 53; 66%) in comparison to matched controls (5 out of 56; 9%). The prevalence of short allele (s) homozygocity in the length polymorphism of the promoter region of the serotonin transporter gene (5-HTTLPR) was significantly higher in MDD patients relative to those with normal BR echogenicity. A stepwise statistical discriminant analysis revealed statistically significant separation between MDD patients with and without BR abnormalities groups based on the four predictors combined: the Hamilton Anxiety Rating Scale item 5 ("difficulty in concentration, poor memory"), presence of social phobia, s allele homozygocity of the 5-HTTLPR polymorphism, and presence of generalized anxiety disorder. Cross-sectional design and heterogenous treatment of depressed patients. Reduced BR echogenicity in at least a subgroup of MDD patients may reflect a particular phenotype, characterized by more prevalent comorbid anxiety disorders, associated with particular genetic polymorphisms and neurotransmitter(s) deficits, most probably altered serotonergic mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Changing patterns of microcalcification on screening mammography for prediction of breast cancer.

    PubMed

    Kim, Kwan Il; Lee, Kyung Hee; Kim, Tae Ryung; Chun, Yong Soon; Lee, Tae Hoon; Choi, Hye Young; Park, Heung Kyu

    2016-05-01

    The presence of microcalcification on mammography is one of the earliest signs in breast cancer detection. However, it is difficult to distinguish malignant calcifications from benign calcifications. The aim of this study is to evaluate correlation between changing patterns of microcalcification on screening mammography and malignant breast lesions. Medical records and diagnostic images of 67 women who had previously undergone at least two digital mammograms at least 6 months apart and underwent mammography-guided needle localization and surgical excision between 2011 and 2013 were retrospectively reviewed and analyzed. Breast cancer was detected in the surgical specimens of 20 patients (29.9 %). Annual change of extent of microcalcification on mammography showed statistically significant correlation with pathologic outcome (P = 0.023). The changing pattern of new appearance or increased extent of microcalcification on mammography had positive predictive value of 54.8 % for breast cancer, and it was a statistically significant predictor for breast cancer (P = 0.012). Shape or number change of microcalcification without increased extent had less accurate predictive value for breast cancer, particularly in women younger than 50 years (P < 0.001). This study showed that the pattern of increased extent of microcalcification on screening mammography was a significant predictor for breast cancer. We suggest that mammography-guided needle localization and surgical excision should be considered when increased extent of microcalcification is observed on screening mammography and closed follow-up without pathologic confirmation can be permitted if absence of extension of microcalcification was confirmed in women younger than 50 years.

  16. Shiga toxigenic Escherichia coli incidence is related to small area variation in cattle density in a region in Ireland.

    PubMed

    Brehony, C; Cullinan, J; Cormican, M; Morris, D

    2018-10-01

    Shiga toxigenic Escherichia coli (STEC) are pathogenic E. coli that cause infectious diarrhoea. In some cases infection may be complicated by renal failure and death. The incidence of human infection with STEC in Ireland is the highest in Europe. The objective of the study was to examine the spatial incidence of human STEC infection in a region of Ireland with significantly higher rates of STEC incidence than the national average and to identify possible risk factors of STEC incidence at area level. Anonymised laboratory records (n = 379) from 2009 to 2015 were obtained from laboratories serving three counties in the West of Ireland. Data included location and sample date. Population and electoral division (ED) data were obtained from the Irish 2011 Census of Population. STEC incidence was calculated for each ED (n = 498) and used to map hotspots/coldspots using the Getis-Ord Gi* spatial statistic and significant spatial clustering using the Anselin's Local Moran's I statistic. Multivariable regression analysis was used to consider the importance of a number of potential predictors of STEC incidence. Incidence rates for the seven-year period ranged from 0 to 10.9 cases per 1000. A number of areas with significant local clustering of STEC incidence as well as variation in the spatial distribution of the two main serogroups associated with disease in the region i.e. O26 and O157 were identified. Cattle density was found to be a statistically significant predictor of STEC in the region. GIS analysis of routine data indicates that cattle density is associated STEC infection in this high incidence region. This finding points to the importance of agricultural practices for human health and the importance of a "one-health" approach to public policy in relation to agriculture, health and environment. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Case-Mix Variables and Predictors for Outcomes of Laparoscopic Hysterectomy: A Systematic Review.

    PubMed

    Driessen, Sara R C; Sandberg, Evelien M; la Chapelle, Claire F; Twijnstra, Andries R H; Rhemrev, Johann P T; Jansen, Frank Willem

    2016-01-01

    The assessment of surgical quality is complex, and an adequate case-mix correction is missing in currently applied quality indicators. The purpose of this study is to give an overview of all studies mentioning statistically significant associations between patient characteristics and surgical outcomes for laparoscopic hysterectomy (LH). Additionally, we identified a set of potential case-mix characteristics for LH. This systematic review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. We searched PubMed and EMBASE from January 1, 2000 to August 1, 2015. All articles describing statistically significant associations between patient characteristics and adverse outcomes of LH for benign indications were included. Primary outcomes were blood loss, operative time, conversion, and complications. The methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The included articles were summed per predictor and surgical outcome. Three sets of case-mix characteristics were determined, stratified by different levels of evidence. Eighty-five of 1549 identified studies were considered eligible. Uterine weight and body mass index (BMI) were the most mentioned predictors (described, respectively, 83 and 45 times) in high quality studies. For longer operative time and higher blood loss, uterine weight ≥ 250 to 300 g and ≥500 g and BMI ≥ 30 kg/m(2) dominated as predictors. Previous operations, adhesions, and higher age were also considered as predictors for longer operative time. For complications and conversions, the patient characteristics varied widely, and uterine weight, BMI, previous operations, adhesions, and age predominated. Studies of high methodologic quality indicated uterine weight and BMI as relevant case-mix characteristics for all surgical outcomes. For future development of quality indicators of LH and to compare surgical outcomes adequately, a case-mix correction is suggested for at least uterine weight and BMI. A potential case-mix correction for adhesions and previous operations can be considered. For both surgeons and patients it is valuable to be aware of potential factors predicting adverse outcomes and to anticipate this. Finally, to benchmark clinical outcomes at an international level, it is of the utmost importance to introduce uniform outcome definitions. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  18. Comparison of 20% sulfur hexafluoride with air for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK).

    PubMed

    Botsford, Benjamin; Vedana, Gustavo; Cope, Leslie; Yiu, Samuel C; Jun, Albert S

    2016-01-01

    To compare the effect of 20% sulfur hexafluoride (SF6) with that of air on graft detachment rates for intraocular tamponade in Descemet membrane endothelial keratoplasty (DMEK). Forty-two eyes of patients who underwent DMEK by a single surgeon (A.S.J.) at Wilmer Eye Institute between January 2012 and 2014 were identified; 21 received air for intraocular tamponade and the next consecutive 21 received SF6. The main outcome measure was the graft detachment rate; univariate and multivariate analyses were performed. The graft detachment rate was 67% in the air group and 19% in the SF6 group (p<0.05). No complete graft detachments occurred, and all partial detachments underwent intervention with injection of intraocular air. The percentages of eyes with 20/25 or better vision were not different between the groups (67% vs. 71%). Univariate analysis showed significantly higher detachment rates with air tamponade (OR, 8.50; p<0.005) and larger donor graft size (OR, 14.96; p<0.05). Multivariate analysis with gas but not graft size included showed that gas was an independent statistically significant predictor of outcome (OR, 6.65; p<0.05). When graft size was included as a covariate, gas was no longer a statistically significant predictor of detachment but maintained OR of 7.81 (p=0.063) similar to the results of univariate and multivariate analyses without graft size. In comparison with air, graft detachment rates for intraocular tamponade in DMEK were significantly reduced by 20% SF6.

  19. Fatigue in sarcoidosis and idiopathic pulmonary fibrosis: differences in character and severity between diseases.

    PubMed

    Atkins, Christopher Peter; Gilbert, Daniel; Brockwell, Claire; Robinson, Sue; Wilson, Andrew Malcolm

    2016-08-01

    Sarcoidosis and idiopathic pulmonary fibrosis (IPF) are two common forms of interstitial lung disease. Fatigue is a recognised feature of sarcoidosis but an association between IPF and fatigue has not been investigated. To investigate the frequency and severity of fatigue in these groups, and variables affecting fatigue scores. A cross-sectional questionnaire study of patients with sarcoidosis and IPF followed-up at a single hospital was undertaken. Questionnaire data included validated measures of fatigue, anxiety, depression, sleepiness and dyspnoea, plus measures of disease severity including spirometry data. Questionnaires were administered to 232 patients (82 healthy volunteers, 73 sarcoidosis patients and 77 IPF patients). Sarcoidosis patients had statistically higher sleepiness scores but no significant difference was seen between overall measures of fatigue, anxiety or depression. Stratification by severity revealed a non-statistically significant tendency towards more severe fatigue scores in sarcoidosis. Regression analysis failed to identify any significant predictor variables measured in the sarcoidosis cohort, though in the IPF group both dyspnoea and sleepiness scores were significant predictors of fatigue (R2=0.74). Both sarcoidosis and IPF patients suffer with fatigue, although sarcoidosis patients tended towards reporting more severe fatigue scores, suggesting a subgroup with severe fatigue. The fatigue experienced by the two groups appears to be different; sarcoidosis patients report greater frequency of mental fatigue whereas IPF patients appear to suffer exhaustion, potentially related to dyspnoea. Dyspnoea and sleepiness scores modeled the majority of fatigue in the IPF group, whereas no single factor was able to predict fatigue in sarcoidosis.

  20. [Predictors of Turnover among New Nurses using Multilevel Survival Analysis].

    PubMed

    Kim, Suhee; Lee, Kyongeun

    2016-10-01

    The purpose of this study was to examine factors influencing new graduate nurse turnover. This study was carried out as a secondary analysis of data from the 2010 Graduates Occupational Mobility Survey (GOMS). A total of 323 nurses were selected for analysis concerning reasons for turnover. Data were analyzed using descriptive statistics and multilevel survival analysis. About 24.5% of new nurses left their first job within 1 year of starting their jobs. Significant predictors of turnover among new nurse were job status, monthly income, job satisfaction, the number of hospitals in region, and the number of nurses per 100 beds. New graduate nurses are vulnerable to turnover. In order to achieve the best health of the nation, policy approaches and further studies regarding reducing new graduate nurse turnover are needed.

  1. Indicators of science, technology, engineering, and math (STEM) career interest among middle school students in the USA

    NASA Astrophysics Data System (ADS)

    Mills, Leila A.

    This study examines middle school students' perceptions of a future career in a science, math, engineering, or technology (STEM) career field. Gender, grade, predispositions to STEM contents, and learner dispositions are examined for changing perceptions and development in career-related choice behavior. Student perceptions as measured by validated measurement instruments are analyzed pre and post participation in a STEM intervention energy-monitoring program that was offered in several U.S. middle schools during the 2009-2010, 2010-2011 school years. A multiple linear regression (MLR) model, developed by incorporating predictors identified by an examination of the literature and a hypothesis-generating pilot study for prediction of STEM career interest, is introduced. Theories on the career choice development process from authors such as Ginzberg, Eccles, and Lent are examined as the basis for recognition of career concept development among students. Multiple linear regression statistics, correlation analysis, and analyses of means are used to examine student data from two separate program years. Study research questions focus on predictive ability, RSQ, of MLR models by gender/grade, and significance of model predictors in order to determine the most significant predictors of STEM career interest, and changes in students' perceptions pre and post program participation. Analysis revealed increases in the perceptions of a science career, decreases in perceptions of a STEM career, increase of the significance of science and mathematics to predictive models, and significant increases in students' perceptions of creative tendencies.

  2. The relationship between performance and flow state in tennis competition.

    PubMed

    Koehn, S; Morris, T

    2012-08-01

    The study aimed to examine 1) the validity of the nine-factor flow model in tennis competition; 2) differences in flow state between athletes who won or lost their competition match; 3) the link between flow and subjective performance; and 4) flow dimensions as predictors of performance outcome The sample consisted of 188 junior tennis players (115 male, 73 female) between 12 and 18 years of age. Participants' performance was recorded during junior ranking-list tournaments. Following the completion of a tennis competition match, participants completed the Flow State Scale-2 and a subjective performance outcome measure. Acceptable flow model fit indices of CFI, TLI, SRMR, and RMSEA were only found for winning athletes. The group of winning athletes scored significantly higher on all nine flow dimensions, except time transformation, than losing athletes, showing statistically significant differences for challenge-skills balance, clear goals, sense of control, and autotelic experience. Significant correlation coefficients were found between flow state and subjective performance assessments. The binary logistic regression revealed concentration on the task and sense of control to be significant predictors of performance outcome. The predictor variables explained 13% of the variance in games won. The study showed that athletes who win or lose perceived flow state differently. Studies using retrospective assessments need to be aware that subjective experience could be biased by performance outcomes. Pinpointing psychological variables and their impact on ecologically valid measures, such as performance results, would support the development of effective intervention studies to increase performance in sport competition.

  3. Prevalence and predictors of adolescents' cigarette smoking in Madinah, Saudi Arabia: a school-based cross-sectional study.

    PubMed

    Al-Zalabani, Abdulmohsen; Kasim, Khaled

    2015-01-21

    Although the prevalence of adolescents' cigarette smoking has increased in recent decades, little is known regarding its epidemiology in certain Saudi regions, including the Madinah region. The aim of this study was to determine the prevalence and predictors of adolescent cigarette smoking in Madinah, Saudi Arabia. A school-based cross-sectional study was carried out in the Madinah region during 2013. A multistage stratified cluster sample was taken and included 3400 students (11-19 years) from 34 intermediate and secondary schools. Data concerning sociodemographic and smoking-related factors were collected using a valid and reliable self-administered questionnaire. The prevalence of smoking was estimated, and appropriate statistical analyses were performed, including univariate, predictive and multivariate regression analyses. The overall response rate was 97.7%. The prevalence of cigarette smoking in the respondents' 3322 adolescents was 15.17% (95% CI = 13.95-16.39) with significant differences in sociodemographic factors. The most important predictors were most or all friends smoking (OR = 12.5; 95% CI = 9.40-16.8). Other significant less important factors were parental smoking, belief in the harmful effects of smoking, cigarette advertisement in mass media, and pocket money. Cigarette smoking prevalence is a relatively low among adolescents in Madinah region. However, friends and parents smoking play an important role in the increased risk of smoking in the studied adolescents. These predictors must be included in any antismoking education programs targeting to this sector of population in the region.

  4. Profile and predictors of bile infection in patients undergoing laparoscopic cholecystectomy.

    PubMed

    Mahafzah, Azmi M; Daradkeh, Salam S

    2009-08-01

    To study the bacteriological profile, and to determine predictors of bile infection and septic complications following laparoscopic cholecystectomy. This cross-sectional study reviewed 1248 laparoscopic cholecystectomy cases performed between January 1994 and December 2007 by one surgical team at the Jordan University Hospital, Amman, Jordan. Bile cultures were performed for all patients and statistical analysis was performed on culture results and postoperative complications as well as, on the possible predictors of bile infection including age, gender, associated diseases, preoperative retrograde cholangiopancreatography (ERCP), and indications for surgery. Uncomplicated gallstone disease was diagnosed in 993 patients (79.6%), 221 patients (17.7%) had acute cholecystitis, and 34 patients (2.7%) had jaundice. Associated morbidities were present in 513 patients (41.1%), preoperative ERCP was performed for 132 patients (10.6%), and postoperative septic complications developed in 25 patients (2%). Bile culture was positive in 250 patients (20%), 134 (53.6%) of whom had gram negative bacteria, 73 (29.2%) had gram positive bacteria, and 43 (17.2%) had mixed cultures. The chi-square test has shown that positive bile culture is significantly associated with age, gender, preoperative ERCP, associated morbidities, and complicated gallbladder disease, whereas multinomial regression analysis has shown that age and preoperative ERCP were the only significant predictors of bile infection. Bile infection commonly complicates gallstone disease, and it can be influenced by age and preoperative endoscopic interventions, but it does not influence the occurrence of postoperative septic complications.

  5. OPLS statistical model versus linear regression to assess sonographic predictors of stroke prognosis.

    PubMed

    Vajargah, Kianoush Fathi; Sadeghi-Bazargani, Homayoun; Mehdizadeh-Esfanjani, Robab; Savadi-Oskouei, Daryoush; Farhoudi, Mehdi

    2012-01-01

    The objective of the present study was to assess the comparable applicability of orthogonal projections to latent structures (OPLS) statistical model vs traditional linear regression in order to investigate the role of trans cranial doppler (TCD) sonography in predicting ischemic stroke prognosis. The study was conducted on 116 ischemic stroke patients admitted to a specialty neurology ward. The Unified Neurological Stroke Scale was used once for clinical evaluation on the first week of admission and again six months later. All data was primarily analyzed using simple linear regression and later considered for multivariate analysis using PLS/OPLS models through the SIMCA P+12 statistical software package. The linear regression analysis results used for the identification of TCD predictors of stroke prognosis were confirmed through the OPLS modeling technique. Moreover, in comparison to linear regression, the OPLS model appeared to have higher sensitivity in detecting the predictors of ischemic stroke prognosis and detected several more predictors. Applying the OPLS model made it possible to use both single TCD measures/indicators and arbitrarily dichotomized measures of TCD single vessel involvement as well as the overall TCD result. In conclusion, the authors recommend PLS/OPLS methods as complementary rather than alternative to the available classical regression models such as linear regression.

  6. Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors.

    PubMed

    Husebø, Anne M Lunde; Dyrstad, Sindre M; Søreide, Jon A; Bru, Edvin

    2013-01-01

    To examine research findings regarding predictors of adherence to exercise programmes in cancer populations. Cancer patients are advised to participate in daily exercise. Whether they comply with the recommendations for physical activity or not remains unclear. A systematic review and meta-analysis. Empirical articles published in English between 1995 and 2011 were searched in electronic databases and in reference lists, using the search terms 'adherence', 'predictors', 'exercise', and 'cancer' in varying combinations. Twelve of 541 screened abstracts met the inclusion criteria. The included studies' eligibility considering predictors of exercise adherence were reviewed. A quality assessment process evaluating the studies methodological quality was performed. Eight of the reviewed studies were considered eligible for a meta-analysis involving Pearson's r correlations. Exercise stage of change, derived from the transtheoretical model of behaviour change (TTM) was found to be statistically significant and a strong predictor of exercise adherence. In addition, the theory of planned behaviour (TPB) construct; intention to engage in a health-changing behaviour and perceived behavioural control, demonstrated significant correlations with exercise adherence. The review identified that both the TPB and the TTM frameworks include aspects that predicts exercise adherence in cancer patients, and thus contributes to the understanding of motivational factors of change in exercise behaviour in cancer populations. However, the strengths of predictions were relatively weak. More research is needed to identify predictors of greater importance. Surveying the patients' readiness and intention to initiate and maintain exercise levels, as well as tailoring exercise programmes to individual needs may be important for nurses in order to help patients meet exercise guidelines and stay active. © 2012 Blackwell Publishing Ltd.

  7. The Relationship Between Procrastination, Learning Strategies and Statistics Anxiety Among Iranian College Students: A Canonical Correlation Analysis

    PubMed Central

    Vahedi, Shahrum; Farrokhi, Farahman; Gahramani, Farahnaz; Issazadegan, Ali

    2012-01-01

    Objective: Approximately 66-80%of graduate students experience statistics anxiety and some researchers propose that many students identify statistics courses as the most anxiety-inducing courses in their academic curriculums. As such, it is likely that statistics anxiety is, in part, responsible for many students delaying enrollment in these courses for as long as possible. This paper proposes a canonical model by treating academic procrastination (AP), learning strategies (LS) as predictor variables and statistics anxiety (SA) as explained variables. Methods: A questionnaire survey was used for data collection and 246-college female student participated in this study. To examine the mutually independent relations between procrastination, learning strategies and statistics anxiety variables, a canonical correlation analysis was computed. Results: Findings show that two canonical functions were statistically significant. The set of variables (metacognitive self-regulation, source management, preparing homework, preparing for test and preparing term papers) helped predict changes of statistics anxiety with respect to fearful behavior, Attitude towards math and class, Performance, but not Anxiety. Conclusion: These findings could be used in educational and psychological interventions in the context of statistics anxiety reduction. PMID:24644468

  8. Optimising predictor domains for spatially coherent precipitation downscaling

    NASA Astrophysics Data System (ADS)

    Radanovics, S.; Vidal, J.-P.; Sauquet, E.; Ben Daoud, A.; Bontron, G.

    2012-04-01

    Relationships between local precipitation (predictands) and large-scale circulation (predictors) are used for statistical downscaling purposes in various contexts, from medium-term forecasting to climate change impact studies. For hydrological purposes like flood forecasting, the downscaled precipitation spatial fields have furthermore to be coherent over possibly large basins. This thus first requires to know what predictor domain can be associated to the precipitation over each part of the studied basin. This study addresses this issue by identifying the optimum predictor domains over the whole of France, for a specific downscaling method based on a analogue approach and developed by Ben Daoud et al. (2011). The downscaling method used here is based on analogies on different variables: temperature, relative humidity, vertical velocity and geopotentials. The optimum predictor domain has been found to consist of the nearest grid cell for all variables except geopotentials (Ben Daoud et al., 2011). Moreover, geopotential domains have been found to be sensitive to the target location by Obled et al. (2002), and the present study thus focuses on optimizing the domains of this specific predictor over France. The predictor domains for geopotential at 500 hPa and 1000 hPa are optimised for 608 climatologically homogeneous zones in France using the ERA-40 reanalysis data for the large-scale predictors and local precipitation from the Safran near-surface atmospheric reanalysis (Vidal et al., 2010). The similarity of geopotential fields is measured by the Teweles and Wobus shape criterion. The predictive skill of different predictor domains for the different regions is tested with the Continuous Ranked Probability Score (CRPS) for the 25 best analogue days found with the statistical downscaling method. Rectangular predictor domains of different sizes, shapes and locations are tested, and the one that leads to the smallest CRPS for the zone in question is retained. The resulting optimised domains are analysed for defining regions where neighbouring zones have equal or similar predictor domains and identifying which French river basins contain zones associated with different predictor domains, i.e. are exposed to different meteorological influences. The above analysis will be used (1) to extend the statistical downscaling method of Ben Daoud et al. (2011) to the whole of France and (2) to develop it further in order to achieve spatially coherent forecasts while preserving the predictive skill on the local scale. Ben Daoud, A., Sauquet, E., Lang, M., Bontron, G., and Obled, C. (2011). Precipitation forecasting through an analog sorting technique: a comparative study. Advances in Geosciences, 29:103-107. doi: 10.5194/adgeo-29-103-2011 Obled, C., Bontron, G., and Garçon, R. (2002). Quantitative precipitation forecasts: a statistical adaptation of model outputs through an analogues sorting approach. Atmospheric Research, 63(3-4):303-324. doi: 10.1016/S0169-8095(02)00038-8 Vidal, J.-P., Martin, E., Franchistéguy, L., Baillon, M., and Soubeyroux, J.-M. (2010) A 50-year high-resolution atmospheric reanalysis over France with the Safran system. International Journal of Climatology, 30:1627-1644. doi: 10.1002/joc.2003

  9. Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome

    PubMed Central

    Arcelus, Jon; Sánchez, Isabel; Riesco, Nadine; Jiménez-Murcia, Susana; González-Gómez, Jana; Granero, Roser; Custal, Nuria; Montserrat-Gil de Bernabé, Monica; Tárrega, Salomé; Baños, Rosa M.; Botella, Cristina; de la Torre, Rafael; Fernández-García, José C.; Fernández-Real, José M.; Frühbeck, Gema; Gómez-Ambrosi, Javier; Tinahones, Francisco J.; Crujeiras, Ana B.; Casanueva, Felipe F.; Menchón, José M.; Fernández-Aranda, Fernando

    2015-01-01

    The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome. PMID:26600309

  10. Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.

    PubMed

    Agüera, Zaida; Romero, Xandra; Arcelus, Jon; Sánchez, Isabel; Riesco, Nadine; Jiménez-Murcia, Susana; González-Gómez, Jana; Granero, Roser; Custal, Nuria; Montserrat-Gil de Bernabé, Monica; Tárrega, Salomé; Baños, Rosa M; Botella, Cristina; de la Torre, Rafael; Fernández-García, José C; Fernández-Real, José M; Frühbeck, Gema; Gómez-Ambrosi, Javier; Tinahones, Francisco J; Crujeiras, Ana B; Casanueva, Felipe F; Menchón, José M; Fernández-Aranda, Fernando

    2015-01-01

    The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.

  11. Predictors of Sunburn Risk Among Florida Residents.

    PubMed

    Arutyunyan, Sergey; Alfonso, Sarah V; Hernandez, Nilda; Favreau, Tracy; Fernández, M Isabel

    2017-03-01

    The incidence of skin cancer, the most common type of cancer in the United States, is increasing. Sunburn is a major modifiable risk factor for skin cancer, and its prevalence among the US population is high. To identify predictors of having had a red or painful sunburn in the past 12 months among people living in Florida. Florida residents were recruited from public places and online. They were asked to complete an anonymous cross-sectional survey that assessed demographic information, dermatologic history, as well as knowledge, attitude, and behavior factors associated with sunburn. A total of 437 participants whose data were complete for all variables were included in the multivariate analysis. In multivariate logistic regression, younger age (18-29 years) was the most significant predictor of sunburn (OR, 15.26; 95% CI, 5.97-38.98; P<.001). Other significant predictors included identifying as nonwhite (OR, 0.51; 95% CI, 0.29-0.90; P<.02), having had a full-body skin examination by a physician (OR, 1.8; 95% CI, 1.03-3.14; P<.04), reporting higher levels of skin sensitivity to the sun (OR, 4.63; 95% CI, 2.07-10.34; P<.001), having a less favorable attitude toward sun protection (OR, 0.88; 95% CI, 0.81-0.94; P<.001), having high perceived vulnerability to skin cancer (OR, 1.21; 95% CI, 1.05-1.41; P<.009), and spending less than 1 hour outside between 10 am and 4 pm on weekends (OR, 0.46; 95% CI, 0.22-0.96; P<.04). The model was statistically significant at P<.001 and correctly classified 78% of participants. Sunburn prevention programs that osteopathic physicians can readily implement in clinical practice are urgently needed, particularly for young adult patients. This study identified 7 predictors of sunburn in Florida residents. With additional research findings, promoting attitude change toward sun protection may be a viable strategy.

  12. Predicting Adherence to Aromatase Inhibitor Therapy among Breast Cancer Survivors: An Application of the Protection Motivation Theory

    PubMed Central

    Karmakar, Monita; Pinto, Sharrel L; Jordan, Timothy R; Mohamed, Iman; Holiday-Goodman, Monica

    2017-01-01

    The purpose of this observational study was to determine if the Protection Motivation Theory could predict and explain adherence to aromatase inhibitor (AI) therapy among breast cancer survivors. Purposive sampling was used to identify 288 survivors who had been prescribed AI therapy. A valid and reliable survey was mailed to survivors. A total of 145 survivors completed the survey. The Morisky scale was used to measure adherence to AI. The survivors reported a mean score of 6.84 (±0.66) on the scale. Nearly 4 in 10 survivors (38%) were non-adherent. Adherence differed by age, marital status, insurance status, income, and presence of co-morbid conditions. Self-efficacy (r=0.485), protection motivation (r=0.310), and Response Efficacy (r=0.206) were positively and significantly correlated with adherence. Response Cost (r=-0.235) was negatively correlated with adherence. The coping appraisal constructs were statistically significant predictors medication adherence (β=0.437) with self-efficacy being the strongest significant predictor of adherence (β = 0.429). PMID:28469437

  13. Predicting Adherence to Aromatase Inhibitor Therapy among Breast Cancer Survivors: An Application of the Protection Motivation Theory.

    PubMed

    Karmakar, Monita; Pinto, Sharrel L; Jordan, Timothy R; Mohamed, Iman; Holiday-Goodman, Monica

    2017-01-01

    The purpose of this observational study was to determine if the Protection Motivation Theory could predict and explain adherence to aromatase inhibitor (AI) therapy among breast cancer survivors. Purposive sampling was used to identify 288 survivors who had been prescribed AI therapy. A valid and reliable survey was mailed to survivors. A total of 145 survivors completed the survey. The Morisky scale was used to measure adherence to AI. The survivors reported a mean score of 6.84 (±0.66) on the scale. Nearly 4 in 10 survivors (38%) were non-adherent. Adherence differed by age, marital status, insurance status, income, and presence of co-morbid conditions. Self-efficacy (r=0.485), protection motivation (r=0.310), and Response Efficacy (r=0.206) were positively and significantly correlated with adherence. Response Cost (r=-0.235) was negatively correlated with adherence. The coping appraisal constructs were statistically significant predictors medication adherence (β=0.437) with self-efficacy being the strongest significant predictor of adherence (β = 0.429).

  14. Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period.

    PubMed

    Marín-Morales, Dolores; Toro-Molina, Susana; Peñacoba-Puente, Cecilia; Losa-Iglesias, Marta; Carmona-Monge, Francisco Javier

    2018-06-01

    Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.

  15. Retinal Thickness Analysis by Race, Gender, and Age Using Stratus OCT™

    PubMed Central

    Kashani, Amir H.; Zimmer-Galler, Ingrid E.; Shah, Syed Mahmood; Dustin, Laurie; Do, Diana V.; Eliott, Dean; Haller, Julia A.; Nguyen, Quan Dong

    2010-01-01

    PURPOSE To detect differences in retinal thickness among patients of different race, gender and age using Stratus OCT™. DESIGN Cross-sectional study. METHODS In a multicenter, university-based study, 126 patients with no history of ocular disease were enrolled (78 diabetics without retinopathy and 48 nondiabetics). Optical coherence tomography measurements were performed using Stratus OCT™. Statistical comparisons of centerpoint foveal thickness and mean foveal thickness were made using generalized estimating equations adjusting for diabetic status, race, age, and gender. RESULTS The study population consisted of 36% males, 39% Caucasians, 33% African Americans, and 28% Hispanics. Mean foveal thickness was 191.6±2.7µm and 194.5±2.7µm for diabetics and nondiabetics, respectively (P=0.49). Mean foveal thickness in males was significantly larger than in females (201.8±2.7µm and 186.9±2.6µm, respectively; P<0.001). Mean foveal thickness was 200.2±2.7µm for Caucasians, 181.0±3.7µm for African Americans, and 194.7±3.9µm for Hispanics. Mean foveal thickness was significantly less for African Americans than Caucasians (P <0.0001) or Hispanics (P=0.005). Centerpoint foveal thickness and mean foveal thickness showed a significant increase with age. CONCLUSIONS There are statistically significant differences in retinal thickness between subjects of different race, gender, and age. When compared to Caucasians and Hispanics, African-American race is a predictor of decreased mean foveal thickness; and male sex (regardless of race) is a significant predictor of increased mean foveal thickness. Mean foveal thickness is similar among diabetics and nondiabetics when data are controlled for age, race, and sex. These results suggest that studies comparing OCT measurements should carefully control for age, race, and gender-based variations in retinal thickness. PMID:20042179

  16. EXTENDING MULTIVARIATE DISTANCE MATRIX REGRESSION WITH AN EFFECT SIZE MEASURE AND THE ASYMPTOTIC NULL DISTRIBUTION OF THE TEST STATISTIC

    PubMed Central

    McArtor, Daniel B.; Lubke, Gitta H.; Bergeman, C. S.

    2017-01-01

    Person-centered methods are useful for studying individual differences in terms of (dis)similarities between response profiles on multivariate outcomes. Multivariate distance matrix regression (MDMR) tests the significance of associations of response profile (dis)similarities and a set of predictors using permutation tests. This paper extends MDMR by deriving and empirically validating the asymptotic null distribution of its test statistic, and by proposing an effect size for individual outcome variables, which is shown to recover true associations. These extensions alleviate the computational burden of permutation tests currently used in MDMR and render more informative results, thus making MDMR accessible to new research domains. PMID:27738957

  17. Extending multivariate distance matrix regression with an effect size measure and the asymptotic null distribution of the test statistic.

    PubMed

    McArtor, Daniel B; Lubke, Gitta H; Bergeman, C S

    2017-12-01

    Person-centered methods are useful for studying individual differences in terms of (dis)similarities between response profiles on multivariate outcomes. Multivariate distance matrix regression (MDMR) tests the significance of associations of response profile (dis)similarities and a set of predictors using permutation tests. This paper extends MDMR by deriving and empirically validating the asymptotic null distribution of its test statistic, and by proposing an effect size for individual outcome variables, which is shown to recover true associations. These extensions alleviate the computational burden of permutation tests currently used in MDMR and render more informative results, thus making MDMR accessible to new research domains.

  18. Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors.

    PubMed

    Nicholas, Sara S; Stamilio, David M; Dicke, Jeffery M; Gray, Diana L; Macones, George A; Odibo, Anthony O

    2009-10-01

    The aim of this study was to determine whether prenatal variables can predict adverse neonatal outcomes in fetuses with abdominal wall defects. A retrospective cohort study that used ultrasound and neonatal records for all cases of gastroschisis and omphalocele seen over a 16-year period. Cases with adverse neonatal outcomes were compared with noncases for multiple candidate predictive factors. Univariable and multivariable statistical methods were used to develop the prediction models, and effectiveness was evaluated using the area under the receiver operating characteristic curve. Of 80 fetuses with gastroschisis, 29 (36%) had the composite adverse outcome, compared with 15 of 33 (47%) live neonates with omphalocele. Intrauterine growth restriction was the only significant variable in gastroschisis, whereas exteriorized liver was the only predictor in omphalocele. The areas under the curve for the prediction models with gastroschisis and omphalocele are 0.67 and 0.74, respectively. Intrauterine growth restriction and exteriorization of the liver are significant predictors of adverse neonatal outcome with gastroschisis and omphalocele.

  19. Premigration harm and depression: findings from the new immigrant survey, 2003.

    PubMed

    Montgomery, Michelle A; Jackson, Charlotte T; Kelvin, Elizabeth A

    2014-10-01

    Studies examining refugees from conflict areas have found that persecution in the place of origin is a risk factor for depression. No studies have looked at this association between mental health and the experience of premigration harm due to race, gender or religion in the general population of United States immigrants. The New Immigrant Survey baseline questionnaire was administered to a random sample of adults receiving legal permanent residency in the U.S. in 2003 (n = 8,573), including refugees, asylees and other immigrants. In multivariate analysis controlling for visa type, premigration harm was a predictor of general depression of borderline statistical significance [odds ratio (OR), 1.33; 95 % CI 0.98-1.80, p = 0.068] and a significant predictor of major depression with dysphoria (OR, 2.24; 95 % CI 1.48-3.38, p = 0.0001). These findings suggest that premigration harm is a risk factor for depression in the general immigrant population and not just among refugees.

  20. A four-year longitudinal study examining psychache and suicide ideation in elevated-risk undergraduates: A test of Shneidman's model of suicidal behavior.

    PubMed

    Montemarano, Vanessa; Troister, Talia; Lambert, Christine E; Holden, Ronald R

    2018-05-16

    Using a 4-year follow-up design, this research investigated Shneidman's model of psychache (i.e., intense mental pain/anguish) as the cause of suicide. Operationalizing suicidal manifestations using suicide ideation, we evaluated Shneidman's assertion that psychache is the prominent predictor of suicide ideation and that other suicide-related psychological variables associate with suicide ideation only through psychache. Eighty-two undergraduates at elevated suicide risk were assessed at baseline and follow-up with measures of suicide ideation and three psychological predictors: depression, hopelessness, and psychache. At baseline, only psychache and neither depression nor hopelessness contributed significant, unique information to statistically predicting suicide ideation. For 4-year change in suicide ideation, only psychache and neither depression nor hopelessness provided significant, unique information. Results provided partial support for Shneidman's contention of the importance of psychache for suicidal behavior and that other psychological factors are only important to suicide insofar as they relate through psychache. © 2018 Wiley Periodicals, Inc.

  1. Prevalence and Predictors of Use of Home Sphygmomanometers Among Hypertensive Patients.

    PubMed

    Zahid, Hira; Amin, Aisha; Amin, Emaan; Waheed, Summaiya; Asad, Ameema; Faheem, Ariba; Jawaid, Samreen; Afzal, Adila; Misbah, Sarah; Majid, Kanza

    2017-04-11

    Few studies have looked at the predictors of use of home sphygmomanometers among hypertensive patients in low-income countries such as Pakistan. Considering the importance of home blood pressure monitoring (HBPM), cross-sectional study was conducted to evaluate the prevalence and predictors of the usage of all kinds of HBPM devices. This study was conducted in Karachi during the time period of January-February 2017. Adult patients previously diagnosed with hypertension visiting tertiary care hospitals were selected for the study. Interviews from the individuals were conducted after verbal consent using a pre-coded questionnaire. The data was analyzed using Statistical Package for the Social Sciences v. 23.0 (SPSS, IBM Corporation, NY, USA). Chi-squared test was applied as the primary statistical test. More than half of the participants used a home sphygmomanometer (n=250, 61.7%). The age, level of education, family history of hypertension, compliance to drugs and blood pressure (BP) monitoring, few times a month at clinics were significant determinants of HBPM (P values < 0.001). It was found that more individuals owned a digital sphygmomanometer (n=128, 51.3%) as compared to a manual type (n=122, 48.8%). Moreover, avoiding BP measurement in a noisy environment was the most common precaution taken (n=117, 46.8%). The study showed that around 40% of the hypertensive individuals did not own a sphygmomanometer and less than 25% performed HBPM regularly. General awareness by healthcare professionals can be a possible factor which can increase HBPM.

  2. A Prediction Formula for Double Product in Pregnancy.

    PubMed

    Teli, Anita; Bagali, Shrilaxmi; Ghatanatti, Ravi

    2016-02-01

    Maternal cardiovascular changes in pregnancy are numerous and increase in double product throughout pregnancy is the part of the same process. Double product is a cardinal surrogate of the myocardial oxygen demand and cardiac workload. It is the product of heart rate and systolic blood pressure and an important determinant of cardiovascular risk in hypertensive patients. This study was intended to determine the double product by comparing normal individuals with different trimesters of pregnancy. A cross sectional study was conducted in 220 healthy women in the age range of 18-35 years with 60 subjects each in 1(st), 2(nd) and 3(rd) trimesters and 40 non pregnant subjects as control group. Cardiovascular parameters were recorded in both the groups. Statistical analysis was done by comparison of parameters using one-way ANOVA and post-hoc by Tukey-Krammer test. Correlation of double product and weeks of pregnancy was done using Pearson's correlation. Regression analysis was done to know the predictor of double product. It was observed that there was statistically very highly significant increase (p=0.000) in the double product throughout the pregnancy and duration of pregnancy was found to be the predictor of the product. The increase in the double product is due to increase in heart rate and stroke volume. Double product is the useful predictor for early identification of preeclampsia and acute myocardial infarction in pregnant women when compared to normal non- pregnant women and hence helps in the early management of complications.

  3. Prediction of Active-Region CME Productivity from Magnetograms

    NASA Technical Reports Server (NTRS)

    Falconer, D. A.; Moore, R. L.; Gary, G. A.

    2004-01-01

    We report results of an expanded evaluation of whole-active-region magnetic measures as predictors of active-region coronal mass ejection (CME) productivity. Previously, in a sample of 17 vector magnetograms of 12 bipolar active regions observed by the Marshall Space Flight Center (MSFC) vector magnetograph, from each magnetogram we extracted a measure of the size of the active region (the active region s total magnetic flux a) and four measures of the nonpotentiality of the active region: the strong-shear length L(sub SS), the strong-gradient length L(sub SG), the net vertical electric current I(sub N), and the net-current magnetic twist parameter alpha (sub IN). This sample size allowed us to show that each of the four nonpotentiality measures was statistically significantly correlated with active-region CME productivity in time windows of a few days centered on the day of the magnetogram. We have now added a fifth measure of active-region nonpotentiality (the best-constant-alpha magnetic twist parameter (alpha sub BC)), and have expanded the sample to 36 MSFC vector magnetograms of 31 bipolar active regions. This larger sample allows us to demonstrate statistically significant correlations of each of the five nonpotentiality measures with future CME productivity, in time windows of a few days starting from the day of the magnetogram. The two magnetic twist parameters (alpha (sub 1N) and alpha (sub BC)) are normalized measures of an active region s nonpotentially in that they do not depend directly on the size of the active region, while the other three nonpotentiality measures (L(sub SS), L(sub SG), and I(sub N)) are non-normalized measures in that they do depend directly on active-region size. We find (1) Each of the five nonpotentiality measures is statistically significantly correlated (correlation confidence level greater than 95%) with future CME productivity and has a CME prediction success rate of approximately 80%. (2) None of the nonpotentiality measures is a significantly better CME predictor than the others. (3) The active-region phi shows some correlation with CME productivity, but well below a statistically significant level (correlation confidence level less than approximately 80%; CME prediction success rate less than approximately 65%). (4) In addition to depending on magnetic twist, CME productivity appears to have some direct dependence on active-region size (rather than only an indirect dependence through a correlation of magnetic twist with active-region size), but it will take a still larger sample of active regions (50 or more) to certify this. (5) Of the five nonpotentiality measures, L(sub SG) appears to be the best for operational CME forecasting because it is as good or better a CME predictor than the others and it alone does not require a vector magnetogram; L(sub SG) can be measured from a line-of-sight magnetogram such as from the Michelson Doppler Imager (MDI) on the Solar and Heliospheric Observatory (SOHO).

  4. Self-Concept and the Perception of Facial Appearance in Children and Adolescents Seeking Orthodontic Treatment

    PubMed Central

    Phillips, Ceib; Beal, Kimberly N. Edwards

    2009-01-01

    Objective To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Methods and Materials Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need–Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients’ diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Results Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. Conclusion The self-perceived level of the attractiveness or “positive” feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion. PMID:19123700

  5. Early warnings for suicide attempt among Chinese rural population.

    PubMed

    Lyu, Juncheng; Wang, Yingying; Shi, Hong; Zhang, Jie

    2018-06-05

    This study was to explore the main influencing factors of attempted suicide and establish an early warning model, so as to put forward prevention strategies for attempted suicide. Data came from a large-scale case-control epidemiological survey. A sample of 659 serious suicide attempters was randomly recruited from 13 rural counties in China. Each case was matched by a community control for gender, age, and residence location. Face to face interviews were conducted for all the cases and controls with the same structured questionnaire. Univariate logistic regression was applied to screen the factors and multivariate logistic regression was used to excavate the predictors. There were no statistical differences between suicide attempters and the community controls in gender, age, and residence location. The Cronbach`s coefficients for all the scales used were above 0.675. The multivariate logistic regressions have revealed 12 statistically significant variables predicting attempted suicide, including less education, family history of suicide, poor health, mental problem, aspiration strain, hopelessness, impulsivity, depression, negative life events. On the other hand, social support, coping skills, and healthy community protected the rural residents from suicide attempt. The excavated warning predictors are significant clinical meaning for the clinical psychiatrist. Crisis intervention strategies in rural China should be informed by the findings from this research. Education, social support, healthy community, and strain reduction are all measures to decrease the likelihood of crises. Copyright © 2018. Published by Elsevier B.V.

  6. Cardiac biomarkers, mortality, and post-traumatic stress disorder in military veterans.

    PubMed

    Xue, Yang; Taub, Pam R; Iqbal, Navaid; Fard, Arrash; Wentworth, Bailey; Redwine, Laura; Clopton, Paul; Stein, Murray; Maisel, Alan

    2012-04-15

    Post-traumatic stress disorder (PTSD) is gaining increasing recognition as a risk factor for morbidity and mortality. The aim of this study was to examine the impact of PTSD and abnormal cardiovascular biomarkers on mortality in military veterans. Eight hundred ninety-one patients presenting for routine echocardiography were enrolled. Baseline clinical data and serum samples for biomarker measurement were obtained and echocardiography was performed at the time of enrollment. Patients were followed for up to 7.5 years for the end point of all-cause mortality. Ninety-one patients had PTSD at the time of enrollment. There were 33 deaths in patients with PTSD and 221 deaths in those without PTSD. Patients with PTSD had a trend toward worse survival on Kaplan-Meier analysis (p = 0.057). Among patients with elevated B-type natriuretic peptide (>60 pg/ml), those with PTSD had significantly increased mortality (p = 0.024). Among patients with PTSD, midregional proadrenomedullin (MR-proADM), creatinine, and C-terminal proendothelin-1 were significant univariate predictors of mortality (p = 0.006, p = 0.024, and p = 0.003, respectively). In a multivariate model, PTSD, B-type natriuretic peptide, and MR-proADM were independent predictors of mortality. In patients with PTSD, MR-proADM was a significant independent predictor of mortality after adjusting for B-type natriuretic peptide, cardiovascular risk factors, cancer, and sleep apnea. Adding MR-proADM to clinical predictors of mortality increased the C-statistic from 0.572 to 0.697 (p = 0.007). In conclusion, this study demonstrates an association among PTSD, abnormal cardiac biomarker levels, and increased mortality. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Non-surgical and supportive periodontal therapy: predictors of compliance

    PubMed Central

    Delatola, Chrysoula; Adonogianaki, Evagelia; Ioannidou, Effie

    2015-01-01

    Aim To identify predictors of compliance during non-surgical and supportive periodontal therapy (SPT). Materials and Methods In this retrospective study, demographic, dental, medical data of 427 new patients in a private practice were collected. Data were analysed in statistical models with non-surgical therapy and SPT compliance used as dependent variables. Results Of the 427 patients, 17.3% never agreed to initial therapy, 10.7% never completed therapy and 20.8% completed treatment, but never entered SPT. Of the 218 SPT patients, 56% became non-attenders after a period of 20 months, 33% were erratic attenders and 10.5% were regular attenders until the end of the observation period (5.5–6.5 years). Patients became erratic attenders after a mean period of regular attendance of 18.1 ± 16.2 months, whereas 49.6% of the patients, who abandoned SPT, were regular attenders until the time they stopped. In a univariate correlation model, periodontal disease severity emerged as a significant predictor of the completion of non-surgical periodontal therapy (p = 0.01). In a multivariate linear regression model, smoking was negatively associated with SPT compliance (p = 0.047). Conclusions A low compliance of the population was observed. Smoking and periodontal disease severity represented significant, but modest modifiers of a patient compliance with SPT and initial therapy respectively. PMID:24813661

  8. [Stigmatizing Attitudes towards Cancer Patients--Results of a Representative Population Survey].

    PubMed

    Ernst, Jochen; Brähler, Elmar; Hinz, Andreas; Friedrich, Michael; Lehmann-Laue, Antje; Mehnert, Anja; Weißflog, Gregor

    2016-03-01

    To investigate stigmatizing attitudes towards cancer patients in the general population and to examine their association with socio-structural characteristics and perceived causes of disease. We recruited a representative sample from the German general population (n=2420; mean age: 52 years; 54% women). Stigmatizing attitudes were assessed with a 9-item scale. Predictors of stigmatizing attitudes were identified using a regression analysis. Agreement with stigmatization items ranged from 3.6% (item: work together with a cancer patient) to 18.9% (item: use the same dishes as a cancer patient). Perceived causes of disease with a high levels of personal responsibility showed only weak correlations with stigmatizing attitudes (all r<0.31) and were partially statistical significant (e. g. food intake) or not significant (e. g. alcohol). The strongest predictors of stigmatizing attitudes were lack of cancer-related experiences (Beta=-0,26), age <60 years (Beta=0,1) and the assumption that one cannot protect oneself from cancer (Beta=0,11) (all p<0.001). Further predictors were male gender and living in rural area (p<0.01). The results demonstrate a need for further research and the development of valid methodological instruments to assess stigmatization towards cancer patients. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Lexical diversity and omission errors as predictors of language ability in the narratives of sequential Spanish-English bilinguals: a cross-language comparison.

    PubMed

    Jacobson, Peggy F; Walden, Patrick R

    2013-08-01

    This study explored the utility of language sample analysis for evaluating language ability in school-age Spanish-English sequential bilingual children. Specifically, the relative potential of lexical diversity and word/morpheme omission as predictors of typical or atypical language status was evaluated. Narrative samples were obtained from 48 bilingual children in both of their languages using the suggested narrative retell protocol and coding conventions as per Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2008) software. An additional lexical diversity measure, VocD, was also calculated. A series of logistical hierarchical regressions explored the utility of the number of different words, VocD statistic, and word and morpheme omissions in each language for predicting language status. Omission errors turned out to be the best predictors of bilingual language impairment at all ages, and this held true across languages. Although lexical diversity measures did not predict typical or atypical language status, the measures were significantly related to oral language proficiency in English and Spanish. The results underscore the significance of omission errors in bilingual language impairment while simultaneously revealing the limitations of lexical diversity measures as indicators of impairment. The relationship between lexical diversity and oral language proficiency highlights the importance of considering relative language proficiency in bilingual assessment.

  10. Tracing the source of numerical climate model uncertainties in precipitation simulations using a feature-oriented statistical model

    NASA Astrophysics Data System (ADS)

    Xu, Y.; Jones, A. D.; Rhoades, A.

    2017-12-01

    Precipitation is a key component in hydrologic cycles, and changing precipitation regimes contribute to more intense and frequent drought and flood events around the world. Numerical climate modeling is a powerful tool to study climatology and to predict future changes. Despite the continuous improvement in numerical models, long-term precipitation prediction remains a challenge especially at regional scales. To improve numerical simulations of precipitation, it is important to find out where the uncertainty in precipitation simulations comes from. There are two types of uncertainty in numerical model predictions. One is related to uncertainty in the input data, such as model's boundary and initial conditions. These uncertainties would propagate to the final model outcomes even if the numerical model has exactly replicated the true world. But a numerical model cannot exactly replicate the true world. Therefore, the other type of model uncertainty is related the errors in the model physics, such as the parameterization of sub-grid scale processes, i.e., given precise input conditions, how much error could be generated by the in-precise model. Here, we build two statistical models based on a neural network algorithm to predict long-term variation of precipitation over California: one uses "true world" information derived from observations, and the other uses "modeled world" information using model inputs and outputs from the North America Coordinated Regional Downscaling Project (NA CORDEX). We derive multiple climate feature metrics as the predictors for the statistical model to represent the impact of global climate on local hydrology, and include topography as a predictor to represent the local control. We first compare the predictors between the true world and the modeled world to determine the errors contained in the input data. By perturbing the predictors in the statistical model, we estimate how much uncertainty in the model's final outcomes is accounted for by each predictor. By comparing the statistical model derived from true world information and modeled world information, we assess the errors lying in the physics of the numerical models. This work provides a unique insight to assess the performance of numerical climate models, and can be used to guide improvement of precipitation prediction.

  11. Pitfalls in statistical landslide susceptibility modelling

    NASA Astrophysics Data System (ADS)

    Schröder, Boris; Vorpahl, Peter; Märker, Michael; Elsenbeer, Helmut

    2010-05-01

    The use of statistical methods is a well-established approach to predict landslide occurrence probabilities and to assess landslide susceptibility. This is achieved by applying statistical methods relating historical landslide inventories to topographic indices as predictor variables. In our contribution, we compare several new and powerful methods developed in machine learning and well-established in landscape ecology and macroecology for predicting the distribution of shallow landslides in tropical mountain rainforests in southern Ecuador (among others: boosted regression trees, multivariate adaptive regression splines, maximum entropy). Although these methods are powerful, we think it is necessary to follow a basic set of guidelines to avoid some pitfalls regarding data sampling, predictor selection, and model quality assessment, especially if a comparison of different models is contemplated. We therefore suggest to apply a novel toolbox to evaluate approaches to the statistical modelling of landslide susceptibility. Additionally, we propose some methods to open the "black box" as an inherent part of machine learning methods in order to achieve further explanatory insights into preparatory factors that control landslides. Sampling of training data should be guided by hypotheses regarding processes that lead to slope failure taking into account their respective spatial scales. This approach leads to the selection of a set of candidate predictor variables considered on adequate spatial scales. This set should be checked for multicollinearity in order to facilitate model response curve interpretation. Model quality assesses how well a model is able to reproduce independent observations of its response variable. This includes criteria to evaluate different aspects of model performance, i.e. model discrimination, model calibration, and model refinement. In order to assess a possible violation of the assumption of independency in the training samples or a possible lack of explanatory information in the chosen set of predictor variables, the model residuals need to be checked for spatial auto¬correlation. Therefore, we calculate spline correlograms. In addition to this, we investigate partial dependency plots and bivariate interactions plots considering possible interactions between predictors to improve model interpretation. Aiming at presenting this toolbox for model quality assessment, we investigate the influence of strategies in the construction of training datasets for statistical models on model quality.

  12. Automated Statistical Forecast Method to 36-48H ahead of Storm Wind and Dangerous Precipitation at the Mediterranean Region

    NASA Astrophysics Data System (ADS)

    Perekhodtseva, E. V.

    2009-09-01

    Development of successful method of forecast of storm winds, including squalls and tornadoes and heavy rainfalls, that often result in human and material losses, could allow one to take proper measures against destruction of buildings and to protect people. Well-in-advance successful forecast (from 12 hours to 48 hour) makes possible to reduce the losses. Prediction of the phenomena involved is a very difficult problem for synoptic till recently. The existing graphic and calculation methods still depend on subjective decision of an operator. Nowadays in Russia there is no hydrodynamic model for forecast of the maximal precipitation and wind velocity V> 25m/c, hence the main tools of objective forecast are statistical methods using the dependence of the phenomena involved on a number of atmospheric parameters (predictors). Statistical decisive rule of the alternative and probability forecast of these events was obtained in accordance with the concept of "perfect prognosis" using the data of objective analysis. For this purpose the different teaching samples of present and absent of this storm wind and rainfalls were automatically arranged that include the values of forty physically substantiated potential predictors. Then the empirical statistical method was used that involved diagonalization of the mean correlation matrix R of the predictors and extraction of diagonal blocks of strongly correlated predictors. Thus for these phenomena the most informative predictors were selected without loosing information. The statistical decisive rules for diagnosis and prognosis of the phenomena involved U(X) were calculated for choosing informative vector-predictor. We used the criterion of distance of Mahalanobis and criterion of minimum of entropy by Vapnik-Chervonenkis for the selection predictors. Successful development of hydrodynamic models for short-term forecast and improvement of 36-48h forecasts of pressure, temperature and others parameters allowed us to use the prognostic fields of those models for calculations of the discriminant functions in the nodes of the grid 150x150km and the values of probabilities P of dangerous wind and thus to get fully automated forecasts. In order to change to the alternative forecast the author proposes the empirical threshold values specified for this phenomenon and advance period 36 hours. In the accordance to the Pirsey-Obukhov criterion (T), the success of these automated statistical methods of forecast of squalls and tornadoes to 36 -48 hours ahead and heavy rainfalls in the warm season for the territory of Italy, Spain and Balkan countries is T = 1-a-b=0,54: 0,78 after author experiments. A lot of examples of very successful forecasts of summer storm wind and heavy rainfalls over the Italy and Spain territory are submitted at this report. The same decisive rules were applied to the forecast of these phenomena during cold period in this year too. This winter heavy snowfalls in Spain and in Italy and storm wind at this territory were observed very often. And our forecasts are successful.

  13. Statistical evaluation of forecasts

    NASA Astrophysics Data System (ADS)

    Mader, Malenka; Mader, Wolfgang; Gluckman, Bruce J.; Timmer, Jens; Schelter, Björn

    2014-08-01

    Reliable forecasts of extreme but rare events, such as earthquakes, financial crashes, and epileptic seizures, would render interventions and precautions possible. Therefore, forecasting methods have been developed which intend to raise an alarm if an extreme event is about to occur. In order to statistically validate the performance of a prediction system, it must be compared to the performance of a random predictor, which raises alarms independent of the events. Such a random predictor can be obtained by bootstrapping or analytically. We propose an analytic statistical framework which, in contrast to conventional methods, allows for validating independently the sensitivity and specificity of a forecasting method. Moreover, our method accounts for the periods during which an event has to remain absent or occur after a respective forecast.

  14. Impact of facebook addiction on narcissistic behavior and self-esteem among students.

    PubMed

    Malik, Sadia; Khan, Maheen

    2015-03-01

    To investigate the relationship between Facebook addiction, narcissism and self-esteem and to see if gender played any role in this equation. The correlational study was conducted from February to March 2013 at the Department of Psychology, University of Sargodha, Punjab, Pakistan. Using convenient sampling, two equal groups of male and female students were enrolled from different departments of the university. Bergen Facebook Addiction Scale, Hypersensitive Narcissism Scale and Rosenberg's Self-esteem Scale were used for evaluation. SPSS 17 was used for statistical analysis. Of the 200 subjects in the study, 100(50%) each were males and females. Facebook addiction was positively correlated with narcissism(r=0.20; p<0.05) and negatively with self-esteem(r=-0.18; p<0.05). Relationship between narcissism and self-esteem was non-significant(r=0.05; p>0.05). Facebook addiction was a significant predictor of narcissistic behaviour (b=0.202; p<0.001) and low self-esteem (b=-0.18; p<0.001). There were no significant gender differences in the three variables (p>0.05 each). Facebook addiction was a significant predictor of narcissistic behaviour and low levels of self-esteem among students.

  15. Single Parent Family Structure as a Predictor of Alcohol Use among Secondary School Students: Evidence from Jamaica

    PubMed

    Oshi, Sarah N; Abel, Wendel D; Agu, Chinwendu F; Omeje, Joachim C; Smith, Patrice Whitehorne; Ukwaja, Kingsley N; Ricketts Roomes, Tana; Meka, Ijeoma A; Weaver, Steve; Rae, Tania; Oshi, Daniel C

    2018-04-23

    The aim of this study was to examine the potential relationship between Jamaican secondary students’ alcohol drinking habits and their family structure. Methods: Data collected from a nationally representative survey of 3,365 students were analysed. Descriptive and inferential statistics were performed. Results: Out of the 3,365 students, 1,044 (31.0%) were from single-parent families. Single-parent families, married-parent families and common law-parent families were significantly associated with lifetime use of alcohol (AOR= 1.72, 95% CI= 1.06 - 2.79; AOR= 1.73, 95% CI= 1.07- 2.81, AOR= 1.94, 95%CI= 1.17- 3.21 respectively). However, family structure was not significantly associated with past year and past month alcohol use. Students whose parents “sometimes” knew their whereabouts were significantly less likely to use alcohol in their lifetime compared to students whose parents “Always” knew where the students were. Conclusion: Family structure is an independent predictor of alcohol use among high school students in Jamaica. Being from single-parent families, married-parent and common- law parent families were significantly associated with increased likelihood for lifetime alcohol use. Creative Commons Attribution License

  16. Child Mortality in a Developing Country: A Statistical Analysis

    ERIC Educational Resources Information Center

    Uddin, Md. Jamal; Hossain, Md. Zakir; Ullah, Mohammad Ohid

    2009-01-01

    This study uses data from the "Bangladesh Demographic and Health Survey (BDHS] 1999-2000" to investigate the predictors of child (age 1-4 years) mortality in a developing country like Bangladesh. The cross-tabulation and multiple logistic regression techniques have been used to estimate the predictors of child mortality. The…

  17. Fasting triglycerides as a predictor of incident diabetes, insulin resistance and β-cell function in a Canadian First Nation

    PubMed Central

    Riediger, Natalie D.; Clark, Kirsten; Lukianchuk, Virginia; Roulette, Joanne; Bruce, Sharon

    2017-01-01

    ABSTRACT Background: Diabetes prevalence is substantially higher among Canadian First Nations populations than the non-First Nation population. Fasting serum triglycerides have been found to be an important predictor of incident diabetes among non-indigenous populations. However, there is a great need to understand diabetes progression within specific ethnic groups, particularly First Nations populations. Objective: The purpose of this study was to test for an association between fasting serum triglycerides and incident diabetes, changes in insulin resistance and changes in β-cell function in a Manitoba First Nation cohort. Methods: Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples and anthropometric, health and demographic data were collected. A generalised linear model with Poisson distribution was used to test for an association between fasting triglycerides and incident diabetes. Results: There were 35 incident cases of diabetes among 128 persons without diabetes at baseline. Participants who developed incident type 2 diabetes were significantly older and had significantly higher body mass index (BMI; p=0.012), total cholesterol (p=0.007), fasting triglycerides (p<0.001), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p<0.001). Fasting triglyceride level was found to be a statistically significant positive predictor of incident diabetes independent of age, sex and waist circumference at baseline. Participants with triglycerides in the highest tertile (≥2.11 mmol/l) had a 4.0-times higher risk of developing incident diabetes compared to those in the lowest tertile (p=0.03). Notably, neither waist circumference nor BMI were significant predictors of incident diabetes independent of age, sex and triglycerides. Conclusion: Fasting triglycerides may be useful as a clinical predictor of insulin resistance and diabetes development among First Nations populations. Unlike other ethnic groups, BMI and waist circumference may be less important factors in diabetes development. PMID:28406758

  18. Is generic physical activity or specific exercise associated with motor abilities?

    PubMed

    Rinne, Marjo; Pasanen, Matti; Miilunpalo, Seppo; Mälkiä, Esko

    2010-09-01

    Evidence of the effect of leisure time physical activity (LTPA) modes on the motor abilities of a mature population is scarce. The purpose of this study was to compare the motor abilities of physically active and inactive men and women and to examine the associations of different exercise modes and former and recent LTPA (R-LTPA) with motor ability and various physical tests. The LTPA of the participants (men n = 69, women n = 79; aged 41-47 yr) was ascertained by a modified Physical Activity Readiness Questionnaire, including questions on the frequency, duration, and intensity of R-LTPA and former LTPA and on exercise modes. Motor abilities in terms of balance, agility, and coordination were assessed with a battery of nine tests supplemented with five physical fitness tests. Multiple statistical methods were used in analyses that were conducted separately for men and women. The MET-hours per week of R-LTPA correlated statistically significantly with the tests of agility and static balance (rs = -0.28, P = 0.022; rs = -0.25, P = 0.043, respectively) among men and with the static balance (rs = 0.41), 2-km walking (rs = 0.36), step squat (rs = 0.36) (P < or = 0.001, respectively), and static back endurance (rs = 0.25, P = 0.024) among women. In the stepwise regression among men, the most frequent statistically significant predictor was the playing of several games. For women, a history of LTPA for more than 3 yr was the strongest predictor for good results in almost all tests. Participants with long-term and regular LTPA had better motor performance, and especially a variety of games improve components of motor ability. Diverse, regular, and long-term exercise including both specific training and general activity develops both motor abilities and physical fitness.

  19. Predictors of quality of life outcomes in chronic rhinosinusitis after sinus surgery.

    PubMed

    Katotomichelakis, Michael; Simopoulos, Efthimios; Tripsianis, Gregory; Balatsouras, Dimitrios; Danielides, Gerasimos; Kourousis, Christos; Livaditis, Miltos; Danielides, Vassilios

    2014-04-01

    The predictive value of olfaction for quality of life (QoL) recovery after endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) is still underestimated. The aim of this study was to explore the proportion of patients suffering from CRS who experience clinically significant QoL improvement after ESS and identify pre-operative clinical phenotypes that best predict surgical outcomes for QoL, focusing mainly on the role of patients' olfaction. One hundred eleven patients following ESS for CRS and 48 healthy subjects were studied. Olfactory function was expressed by the combined "Threshold Discrimination Identification" score using "Sniffin' sticks" test pre-treatment and 12 months after treatment. All subjects completed validated, widely used QoL questionnaires, specific for olfaction (Questionnaire of Olfactory Deficits: QOD), for assessing psychology (Beck Depression Inventory: BDI) and for general health (Short Form-36: SF-36). Statistically significant improvement of olfactory function by 41.8% and of all QoL questionnaires scores (all p < 0.001) was observed on the 12-month follow-up examination. Clinically significant improvement for QoL was measured in a proportion of 56.8% of patients on QOD, 64.9% on SF-36 and 49.5% on BDI scales results. Although olfactory dysfunction, nasal polyps, female gender, high socio-economic status and non-smoking habits were significantly associated with better QoL results, multivariate logistic regression analysis revealed that only olfactory dysfunction and nasal polyps were independent predictors significantly associated with higher likelihood of clinically significant improvement in all QoL questionnaire results. Olfactory dysfunction and nasal polyps were independent pre-operative predictors for surgical outcomes with regard to QoL results.

  20. Summer and winter habitat suitability of Marco Polo argali in southeastern Tajikistan: A modeling approach.

    PubMed

    Salas, Eric Ariel L; Valdez, Raul; Michel, Stefan

    2017-11-01

    We modeled summer and winter habitat suitability of Marco Polo argali in the Pamir Mountains in southeastern Tajikistan using these statistical algorithms: Generalized Linear Model, Random Forest, Boosted Regression Tree, Maxent, and Multivariate Adaptive Regression Splines. Using sheep occurrence data collected from 2009 to 2015 and a set of selected habitat predictors, we produced summer and winter habitat suitability maps and determined the important habitat suitability predictors for both seasons. Our results demonstrated that argali selected proximity to riparian areas and greenness as the two most relevant variables for summer, and the degree of slope (gentler slopes between 0° to 20°) and Landsat temperature band for winter. The terrain roughness was also among the most important variables in summer and winter models. Aspect was only significant for winter habitat, with argali preferring south-facing mountain slopes. We evaluated various measures of model performance such as the Area Under the Curve (AUC) and the True Skill Statistic (TSS). Comparing the five algorithms, the AUC scored highest for Boosted Regression Tree in summer (AUC = 0.94) and winter model runs (AUC = 0.94). In contrast, Random Forest underperformed in both model runs.

  1. Factors related to the perceived stigmatization of people living with HIV.

    PubMed

    Caliari, Juliano de Souza; Teles, Sheila Araujo; Reis, Renata Karina; Gir, Elucir

    2017-10-09

    Analyzing the factors related to perceived stigmatization of people living with HIV. A cross-sectional study conducted from September of 2014 to December 2015 with users from a specialized service in Minas Gerais. Data were collected through individual instrument application, organized in Microsoft Office Excel(r) 2010 spreadsheets and processed on IBM(r) SPSS 23.0. Descriptive statistics and multiple linear regression method were used for data analysis, adopting statistical significance set at 5.0% (p≤0.05). The study development met research ethics standards. 258 users participated in the study. Most were males between 40 and 49 years of age, single, with low educational level and income. Being between 40 and 49 years of age and having been hospitalized for complications related to HIV were positively associated predictors to increased stigmatization; while not having comorbidities and not being aware of exposure to HIV were predictors associated to reduced stigmatization. Given these results, we highlight that stigmatization can have an impact on the lives of people living with HIV, strengthening their feelings of guilt and shame, which can lead to depression, social isolation and abandoning treatment and clinical follow-up.

  2. Predictors of health-related quality of life among industrial workers: A descriptive correlational study.

    PubMed

    Malak, Malakeh Z

    2017-06-01

    Assessment and evaluation of the health-related quality of life of industrial workers is an important research focus. This descriptive correlational study identifies the predictors of health-related quality of life using a random sampling of industrial workers (n = 640) from construction factories in Amman Governorate in Jordan using demographic characteristics, a health and work-related factors questionnaire, and the World Health Organization Quality of Life-Brief scale. Results showed that industrial workers had good physical health but a poor working environment. There was a statistically significant relationship between educational level, conflict between work and individual life and work and social life, working hours, and workload, and all domains of health-related quality of life. Overall, educational level was the main predictor for all domains of health-related quality of life. Such results confirm the need to develop appropriate interventions and strategies to improve workers' health-related quality of life. Furthermore, developing an integrated approach among policymakers, employers, and work organizations to enhance industrial workers' occupational health programs could be effective. © 2017 John Wiley & Sons Australia, Ltd.

  3. Predictors of self-rated health: a 12-month prospective study of IT and media workers.

    PubMed

    Hasson, Dan; Arnetz, Bengt B; Theorell, Töres; Anderberg, Ulla Maria

    2006-07-31

    The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0-12 months). A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23-64) from four information technology and two media companies. There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes.

  4. Effort test failure: toward a predictive model.

    PubMed

    Webb, James W; Batchelor, Jennifer; Meares, Susanne; Taylor, Alan; Marsh, Nigel V

    2012-01-01

    Predictors of effort test failure were examined in an archival sample of 555 traumatically brain-injured (TBI) adults. Logistic regression models were used to examine whether compensation-seeking, injury-related, psychological, demographic, and cultural factors predicted effort test failure (ETF). ETF was significantly associated with compensation-seeking (OR = 3.51, 95% CI [1.25, 9.79]), low education (OR:. 83 [.74, . 94]), self-reported mood disorder (OR: 5.53 [3.10, 9.85]), exaggerated displays of behavior (OR: 5.84 [2.15, 15.84]), psychotic illness (OR: 12.86 [3.21, 51.44]), being foreign-born (OR: 5.10 [2.35, 11.06]), having sustained a workplace accident (OR: 4.60 [2.40, 8.81]), and mild traumatic brain injury severity compared with very severe traumatic brain injury severity (OR: 0.37 [0.13, 0.995]). ETF was associated with a broader range of statistical predictors than has previously been identified and the relative importance of psychological and behavioral predictors of ETF was evident in the logistic regression model. Variables that might potentially extend the model of ETF are identified for future research efforts.

  5. Sociodemographic and Psychiatric Diagnostic Predictors of 3-Year Incidence of DSM-IV Substance Use Disorders among Men and Women in the National Epidemiologic Survey on Alcohol and Related Conditions

    PubMed Central

    Goldstein, Risë B.; Smith, Sharon M.; Dawson, Deborah A.; Grant, Bridget F.

    2016-01-01

    Incidence rates of alcohol and drug use disorders (AUDs and DUDs) are consistently higher in men than women, but information on whether sociodemographic and psychiatric diagnostic predictors of AUD and DUD incidence differ by sex is limited. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, sex-specific 3-year incidence rates of AUDs and DUDs among United States adults were compared by sociodemographic variables and baseline psychiatric disorders. Sex-specific logistic regression models estimated odds ratios for prediction of incident AUDs and DUDs, adjusting for potentially confounding baseline sociodemographic and diagnostic variables. Few statistically significant sex differences in predictive relationships were identified and those observed were generally modest. Prospective research is needed to identify predictors of incident DSM-5 AUDs and DUDs and their underlying mechanisms, including whether there is sex specificity by developmental phase, in the role of additional comorbidity in etiology and course, and in outcomes of prevention and treatment. PMID:26727008

  6. Predictors of positive mental health among refugees: Results from Canada's General Social Survey.

    PubMed

    Beiser, Morton; Hou, Feng

    2017-01-01

    Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

  7. Newly graduated nurses' perception of competence and possible predictors: a cross-sectional survey.

    PubMed

    Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun

    2012-01-01

    The aim of this study was to describe newly graduated nurses' own perception of competence and to identify possible predictors influencing their perceptions. The target population included nurses who graduated from nursing colleges in June 2006. Data collection was carried out from October 2006 until April 2007 using the Nurse Competence Scale (NCS), the California Critical Thinking Disposition Inventory, and the Research Utilization Questionnaire. The response rate was 33% (n = 620). Pearson's chi-square test, Student t test, and regression analyses were used for statistical calculations. The respondents assessed their overall competence level as "good" and assessed themselves most competent in providing ethical and individualized nursing care. They assessed themselves least competent in evaluating outcomes and further development of patient care. Their use of competence explained between 40% (helping) and 10% (managing) of the variance within the NCS competence categories. Critical thinking (CT) was the most prominent predictor for perception of competence in all competence categories and the overall competence, alone explaining between 20% (NCS total score) and 9% (managing) of the variance. The finding that CT was a significant predictor for perception of competence may indicate that developing nursing students' CT abilities is valuable to increase newly graduated nurses' perception of competence. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Determinants of residential water consumption: Evidence and analysis from a 10-country household survey

    NASA Astrophysics Data System (ADS)

    Grafton, R. Quentin; Ward, Michael B.; To, Hang; Kompas, Tom

    2011-08-01

    Household survey data for 10 countries are used to quantify and test the importance of price and nonprice factors on residential water demand and investigate complementarities between household water-saving behaviors and the average volumetric price of water. Results show (1) the average volumetric price of water is an important predictor of differences in residential consumption in models that include household characteristics, water-saving devices, attitudinal characteristics and environmental concerns as explanatory variables; (2) of all water-saving devices, only a low volume/dual-flush toilet has a statistically significant and negative effect on water consumption; and (3) environmental concerns have a statistically significant effect on some self-reported water-saving behaviors. While price-based approaches are espoused to promote economic efficiency, our findings stress that volumetric water pricing is also one of the most effective policy levers available to regulate household water consumption.

  9. Massive parallelization of serial inference algorithms for a complex generalized linear model

    PubMed Central

    Suchard, Marc A.; Simpson, Shawn E.; Zorych, Ivan; Ryan, Patrick; Madigan, David

    2014-01-01

    Following a series of high-profile drug safety disasters in recent years, many countries are redoubling their efforts to ensure the safety of licensed medical products. Large-scale observational databases such as claims databases or electronic health record systems are attracting particular attention in this regard, but present significant methodological and computational concerns. In this paper we show how high-performance statistical computation, including graphics processing units, relatively inexpensive highly parallel computing devices, can enable complex methods in large databases. We focus on optimization and massive parallelization of cyclic coordinate descent approaches to fit a conditioned generalized linear model involving tens of millions of observations and thousands of predictors in a Bayesian context. We find orders-of-magnitude improvement in overall run-time. Coordinate descent approaches are ubiquitous in high-dimensional statistics and the algorithms we propose open up exciting new methodological possibilities with the potential to significantly improve drug safety. PMID:25328363

  10. The Influence of Cognitive Reserve on Recovery from Traumatic Brain Injury.

    PubMed

    Donders, Jacobus; Stout, Jacob

    2018-04-12

    we sought to determine the degree to which cognitive reserve, as assessed by the Test of Premorbid Functioning in combination with demographic variables, could act as a buffer against the effect of traumatic brain injury (TBI) on cognitive test performance. retrospective analysis of a cohort of 121 persons with TBI who completed the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) within 1-12 months after injury. regression analyses indicated that cognitive reserve was a statistically significant predictor of all postinjury WAIS-IV factor index scores, after controlling for various premorbid and comorbid confounding variables. Only for Processing Speed did injury severity make an additional statistically significant contribution to the prediction model. cognitive reserve has a protective effect with regard to the impact of TBI on cognitive test performance but this effect is imperfect and does not completely negate the effect of injury severity.

  11. The value of model averaging and dynamical climate model predictions for improving statistical seasonal streamflow forecasts over Australia

    NASA Astrophysics Data System (ADS)

    Pokhrel, Prafulla; Wang, Q. J.; Robertson, David E.

    2013-10-01

    Seasonal streamflow forecasts are valuable for planning and allocation of water resources. In Australia, the Bureau of Meteorology employs a statistical method to forecast seasonal streamflows. The method uses predictors that are related to catchment wetness at the start of a forecast period and to climate during the forecast period. For the latter, a predictor is selected among a number of lagged climate indices as candidates to give the "best" model in terms of model performance in cross validation. This study investigates two strategies for further improvement in seasonal streamflow forecasts. The first is to combine, through Bayesian model averaging, multiple candidate models with different lagged climate indices as predictors, to take advantage of different predictive strengths of the multiple models. The second strategy is to introduce additional candidate models, using rainfall and sea surface temperature predictions from a global climate model as predictors. This is to take advantage of the direct simulations of various dynamic processes. The results show that combining forecasts from multiple statistical models generally yields more skillful forecasts than using only the best model and appears to moderate the worst forecast errors. The use of rainfall predictions from the dynamical climate model marginally improves the streamflow forecasts when viewed over all the study catchments and seasons, but the use of sea surface temperature predictions provide little additional benefit.

  12. Evaluation of White Blood Cell Count, Neutrophil Percentage, and Elevated Temperature as Predictors of Bloodstream Infection in Burn Patients

    DTIC Science & Technology

    2007-07-01

    Table 2). Three cultures were mixed with gram-positive and gram- negative bacteria, and 3 cultures produced yeasts (Can- dida albicans [n=2] and Candida ...that were gram positive, 3 that were mixed gram positive/gram nega- tive, and 3 yeasts . Although white blood cell count and neutrophil percentage at the...negative [but not mixed], or yeast ) because of small numbers. Statistical significance was set at P .01. RESULTS During the study period, 223 patients were

  13. Vitamin D status in Egyptian euthyroid multinodular non-toxic goiter patients and its correlation with TSH levels.

    PubMed

    Aboelnaga, Mohamed M; Elshafei, Maha M; Elsayed, Eman

    2016-10-01

    Although the prevalence of MNG is widespread throughout the world, its pathogenesis is poorly understood, and the complex interactions of both genetic predisposition and the individuals' environment are likely. However, to the best of our knowledge, it remains unknown whether there is a relationship between vitamin D status and prevalence or pathogenesis of euthyroid MNG. Therefore, the goal of the present study was determination of vitamin D status in euthyroid MNG as well as exploration of the correlation between vitamin D status & TSH levels. A total of 77 patients diagnosed with euthyroid MNG and 50 subjects without goiter were matched according to age, weight and BMI as control group in this case control study. We found that patients with euthyroid MNG had statistically significant lower mean of [25(OH)D] (24.21±8.68ng/mL) in comparison with its mean in control subjects (28.37±10.91ng/mL, P value=0.019). The 28 sufficient vitamin D MNG patients had statistically significant lower level of TSH than 49 insufficient vitamin D MNG patients. Vitamin D and TSH levels correlate with vitamin D levels in MNG patients in Pearson correlation. Also 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients in regression analysis. Patients with euthyroid MNG have lower levels of vitamin D and TSH levels correlate with vitamin D levels in euthyroid MNG patients. In addition, 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients. We recommend hypovitaminosis D evaluation and correction in patients with MNG. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.

    PubMed

    Tepavcevic, Darija Kisic; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Basuroski, Irena Dujmovic; Mesaros, Sarlota; Drulovic, Jelena

    2014-04-01

    The aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study. At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed. During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period. Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.

  15. Evaluation of bone mineral density and related parameters in patients with haemophilia: a single center cross-sectional study

    PubMed Central

    Kiper Unal, Hatice Demet; Comert Ozkan, Melda; Atilla, Fatos Dilan; Demirci, Zuhal; Soyer, Nur; Yildirim Simsir, Ilgin; Omur, Ozgur; Capaci, Kazim; Saydam, Guray; Sahin, Fahri

    2017-01-01

    Haemophilia has been associated with low bone mineral density (BMD) probably due to some predisposing factors. The aim of this study was to evaluate the relationship between BMD and potential clinical predictors in adult haemophilic patients. Fortynine patients with moderate and severe haemophilia were enrolled. BMD was measured by Dual Energy X-Ray Absorptiometry (DXA) and blood tests were performed for vitamin D, calcium, phosphore, alkaline phosphatase and parathormone levels. Functional Independence Score in Haemophilia (FISH) and Haemophilia Joint Health Score (HJHS) were used to assess musculoskeletal functions. Body mass index (BMI), Hepatitis C virus (HCV)/Human immunodeficiency virus (HIV) seropositivity and smoking status were also recorded. BMD was found lower than expected for reference age in 34.8% of patients of less than 50 years old. In patients older than 50 years, 66.6% of them had osteoporosis and 33.3% of them had normal BMD. FISH score was statistically significant correlated with BMD of total hip (TH) and femur neck (FN) but not with lumbar spine (LS). In eligible patients, there was also a statistically significant correlation between BMD of TH and HJHS. Vitamine D deficiency was common and found in 77.5% of patients, although there was no significant correlation with BMD. Also no correlation was found between BMD and blood tests, HCV/HIV status, BMI and smoking. This study confirmed that patients with haemophilia have an increased prevelance of low BMD even in younger group. Our results showed that there are significant correlations between FISH score and BMD of TH and FN and also between HJHS score and BMD of TH. Thus, using scoring systems may be beneficial as a simple predictors of BMD to reflect the severity of haemophilic arthropathy. PMID:29181264

  16. Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty

    PubMed Central

    Schwitzer, Jonathan A.; Albino, Frank P.; Mathis, Ryan K.; Scott, Amie M.; Gamble, Laurie; Baker, Stephen B.

    2015-01-01

    Background As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction. Objectives The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument. Methods Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics. Results The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000. Conclusions In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction. Level of Evidence 3 Therapeutic PMID:26063837

  17. Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty.

    PubMed

    Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

    2015-09-01

    As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction. The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument. Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics. The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000. In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  18. Evaluation of bone mineral density and related parameters in patients with haemophilia: a single center cross-sectional study.

    PubMed

    Kiper Unal, Hatice Demet; Comert Ozkan, Melda; Atilla, Fatos Dilan; Demirci, Zuhal; Soyer, Nur; Yildirim Simsir, Ilgin; Omur, Ozgur; Capaci, Kazim; Saydam, Guray; Sahin, Fahri

    2017-01-01

    Haemophilia has been associated with low bone mineral density (BMD) probably due to some predisposing factors. The aim of this study was to evaluate the relationship between BMD and potential clinical predictors in adult haemophilic patients. Fortynine patients with moderate and severe haemophilia were enrolled. BMD was measured by Dual Energy X-Ray Absorptiometry (DXA) and blood tests were performed for vitamin D, calcium, phosphore, alkaline phosphatase and parathormone levels. Functional Independence Score in Haemophilia (FISH) and Haemophilia Joint Health Score (HJHS) were used to assess musculoskeletal functions. Body mass index (BMI), Hepatitis C virus (HCV)/Human immunodeficiency virus (HIV) seropositivity and smoking status were also recorded. BMD was found lower than expected for reference age in 34.8% of patients of less than 50 years old. In patients older than 50 years, 66.6% of them had osteoporosis and 33.3% of them had normal BMD. FISH score was statistically significant correlated with BMD of total hip (TH) and femur neck (FN) but not with lumbar spine (LS). In eligible patients, there was also a statistically significant correlation between BMD of TH and HJHS. Vitamine D deficiency was common and found in 77.5% of patients, although there was no significant correlation with BMD. Also no correlation was found between BMD and blood tests, HCV/HIV status, BMI and smoking. This study confirmed that patients with haemophilia have an increased prevelance of low BMD even in younger group. Our results showed that there are significant correlations between FISH score and BMD of TH and FN and also between HJHS score and BMD of TH. Thus, using scoring systems may be beneficial as a simple predictors of BMD to reflect the severity of haemophilic arthropathy.

  19. Modeling driver stop/run behavior at the onset of a yellow indication considering driver run tendency and roadway surface conditions.

    PubMed

    Elhenawy, Mohammed; Jahangiri, Arash; Rakha, Hesham A; El-Shawarby, Ihab

    2015-10-01

    The ability to model driver stop/run behavior at signalized intersections considering the roadway surface condition is critical in the design of advanced driver assistance systems. Such systems can reduce intersection crashes and fatalities by predicting driver stop/run behavior. The research presented in this paper uses data collected from two controlled field experiments on the Smart Road at the Virginia Tech Transportation Institute (VTTI) to model driver stop/run behavior at the onset of a yellow indication for different roadway surface conditions. The paper offers two contributions. First, it introduces a new predictor related to driver aggressiveness and demonstrates that this measure enhances the modeling of driver stop/run behavior. Second, it applies well-known artificial intelligence techniques including: adaptive boosting (AdaBoost), random forest, and support vector machine (SVM) algorithms as well as traditional logistic regression techniques on the data in order to develop a model that can be used by traffic signal controllers to predict driver stop/run decisions in a connected vehicle environment. The research demonstrates that by adding the proposed driver aggressiveness predictor to the model, there is a statistically significant increase in the model accuracy. Moreover the false alarm rate is significantly reduced but this reduction is not statistically significant. The study demonstrates that, for the subject data, the SVM machine learning algorithm performs the best in terms of optimum classification accuracy and false positive rates. However, the SVM model produces the best performance in terms of the classification accuracy only. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Telephone intervention and quality of life in patients with breast cancer.

    PubMed

    Salonen, Päivi; Tarkka, Marja-Terttu; Kellokumpu-Lehtinen, Pirkko-Liisa; Astedt-Kurki, Päivi; Luukkaala, Tiina; Kaunonen, Marja

    2009-01-01

    The aim of this quasi-experimental study was to examine the effectiveness of a telephone support intervention 1 week after surgery on the quality of life (QOL) of patients with breast cancer. The sample consisted of 228 patients with breast cancer allocated to an intervention group (n = 120) and control group (n = 108). The data were collected using Ferrans and Powers Quality of Life Index-Cancer Version (QLI-CV) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-BR23). The self-reported QOL of patients with breast cancer was considered moderately high. Statistically significant associations were found between QOL and the demographic characteristics of age, education, and employment status and of having underage children. Statistically significant associations were found between QOL and clinical characteristics such as type of surgery and axilla treatment. The strongest predictors of poor QOL were age, control group, and type of surgery. Age was the strongest predictor of poor QOL in global QLI and in the health and functioning, socioeconomic, and family subscales. The patients' experiences show that the telephone intervention was helpful and the timing was appropriate. The QOL in patients with breast cancer was better in subscales of body image, future perspective, and postoperative side effects. The intervention group showed significantly better body image; they worried less about the future and had less postoperative side effects than the control group did. These results may help in discussing QOL issues and should be considered when planning and implementing interventions for patients with breast cancer.

  1. Further analysis of a snowfall enhancement project in the Snowy Mountains of Australia

    NASA Astrophysics Data System (ADS)

    Manton, Michael J.; Peace, Andrew D.; Kemsley, Karen; Kenyon, Suzanne; Speirs, Johanna C.; Warren, Loredana; Denholm, John

    2017-09-01

    The first phase of the Snowy Precipitation Enhancement Research Project (SPERP-1) was a confirmatory experiment on winter orographic cloud seeding (Manton et al., 2011). Analysis of the data (Manton and Warren, 2011) found that a statistically significant impact of seeding could be obtained by removing any 5-hour experimental units (EUs) for which the amount of released seeding material was below a specified minimum. Analysis of the SPERP-1 data is extended in the present work by first considering the uncertainties in the measurement of precipitation and in the methodology. It is found that the estimation of the natural precipitation in the target area, based solely on the precipitation in the designated control area, is a significant source of uncertainty. A systematic search for optimal predictors shows that both the Froude number of the low-level flow across the mountains and the control precipitation should be used to estimate the natural precipitation. Applying the optimal predictors for the natural precipitation, statistically significant impacts are found using all EUs. This approach also supports a novel analysis of the sensitivity of seeding impacts to environmental variables, such as wind speed and cloud top temperature. The spatial distribution of seeding impact across the target is investigated. Building on the results of SPERP-1, phase 2 of the experiment (SPERP-2) ran from 2010 to 2013 with the target area extended to the north along the mountain ridges. Using the revised methodology, the seeding impacts in SPERP-2 are found to be consistent with those in SPERP-1, provided that the natural precipitation is estimated accurately.

  2. LpMab-23-recognizing cancer-type podoplanin is a novel predictor for a poor prognosis of early stage tongue cancer.

    PubMed

    Miyazaki, Akihiro; Nakai, Hiromi; Sonoda, Tomoko; Hirohashi, Yoshihiko; Kaneko, Mika K; Kato, Yukinari; Sawa, Yoshihiko; Hiratsuka, Hiroyoshi

    2018-04-20

    We report that the reactivity of a novel monoclonal antibody LpMab-23 for human cancer-type podoplanin (PDPN) is a predictor for a poor prognosis of tongue cancer. The association between LpMab-23-recognizing cancer-type PDPN expression and clinical/pathological features were analyzed on 60 patients with stage I and II tongue cancer treated with transoral resection of the primary tumor. In the mode of invasion, the LpMab-23-dull/negative cases were significantly larger in cases with low-grade malignancies and without late cervical lymph node metastasis, than in cases with high-grade malignancies and the metastasis. In the high-grade malignant cases, LpMab-23-positive cases were significantly larger than LpMab-23-dull/negative cases. The Kaplan-Meier curves of the five-year metastasis-free survival rate (MFS) were significantly lower in the LpMab-23 positive patients than in LpMab-23 dull/negative patients. The LpMab-23-dull/negative cases showed the highest MFS in all of the clinical/pathological features and particularly, the MFS of the LpMab-23 positive cases decreased to less than 60% in the first year. In the Cox proportional hazard regression models a comparison of the numbers of LpMab-23 dull/negative with positive cases showed the highest hazard ratio with statistical significance in all of the clinical/pathological features. LpMab-23 positive cases may be considered to present a useful predictor of poor prognosis for early stage tongue cancer.

  3. Curricular Activities that Promote Metacognitive Skills Impact Lower-Performing Students in an Introductory Biology Course.

    PubMed

    Dang, Nathan V; Chiang, Jacob C; Brown, Heather M; McDonald, Kelly K

    2018-01-01

    This study explores the impacts of repeated curricular activities designed to promote metacognitive skills development and academic achievement on students in an introductory biology course. Prior to this study, the course curriculum was enhanced with pre-assignments containing comprehension monitoring and self-evaluation questions, exam review assignments with reflective questions related to study habits, and an optional opportunity for students to explore metacognition and deep versus surface learning. We used a mixed-methods study design and collected data over two semesters. Self-evaluation, a component of metacognition, was measured via exam score postdictions, in which students estimated their exam scores after completing their exam. Metacognitive awareness was assessed using the Metacognitive Awareness Inventory (MAI) and a reflective essay designed to gauge students' perceptions of their metacognitive skills and study habits. In both semesters, more students over-predicted their Exam 1 scores than under-predicted, and statistical tests revealed significantly lower mean exam scores for the over-predictors. By Exam 3, under-predictors still scored significantly higher on the exam, but they outnumbered the over-predictors. Lower-performing students also displayed a significant increase in exam postdiction accuracy by Exam 3. While there was no significant difference in students' MAI scores from the beginning to the end of the semester, qualitative analysis of reflective essays indicated that students benefitted from the assignments and could articulate clear action plans to improve their learning and performance. Our findings suggest that assignments designed to promote metacognition can have an impact on students over the course of one semester and may provide the greatest benefits to lower-performing students.

  4. Prevalence of cold sensitivity in patients with hand pathology.

    PubMed

    Novak, Christine B; McCabe, Steven J

    2015-06-01

    The purpose of this study was to evaluate the prevalence of cold sensitivity in patients with hand- and wrist-related diagnoses. We included English-speaking adults who were more than 1 month following hand injury or onset of symptoms. Patients were asked if exposure to cold air or water provoked cold-related symptoms and to rank symptom severity (scale 0-10). Statistical analyses evaluated the relationships between the cold sensitivity and independent variables (age, gender, history of trauma, and time from injury/symptoms). There were 197 patients (mean age 49 ± 16 years): 98 trauma and 99 non-trauma cases. Cold-induced symptoms were reported by 34 %, with 10 % reporting severe symptoms. Exposure to cold air is the most common catalyst; mean severity score was 6.7 ± 2.2. Those with traumatic injuries compared to non-trauma diagnoses reported significantly more cold-induced symptoms (p = .04). Using backward linear regression, the significant predictors of cold symptom severity were trauma (p = .004) and time since onset (p = .003). Including only the trauma patients in the regression model, the significant predictor was time since injury (p = .005). Cold-induced symptoms are reported by more than 30 % of hand-related diagnoses, and exposure to cold air was the most commonly reported trigger. The significant predictors of cold-induced symptoms are traumatic injuries and longer time from injury. This study provides evidence of the common problem of cold sensitivity in patients with hand pathology. Prognostic Level II.

  5. Predictors of poor sleep quality among head and neck cancer patients.

    PubMed

    Shuman, Andrew G; Duffy, Sonia A; Ronis, David L; Garetz, Susan L; McLean, Scott A; Fowler, Karen E; Terrell, Jeffrey E

    2010-06-01

    The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Both baseline (67.1) and 1-year postdiagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life.

  6. Examining Preservice Science Teacher Understanding of Nature of Science: Discriminating Variables on the Aspects of Nature of Science

    NASA Astrophysics Data System (ADS)

    Jones, William I.

    This study examined the understanding of nature of science among participants in their final year of a 4-year undergraduate teacher education program at a Midwest liberal arts university. The Logic Model Process was used as an integrative framework to focus the collection, organization, analysis, and interpretation of the data for the purpose of (1) describing participant understanding of NOS and (2) to identify participant characteristics and teacher education program features related to those understandings. The Views of Nature of Science Questionnaire form C (VNOS-C) was used to survey participant understanding of 7 target aspects of Nature of Science (NOS). A rubric was developed from a review of the literature to categorize and score participant understanding of the target aspects of NOS. Participants' high school and college transcripts, planning guides for their respective teacher education program majors, and science content and science teaching methods course syllabi were examined to identify and categorize participant characteristics and teacher education program features. The R software (R Project for Statistical Computing, 2010) was used to conduct an exploratory analysis to determine correlations of the antecedent and transaction predictor variables with participants' scores on the 7 target aspects of NOS. Fourteen participant characteristics and teacher education program features were moderately and significantly ( p < .01) correlated with participant scores on the target aspects of NOS. The 6 antecedent predictor variables were entered into multiple regression analyses to determine the best-fit model of antecedent predictor variables for each target NOS aspect. The transaction predictor variables were entered into separate multiple regression analyses to determine the best-fit model of transaction predictor variables for each target NOS aspect. Variables from the best-fit antecedent and best-fit transaction models for each target aspect of NOS were then combined. A regression analysis for each of the combined models was conducted to determine the relative effect of these variables on the target aspects of NOS. Findings from the multiple regression analyses revealed that each of the fourteen predictor variables was present in the best-fit model for at least 1 of the 7 target aspects of NOS. However, not all of the predictor variables were statistically significant (p < .007) in the models and their effect (beta) varied. Participants in the teacher education program who had higher ACT Math scores, completed more high school science credits, and were enrolled either in the Middle Childhood with a science concentration program major or in the Adolescent/Young Adult Science Education program major were more likely to have an informed understanding on each of the 7 target aspects of NOS. Analyses of the planning guides and the course syllabi in each teacher education program major revealed differences between the program majors that may account for the results.

  7. Using amphiphilic pseudo amino acid composition to predict enzyme subfamily classes.

    PubMed

    Chou, Kuo-Chen

    2005-01-01

    With protein sequences entering into databanks at an explosive pace, the early determination of the family or subfamily class for a newly found enzyme molecule becomes important because this is directly related to the detailed information about which specific target it acts on, as well as to its catalytic process and biological function. Unfortunately, it is both time-consuming and costly to do so by experiments alone. In a previous study, the covariant-discriminant algorithm was introduced to identify the 16 subfamily classes of oxidoreductases. Although the results were quite encouraging, the entire prediction process was based on the amino acid composition alone without including any sequence-order information. Therefore, it is worthy of further investigation. To incorporate the sequence-order effects into the predictor, the 'amphiphilic pseudo amino acid composition' is introduced to represent the statistical sample of a protein. The novel representation contains 20 + 2lambda discrete numbers: the first 20 numbers are the components of the conventional amino acid composition; the next 2lambda numbers are a set of correlation factors that reflect different hydrophobicity and hydrophilicity distribution patterns along a protein chain. Based on such a concept and formulation scheme, a new predictor is developed. It is shown by the self-consistency test, jackknife test and independent dataset tests that the success rates obtained by the new predictor are all significantly higher than those by the previous predictors. The significant enhancement in success rates also implies that the distribution of hydrophobicity and hydrophilicity of the amino acid residues along a protein chain plays a very important role to its structure and function.

  8. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors.

    PubMed

    Lutfi, R; Torquati, A; Sekhar, N; Richards, W O

    2006-06-01

    Laparoscopic gastric bypass (LGB) has proven efficacy in causing significant and durable weight loss. However, the degree of postoperative weight loss and metabolic improvement varies greatly among individuals. Our study is aimed to identify independent predictors of successful weight loss after LGB. Socioeconomic demographics were prospectively collected on patients undergoing LGB. Primary endpoint was percent of excess weight loss (EWL) at 1-year follow-up. Insufficient weight loss was defined as EWL or=52.8%. According to this definition, 147 patients (81.7%) achieved successful weight loss 1 year after LGB. On univariate analysis, preoperative BMI had a significant effect on EWL, with patients with BMI <50 achieving a higher percentage of EWL (91.7% vs 61.6%; p = 0.001). Marriage status was also a significant predictor of successful outcome, with single patients achieving a higher percentage of EWL than married patients (89.8% vs 77.7%; p = 0.04). Race had a noticeable but not statistically significant effect, with Caucasian patients achieving a higher percentage of EWL than African Americans (82.9% vs 60%; p = 0.06). Marital status remained an independent predictor of success in the multivariate logistic regression model after adjusting for covariates. Married patients were at more than two times the risk of failure compared to those who were unmarried (OR 2.6; 95% CI: 1.1-6.5, p = 0.04). Weight loss achieved at 1 year after LGB is suboptimal in superobese patients. Single patients with BMI < 50 had the best chance of achieving greater weight loss.

  9. Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.

    PubMed

    Kojima, Gotaro

    2015-12-01

    Although multiple longitudinal studies have investigated frailty as a predictor of future falls, the results were mixed. Thus far, no systematic review or meta-analysis on this topic has been conducted. To review the evidence of frailty as a predictor of future falls among community-dwelling older people. Systematic review of literature and meta-analysis were performed using 6 electronic databases (Embase, Scopus, MEDLINE, CINAHL Plus, PsycINFO, and the Cochrane Library) searching for studies that prospectively examined risk of future fall risk according to frailty among community-dwelling older people published from 2010 to April 2015 with no language restrictions. Of 2245 studies identified through the systematic review, 11 studies incorporating 68,723 individuals were included in the meta-analysis. Among 7 studies reporting odds ratios (ORs), frailty and prefrailty were significantly associated with higher risk of future falls (pooled OR = 1.84, 95% confidence interval [95% CI] = 1.43-2.38, P < .001; pooled OR = 1.25, 95% CI = 1.01-1.53, P = .005, respectively). Among 4 studies reporting hazard ratios (HRs), whereas frailty was significantly associated with higher risk of future falls (pooled HR = 1.24, 95% CI = 1.10-1.41, P < .001), future fall risk according to prefrailty did not reach statistical significance (pooled HR = 1.14, 95% CI = 0.95-1·36, P = .15). High heterogeneity was noted among 7 studies reporting ORs and seemed attributed to difference in gender proportion of cohorts according to subgroup and meta-regression analyses. Frailty is demonstrated to be a significant predictor of future falls among community-dwelling older people despite various criteria used to define frailty. The future fall risk according to frailty seemed to be higher in men than in women. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. Validating Future Force Performance Measures (Army Class): Concluding Analyses

    DTIC Science & Technology

    2016-06-01

    32 Table 3.10. Descriptive Statistics and Intercorrelations for LV Final Predictor Factor Scores...55 Table 4.7. Descriptive Statistics for Analysis Criteria...Soldier attrition and performance: Dependability (Non- Delinquency ), Adjustment, Physical Conditioning, Leadership, Work Orientation, and Agreeableness

  11. A quantitative analysis of factors influencing the professional longevity of high school science teachers in Florida

    NASA Astrophysics Data System (ADS)

    Ridgley, James Alexander, Jr.

    This dissertation is an exploratory quantitative analysis of various independent variables to determine their effect on the professional longevity (years of service) of high school science teachers in the state of Florida for the academic years 2011-2012 to 2013-2014. Data are collected from the Florida Department of Education, National Center for Education Statistics, and the National Assessment of Educational Progress databases. The following research hypotheses are examined: H1 - There are statistically significant differences in Level 1 (teacher variables) that influence the professional longevity of a high school science teacher in Florida. H2 - There are statistically significant differences in Level 2 (school variables) that influence the professional longevity of a high school science teacher in Florida. H3 - There are statistically significant differences in Level 3 (district variables) that influence the professional longevity of a high school science teacher in Florida. H4 - When tested in a hierarchical multiple regression, there are statistically significant differences in Level 1, Level 2, or Level 3 that influence the professional longevity of a high school science teacher in Florida. The professional longevity of a Floridian high school science teacher is the dependent variable. The independent variables are: (Level 1) a teacher's sex, age, ethnicity, earned degree, salary, number of schools taught in, migration count, and various years of service in different areas of education; (Level 2) a school's geographic location, residential population density, average class size, charter status, and SES; and (Level 3) a school district's average SES and average spending per pupil. Statistical analyses of exploratory MLRs and a HMR are used to support the research hypotheses. The final results of the HMR analysis show a teacher's age, salary, earned degree (unknown, associate, and doctorate), and ethnicity (Hispanic and Native Hawaiian/Pacific Islander); a school's charter status; and a school district's average SES are all significant predictors of a Florida high school science teacher's professional longevity. Although statistically significant in the initial exploratory MLR analyses, a teacher's ethnicity (Asian and Black), a school's geographic location (city and rural), and a school's SES are not statistically significant in the final HMR model.

  12. Cognitive and attitudinal predictors related to graphing achievement among pre-service elementary teachers

    NASA Astrophysics Data System (ADS)

    Szyjka, Sebastian P.

    The purpose of this study was to determine the extent to which six cognitive and attitudinal variables predicted pre-service elementary teachers' performance on line graphing. Predictors included Illinois teacher education basic skills sub-component scores in reading comprehension and mathematics, logical thinking performance scores, as well as measures of attitudes toward science, mathematics and graphing. This study also determined the strength of the relationship between each prospective predictor variable and the line graphing performance variable, as well as the extent to which measures of attitude towards science, mathematics and graphing mediated relationships between scores on mathematics, reading, logical thinking and line graphing. Ninety-four pre-service elementary education teachers enrolled in two different elementary science methods courses during the spring 2009 semester at Southern Illinois University Carbondale participated in this study. Each subject completed five different instruments designed to assess science, mathematics and graphing attitudes as well as logical thinking and graphing ability. Sixty subjects provided copies of primary basic skills score reports that listed subset scores for both reading comprehension and mathematics. The remaining scores were supplied by a faculty member who had access to a database from which the scores were drawn. Seven subjects, whose scores could not be found, were eliminated from final data analysis. Confirmatory factor analysis (CFA) was conducted in order to establish validity and reliability of the Questionnaire of Attitude Toward Line Graphs in Science (QALGS) instrument. CFA tested the statistical hypothesis that the five main factor structures within the Questionnaire of Attitude Toward Statistical Graphs (QASG) would be maintained in the revised QALGS. Stepwise Regression Analysis with backward elimination was conducted in order to generate a parsimonious and precise predictive model. This procedure allowed the researcher to explore the relationships among the affective and cognitive variables that were included in the regression analysis. The results for CFA indicated that the revised QALGS measure was sound in its psychometric properties when tested against the QASG. Reliability statistics indicated that the overall reliability for the 32 items in the QALGS was .90. The learning preferences construct had the lowest reliability (.67), while enjoyment (.89), confidence (.86) and usefulness (.77) constructs had moderate to high reliabilities. The first four measurement models fit the data well as indicated by the appropriate descriptive and statistical indices. However, the fifth measurement model did not fit the data well statistically, and only fit well with two descriptive indices. The results addressing the research question indicated that mathematical and logical thinking ability were significant predictors of line graph performance among the remaining group of variables. These predictors accounted for 41% of the total variability on the line graph performance variable. Partial correlation coefficients indicated that mathematics ability accounted for 20.5% of the variance on the line graphing performance variable when removing the effect of logical thinking. The logical thinking variable accounted for 4.7% of the variance on the line graphing performance variable when removing the effect of mathematics ability.

  13. Child and Adolescent Adherence With Cognitive Behavioral Therapy for Anxiety: Predictors and Associations With Outcomes.

    PubMed

    Lee, Phyllis; Zehgeer, Asima; Ginsburg, Golda S; McCracken, James; Keeton, Courtney; Kendall, Philip C; Birmaher, Boris; Sakolsky, Dara; Walkup, John; Peris, Tara; Albano, Anne Marie; Compton, Scott

    2017-04-27

    Cognitive behavioral therapy (CBT) for anxiety disorders is effective, but nonadherence with treatment may reduce the benefits of CBT. This study examined (a) four baseline domains (i.e., demographic, youth clinical characteristics, therapy related, family/parent factors) as predictors of youth adherence with treatment and (b) the associations between youth adherence and treatment outcomes. Data were from 279 youth (7-17 years of age, 51.6% female; 79.6% White, 9% African American), with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, who participated in CBT in the Child/Adolescent Anxiety Multimodal Study. Adherence was defined in three ways (session attendance, therapist-rated compliance, and homework completion). Multiple regressions revealed several significant predictors of youth adherence with CBT, but predictors varied according to the definition of adherence. The most robust predictors of greater adherence were living with both parents and fewer youth comorbid externalizing disorders. With respect to outcomes, therapist ratings of higher youth compliance with CBT predicted several indices of favorable outcome: lower anxiety severity, higher global functioning, and treatment responder status after 12 weeks of CBT. Number of sessions attended and homework completion did not predict treatment outcomes. Findings provide information about risks for youth nonadherence, which can inform treatment and highlight the importance of youth compliance with participating in therapy activities, rather than just attending sessions or completing homework assignments.

  14. Developing in situ non-destructive estimates of crop biomass to address issues of scale in remote sensing

    USGS Publications Warehouse

    Marshall, Michael T.; Thenkabail, Prasad S.

    2015-01-01

    Ground-based estimates of aboveground wet (fresh) biomass (AWB) are an important input for crop growth models. In this study, we developed empirical equations of AWB for rice, maize, cotton, and alfalfa, by combining several in situ non-spectral and spectral predictors. The non-spectral predictors included: crop height (H), fraction of absorbed photosynthetically active radiation (FAPAR), leaf area index (LAI), and fraction of vegetation cover (FVC). The spectral predictors included 196 hyperspectral narrowbands (HNBs) from 350 to 2500 nm. The models for rice, maize, cotton, and alfalfa included H and HNBs in the near infrared (NIR); H, FAPAR, and HNBs in the NIR; H and HNBs in the visible and NIR; and FVC and HNBs in the visible; respectively. In each case, the non-spectral predictors were the most important, while the HNBs explained additional and statistically significant predictors, but with lower variance. The final models selected for validation yielded an R2 of 0.84, 0.59, 0.91, and 0.86 for rice, maize, cotton, and alfalfa, which when compared to models using HNBs alone from a previous study using the same spectral data, explained an additional 12%, 29%, 14%, and 6% in AWB variance. These integrated models will be used in an up-coming study to extrapolate AWB over 60 × 60 m transects to evaluate spaceborne multispectral broad bands and hyperspectral narrowbands.

  15. Psychological Characteristics and Traits for Finding Benefit From Prostate Cancer: Correlates and Predictors.

    PubMed

    Pascoe, Elizabeth C; Edvardsson, David

    Although beginning evidence suggests that the capacity to derive benefit from cancer-associated experiences may be influenced by some individual psychological characteristics and traits, little is known about predictors for finding benefit from prostate cancer. The aim of this study was to explore the correlates and predictors for finding benefit from prostate cancer among a sample of men undergoing androgen deprivation. Pearson correlation and multiple linear regression modeling were performed on data collected in an acute tertiary hospital outpatient setting (N = 209) between July 2011 and December 2013 to determine correlates and predictors for finding benefit from prostate cancer. Multiple linear regression modeling showed that while the 6 predictors of self-reported coping, depression, anxiety, distress, resilience, and hope explained 38% of the variance in finding benefit, coping provided the strongest and statistically significant predictive contribution. Self-reported coping was strongly predictive of finding benefit from prostate cancer, but questions remain about if subtypes of coping strategies can be more or less predictive of finding benefit. Self-reported levels of depression, anxiety, distress, resilience, and hope had a less predictive and nonsignificant role in finding benefit from prostate cancer and raise questions about their function in this subpopulation. The findings suggest that coping strategies can maximize finding benefit from prostate cancer. Knowledge of influential coping strategies for finding benefit from prostate cancer can be immensely valuable to support men in rebuilding positive meaning amid a changed illness reality. Developing practice initiatives that foster positive meaning-making coping strategies seems valuable.

  16. The fragility of statistically significant findings from randomized trials in head and neck surgery.

    PubMed

    Noel, Christopher W; McMullen, Caitlin; Yao, Christopher; Monteiro, Eric; Goldstein, David P; Eskander, Antoine; de Almeida, John R

    2018-04-23

    The Fragility Index (FI) is a novel tool for evaluating the robustness of statistically significant findings in a randomized control trial (RCT). It measures the number of events upon which statistical significance depends. We sought to calculate the FI scores for RCTs in the head and neck cancer literature where surgery was a primary intervention. Potential articles were identified in PubMed (MEDLINE), Embase, and Cochrane without publication date restrictions. Two reviewers independently screened eligible RCTs reporting at least one dichotomous and statistically significant outcome. The data from each trial were extracted and the FI scores were calculated. Associations between trial characteristics and FI were determined. In total, 27 articles were identified. The median sample size was 67.5 (interquartile range [IQR] = 42-143) and the median number of events per trial was 8 (IQR = 2.25-18.25). The median FI score was 1 (IQR = 0-2.5), meaning that changing one patient from a nonevent to an event in the treatment arm would change the result to a statistically nonsignificant result, or P > .05. The FI score was less than the number of patients lost to follow-up in 71% of cases. The FI score was found to be moderately correlated with P value (ρ = -0.52, P = .007) and with journal impact factor (ρ = 0.49, P = .009) on univariable analysis. On multivariable analysis, only the P value was found to be a predictor of FI score (P = .001). Randomized trials in the head and neck cancer literature where surgery is a primary modality are relatively nonrobust statistically with low FI scores. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

    PubMed Central

    Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

    2016-01-01

    Objective We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Methods Participants (N=116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory–III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Results Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and, 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI[0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI[0.70, 0.88]). Conclusions Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking. PMID:27064523

  18. Statistics 101 for Radiologists.

    PubMed

    Anvari, Arash; Halpern, Elkan F; Samir, Anthony E

    2015-10-01

    Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treatment effect, and determining prognosis. Interpreting diagnostic test results requires an understanding of key statistical concepts used to evaluate test efficacy. This review explains descriptive statistics and discusses probability, including mutually exclusive and independent events and conditional probability. In the inferential statistics section, a statistical perspective on study design is provided, together with an explanation of how to select appropriate statistical tests. Key concepts in recruiting study samples are discussed, including representativeness and random sampling. Variable types are defined, including predictor, outcome, and covariate variables, and the relationship of these variables to one another. In the hypothesis testing section, we explain how to determine if observed differences between groups are likely to be due to chance. We explain type I and II errors, statistical significance, and study power, followed by an explanation of effect sizes and how confidence intervals can be used to generalize observed effect sizes to the larger population. Statistical tests are explained in four categories: t tests and analysis of variance, proportion analysis tests, nonparametric tests, and regression techniques. We discuss sensitivity, specificity, accuracy, receiver operating characteristic analysis, and likelihood ratios. Measures of reliability and agreement, including κ statistics, intraclass correlation coefficients, and Bland-Altman graphs and analysis, are introduced. © RSNA, 2015.

  19. Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey.

    PubMed

    Yu, Hairong; Jiang, Anli; Shen, Jie

    2016-05-01

    Cancer is a leading cause of death worldwide. Given the complexity of caring work, recent studies have focused on the professional quality of life of oncology nurses. China, the world's largest developing country, faces heavy burdens of care for cancer patients. Chinese oncology nurses may be encountering the negative side of their professional life. However, studies in this field are scarce, and little is known about the prevalence and predictors of oncology nurses' professional quality of life. To describe and explore the prevalence of predictors of professional quality of life (compassion fatigue, burnout and compassion satisfaction) among Chinese oncology nurses under the guidance of two theoretical models. A cross-sectional design with a survey. Ten tertiary hospitals and five secondary hospitals in Shanghai, China. A convenience and cluster sample of 669 oncology nurses was used. All of the nurses worked in oncology departments and had over 1 year of oncology nursing experience. Of the selected nurses, 650 returned valid questionnaires that were used for statistical analyses. The participants completed the demographic and work-related questionnaire, the Chinese version of the Professional Quality of Life Scale for Nurses, the Chinese version of the Jefferson Scales of Empathy, the Simplified Coping Style Questionnaire, the Perceived Social Support Scale, and the Chinese Big Five Personality Inventory brief version. Descriptive statistics, t-tests, one-way analysis of variance, simple and multiple linear regressions were used to determine the predictors of the main research variables. Higher compassion fatigue and burnout were found among oncology nurses who had more years of nursing experience, worked in secondary hospitals and adopted passive coping styles. Cognitive empathy, training and support from organizations were identified as significant protectors, and 'perspective taking' was the strongest predictor of compassion satisfaction, explaining 23.0% of the variance. Personality traits of openness and conscientiousness were positively associated with compassion satisfaction, while neuroticism was a negative predictor, accounting for 24.2% and 19.8% of the variance in compassion fatigue and burnout, respectively. Oncology care has unique features, and oncology nurses may suffer from more work-related stressors compared with other types of nurses. Various predictors can influence the professional quality of life, and some of these should be considered in the Chinese nursing context. The results may provide clues to help nurse administrators identify oncology nurses' vulnerability to compassion fatigue and burnout and develop comprehensive strategies to improve their professional quality of life. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Prediction model for peninsular Indian summer monsoon rainfall using data mining and statistical approaches

    NASA Astrophysics Data System (ADS)

    Vathsala, H.; Koolagudi, Shashidhar G.

    2017-01-01

    In this paper we discuss a data mining application for predicting peninsular Indian summer monsoon rainfall, and propose an algorithm that combine data mining and statistical techniques. We select likely predictors based on association rules that have the highest confidence levels. We then cluster the selected predictors to reduce their dimensions and use cluster membership values for classification. We derive the predictors from local conditions in southern India, including mean sea level pressure, wind speed, and maximum and minimum temperatures. The global condition variables include southern oscillation and Indian Ocean dipole conditions. The algorithm predicts rainfall in five categories: Flood, Excess, Normal, Deficit and Drought. We use closed itemset mining, cluster membership calculations and a multilayer perceptron function in the algorithm to predict monsoon rainfall in peninsular India. Using Indian Institute of Tropical Meteorology data, we found the prediction accuracy of our proposed approach to be exceptionally good.

  1. Profile and predictors of health related quality of life among type II diabetes mellitus patients in Quetta city, Pakistan.

    PubMed

    Iqbal, Qaiser; Ul Haq, Noman; Bashir, Sajid; Bashaar, Mohammad

    2017-07-14

    This study aims to assess the profile and predictors of Health-Related Quality of Life (HRQoL) in Type II Diabetes Mellitus (T2DM) patients in Quetta, Pakistan. The study was designed as a questionnaire based, cross sectional analysis. 300 Type II diabetic patients attending public and private hospitals were targeted for data collection. In addition to demographic and disease related information, Euroqol Quality of Life was used to measure HRQoL. Moreover, Drug Attitude Inventory and Michigan Diabetes Knowledge Test were used to assess medication adherence and diabetes related knowledge respectively. Treatment satisfaction was assessed by patient's experience towards health care professionals and available facilities. Descriptive statistics were used to elaborate patients' demographic and disease related characteristics. Binary logistic regression was used to predict factors independently associated with HRQoL. SPSS v. 20 was used for data analysis and p < 0.05 was taken as significant. Patients in the current study reported poor HRQoL with a mean score of 0.48 ± 0.36. Age, duration of disease, number of prescribed drugs, medication adherence and treatment satisfaction were significantly associated (p < 0.05) with HRQoL in the cross tabulation analysis. The significant variables were entered into the model that showed significant goodness of fit with highly significant Omnibus Test of Model Coefficient (Chi-square = 12.983, p = 0.030, df = 4). Medication adherence was reported as a significant predictor of HRQoL with an increase of one adherence score was associated with improvement of HRQoL by a factor of 1.75 provided other variables remain constant. The study presents a model that is associated with HRQoL with patient with T2DM, where medication adherence shaped as a predictor of HRQoL. Healthcare professionals should pay special attention on patients' medication taking behavior and should put their efforts in explaining the benefits of the medication adherence to the patients.

  2. Detection of major climatic and environmental predictors of liver fluke exposure risk in Ireland using spatial cluster analysis.

    PubMed

    Selemetas, Nikolaos; de Waal, Theo

    2015-04-30

    Fasciolosis caused by Fasciola hepatica (liver fluke) can cause significant economic and production losses in dairy cow farms. The aim of the current study was to identify important weather and environmental predictors of the exposure risk to liver fluke by detecting clusters of fasciolosis in Ireland. During autumn 2012, bulk-tank milk samples from 4365 dairy farms were collected throughout Ireland. Using an in-house antibody-detection ELISA, the analysis of BTM samples showed that 83% (n=3602) of dairy farms had been exposed to liver fluke. The Getis-Ord Gi* statistic identified 74 high-risk and 130 low-risk significant (P<0.01) clusters of fasciolosis. The low-risk clusters were mostly located in the southern regions of Ireland, whereas the high-risk clusters were mainly situated in the western part. Several climatic variables (monthly and seasonal mean rainfall and temperatures, total wet days and rain days) and environmental datasets (soil types, enhanced vegetation index and normalised difference vegetation index) were used to investigate dissimilarities in the exposure to liver fluke between clusters. Rainfall, total wet days and rain days, and soil type were the significant classes of climatic and environmental variables explaining the differences between significant clusters. A discriminant function analysis was used to predict the exposure risk to liver fluke using 80% of data for modelling and the remaining subset of 20% for post hoc model validation. The most significant predictors of the model risk function were total rainfall in August and September and total wet days. The risk model presented 100% sensitivity and 91% specificity and an accuracy of 95% correctly classified cases. A risk map of exposure to liver fluke was constructed with higher probability of exposure in western and north-western regions. The results of this study identified differences between clusters of fasciolosis in Ireland regarding climatic and environmental variables and detected significant predictors of the exposure risk to liver fluke. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. The deleterious effects of methamphetamine use on initial presentation and clinical outcomes in aneurysmal subarachnoid hemorrhage.

    PubMed

    Beadell, Noah C; Thompson, Eric M; Delashaw, Johnny B; Cetas, Justin S

    2012-10-01

    The objective of this study was to retrospectively look at methamphetamine (MA) use in patients with aneurysmal subarachnoid hemorrhage (SAH) to determine if MA use affects clinical presentation and outcomes after aneurysmal SAH. A retrospective review of patients admitted to the Oregon Health & Science University neurosurgical service with aneurysmal SAH during the past 6 years was undertaken. Variables analyzed included MA use, age, sex, cigarette use, Hunt and Hess grade, Fisher grade, admission blood pressure, aneurysm characteristics, occurrence of vasospasm, hospital length of stay (LOS), cerebral infarction, aneurysm treatment, and Glasgow Outcome Scale (GOS) score. Data differences between MA users and nonusers were statistically analyzed using multivariate logistic regression analysis. A separate comparison with randomly selected age-matched nonuser controls was also performed. Twenty-eight (7%) of 374 patients with aneurysmal SAH were identified as MA users. Methamphetamine users were younger than nonusers (45.2 vs 55.9 years, respectively; p <0.001). Despite a younger age, MA users had significantly higher Hunt and Hess grades than nonusers (3.0 vs 2.5, respectively; p <0.020) and age-matched controls (3.0 vs 2.0, respectively; p <0.001). Earliest available mean arterial pressure was significantly higher in MA users (122.1 vs 109.7, respectively; p = 0.005) than all nonusers but not age-matched controls. Methamphetamine users had significantly higher vasospasm rates than nonusers (92.9% vs 71.1%, respectively; p = 0.008) but similar rates as age-matched controls (92.9% vs 89.3%, respectively; p = 0.500). Glasgow Outcome Scale score did not differ significantly between users and nonusers (3 vs 4, respectively; p = 0.170), but users had significantly lower GOS scores than age-matched controls (3 vs 5, respectively; p <0.001). There was no statistically significant difference in the LOS between users and nonusers (18 days vs 16 days, respectively; p = 0.431) or users and age-matched controls (18 days vs 14 days, respectively; p = 0.250). In the multivariate analysis, MA use (OR 3.777, p = 0.018), age (p <0.001), Fisher grade (p = 0.011), Hunt and Hess grade (p <0.001), and cerebral infarction (p <0.001) were predictors of poor GOS score. The only predictor of vasospasm was age (p <0.001), although a strong predictive trend in MA use (p = 0.149) was found. Predictors of a hospital LOS >15 days included age (p = 0.002), Fisher grade (p = 0.002), Hunt and Hess grade (p <0.001), and cerebral infarction (p <0.001). Predictors of cerebral infarction include male sex (p = 0.022) and Hunt and Hess grade (p = 0.006), with vasospasm demonstrating a strong trend (p = 0.056). A history of MA use may predict poorer outcomes in patients who present with aneurysmal SAH. Methamphetamine users have significantly worse presentations and outcomes when compared with age-matched controls.

  4. An Interactive Tool For Semi-automated Statistical Prediction Using Earth Observations and Models

    NASA Astrophysics Data System (ADS)

    Zaitchik, B. F.; Berhane, F.; Tadesse, T.

    2015-12-01

    We developed a semi-automated statistical prediction tool applicable to concurrent analysis or seasonal prediction of any time series variable in any geographic location. The tool was developed using Shiny, JavaScript, HTML and CSS. A user can extract a predictand by drawing a polygon over a region of interest on the provided user interface (global map). The user can select the Climatic Research Unit (CRU) precipitation or Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS) as predictand. They can also upload their own predictand time series. Predictors can be extracted from sea surface temperature, sea level pressure, winds at different pressure levels, air temperature at various pressure levels, and geopotential height at different pressure levels. By default, reanalysis fields are applied as predictors, but the user can also upload their own predictors, including a wide range of compatible satellite-derived datasets. The package generates correlations of the variables selected with the predictand. The user also has the option to generate composites of the variables based on the predictand. Next, the user can extract predictors by drawing polygons over the regions that show strong correlations (composites). Then, the user can select some or all of the statistical prediction models provided. Provided models include Linear Regression models (GLM, SGLM), Tree-based models (bagging, random forest, boosting), Artificial Neural Network, and other non-linear models such as Generalized Additive Model (GAM) and Multivariate Adaptive Regression Splines (MARS). Finally, the user can download the analysis steps they used, such as the region they selected, the time period they specified, the predictand and predictors they chose and preprocessing options they used, and the model results in PDF or HTML format. Key words: Semi-automated prediction, Shiny, R, GLM, ANN, RF, GAM, MARS

  5. In vivo serial MRI-based models and statistical methods to quantify sensitivity and specificity of mechanical predictors for carotid plaque rupture: location and beyond.

    PubMed

    Wu, Zheyang; Yang, Chun; Tang, Dalin

    2011-06-01

    It has been hypothesized that mechanical risk factors may be used to predict future atherosclerotic plaque rupture. Truly predictive methods for plaque rupture and methods to identify the best predictor(s) from all the candidates are lacking in the literature. A novel combination of computational and statistical models based on serial magnetic resonance imaging (MRI) was introduced to quantify sensitivity and specificity of mechanical predictors to identify the best candidate for plaque rupture site prediction. Serial in vivo MRI data of carotid plaque from one patient was acquired with follow-up scan showing ulceration. 3D computational fluid-structure interaction (FSI) models using both baseline and follow-up data were constructed and plaque wall stress (PWS) and strain (PWSn) and flow maximum shear stress (FSS) were extracted from all 600 matched nodal points (100 points per matched slice, baseline matching follow-up) on the lumen surface for analysis. Each of the 600 points was marked "ulcer" or "nonulcer" using follow-up scan. Predictive statistical models for each of the seven combinations of PWS, PWSn, and FSS were trained using the follow-up data and applied to the baseline data to assess their sensitivity and specificity using the 600 data points for ulcer predictions. Sensitivity of prediction is defined as the proportion of the true positive outcomes that are predicted to be positive. Specificity of prediction is defined as the proportion of the true negative outcomes that are correctly predicted to be negative. Using probability 0.3 as a threshold to infer ulcer occurrence at the prediction stage, the combination of PWS and PWSn provided the best predictive accuracy with (sensitivity, specificity) = (0.97, 0.958). Sensitivity and specificity given by PWS, PWSn, and FSS individually were (0.788, 0.968), (0.515, 0.968), and (0.758, 0.928), respectively. The proposed computational-statistical process provides a novel method and a framework to assess the sensitivity and specificity of various risk indicators and offers the potential to identify the optimized predictor for plaque rupture using serial MRI with follow-up scan showing ulceration as the gold standard for method validation. While serial MRI data with actual rupture are hard to acquire, this single-case study suggests that combination of multiple predictors may provide potential improvement to existing plaque assessment schemes. With large-scale patient studies, this predictive modeling process may provide more solid ground for rupture predictor selection strategies and methods for image-based plaque vulnerability assessment.

  6. Advance in prediction of soil slope instabilities

    NASA Astrophysics Data System (ADS)

    Sigarán-Loría, C.; Hack, R.; Nieuwenhuis, J. D.

    2012-04-01

    Six generic soils (clays and sands) were systematically modeled with plane-strain finite elements (FE) at varying heights and inclinations. A dataset was generated in order to develop predictive relations of soil slope instabilities, in terms of co-seismic displacements (u), under strong motions with a linear multiple regression. For simplicity, the seismic loads are monochromatic artificial sinusoidal functions at four frequencies: 1, 2, 4, and 6 Hz, and the slope failure criterion used corresponds to near 10% Cartesian shear strains along a continuous region comparable to a slip surface. The generated dataset comprises variables from the slope geometry and site conditions: height, H, inclination, i, shear wave velocity from the upper 30 m, vs30, site period, Ts; as well as the input strong motion: yield acceleration, ay (equal to peak ground acceleration, PGA in this research), frequency, f; and in some cases moment magnitude, M, and Arias intensity, Ia, assumed from empirical correlations. Different datasets or scenarios were created: "Magnitude-independent", "Magnitude-dependent", and "Soil-dependent", and the data was statistically explored and analyzed with varying mathematical forms. Qualitative relations show that the permanent deformations are highly related to the soil class for the clay slopes, but not for the sand slopes. Furthermore, the slope height does not constrain the variability in the co-seismic displacements. The input frequency decreases the variability of the co-seismic displacements for the "Magnitude-dependent" and "Soil-dependent" datasets. The empirical models were developed with two and three predictors. For the sands it was not possible because they could not satisfy the constrains from the statistical method. For the clays, the best models with the smallest errors coincided with the simple general form of multiple regression with three predictors (e.g. near 0.16 and 0.21 standard error, S.E. and 0.75 and 0.55 R2 for the "M-independent" and "M-dependent" datasets correspondingly). From the models with two predictors, a 2nd-order polynom gave the best performance but with a not-significant parameter. The best models with both predictors significant have slightly larger error and smaller R2, e.g. 0.15 S.E., 44% R2 with ay and i. The predictive models obtained with the three scenarios from the clay slopes provide well-constrained predictions but low R2, suggesting the predictors are "not complete", most likely in relation to the simplicity used in the strong motion characterization. Nevertheless, the findings from this work demonstrate the potential from analytical methods in developing more precise predictions as well as the importance on treating different different ground types.

  7. Hydrodaynamic - Statistical Forecast Method To 36-48h Ahead Of Storm Wind And Tornadoes Over The Territory Of Europe And Siberia

    NASA Astrophysics Data System (ADS)

    Perekhodtseva, Elvira V.

    2010-05-01

    Development of successful method of forecast of storm winds, including squalls and tornadoes, that often result in human and material losses, could allow one to take proper measures against destruction of buildings and to protect people. Well-in-advance successful forecast (from 12 hours to 48 hour) makes possible to reduce the losses. Prediction of the phenomena involved is a very difficult problem for synoptic till recently. The existing graphic and calculation methods still depend on subjective decision of an operator. Nowadays in Russia there is no hydrodynamic model for forecast of the maximal wind velocity V> 25m/c, hence the main tools of objective forecast are statistical methods using the dependence of the phenomena involved on a number of atmospheric parameters (predictors). . Statistical decisive rule of the alternative and probability forecast of these events was obtained in accordance with the concept of "perfect prognosis" using the data of objective analysis. For this purpose the different teaching samples of present and absent of this storm wind and rainfalls were automatically arranged that include the values of forty physically substantiated potential predictors. Then the empirical statistical method was used that involved diagonalization of the mean correlation matrix R of the predictors and extraction of diagonal blocks of strongly correlated predictors. Thus for these phenomena the most informative predictors were selected without loosing information. The statistical decisive rules for diagnosis and prognosis of the phenomena involved U(X) were calculated for choosing informative vector-predictor. We used the criterion of distance of Mahalanobis and criterion of minimum of entropy by Vapnik-Chervonenkis for the selection predictors. Successful development of hydrodynamic models for short-term forecast and improvement of 36-48h forecasts of pressure, temperature and others parameters allowed us to use the prognostic fields of those models for calculations of the discriminant functions in the nodes of the grid 75x75km and the values of probabilities P of dangerous wind and thus to get fully automated forecasts. . In order to apply the alternative forecast to European part of Russia and Europe the author proposes the empirical threshold values specified for this phenomenon and advance period 36 hours. According to the Pirsey-Obukhov criterion (T), the success of this hydrometeorological-statistical method of forecast of storm wind and tornadoes to 36 -48 hours ahead in the warm season for the territory of Europe part of Russia and Siberia is T = 1-a-b=0,54-0,78 after independent and author experiments during the period 2004-2009 years. A lot of examples of very successful forecasts are submitted at this report for the territory of Europe and Russia. The same decisive rules were applied to the forecast of these phenomena during cold period in 2009-2010 years too. On the first month of 2010 a lot of cases of storm wind with heavy snowfall were observed and were forecasting over the territory of France, Italy and Germany.

  8. Does patient empowerment predict self-care behavior and glycosylated hemoglobin in chinese patients with type 2 diabetes?

    PubMed

    Yang, Shengnan; Hsue, Cunyi; Lou, Qingqing

    2015-05-01

    Patient empowerment is playing an increasingly important role in diabetes and related disorders. This study evaluated the correlations among patient empowerment, self-care behavior, and glycemic control among patients with type 2 diabetes in mainland China. We conducted a multicenter cross-sectional study. Eight hundred eighty-five patients who sought care at hospitals in Nanjing, Changsha, Yunnan, and Chongqing, China, were enrolled. Structured questionnaires and medical records provided the data. The instruments included a demographic and clinical questionnaire, the Diabetes Empowerment Scale-Short Form, and the Chinese version of the Summary of Diabetes Self-Care Activities Scale. Glycosylated hemoglobin (HbA1c) was used as a measure of glycemic control. The data analyses are presented as proportions, means (±SD), β, and 95% confidence intervals (CIs). Multilinear regressions were used to examine the correlations among the scores of patient empowerment, self-care behavior, and HbA1c values. Linear regression revealed that patient empowerment was a statistically significant predictor of patients' self-care behavior even after controlling for age, gender, marital status, educational level, and diabetes duration. Diet (β=0.449; 95% CI, 0.370, 0.528), exercise (β=0.222; 95% CI, 0.164, 0.279), blood glucose testing (β=0.152; 95% CI, 0.106, 0.199), medication taking (β=0.062; 95% CI, 0.030, 0.095), and foot care (β=0.279; 95% CI, 0.217, 0.342). Additionally, patient empowerment was a statistically significant predictor of HbA1c (β=-0.094; 95% CI, -0.123, -0.065). Our study indicated that perceived diabetes empowerment is a predictor of self-care behavior and HbA1c in Chinese patients with type 2 diabetes. Therefore, interventions to enhance and promote patient empowerment should be essential components of diabetes education programs to improve self-care behavior and glycemic control.

  9. Biomonitoring exposure assessment to contemporary pesticides in a school children population of Spain.

    PubMed

    Roca, Marta; Miralles-Marco, Ana; Ferré, Joan; Pérez, Rosa; Yusà, Vicent

    2014-05-01

    The exposure to pesticides amongst school-aged children (6-11 years old) was assessed in this study. One hundred twenty-five volunteer children were selected from two public schools located in an agricultural and in an urban area of Valencia Region, Spain. Twenty pesticide metabolites were analyzed in children's urine as biomarkers of exposure to organophosphate (OP) insecticides, synthetic pyrethroid insecticides, and herbicides. These data were combined with a survey to evaluate the main predictors of pesticide exposure in the children's population. A total of 15 metabolites were present in the urine samples with detection frequencies (DF) ranging from 5% to 86%. The most frequently detected metabolites with DF>53%, were 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos), diethyl phosphate (DEP, generic metabolite of OP insecticides), 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY, metabolite of diazinon) and para-nitrophenol (PNP, metabolite of parathion and methyl parathion). The calculated geometric means ranged from 0.47 to 3.36 µg/g creatinine, with TCPy and IMPY showing the higher mean concentrations. Statistical significant differences were found between exposure subgroups (Mann-Whitney test, p<0.05) for TCPy, DEP, and IMPY. Children living in the agricultural area had significantly higher concentrations of DEP than those living in the urban area. In contrast, children aged 6-8 years from the urban area, showed statistically higher IMPY levels than those from agricultural area. Higher levels of TCPy were also found in children with high consumption of vegetables and higher levels of DEP in children whose parents did not have university degree studies. The multivariable regression analysis showed that age, vegetable consumption, and residential use of pesticides were predictors of exposure for TCPy, and IMPY; whereas location and vegetable consumption were factors associated with DEP concentrations. Creatinine concentrations were the most important predictors of urinary TCPy and PNP metabolites. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. A quantitative study of factors influencing quality of life in rural Mexican women diagnosed with HIV.

    PubMed

    Holtz, Carol; Sowell, Richard; VanBrackle, Lewis; Velasquez, Gabriela; Hernandez-Alonso, Virginia

    2014-01-01

    This quantitative study explored the level of Quality of Life (QoL) in indigenous Mexican women and identified psychosocial factors that significantly influenced their QoL, using face-to-face interviews with 101 women accessing care in an HIV clinic in Oaxaca, Mexico. Variables included demographic characteristics, levels of depression, coping style, family functioning, HIV-related beliefs, and QoL. Descriptive statistics were used to analyze participant characteristics, and women's scores on data collection instruments. Pearson's R correlational statistics were used to determine the level of significance between study variables. Multiple regression analysis examined all variables that were significantly related to QoL. Pearson's correlational analysis of relationships between Spirituality, Educating Self about HIV, Family Functioning, Emotional Support, Physical Care, and Staying Positive demonstrated positive correlation to QoL. Stigma, depression, and avoidance coping were significantly and negatively associated with QoL. The final regression model indicated that depression and avoidance coping were the best predictor variables for QoL. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  11. Adaptation of clinical prediction models for application in local settings.

    PubMed

    Kappen, Teus H; Vergouwe, Yvonne; van Klei, Wilton A; van Wolfswinkel, Leo; Kalkman, Cor J; Moons, Karel G M

    2012-01-01

    When planning to use a validated prediction model in new patients, adequate performance is not guaranteed. For example, changes in clinical practice over time or a different case mix than the original validation population may result in inaccurate risk predictions. To demonstrate how clinical information can direct updating a prediction model and development of a strategy for handling missing predictor values in clinical practice. A previously derived and validated prediction model for postoperative nausea and vomiting was updated using a data set of 1847 patients. The update consisted of 1) changing the definition of an existing predictor, 2) reestimating the regression coefficient of a predictor, and 3) adding a new predictor to the model. The updated model was then validated in a new series of 3822 patients. Furthermore, several imputation models were considered to handle real-time missing values, so that possible missing predictor values could be anticipated during actual model use. Differences in clinical practice between our local population and the original derivation population guided the update strategy of the prediction model. The predictive accuracy of the updated model was better (c statistic, 0.68; calibration slope, 1.0) than the original model (c statistic, 0.62; calibration slope, 0.57). Inclusion of logistical variables in the imputation models, besides observed patient characteristics, contributed to a strategy to deal with missing predictor values at the time of risk calculation. Extensive knowledge of local, clinical processes provides crucial information to guide the process of adapting a prediction model to new clinical practices.

  12. Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.

    PubMed

    Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M

    2015-12-01

    Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.

  13. Potential predictors of risk sexual behavior among private college students in Mekelle City, North Ethiopia.

    PubMed

    Gebresllasie, Fanna; Tsadik, Mache; Berhane, Eyoel

    2017-01-01

    Risk sexual practice among students from public universities/colleges is common in Ethiopia. However, little has been known about risk sexual behavior of students in private colleges where more students are potentially enrolled. Therefore, this study aimed to assess the magnitude of risky sexual behaviors and predictors among students of Private Colleges in Mekelle City. A mixed design of both quantitative and qualitative methods was used among 627 randomly selected students of private colleges from February to march 2013. Self administered questionnaire and focus group discussion was used to collect data. A thematic content analysis was used for the qualitative part. For the quantitative study, Univariate, Bivariate and multivariable analysis was made using SPSS version 16 statistical package and p value less than 0.05 was used as cut off point for a statistical significance. Among the total 590 respondents, 151 (29.1%) have ever had sex. Among the sexually active students, 30.5% reported having had multiple sexual partners and consistent condom use was nearly 39%. In multivariable logistic regression analysis, variables such as sex, age group, sex last twelve months and condom use last twelve months was found significantly associated with risky sexual behavior. The findings of qualitative and quantitative study showed consistency in presence of risk factors. Finding of this study showed sexual risk behaviors is high among private colleges such as multiple sexual partners and substance use. So that colleges should emphasis on promoting healthy sexual and reproductive health programs.

  14. Clinical predictors cannot replace biological predictors in HIV-2 infection in a community setting in West Africa

    PubMed Central

    Gourlay, Annabelle J.; van Tienen, Carla; Dave, Sangeeta S.; Vincent, Tim; Rowland-Jones, Sarah L.; Glynn, Judith R.; Whittle, Hilton C.; van der Loeff, Maarten F. Schim

    2012-01-01

    Summary Objective To identify clinical predictors of mortality in HIV-2-infected individuals that may be used in place of CD4 count or plasma viral load (PVL) to guide treatment management in resource-limited settings. Methods A prospective community cohort study of HIV-infected and HIV-negative individuals in a rural area of Guinea-Bissau has been ongoing since 1989. In 2003 participants were invited for a clinical examination and blood tests. They were followed-up for vital status until 2010. Antiretroviral treatment (ART) became available in 2007. Cox regression was used to examine the association of clinical measures (World Health Organization (WHO) stage, body mass index (BMI), mid-upper arm circumference (MUAC), and WHO performance scale) measured in 2003 with subsequent mortality. Results In 2003, 146 HIV-2-infected individuals (68% women; mean age 56 years) were examined. Over the next 7 years, 44 (30%) died. BMI < 18.5 kg/m2 was associated with a crude mortality hazard ratio (HR) of 1.9 (95% confidence interval (CI) 1.0–3.9, p = 0.08); adjusted for age and sex, HR 1.8 (95% CI 0.9–3.8, p = 0.1). MUAC <230 mm in women and <240 mm in men was also associated with an elevated mortality HR, though statistical evidence was weak (crude HR 2.2, 95% CI 0.9–5.3, p = 0.1). WHO clinical stage and WHO performance scale were not associated with mortality (p = 0.6 and p = 0.2, respectively, for crude associations). Conclusions Baseline BMI, MUAC, WHO stage, and WHO performance scale were not strong or statistically significant predictors of mortality among HIV-2-infected individuals. CD4 count and PVL are more reliable tools, when available, for the management of HIV-2-infected patients in the community setting. PMID:22387142

  15. Role of B-Type Natriuretic Peptide and N-Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus.

    PubMed

    Wolsk, Emil; Claggett, Brian; Pfeffer, Marc A; Diaz, Rafael; Dickstein, Kenneth; Gerstein, Hertzel C; Lawson, Francesca C; Lewis, Eldrin F; Maggioni, Aldo P; McMurray, John J V; Probstfield, Jeffrey L; Riddle, Matthew C; Solomon, Scott D; Tardif, Jean-Claude; Køber, Lars

    2017-05-29

    Natriuretic peptides are recognized as important predictors of cardiovascular events in patients with heart failure, but less is known about their prognostic importance in patients with acute coronary syndrome. We sought to determine whether B-type natriuretic peptide (BNP) and N-terminal prohormone B-type natriuretic peptide (NT-proBNP) could enhance risk prediction of a broad range of cardiovascular outcomes in patients with acute coronary syndrome and type 2 diabetes mellitus. Patients with a recent acute coronary syndrome and type 2 diabetes mellitus were prospectively enrolled in the ELIXA trial (n=5525, follow-up time 26 months). Best risk models were constructed from relevant baseline variables with and without BNP/NT-proBNP. C statistics, Net Reclassification Index, and Integrated Discrimination Index were analyzed to estimate the value of adding BNP or NT-proBNP to best risk models. Overall, BNP and NT-proBNP were the most important predictors of all outcomes examined, irrespective of history of heart failure or any prior cardiovascular disease. BNP significantly improved C statistics when added to risk models for each outcome examined, the strongest increments being in death (0.77-0.82, P <0.001), cardiovascular death (0.77-0.83, P <0.001), and heart failure (0.84-0.87, P <0.001). BNP or NT-proBNP alone predicted death as well as all other variables combined (0.77 versus 0.77). In patients with a recent acute coronary syndrome and type 2 diabetes mellitus, BNP and NT-proBNP were powerful predictors of cardiovascular outcomes beyond heart failure and death, ie, were also predictive of MI and stroke. Natriuretic peptides added as much predictive information about death as all other conventional variables combined. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01147250. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  16. Why the Long Face? The Mechanics of Mandibular Symphysis Proportions in Crocodiles

    PubMed Central

    Walmsley, Christopher W.; Smits, Peter D.; Quayle, Michelle R.; McCurry, Matthew R.; Richards, Heather S.; Oldfield, Christopher C.; Wroe, Stephen; Clausen, Phillip D.; McHenry, Colin R.

    2013-01-01

    Background Crocodilians exhibit a spectrum of rostral shape from long snouted (longirostrine), through to short snouted (brevirostrine) morphologies. The proportional length of the mandibular symphysis correlates consistently with rostral shape, forming as much as 50% of the mandible’s length in longirostrine forms, but 10% in brevirostrine crocodilians. Here we analyse the structural consequences of an elongate mandibular symphysis in relation to feeding behaviours. Methods/Principal Findings Simple beam and high resolution Finite Element (FE) models of seven species of crocodile were analysed under loads simulating biting, shaking and twisting. Using beam theory, we statistically compared multiple hypotheses of which morphological variables should control the biomechanical response. Brevi- and mesorostrine morphologies were found to consistently outperform longirostrine types when subject to equivalent biting, shaking and twisting loads. The best predictors of performance for biting and twisting loads in FE models were overall length and symphyseal length respectively; for shaking loads symphyseal length and a multivariate measurement of shape (PC1– which is strongly but not exclusively correlated with symphyseal length) were equally good predictors. Linear measurements were better predictors than multivariate measurements of shape in biting and twisting loads. For both biting and shaking loads but not for twisting, simple beam models agree with best performance predictors in FE models. Conclusions/Significance Combining beam and FE modelling allows a priori hypotheses about the importance of morphological traits on biomechanics to be statistically tested. Short mandibular symphyses perform well under loads used for feeding upon large prey, but elongate symphyses incur high strains under equivalent loads, underlining the structural constraints to prey size in the longirostrine morphotype. The biomechanics of the crocodilian mandible are largely consistent with beam theory and can be predicted from simple morphological measurements, suggesting that crocodilians are a useful model for investigating the palaeobiomechanics of other aquatic tetrapods. PMID:23342027

  17. PREVALENCE AND DETERMINANTS OF STUNTING AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN OBAFEMI OWODE LOCAL GOVERNMENT AREA, SOUTHWESTERN NIGERIA

    PubMed Central

    Adenuga, W.U.; Obembe, T.A.; Odebunmi, K.O.; Asuzu, M.C.

    2017-01-01

    Background: Studies on stunting in children have largely focused on the underfive, establishing it as a strong predictor of mortality in these children. Few studies have documented the prevalence or determinants of stunting among school children in southwestern Nigeria. The aim of the study was to determine the prevalence and predictors of stunting among selected primary school children in rural and urban communities of Obafemi Owode Local Government Area, Ogun State. Method: A cross-sectional study of rural and urban primary school children was conducted. An interviewer-administered questionnaire was used to collect information on respondents' and parents' socio-demographic characteristics. Stunting was defined as height-for-age less than two standard deviations from the median height-for-age of the standard World Health Organization reference population. Using EPI-INFO version 6.03, children were classified as stunted if z-scores of height-for-age were less than 2 standard deviations below the National Centre for Health statistics (NCHS)/WHO median. Height and weight were taken using a stadiometer and weighing scale respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 16.0 while predictors were determined using logistic regression at 95% level of significance. Results: A total of 1,160 primary school children were studied with 52.2% from rural schools. Males constituted 57.1% and 51.8% in the rural and urban school respectively. Prevalence of stunting among rural school children was 46.2%, and was significantly higher (p≤0.001) than among urban children at 33.8%. Younger children <10 years (OR: 0.088; 95CI: 0.052 - 0.150) and children between 11-12 years (OR: 0.534; 95CI: 0.322 - 0.886) were at a significantly lower risk of stunting both in rural schools compared to children >13 years. Conclusion: The prevalence of stunting was high especially among pupils from schools in the rural communities. This underscores the need for urgent feasible and effective nutrition programs for primary school children especially those in rural schools within the study area. PMID:28970765

  18. Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study

    PubMed Central

    2014-01-01

    Background The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results. Methods We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data. Results At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students. Conclusions Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students. PMID:24996637

  19. Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study.

    PubMed

    Kötter, Thomas; Tautphäus, Yannick; Scherer, Martin; Voltmer, Edgar

    2014-07-04

    The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results. We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data. At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students. Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students.

  20. Family Atmosphere and Relationships as Predictors of Heroin Addiction.

    PubMed

    Mirković-Hajdukov, Mitra; Spahić, Tamara Efendić; Softić, Rusmir; Bećirović, Elvir; Šimić, Josip

    2017-05-01

    Studies show that dysfunctional family relationships are important predictors of addictions to all psychoactive substances. To establish if there is a connection between family relations and heroin addiction and if found to exist, what is the quality of this connection. This research was conducted on the sample comprised of 160 subjects divided into two groups. The first group consisted of 61 heroin addicts treated at the Tuzla University Clinical Centre Psychiatric Hospital. The second group consisted of 99 subjects who were students at the Tuzla University Faculties of Philosophy and Electrical Engineering and who were not using any psychoactive substances. The subjects were tested with the Quality of Family Interactions Scale (KOBI) which measures the interactions between children and parents in two dimensions, described in literature as 'acceptance' and 'rejection'. The research team established statistically significant differences between the heroin addicts and the students, the non-users, in terms of their family relationships. The results show that the addicts families were characterized by lack of understanding, by conflicts, rejection, non-acceptance by parents, while the non-users families were characterized by understanding, acceptance by parents and good communication. There is a connection between inter-family relationships and addiction. Namely, rejection and non-acceptance of children/persons by their families and parents, bad communication and dysfunctional family relationships are significant predictors of heroin addiction.

  1. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China

    PubMed Central

    Zhang, Juanjuan; Yan, Li; Fu, Wenlong; Yi, Jing; Chen, Yuzhi; Liu, Chuanhe; Xu, Dongqun; Wang, Qiang

    2016-01-01

    Background. Prevalence of childhood asthma varies significantly among regions, while its reasons are not clear yet with only a few studies reporting relevant causes for this variation. Objective. To investigate the potential role of city-average levels of air pollutants and climatic factors in order to distinguish differences in asthma prevalence in China and explain their reasons. Methods. Data pertaining to 10,777 asthmatic patients were obtained from the third nationwide survey of childhood asthma in China's urban areas. Annual mean concentrations of air pollutants and other climatic factors were obtained for the same period from several government departments. Data analysis was implemented with descriptive statistics, Pearson correlation coefficient, and multiple regression analysis. Results. Pearson correlation analysis showed that the situation of childhood asthma was strongly linked with SO2, relative humidity, and hours of sunshine (p < 0.05). Multiple regression analysis indicated that, among the predictor variables in the final step, SO2 was found to be the most powerful predictor variable amongst all (β = −19.572, p < 0.05). Furthermore, results had shown that hours of sunshine (β = −0.014, p < 0.05) was a significant component summary predictor variable. Conclusion. The findings of this study do not suggest that air pollutants or climate, at least in terms of children, plays a major role in explaining regional differences in asthma prevalence in China. PMID:27556031

  2. Prevalence and Predictors of Self-Medication with Antibiotics in Al Wazarat Health Center, Riyadh City, KSA

    PubMed Central

    Al Rasheed, Abdulrahman; Yagoub, Umar; Alkhashan, Hesham; Abdelhay, Osama; Alawwad, Ahmad; Al Aboud, Aboud; Al Battal, Saad

    2016-01-01

    Background. Antibiotics are responsible for most dramatic improvement in medical therapy in history. These medications contributed significantly to the decreasing mortality and morbidity when prescribed based on evidence of microbial infection. Objective. The aim of this study was to determine the prevalence and predictors of self-prescription with antibiotics in Al Wazarat Health Center, Riyadh City, Kingdom of Saudi Arabia. Material and Methods. Cross-sectional study was conducted in Al Wazarat Health Center between February 2014 and November 2014. Respondents were randomly selected using a multistage clustered random sampling technique. Data was entered into SPSS version 21 and analyzed. Descriptive statistics and multiple logistic regression models were applied. Results. A total of 681 patients have participated in this study with a response rate of 92%. The prevalence of self-prescription with antibiotics in Al Wazarat Health Center was 78.7%. Amoxicillin was the most used self-prescribed antibiotic with prevalence of (22.3%). Friend advice on self-prescription of antibiotics use (p = 0.000) and pharmacy near to the participants (p = 0.002) were the most common predictors for self-prescription with antibiotics. Conclusion. The level of self-prescribing antibiotics is relatively high among participants. Health education on the appropriate use of antibiotics is highly recommended. The proper use of treatment guidelines for antibiotic therapy will significantly reduce self-prescription with antibiotics. PMID:26881218

  3. Renal insufficiency predicts mortality in geriatric patients undergoing emergent general surgery.

    PubMed

    Yaghoubian, Arezou; Ge, Phillip; Tolan, Amy; Saltmarsh, Guy; Kaji, Amy H; Neville, Angela L; Bricker, Scott; De Virgilio, Christian

    2011-10-01

    Clinical predictors of perioperative mortality in geriatric patients undergoing emergent general surgery have not been well described. The purpose of this study was to determine the incidence of postoperative morbidity and mortality in geriatric patients and factors associated with mortality. A retrospective review of patients 65 years of age or older undergoing emergent general surgery at a public teaching hospital was performed over a 7-year period. Data collected included demographics, comorbidities, laboratory studies, perioperative morbidities, and mortality. Descriptive statistics and predictors of morbidity and mortality are described. The mean age was 74 years. Indications for surgery included small bowel obstruction (24%), diverticulitis (20%), perforated viscous (16%), and large bowel obstruction (9%). The overall complication rate was 41 per cent with six cardiac complications (14%) and seven perioperative (16%) deaths. Mean admission serum creatinine was significantly higher in patients who died (3.6 vs 1.5 mg/dL, P = 0.004). Mortality for patients with an admission serum creatinine greater than 2.0 mg/dL was 42 per cent (5 of 12) compared with 3 per cent (2 of 32) for those 2.0 mg/dL or less (OR, 10.7; CI, 1.7 to 67; P = 0.01). Morbidity and mortality in geriatric patients undergoing emergency surgery remains high with the most significant predictor of mortality being the presence of renal insufficiency on admission.

  4. Risk factors predicting hip pain in a 5-year prospective cohort study.

    PubMed

    Tüchsen, Finn; Hannerz, Harald; Burr, Hermann; Lund, Thomas; Krause, Niklas

    2003-02-01

    The aim of the study was to identify and quantify risk factors for hip pain. A representative sample of 5001 Danish men and women aged 18-65 years in 1990 were interviewed about occupational exposures (response rate 90%); 5 years later they were reinterviewed about hip pain (response rate 86%). Logistic regression with forced entry of all the independent variables was used to estimate the odds ratios for the possible risk factors. The impact of the various predictors was assessed through the calculation of population etiologic fractions. A double risk of hip pain was found for the women as compared with the men [odds ratio (OR) 2.28, 95% confidence interval (95% CI) 1.68-3.09]. The risk increased with body mass index. Whole-body vibration (OR 1.86, 95% CI 1.09-2.71) and physically demanding work (OR 1.83, 95% CI 1.23-2.71) were strong predictors of hip pain, while a squatting work posture was protective (OR 0.64, 95% CI 0.42-0.98). The impact of the statistically significant predictors (the etiologic fractions) was as follows: 0.49 for body mass index, 0.05 for whole body vibration, 0.10 for physically demanding work, and 0.32 for squatting (preventive). Female gender, age, high body mass index, whole-body vibration, and physically demanding work are significant risk factors for hip pain.

  5. RN work engagement in generational cohorts: the view from rural US hospitals.

    PubMed

    Sullivan Havens, Donna; Warshawsky, Nora E; Vasey, Joseph

    2013-10-01

    To describe staff nurse work engagement, identify predictors by generational cohort, present implications for nurse managers and suggest future research. A global nurse shortage looms. While an adequate supply of nurses is needed to ensure access to care, access to quality care may be enhanced by an adequate supply of highly engaged nurses-those who are dedicated, energized, and absorbed. Nurses have long reported the presence of energy depleting practice environments. Nurses practicing in professional practice environments may be more engaged. A non-experimental survey design was executed. Direct care Registered Nurses (n = 747) working in five rural acute care hospitals completed questionnaires to assess work engagement (Utrecht Work Engagement Scale-9), decisional involvement (Decisional Involvement Scale), relational coordination (Relational Coordination Survey) and the nursing practice environment (Practice Environment Scale of the Nursing Work Index). Descriptive, correlational and regression analyses examined work engagement and predictors by generational cohort. With the exception of the absorption component, no statistically significant differences in engagement emerged across generational cohorts. Predictors of engagement differed by cohort, however across all cohorts, professional nursing practice environments predicted nurse work engagement. Professional nursing practice environments are significantly associated with nurse work engagement. Enhancing nurse work engagement is a complex challenge. Generational cohorts may respond to different strategies to enhance engagement. © 2013 John Wiley & Sons Ltd.

  6. Aneurysm Morphology and Prediction of Rupture: An International Study of Unruptured Intracranial Aneurysms Analysis.

    PubMed

    Mocco, J; Brown, Robert D; Torner, James C; Capuano, Ana W; Fargen, Kyle M; Raghavan, Madhavan L; Piepgras, David G; Meissner, Irene; Huston, John

    2018-04-01

    There are conflicting data between natural history studies suggesting a very low risk of rupture for small, unruptured intracranial aneurysms and retrospective studies that have identified a much higher frequency of small, ruptured aneurysms than expected. To use the prospective International Study of Unruptured Intracranial Aneurysms cohort to identify morphological characteristics predictive of unruptured intracranial aneurysm rupture. A case-control design was used to analyze morphological characteristics associated with aneurysm rupture in the International Study of Unruptured Intracranial Aneurysms database. Fifty-seven patients with ruptured aneurysms during follow-up were matched (by size and location) with 198 patients with unruptured intracranial aneurysms without rupture during follow-up. Twelve morphological metrics were measured from cerebral angiograms in a blinded fashion. Perpendicular height (P = .008) and size ratio (ratio of maximum diameter to the parent vessel diameter; P = .01) were predictors of aneurysm rupture on univariate analysis. Aspect ratio, daughter sacs, multiple lobes, aneurysm angle, neck diameter, parent vessel diameter, and calculated aneurysm volume were not statistically significant predictors of rupture. On multivariate analysis, perpendicular height was the only significant predictor of rupture (Chi-square 7.1, P-value .008). This study underscores the importance of other morphological factors, such as perpendicular height and size ratio, that may influence unruptured intracranial aneurysm rupture risk in addition to greatest diameter and anterior vs posterior location.

  7. Relationship Between Total and Bioaccessible Lead on Children's Blood Lead Levels in Urban Residential Philadelphia Soils.

    PubMed

    Bradham, Karen D; Nelson, Clay M; Kelly, Jack; Pomales, Ana; Scruton, Karen; Dignam, Tim; Misenheimer, John C; Li, Kevin; Obenour, Daniel R; Thomas, David J

    2017-09-05

    Relationships between total soil or bioaccessible lead (Pb), measured using an in vitro bioaccessibility assay, and children's blood lead levels (BLL) were investigated in an urban neighborhood in Philadelphia, PA, with a history of soil Pb contamination. Soil samples from 38 homes were analyzed to determine whether accounting for the bioaccessible Pb fraction improves statistical relationships with children's BLLs. Total soil Pb concentration ranged from 58 to 2821 mg/kg; the bioaccessible Pb concentration ranged from 47 to 2567 mg/kg. Children's BLLs ranged from 0.3 to 9.8 μg/dL. Hierarchical models were used to compare relationships between total or bioaccessible Pb in soil and children's BLLs. Total soil Pb concentration as the predictor accounted for 23% of the variability in child BLL; bioaccessible soil Pb concentration as the predictor accounted for 26% of BLL variability. A bootstrapping analysis confirmed a significant increase in R 2 for the model using bioaccessible soil Pb concentration as the predictor with 99.0% of bootstraps showing a positive increase. Estimated increases of 1.3 μg/dL and 1.5 μg/dL in BLL per 1000 mg/kg Pb in soil were observed for this study area using total and bioaccessible Pb concentrations, respectively. Children's age did not contribute significantly to the prediction of BLLs.

  8. Differentiation of benign and malignant ampullary obstruction by multi-row detector CT.

    PubMed

    Angthong, Wirana; Jiarakoop, Kran; Tangtiang, Kaan

    2018-05-21

    To determine useful CT parameters to differentiate ampullary carcinomas from benign ampullary obstruction. This study included 93 patients who underwent abdominal CT, 31 patients with ampullary carcinomas, and 62 patients with benign ampullary obstruction. Two radiologists independently evaluated CT parameters then reached consensus decisions. Statistically significant CT parameters were identified through univariate and multivariate analyses. In univariate analysis, the presence of ampullary mass, asymmetric, abrupt narrowing of distal common bile duct (CBD), dilated intrahepatic bile duct (IHD), dilated pancreatic duct (PD), peripancreatic lymphadenopathy, duodenal wall thickening, and delayed enhancement were more frequently in ampullary carcinomas observed (P < 0.05). Multivariate logistic regression analysis using significant CT parameters and clinical data from univariate analysis, and clinical symptom with jaundice (P = 0.005) was an independent predictor of ampullary carcinomas. For multivariate analysis using only significant CT parameters, abrupt narrowing of distal CBD was an independent predictor of ampullary carcinomas (P = 0.019). Among various CT criteria, abrupt narrowing of distal CBD and dilated IHD had highest sensitivity (77.4%) and highest accuracy (90.3%). The abrupt narrowing of distal CBD and dilated IHD is useful for differentiation of ampullary carcinomas from benign entity in patients without the presence of mass.

  9. Improving performance in thermodynamics: Integrating learning by teaching pedagogy

    NASA Astrophysics Data System (ADS)

    Campagni, Jamie Anthony

    Historically, Thermo is perceived to be the most challenging course in the MET Curriculum at UNC Charlotte. The complexity and difficulties of this course have contributed to the some of the highest DFW rates compared to any other courses offered within the MET program. One hypothesis contributing to high DFW rates is the pedagogy in which Thermo is taught, which is the foundation of this study. Implementation of LBT in the spring 2014 offering of Thermo was deemed a success. The DFW rate in spring 2014 was reduced by 19 percentage points compared to the DFW rate in spring 2013, which exceeded the target of 10 percentage points. However, only cumulative GPA was a significant predictor of whether a student passed or failed the course. The semester in which students took Thermo was not a significant predictor. Students in the spring 2014 semester also exhibited statistically significant higher final exam averages compared to the 2012 and 2013 semesters. In general, students felt that LBT activities enhanced their learning and application of Thermodynamic concepts. Students had a very positive perception of LBT compared to traditional lecture in that 100% of students would recommend this teaching style to other students.

  10. Echo Decorrelation Imaging of Rabbit Liver and VX2 Tumor during In Vivo Ultrasound Ablation.

    PubMed

    Fosnight, Tyler R; Hooi, Fong Ming; Keil, Ryan D; Ross, Alexander P; Subramanian, Swetha; Akinyi, Teckla G; Killin, Jakob K; Barthe, Peter G; Rudich, Steven M; Ahmad, Syed A; Rao, Marepalli B; Mast, T Douglas

    2017-01-01

    In open surgical procedures, image-ablate ultrasound arrays performed thermal ablation and imaging on rabbit liver lobes with implanted VX2 tumor. Treatments included unfocused (bulk ultrasound ablation, N = 10) and focused (high-intensity focused ultrasound ablation, N = 13) exposure conditions. Echo decorrelation and integrated backscatter images were formed from pulse-echo data recorded during rest periods after each therapy pulse. Echo decorrelation images were corrected for artifacts using decorrelation measured prior to ablation. Ablation prediction performance was assessed using receiver operating characteristic curves. Results revealed significantly increased echo decorrelation and integrated backscatter in both ablated liver and ablated tumor relative to unablated tissue, with larger differences observed in liver than in tumor. For receiver operating characteristic curves computed from all ablation exposures, both echo decorrelation and integrated backscatter predicted liver and tumor ablation with statistically significant success, and echo decorrelation was significantly better as a predictor of liver ablation. These results indicate echo decorrelation imaging is a successful predictor of local thermal ablation in both normal liver and tumor tissue, with potential for real-time therapy monitoring. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Attachment and compassion fatigue among American and Israeli mental health clinicians working with traumatized victims of terrorism.

    PubMed

    Racanelli, Christine

    2005-01-01

    This study compared the construct of compassion fatigue with the role of attachment as a potential mediator among mental health clinicians working with victims of terrorism in the New York metropolitan region of the United States and Israel. Differences between clinicians practicing within Israel (n = 31) and New York (n = 35), in terms of their symptoms of compassion fatigue, compassion satisfaction, and "burnout," were not significant, as measured by multivariate analyses of variance. Based upon nonsignificant differences, mediational statistical tests could not be run; thus, mediation did not hold. The data failed to support a significant difference between compassion fatigue and attachment avoidance or anxiety. However, data collection resulted in attenuated scores for compassion fatigue and compassion satisfaction within both study groups of clinicians and moderate to average scores for burnout. Israeli clinicians had significantly more avoidant attachment dimensions than their New York cohorts. The strongest predictors of compassion satisfaction were (a) low attachment anxiety and (b) sufficient clinical experience related to treating victims of trauma. The strongest predictors of burnout were (a) minimal clinical experience, (b) minimal experience working with trauma victims, and (c) greater avoidant attachment dimensions.

  12. [Structural equation modeling on contraception behavior of unmarried men and women in Korea: gender difference].

    PubMed

    Hwang, Shin Woo; Chung, Chae Weon

    2014-04-01

    The purpose of this study was to test and validate a model to predict contraception behavior in unmarried men and women. Data were collected from a questionnaire survey of 180 unmarried men and 186 unmarried women 20 years of age or over who had sexual relationships in the past 6 months. Participants were from Seoul, Kyunggi, Daegu, and Busan and data collection was done from February 19 to April 16, 2013. Model fit indices for the hypotheoretical model fitted to the recommended levels. Out of 15 paths, 11 were statistically significant in both. Predictors of contraception behavior in unmarried men and women were intention to use contraception and self-efficacy for contraception. Exposure to sexual content was directly significant to the intention in men only. Self-efficacy for contraception was affected by perceived threat of pregnancy and gender role attitude. In women, the two predictors were also significant except for the effect of exposure to sexual contents. Results indicate that an intervention program which increases self-efficacy in unmarried men and women contributes to effective contraception behavior. In addition, proper sexual education programs using positive aspect of mass media can help develop active participation for contraception behavior.

  13. Examining the Relationship Between Nursing Informatics Competency and the Quality of Information Processing.

    PubMed

    Al-Hawamdih, Sajidah; Ahmad, Muayyad M

    2018-03-01

    The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months. The analysis showed that nine predictors explained 22% of the variance in the quality of information processing, whereas the statistically significant predictors were nursing informatics competency, clinical specialty, and years of nursing experience. There is a need for policies that advocate for every nurse to be educated in nursing informatics and the quality of information processing.

  14. The Impact of Critical Thinking on Clinical Judgment During Simulation With Senior Nursing Students.

    PubMed

    Cazzell, Mary; Anderson, Mindi

    2016-01-01

    The study examined the impact of critical thinking (CT) on clinical judgment (CJ) during a pediatric Objective Structured Clinical Evaluation (OSCE) with 160 pre-licensure nursing students. Educators are called to transform teaching strategies to develop CJ but confusion exists over definitions. A descriptive correlational design was used to examine demographics and Tower of Hanoi (TOH) and Health Science Reasoning Test (HSRT) scores. CJ was measured by scores on the Lasater Clinical Judgment Rubric (LCJR) from videotaped OSCEs. Participants were: 86 percent female, 42 percent Caucasian, median 23 years, with 49 percent having health care experience. Students averaged seven moves over minimum on the TOH. Average scores were: HSRT 25/38 and LCJR 31/44. Statistically significant predictors of CJ were gender, ethnicity, HSRT deduction, and analysis; 11 CT variables accounted for 17 percent of LCJR scores. Educators need to utilize/develop innovative teaching strategies addressing CJ predictors.

  15. Predictors of attributional style change in children.

    PubMed

    Gibb, Brandon E; Alloy, Lauren B; Walshaw, Patricia D; Comer, Jonathan S; Shen, Gail H C; Villari, Annette G

    2006-06-01

    A number of studies have supported the hypothesis that negative attributional styles may confer vulnerability to the development of depression. The goal of this study was to explore factors that may contribute to the development of negative attributional styles in children. As hypothesized, elevated levels of depressive symptoms and hopelessness at the initial assessment predicted negative changes in children's attributional styles over the 6-month follow-up period. In addition, elevated levels of verbal victimization occurring between the 2 assessments, as well as that occurring in the 6 months preceding the initial assessment, prospectively predicted negative changes in children's attributional styles over the follow-up. Further, initial depressive symptoms and verbal victimization during the follow-up continued to significantly predict attributional style change even when the overlap among the predictors was statistically controlled. Contrary to the hypotheses, however, neither parent-reported levels of overall negative life events nor parents' attributions for their children's events predicted changes in children's attributional styles.

  16. Internet addiction is related to attention deficit but not hyperactivity in a sample of high school students.

    PubMed

    Yılmaz, Savaş; Hergüner, Sabri; Bilgiç, Ayhan; Işık, Ümit

    2015-03-01

    To assess the effects of attention-deficit/hyperactivity disorder (ADHD) symptom dimensions on Internet addiction (IA) after controlling for Internet usage features among high school students. This study consisted of 640 students (331 females and 309 males) ranging from 14 to 19 years of age. The Internet Addiction Scale, the Conners-Wells' Adolescent Self-Report Scale-Short Form, and a personal information form were completed by the participants. Statistical analyses were conducted for both sexes and the total sample. According to the logistic regression analysis, attention deficit and playing online games were significant predictors of IA in both sexes. Other predictors of IA included behavioral problems for females, total weekly Internet usage time, and lifelong total Internet use for males. Hyperactivity and other Internet usage features did not predict IA. These results suggest that attention deficit and playing online games are important determinants of IA in this age group.

  17. Predictors of salivary fistula after total laryngectomy.

    PubMed

    Sousa, Alexandre de Andrade; Porcaro-Salles, José Maria; Soares, João Marcos Arantes; de Moraes, Gustavo Meyer; Carvalho, Jomar Rezende; Silva, Guilherme Souza; Savassi-Rocha, Paulo Roberto

    2013-01-01

    To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.

  18. Artificial neural network modeling of the water quality index using land use areas as predictors.

    PubMed

    Gazzaz, Nabeel M; Yusoff, Mohd Kamil; Ramli, Mohammad Firuz; Juahir, Hafizan; Aris, Ahmad Zaharin

    2015-02-01

    This paper describes the design of an artificial neural network (ANN) model to predict the water quality index (WQI) using land use areas as predictors. Ten-year records of land use statistics and water quality data for Kinta River (Malaysia) were employed in the modeling process. The most accurate WQI predictions were obtained with the network architecture 7-23-1; the back propagation training algorithm; and a learning rate of 0.02. The WQI forecasts of this model had significant (p < 0.01), positive, very high correlation (ρs = 0.882) with the measured WQI values. Sensitivity analysis revealed that the relative importance of the land use classes to WQI predictions followed the order: mining > rubber > forest > logging > urban areas > agriculture > oil palm. These findings show that the ANNs are highly reliable means of relating water quality to land use, thus integrating land use development with river water quality management.

  19. Crop weather models of barley and spring wheat yield for agrophysical units in North Dakota

    NASA Technical Reports Server (NTRS)

    Leduc, S. (Principal Investigator)

    1982-01-01

    Models based on multiple regression were developed to estimate barley yield and spring wheat yield from weather data for Agrophysical units(APU) in North Dakota. The predictor variables are derived from monthly average temperature and monthly total precipitation data at meteorological stations in the cooperative network. The models are similar in form to the previous models developed for Crop Reporting Districts (CRD). The trends and derived variables were the same and the approach to select the significant predictors was similar to that used in developing the CRD models. The APU models show sight improvements in some of the statistics of the models, e.g., explained variation. These models are to be independently evaluated and compared to the previously evaluated CRD models. The comparison will indicate the preferred model area for this application, i.e., APU or CRD.

  20. Juvenile Psychopathic Personality Traits are Associated with Poor Reading Achievement

    PubMed Central

    DeLisi, Matt; Beaver, Kevin M.; Wexler, Jade; Barth, Amy; Fletcher, Jack

    2011-01-01

    The current study sought to further the understanding of the linkage between maladaptive behavior and cognitive problems by examining the relations between psychopathic personality traits and reading comprehension performance. Data were derived from a study of 432 predominately African-American and Hispanic middle-school students. Dependent variables consisted of three measures of reading comprehension. Psychopathy measures included the Inventory of Callous-Unemotional traits (ICU—teacher rated) and the self-reported Youth Psychopathic traits Inventory (YPI). Findings from regression models indicated that self-report and teacher ratings of psychopathy were statistically significant inverse predictors of reading performance. Specifically, affective facets of psychopathy were potent predictors of reading comprehension over and above ADHD, IQ, and an impulsivity component of psychopathy. Study results extend the utility of psychopathy construct generally and affective traits specifically to reading achievement, which has broad implications. Findings are discussed with respect to future research and prevention. PMID:20957434

  1. Experience of elder abuse among older Korean immigrants.

    PubMed

    Chang, Miya

    2016-01-01

    Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims' health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.

  2. Executive functions as predictors of visual-motor integration in children with intellectual disability.

    PubMed

    Memisevic, Haris; Sinanovic, Osman

    2013-12-01

    The goal of this study was to assess the relationship between visual-motor integration and executive functions, and in particular, the extent to which executive functions can predict visual-motor integration skills in children with intellectual disability. The sample consisted of 90 children (54 boys, 36 girls; M age = 11.3 yr., SD = 2.7, range 7-15) with intellectual disabilities of various etiologies. The measure of executive functions were 8 subscales of the Behavioral Rating Inventory of Executive Function (BRIEF) consisting of Inhibition, Shifting, Emotional Control, Initiating, Working memory, Planning, Organization of material, and Monitoring. Visual-motor integration was measured with the Acadia test of visual-motor integration (VMI). Regression analysis revealed that BRIEF subscales explained 38% of the variance in VMI scores. Of all the BRIEF subscales, only two were statistically significant predictors of visual-motor integration: Working memory and Monitoring. Possible implications of this finding are further elaborated.

  3. Investigating the cognitive structure of stereotypes: Generic beliefs about groups predict social judgments better than statistical beliefs.

    PubMed

    Hammond, Matthew D; Cimpian, Andrei

    2017-05-01

    Stereotypes are typically defined as beliefs about groups, but this definition is underspecified. Beliefs about groups can be generic or statistical. Generic beliefs attribute features to entire groups (e.g., men are strong), whereas statistical beliefs encode the perceived prevalence of features (e.g., how common it is for men to be strong). In the present research, we sought to determine which beliefs-generic or statistical-are more central to the cognitive structure of stereotypes. Specifically, we tested whether generic or statistical beliefs are more influential in people's social judgments, on the assumption that greater functional importance indicates greater centrality in stereotype structure. Relative to statistical beliefs, generic beliefs about social groups were significantly stronger predictors of expectations (Studies 1-3) and explanations (Study 4) for unfamiliar individuals' traits. In addition, consistent with prior evidence that generic beliefs are cognitively simpler than statistical beliefs, generic beliefs were particularly predictive of social judgments for participants with more intuitive (vs. analytic) cognitive styles and for participants higher (vs. lower) in authoritarianism, who tend to view outgroups in simplistic, all-or-none terms. The present studies suggest that generic beliefs about groups are more central than statistical beliefs to the cognitive structure of stereotypes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Bayesian depth estimation from monocular natural images.

    PubMed

    Su, Che-Chun; Cormack, Lawrence K; Bovik, Alan C

    2017-05-01

    Estimating an accurate and naturalistic dense depth map from a single monocular photographic image is a difficult problem. Nevertheless, human observers have little difficulty understanding the depth structure implied by photographs. Two-dimensional (2D) images of the real-world environment contain significant statistical information regarding the three-dimensional (3D) structure of the world that the vision system likely exploits to compute perceived depth, monocularly as well as binocularly. Toward understanding how this might be accomplished, we propose a Bayesian model of monocular depth computation that recovers detailed 3D scene structures by extracting reliable, robust, depth-sensitive statistical features from single natural images. These features are derived using well-accepted univariate natural scene statistics (NSS) models and recent bivariate/correlation NSS models that describe the relationships between 2D photographic images and their associated depth maps. This is accomplished by building a dictionary of canonical local depth patterns from which NSS features are extracted as prior information. The dictionary is used to create a multivariate Gaussian mixture (MGM) likelihood model that associates local image features with depth patterns. A simple Bayesian predictor is then used to form spatial depth estimates. The depth results produced by the model, despite its simplicity, correlate well with ground-truth depths measured by a current-generation terrestrial light detection and ranging (LIDAR) scanner. Such a strong form of statistical depth information could be used by the visual system when creating overall estimated depth maps incorporating stereopsis, accommodation, and other conditions. Indeed, even in isolation, the Bayesian predictor delivers depth estimates that are competitive with state-of-the-art "computer vision" methods that utilize highly engineered image features and sophisticated machine learning algorithms.

  5. The Alzheimer’s Disease Neuroimaging Initiative: Progress report and future plans

    PubMed Central

    Weiner, Michael W.; Aisen, Paul S.; Jack, Clifford R.; Jagust, William J.; Trojanowski, John Q.; Shaw, Leslie; Saykin, Andrew J.; Morris, John C.; Cairns, Nigel; Beckett, Laurel A.; Toga, Arthur; Green, Robert; Walter, Sarah; Soares, Holly; Snyder, Peter; Siemers, Eric; Potter, William; Cole, Patricia E.; Schmidt, Mark

    2010-01-01

    The Alzheimer’s Disease Neuroimaging Initiative (ADNI) beginning in October 2004, is a 6-year re-search project that studies changes of cognition, function, brain structure and function, and biomarkers in elderly controls, subjects with mild cognitive impairment, and subjects with Alzheimer’s disease (AD). A major goal is to determine and validate MRI, PET images, and cerebrospinal fluid (CSF)/blood biomarkers as predictors and outcomes for use in clinical trials of AD treatments. Structural MRI, FDG PET, C-11 Pittsburgh compound B (PIB) PET, CSF measurements of amyloid β (Aβ) and species of tau, with clinical/cognitive measurements were performed on elderly controls, subjects with mild cognitive impairment, and subjects with AD. Structural MRI shows high rates of brain atrophy, and has high statistical power for determining treatment effects. FDG PET, C-11 Pittsburgh compound B PET, and CSF measurements of Aβ and tau were significant predictors of cognitive decline and brain atrophy. All data are available at UCLA/LONI/ADNI, without embargo. ADNI-like projects started in Australia, Europe, Japan, and Korea. ADNI provides significant new information concerning the progression of AD. PMID:20451868

  6. Significance of Perceived Social Expectation and Implications to Conservation Education: Turtle Conservation as a Case Study

    NASA Astrophysics Data System (ADS)

    Lo, Alex Y.; Chow, Alex T.; Cheung, Sze Man

    2012-11-01

    The likelihood of participating in wildlife conservation programs is dependent on social influences and circumstances. This view is validated by a case study of behavioral intention to support conservation of Asian turtles. A total of 776 college students in China completed a questionnaire survey designed to identify factors associated with their intention to support conservation. A regression model explained 48 % of variance in the level of intention. Perceived social expectation was the strongest predictor, followed by attitudes toward turtle protection and perceived behavioral control, altogether explaining 44 %. Strong ethics and socio-economic variables had some statistical significant impacts and accounted for 3 % of the variance. The effects of general environmental awareness, trust and responsibility ascription were modest. Knowledge about turtles was a weak predictor. We conclude that perceived social expectation is a limiting factor of conservation behavior. Sustained interest and commitment to conservation can be created by enhancing positive social influences. Conservation educators should explore the potential of professionally supported, group-based actions that can nurture a sense of collective achievement as part of an educational campaign.

  7. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    PubMed

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p < .001) and the importance of receiving dental care (p < .001) were significant factors in relation to self-rated dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  8. Poor oral intake causes enteral nutrition dependency after concomitant chemoradiotherapy for pharyngeal cancers.

    PubMed

    Ishii, Ryo; Kato, Kengo; Ogawa, Takenori; Sato, Takeshi; Nakanome, Ayako; Ohkoshi, Akira; Kawamoto-Hirano, Ai; Shirakura, Masayuki; Hidaka, Hiroshi; Katori, Yukio

    2018-06-01

    To identify precipitating factors responsible for enteral nutrition (EN) dependency after concomitant chemoradiotherapy (CCRT) of head and neck cancers and to examine their statistical correlations. Factors related to feeding condition, nutritional status, disease, and treatment of 26 oropharyngeal and hypopharyngeal cancer patients who received definitive CCRT were retrospectively investigated by examining their medical records. The days of no oral intake (NOI) during hospitalization and the months using enteral nutrition after CCRT were counted as representing the feeding condition, and the changes in body weight (BW) were examined as reflecting nutritional status. The factors related to EN dependency after CCRT were analyzed. Long duration of total NOI (≥ 30 days) and maximum NOI ≥ 14 days were significant predictors of EN dependency. Decreased BW (≥ 7.5 kg) was the next predictor identified, but it was not significant. Multivariate analysis showed that the total duration of NOI was more correlated with EN dependency than changes in BW. A long duration of NOI was more strongly related to EN dependency than nutritional factors.

  9. Trends of abortion complications in a transition of abortion law revisions in Ethiopia.

    PubMed

    Gebrehiwot, Yirgu; Liabsuetrakul, Tippawan

    2009-03-01

    Evidence from developed countries has shown that abortion-related mortality and morbidity has decreased with the liberalization of the abortion law. This study aimed to assess the trend of hospital-based abortion complications during the transition of legalization in Ethiopia in May 2005. Medical records of women with abortion complications from 2003 to 2007 were reviewed (n = 773). Abortion and its complications with regard to legalization were described by rates and ratios, and predictors of fatal outcomes were analyzed by logistic regression. The overall and abortion-related maternal mortality ratios (AMMRs) showed a non-statistically significant downward trend over the 5-year period. However, the case fatality rate of abortion increased from 1.1% in 2003 to 3.6% in 2007. Late gestational age, history of interference and presenting after new abortion legislation passed have been found to be significant predictors of mortality. Decreased trends of abortion ratio and the AMMR were identified, but the severity of abortion complications and the case fatality rate increased during the transition of legal revision.

  10. Why significant variables aren't automatically good predictors.

    PubMed

    Lo, Adeline; Chernoff, Herman; Zheng, Tian; Lo, Shaw-Hwa

    2015-11-10

    Thus far, genome-wide association studies (GWAS) have been disappointing in the inability of investigators to use the results of identified, statistically significant variants in complex diseases to make predictions useful for personalized medicine. Why are significant variables not leading to good prediction of outcomes? We point out that this problem is prevalent in simple as well as complex data, in the sciences as well as the social sciences. We offer a brief explanation and some statistical insights on why higher significance cannot automatically imply stronger predictivity and illustrate through simulations and a real breast cancer example. We also demonstrate that highly predictive variables do not necessarily appear as highly significant, thus evading the researcher using significance-based methods. We point out that what makes variables good for prediction versus significance depends on different properties of the underlying distributions. If prediction is the goal, we must lay aside significance as the only selection standard. We suggest that progress in prediction requires efforts toward a new research agenda of searching for a novel criterion to retrieve highly predictive variables rather than highly significant variables. We offer an alternative approach that was not designed for significance, the partition retention method, which was very effective predicting on a long-studied breast cancer data set, by reducing the classification error rate from 30% to 8%.

  11. Global Positioning System (GPS) Precipitable Water in Forecasting Lightning at Spaceport Canaveral

    NASA Technical Reports Server (NTRS)

    Kehrer, Kristen C.; Graf, Brian; Roeder, William

    2006-01-01

    This paper evaluates the use of precipitable water (PW) from Global Positioning System (GPS) in lightning prediction. Additional independent verification of an earlier model is performed. This earlier model used binary logistic regression with the following four predictor variables optimally selected from a candidate list of 23 candidate predictors: the current precipitable water value for a given time of the day, the change in GPS-PW over the past 9 hours, the KIndex, and the electric field mill value. This earlier model was not optimized for any specific forecast interval, but showed promise for 6 hour and 1.5 hour forecasts. Two new models were developed and verified. These new models were optimized for two operationally significant forecast intervals. The first model was optimized for the 0.5 hour lightning advisories issued by the 45th Weather Squadron. An additional 1.5 hours was allowed for sensor dwell, communication, calculation, analysis, and advisory decision by the forecaster. Therefore the 0.5 hour advisory model became a 2 hour forecast model for lightning within the 45th Weather Squadron advisory areas. The second model was optimized for major ground processing operations supported by the 45th Weather Squadron, which can require lightning forecasts with a lead-time of up to 7.5 hours. Using the same 1.5 lag as in the other new model, this became a 9 hour forecast model for lightning within 37 km (20 NM)) of the 45th Weather Squadron advisory areas. The two new models were built using binary logistic regression from a list of 26 candidate predictor variables: the current GPS-PW value, the change of GPS-PW over 0.5 hour increments from 0.5 to 12 hours, and the K-index. The new 2 hour model found the following for predictors to be statistically significant, listed in decreasing order of contribution to the forecast: the 0.5 hour change in GPS-PW, the 7.5 hour change in GPS-PW, the current GPS-PW value, and the KIndex. The new 9 hour forecast model found the following five independent variables to be statistically significant, listed in decreasing order of contribution to the forecast: the current GPSPW value, the 8.5 hour change in GPS-PW, the 3.5 hour change in GPS-PW, the 12 hour change in GPS-PW, and the K-Index. In both models, the GPS-PW parameters had better correlation to the lightning forecast than the K-Index, a widely used thunderstorm index. Possible future improvements to this study are discussed.

  12. Early and Mid-Term Outcome of Pediatric Congenital Mitral Valve Surgery

    PubMed Central

    Baghaei, Ramin; Tabib, Avisa; Jalili, Farshad; Totonchi, Ziae; Mahdavi, Mohammad; Ghadrdoost, Behshid

    2015-01-01

    Background: Congenital lesions of the mitral valve are relatively rare and are associated with a wide spectrum of cardiac malformations. The surgical management of congenital mitral valve malformations has been a great challenge. Objectives: The aim of this study was to evaluate the early and intermediate-term outcome of congenital mitral valve (MV) surgery in children and to identify the predictors for poor postoperative outcomes and death. Patients and Methods: In this retrospective study, 100 consecutive patients with congenital MV disease undergoing mitral valve surgery were reviewed in 60-month follow-up (mean, 42.4 ± 16.4 months) during 2008 - 2013. Twenty-six patients (26%) were under one-year old. The mean age and weight of the patients were 41.63 ± 38.18 months and 11.92 ± 6.12 kg, respectively. The predominant lesion of the mitral valve was MV stenosis (MS group) seen in 21% and MR (MR group) seen in 79% of the patients. All patients underwent preoperative two-dimensional echocardiography and then every six months after surgery Results: Significant improvement in degree of MR was noted in all patients with MR during postoperative and follow-up period in both patients with or without atrioventricular septal defect (AVSD) (P = 0.045 in patients with AVSD and P = 0.008 in patients without AVSD). Decreasing trend of mean gradient (MG) in MS group was statistically significant (P = 0.005). In patients with MR, the mean pulmonary artery pressure (PAP) had improved postoperatively (P < 0.001). Although PAP in patients with MV stenosis was reduced, this reduction was not statistically significant (P = 0.17). In-hospital mortality was 7%. Multivariate analysis demonstrated that age (P < 0.001), weight (P < 0.001), and pulmonary stenosis (P = 0.03) are strong predictors for mortality. Based on the echocardiography report at the day of discharge from hospital, surgical results were optimal (up to moderate degree for MR group and up to mild degree for MS group) in 85.7% of patients with MS and in 76.6% of patients with MR. Age (P = 0.002) and weight (P = 0.003) of patients are strong predictors for surgical success in multivariate analysis. Conclusions: Surgical repair of the congenital MV disease yields acceptable early and intermediate-term satisfactory valve function and good survival at intermediate-term follow-up. Strong predictors for poor surgical outcome and death were age smaller than 1 year, weight smaller or equal than 6 kg, and associated cardiac anomalies such as pulmonary stenosis. PMID:26446282

  13. Predictors of patients who will develop prolonged occult hypoperfusion following blunt trauma.

    PubMed

    Schulman, Andrew M; Claridge, Jeffrey A; Carr, Gordon; Diesen, Diana L; Young, Jeffrey S

    2004-10-01

    Prolonged occult hypoperfusion or POH (serum lactate >2.4 mmol/L persisting >12 hours from admission) represents a reversible risk factor for adverse outcomes following traumatic injury. We hypothesized that patients at increased risk for POH could be identified at the time of admission. Prospective data from adult trauma admissions between January 1, 1998 and December 31, 2000 were analyzed. Potential risk factors for POH were determined by univariate analysis (p < or =0.10= significant). Significant factors were tested in a logistic regression model (LR) (p < or =0.05= significant). The predictive ability of the LR was tested by receiver operating curve (ROC) analysis (p < or =0.05= significant). Three hundred seventy-eight patients were analyzed, 129 with POH. Injury Severity Score (ISS), emergency department Glasgow Coma Scale score, hypotension, and the individual Abbreviated Injury Scale score (AIS) for Head (H), Abdominal/Pelvic Viscera (A) and Pelvis/Bony Extremity (P) were significantly associated with POH. LR demonstrated that ISS, A-AIS > or =3 and P-AIS > or =3 were independent predictors of POH (p <0.05). ROC analysis of the LR equation was statistically significant (Area=0.69, p <0.001). We identified factors at admission that placed patients at higher risk for developing POH. Select patients may benefit from rapid, aggressive monitoring and resuscitation, possibly preventing POH and its associated morbidity and mortality.

  14. Neutrophil-to-lymphocyte ratio as a predictor of preoperative tumor staging in testicular germ cell tumors.

    PubMed

    Jankovich, M; Jankovichova, T; Ondrus, D; Breza, J

    2017-01-01

    The aim of our study was to evaluate associations of elevated preoperative neutrophil-to-lymphocyte ratio (NLR) with testicular germ cell tumors (GCT) characteristics other than cancer specific survival (CSS) and progression free survival (PFS). NLR was recently presented as a widely available and inexpensive marker of poor prognosis in several types of solid tumors. Previous study showed no predictive value of NLR for CSS and PFS in testicular GCT. Association of high NLR with histological type of tumor, presence of metastatic disease preoperatively and worse than T1 stadium in TNM classification preoperatively was analyzed in 103 patients who underwent radical orchiectomy for testicular GCT. No statistically significant difference in the prevalence of seminomas and non-seminomas neither in the group with NLR≥4 (p=0.6698) nor in the group with NLR<4 (p=0.9115) was detected. Similarly, no statistically significant difference in the prevalence of metastatic and non-metastatic disease in the group with NLR≥4 (p=0.2008), however statistically significant higher prevalence of non-metastatic disease in the group with NLR<4 (p=0.0001) was found. There was a statistically significant higher number of patients with worse than T1 stadium in patients with NLR≥4 (p=0.0105), but not significant difference in the group with NLR<4 (p=0.0956). The results of our study showed that NLR lower than 4 predicts non-metastatic disease and NLR higher or equal 4 predicts worse than T1 stadium (Tab. 3, Ref. 12).

  15. Adult sports-related traumatic brain injury in United States trauma centers.

    PubMed

    Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to home. CONCLUSIONS Age, hypotension on ED admission, severity of head and extracranial injuries, and sports mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet use-particularly in equestrian and roller sports-are critical elements for decreasing sports-related TBI events in adults.

  16. Developing a spatial-statistical model and map of historical malaria prevalence in Botswana using a staged variable selection procedure

    PubMed Central

    Craig, Marlies H; Sharp, Brian L; Mabaso, Musawenkosi LH; Kleinschmidt, Immo

    2007-01-01

    Background Several malaria risk maps have been developed in recent years, many from the prevalence of infection data collated by the MARA (Mapping Malaria Risk in Africa) project, and using various environmental data sets as predictors. Variable selection is a major obstacle due to analytical problems caused by over-fitting, confounding and non-independence in the data. Testing and comparing every combination of explanatory variables in a Bayesian spatial framework remains unfeasible for most researchers. The aim of this study was to develop a malaria risk map using a systematic and practicable variable selection process for spatial analysis and mapping of historical malaria risk in Botswana. Results Of 50 potential explanatory variables from eight environmental data themes, 42 were significantly associated with malaria prevalence in univariate logistic regression and were ranked by the Akaike Information Criterion. Those correlated with higher-ranking relatives of the same environmental theme, were temporarily excluded. The remaining 14 candidates were ranked by selection frequency after running automated step-wise selection procedures on 1000 bootstrap samples drawn from the data. A non-spatial multiple-variable model was developed through step-wise inclusion in order of selection frequency. Previously excluded variables were then re-evaluated for inclusion, using further step-wise bootstrap procedures, resulting in the exclusion of another variable. Finally a Bayesian geo-statistical model using Markov Chain Monte Carlo simulation was fitted to the data, resulting in a final model of three predictor variables, namely summer rainfall, mean annual temperature and altitude. Each was independently and significantly associated with malaria prevalence after allowing for spatial correlation. This model was used to predict malaria prevalence at unobserved locations, producing a smooth risk map for the whole country. Conclusion We have produced a highly plausible and parsimonious model of historical malaria risk for Botswana from point-referenced data from a 1961/2 prevalence survey of malaria infection in 1–14 year old children. After starting with a list of 50 potential variables we ended with three highly plausible predictors, by applying a systematic and repeatable staged variable selection procedure that included a spatial analysis, which has application for other environmentally determined infectious diseases. All this was accomplished using general-purpose statistical software. PMID:17892584

  17. Assessing Threat Detection Scenarios through Hypothesis Generation and Testing

    DTIC Science & Technology

    2015-12-01

    Publications. Field, A. (2005). Discovering statistics using SPSS (2nd ed.). Thousand Oaks, CA: Sage Publications. Fisher, S. D., Gettys, C. F...therefore, subsequent F statistics are reported using the Huynh-Feldt correction (Greenhouse-Geisser Epsilon > .775). Experienced and inexperienced...change in hypothesis using experience and initial confidence as predictors. In the Dog Day scenario, the regression was not statistically

  18. Student and Teacher Factors as Predictors of Statistics Achievement in Federal School of Statistics Ibadan

    ERIC Educational Resources Information Center

    Adetona, Abel Adekanmi

    2017-01-01

    The study aimed at assessing how students and teachers factor taken together influence students' achievement in Statistics as well as their relative contribution to the prediction. Two research questions were raised and purposive sampling was adopted to select national diploma year 2 students since they are already in their final level in the…

  19. Statistical Prediction in Proprietary Rehabilitation.

    ERIC Educational Resources Information Center

    Johnson, Kurt L.; And Others

    1987-01-01

    Applied statistical methods to predict case expenditures for low back pain rehabilitation cases in proprietary rehabilitation. Extracted predictor variables from case records of 175 workers compensation claimants with some degree of permanent disability due to back injury. Performed several multiple regression analyses resulting in a formula that…

  20. Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at Bamenda Regional Hospital, Cameroon.

    PubMed

    Fondoh, Victor N; Mom, Njong A

    2017-01-01

    Mother-to-child transmission (MTCT) of HIV, has been a major global public health burden. Despite the use of antiretroviral prophylaxis by HIV-positive pregnant women and their infants, safe obstetric practice and safe infant feeding habits in the prevention of MTCT of HIV, the prevalence of HIV among HIV-exposed infants is still high in Cameroon. Our objectives were to determine the prevalence, assess the predictors and determine the effect of combination antiretroviral therapy (cART) on MTCT of HIV at the regional hospital in Bamenda, Cameroon. This was a retrospective study. Secondary data from 877 HIV-exposed infants aged ≤ 72 weeks were extracted from the records between January 2008 and December 2014. The predictors and effect of cART on MTCT of HIV were analysed using a multivariable logistic regression model and risk analysis, respectively. Out of 877 HIV-exposed infants, 62 were positive for HIV, giving a prevalence of 7.1%. Maternal antiretroviral intervention and infant age group were statistically significant predictors of MTCT of HIV. HIV-positive mothers who were on cART were 2.49 times less likely to transmit HIV than those who were not on cART. In order to reduce the prevalence of HIV among HIV-exposed infants, maternal antiretroviral intervention should be targeted and the use of cART by HIV-positive pregnant women should be encouraged.

  1. Mental Health Treatment Among Soldiers With Current Mental Disorders in the Army Study to Assess Risk and Resilience in Service Members (Army STARRS).

    PubMed

    Colpe, Lisa J; Naifeh, James A; Aliaga, Pablo A; Sampson, Nancy A; Heeringa, Steven G; Stein, Murray B; Ursano, Robert J; Fullerton, Carol S; Nock, Matthew K; Schoenbaum, Michael L; Zaslavsky, Alan M; Kessler, Ronald C

    2015-10-01

    A representative sample of 5,428 nondeployed Regular Army soldiers completed a self-administered questionnaire (SAQ) and consented to linking SAQ data with administrative records as part of the Army Study to Assess Risk and Resilience in Service members. The SAQ included information about prevalence and treatment of mental disorders among respondents with current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) internalizing (anxiety, mood) and externalizing (disruptive behavior, substance) disorders. 21.3% of soldiers with any current disorder reported current treatment. Seven significant predictors of being in treatment were identified. Four of these 7 were indicators of psychopathology (bipolar disorder, panic disorder, post-traumatic stress disorder, 8+ months duration of disorder). Two were sociodemographics (history of marriage, not being non-Hispanic Black). The final predictor was history of deployment. Treatment rates varied between 4.7 and 71.5% depending on how many positive predictors the soldier had. The vast majority of soldiers had a low number of these predictors. These results document that most nondeployed soldiers with mental disorders are not in treatment and that untreated soldiers are not concentrated in a particular segment of the population that might be targeted for special outreach efforts. Analysis of modifiable barriers to treatment is needed to help strengthen outreach efforts. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  2. Multidisciplinary intervention with sibutramine: assessing successful weight loss predictors in military adolescent dependents.

    PubMed

    Cabrera, Jorge L; Wilks, Edward G; Symons, Jenna E; Blankson, Kwabena L; Cole, Renee E

    2012-03-01

    Assess body mass index (BMI) reduction through a multidisciplinary intervention with sibutramine in adolescents of military parents and examine characteristics and behavioral traits as predictors of successful weight loss. A prospective study where participants received sibutramine daily for 6 months. Adolescents ages 12 to 18 with BMI-for-age and sex greater than 95 percentile and good health were enrolled. Outcome variables are BMI, biochemical indices, and clinical measurements. Predictor variables are participant demographics, family history, lifestyle changes, and behavioral traits assessed with behavioral assessment for children. One hundred participants were recruited with 81% completion. In those participants who completed the 6-month intervention, a mean participant BMI reduction of 3.1 kg/m2 (-9.3%) (p < 0.001; 95% CI: -10.5% to -7.9%) was obtained with 79% successfully meeting the weight loss goal. Sibutramine dose was increased from 10 to 15 mg at 3 months for participant with <2.5% BMI reduction from baseline. Sibutramine dose at 3 months (p < 0.001) and participants perception of relationship with parents (p = 0.05) were statistically significant predictors of successful weight loss (> or =10% reduction in BMI). Sibutramine was effective at promoting minimum beneficial BMI reduction of 5% in adolescents with service-connected parents; however, increasing dosage at 3 months did not improve the likelihood of being successful.

  3. Medical malpractice predictors and risk factors for ophthalmologists performing LASIK and PRK surgery.

    PubMed Central

    Abbott, Richard L

    2003-01-01

    PURPOSE: To identify physician predictors in laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) surgery that correlate with a higher risk for malpractice liability claims and lawsuits. METHODOLOGY: A retrospective, longitudinal, cohort study comparing physician characteristics of 100 consecutive Ophthalmic Mutual Insurance Company (OMIC) LASIK and PRK claims and suits to demographic and practice pattern data for all active refractive surgeons insured by OMIC between 1996 and 2002. Background information and data were obtained from OMIC underwriting applications, a physician practice pattern survey, and claims file records. Using an outcome of whether or not a physician had a prior history of a claim or suit, logistic regression analyses were used separately for each predictor as well as controlling for refractive surgery volume. RESULTS: Logistic regression analysis demonstrated that the most important predictor of filing a claim was surgical volume, with those performing more surgery having a greater risk of incurring a claim (odds ratio [OR], 31.4 for >1,000/year versus 0 to 20/year; 95% confidence interval [CI], 7.9 - 125; P = .0001). Having one or more prior claims was the only other predictor examined that remained statistically significant after controlling for patient volume (OR, 6.4; 95% CI 2.5 - 16.4; P = .0001). Physician gender, advertising, preoperative time spent with patient, and comanagement appeared to be strong predictors in multivariate analyses when surgical volume was greater than 100 cases per year. CONCLUSION: The chances of incurring a malpractice claim or suit for PRK or LASIK correlates significantly with higher surgical volume and a history of a prior claim or suit. Additional risk factors that increase in importance with higher surgical volume include gender, advertising, preoperative time spent with patient, and comanagement with optometrists. These findings may be used in the future to help improve the quality of care for patients undergoing refractive surgery and provide data for underwriting criteria and risk management protocols to proactively manage and reduce the risk of claims and lawsuits against refractive surgeons. PMID:14971582

  4. Value-Added Predictors of Expressive and Receptive Language Growth in Initially Nonverbal Preschoolers with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Yoder, Paul; Watson, Linda R.; Lambert, Warren

    2015-01-01

    Eighty-seven preschoolers with autism spectrum disorders who were initially nonverbal (under 6 words in language sample and under 21 parent-reported words said) were assessed at five time points over 16 months. Statistical models that accounted for the intercorrelation among nine theoretically- and empirically-motivated predictors, as well as two…

  5. Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature—empirical evidence from Pakistan

    NASA Astrophysics Data System (ADS)

    Abbas, Tariq; Xu, Zhiwei; Younus, Muhammad; Qayyum, Abdul; Riaz, Muhammad T.

    2017-11-01

    Crimean-Congo hemorrhagic fever (CCHF) has been reported from all provinces of Pakistan. Little is known about the seasonal variations in the disease and its association with weather conditions. In this study, we explored time-series data about monthly number of CCHF admissions (2007-2010) in three public sector hospitals of Quetta—the capital city of Baluchistan province of Pakistan. Cosinor analysis was carried out to investigate seasonality in the data. To assess the effect of average monthly ambient temperature (°C) on disease, a distributed lag nonlinear model (DLNM) was applied. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the study hospitals. The estimated amplitude was 3.24 cases per month with phase in mid-June and low point in mid-December. DLNM confirmed nonlinear and delayed effect of temperature on hospital admissions. At a lag of 2 months, the cumulative relative risk was more than 1 at temperature at 18.37 °C and above. In addition, relative risk was significantly high at 60th (21.98 °C), 70th (24.50 °C), 80th (27.33 °C), and 90th (29.25 °C) percentiles of temperature (relative to median value, 18.37 °C). Inclusion of Eid-al-Adha as a predictor did not improve the fitness of DLNM. Based on our analysis, we concluded significant seasonality in CCHF hospital admissions. Our findings also suggested average monthly ambient temperature (°C) as a significant predictor of CCHF hospitalizations. DLNM presented in this study may be improved with inclusion of other possible time-varying predictors particularly meteorological conditions of this region.

  6. Curricular Activities that Promote Metacognitive Skills Impact Lower-Performing Students in an Introductory Biology Course†

    PubMed Central

    Dang, Nathan V.; Chiang, Jacob C.; Brown, Heather M.

    2018-01-01

    This study explores the impacts of repeated curricular activities designed to promote metacognitive skills development and academic achievement on students in an introductory biology course. Prior to this study, the course curriculum was enhanced with pre-assignments containing comprehension monitoring and self-evaluation questions, exam review assignments with reflective questions related to study habits, and an optional opportunity for students to explore metacognition and deep versus surface learning. We used a mixed-methods study design and collected data over two semesters. Self-evaluation, a component of metacognition, was measured via exam score postdictions, in which students estimated their exam scores after completing their exam. Metacognitive awareness was assessed using the Metacognitive Awareness Inventory (MAI) and a reflective essay designed to gauge students’ perceptions of their metacognitive skills and study habits. In both semesters, more students over-predicted their Exam 1 scores than under-predicted, and statistical tests revealed significantly lower mean exam scores for the over-predictors. By Exam 3, under-predictors still scored significantly higher on the exam, but they outnumbered the over-predictors. Lower-performing students also displayed a significant increase in exam postdiction accuracy by Exam 3. While there was no significant difference in students’ MAI scores from the beginning to the end of the semester, qualitative analysis of reflective essays indicated that students benefitted from the assignments and could articulate clear action plans to improve their learning and performance. Our findings suggest that assignments designed to promote metacognition can have an impact on students over the course of one semester and may provide the greatest benefits to lower-performing students. PMID:29904551

  7. Fat necrosis in autologous abdomen-based breast reconstruction: a systematic review.

    PubMed

    Khansa, Ibrahim; Momoh, Adeyiza O; Patel, Priti P; Nguyen, John T; Miller, Michael J; Lee, Bernard T

    2013-03-01

    Fat necrosis is a common and potentially exasperating complication of autologous breast reconstruction. The authors performed a systematic review of the English literature on autologous breast reconstruction to determine significant patient and surgical factors that are predictors of postoperative fat necrosis. A PubMed search using the terms "fat necrosis" and "breast reconstruction" was conducted. Articles were screened using predetermined inclusion and exclusion criteria. Data collected included patient characteristics, reconstructive techniques used, and the specific postoperative morbidity of interest. Patient cohorts were pooled, and the incidence of fat necrosis was calculated in the presence and absence of each risk factor. Chi-square analysis was applied, and p < 0.05 was considered statistically significant. Of 172 articles found, 70 met the inclusion criteria. The mean rate of fat necrosis was 11.3 percent. Deep inferior epigastric artery perforator flaps had the highest rate of fat necrosis (14.4 percent), followed by pedicled transverse rectus abdominis musculocutaneous (12.3 percent), superficial inferior epigastric artery (8.1 percent), and free transverse rectus abdominis musculocutaneous flaps (6.9 percent). Significant predictors of fat necrosis included obesity (p = 0.035), prereconstruction irradiation (p = 0.022), postreconstruction irradiation (p < 0.001), active smoking (p < 0.001), and abdominal scars (p = 0.05). Protective factors included supercharging (p < 0.001) and bilateral reconstruction (p = 0.01). Although there is little agreement in the literature regarding risk factors for fat necrosis, the authors were able to demonstrate several significant predictors by systematically analyzing 70 articles. Improved knowledge of the risk factors for fat necrosis can help surgeons provide improved preoperative counseling and take measures to minimize the risk of this complication.

  8. Risk Factors for Hearing Decrement Among U.S. Air Force Aviation-Related Personnel.

    PubMed

    Greenwell, Brandon M; Tvaryanas, Anthony P; Maupin, Genny M

    2018-02-01

    The purpose of this study was to analyze historical hearing sensitivity data to determine factors associated with an occupationally significant change in hearing sensitivity in U.S. Air Force aviation-related personnel. This study was a longitudinal, retrospective cohort analysis of audiogram records for Air Force aviation-related personnel on active duty during calendar year 2013 without a diagnosis of non-noise-related hearing loss. The outcomes of interest were raw change in hearing sensitivity from initial baseline to 2013 audiogram and initial occurrence of a significant threshold shift (STS) and non-H1 audiogram profile. Potential predictor variables included age and elapsed time in cohort for each audiogram, gender, and Air Force Specialty Code. Random forest analyses conducted on a learning sample were used to identify relevant predictor variables. Mixed effects models were fitted to a separate validation sample to make statistical inferences. The final dataset included 167,253 nonbaseline audiograms on 10,567 participants. Only the interaction between time since baseline audiogram and age was significantly associated with raw change in hearing sensitivity by STS metric. None of the potential predictors were associated with the likelihood for an STS. Time since baseline audiogram, age, and their interaction were significantly associated with the likelihood for a non-HI hearing profile. In this study population, age and elapsed time since baseline audiogram were modestly associated with decreased hearing sensitivity and increased likelihood for a non-H1 hearing profile. Aircraft type, as determined from Air Force Specialty Code, was not associated with changes in hearing sensitivity by STS metric.Greenwell BM, Tvaryanas AP, Maupin GM. Risk factors for hearing decrement among U.S. Air Force aviation-related personnel. Aerosp Med Hum Perform. 2018; 89(2):80-86.

  9. Employment program for patients with severe mental illness in Malaysia: a 3-month outcome.

    PubMed

    Wan Kasim, Syarifah Hafizah; Midin, Marhani; Abu Bakar, Abdul Kadir; Sidi, Hatta; Nik Jaafar, Nik Ruzyanei; Das, Srijit

    2014-01-01

    This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI). A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment. The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]). Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Fluoroscopically guided transforaminal epidural steroid injections at a quaternary-care teaching institution: effect of trainee involvement and patient body mass index on fluoroscopy time and patient dose.

    PubMed

    Tiegs-Heiden, C A; Murthy, N S; Geske, J R; Diehn, F E; Schueler, B A; Wald, J T; Kaufmann, T J; Lehman, V T; Carr, C M; Amrami, K K; Morris, J M; Thielen, K R; Maus, T P

    2016-01-01

    To investigate whether there are differences in fluoroscopy time and patient dose for fluoroscopically guided lumbar transforaminal epidural steroid injections (TFESIs) performed by staff radiologists versus with trainees and to evaluate the effect of patient body mass index (BMI) on fluoroscopy time and patient dose, including their interactions with other variables. Single-level lumbar TFESIs (n=1844) between 1 January 2011 and 31 December 2013 were reviewed. Fluoroscopy time, reference point air kerma (Ka,r), and kerma area product (KAP) were recorded. BMI and trainee involvement were examined as predictors of fluoroscopy time, Ka,r, and KAP in models adjusted for age and gender in multivariable linear models. Stratified models of BMI groups by trainee presence were performed. Increased age was the only significant predictor of increased fluoroscopy time (p<0.0001). Ka,r and KAP were significantly higher in patients with a higher BMI (p<0.0001 and p=0.0009). When stratified by BMI, longer fluoroscopy time predicted increased Ka,r and KAP in all groups (p<0.0001). Trainee involvement was not a statistically significant predictor of fluoroscopy time or Ka,r in any BMI category. KAP was lower with trainees in the overweight group (p=0.0009) and higher in male patients for all BMI categories (p<0.02). Trainee involvement did not result in increased fluoroscopy time or patient dose. BMI did not affect fluoroscopy time; however, overweight and obese patients received significantly higher Ka,r and KAP. Male patients received a higher KAP in all BMI categories. Limiting fluoroscopy time and good collimation practices should be reinforced in these patients. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. Khat chewing habit among school students of Jazan region, Saudi Arabia.

    PubMed

    Alsanosy, Rashad Mohammed; Mahfouz, Mohamed Salih; Gaffar, Abdelrahim Mutwakel

    2013-01-01

    The use of Khat leaves (Catha edulis) in Jazan, southwest of KSA, is prevalent among all segments of the population. This study was conducted to assess the prevalence and predictors of Khat chewing among intermediate and secondary school students of Jazan region. A cross-sectional survey was conducted in late 2011 in Jazan region. A random sample of 3923 students was selected from 72 intermediate and upper secondary schools representing the different educational sectors of the region. A structured self-administered questionnaire was used for data collection. Descriptive statistics, a chi-squared test and logistic regression were performed to examine the prevalence, associations and predictors of Khat chewing. The overall Khat chewing prevalence among students was 20.5% (95% C.I.: 19.27-21.79). The prevalence was significantly higher among males, at 33.1% (95% CI: 31.16-35.08), than among females 4.3% (95% C.I.: 3.39-5.31) ( P <0.001). Univariate analysis revealed that gender, age, academic performance, friends' smoking and Khat chewing, and students' smoking status were associated with a significantly high risk of Khat chewing ( P <0.001 for all). The multivariate logistic regression analysis suggested that the most important independent predictors of Khat chewing among the students in our sample were students' smoking status (OR = 13.02, P <0.001), friends' use of Khat (OR = 5.65, P <0.001), gender (OR = 4.62, P <0.001), and friend's use of tobacco (OR = 1.43, P <0.001). A significant percentage of students chew Khat. The abuse of Khat is significantly associated with gender, peer influence, and cigarette smoking. Intervention programs are needed to create awareness among school students and to reduce the prevalence of the habit and its unfavorable consequences.

  12. Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature-empirical evidence from Pakistan.

    PubMed

    Abbas, Tariq; Xu, Zhiwei; Younus, Muhammad; Qayyum, Abdul; Riaz, Muhammad T

    2017-11-01

    Crimean-Congo hemorrhagic fever (CCHF) has been reported from all provinces of Pakistan. Little is known about the seasonal variations in the disease and its association with weather conditions. In this study, we explored time-series data about monthly number of CCHF admissions (2007-2010) in three public sector hospitals of Quetta-the capital city of Baluchistan province of Pakistan. Cosinor analysis was carried out to investigate seasonality in the data. To assess the effect of average monthly ambient temperature (°C) on disease, a distributed lag nonlinear model (DLNM) was applied. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the study hospitals. The estimated amplitude was 3.24 cases per month with phase in mid-June and low point in mid-December. DLNM confirmed nonlinear and delayed effect of temperature on hospital admissions. At a lag of 2 months, the cumulative relative risk was more than 1 at temperature at 18.37 °C and above. In addition, relative risk was significantly high at 60th (21.98 °C), 70th (24.50 °C), 80th (27.33 °C), and 90th (29.25 °C) percentiles of temperature (relative to median value, 18.37 °C). Inclusion of Eid-al-Adha as a predictor did not improve the fitness of DLNM. Based on our analysis, we concluded significant seasonality in CCHF hospital admissions. Our findings also suggested average monthly ambient temperature (°C) as a significant predictor of CCHF hospitalizations. DLNM presented in this study may be improved with inclusion of other possible time-varying predictors particularly meteorological conditions of this region.

  13. Can we predict urinary stress incontinence by using demographic, clinical, imaging and urodynamic data?

    PubMed

    Wlaźlak, Edyta; Surkont, Grzegorz; Shek, Ka L; Dietz, Hans P

    2015-10-01

    It has been claimed that urethral hypermobility and resting urethral pressure can largely explain stress incontinence in women. In this study we tried to replicate these findings in an unselected cohort of women seen for urodynamic testing, including as many potential confounders as possible. This study is a retrospective analysis of data obtained from 341 women. They attended for urodynamic testing due to symptoms of pelvic floor dysfunction. We excluded from the analysis women with a history of previous anti-incontinence and prolapse surgery. All patients had a standardised clinical assessment, 4D transperineal pelvic floor ultrasound and multichannel urodynamic testing. Urodynamic stress incontinence (USI) was diagnosed by multichannel urodynamic testing. Its severity was subjectively graded as mild, moderate and severe. Candidate variables were: age, BMI, symptoms of prolapse, vaginal parity, significant prolapse (compartment-specific), levator avulsion, levator hiatal area, Oxford grading, midurethral mobility, maximum urethral pressure (MUP), maximum cough pressure and maximum Valsalva pressure reached. On binary logistic regression, the following parameters were statistically significant in predicting urodynamic stress incontinence: age (P=0.03), significant rectocele (P=0.02), max. abdominal pressure reached (negatively, P<0.0001), midurethral mobility (P=0.0004) and MUP (negatively, P<0.0001). On multivariate analysis, accounting for multiple interdependencies, the following predictors remained significant: max. abdominal pressure reached (negatively, P<0.0001), cough pressure (P=0.006), midurethral mobility (P=0.003) and MUP (negatively, P<0.0001), giving an R(2) of 0.24. Mid-urethral mobility and MUP are the main predictors of USI. Demographic and clinical data are at best weak predictors. Our results suggest the presence of major unrecognised confounders. Copyright © 2015. Published by Elsevier Ireland Ltd.

  14. Predictors of suicidal ideation in older people: a decision tree analysis.

    PubMed

    Handley, Tonelle E; Hiles, Sarah A; Inder, Kerry J; Kay-Lambkin, Frances J; Kelly, Brian J; Lewin, Terry J; McEvoy, Mark; Peel, Roseanne; Attia, John R

    2014-11-01

    Suicide among older adults is a major public health issue worldwide. Although studies have identified psychological, physical, and social contributors to suicidal thoughts in older adults, few have explored the specific interactions between these factors. This article used a novel statistical approach to explore predictors of suicidal ideation in a community-based sample of older adults. Prospective cohort study. Participants aged 55-85 years were randomly selected from the Hunter Region, a large regional center in New South Wales, Australia. Baseline psychological, physical, and social factors, including psychological distress, physical functioning, and social support, were used to predict suicidal ideation at the 5-year follow-up. Classification and regression tree modeling was used to determine specific risk profiles for participants depending on their individual well-being in each of these key areas. Psychological distress was the strongest predictor, with 25% of people with high distress reporting suicidal ideation. Within high psychological distress, lower physical functioning significantly increased the likelihood of suicidal ideation, with high distress and low functioning being associated with ideation in 50% of cases. A substantial subgroup reported suicidal ideation in the absence of psychological distress; dissatisfaction with social support was the most important predictor among this group. The performance of the model was high (area under the curve: 0.81). Decision tree modeling enabled individualized "risk" profiles for suicidal ideation to be determined. Although psychological factors are important for predicting suicidal ideation, both physical and social factors significantly improved the predictive ability of the model. Assessing these factors may enhance identification of older people at risk of suicidal ideation. Copyright © 2014. Published by Elsevier Inc.

  15. A Field Data Analysis of Risk Factors Affecting the Injury Risks in Vehicle-To-Pedestrian Crashes

    PubMed Central

    Zhang, Guanjun; Cao, Libo; Hu, Jingwen; Yang, King H.

    2008-01-01

    The head, torso, and lower extremity are the most commonly injured body regions during vehicle-to-pedestrian crashes. A total of 312 cases were selected from the National Automotive Sampling System (NASS) Pedestrian Crash Data Study (PCDS) database to investigate factors affecting the likelihood of sustaining MAIS 3+, AIS 3+ head, AIS 3+ torso, and AIS 2+ lower extremity injuries during vehicle-to-pedestrian frontal crashes. The inclusion criteria were pedestrians: (a) aged 14 years or older, (b) with a height of 1.5 m and taller, and (c) who were injured in an upright standing position via vehicle frontal collision. The injury odds ratios (ORs) calculated from logistic regression analyses were used to evaluate the association between selected injury predictors and the odds of sustaining pedestrian head, torso, and lower extremity injuries. These predictors included a crash factor (impact speed), pedestrian factors (age, gender, height, and weight), and vehicle factors (front bumper central height, front bumper lead, ground to front/top transition point height (FTTPH), and rear hood opening distance (RHOD)). Results showed that impact speed was a statistically significant predictor for head, torso, and lower extremity injury odds, as expected. Comparison of people 65 years of age and older to young adults aged 14 to 64 showed that age was also a significant predictor for torso (p<0.001, OR=23.8) and lower extremity (p=0.020, OR=2.44) injury odds, but not for head injuries (p=0.661). Vehicles with higher FTTPH and more vertical frontal structures were aggressive to pedestrians, especially regarding injuries to the torso. A very short RHOD would be more likely to lead the pedestrian to impact the windshield and windshield frame, thus increasing the head injury risk. PMID:19026237

  16. Use of and confidence in administering outcome measures among clinical prosthetists: Results from a national survey and mixed-methods training program.

    PubMed

    Gaunaurd, Ignacio; Spaulding, Susan E; Amtmann, Dagmar; Salem, Rana; Gailey, Robert; Morgan, Sara J; Hafner, Brian J

    2015-08-01

    Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Cross-sectional and single-group pretest-posttest survey. Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p < 0.0001) improved prosthetists' confidence in administering both instruments. Prosthetists in this study reported limited use of and confidence with standardized outcome measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice. © The International Society for Prosthetics and Orthotics 2014.

  17. Childhood conscientiousness predicts the social gradient of smoking in adulthood: a life course analysis.

    PubMed

    Pluess, Michael; Bartley, Mel

    2015-04-01

    The social gradient in smoking is well known, with higher rates among those in less advantaged socioeconomic position. Some recent research has reported that personality characteristics partly explain this gradient. However, the majority of existing work is limited by cross-sectional designs unsuitable to determine whether differences in conscientiousness are a predictor or a product of social inequalities. Adopting a life course perspective, we investigated in the current paper the influence of conscientiousness in early and mid-life on the social gradient in smoking and the role of potential confounding factors in a large longitudinal cohort study. Using data from the 1958 National Child Development Study, we examined the extent to which two measures of conscientiousness, one assessed with a personality questionnaire at age 50 and one derived from three related items at 16 years in childhood, explained the social gradient of smoking at age 50 by comparing nested logistic regression models that included social class at birth, cognitive ability, attention and conduct problems at age 7, and educational qualification. Childhood conscientiousness was a significant predictor of smoking at 50 years (OR=0.86, CI (95%) 0.84 to 0.88), explaining 5.0% of the social gradient independent of all other variables. Childhood conscientiousness was a stronger predictor than adult conscientiousness, statistically accounting for the observed direct association of adult conscientiousness with smoking. Conscientiousness may be a predictor rather than a product of social differences in smoking. Inclusion of personality measures and adoption of a life course perspective add significantly to our understanding of health inequalities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures.

    PubMed

    Heinrich, Sebastian; Birkholz, Torsten; Ihmsen, Harald; Irouschek, Andrea; Ackermann, Andreas; Schmidt, Joachim

    2012-08-01

    Difficult laryngoscopy in pediatric patients undergoing anesthesia. This retrospective analysis was conducted to investigate incidence and predictors of difficult laryngoscopy in a large cohort of pediatric patients receiving general anesthesia with endotracheal intubation. Young age and craniofacial dysmorphy are predictors for the difficult pediatric airway and difficult laryngoscopy. For difficult laryngoscopy, other general predictors are not yet described. Retrospectively, from a 5-year period, data from 11.219 general anesthesia procedures in pediatric patients with endotracheal intubation using age-adapted Macintosh blades in a single center (university hospital) were analyzed statistically. The overall incidence of difficult laryngoscopy [Cormack and Lehane (CML) grade III and IV] was 1.35%. In patients younger than 1 year, the incidence of CML III or IV was significantly higher than in the older patients (4.7% vs 0.7%). ASA Physical Status III and IV, a higher Mallampati Score (III and IV) and a low BMI were all associated (P < 0.05) with difficult laryngoscopy. Patients undergoing oromaxillofacial surgery and cardiac surgery showed a significantly higher rate of CML III/IV findings. The general incidence of difficult laryngoscopy in pediatric anesthesia is lower than in adults. Our results show that the risk of difficult laryngoscopy is much higher in patients below 1 year of age, in underweight patients and in ASA III and IV patients. The underlying disease might also contribute to the risk. If the Mallampati score could be obtained, prediction of difficult laryngoscopy seems to be reliable. Our data support the existing recommendations for a specialized anesthesiological team to provide safe anesthesia for infants and neonates. © 2012 Blackwell Publishing Ltd.

  19. Relation of endothelial function to cardiovascular risk in women with sedentary occupations and without known cardiovascular disease.

    PubMed

    Lippincott, Margaret F; Carlow, Andrea; Desai, Aditi; Blum, Arnon; Rodrigo, Maria; Patibandla, Sushmitha; Zalos, Gloria; Smith, Kevin; Schenke, William H; Csako, Gyorgy; Waclawiw, Myron A; Cannon, Richard O

    2008-08-01

    Our purpose was to determine predictors of endothelial function and potential association with cardiovascular risk in women with sedentary occupations, in whom obesity-associated risk factors may contribute to excess morbidity and mortality. Ninety consecutive women (age range 22 to 63 years, 22 overweight (body mass index [BMI] > or =25 to 29.9 kg/m(2)) and 42 obese (BMI > or = 30 kg/m(2)), had vital signs, lipids, insulin, glucose, high-sensitivity C-reactive protein, and sex hormones measured. Endothelial function was determined using brachial artery flow-mediated dilation after 5 minutes of forearm ischemia. Treadmill stress testing was performed with gas exchange analysis at peak exercise (peak oxygen consumption [Vo(2)]) to assess cardiorespiratory fitness. Brachial artery reactivity was negatively associated with Framingham risk score (r = -0.3542, p = 0.0007). Univariate predictors of endothelial function included peak Vo(2) (r = 0.4483, p <0.0001), age (r = -0.3420, p = 0.0010), BMI (r = -0.3065, p = 0.0035), and high-sensitivity C-reactive protein (r = -0.2220, p = 0.0400). Using multiple linear regression analysis with stepwise modeling, peak Vo(2) (p = 0.0003) was the best independent predictor of brachial artery reactivity, with age as the only other variable reaching statistical significance (p = 0.0436) in this model. In conclusion, endothelial function was significantly associated with cardiovascular risk in women with sedentary occupations, who were commonly overweight or obese. Even in the absence of routine exercise, cardiorespiratory fitness, rather than conventional risk factors or body mass, is the dominant predictor of endothelial function and suggests a modifiable approach to risk.

  20. Magnetic resonance imaging-based measures predictive of short-term surgical outcome in patients with Chiari malformation Type I: a pilot study.

    PubMed

    Alperin, Noam; Loftus, James Ryan; Bagci, Ahmet M; Lee, Sang H; Oliu, Carlos J; Shah, Ashish H; Green, Barth A

    2017-01-01

    OBJECTIVE This study identifies quantitative imaging-based measures in patients with Chiari malformation Type I (CM-I) that are associated with positive outcomes after suboccipital decompression with duraplasty. METHODS Fifteen patients in whom CM-I was newly diagnosed underwent MRI preoperatively and 3 months postoperatively. More than 20 previously described morphological and physiological parameters were derived to assess quantitatively the impact of surgery. Postsurgical clinical outcomes were assessed in 2 ways, based on resolution of the patient's chief complaint and using a modified Chicago Chiari Outcome Scale (CCOS). Statistical analyses were performed to identify measures that were different between the unfavorable- and favorable-outcome cohorts. Multivariate analysis was used to identify the strongest predictors of outcome. RESULTS The strongest physiological parameter predictive of outcome was the preoperative maximal cord displacement in the upper cervical region during the cardiac cycle, which was significantly larger in the favorable-outcome subcohorts for both outcome types (p < 0.05). Several hydrodynamic measures revealed significantly larger preoperative-to-postoperative changes in the favorable-outcome subcohort. Predictor sets for the chief-complaint classification included the cord displacement, percent venous drainage through the jugular veins, and normalized cerebral blood flow with 93.3% accuracy. Maximal cord displacement combined with intracranial volume change predicted outcome based on the modified CCOS classification with similar accuracy. CONCLUSIONS Tested physiological measures were stronger predictors of outcome than the morphological measures in patients with CM-I. Maximal cord displacement and intracranial volume change during the cardiac cycle together with a measure that reflects the cerebral venous drainage pathway emerged as likely predictors of decompression outcome in patients with CM-I.

  1. A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

    PubMed

    Strayhorn, G

    2000-04-01

    To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.

  2. Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike

    PubMed Central

    Gruebner, Oliver; Lowe, Sarah R.; Tracy, Melissa; Joshi, Spruha; Cerdá, Magdalena; Norris, Fran H.; Subramanian, S. V.; Galea, Sandro

    2016-01-01

    We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N = 561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide. PMID:27558011

  3. Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.

    PubMed

    Gruebner, Oliver; Lowe, Sarah R; Tracy, Melissa; Joshi, Spruha; Cerdá, Magdalena; Norris, Fran H; Subramanian, S V; Galea, Sandro

    2016-08-25

    We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N = 561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide.

  4. Simpson's paradox - aggregating and partitioning populations in health disparities of lung cancer patients.

    PubMed

    Fu, P; Panneerselvam, A; Clifford, B; Dowlati, A; Ma, P C; Zeng, G; Halmos, B; Leidner, R S

    2015-12-01

    It is well known that non-small cell lung cancer (NSCLC) is a heterogeneous group of diseases. Previous studies have demonstrated genetic variation among different ethnic groups in the epidermal growth factor receptor (EGFR) in NSCLC. Research by our group and others has recently shown a lower frequency of EGFR mutations in African Americans with NSCLC, as compared to their White counterparts. In this study, we use our original study data of EGFR pathway genetics in African American NSCLC as an example to illustrate that univariate analyses based on aggregation versus partition of data leads to contradictory results, in order to emphasize the importance of controlling statistical confounding. We further investigate analytic approaches in logistic regression for data with separation, as is the case in our example data set, and apply appropriate methods to identify predictors of EGFR mutation. Our simulation shows that with separated or nearly separated data, penalized maximum likelihood (PML) produces estimates with smallest bias and approximately maintains the nominal value with statistical power equal to or better than that from maximum likelihood and exact conditional likelihood methods. Application of the PML method in our example data set shows that race and EGFR-FISH are independently significant predictors of EGFR mutation. © The Author(s) 2011.

  5. Factors Influencing Fluid Milk Waste in a Breakfast in the Classroom School Breakfast Program.

    PubMed

    Blondin, Stacy A; Goldberg, Jeanne P; Cash, Sean B; Griffin, Timothy S; Economos, Christina D

    2018-04-01

    To determine predictors of fluid milk waste in a Breakfast in the Classroom School Breakfast Program. Cross-sectional with 3 repeated measures/classroom. Elementary schools in a medium-sized, low-income, urban school district. Twenty third- through fourth-grade classrooms across 6 schools. Dependent variables include percentage of total and served milk wasted. Independent variables included observed daily menu offerings, program factors, and teacher and student behavior. Descriptive statistics were used to characterize variables across classrooms and schools. Multilevel mixed-effects models were used to test associations between predictors and outcomes of interest. P ≤ .05 was considered statistically significant. Total milk waste increased 12% when juice was offered and 3% for each additional carton of unserved milk. Teacher encouragement to take and/or consume breakfast was associated with a 5% and 9% increase in total and served milk waste, respectively. When students were engaged in other activities in addition to eating breakfast, total milk waste decreased 10%. Beverage offerings were predictive of greater total milk waste. Teacher and student behavior also appeared to influence milk consumption. Findings suggest that specific changes to School Breakfast Program implementation policies and practices could have an important role in waste mitigation. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  6. Tanning accelerators: prevalence, predictors of use, and adverse effects.

    PubMed

    Herrmann, Jennifer L; Cunningham, Rachel; Cantor, Alan; Elewski, Boni E; Elmets, Craig A

    2015-01-01

    Tanning accelerators are topical products used by indoor tanners to augment and hasten the tanning process. These products contain tyrosine, psoralens, and/or other chemicals. We sought to better define the population using accelerators, identify predictors of their use, and describe any related adverse effects. This cross-sectional study surveyed 200 indoor tanners about their tanning practices and accelerator use. Primary analysis compared accelerator users with nonusers with respect to questionnaire variables. Descriptive statistics and χ(2) contingency tables were applied to identify statistically significant variables. Of respondents, 53% used accelerators; 97% were female and 3% were male with a median age of 22 years (range: 19-67). Users were more likely to spray tan, tan frequently, and be addicted to tanning. Acne and rashes were more common in accelerator users. Adverse reactions to accelerators prevented their further use 31% of the time. A limited adult population was evaluated; exact accelerator ingredients were not examined. Tanning accelerator users are high-risk indoor tanners who tan more frequently and who are more likely addicted to tanning. Acne and rashes are more common with these products and act as only mild deterrents to continued use. Additional research should investigate accelerators' longer-term health effects. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. External validation and comparison of three pediatric clinical dehydration scales.

    PubMed

    Jauregui, Joshua; Nelson, Daniel; Choo, Esther; Stearns, Branden; Levine, Adam C; Liebmann, Otto; Shah, Sachita P

    2014-01-01

    To prospectively validate three popular clinical dehydration scales and overall physician gestalt in children with vomiting or diarrhea relative to the criterion standard of percent weight change with rehydration. We prospectively enrolled a non-consecutive cohort of children ≤ 18 years of age with an acute episode of diarrhea or vomiting. Patient weight, clinical scale variables and physician clinical impression, or gestalt, were recorded before and after fluid resuscitation in the emergency department and upon hospital discharge. The percent weight change from presentation to discharge was used to calculate the degree of dehydration, with a weight change of ≥ 5% considered significant dehydration. Receiver operating characteristics (ROC) curves were constructed for each of the three clinical scales and physician gestalt. Sensitivity and specificity were calculated based on the best cut-points of the ROC curve. We approached 209 patients, and of those, 148 were enrolled and 113 patients had complete data for analysis. Of these, 10.6% had significant dehydration based on our criterion standard. The Clinical Dehydration Scale (CDS) and Gorelick scales both had an area under the ROC curve (AUC) statistically different from the reference line with AUCs of 0.72 (95% CI 0.60, 0.84) and 0.71 (95% CI 0.57, 0.85) respectively. The World Health Organization (WHO) scale and physician gestalt had AUCs of 0.61 (95% CI 0.45, 0.77) and 0.61 (0.44, 0.78) respectively, which were not statistically significant. The Gorelick scale and Clinical Dehydration Scale were fair predictors of dehydration in children with diarrhea or vomiting. The World Health Organization scale and physician gestalt were not helpful predictors of dehydration in our cohort.

  8. External Validation and Comparison of Three Pediatric Clinical Dehydration Scales

    PubMed Central

    Jauregui, Joshua; Nelson, Daniel; Choo, Esther; Stearns, Branden; Levine, Adam C.; Liebmann, Otto; Shah, Sachita P.

    2014-01-01

    Objective To prospectively validate three popular clinical dehydration scales and overall physician gestalt in children with vomiting or diarrhea relative to the criterion standard of percent weight change with rehydration. Methods We prospectively enrolled a non-consecutive cohort of children ≤ 18 years of age with an acute episode of diarrhea or vomiting. Patient weight, clinical scale variables and physician clinical impression, or gestalt, were recorded before and after fluid resuscitation in the emergency department and upon hospital discharge. The percent weight change from presentation to discharge was used to calculate the degree of dehydration, with a weight change of ≥ 5% considered significant dehydration. Receiver operating characteristics (ROC) curves were constructed for each of the three clinical scales and physician gestalt. Sensitivity and specificity were calculated based on the best cut-points of the ROC curve. Results We approached 209 patients, and of those, 148 were enrolled and 113 patients had complete data for analysis. Of these, 10.6% had significant dehydration based on our criterion standard. The Clinical Dehydration Scale (CDS) and Gorelick scales both had an area under the ROC curve (AUC) statistically different from the reference line with AUCs of 0.72 (95% CI 0.60, 0.84) and 0.71 (95% CI 0.57, 0.85) respectively. The World Health Organization (WHO) scale and physician gestalt had AUCs of 0.61 (95% CI 0.45, 0.77) and 0.61 (0.44, 0.78) respectively, which were not statistically significant. Conclusion The Gorelick scale and Clinical Dehydration Scale were fair predictors of dehydration in children with diarrhea or vomiting. The World Health Organization scale and physician gestalt were not helpful predictors of dehydration in our cohort. PMID:24788134

  9. Predictors for 1-year mortality following hip fracture: a retrospective review of 465 consecutive patients.

    PubMed

    Heyes, G J; Tucker, A; Marley, D; Foster, A

    2017-02-01

    In Europe, trauma admissions and in particular hip fractures are on the rise. In recent years, health care systems have placed particular emphasis, including financial incentives, on delivering patients quickly and safely to surgery. At our unit, we have observed that hip fracture patients appear to be at significant risk of mortality even up to a year following injury. This study reviews a consecutive population of hip fracture patients to identify predictors of excess risk. Four hundred and sixty-five consecutive patients were treated over a 2-year period at our district general hospital with no ward-based orthogeriatricians. Follow-up was for 1 year following hip fracture admission. Statistical analysis of variables and their influence on 1-year mortality were performed by calculating odd's ratio (OR) using a logistic regression model and a p value <0.05 was considered statistically significant. Four patients were lost to follow-up, 18 patients (4.1 %) were managed conservatively, 16 were too unwell for surgery and their mortality rate at 1 year was 50 %. Following hip fracture, we found an overall 1-year mortality rate of 15.1 %. Patients with a time to surgery ≥36 h were at significantly increased risk of mortality even up to 1 year. We did not identify a further reduction in mortality in those operated on within 24 h. Raised ORs (p > 0.05) were found with increasing comorbidity, surgery type, independence on discharge, alcohol ingestion, history of smoking, readmission and several biochemical markers. Minimising mortality risk, even over the longer term, should begin on admission with prompt optimisation of any acute medical or biochemical abnormalities, followed by early surgery and intensive rehabilitation to maintain patients' functional independence.

  10. Chordee and Penile Shortening Rather Than Voiding Function Are Associated With Patient Dissatisfaction After Urethroplasty.

    PubMed

    Maciejewski, Conrad C; Haines, Trevor; Rourke, Keith F

    2017-05-01

    To identify factors that predict patient satisfaction after urethroplasty by prospectively examining patient-reported quality of life scores using 3 validated instruments. A 3-part prospective survey consisting of the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF) score, and a urethroplasty quality of life survey was completed by patients who underwent urethroplasty preoperatively and at 6 months postoperatively. The quality of life score included questions on genitourinary pain, urinary tract infection (UTI), postvoid dribbling, chordee, shortening, overall satisfaction, and overall health. Data were analyzed using descriptive statistics, paired t test, univariate and multivariate logistic regression analyses, and Wilcoxon signed-rank analysis. Patients were enrolled in the study from February 2011 to December 2014, and a total of 94 patients who underwent a total of 102 urethroplasties completed the study. Patients reported statistically significant improvements in IPSS (P < .001). Ordinal linear regression analysis revealed no association between age, IPSS, or IIEF score and patient satisfaction. Wilcoxon signed-rank analysis revealed significant improvements in pain scores (P = .02), UTI (P < .001), perceived overall health (P = .01), and satisfaction (P < .001). Univariate logistic regression identified a length >4 cm and the absence of UTI, pain, shortening, and chordee as predictors of patient satisfaction. Multivariate analysis of quality of life domain scores identified absence of shortening and absence of chordee as independent predictors of patient satisfaction following urethroplasty (P < .01). Patient voiding function and quality of life improve significantly following urethroplasty, but improvement in voiding function is not associated with patient satisfaction. Chordee status and perceived penile shortening impact patient satisfaction, and should be included in patient-reported outcome measures. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Adult outcomes of preterm children.

    PubMed

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

  12. The outcome of apical microsurgery using MTA as the root-end filling material: 2- to 6-year follow-up study.

    PubMed

    Çalışkan, M K; Tekin, U; Kaval, M E; Solmaz, M C

    2016-03-01

    To evaluate the influence of various predictors on the healing outcome 2-6 years after apical microsurgery (AMS) using MTA as the root-end filling material. A total of 90 anterior teeth with asymptomatic persistent periradicular periodontitis of strictly endodontic origin that failed after either nonsurgical or surgical treatment were included. Surgery was completed under local anaesthesia using a standardized clinical protocol. Clinical and radiographic measures as well as the follow-up period were used to determine the healing outcome. For statistical analysis of the predictors, the outcome was dichotomized into healed cases and nonhealed cases. Odds ratios were calculated, and Pearson chi-square or Fisher's exact tests were used to analyse the data. Clinical and radiographic assessment of AMS revealed that 80% were healed, 14.4% were nonhealed, whilst 5.6% were judged to be uncertain. None of the various predictors investigated had a significant influence on the outcome of AMS. The results of this clinical study demonstrated that 80% of cases that received apical microsurgery healed when using MTA as the root-end filling material. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  13. Ischemic Stroke After Treatment of Intraprocedural Thrombosis During Stent-Assisted Coiling and Flow Diversion.

    PubMed

    Adeeb, Nimer; Griessenauer, Christoph J; Moore, Justin M; Foreman, Paul M; Shallwani, Hussain; Motiei-Langroudi, Rouzbeh; Gupta, Raghav; Baccin, Carlos E; Alturki, Abdulrahman; Harrigan, Mark R; Siddiqui, Adnan H; Levy, Elad I; Ogilvy, Christopher S; Thomas, Ajith J

    2017-04-01

    Intraprocedural thrombosis poses a formidable challenge during neuroendovascular procedures because the risks of aggressive thromboembolic treatment must be balanced against the risk of postprocedural hemorrhage. The aim of this study was to identify predictors of ischemic stroke after intraprocedural thrombosis after stent-assisted coiling and pipeline embolization device placement. A retrospective analysis of intracranial aneurysms treated with stent-assisted coiling or pipeline embolization device placement between 2007 and 2016 at 4 major academic institutions was performed to identify procedures that were complicated by intraprocedural thrombosis. Intraprocedural thrombosis occurred in 34 (4.6%) procedures. Postprocedural ischemic stroke and hemorrhage occurred in 20.6% (7/34) and 11.8% (4/34) of procedures complicated by intraprocedural thrombosis, respectively. Current smoking was an independent predictor of ischemic stroke. There was no statistically significant difference in the rate of ischemic stroke or postprocedural hemorrhage with the use of abciximab compared with the use of eptifibatide in treatment of intraprocedural thrombosis. Current protocols for treatment of intraprocedural thrombosis associated with placement of intra-arterial devices were effective in preventing ischemic stroke in ≈80% of cases. Current smoking was the only independent predictor of ischemic stroke. © 2017 American Heart Association, Inc.

  14. [To the issue of postreperfusion syndrome predictors in orthotopic liver transplantation (OLT)].

    PubMed

    Kiseleva, E A; Ushakova, I A; Kim, E F; Matveev, G P; Biriulina, N Iu; Vabishchevich, A V

    2012-01-01

    The aim of the study is revelation of postperfusion syndrome (pPS) predictors in orthotopic liver transplantation (OLT). Was conducted a retrospective analysis of anesthesia maintainance protocols during orthotopic liver transplantation in 261 patients aged from 6 months to 60 years. Investigated the effect of various factors on the development of PPS by the application of methods of non-parametric statistics. Significantly more frequent development of the PPS is noted in the age group from 3 to 18 years (up to 30% of patients). In recipients older than 18 years the frequency of the development of the PPS does not depend on age, with an average of 14%. The development of the PPS does not depend on the recipient sex, the nature of the pathology which served as an indication to the OTP, the initial severity of the state, type of OTP (living related donor or cadaveric transplantation, primary or re-transplantation), the transplant warm ischemia duration, use, or the lack of venous-venous bypass, metabolic status of the patient. The obtained results do not contradict to the data of foreign publications. Among parameters available for screening, predictor of PPS was not detected.

  15. Epithelial Membrane Protein-2 Expression is an Early Predictor of Endometrial Cancer Development

    PubMed Central

    Habeeb, Omar; Goodglick, Lee; Soslow, Robert A.; Rao, Rajiv; Gordon, Lynn K.; Schirripa, Osvaldo; Horvath, Steve; Braun, Jonathan; Seligson, David B.; Wadehra, Madhuri

    2010-01-01

    BACKGROUND Endometrial cancer (EC) is a common malignancy worldwide. It is often preceded by endometrial hyperplasia, whose management and risk of neoplastic progression vary. Previously, we have shown that the tetraspan protein Epithelial Membrane Protein-2 (EMP2) is a prognostic indicator for EC aggressiveness and survival. Here we validate the expression of EMP2 in EC, and further examine whether EMP2 expression within preneoplastic lesions is an early prognostic biomarker for EC development. METHODS A tissue microarray (TMA) was constructed with a wide representation of benign and malignant endometrial samples. The TMA contains a metachronous cohort of cases from individuals who either developed or did not develop EC. Intensity and frequency of EMP2 expression were assessed using immunohistochemistry. RESULTS There was a stepwise, statistically-significant increase in the average EMP2 expression from benign to hyperplasia to atypia to EC. Furthermore, detailed analysis of EMP2 expression in potentially premalignant cases demonstrated that EMP2 positivity was a strong predictor for EC development. CONCLUSION EMP2 is an early predictor of EC development in preneoplastic lesions. In addition, combined with our previous findings, these results validate that EMP2 as a novel biomarker for EC development. PMID:20578181

  16. Suicide attempts and clinical features of bipolar patients.

    PubMed

    Berkol, Tonguç D; İslam, Serkan; Kırlı, Ebru; Pınarbaşı, Rasim; Özyıldırım, İlker

    2016-06-01

    To identify clinical predictors of suicide attempts in patients with bipolar disorder. This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two  hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis-I (SCID-I) in order to detect all possible psychiatric comorbid diagnoses. Clinical predictors of suicide attempts were examined in attempters and non-attempters. The study design was retrospective. The lifetime suicide attempt rate for the entire sample was 19.2%. Suicide attempters with bipolar disorder had more lifetime comorbidity of eating disorder. Female gender and family history of mood disorder were significant predictors for suicide attempts. There was no difference between groups in terms of bipolar disorder subtype, onset age of bipolar disorder, total number of episodes, first and predominant episode type, suicide history in first degree relatives, severity of episodes, and hospitalization and being psychotic. Our study revealed that female gender, family history of mood disorder, and eating disorder are more frequent in bipolar patients with at least one suicide attempt.

  17. Influence of self-efficacy on compliance to workplace exercise.

    PubMed

    Pedersen, Mette Merete; Zebis, Mette Kreutzfeldt; Langberg, Henning; Poulsen, Otto Melchior; Mortensen, Ole Steen; Jensen, Jette Nygaard; Sjøgaard, Gisela; Bredahl, Thomas; Andersen, Lars Louis

    2013-09-01

    Continuous neck and shoulder pain is a common musculoskeletal complaint. Physical exercise can reduce pain symptoms, but compliance to exercise is a challenge. Exercise-specific self-efficacy has been found to be a predictor of participation in preplanned exercise. Little is known about the influence of exercise-specific self-efficacy on compliance to workplace physical exercise. To determine the influence of exercise-specific self-efficacy on compliance to specific strength exercises during working hours for laboratory technicians. We performed a cluster-randomized controlled trial, including laboratory technicians from two industrial production units in Copenhagen, Denmark. The participants were randomized to supervised specific strength exercises for the neck and shoulder muscles for 20 minutes three times a week (n = 282) or to a reference group (n = 255). The participants answered baseline and follow-up questions regarding self-efficacy and registered all exercises in a diary. Overall compliance to exercises was 45 %. Compliance in company A (private sector) differed significantly between the three self-efficacy groups after 20 weeks. The odds ratio of compliance was 2.37 for moderate versus low self-efficacy, and 2.93 for high versus low self-efficacy. No significant difference was found in company B (public sector) or in the intervention group as a whole. We did not find self-efficacy to be a general statistically significant predictor of compliance to exercises during 20 weeks, but found self-efficacy to be a predictor of compliance in a private sector setting. Workplace-specific differences might be present and should be taken into account.

  18. Outpatient Pain Predicts Subsequent One-Year Acute Health Care Utilization Among Adults With Sickle Cell Disease

    PubMed Central

    Ezenwa, Miriam O.; Molokie, Robert E.; Wang, Zaijie Jim; Yao, Yingwei; Suarez, Marie L.; Angulo, Veronica; Wilkie, Diana J.

    2014-01-01

    Context Patient demographic and clinical factors have known associations with acute health care utilization (AHCU) among patients with sickle cell disease (SCD), but it is unknown if pain measured predominantly in an outpatient setting is a predictor of future AHCU in patients with SCD. Objectives To determine whether multidimensional pain scores obtained predominantly in an outpatient setting predicted subsequent one-year AHCU by 137 adults with SCD and whether the pain measured at a second visit also predicted AHCU. Methods Pain data included the Composite Pain Index (CPI), a single score representative of a multidimensional pain experience (number of pain sites, intensity, quality, and pattern). Based on the distribution of AHCU events, we divided patients into three groups: (1) zero events (Zero), (2) 1–3 events (Low), or (3) 4–23 events (High). Results The initial CPI scores differed significantly by the three groups (F(2,134)=7.38, P=0.001). Post hoc comparisons showed that the Zero group had lower CPI scores than both the Low group (P<0.01) and the High group (P<0.001). In multiviariate, overdispersed Poisson regression analyses, age, and CPI scores (at both measurement times) were statistically significant predictors of utilization events. Pain intensity scores at both measurement times were significant predictors of utilization, but other pain scores (number of pain sites, quality, and pattern) were not. Conclusion Findings support use of outpatient CPI scores or pain intensity and age to identify at-risk young adults with SCD who are likely to benefit from improved outpatient pain management plans. PMID:24636960

  19. Predictors of Poor Sleep Quality Among Head and Neck Cancer Patients

    PubMed Central

    Shuman, Andrew G.; Duffy, Sonia A.; Ronis, David L.; Garetz, Susan L.; McLean, Scott A.; Fowler, Karen E.; Terrell, Jeffrey E.

    2013-01-01

    Objectives/Hypothesis The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis. Study Design This was a prospective, multisite cohort study of head and neck cancer patients (N = 457). Methods Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex. Results Both baseline (67.1) and 1-year post-diagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores. Conclusions Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life. PMID:20513034

  20. The evolution of high summit metabolism and cold tolerance in birds and its impact on present-day distributions.

    PubMed

    Swanson, David L; Garland, Theodore

    2009-01-01

    Summit metabolic rate (M(sum), maximum cold-induced metabolic rate) is positively correlated with cold tolerance in birds, suggesting that high M(sum) is important for residency in cold climates. However, the phylogenetic distribution of high M(sum) among birds and the impact of its evolution on current distributions are not well understood. Two potential adaptive hypotheses might explain the phylogenetic distribution of high M(sum) among birds. The cold adaptation hypothesis contends that species wintering in cold climates should have higher M(sum) than species wintering in warmer climates. The flight adaptation hypothesis suggests that volant birds might be capable of generating high M(sum) as a byproduct of their muscular capacity for flight; thus, variation in M(sum) should be associated with capacity for sustained flight, one indicator of which is migration. We collected M(sum) data from the literature for 44 bird species and conducted both conventional and phylogenetically informed statistical analyses to examine the predictors of M(sum) variation. Significant phylogenetic signal was present for log body mass, log mass-adjusted M(sum), and average temperature in the winter range. In multiple regression models, log body mass, winter temperature, and clade were significant predictors of log M(sum). These results are consistent with a role for climate in determining M(sum) in birds, but also indicate that phylogenetic signal remains even after accounting for associations indicative of adaptation to winter temperature. Migratory strategy was never a significant predictor of log M(sum) in multiple regressions, a result that is not consistent with the flight adaptation hypothesis.

  1. Validity of self-reported periodontal measures, demographic characteristics and systemic medical conditions.

    PubMed

    Chatzopoulos, Georgios S; Cisneros, Alejandro; Sanchez, Miguel; Lunos, Scott; Wolff, Larry F

    2018-04-06

    The objective of the present study was to assess self-reported periodontal screening questions, demographic characteristics, systemic medical conditions and tobacco use for predicting periodontal disease among individuals seeking dental therapy in a university dental clinic. In this retrospective study, a total of 4,890 randomly selected dental charts were evaluated from among patients who had attended the University of Minnesota School of Dentistry clinics for treatment. Radiographic bone loss measurements were utilized to assess the severity of periodontal disease. Demographic characteristics as well as medical history of the patients were also recorded. Five self-reported periodontal screening questions were included with the range of answers limited to Yes/No. Generalized logit models were used to assess the association between bone loss and the predictors. The sample mean age was 54.1 years and included 52.6% males and 14.9% smokers with a mean number of missing teeth of 3.5. Self-reported tooth mobility, history of "gum treatment" and the importance to keep the teeth as well as age, tobacco use and cancer were statistically significant (p < 0.05) predictors of a radiographic diagnosis of moderate and severe periodontal disease. With respect to severe periodontal disease, significant (p < 0.05) associations were also found with "bleeding while brushing", gender, diabetes, anxiety and arthritis. Self-reported periodontal screening questions as well as demographic characteristics, smoking and systemic medical conditions were significant predictors of periodontal disease and they could be used as valid, economical and practical measures. This article is protected by copyright. All rights reserved. © 2018 American Academy of Periodontology.

  2. Predictors of radio-cephalic arteriovenous fistulae patency in an Asian population.

    PubMed

    Joseph Lo, Zhiwen; Tay, Wee Ming; Lee, Qinyi; Chua, Jia Long; Tan, Glenn Wei Leong; Chandrasekar, Sadhana; Narayanan, Sriram

    2016-09-21

    To identify predictors of arteriovenous fistula (AVF) patency in Asian patients with autogenous radio-cephalic arteriovenous fistula (RCAVF). Retrospective review of 436 RCAVFs created between 2009 and 2013. Predictors of patency were identified with univariate and multivariate analysis. Kaplan-Meier survival analysis and log-rank test were used to calculate patency rates. Overall secondary patency rate was 72% at 12 months, 69% at 24 months, 58% at 36 months, 57% at 48 months, 56% at 60 months and 54% at 72 months. Univariate analysis showed that factors which predict for patency include male gender (p = 0.003), good diabetic control (p = 0.025), aspirin use (p = 0.031), pre-dialysis status (p = 0.037), radial artery diameter (p = 0.029) and non-calcified radial arteries (p = 0.002). Age (p = 0.866), cephalic vein diameter (p = 0.630) and surgeon grade (p = 0.472) did not predict for primary AVF failure. Multivariate analysis revealed the male gender to be an independent predictor for patency (odds ratio 1.99, p = 0.01). Subset analysis showed a significantly larger average radial artery diameter of 2.3 mm amongst males, as compared to 1.9 mm amongst females (p = 0.001) and no statistical difference in the average cephalic vein diameter. Within our Asian study population, 12-month patency rate of RCAVF is 72%, 69% at 24 months, 58% at 36 months, 57% at 48 months, 56% at 60 months and 54% at 72 months. Male gender is an independent predictor for RCAVF patency. In females or patients with calcified radial arteries, a more proximal AVF should be considered.

  3. [The impact of compulsory health service on physicians and burnout in a province in Eastern Anatolia].

    PubMed

    Taycan, Okan; Erdoğan Taycan, Serap; Çelik, Cihat

    2013-01-01

    The Compulsory Health Service (CHS) for physicians has been in place since 2005. The aim of this study was to investigate the impact of the CHS on physicians and the factors associated with burnout. The sample group consisted of all physicians working within the province of Muş in this cross-sectional, descriptive, epidemiological study. All participants were assessed using the Maslach Burnout Inventory (MBI), the Beck Depression Inventory, the Job Satisfaction Scale (JSS), the Satisfaction with Life Scale, the Professional Quality of Life Scale (ProQOL) and the General Health Questiannaire-12, along with a detailed sociodemographic and professional data form. A total of 139 physicians participated in this study, and 100 of them (71%) were fulfilling the CHS. Physicians who fulfilled the CHS were found to have lower levels of job satisfaction and professional quality of life. They also had higher levels of depression, general psychiatric symptoms, and psychological stress. The relationships between the level of burnout in physicians fulfilling the CHS and the scores from the scales used in the study were statistically significant except those between MBI-Personal Accomplishment, JSS, and ProQOL-Compassion Fatigue subscales. The extent of depressive symptoms and the daily number of patients were predictors of all three subscales of burnout. Job satisfaction was a predictor of both emotional exhaustion and depersonalization, while life satisfaction was a predictor of emotional exhaustion, and gender was a predictor of personal accomplishment. The level of burnout among physicians who had fulfilled the CHS was high. The factors and predictors associated with burnout were discussed.

  4. Quantifying effectiveness of failure prediction and response in HPC systems : methodology and example.

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

    Mayo, Jackson R.; Chen, Frank Xiaoxiao; Pebay, Philippe Pierre

    2010-06-01

    Effective failure prediction and mitigation strategies in high-performance computing systems could provide huge gains in resilience of tightly coupled large-scale scientific codes. These gains would come from prediction-directed process migration and resource servicing, intelligent resource allocation, and checkpointing driven by failure predictors rather than at regular intervals based on nominal mean time to failure. Given probabilistic associations of outlier behavior in hardware-related metrics with eventual failure in hardware, system software, and/or applications, this paper explores approaches for quantifying the effects of prediction and mitigation strategies and demonstrates these using actual production system data. We describe context-relevant methodologies for determining themore » accuracy and cost-benefit of predictors. While many research studies have quantified the expected impact of growing system size, and the associated shortened mean time to failure (MTTF), on application performance in large-scale high-performance computing (HPC) platforms, there has been little if any work to quantify the possible gains from predicting system resource failures with significant but imperfect accuracy. This possibly stems from HPC system complexity and the fact that, to date, no one has established any good predictors of failure in these systems. Our work in the OVIS project aims to discover these predictors via a variety of data collection techniques and statistical analysis methods that yield probabilistic predictions. The question then is, 'How good or useful are these predictions?' We investigate methods for answering this question in a general setting, and illustrate them using a specific failure predictor discovered on a production system at Sandia.« less

  5. Predictors of Total Mortality and Echocardiographic Response for Cardiac Resynchronization Therapy: A Cohort Study

    PubMed Central

    Gazzoni, Guilherme Ferreira; Fraga, Matheus Bom; Ferrari, Andres Di Leoni; Soliz, Pablo da Costa; Borges, Anibal Pires; Bartholomay, Eduardo; Kalil, Carlos Antonio Abunader; Giaretta, Vanessa; Rohde, Luis Eduardo Paim

    2017-01-01

    Background Clinical studies demonstrate that up to 40% of patients do not respond to cardiac resynchronization therapy (CRT), thus, appropriate patient selection is critical to the success of CRT in heart failure. Objective Evaluation of mortality predictors and response to CRT in the Brazilian scenario. Methods Retrospective cohort study including patients submitted to CRT in a tertiary hospital in southern Brazil from 2008 to 2014. Survival was assessed through a database of the State Department of Health (RS). Predictors of echocardiographic response were evaluated using Poisson regression. Survival analysis was performed by Cox regression and Kaplan Meyer curves. A two-tailed p value less than 0.05 was considered statistically significant. Results A total of 170 patients with an average follow-up of 1011 ± 632 days were included. The total mortality was 30%. The independent predictors of mortality were age (hazard ratio [HR] of 1.05, p = 0.027), previous acute myocardial infarction (AMI) (HR of 2.17, p = 0.049) and chronic obstructive pulmonary disease (COPD) (HR of 3.13, p = 0.015). The percentage of biventricular stimulation at 6 months was identified as protective factor of mortality ([HR] 0.97, p = 0.048). The independent predictors associated with the echocardiographic response were absence of mitral insufficiency, presence of left bundle branch block and percentage of biventricular stimulation. Conclusion Mortality in patients submitted to CRT in a tertiary hospital was independently associated with age, presence of COPD and previous AMI. The percentage of biventricular pacing evaluated 6 months after resynchronizer implantation was independently associated with improved survival and echocardiographic response. PMID:29185615

  6. Diffusion Tensor Imaging for Outcome Prediction in Mild Traumatic Brain Injury: A TRACK-TBI Study

    PubMed Central

    Yuh, Esther L.; Cooper, Shelly R.; Mukherjee, Pratik; Yue, John K.; Lingsma, Hester F.; Gordon, Wayne A.; Valadka, Alex B.; Okonkwo, David O.; Schnyer, David M.; Vassar, Mary J.; Maas, Andrew I.R.; Casey, Scott S.; Cheong, Maxwell; Dams-O'Connor, Kristen; Hricik, Allison J.; Inoue, Tomoo; Menon, David K.; Morabito, Diane J.; Pacheco, Jennifer L.; Puccio, Ava M.; Sinha, Tuhin K.

    2014-01-01

    Abstract We evaluated 3T diffusion tensor imaging (DTI) for white matter injury in 76 adult mild traumatic brain injury (mTBI) patients at the semiacute stage (11.2±3.3 days), employing both whole-brain voxel-wise and region-of-interest (ROI) approaches. The subgroup of 32 patients with any traumatic intracranial lesion on either day-of-injury computed tomography (CT) or semiacute magnetic resonance imaging (MRI) demonstrated reduced fractional anisotropy (FA) in numerous white matter tracts, compared to 50 control subjects. In contrast, 44 CT/MRI-negative mTBI patients demonstrated no significant difference in any DTI parameter, compared to controls. To determine the clinical relevance of DTI, we evaluated correlations between 3- and 6-month outcome and imaging, demographic/socioeconomic, and clinical predictors. Statistically significant univariable predictors of 3-month Glasgow Outcome Scale-Extended (GOS-E) included MRI evidence for contusion (odds ratio [OR] 4.9 per unit decrease in GOS-E; p=0.01), ≥1 ROI with severely reduced FA (OR, 3.9; p=0.005), neuropsychiatric history (OR, 3.3; p=0.02), age (OR, 1.07/year; p=0.002), and years of education (OR, 0.79/year; p=0.01). Significant predictors of 6-month GOS-E included ≥1 ROI with severely reduced FA (OR, 2.7; p=0.048), neuropsychiatric history (OR, 3.7; p=0.01), and years of education (OR, 0.82/year; p=0.03). For the subset of 37 patients lacking neuropsychiatric and substance abuse history, MRI surpassed all other predictors for both 3- and 6-month outcome prediction. This is the first study to compare DTI in individual mTBI patients to conventional imaging, clinical, and demographic/socioeconomic characteristics for outcome prediction. DTI demonstrated utility in an inclusive group of patients with heterogeneous backgrounds, as well as in a subset of patients without neuropsychiatric or substance abuse history. PMID:24742275

  7. Wheeled-mobility correlates of life-space and social participation in adult manual wheelchair users aged 50 and older.

    PubMed

    Sakakibara, Brodie M; Routhier, François; Miller, William C

    2017-08-01

    To characterize the life-space mobility and social participation of manual wheelchair users using objective measures of wheeled mobility. Individuals (n = 49) were included in this cross-sectional study if they were aged 50 or older, community-dwelling and used their wheelchair on a daily basis for the past 6 months. Life-space mobility and social participation were measured using the life-space assessment and late-life disability instrument. The wheeled mobility variables (distance travelled, occupancy time, number of bouts) were captured using a custom-built data logger. After controlling for age and sex, multivariate regression analyses revealed that the wheeled mobility variables accounted for 24% of the life-space variance. The number of bouts variable, however, did not account for any appreciable variance above and beyond the occupancy time and distance travelled. Occupancy time and number of bouts were significant predictors of social participation and accounted for 23% of the variance after controlling for age and sex. Occupancy time and distance travelled are statistically significant predictors of life-space mobility. Lower occupancy time may be an indicative of travel to more distant life-spaces, whereas the distance travelled is likely a better reflection of mobility within each life-space. Occupancy time and number of bouts are significant predictors of participation frequency. Implications for rehabilitation Component measures of wheelchair mobility, such as distance travelled, occupancy time and number of bouts, are important predictors of life-space mobility and social participation in adult manual wheelchair users. Lower occupancy time is an indication of travel to more distant life-spaces, whereas distance travelled is likely a better reflection of mobility within each life-space. That lower occupancy time and greater number of bouts are associated with more frequent participation raises accessibility and safety issues for manual wheelchair users.

  8. Role of late gadolinium enhancement cardiovascular magnetic resonance in the risk stratification of hypertrophic cardiomyopathy.

    PubMed

    Ismail, Tevfik F; Jabbour, Andrew; Gulati, Ankur; Mallorie, Amy; Raza, Sadaf; Cowling, Thomas E; Das, Bibek; Khwaja, Jahanzaib; Alpendurada, Francisco D; Wage, Ricardo; Roughton, Michael; McKenna, William J; Moon, James C; Varnava, Amanda; Shakespeare, Carl; Cowie, Martin R; Cook, Stuart A; Elliott, Perry; O'Hanlon, Rory; Pennell, Dudley J; Prasad, Sanjay K

    2014-12-01

    Myocardial fibrosis identified by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM) is associated with adverse cardiovascular events, but its value as an independent risk factor for sudden cardiac death (SCD) is unknown. We investigated the role of LGE-CMR in the risk stratification of HCM. We conducted a prospective cohort study in a tertiary referral centre. Consecutive patients with HCM (n=711, median age 56.3 years, IQR 46.7-66.6; 70.0% male) underwent LGE-CMR and were followed for a median 3.5 years. The primary end point was SCD or aborted SCD. Overall, 471 patients (66.2%) had myocardial fibrosis (median 5.9% of left ventricular mass, IQR: 2.2-13.3). Twenty-two (3.1%) reached the primary end point. The extent but not the presence of fibrosis was a significant univariable predictor of the primary end point (HR per 5% LGE: 1.24, 95% CI 1.06 to 1.45; p=0.007 and HR for LGE: 2.69, 95% CI 0.91 to 7.97; p=0.073, respectively). However, on multivariable analysis, only LV-EF remained statistically significant (HR: 0.92, 95% CI 0.89 to 0.95; p<0.001). For the secondary outcome of cardiovascular mortality/aborted SCD, the presence and the amount of fibrosis were significant predictors on univariable but not multivariable analysis after adjusting for LV-EF and non-sustained ventricular tachycardia. The amount of myocardial fibrosis was a strong univariable predictor of SCD risk. However, this effect was not maintained after adjusting for LV-EF. Further work is required to elucidate the interrelationship between fibrosis and traditional predictors of outcome in HCM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Predictors of Individual Tumor Local Control After Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Brain Metastases

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

    Garsa, Adam A.; Badiyan, Shahed N.; DeWees, Todd

    2014-10-01

    Purpose: To evaluate local control rates and predictors of individual tumor local control for brain metastases from non-small cell lung cancer (NSCLC) treated with stereotactic radiosurgery (SRS). Methods and Materials: Between June 1998 and May 2011, 401 brain metastases in 228 patients were treated with Gamma Knife single-fraction SRS. Local failure was defined as an increase in lesion size after SRS. Local control was estimated using the Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis. Receiver operating characteristic analysis was used to identify an optimal cutpoint for conformality index relative to local control. Amore » P value <.05 was considered statistically significant. Results: Median age was 60 years (range, 27-84 years). There were 66 cerebellar metastases (16%) and 335 supratentorial metastases (84%). The median prescription dose was 20 Gy (range, 14-24 Gy). Median overall survival from time of SRS was 12.1 months. The estimated local control at 12 months was 74%. On multivariate analysis, cerebellar location (hazard ratio [HR] 1.94, P=.009), larger tumor volume (HR 1.09, P<.001), and lower conformality (HR 0.700, P=.044) were significant independent predictors of local failure. Conformality index cutpoints of 1.4-1.9 were predictive of local control, whereas a cutpoint of 1.75 was the most predictive (P=.001). The adjusted Kaplan-Meier 1-year local control for conformality index ≥1.75 was 84% versus 69% for conformality index <1.75, controlling for tumor volume and location. The 1-year adjusted local control for cerebellar lesions was 60%, compared with 77% for supratentorial lesions, controlling for tumor volume and conformality index. Conclusions: Cerebellar tumor location, lower conformality index, and larger tumor volume were significant independent predictors of local failure after SRS for brain metastases from NSCLC. These results warrant further investigation in a prospective setting.« less

  10. Global cardiovascular mortality risk in the adult Polish population: prospective assessment of the cohorts studied in multicentre national WOBASZ and WOBASZ Senior studies.

    PubMed

    Piotrowski, Walerian; Waśkiewicz, Anna; Cicha-Mikołajczyk, Alicja

    2016-01-01

    To develop a global cardiovascular disease (CVD) mortality risk model for the Polish population and to verify these data in the context of the SCORE risk algorithm. We analysed data obtained in two multicentre national population studies, the WOBASZ study which was conducted in 2003-2005 and included 14,769 subjects aged 20-74 years, and the WOBASZ Senior study which was conducted in 2007 and included 1096 subjects above 74 years of age. All these subjects were followed for survival status until 2012 and the cause of death was determined. The mean duration of follow-up was 8.2 years for WOBASZ study participants and about 5 years for WOBASZ Senior study participants. Overall, 1436 subjects died, including 568 due to CVD. For the purpose of our analysis of overall and CVD mortality, 15 established risk factors were selected. Survival was analysed separately in WOBASZ and WOBASZ Senior study participants. Statistical methods included descriptive statistics, Kaplan-Meier curves, Cox proportional hazard models, and the SCORE risk algorithm. Measure of incompatibility of the SCORE risk model to the Polish population was determined as the difference between mortality rates by the SCORE risk quartiles and the Cox approach. During the 8-year follow-up of the WOBASZ study population, mortality due to CVD was 38% among men and 31% among women. The most common causes of CVD mortality were ischaemic heart disease (IHD, 33%) followed by cerebro-vascular disease (17%) in men, and cerebrovascular disease (31%) followed by IHD (23%) in women. We found significant differences between men and women in regard to survival curves for both overall mortality and CVD mortality (p < 0.0001). For overall mortality among men and women, nearly all selected risk factors were shown to be significant in univariate analyses, except for high density lipoprotein cholesterol (HDL-C) level and the total cholesterol/HDL-C ratio in men, and smoking status in women. In multivariate analysis, independent predictors in men included age, glucose level, systolic blood pressure, and smoking status. In women, independent predictors were age, smoking status, and diabetes. During the 5-year follow-up of the WOBASZ Senior study population, mortality due to CVD was 48% among men and 58% among women. The most common cause of CVD mortality in both men and women was IHD (29% and 24%, respectively), followed by cerebrovascular disease (16% and 21%, respectively). We found significant differences between men and women in regard to survival curves for overall mortality (p < 0.0001) but not for CVD mortality (p = 0.0755). Due to the fact that survival curves for CVD mortality did not differ between men and women, we estimated the cut-off age for no survival difference in the WOBASZ study. By selecting the oldest patients and adding them to the WOBASZ Senior cohort, we obtained the cut-off age of 70 years above which the survival curves were not significantly different between men and women. In univariate analyses, independent predictors in men were age and creatinine level. These factors remained significant in multivariate analysis. In women above 74 years of age, independent predictors in univariate analyses included age, HDL-C level, creatinine level, total cholesterol/HDL-C ratio, and smoking status. Age, HDL-C level, creatinine level, and smoking status remained independent predictors of overall mortality in multivariate analysis. For CVD mortality, significant predictors were the same as for overall mortality. In women, significant predictors in uni- and multivariate analyses were age and smoking status. Overall disagreement between CVD mortality rates by the SCORE risk model and the Cox model was 5.7% in men and 2% in women. 1. Long-term follow-up of WOBASZ and WOBASZ Senior study participants allowed assessment of the inde-pendent association of the evaluated cardiovascular risk factors with CVD mortality in the Polish population. 2. Validation of the SCORE risk algorithm to estimate individual global CVD risk in the Polish population showed a high predictive value of this algorithm.

  11. Relationship between self-reported upper limb disability and quantitative tests in hand-arm vibration syndrome.

    PubMed

    Poole, Kerry; Mason, Howard

    2007-03-15

    To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS). A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire. PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%. Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.

  12. Sex-Specific Prediction Models for Sleep Apnea From the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Shah, Neomi; Hanna, David B; Teng, Yanping; Sotres-Alvarez, Daniela; Hall, Martica; Loredo, Jose S; Zee, Phyllis; Kim, Mimi; Yaggi, H Klar; Redline, Susan; Kaplan, Robert C

    2016-06-01

    We developed and validated the first-ever sleep apnea (SA) risk calculator in a large population-based cohort of Hispanic/Latino subjects. Cross-sectional data on adults from the Hispanic Community Health Study/Study of Latinos (2008-2011) were analyzed. Subjective and objective sleep measurements were obtained. Clinically significant SA was defined as an apnea-hypopnea index ≥ 15 events per hour. Using logistic regression, four prediction models were created: three sex-specific models (female-only, male-only, and a sex × covariate interaction model to allow differential predictor effects), and one overall model with sex included as a main effect only. Models underwent 10-fold cross-validation and were assessed by using the C statistic. SA and its predictive variables; a total of 17 variables were considered. A total of 12,158 participants had complete sleep data available; 7,363 (61%) were women. The population-weighted prevalence of SA (apnea-hypopnea index ≥ 15 events per hour) was 6.1% in female subjects and 13.5% in male subjects. Male-only (C statistic, 0.808) and female-only (C statistic, 0.836) prediction models had the same predictor variables (ie, age, BMI, self-reported snoring). The sex-interaction model (C statistic, 0.836) contained sex, age, age × sex, BMI, BMI × sex, and self-reported snoring. The final overall model (C statistic, 0.832) contained age, BMI, snoring, and sex. We developed two websites for our SA risk calculator: one in English (https://www.montefiore.org/sleepapneariskcalc.html) and another in Spanish (http://www.montefiore.org/sleepapneariskcalc-es.html). We created an internally validated, highly discriminating, well-calibrated, and parsimonious prediction model for SA. Contrary to the study hypothesis, the variables did not have different predictive magnitudes in male and female subjects. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  13. Can human experts predict solubility better than computers?

    PubMed

    Boobier, Samuel; Osbourn, Anne; Mitchell, John B O

    2017-12-13

    In this study, we design and carry out a survey, asking human experts to predict the aqueous solubility of druglike organic compounds. We investigate whether these experts, drawn largely from the pharmaceutical industry and academia, can match or exceed the predictive power of algorithms. Alongside this, we implement 10 typical machine learning algorithms on the same dataset. The best algorithm, a variety of neural network known as a multi-layer perceptron, gave an RMSE of 0.985 log S units and an R 2 of 0.706. We would not have predicted the relative success of this particular algorithm in advance. We found that the best individual human predictor generated an almost identical prediction quality with an RMSE of 0.942 log S units and an R 2 of 0.723. The collection of algorithms contained a higher proportion of reasonably good predictors, nine out of ten compared with around half of the humans. We found that, for either humans or algorithms, combining individual predictions into a consensus predictor by taking their median generated excellent predictivity. While our consensus human predictor achieved very slightly better headline figures on various statistical measures, the difference between it and the consensus machine learning predictor was both small and statistically insignificant. We conclude that human experts can predict the aqueous solubility of druglike molecules essentially equally well as machine learning algorithms. We find that, for either humans or algorithms, combining individual predictions into a consensus predictor by taking their median is a powerful way of benefitting from the wisdom of crowds.

  14. A comparison of dynamical and statistical downscaling methods for regional wave climate projections along French coastlines.

    NASA Astrophysics Data System (ADS)

    Laugel, Amélie; Menendez, Melisa; Benoit, Michel; Mattarolo, Giovanni; Mendez, Fernando

    2013-04-01

    Wave climate forecasting is a major issue for numerous marine and coastal related activities, such as offshore industries, flooding risks assessment and wave energy resource evaluation, among others. Generally, there are two main ways to predict the impacts of the climate change on the wave climate at regional scale: the dynamical and the statistical downscaling of GCM (Global Climate Model). In this study, both methods have been applied on the French coast (Atlantic , English Channel and North Sea shoreline) under three climate change scenarios (A1B, A2, B1) simulated with the GCM ARPEGE-CLIMAT, from Météo-France (AR4, IPCC). The aim of the work is to characterise the wave climatology of the 21st century and compare the statistical and dynamical methods pointing out advantages and disadvantages of each approach. The statistical downscaling method proposed by the Environmental Hydraulics Institute of Cantabria (Spain) has been applied (Menendez et al., 2011). At a particular location, the sea-state climate (Predictand Y) is defined as a function, Y=f(X), of several atmospheric circulation patterns (Predictor X). Assuming these climate associations between predictor and predictand are stationary, the statistical approach has been used to project the future wave conditions with reference to the GCM. The statistical relations between predictor and predictand have been established over 31 years, from 1979 to 2009. The predictor is built as the 3-days-averaged squared sea level pressure gradient from the hourly CFSR database (Climate Forecast System Reanalysis, http://cfs.ncep.noaa.gov/cfsr/). The predictand has been extracted from the 31-years hindcast sea-state database ANEMOC-2 performed with the 3G spectral wave model TOMAWAC (Benoit et al., 1996), developed at EDF R&D LNHE and Saint-Venant Laboratory for Hydraulics and forced by the CFSR 10m wind field. Significant wave height, peak period and mean wave direction have been extracted with an hourly-resolution at 110 coastal locations along the French coast. The model, based on the BAJ parameterization of the source terms (Bidlot et al, 2007) was calibrated against ten years of GlobWave altimeter observations (2000-2009) and validated through deep and shallow water buoy observations. The dynamical downscaling method has been performed with the same numerical wave model TOMAWAC used for building ANEMOC-2. Forecast simulations are forced by the 10m wind fields of ARPEGE-CLIMAT (A1B, A2, B1) from 2010 to 2100. The model covers the Atlantic Ocean and uses a spatial resolution along the French and European coast of 10 and 20 km respectively. The results of the model are stored with a time resolution of one hour. References: Benoit M., Marcos F., and F. Becq, (1996). Development of a third generation shallow-water wave model with unstructured spatial meshing. Proc. 25th Int. Conf. on Coastal Eng., (ICCE'1996), Orlando (Florida, USA), pp 465-478. Bidlot J-R, Janssen P. and Adballa S., (2007). A revised formulation of ocean wave dissipation and its model impact, technical memorandum ECMWF n°509. Menendez, M., Mendez, F.J., Izaguirre,C., Camus, P., Espejo, A., Canovas, V., Minguez, R., Losada, I.J., Medina, R. (2011). Statistical Downscaling of Multivariate Wave Climate Using a Weather Type Approach, 12th International Workshop on Wave Hindcasting and Forecasting and 3rd Coastal Hazard Symposium, Kona (Hawaii).

  15. STATISTICAL TECHNIQUES FOR DETERMINATION AND PREDICTION OF FUNDAMENTAL FISH ASSEMBLAGES OF THE MID-ATLANTIC HIGHLANDS

    EPA Science Inventory

    A statistical software tool, Stream Fish Community Predictor (SFCP), based on EMAP stream sampling in the mid-Atlantic Highlands, was developed to predict stream fish communities using stream and watershed characteristics. Step one in the tool development was a cluster analysis t...

  16. Improving satellite-driven PM2.5 models with Moderate Resolution Imaging Spectroradiometer fire counts in the southeastern U.S.

    PubMed

    Hu, Xuefei; Waller, Lance A; Lyapustin, Alexei; Wang, Yujie; Liu, Yang

    2014-10-16

    Multiple studies have developed surface PM 2.5 (particle size less than 2.5 µm in aerodynamic diameter) prediction models using satellite-derived aerosol optical depth as the primary predictor and meteorological and land use variables as secondary variables. To our knowledge, satellite-retrieved fire information has not been used for PM 2.5 concentration prediction in statistical models. Fire data could be a useful predictor since fires are significant contributors of PM 2.5 . In this paper, we examined whether remotely sensed fire count data could improve PM 2.5 prediction accuracy in the southeastern U.S. in a spatial statistical model setting. A sensitivity analysis showed that when the radius of the buffer zone centered at each PM 2.5 monitoring site reached 75 km, fire count data generally have the greatest predictive power of PM 2.5 across the models considered. Cross validation (CV) generated an R 2 of 0.69, a mean prediction error of 2.75 µg/m 3 , and root-mean-square prediction errors (RMSPEs) of 4.29 µg/m 3 , indicating a good fit between the dependent and predictor variables. A comparison showed that the prediction accuracy was improved more substantially from the nonfire model to the fire model at sites with higher fire counts. With increasing fire counts, CV RMSPE decreased by values up to 1.5 µg/m 3 , exhibiting a maximum improvement of 13.4% in prediction accuracy. Fire count data were shown to have better performance in southern Georgia and in the spring season due to higher fire occurrence. Our findings indicate that fire count data provide a measurable improvement in PM 2.5 concentration estimation, especially in areas and seasons prone to fire events.

  17. Risk assessment of student performance in the International Foundations of Medicine Clinical Science Examination by the use of statistical modeling.

    PubMed

    David, Michael C; Eley, Diann S; Schafer, Jennifer; Davies, Leo

    2016-01-01

    The primary aim of this study was to assess the predictive validity of cumulative grade point average (GPA) for performance in the International Foundations of Medicine (IFOM) Clinical Science Examination (CSE). A secondary aim was to develop a strategy for identifying students at risk of performing poorly in the IFOM CSE as determined by the National Board of Medical Examiners' International Standard of Competence. Final year medical students from an Australian university medical school took the IFOM CSE as a formative assessment. Measures included overall IFOM CSE score as the dependent variable, cumulative GPA as the predictor, and the factors age, gender, year of enrollment, international or domestic status of student, and language spoken at home as covariates. Multivariable linear regression was used to measure predictor and covariate effects. Optimal thresholds of risk assessment were based on receiver-operating characteristic (ROC) curves. Cumulative GPA (nonstandardized regression coefficient [B]: 81.83; 95% confidence interval [CI]: 68.13 to 95.53) and international status (B: -37.40; 95% CI: -57.85 to -16.96) from 427 students were found to be statistically associated with increased IFOM CSE performance. Cumulative GPAs of 5.30 (area under ROC [AROC]: 0.77; 95% CI: 0.72 to 0.82) and 4.90 (AROC: 0.72; 95% CI: 0.66 to 0.78) were identified as being thresholds of significant risk for domestic and international students, respectively. Using cumulative GPA as a predictor of IFOM CSE performance and accommodating for differences in international status, it is possible to identify students who are at risk of failing to satisfy the National Board of Medical Examiners' International Standard of Competence.

  18. Improving satellite-driven PM2.5 models with Moderate Resolution Imaging Spectroradiometer fire counts in the southeastern U.S

    PubMed Central

    Hu, Xuefei; Waller, Lance A.; Lyapustin, Alexei; Wang, Yujie; Liu, Yang

    2017-01-01

    Multiple studies have developed surface PM2.5 (particle size less than 2.5 µm in aerodynamic diameter) prediction models using satellite-derived aerosol optical depth as the primary predictor and meteorological and land use variables as secondary variables. To our knowledge, satellite-retrieved fire information has not been used for PM2.5 concentration prediction in statistical models. Fire data could be a useful predictor since fires are significant contributors of PM2.5. In this paper, we examined whether remotely sensed fire count data could improve PM2.5 prediction accuracy in the southeastern U.S. in a spatial statistical model setting. A sensitivity analysis showed that when the radius of the buffer zone centered at each PM2.5 monitoring site reached 75 km, fire count data generally have the greatest predictive power of PM2.5 across the models considered. Cross validation (CV) generated an R2 of 0.69, a mean prediction error of 2.75 µg/m3, and root-mean-square prediction errors (RMSPEs) of 4.29 µg/m3, indicating a good fit between the dependent and predictor variables. A comparison showed that the prediction accuracy was improved more substantially from the nonfire model to the fire model at sites with higher fire counts. With increasing fire counts, CV RMSPE decreased by values up to 1.5 µg/m3, exhibiting a maximum improvement of 13.4% in prediction accuracy. Fire count data were shown to have better performance in southern Georgia and in the spring season due to higher fire occurrence. Our findings indicate that fire count data provide a measurable improvement in PM2.5 concentration estimation, especially in areas and seasons prone to fire events. PMID:28967648

  19. Predictors of Mortality in the Critically Ill Cirrhotic Patient: Is the Model for End-Stage Liver Disease Enough?

    PubMed

    Annamalai, Alagappan; Harada, Megan Y; Chen, Melissa; Tran, Tram; Ko, Ara; Ley, Eric J; Nuno, Miriam; Klein, Andrew; Nissen, Nicholas; Noureddin, Mazen

    2017-03-01

    Critically ill cirrhotics require liver transplantation urgently, but are at high risk for perioperative mortality. The Model for End-stage Liver Disease (MELD) score, recently updated to incorporate serum sodium, estimates survival probability in patients with cirrhosis, but needs additional evaluation in the critically ill. The purpose of this study was to evaluate the predictive power of ICU admission MELD scores and identify clinical risk factors associated with increased mortality. This was a retrospective review of cirrhotic patients admitted to the ICU between January 2011 and December 2014. Patients who were discharged or underwent transplantation (survivors) were compared with those who died (nonsurvivors). Demographic characteristics, admission MELD scores, and clinical risk factors were recorded. Multivariate regression was used to identify independent predictors of mortality, and measures of model performance were assessed to determine predictive accuracy. Of 276 patients who met inclusion criteria, 153 were considered survivors and 123 were nonsurvivors. Survivor and nonsurvivor cohorts had similar demographic characteristics. Nonsurvivors had increased MELD, gastrointestinal bleeding, infection, mechanical ventilation, encephalopathy, vasopressors, dialysis, renal replacement therapy, requirement of blood products, and ICU length of stay. The MELD demonstrated low predictive power (c-statistic 0.73). Multivariate analysis identified MELD score (adjusted odds ratio [AOR] = 1.05), mechanical ventilation (AOR = 4.55), vasopressors (AOR = 3.87), and continuous renal replacement therapy (AOR = 2.43) as independent predictors of mortality, with stronger predictive accuracy (c-statistic 0.87). The MELD demonstrated relatively poor predictive accuracy in critically ill patients with cirrhosis and might not be the best indicator for prognosis in the ICU population. Prognostic accuracy is significantly improved when variables indicating organ support (mechanical ventilation, vasopressors, and continuous renal replacement therapy) are included in the model. Copyright © 2016. Published by Elsevier Inc.

  20. Effect of correlation on covariate selection in linear and nonlinear mixed effect models.

    PubMed

    Bonate, Peter L

    2017-01-01

    The effect of correlation among covariates on covariate selection was examined with linear and nonlinear mixed effect models. Demographic covariates were extracted from the National Health and Nutrition Examination Survey III database. Concentration-time profiles were Monte Carlo simulated where only one covariate affected apparent oral clearance (CL/F). A series of univariate covariate population pharmacokinetic models was fit to the data and compared with the reduced model without covariate. The "best" covariate was identified using either the likelihood ratio test statistic or AIC. Weight and body surface area (calculated using Gehan and George equation, 1970) were highly correlated (r = 0.98). Body surface area was often selected as a better covariate than weight, sometimes as high as 1 in 5 times, when weight was the covariate used in the data generating mechanism. In a second simulation, parent drug concentration and three metabolites were simulated from a thorough QT study and used as covariates in a series of univariate linear mixed effects models of ddQTc interval prolongation. The covariate with the largest significant LRT statistic was deemed the "best" predictor. When the metabolite was formation-rate limited and only parent concentrations affected ddQTc intervals the metabolite was chosen as a better predictor as often as 1 in 5 times depending on the slope of the relationship between parent concentrations and ddQTc intervals. A correlated covariate can be chosen as being a better predictor than another covariate in a linear or nonlinear population analysis by sheer correlation These results explain why for the same drug different covariates may be identified in different analyses. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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