The Impact of Intensive Vocation-Related Course Taking on Employment Outcomes for Individuals Who Are Deaf

Science.gov (United States)

Cawthon, Stephanie W.; Wendel, Erica M.; Bond, Mark P.; Garberoglio, Carrie Lou

2016-01-01

Individuals who are deaf have historically faced significant obstacles to equity in employment. This secondary analysis of data from the second National Longitudinal Transition Study (NLTS2) examined (a) intensive vocation-related courses taken by students who are deaf and (b) their impact on long-term employment outcomes. Deaf students in general…

[Informed consent right of the appraised individuals in forensic clinical examination].

Science.gov (United States)

Li, Ju-Ping; Han, Wei; Gu, Shan-Zhi; Chen, Teng

2015-02-01

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.

Outcomes of Cognitive-Behavioral Treatment for Insomnia on Insomnia, Depression, and Fatigue for Individuals with Multiple Sclerosis: A Case Series

OpenAIRE

Clancy, Megan; Drerup, Michelle; Sullivan, Amy Burleson

2015-01-01

Background: This clinical case series examined outcomes of cognitive-behavioral therapy for insomnia (CBT-I) in individuals with multiple sclerosis (MS). Current literature links insomnia with higher rates of depression and fatigue in individuals with MS. However, no research to date evaluates a targeted psychotherapeutic intervention for insomnia in this population.

Monitoring individual and joint action outcomes in duet music performance

DEFF Research Database (Denmark)

Loehr, Janeen; Kourtis, Dimitrios; Vesper, Cordula

2013-01-01

We investigated whether people monitor the outcomes of their own and their partners’ individual actions as well as the outcome of their combined actions when performing joint actions together. Pairs of pianists memorized both parts of a piano duet. Each pianist then performed one part while their...

Measuring what latent fingerprint examiners consider sufficient information for individualization determinations.

Directory of Open Access Journals (Sweden)

Bradford T Ulery

Full Text Available Latent print examiners use their expertise to determine whether the information present in a comparison of two fingerprints (or palmprints is sufficient to conclude that the prints were from the same source (individualization. When fingerprint evidence is presented in court, it is the examiner's determination--not an objective metric--that is presented. This study was designed to ascertain the factors that explain examiners' determinations of sufficiency for individualization. Volunteer latent print examiners (n = 170 were each assigned 22 pairs of latent and exemplar prints for examination, and annotated features, correspondence of features, and clarity. The 320 image pairs were selected specifically to control clarity and quantity of features. The predominant factor differentiating annotations associated with individualization and inconclusive determinations is the count of corresponding minutiae; other factors such as clarity provided minimal additional discriminative value. Examiners' counts of corresponding minutiae were strongly associated with their own determinations; however, due to substantial variation of both annotations and determinations among examiners, one examiner's annotation and determination on a given comparison is a relatively weak predictor of whether another examiner would individualize. The extensive variability in annotations also means that we must treat any individual examiner's minutia counts as interpretations of the (unknowable information content of the prints: saying "the prints had N corresponding minutiae marked" is not the same as "the prints had N corresponding minutiae." More consistency in annotations, which could be achieved through standardization and training, should lead to process improvements and provide greater transparency in casework.

Using assistive technology outcomes research to inform policy related to the employment of individuals with disabilities.

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Mendelsohn, Steven; Edyburn, Dave L; Rust, Kathy L; Schwanke, Todd D; Smith, Roger O

2008-01-01

We know that work is recognized as a central component of life for individuals with and without disabilities. It yields many physical and psychological benefits to the individual while simultaneously contributing numerous benefits to society. Lawmakers have enacted a plethora of laws designed to prevent discrimination, provide incentives for employers to hire individuals with disabilities, and facilitate job training/career preparation. Assistive technology figures prominently in disability employment law as a critical strategy for gaining access and supporting employment and upward mobility in the workplace. However, little systematic effort has been devoted to examining assistive technology use and outcomes as they relate to the employment of individuals with disabilities. The purpose of this article is to articulate a series of issues that permeate assistive technology outcome measurement in employment settings and subsequently affect the use of research knowledge for federal and state policy makers. For each issue, the authors pose three questions for critical analysis: Does the law compel the provision of assistive technology? Does outcome data play any part in the operation of the law? When it does, what kind of data would be useful to collect and where could it be found? Finally, the authors provide a brief glimpse of the current and future research efforts concerning the RSA-911 database. The recent database summaries exemplify the importance of such a national data collection system for informing federal policy, particularly concerning the contributions of assistive technology device use and services on improving the employment of individuals with disabilities.

Individual plant examination program aspirations and achievements

International Nuclear Information System (INIS)

Flack, J.H.

1994-01-01

An Individual Plant Examination (IPE) is a systematic examination of a nuclear power plant for vulnerabilities, or risk significant contributors. By mid 1994, all licensees of commercial nuclear power plants will have performed an IPE on their units. To date, the NRC staff has received sixty-three (80%) of the seventy-eight expected IPE submittals. Twelve IPE reviews are now complete, with twenty-two in various stages of review. This paper provides a preliminary overview and comparison of licensees IPEs to Commission objectives. Insights and findings stemming from the review program are also presented

Examining the Relationship between Equal Opportunity Climate and Individual Level Outcome Variables

Science.gov (United States)

2010-10-28

individual level of analysis to determine whether subsequent findings in this inquiry would be attributable to method bias. According to Podsakoff ...23rd annual conference of the Society for Industrial and Organizational Psychologists, 10 - 12 April, 2008, San Francisco, CA. Podsakoff , P. M

The influence of individual, group, and relative self-esteem on outcome for patients undergoing group cognitive-behavioural therapy treatment.

Science.gov (United States)

Parker, Thomas J; Page, Andrew C; Hooke, Geoff R

2013-11-01

Despite a strong association between individual self-esteem and treatment outcome in group cognitive-behavioural therapy (GCBT), no study has investigated how patient outcomes might be influenced by an individual's self-esteem relative to other group members. The study comprised a retrospective examination of patients' data and used a multiple regression analysis to identify predictors of treatment outcome. Patients' pre-treatment self-esteem scores were assessed on a continuum and assigned to be low, medium, or high. Therapy groups were assigned to be either low, balanced or high self-esteem groups based on averaged self-esteem scores of participants. In this study, 3,878 patients who had completed a 10-day intensive cognitive behavioural group therapy programme at a private psychiatric facility were included in the study. The Rosenberg Self-Esteem measure was chosen to assess self-esteem. The three subscales of the Depression Anxiety Stress Scales were used as the outcome measures. Patient outcomes were influenced by pre-treatment self-esteem scores, such that higher initial self-esteem was associated with better treatment outcomes. Low group self-esteem was predictive of significantly better outcomes for depression, relative to higher self-esteem groups. Additionally, the combined influence of high individual self-esteem and low group self-esteem was associated with significantly enhanced depression improvement. High self-esteem patients perform better on outcome measures following completion of GCBT. Low self-esteem groups show greater improvement in depression symptoms. Similar results for depression are achieved when patients with high self-esteem complete treatment in low self-esteem groups. © 2013 The British Psychological Society.

The relationship of individual characteristics, perceived worksite support and perceived creativity to clinical nurses' innovative outcome.

Science.gov (United States)

Tsai, Hsiu-Min; Liou, Shwu-Ru; Hsiao, Ya-Chu; Cheng, Ching-Yu

2013-09-01

To understand the relationship of individual characteristics, perceived worksite support and perceived personal creativity to clinical nurses' innovative outcome (receiving the Nursing Innovation Award). Since the idea of applying creativity and innovation to clinical nursing practice and management was first advocated in the Nursing Administration Quarterly in 1982, the topic of nursing innovation has gained worldwide attention. To increase the prevalence of nursing innovation, it is important to identify and understand the related factors that influence nurses' innovative outcome. This study used a cross-sectional descriptive survey design. A self-administered questionnaire was completed by 32 award winners and 506 nonawarded clinical nurses in Taiwan. The level of creativity perceived by all participants was moderate-to-high. Individual characteristics (r = 0·61) and worksite support (r = 0·27) were both correlated with perceived creativity. Individual characteristics and worksite support showed some correlation as well (r = 0·21). Individual characteristics and worksite support could predict perceived creativity after controlling for demographic variables, but only individual characteristics had an effect on innovative outcome. Perceived creativity did not have mediation effects either between individual characteristics and innovative outcome or between worksite support and innovative outcome. Clinical nurses' individual characteristics had a direct relationship to innovative outcome, whereas neither worksite support nor creativity was correlated with innovative outcome. Although worksite support did not show effects on innovative outcome, it was related to both perceived creativity and individual characteristics. As suggested by other scholars, there might be other related factors between creativity and innovative outcome. Although worksite support did not have effect on clinical nurses' innovative outcome, it was related to individual characteristics

Does Working Memory Impact Functional Outcomes in Individuals With ADHD: A Qualitative and Comprehensive Literature Review.

Science.gov (United States)

Fried, Ronna; Abrams, Jessica; Hall, Anna; Feinberg, Leah; Pope, Amanda; Biederman, Joseph

2017-09-01

Working Memory (WM) is a domain of executive functioning often impaired in individuals with ADHD. Although assumed to cause difficulties across functioning, the scope of impairments from WM deficits in ADHD has not been investigated. The aim of this study was to examine outcomes associated with WM deficits in ADHD. We conducted a search of the scientific literature on WM deficits, and Freedom From Distractibility (FFD), in ADHD using PubMed and PsycInfo databases. The final sample included 11 controlled studies of WM/FFD deficits in ADHD with operationalized assessment of outcomes in academic, social, and emotional areas. WM assessment was divided into auditory-verbal memory (AVM) and spatial-visual memory (SWM). Seven studies examined WM deficits in academic functioning, eight studies assessed WM deficits in social functioning, and three assessed WM deficits in psychopathology. The majority of the literature suggests that WM deficits affect primarily academic functioning.

The relationship between interpersonal problems, therapeutic alliance, and outcomes following group and individual cognitive behaviour therapy.

Science.gov (United States)

McEvoy, Peter M; Burgess, Melissa M; Nathan, Paula

2014-03-01

Cognitive behavioural therapy (CBT) is efficacious, but there remains individual variability in outcomes. Patient's interpersonal problems may affect treatment outcomes, either directly or through a relationship mediated by helping alliance. Interpersonal problems may affect alliance and outcomes differentially in individual and group (CBGT) treatments. The main aim of this study was to investigate the relationship between interpersonal problems, alliance, dropout and outcomes for a clinical sample receiving either individual or group CBT for anxiety or depression in a community clinic. Patients receiving individual CBT (N=84) or CBGT (N=115) completed measures of interpersonal problems, alliance, and disorder specific symptoms at the commencement and completion of CBT. In CBGT higher pre-treatment interpersonal problems were associated with increased risk of dropout and poorer outcomes. This relationship was not mediated by alliance. In individual CBT those who reported higher alliance were more likely to complete treatment, although alliance was not associated with symptom change, and interpersonal problems were not related to attrition or outcome. Allocation to group and individual therapy was non-random, so selection bias may have influenced these results. Some analyses were only powered to detect large effects. Helping alliance ratings were high, so range restriction may have obscured the relationship between helping alliance, attrition and outcomes. Pre-treatment interpersonal problems increase risk of dropout and predict poorer outcomes in CBGT, but not in individual CBT, and this relationship is not mediated by helping alliance. Stronger alliance is associated with treatment completion in individual, but not group CBT. Copyright © 2014 Elsevier B.V. All rights reserved.

Who benefits? Outcome following a coping skills group intervention for traumatically brain injured individuals.

Science.gov (United States)

Anson, Katie; Ponsford, Jennie

2006-01-01

To investigate the variables associated with positive psychological outcome following a group intervention for 33 individuals with traumatic brain injury. Evaluation study which used multiple regression analysis to examine the variables associated with change in psychological adjustment following a 10-session cognitive behaviour therapy-based group. The predictor variables were age at injury, time since injury, injury severity, self-awareness, pre-morbid intellectual function, memory function, executive function and level of depression and anxiety prior to intervention. The predictor variables contributed a significant proportion of the variance in percentage change in depression. The major finding was that better outcomes following intervention were associated with greater self-awareness of injury-related deficits. The present study identified a number of variables that were associated with improvement in depression following psychological intervention and may assist future treatment resources to be directed most effectively.

Public computing options for individuals with cognitive impairments: survey outcomes.

Science.gov (United States)

Fox, Lynn Elizabeth; Sohlberg, McKay Moore; Fickas, Stephen; Lemoncello, Rik; Prideaux, Jason

2009-09-01

To examine availability and accessibility of public computing for individuals with cognitive impairment (CI) who reside in the USA. A telephone survey was administered as a semi-structured interview to 145 informants representing seven types of public facilities across three geographically distinct regions using a snowball sampling technique. An Internet search of wireless (Wi-Fi) hotspots supplemented the survey. Survey results showed the availability of public computer terminals and Internet hotspots was greatest in the urban sample, followed by the mid-sized and rural cities. Across seven facility types surveyed, libraries had the highest percentage of access barriers, including complex queue procedures, login and password requirements, and limited technical support. University assistive technology centres and facilities with a restricted user policy, such as brain injury centres, had the lowest incidence of access barriers. Findings suggest optimal outcomes for people with CI will result from a careful match of technology and the user that takes into account potential barriers and opportunities to computing in an individual's preferred public environments. Trends in public computing, including the emergence of widespread Wi-Fi and limited access to terminals that permit auto-launch applications, should guide development of technology designed for use in public computing environments.

Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome.

Science.gov (United States)

Hollis, Ann M; Duncanson, Haley; Kapust, Lissa R; Xi, Patricia M; O'Connor, Margaret G

2015-05-01

To evaluate the effectiveness of two cognitive screening measures, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in predicting driving test outcome for individuals with and without cognitive impairment. Retrospective cohort study. A clinical driving evaluation program at a teaching hospital in the United States. Adult drivers who underwent assessment with the MMSE and MoCA as part of a comprehensive driving evaluation between 2010 and 2014 (N=92). MMSE and MoCA total scores were independent variables. The outcome measure was performance on a standardized road test. A preestablished diagnosis of cognitive impairment enhanced the validity of cognitive screening measures in the identification of at-risk drivers. In individuals with cognitive impairment there was a significant relationship between MoCA score and on-road outcome. Specifically, an individual was 1.36 times as likely to fail the road test with each 1-point decrease in MoCA score. No such relationship was detected in those without a diagnosis of cognitive impairment. For individuals who have not been diagnosed with cognitive impairment, neither the MMSE nor the MoCA can be reliably used as an indicator of driving risk, but for individuals with a preestablished diagnosis of cognitive impairment, the MoCA is a useful tool in this regard. A score on the MoCA of 18 or less should raise concerns about driving safety. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses.

Science.gov (United States)

Townley, Greg; Brusilovskiy, Eugene; Snethen, Gretchen; Salzer, Mark S

2018-03-01

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses. © Society for Community Research and Action 2017.

Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite.

Science.gov (United States)

Schlaudraff, Kai-Uwe; Kiessling, Maren C; Császár, Nikolaus Bm; Schmitz, Christoph

2014-01-01

Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI), weight, and/or height. Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean) cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast(®) device (Electro Medical Systems, S.A., Nyon, Switzerland). Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right), totaling eight treatments on the selected side. Treatment was performed at 3.5-4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area). Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires. The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades) and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades). Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, Pcellulite grade at baseline, BMI, weight, height, or age. Radial shock wave therapy is a safe and effective treatment option for cellulite. The individual clinical outcome cannot be predicted by the patient's individual cellulite grade at baseline, BMI, weight

Relationship stigma and relationship outcomes in interracial and same-sex relationships: Examination of sources and buffers.

Science.gov (United States)

Rosenthal, Lisa; Starks, Tyrel J

2015-12-01

Interracial and same-sex romantic relationships are more common and socially accepted in the United States than ever before; yet, stigmatization of these relationships persists, with consequences for relationship dynamics. We conducted an online survey study with adults living in the United States in interracial and same-sex relationships to examine associations of relationship stigma from family, friends, and public with several relationship outcomes (i.e., investment, satisfaction, intimate partner aggression victimization and perpetration, commitment, intimacy, trust, passion, love, sexual communication, and sexual satisfaction), as well as the potential buffering roles of egalitarianism and dyadic coping. Regression analyses with 480 participants support that above and beyond individually experienced discrimination and other well-known predictors of relationship outcomes, relationship stigma from friends in particular was associated with lower relationship commitment, trust, love, and sexual communication, as well as greater odds of intimate partner aggression victimization. Egalitarianism and dyadic coping moderated some of the associations of relationship stigma from family, friends, and public with relationship outcomes, supporting their potential roles as buffers. These findings suggest many avenues for future research and implications for clinicians working with interracial and same-sex couples, individuals in those couples, and their families. Given increasing prevalence of interracial and same-sex relationships and marriages, more work should continue to explore these couples' experiences and how best to support them. (c) 2015 APA, all rights reserved).

Individual-level outcomes from a national clinical leadership development programme.

Science.gov (United States)

Patton, Declan; Fealy, Gerard; McNamara, Martin; Casey, Mary; Connor, Tom O; Doyle, Louise; Quinlan, Christina

2013-08-01

A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses' and midwives' clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

Examination of Automation-Induced Complacency and Individual Difference Variates

Science.gov (United States)

Prinzel, Lawrence J., III; DeVries, Holly; Freeman, Fred G.; Mikulka, Peter

2001-01-01

Automation-induced complacency has been documented as a cause or contributing factor in many airplane accidents throughout the last two decades. It is surmised that the condition results when a crew is working in highly reliable automated environments in which they serve as supervisory controllers monitoring system states for occasional automation failures. Although many reports have discussed the dangers of complacency, little empirical research has been produced to substantiate its harmful effects on performance as well as what factors produce complacency. There have been some suggestions, however, that individual characteristics could serve as possible predictors of performance in automated systems. The present study examined relationship between the individual differences of complacency potential, boredom proneness, and cognitive failure, automation-induced complacency. Workload and boredom scores were also collected and analyzed in relation to the three individual differences. The results of the study demonstrated that there are personality individual differences that are related to whether an individual will succumb to automation-induced complacency. Theoretical and practical implications are discussed.

Individual and Community Socioeconomic Status: Impact on Mental Health in Individuals with Arthritis

Directory of Open Access Journals (Sweden)

Chivon A. Mingo

2014-01-01

Full Text Available To examine the impact of individual and community socioeconomic status (SES measures on mental health outcomes in individuals with arthritis, participants with self-reported arthritis completed a telephone survey assessing health status, health attitudes and beliefs, and sociodemographic variables. Regression analyses adjusting for race, gender, BMI, comorbidities, and age were performed to determine the impact of individual and community level SES on mental health outcomes (i.e., Medical Outcomes Study SF-12v2 mental health component, the Centers for Disease Control and Prevention Health-Related Quality of Life Healthy Days Measure, Center for Epidemiological Studies Depression [CES-D] scale. When entered singly, lower education and income, nonmanagerial occupation, non-homeownership, and medium and high community poverty were all significantly associated with poorer mental health outcomes. Income, however, was more strongly associated with the outcomes in comparison to the other SES variables. In a model including all SES measures simultaneously, income was significantly associated with each outcome variable. Lower levels of individual and community SES showed most consistent statistical significance in association with CES-D scores. Results suggest that both individual and community level SES are associated with mental health status in people with arthritis. It is imperative to consider how interventions focused on multilevel SES factors may influence existing disparities.

An Examination of the "Interpersonalness" of the Outcome Questionnaire

Science.gov (United States)

Hess, Timothy R.; Rohlfing, Jessica E.; Hardy, Amanda O.; Glidden-Tracey, Cynthia; Tracey, Terence J. G.

2010-01-01

This study examined whether the Outcome Questionnaire-45 (OQ) and its subscales assessed unique interpersonal distress. The Inventory of Interpersonal Problems (IIP) was used to assess discriminant validity for unique interpersonal distress. Participants (N = 121) were recruited from a southwestern university counselor training center. Significant…

Elevated outcome-anticipation and outcome-evaluation ERPs associated with a greater preference for larger-but-delayed rewards.

Science.gov (United States)

Pornpattananangkul, Narun; Nadig, Ajay; Heidinger, Storm; Walden, Keegan; Nusslock, Robin

2017-06-01

Although waiting for a reward reduces or discounts its value, some people have a stronger tendency to wait for larger rewards and forgo smaller-but-immediate rewards. This ability to delay gratification is captured by individual differences in so-called intertemporal choices in which individuals are asked to choose between larger-but-delayed versus smaller-but-immediate rewards. The current study used event-related potentials (ERPs) to examine whether enhancement in two neurocognitive processes, outcome anticipation and outcome evaluation, modulate individual variability in intertemporal responses. After completing a behavioral intertemporal choice task, 34 participants performed an ERP gambling task. From this ERP task, we separately examined individual differences in outcome anticipation (stimulus-preceding negativity; SPN), early outcome valuation (feedback-related negativity; FRN), and late outcome evaluation (P3). We observed that both elevated outcome-anticipation (SPN) and late outcome-evaluation (P3) neural processes predicted a stronger preference toward larger-but-delayed rewards. No relationship was observed between intertemporal responses and early outcome evaluation (FRN), indicating that the relationship between outcome evaluation and intertemporal responses was specific to the late outcome-evaluation processing stream. Moreover, multiple regression analyses indicated that the SPN and P3 independently modulate individual differences in intertemporal responses, suggesting separate mechanisms underlie the relationship between these two neurocognitive processes and intertemporal responses. Accordingly, we identify two potential neurocognitive modulators of individual variability in intertemporal responses. We discuss the mechanisms underlying these modulators in terms of anticipation-related processing (SPN) and a saliency bias toward gain (compared to loss) outcomes (P3).

Can prebiotics and probiotics improve therapeutic outcomes for undernourished individuals?

Science.gov (United States)

Sheridan, Paul O; Bindels, Laure B; Saulnier, Delphine M; Reid, Gregor; Nova, Esther; Holmgren, Kerstin; O'Toole, Paul W; Bunn, James; Delzenne, Nathalie; Scott, Karen P

2014-01-01

It has become clear in recent years that the human intestinal microbiota plays an important role in maintaining health and thus is an attractive target for clinical interventions. Scientists and clinicians have become increasingly interested in assessing the ability of probiotics and prebiotics to enhance the nutritional status of malnourished children, pregnant women, the elderly, and individuals with non-communicable disease-associated malnutrition. A workshop was held by the International Scientific Association for Probiotics and Prebiotics (ISAPP), drawing on the knowledge of experts from industry, medicine, and academia, with the objective to assess the status of our understanding of the link between the microbiome and under-nutrition, specifically in relation to probiotic and prebiotic treatments for under-nourished individuals. These discussions led to four recommendations:   (1) The categories of malnourished individuals need to be differentiated To improve treatment outcomes, subjects should first be categorized based on the cause of malnutrition, additional health-concerns, differences in the gut microbiota, and sociological considerations. (2) Define a baseline "healthy" gut microbiota for each category Altered nutrient requirement (for example, in pregnancy and old age) and individual variation may change what constitutes a healthy gut microbiota for the individual. (3) Perform studies using model systems to test the effectiveness of potential probiotics and prebiotics against these specific categories These should illustrate how certain microbiota profiles can be altered, as members of different categories may respond differently to the same treatment. (4) Perform robust well-designed human studies with probiotics and/or prebiotics, with appropriate, defined primary outcomes and sample size These are critical to show efficacy and understand responder and non-responder outcomes. It is hoped that these recommendations will lead to new approaches that

Pharmacy curriculum outcomes assessment for individual student assessment and curricular evaluation.

Science.gov (United States)

Scott, Day M; Bennett, Lunawati L; Ferrill, Mary J; Brown, Daniel L

2010-12-15

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of PCOA was 0.91, 0.90, and 0.93 for the 3 years, respectively. PBAU results showed a positive correlation between GPA and PCOA scale score. A comparison of subtopic results helped to identify areas of strengths and weaknesses of the curriculum. PCOA provides useful comparative data that can facilitate individual student assessment as well as programmatic evaluation. There are no other standardized assessment tools available. Despite limitations, PCOA warrants consideration by colleges and schools of pharmacy. Expanded participation could enhance its utility as a meaningful benchmark.

Variation across individuals and items determine learning outcomes from fast mapping.

Science.gov (United States)

Coutanche, Marc N; Koch, Griffin E

2017-11-01

An approach to learning words known as "fast mapping" has been linked to unique neurobiological and behavioral markers in adult humans, including rapid lexical integration. However, the mechanisms supporting fast mapping are still not known. In this study, we sought to help change this by examining factors that modulate learning outcomes. In 90 subjects, we systematically manipulated the typicality of the items used to support fast mapping (foils), and quantified learners' inclination to employ semantic, episodic, and spatial memory through the Survey of Autobiographical Memory (SAM). We asked how these factors affect lexical competition and recognition performance, and then asked how foil typicality and lexical competition are related in an independent dataset. We find that both the typicality of fast mapping foils, and individual differences in how different memory systems are employed, influence lexical competition effects after fast mapping, but not after other learning approaches. Specifically, learning a word through fast mapping with an atypical foil led to lexical competition, while a typical foil led to lexical facilitation. This effect was particularly evident in individuals with a strong tendency to employ semantic memory. We further replicated the relationship between continuous foil atypicality and lexical competition in an independent dataset. These findings suggest that semantic properties of the foils that support fast mapping can influence the degree and nature of subsequent lexical integration. Further, the effects of foils differ based on an individual's tendency to draw-on the semantic memory system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

Directory of Open Access Journals (Sweden)

Schlaudraff KU

2014-05-01

Full Text Available Kai-Uwe Schlaudraff,1 Maren C Kiessling,2 Nikolaus BM Császár,2 Christoph Schmitz21Concept Clinic, Geneva, Switzerland; 2Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, GermanyBackground: Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI, weight, and/or height.Methods: Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast® device (Electro Medical Systems, S.A., Nyon, Switzerland. Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right, totaling eight treatments on the selected side. Treatment was performed at 3.5–4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area. Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.Results: The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades. Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0

Clinical examination results in individuals with functional ankle instability and ankle-sprain copers.

Science.gov (United States)

Wright, Cynthia J; Arnold, Brent L; Ross, Scott E; Ketchum, Jessica; Ericksen, Jeffrey; Pidcoe, Peter

2013-01-01

Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited. To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings. Cross-sectional study. Sports medicine research laboratory. Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78). Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded. Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM. Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05). Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected immediately postinjury to prospectively identify potential copers is unknown.

Human action perspectives based on individual plant examination results

International Nuclear Information System (INIS)

Forester, J.; Thompson, C.; Drouin, M.; Lois, E.

1996-01-01

This paper provides perspectives on human actions gained from reviewing 76 individual plant examination (IPE) submittals. Human actions found to be important in boiling water reactors (BWRs) and in pressurized water reactors (PWRs) are presented and the events most frequently found important are discussed. Since there are numerous factors that can influence the quantification of human error probabilities (HEPs) and introduce significant variability in the resulting HEPs (which in turn can influence which events are found to be important), the variability in HEPs for similar events across IPEs is examined to assess the extent to which variability in results is due to real versus artifactual differences. Finally, similarities and differences in human action observations across BWRs and PWRs are examined

Outcomes in Adult Life among Siblings of Individuals with Autism

Science.gov (United States)

Howlin, Patricia; Moss, Philippa; Savage, Sarah; Bolton, Patrick; Rutter, Michael

2015-01-01

Little is known about adult siblings of individuals with autism. We report on cognitive, social and mental health outcomes in 87 adult siblings (mean age 39 years). When younger all had been assessed either as being "unaffected" by autism (n = 69) or as meeting criteria for the "Broader Autism Phenotype" (BAP, n = 18). As…

Examining the impact of obesity on individuals with chronic fatigue syndrome.

Science.gov (United States)

Flores, Samantha; Brown, Abigail; Adeoye, Samuel; Jason, Leonard A; Evans, Meredyth

2013-07-01

Chronic fatigue syndrome (CFS) is a complex disorder affecting multiple body systems. The most commonly used definition of CFS is 6 or more months of fatigue and the presence of at least four of eight minor symptoms. In addition, many health and psychological conditions, including severe obesity-body mass index (BMI) of 40 kg/m(2) or greater-exclude individuals from a diagnosis of CFS. Obesity has been correlated with fatigue, sleep problems, and less satisfaction with general health, functioning, and vitality. The current study investigated weight trends over time in a community-based sample of individuals with CFS and healthy controls. The study further investigated the impact of comorbid weight issues on several health and disability outcomes in a subset of overweight individuals. Overweight and obese individuals with CFS demonstrated poorer functioning than controls who were similarly weighted. One participant was excluded because she had gained weight at a monitoring visit and her BMI was greater than 40 kg/m(2). The implications of these findings for health care workers are discussed. Copyright 2013, SLACK Incorporated.

First examination of varying health outcomes of the chronically homeless according to Housing First configuration.

Science.gov (United States)

Whittaker, Elizabeth; Dobbins, Timothy; Swift, Wendy; Flatau, Paul; Burns, Lucinda

2017-06-01

To determine whether two Housing First configurations (scattered site [SS] versus congregated site [CS]) are associated with different health-related outcomes. This ecological study employed a longitudinal, quantitative design to compare the outcomes from 63 individuals (SS: n=37; CS: n=26) in Sydney, Australia, over 12 months. Both configurations showed similar improvements in quality of life and psychological distress. While recent use of substances remained stable across the two configurations over time, a marginally greater increase in the proportion of CS individuals injecting more than weekly was found. For health service utilisation, CS participants had notably higher service utilisation rates for mental health specialists and the emergency department for mental health reasons at follow-up than SS participants. Preliminary evidence of differential injecting and health service utilisation outcomes between configurations emerged within this small-scale study over the 12-month period. Implications for public health: Given the rapid expansion of both SS and CS Housing First configurations across Western countries and the indications from this initial study that outcomes may differ according to configuration, there remains a need for robust evaluative evidence on the efficacy of various supported housing models on long-term individual outcomes. © 2017 Public Health Association of Australia.

Assessing vocational outcome expectancy in individuals with serious mental illness: a factor-analytic approach.

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Iwanaga, Kanako; Umucu, Emre; Wu, Jia-Rung; Yaghmaian, Rana; Lee, Hui-Ling; Fitzgerald, Sandra; Chan, Fong

2017-07-04

Self-determination theory (SDT) and self-efficacy theory (SET) can be used to conceptualize self-determined motivation to engage in mental health and vocational rehabilitation (VR) services and to predict recovery. To incorporate SDT and SET as a framework for vocational recovery, developing and validating SDT/SET measures in vocational rehabilitation is warranted. Outcome expectancy is an important SDT/SET variable affecting rehabilitation engagement and recovery. The purpose of this study was to validate the Vocational Outcome Expectancy Scale (VOES) for use within the SDT/SET vocational recovery framework. One hundred and twenty-four individuals with serious mental illness (SMI) participated in this study. Measurement structure of the VOES was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Both EFA and CFA results supported a two-factor structure: (a) positive outcome expectancy, and (b) negative outcome expectancy. The internal consistency reliability coefficients for both factors were acceptable. In addition, positive outcome expectancy correlated stronger than negative outcome expectancy with other SDT/SET constructs in the expected directions. The VOES is a brief, reliable and valid instrument for assessing vocational outcome expectancy in individuals with SMI that can be integrated into SDT/SET as a vocational rehabilitation engagement and recovery model in psychiatric rehabilitation.

Human event observations in the individual plant examinations

Energy Technology Data Exchange (ETDEWEB)

Forester, J. [Sandia National Labs., Albuquerque, NM (United States)

1995-04-01

A major objective of the Individual Plant Examination Insights Program is to identify the important determinants of core damage frequency for the different reactor and containment types and plant designs as indicated in the IPEs. The human reliability analysis is a critical component of the probabilistic risk assessments which were done for the IPEs. The determination and selection of human actions for incorporation into the event and fault tree models and the quantification of their failure probabilities can have an important impact on the resulting estimates of CDF and risk. Two important goals of the NRCs IPE Insights Program are (1) to determine the extent to which human actions and their corresponding failure probabilities influenced the results of the IPEs and (2) to identify which factors played significant roles in determining the differences and similarities in the results of the HRA analyses across the different plants. To obtain the relevant information, the NRC`s IPE database, which contains information on plant design, CDF, and containment performance obtained from the IPEs, was used in conjunction with a systematic examination of the HRA analyses and results from the IPEs. Regarding the extent to which the results of the HRA analyses were significant contributors to the plants` CDFs, examinations of several different measures indicated that while individual human actions could have important influences on CDF for particular initiators, the HRA results did not appear to be the most significant driver of plant risk. Another finding was that while there were relatively wide variations in the calculated human error probabilities for similar events across plants, there was no evidence for any systematic variation as a function of the HRA methods used in the analyses. Much of the variability in HEP values can be explained by differences in plant characteristics and sequence-specific factors. Details of these results and other findings are discussed.

Human event observations in the individual plant examinations

International Nuclear Information System (INIS)

Forester, J.

1995-01-01

A major objective of the Individual Plant Examination Insights Program is to identify the important determinants of core damage frequency for the different reactor and containment types and plant designs as indicated in the IPEs. The human reliability analysis is a critical component of the probabilistic risk assessments which were done for the IPEs. The determination and selection of human actions for incorporation into the event and fault tree models and the quantification of their failure probabilities can have an important impact on the resulting estimates of CDF and risk. Two important goals of the NRCs IPE Insights Program are (1) to determine the extent to which human actions and their corresponding failure probabilities influenced the results of the IPEs and (2) to identify which factors played significant roles in determining the differences and similarities in the results of the HRA analyses across the different plants. To obtain the relevant information, the NRC's IPE database, which contains information on plant design, CDF, and containment performance obtained from the IPEs, was used in conjunction with a systematic examination of the HRA analyses and results from the IPEs. Regarding the extent to which the results of the HRA analyses were significant contributors to the plants' CDFs, examinations of several different measures indicated that while individual human actions could have important influences on CDF for particular initiators, the HRA results did not appear to be the most significant driver of plant risk. Another finding was that while there were relatively wide variations in the calculated human error probabilities for similar events across plants, there was no evidence for any systematic variation as a function of the HRA methods used in the analyses. Much of the variability in HEP values can be explained by differences in plant characteristics and sequence-specific factors. Details of these results and other findings are discussed

Human event observations in the individual plant examinations

International Nuclear Information System (INIS)

Forester, J.

1995-01-01

A major objective of the Nuclear Regulatory Commission's (NRC) Individual Plant Examination (IPE) Insights Program is to identify the important determinants of core damage frequency (CDF) for the different reactor and containment types and plant designs as indicated in the IPEs. The human reliability analysis (HRA) is a critical component of the probabilistic risk assessments (PRAS) which were done for the IPES. The determination and selection of human actions for incorporation into the event and fault tree models and the quantification of their failure probabilities can have an important impact on the resulting estimates of CDF and risk. Therefore, two important goals of the NRCs IPE Insights Program are (1) to determine the extent to which human actions and their corresponding failure probabilities influenced the results of the IPEs and (2) to identify which factors played significant roles in determining the differences and similarities in the results of the HRA analyses across the different plants. To obtain the relevant information, the NRC's IPE database, which contains information on plant design, CDF, and containment performance obtained from the IPES, was used in conjunction with a systematic examination of the HRA analyses and results from the IPES. Regarding the extent to which the results of the HRA analyses were significant contributors to the plants' CDFs, examinations of several different measures indicated that while individual human actions could have important influences on CDF for particular initiators, the HRA results did not appear to be the most significant driver of plant risk (CDF). Another finding was that while there were relatively wide variations in the calculated human error probabilities (HEPs) for similar events across plants, there was no evidence for any systematic variation as a function of the HRA methods used in the analyses

Individual plant examination and future PRA applications

International Nuclear Information System (INIS)

Monty, B.S.; Sursock, J.P.; Thierry, R.J.

1992-01-01

PRA is being used in many areas of plant operation as has been demonstrated in previous studies. With the U.S. NRC's emphasis on the use of risk to identify plant vulnerabilities and the development of plant specific PRA models for all plants, it is expected that the use of PRA will be expanded. Key areas where this is expected to occur include the development of risk-based Technical Specifications, risk management, and risk-centered maintenance programs. This paper focuses on the Individual Plant Examination requirement and the possible uses of risk-based methods in controlling plant operation to enhance plant safety and availability, and how the IPE requirement will potentially further this area of development. (orig./DG)

75 FR 52456 - Customs Broker License Examination Individual Eligibility Requirements

Science.gov (United States)

2010-08-26

... DEPARTMENT OF HOMELAND SECURITY U.S. Customs and Border Protection 19 CFR Part 111 [USCBP-2008-0059; CBP Dec. 10-28] RIN 1651-AA74 Customs Broker License Examination Individual Eligibility Requirements AGENCY: Customs and Border Protection, Department of Homeland Security. ACTION: Final rule...

Examination of Student Outcomes in Play Therapy: A Qualitative Case Study Design

Science.gov (United States)

Dillman Taylor, Dalena L.; Blount, Ashley J.; Bloom, Zachary

2017-01-01

Outcome research examining the effectiveness of teaching methods in counselor education is sparse. The researchers conducted a qualitative investigation utilizing an instrumental case study to examine the influence of a constructivist-developmental format on a play therapy counseling course in a large CACREP accredited university in the…

Shared sanitation versus individual household latrines: a systematic review of health outcomes.

Directory of Open Access Journals (Sweden)

Marieke Heijnen

Full Text Available BACKGROUND: More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. In connection with a proposed change in such policy, we undertook this review to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines. METHODS AND FINDINGS: Shared sanitation included any type of facilities intended for the containment of human faeces and used by more than one household, but excluded public facilities. Health outcomes included diarrhoea, helminth infections, enteric fevers, other faecal-oral diseases, trachoma and adverse maternal or birth outcomes. Studies were included regardless of design, location, language or publication status. Studies were assessed for methodological quality using the STROBE guidelines. Twenty-two studies conducted in 21 countries met the inclusion criteria. Studies show a pattern of increased risk of adverse health outcomes associated with shared sanitation compared to individual household latrines. A meta-analysis of 12 studies reporting on diarrhoea found increased odds of disease associated with reliance on shared sanitation (odds ratio (OR 1.44, 95% CI: 1.18-1.76. CONCLUSION: Evidence to date does not support a change of existing policy of excluding shared sanitation from the definition of improved sanitation used in international monitoring and targets. However, such evidence is limited, does not adequately address likely confounding, and does not identify potentially important distinctions among types of shared facilities. As reliance on shared sanitation is increasing, further research is necessary to determine the circumstances, if any, under which shared sanitation can offer a safe, appropriate and acceptable alternative to individual household latrines.

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

Science.gov (United States)

Heuft, G; Senf, W; Wagener, R; Pintelon, C; Lorenzen, J

1996-01-01

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

Social Security Individual Accounts in China: Toward Sustainability in Individual Account Financing

Directory of Open Access Journals (Sweden)

Tianhong Chen

2014-08-01

Full Text Available China has both mandatory and voluntary individual account pensions that are provided through the government. The experience of China makes a particularly interesting case study concerning the functioning of individual accounts in that its mandatory individual accounts have been defunded to pay for benefits in the associated pay-as-you-go system, while its voluntary individual accounts are fully funded. This paper examines three questions. First, it analyses why the mandatory individual accounts have become defunded and converted largely to notional accounts generally holding little in financial assets, while the voluntary accounts have been fully funded. Second, it examines the merits of funding versus pay-as-you-go financing of pensions in the context of China’s economic and demographic situation. Third, it discusses a policy change to insure the sustainability of financing for the defunded individual accounts. The experience of China, with its two types of individual accounts, and with different outcomes for those accounts, may provide lessons for other countries.

Examination of arthritis-related work place activity limitations and intermittent disability over four-and-a-half years and its relationship to job modifications and outcomes.

Science.gov (United States)

Gignac, Monique A M; Cao, Xingshan; Tang, Kenneth; Beaton, Dorcas E

2011-07-01

To examine the type, degree, and episodic nature of arthritis-related work place activity limitations and the consistency of the relationship of activity limitations to job modifications and work place outcomes. Using an interviewer-administered structured questionnaire, individuals with osteoarthritis (OA) or inflammatory arthritis (IA) were interviewed at 4 time points, 18 months apart. At baseline, all participants (n = 490; 381 women, 109 men) were employed. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. The Workplace Activity Limitations Scale (WALS) assessed arthritis-related disability with job tasks. Job modifications/accommodations (e.g., scheduling changes), work place outcomes (e.g., absenteeism), demographics, illness, and work context were also measured. Repeated cross-sectional logistic regressions examined levels of WALS disability with job modifications and outcomes at each time point. Similar levels of activity limitations were found comparing OA and IA with fewer difficulties with global aspects of work (e.g., scheduling) than with specific tasks (e.g., working with hands). Three-quarters of the participants had episodic or intermittent WALS difficulty over time. Medium and high levels of work place activity limitations were significantly associated with job modifications, and high WALS difficulty was consistently related to negative work outcomes. Many individuals with arthritis report some difficulty with work place activities. However, these difficulties are often intermittent and may not result in changes to work productivity until they are consistently high. This is important for designing work place interventions and for employers, insurers, and the government to understand to avoid viewing individuals with arthritis as a permanent drain on work place and health resources. Copyright © 2011 by the American College of Rheumatology.

Examining effectiveness of tailorable computer-assisted therapy programmes for substance misuse: Programme usage and clinical outcomes data from Breaking Free Online.

Science.gov (United States)

Elison, Sarah; Jones, Andrew; Ward, Jonathan; Davies, Glyn; Dugdale, Stephanie

2017-11-01

When evaluating complex, tailorable digital behavioural interventions, additional approaches may be required alongside established methodologies such as randomised controlled trials (RCTs). Research evaluating a computer-assisted therapy (CAT) programme for substance misuse, Breaking Free Online (BFO), is informed by Medical Research Council (MRC) guidance recommending examination of 'mechanisms of action' of individual intervention strategies, which is relevant when evaluating digital interventions with content that may evolve over time. To report findings from examination of mechanisms of action of tailoring advice within the BFO programme and outcomes from specific intervention strategies. Analysis of covariance and linear regressions were used to assess intervention completion data, and psychometric and clinical outcomes, for 2311 service users accessing drug and alcohol treatment services across the UK. Tailoring advice provided to users appeared to prompt them to prioritise completion of intervention strategies associated with their areas of highest biopsychosocial impairment. Completion of specific intervention strategies within BFO were associated with specific clinical outcomes, with a dose response also being found. Mechanisms of action analyses revealed the primacy of cognitions, with cognitive restructuring strategies being associated with improvements in mental health, severity of substance dependence, quality of life and global biopsychosocial functioning. The MRC framework provides an evolved research paradigm within the field of digital behavioural change. By assessing baseline profiles of need, BFO can target the most appropriate clinical content for individual users. Mechanisms of action research can be used to inform modifications to BFO to continually update clinical content and the technology platform. Copyright © 2017 Elsevier Ltd. All rights reserved.

The fading affect bias shows positive outcomes at the general but not the individual level of analysis in the context of social media.

Science.gov (United States)

Gibbons, Jeffrey A; Horowitz, Kyle A; Dunlap, Spencer M

2017-08-01

Unpleasant affect fades faster than pleasant affect (e.g., Walker, Vogl, & Thompson, 1997); this effect is referred to as the Fading Affect Bias (FAB; Walker, Skowronski, Gibbons, Vogl, & Thompson, 2003a). Research shows that the FAB is consistently related to positive/healthy outcomes at a general but not at a specific level of analysis based on event types and individual differences (e.g., Gibbons et al., 2013). Based on the positive outcomes for FAB and negative outcomes for social media (Bolton et al., 2013; Huang, 2010), the current study examined FAB in the context of social media events along with related individual differences. General positive outcomes were shown in the form of robust FAB effects across social media and non-social media events, a larger FAB for non-social media events than for social media events, negative correlations of FAB with depression, anxiety, and stress as well as a positive correlation of FAB with self-esteem. However, the lack of a negative correlation between FAB and anxiety for social media events in a 3-way interaction did not show positive outcomes at a specific level of analysis. Rehearsal ratings mediated the 3-way interaction. Implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining the Role of Learning Context and Individual Differences in Gains in L2 Writing Performance: The Case of Teenagers on an Intensive Study-Abroad Programme

Science.gov (United States)

Llanes, Àngels; Tragant, Elsa; Serrano, Raquel

2018-01-01

The present study examines the effects that a 3-week study-abroad (SA) experience and a set of individual differences have on the foreign language (FL) development of a group of 64 Catalan/Spanish speakers, learners of English as an FL. Moreover, the present study attempts to account for the outcome differences between successful and less…

Examination of Individual Differences in Outcomes from a Randomized Controlled Clinical Trial Comparing Formal and Informal Individual Auditory Training Programs

Science.gov (United States)

Smith, Sherri L.; Saunders, Gabrielle H.; Chisolm, Theresa H.; Frederick, Melissa; Bailey, Beth A.

2016-01-01

Purpose: The purpose of this study was to determine if patient characteristics or clinical variables could predict who benefits from individual auditory training. Method: A retrospective series of analyses were performed using a data set from a large, multisite, randomized controlled clinical trial that compared the treatment effects of at-home…

The relationship between clinician turnover and adolescent treatment outcomes: An examination from the client perspective

Science.gov (United States)

Garner, Bryan R.; Funk, Rodney R.; Hunter, Brooke D.

2012-01-01

The turnover of substance use disorder (SUD) treatment staff has been assumed to adversely impact treatment effectiveness, yet only limited research has empirically examined this assumption. Representing an extension of prior organizational-level analyses of the impact of staff turnover on client outcomes, this study examined the impact of SUD clinician turnover on adolescent treatment outcomes using a client perspective. Multilevel regression analysis did reveal that relative to those adolescents who did not experience clinician turnover, adolescents who experienced both direct and indirect clinician turnover reported a significantly higher percentage of days using alcohol or drugs at 6-month follow-up. However, clinician turnover was not found to have significant associations (negative or positive) with the other five treatment outcomes examined (e.g., substance-related problems, involvement in illegal activity). Thus, consistent with our prior findings, the current study provides additional evidence that turnover of SUD clinicians is not necessarily associated with adverse treatment outcomes. PMID:23083980

The effects of kinesiotape on athletic-based performance outcomes in healthy, active individuals: a literature synthesis

Science.gov (United States)

Drouin, Jillian L.; McAlpine, Caitlin T.; Primak, Kari A.; Kissel, Jaclyn

2013-01-01

Context: The effect of the application of kinesiotape to skin overlying musculature on measurable athletic-based performance outcomes in healthy individuals has not been well established. Objective: To systematically search and assess the quality of the literature on the effect of kinesiotape on athletic-based performance outcomes in healthy, active individuals. Methods: An electronic search strategy was conducted in MANTIS, Cochrane Library and EBSCO databases. Retrieved articles that met the eligibility criteria were rated for methodological quality by using an adaption of the critical appraisal criteria in Clinical Epidemiology by Sackett et al. Results: Ten articles met the inclusion criteria. Seven articles had positive results in at least one athletic-based performance measure compared to controls. Conclusion: Evidence is lacking to support the use of kinesiotape as a successful measure for improving athletic-based performance outcomes in healthy individuals. However, there is no evidence to show that kinesiotape has a negative effect on any of the performace measures. PMID:24302784

Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

Science.gov (United States)

Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

2015-12-01

Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism.

Science.gov (United States)

Tomeny, Theodore S; Ellis, Brandi M; Rankin, James A; Barry, Tammy D

2017-03-01

Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability. Copyright © 2017 Elsevier Ltd. All rights reserved.

PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA.

Science.gov (United States)

Pinkham, Amy E; Harvey, Philip D; Penn, David L

2016-03-01

Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.

Neuroanatomical Predictors of Functional Outcome in Individuals at Ultra-High Risk for Psychosis.

Science.gov (United States)

Reniers, Renate L E P; Lin, Ashleigh; Yung, Alison R; Koutsouleris, Nikolaos; Nelson, Barnaby; Cropley, Vanessa L; Velakoulis, Dennis; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J

2017-03-01

Most individuals at ultra-high risk (UHR) for psychosis do not transition to frank illness. Nevertheless, many have poor clinical outcomes and impaired psychosocial functioning. This study used voxel-based morphometry to investigate if baseline grey and white matter brain densities at identification as UHR were associated with functional outcome at medium- to long-term follow-up. Participants were help-seeking UHR individuals (n = 109, 54M:55F) who underwent magnetic resonance imaging at baseline; functional outcome was assessed an average of 9.2 years later. Primary analysis showed that lower baseline grey matter density, but not white matter density, in bilateral frontal and limbic areas, and left cerebellar declive were associated with poorer functional outcome (Social and Occupational Functioning Assessment Scale [SOFAS]). These findings were independent of transition to psychosis or persistence of the at-risk mental state. Similar regions were significantly associated with lower self-reported levels of social functioning and increased negative symptoms at follow-up. Exploratory analyses showed that lower baseline grey matter densities in middle and inferior frontal gyri were significantly associated with decline in Global Assessment of Functioning (GAF) score over follow-up. There was no association between baseline grey matter density and IQ or positive symptoms at follow-up. The current findings provide novel evidence that those with the poorest functional outcomes have the lowest grey matter densities at identification as UHR, regardless of transition status or persistence of the at-risk mental state. Replication and validation of these findings may allow for early identification of poor functional outcome and targeted interventions. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Brief report: large individual variation in outcomes of autistic children receiving low-intensity behavioral interventions in community settings.

Science.gov (United States)

Kamio, Yoko; Haraguchi, Hideyuki; Miyake, Atsuko; Hiraiwa, Mikio

2015-01-01

Despite widespread awareness of the necessity of early intervention for children with autism spectrum disorders (ASDs), evidence is still limited, in part, due to the complex nature of ASDs. This exploratory study aimed to examine the change across time in young children with autism and their mothers, who received less intensive early interventions with and without applied behavior analysis (ABA) methods in community settings in Japan. Eighteen children with autism (mean age: 45.7 months; range: 28-64 months) received ABA-based treatment (a median of 3.5 hours per week; an interquartile range of 2-5.6 hours per week) and/or eclectic treatment-as-usual (TAU) (a median of 3.1 hours per week; an interquartile range of 2-5.6 hours per week). Children's outcomes were the severity of autistic symptoms, cognitive functioning, internalizing and externalizing behavior after 6 months (a median of 192 days; an interquartile range of 178-206 days). In addition, maternal parenting stress at 6-month follow-up, and maternal depression at 1.5-year follow-up (a median of 512 days; an interquartile range of 358-545 days) were also examined. Large individual variations were observed for a broad range of children's and mothers' outcomes. Neither ABA nor TAU hours per week were significantly associated with an improvement in core autistic symptoms. A significant improvement was observed only for internalizing problems, irrespective of the type, intensity or monthly cost of treatment received. Higher ABA cost per month (a median of 1,188 USD; an interquartile range of 538-1,888 USD) was associated with less improvement in language-social DQ (a median of 9; an interquartile range of -6.75-23.75). To determine an optimal program for each child with ASD in areas with poor ASD resources, further controlled studies are needed that assess a broad range of predictive and outcome variables focusing on both individual characteristics and treatment components.

A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors

Directory of Open Access Journals (Sweden)

Cinnamon S. Bloss

2016-01-01

Full Text Available Background. Mobile health and digital medicine technologies are becoming increasingly used by individuals with common, chronic diseases to monitor their health. Numerous devices, sensors, and apps are available to patients and consumers–some of which have been shown to lead to improved health management and health outcomes. However, no randomized controlled trials have been conducted which examine health care costs, and most have failed to provide study participants with a truly comprehensive monitoring system. Methods. We conducted a prospective randomized controlled trial of adults who had submitted a 2012 health insurance claim associated with hypertension, diabetes, and/or cardiac arrhythmia. The intervention involved receipt of one or more mobile devices that corresponded to their condition(s (hypertension: Withings Blood Pressure Monitor; diabetes: Sanofi iBGStar Blood Glucose Meter; arrhythmia: AliveCor Mobile ECG and an iPhone with linked tracking applications for a period of 6 months; the control group received a standard disease management program. Moreover, intervention study participants received access to an online health management system which provided participants detailed device tracking information over the course of the study. This was a monitoring system designed by leveraging collaborations with device manufacturers, a connected health leader, health care provider, and employee wellness program–making it both unique and inclusive. We hypothesized that health resource utilization with respect to health insurance claims may be influenced by the monitoring intervention. We also examined health-self management. Results & Conclusions. There was little evidence of differences in health care costs or utilization as a result of the intervention. Furthermore, we found evidence that the control and intervention groups were equivalent with respect to most health care utilization outcomes. This result suggests there are not large

Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia

OpenAIRE

Amy E. Pinkham; Philip D. Harvey; David L. Penn

2016-01-01

Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid indiv...

Idiosyncratic deals and employee outcomes: the mediating roles of social exchange and self-enhancement and the moderating role of individualism.

Science.gov (United States)

Liu, Jun; Lee, Cynthia; Hui, Chun; Kwan, Ho Kwong; Wu, Long-Zeng

2013-09-01

The majority of studies on idiosyncratic employment arrangements ("i-deals") are based on social exchange theory. The authors suggest that self-enhancement theory, in addition to social exchange, can be used to explain the effects of i-deals. Using a multisource sample including 230 employees and 102 supervisors from 2 Chinese companies, the authors adopt a 3-wave lagged design to examine the mediating roles of social exchange and self-enhancement and the moderating role of individualism in the relationships between i-deals and employee outcomes, as indicated by proactive behaviors and affective commitment. The results of bootstrapping analyses confirm the mediating effects of social exchange and self-enhancement. In addition, employees with high levels of individualism are more receptive to self-enhancement effects; in contrast, employees with low levels of individualism are more receptive to social exchange effects. PsycINFO Database Record (c) 2013 APA, all rights reserved

Procedural and submittal guidance for the individual plant examination of external events (IPEEE) for severe accident vulnerabilities

International Nuclear Information System (INIS)

Chen, J.T.; Chokshi, N.C.; Kenneally, R.M.; Kelly, G.B.; Beckner, W.D.; McCracken, C.; Murphy, A.J.; Reiter, L.; Jeng, D.

1991-06-01

Based on a Policy statement on Severe Accidents, the licensee of each nuclear power plant is requested to perform an individual plant examination. The plant examination systematically looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document presents guidance for performing and reporting the results of the individual plant examination of external events (IPEEE). The guidance for reporting the results of the individual plant examination of internal events (IPE) is presented in NUREG-1335. 53 refs., 1 figs., 2 tabs

Role of Parent and Peer Relationships and Individual Characteristics in Middle School Children's Behavioral Outcomes in the Face of Community Violence

Science.gov (United States)

Salzinger, Suzanne; Rosario, Margaret; Feldman, Richard S.; Ng-Mak, Daisy S.

2010-01-01

This study examines processes linking inner-city community violence exposure to subsequent internalizing and externalizing problems. Hypothesized risk and protective factors from three ecological domains -- children's parent and peer relationships and individual characteristics -- were examined for mediating, moderating or independent roles in predicting problem behavior among 667 children over three years of middle school. Mediation was not found. However, parent and peer variables moderated the association between exposure and internalizing problems. Under high exposure, normally protective factors (e.g., attachment to parents) were less effective in mitigating exposure's effects than under low exposure; attachment to friends was more effective. Individual competence was independently associated with decreased internalizing problems. Variables from all domains, and exposure, were independently associated with externalizing problems. Protective factors (e.g., parent attachment) predicted decreased problems; risk factors (e.g., friends' delinquency) predicted increased problems. Results indicate community violence reduction as essential in averting inner-city adolescents' poor behavioral outcomes. PMID:21643493

Examining intrinsic versus extrinsic exercise goals: cognitive, affective, and behavioral outcomes.

Science.gov (United States)

Sebire, Simon J; Standage, Martyn; Vansteenkiste, Maarten

2009-04-01

Grounded in self-determination theory (SDT), this study had two purposes: (a) examine the associations between intrinsic (relative to extrinsic) exercise goal content and cognitive, affective, and behavioral outcomes; and (b) test the mediating role of psychological need satisfaction in the Exercise Goal Content --> Outcomes relationship. Using a sample of 410 adults, hierarchical regression analysis showed relative intrinsic goal content to positively predict physical self-worth, self-reported exercise behavior, psychological well-being, and psychological need satisfaction and negatively predict exercise anxiety. Except for exercise behavior, the predictive utility of relative intrinsic goal content on the dependent variables of interest remained significant after controlling for participants' relative self-determined exercise motivation. Structural equation modeling analyses showed psychological need satisfaction to partially mediate the effect of relative intrinsic goal content on the outcome variables. Our findings support further investigation of exercise goals commensurate with the goal content perspective advanced in SDT.

An examination of individual level effects of downsizing in a foodservice organization

OpenAIRE

Joe, Hutchinson

1994-01-01

This research examined the effect of downsizing on the stress-related perceptions and work-related attitudes and behaviors of employees of a school food service organization. A major purpose of this study was to investigate individual level responses according to the severity of the downsizing. The research also examined the relationships between employees' stress-related perceptions and their work-related attitudes and behaviors, and the moderating effect of demographic factor...

Examining regional variability in work ethic within Mexico: Individual difference or shared value.

Science.gov (United States)

Arciniega, Luis M; Woehr, David J; Del Rincón, Germán A

2018-02-19

Despite the acceptance of work ethic as an important individual difference, little research has examined the extent to which work ethic may reflect shared environmental or socio-economic factors. This research addresses this concern by examining the influence of geographic proximity on the work ethic experienced by 254 employees from Mexico, working in 11 different cities in the Northern, Central and Southern regions of the country. Using a sequence of complementary analyses to assess the main source of variance on seven dimensions of work ethic, our results indicate that work ethic is most appropriately considered at the individual level. © 2018 International Union of Psychological Science.

Vocational Rehabilitation Service Patterns and Outcomes for Individuals with Autism of Different Ages

Science.gov (United States)

Chen, June L.; Sung, Connie; Pi, Sukyeong

2015-01-01

Young adults with autism spectrum disorders (ASD) often experience employment difficulties. Using Rehabilitation Service Administration data (RSA-911), this study investigated the service patterns and factors related to the employment outcomes of individuals with ASD in different age groups. Hierarchical logistic regression analyses were conducted…

Human event observations in the individual plant examinations

International Nuclear Information System (INIS)

Lois, E.; Forester, J.

1994-01-01

A main objective of the Nuclear Regulatory Commission's (NRC) Individual Plant Examination (IPE) Insights Program is to document significant safety insights relative to core damage frequency (CDF) for the different reactor and containment types and plant designs as indicated in the IPEs. The Human Reliability Analysis (HRA) is a critical component of the Probabilistic Risk Assessments (PRAs) which were done for the IPEs. The determination and selection of human actions for incorporation into the event and fault tree models and the quantification of their failure probabilities can have an important impact on the resulting estimates of CDF and risk. Therefore, two important goals of the NRCs IPE Insights Program are (1) to determine the extent to which human actions and their corresponding failure probabilities influenced the results of the IPEs and (2) to identify which factors played significant roles in determining the differences and similarities in the results of the HRA analyses across the different plants. To obtain the relevant information, the NRCs IPE database, which contains information on plant design, CDF, and containment performance obtained from the IPEs, was used in conjunction with a systematic examination of the HRA results from the IPEs

Individual plant examination: Submittal guidance

International Nuclear Information System (INIS)

1989-08-01

Based on a Policy Statement on Severe Accidents Regarding Future Designs and Existing Plants, the performance of a plant examination is requested from the licensee of each nuclear power plant. The plant examination looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document delineates guidance for reporting the results of that plant examination. 38 refs., 2 tabs

Individual differences in cyber security behaviors: an examination of who is sharing passwords.

Science.gov (United States)

Whitty, Monica; Doodson, James; Creese, Sadie; Hodges, Duncan

2015-01-01

In spite of the number of public advice campaigns, researchers have found that individuals still engage in risky password practices. There is a dearth of research available on individual differences in cyber security behaviors. This study focused on the risky practice of sharing passwords. As predicted, we found that individuals who scored high on a lack of perseverance were more likely to share passwords. Contrary to our hypotheses, we found younger [corrected] people and individuals who score high on self-monitoring were more likely to share passwords. We speculate on the reasons behind these findings, and examine how they might be considered in future cyber security educational campaigns.

Individualized prediction of seizure relapse and outcomes following antiepileptic drug withdrawal after pediatric epilepsy surgery.

Science.gov (United States)

Lamberink, Herm J; Boshuisen, Kim; Otte, Willem M; Geleijns, Karin; Braun, Kees P J

2018-03-01

The objective of this study was to create a clinically useful tool for individualized prediction of seizure outcomes following antiepileptic drug withdrawal after pediatric epilepsy surgery. We used data from the European retrospective TimeToStop study, which included 766 children from 15 centers, to perform a proportional hazard regression analysis. The 2 outcome measures were seizure recurrence and seizure freedom in the last year of follow-up. Prognostic factors were identified through systematic review of the literature. The strongest predictors for each outcome were selected through backward selection, after which nomograms were created. The final models included 3 to 5 factors per model. Discrimination in terms of adjusted concordance statistic was 0.68 (95% confidence interval [CI] 0.67-0.69) for predicting seizure recurrence and 0.73 (95% CI 0.72-0.75) for predicting eventual seizure freedom. An online prediction tool is provided on www.epilepsypredictiontools.info/ttswithdrawal. The presented models can improve counseling of patients and parents regarding postoperative antiepileptic drug policies, by estimating individualized risks of seizure recurrence and eventual outcome. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

Examining the relationships between span of control and manager job and unit performance outcomes.

Science.gov (United States)

Wong, Carol A; Elliott-Miller, Pat; Laschinger, Heather; Cuddihy, Michael; Meyer, Raquel M; Keatings, Margaret; Burnett, Camille; Szudy, Natalie

2015-03-01

Our aim was to examine the combination of frontline manager (FLM) personal characteristics and span of control (SOC) on their job and unit performance outcomes. Healthcare downsizing and reform have contributed to larger spans for FLMs in Canadian hospitals and increased concerns about manager workload. Despite a heightened awareness of SOC issues among decision makers, there is limited empirical evidence related to the effects of SOC on outcomes. A non-experimental predictive survey design was used to examine FLM SOC in 14 Canadian academic hospitals. Managers (n = 121) completed an online survey of work characteristics and The Ottawa Hospital (TOH) SOC tool. Unit turnover data were collected from organisational databases. The combination of SOC and core self-evaluation significantly predicted role overload, work control and job satisfaction, but only SOC predicted unit adverse outcomes and neither significantly predicted unit turnover. The findings contribute to an understanding of connections between the combination of SOC and core self-evaluation and manager job and unit performance outcomes. Organisational strategies to create manageable FLM SOC are essential to ensure exemplary job and unit outcomes. Core self-evaluation is a personality characteristic that may enhance manager performance in the face of high spans of control. © 2013 John Wiley & Sons Ltd.

Program Use and Outcome Change in a Web-Based Trauma Intervention: Individual and Social Factors.

Science.gov (United States)

Wang, Zhiyun; Wang, Jianping; Maercker, Andreas

2016-09-09

Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, Psocial factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self-talk modules showed a consistent positive association with improvement in PDS, SCL-D, SFI, and CSE. The relaxation module was associated with positive change in PDS, but with negative change in CSS and SFI. The professional help module was associated with positive change in SCL-D, but its use on the first day was associated with negative change in CSS and CSE. The unhelpful coping module was associated with

Identifying Best Practices for and Utilities of the Pharmacy Curriculum Outcome Assessment Examination.

Science.gov (United States)

Mok, Timothy Y; Romanelli, Frank

2016-12-25

Objective. A review was conducted to determine implementation strategies, utilities, score interpretation, and limitations of the Pharmacy Curriculum Outcome Assessment (PCOA) examination. Methods. Articles were identified through the PubMed and American Journal of Pharmaceutical Education , and International Pharmaceutical Abstracts databases using the following terms: "Pharmacy Curriculum Outcomes Assessment," "pharmacy comprehensive examination," and "curricular assessment." Studies containing information regarding implementation, utility, and predictive values for US student pharmacists, curricula, and/or PGY1/PGY2 residents were included. Publications from the Academic Medicine Journal , the Accreditation Council for Pharmacy Education (ACPE), and the American Association of Colleges of Pharmacy (ACCP) were included for background information and comparison of predictive utilities of comprehensive examinations in medicine. Results. Ten PCOA and nine residency-related publications were identified. Based on published information, the PCOA may be best used as an additional tool to identify knowledge gaps for third-year student pharmacists. Conclusion. Administering the PCOA to students after they have completed their didactic coursework may yield scores that reflect student knowledge. Predictive utility regarding the North American Pharmacy Licensure Examination (NAPLEX) and potential applications is limited, and more research is required to determine ways to use the PCOA.

Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment.

Science.gov (United States)

Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Roberts, Andrea G; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

2015-08-01

Individuals with schizophrenia have low employment rates and the job interview presents a critical barrier for them to obtain employment. Virtual reality training has demonstrated efficacy at improving interview skills and employment outcomes among multiple clinical populations. However, the effects of this training on individuals with schizophrenia are unknown. This study evaluated the efficacy of virtual reality job interview training (VR-JIT) at improving job interview skills and employment outcomes among individuals with schizophrenia in a small randomized controlled trial (n=21 VR-JIT trainees, n=11 waitlist controls). Trainees completed up to 10h of virtual interviews using VR-JIT, while controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews scored by blinded raters with expertise in human resources and self-reported interviewing self-confidence. Six-month follow-up data on employment outcomes were collected. Trainees reported that the intervention was easy-to-use, helpful, and prepared them for future interviews. Trainees demonstrated increased role-play scores between pre-test and post-test while controls did not (p=0.001). After accounting for neurocognition and months since prior employment, trainees had greater odds of receiving a job offer by 6month follow-up compared to controls (OR: 8.73, p=0.04) and more training was associated with fewer weeks until receiving a job offer (r=-0.63, pjob interview skills in individuals with schizophrenia. Moreover, trainees had greater odds of receiving a job offer by 6-month follow-up. Future studies could evaluate the effectiveness of VR-JIT within community-based services. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of peer nominations of teacher-student support at individual and classroom levels on social and academic outcomes.

Science.gov (United States)

Hughes, Jan N; Im, Myung Hee; Wehrly, Sarah E

2014-06-01

This longitudinal study examined the prospective relations between 713 elementary students' individual peer teacher support reputation (PTSR) and a measure of the classroom-wide dispersion of peer nominations of teacher support (Centralization of Teacher Support) on students' peer relatedness (i.e., peer acceptance and peer academic reputation) and academic motivation (i.e., academic self-efficacy and teacher-rated behavioral engagement). PTSR was measured as the proportion of classmates who nominated a given student on a descriptor of teacher-student support. Centralization of Teacher Support was assessed using social network analysis to identify the degree to which peer nominations of teacher support in a classroom centered on a few students. PTSR predicted changes in all student outcomes, above academic achievement and relevant covariates. Centralization of Teacher Support predicted changes in students' peer academic reputation, net the effect of PTSR and covariates. Students' academic achievement moderated effects of PTSR and Centralization of Teacher Support on some outcomes. Findings highlight the importance of peers' perceptions of teacher support and of the structure of those perceptions for children's social and academic outcomes. Implications for practice are discussed. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Influences of Training on Individual Outcomes for High School Sports Officials

Directory of Open Access Journals (Sweden)

Timothy D. Ryan

2014-04-01

Full Text Available The primary purpose of this study was to explore the influences of training on specific quality of work outcomes of job satisfaction, pay satisfaction, and intentions to leave within high school sports officials. Evidence suggests that there is a shortage of high school officials in all categories of high school sport. Via a web-based survey, we explored the effects of training on the individual outcomes under study. Results indicated that the level of training had a significant effect on job satisfaction, pay satisfaction, and turnover intentions. Analyses indicated that officials with less training had higher turnover intentions and lower job satisfaction than officials who had more training. Conversely, officials who engaged numerous training hours had lower pay satisfaction. This exploratory study supports the importance of training high school officials but, more importantly, provides an initial assessment on the reverse effects of training on pay satisfaction.

Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes

OpenAIRE

Aasa, Ulrika

2005-01-01

Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a nat...

Gene Polymorphism-related Individual and Interracial Differences in the Outcomes of Androgen Deprivation Therapy for Prostate Cancer.

Science.gov (United States)

Fujimoto, Naohiro; Shiota, Masaki; Tomisaki, Ikko; Minato, Akinori

2017-06-01

Among patients with prostate cancer, the prognosis after androgen deprivation therapy differs significantly among individuals and among races; however, the reasons underlying these differences are poorly understood. Several single nucleotide polymorphisms in genes associated with prostate cancer progression or castration resistance might serve as the host factor that influences prognosis and, thus, accounts for these individual and racial gaps in treatment outcomes. Accordingly, single nucleotide polymorphisms associated with treatment outcomes could be used as predictive and/or prognostic biomarkers for patient stratification and to identify personalized treatment and follow-up protocols. The present review has summarized the genetic polymorphisms that have been reported to associate with androgen deprivation therapy outcomes among patients with prostate cancer and compared the allele frequencies among different ethnic groups. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparative effectiveness studies examining patient-reported outcomes among children with cleft lip and/or palate: a systematic review.

Science.gov (United States)

Ranganathan, Kavitha; Vercler, Christian J; Warschausky, Seth A; MacEachern, Mark P; Buchman, Steven R; Waljee, Jennifer F

2015-01-01

Health care policy makers are increasingly encouraging comparative effectiveness research. Little is known regarding comparative studies among children with cleft lip and/or palate. Cleft lip and/or palate profoundly influences self-perception and social functioning, and patient-reported outcomes provide a unique perspective on the success of reconstruction. The purpose of this study was to systematically review the literature regarding patient-reported outcomes among patients with cleft lip and/or palate. The authors reviewed articles from MEDLINE, Embase, and PsycInfo that examined the use of patient-reported outcome instruments for cleft lip and/or palate. Studies of patients with cleft lip and/or palate across any age that described the use of patient-completed measures in patient and control populations were included. A research librarian confirmed the search, and two independent, blinded reviewers performed full-text review. The authors identified 1979 articles and selected 30 for inclusion. Forty-two different assessment tools were used to analyze factors such as self-esteem, behavior, and social support. The Strengths and Difficulties Questionnaire was most commonly used (n = 7), followed by the Childhood Experience Questionnaire (n = 5), and the Satisfaction with Appearance survey (n = 4). Barriers to analysis included lack of standardization of survey administration, effect of publication bias, and variations in patient populations between individual studies. Comparative studies of patient-reported outcomes among patients with cleft lip and/or palate are infrequent. Many instruments exist to measure patient-reported outcomes in this population, but no specific standard exists. Identifying efficient and targeted forms of instrument selection and administration will enhance comparative studies among children with cleft lip and/or palate. Diagnostic, III.

Neurobiological factors as predictors of cognitive-behavioral therapy outcome in individuals with antisocial behavior: a review of the literature.

Science.gov (United States)

Cornet, Liza J M; de Kogel, Catharina H; Nijman, Henk L I; Raine, Adrian; van der Laan, Peter H

2014-11-01

This review focuses on the predictive value of neurobiological factors in relation to cognitive-behavioral therapy outcome among individuals with antisocial behavior. Ten relevant studies were found. Although the literature on this topic is scarce and diverse, it appears that specific neurobiological characteristics, such as physiological arousal levels, can predict treatment outcome. The predictive value of neurobiological factors is important as it could give more insight into the causes of variability in treatment outcome among individuals with antisocial behavior. Furthermore, results can contribute to improvement in current treatment selection procedures and to the development of alternative treatment options. © The Author(s) 2013.

Predicting optimal outcomes in cognitive therapy or interpersonal psychotherapy for depressed individuals using the personalized advantage index approach

NARCIS (Netherlands)

Huibers, M.J.H.; Cohen, Z.D.; Lemmens, L.H.J.M.; Arntz, A.; Peeters, F.P.M.L.; Cuijpers, P.; DeRubeis, R.J.

2015-01-01

Introduction: Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works

Predicting optimal outcomes in cognitive therapy or interpersonal psychotherapy for depressed individuals using the personalized advantage index approach

NARCIS (Netherlands)

Huibers, M.J.H.; Cohen, Z.D.; Lemmens, L.H.J.M.; Arntz, A.; Peeters, F.P.M.L.; Cuijpers, P.; DeRubeis, R.J.

2015-01-01

Introduction Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works

Assessing the clinical utility of combined movement examination in symptomatic degenerative lumbar spondylosis.

Science.gov (United States)

Monie, A P; Price, R I; Lind, C R P; Singer, K P

2015-07-01

The aim of this study is to report the development and validation of a low back computer-aided combined movement examination protocol in normal individuals and record treatment outcomes of cases with symptomatic degenerative lumbar spondylosis. Test-retest, following intervention. Self-report assessments and combined movement examination were used to record composite spinal motion, before and following neurosurgical and pain medicine interventions. 151 normal individuals aged from 20 years to 69 years were assessed using combined movement examination between L1 and S1 spinal levels to establish a reference range. Cases with degenerative low back pain and sciatica were assessed before and after therapeutic interventions with combined movement examination and a battery of self-report pain and disability questionnaires. Change scores for combined movement examination and all outcome measures were derived. Computer-aided combined movement examination validation and intraclass correlation coefficient with 95% confidence interval and least significant change scores indicated acceptable reliability of combined movement examination when recording lumbar movement in normal subjects. In both clinical cases lumbar spine movement restrictions corresponded with self-report scores for pain and disability. Post-intervention outcomes all showed significant improvement, particularly in the most restricted combined movement examination direction. This study provides normative reference data for combined movement examination that may inform future clinical studies of the technique as a convenient objective surrogate for important clinical outcomes in lumbar degenerative spondylosis. It can be used with good reliability, may be well tolerated by individuals in pain and appears to change in concert with validated measures of lumbar spinal pain, functional limitation and quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.

Memories of early attachment: the use of PBI as a predictor of outcome in Pesso-Boyden System Psychomotor (PBSP) group therapy, Cognitive-Behavioural Group Therapy (CBGT), Individual Cognitive-Behavioural Therapy (CBT) and Individual Treatment As Usual (TAU) with adult out-patients.

Science.gov (United States)

Ryum, Truls; Vogel, Patrick A; Hagen, Roger; Stiles, Tore C

2008-01-01

To examine the predictive validity of the Parental Bonding Instrument (PBI) for outcome in individual and group psychotherapy. Data from four different clinical trials were combined, yielding a total of 105 patients. After controlling for gender, age and initial symptomatic distress, the predictive validity of the PBI subscales was investigated using the symptom checklist-90-revised (SCL-90-R) and inventory of interpersonal problems-64 (IIP-64) at termination as dependent measures in each treatment condition using separate hierarchical multiple regression analyses. Using the SCL-90-R at termination as dependent measure, reports of higher paternal and maternal care were related to a worse outcome in the Pesso-Boyden System Psychomotor condition, whereas reports of higher paternal care were related to a better outcome in the Cognitive-Behavioural Therapy condition. Also, higher maternal protection was related to a better outcome in the Cognitive-Behavioral Group condition. Using the IIP-64 at termination as dependent measure, reports of higher paternal protection were related to a better outcome in the Treatment As Usual condition. The study shows that the PBI may function as a clinical predictor for treatment response, although the results were somewhat contrary to previous reportings. Future studies should contrast and investigate possible differences between individual and group treatments further, as well as more clearly defined diagnostic groups. Clinical implications are presented. Copyright (c) 2008 John Wiley & Sons, Ltd.

Individual-Based Compulsive Sexual Behavior Scale: Its Development and Importance in Examining Compulsive Sexual Behavior.

Science.gov (United States)

Efrati, Yaniv; Mikulincer, Mario

2018-04-03

Compulsive sexual behavior comprises individual-based (e.g., sexual fantasies, compulsive sexual thoughts, masturbation) and partnered (e.g., interpersonal sexual conquests, repeated infidelity) facets. Most instruments for assessing compulsive sexual behavior, however, focus less on the individual-based facet and specifically on fantasies and compulsive thoughts. In the current research, we developed and validated an individual-based compulsive sexual behavior scale (I-CSB). In Study 1 (N = 492), the factorial structure of the I-CSB was examined. In Study 2 (N = 406), we assessed I-CSB's convergent validity. In Study 3 (N = 112), we examined whether the I-CSB differentiates between individuals who suffer from compulsive sexual behavior and those who do not. Results revealed a four-factor structure for individual-based compulsive sexual behavior that is associated with an intense inner conflict regarding sexuality (high arousal contrasting with high sexual anxiety), and that accounts for approximately 75% of the differences between people with compulsive sexual behavior and controls. Results are discussed in light of the need for a broader understanding of compulsive sexual behavior.

Education and Occupational Outcomes

DEFF Research Database (Denmark)

Johnes, Geraint; Freguglia, Ricardo; Spricigo, Gisele

2016-01-01

Purpose: The purpose of this paper is to examine the dynamic relationship between policies related to educational provision and both educational participation and occupational outcomes in Brazil, using PNAD and RAIS-Migra data. Design/methodology/approach: Outcomes are examined using: static...... multinomial logit analysis, and structural dynamic discrete choice modelling. The latter approach, coupled with the quality of the RAIS-Migra data source, allows the authors to evaluate the education policy impacts over time. Findings: The main results show that the education level raises the propensity...... that the individual will be in formal sector work or still in education, and reduces the probability of the other outcomes. Transition into non-manual formal sector work following education may, however, occur via a spell of manual work. Originality/value: This is the first study of occupational destination...

The impact of high performance work systems in Irish companies: an examination of company and employee outcomes

OpenAIRE

Mkamwa, Thadeus F.

2010-01-01

This study examines the impact of High Performance Work Systems (HPWS) on company and employee-level performance outcomes. At the company level, the study examines the outcomes of HPWS usage on innovation, productivity and turnover. The study uses data collected from 132 companies in Ireland who participated in a general manager (GM) and human resource (HR) manager survey conducted in 2006. This study shows that an extensive application ...

The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.

Science.gov (United States)

Savage, Nathan J; Fritz, Julie M; Thackeray, Anne

2014-07-01

Cross-sectional diagnostic accuracy study. To investigate the relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy. Electrodiagnostic testing is routinely used to evaluate patients with sciatica. Recent evidence suggests that the presence of radiculopathy identified with electrodiagnostic testing may predict better functional outcomes in these patients. While some patient history and physical examination findings have been shown to predict the presence of disc herniation or neurological insult, little is known about their relationship to the results of electrodiagnostic testing. Electrodiagnostic testing was performed on 38 patients with sciatica who participated in a randomized trial that compared different physical therapy interventions. The diagnostic gold standard was the presence or absence of radiculopathy, based on the results of the needle electromyographic examination. Diagnostic sensitivity and specificity values were calculated, along with corresponding likelihood ratios, for select patient history and physical examination variables. No significant relationship was found between select patient history and physical examination findings, analyzed individually or in combination, and the outcome of electrodiagnostic testing. Diagnostic sensitivity values ranged from 0.03 (95% confidence interval [CI]: 0.00, 0.24) to a high of 0.95 (95% CI: 0.72, 0.99), and specificity values ranged from 0.10 (95% CI: 0.02, 0.34) to a high of 0.95 (95% CI: 0.72, 0.99). Positive likelihood ratios ranged from 0.15 (95% CI: 0.01, 2.87) to a high of 2.33 (95% CI: 0.71, 7.70), and negative likelihood ratios ranged from 2.00 (95% CI: 0.35, 11.48) to a low of 0.50 (95% CI: 0.03, 8.10). In this investigation, the relationship between patient history and physical examination findings and the outcome of electrodiagnostic testing among patients with sciatica was not found to be

Engagement with the auditory processing system during targeted auditory cognitive training mediates changes in cognitive outcomes in individuals with schizophrenia.

Science.gov (United States)

Biagianti, Bruno; Fisher, Melissa; Neilands, Torsten B; Loewy, Rachel; Vinogradov, Sophia

2016-11-01

Individuals with schizophrenia who engage in targeted cognitive training (TCT) of the auditory system show generalized cognitive improvements. The high degree of variability in cognitive gains maybe due to individual differences in the level of engagement of the underlying neural system target. 131 individuals with schizophrenia underwent 40 hours of TCT. We identified target engagement of auditory system processing efficiency by modeling subject-specific trajectories of auditory processing speed (APS) over time. Lowess analysis, mixed models repeated measures analysis, and latent growth curve modeling were used to examine whether APS trajectories were moderated by age and illness duration, and mediated improvements in cognitive outcome measures. We observed significant improvements in APS from baseline to 20 hours of training (initial change), followed by a flat APS trajectory (plateau) at subsequent time-points. Participants showed interindividual variability in the steepness of the initial APS change and in the APS plateau achieved and sustained between 20 and 40 hours. We found that participants who achieved the fastest APS plateau, showed the greatest transfer effects to untrained cognitive domains. There is a significant association between an individual's ability to generate and sustain auditory processing efficiency and their degree of cognitive improvement after TCT, independent of baseline neurocognition. APS plateau may therefore represent a behavioral measure of target engagement mediating treatment response. Future studies should examine the optimal plateau of auditory processing efficiency required to induce significant cognitive improvements, in the context of interindividual differences in neural plasticity and sensory system efficiency that characterize schizophrenia. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Examining an underlying mechanism between perceived stress and smoking cessation-related outcomes.

Science.gov (United States)

Robles, Zuzuky; Garey, Lorra; Hogan, Julianna; Bakhshaie, Jafar; Schmidt, Norman B; Zvolensky, Michael J

2016-07-01

The mediational role of negative reinforcement smoking outcome expectancies in the relation between perceived stress and (1) perceived barriers to cessation, (2) severity of problematic symptoms during past quit attempts, and (3) smoking-specific experiential avoidance (AIS) was examined. Data were drawn from a baseline assessment of a larger clinical trial. Participants included 332 adult treatment-seeking smokers (47.3% female; Mage=38.45; SD=.50; age range: 18-65 years). Results indicated that perceived stress was indirectly related to perceived barriers to smoking cessation, severity of problematic symptoms during past quit attempts, and AIS through negative reinforcement outcome expectancies. These results were evident after accounting for the variance explained by gender, negative affectivity, and alternative outcome expectancies for smoking. The present findings suggest that smokers with greater perceived stress experience greater negative reinforcement smoking expectancies, which in turn, may be related to numerous processes involved in the maintenance of smoking. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outcomes of a pilates-based intervention for individuals with lateral epicondylosis: A pilot study.

Science.gov (United States)

Dale, Lucinda M; Mikuski, Connie; Miller, Jacqueline

2015-01-01

Core stability and flexibility, features of Pilates exercise, can reduce loads to the upper extremities. Reducing loads is essential to improve symptoms for individuals with lateral epicondylosis. Although Pilates exercise has gained popularity in healthy populations, it has not been studied for individuals with lateral epicondylosis. The purpose of this study was to determine if adding Pilates-based intervention to standard occupational therapy intervention improved outcomes as measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE) more than standard intervention for individuals with lateral epicondylosis. Participants (N= 17) were randomized to the standard intervention group or Pilates-based intervention group. All participants received standard intervention. The Pilates-based intervention group additionally completed abdominal strengthening, postural correction, and flexibility. For both groups, paired t-tests showed significantly improved PRTEE scores, 38.1 for the Pilates-based intervention group, and 22.9 for the standard intervention group. Paired t-test showed significantly improved provocative grip strength and pain for both groups. Independent t-tests showed no significant difference between groups in improved scores of PRTEE, pain, and provocative grip. Although the Pilates-based intervention group showed greater improvement in PRTEE outcome, provocative grip, and pain, scores were not significantly better than those of the standard intervention group, warranting further research.

The relative impact of 13 chronic conditions across three different outcomes.

Science.gov (United States)

Perruccio, Anthony V; Power, J Denise; Badley, Elizabeth M

2007-12-01

Previous estimates of individual and population attributable risks for adverse outcomes due to chronic conditions have considered only a limited number of conditions and outcomes, with some studies using inappropriate formulae or methods of estimation. This study re-examines the magnitude of individual and population attributable risks for a wide range of conditions and various health outcomes. Log-Poisson regression was used to calculate prevalence ratios as an indicator of individual risk and population-associated fractions of 13 chronic conditions, examining activity limitations, self-rated health and physician visits. The effect of multimorbidity on prevalence ratios was examined. Canada, 2000-01. Nationally representative sample of Canadians aged 12+ years (n _ 130 880). At the individual level, fibromyalgia/chronic fatigue syndrome and cancer, and to a lesser extent stroke and heart disease, were associated with an increased risk of both activity limitations and a self-rated health status of fair or poor; high blood pressure was associated with four or more physician visits in the previous 12 months. In contrast, population attributable fractions were substantial for arthritis/rheumatism, heart disease, back problems and high blood pressure across all outcomes. Adjustment for multimorbidity resulted in a marked decreases in prevalence ratios. Differences in the ranking of individual risks and population attributable fractions for different diseases and outcomes are substantial. This needs to be taken into account when setting priorities, as interventions may need to be targeted to different conditions depending on which aspects of health are being considered, and whether the focus is on individuals, such as in clinical care, or improving the health of the population.

The effects of conflict asymmetry on work group and individual outcomes

NARCIS (Netherlands)

Jehn, K.A.; Rispens, S.; Thatcher, S.M.B.

2010-01-01

We examine the consequences of an often ignored aspect of work group conflict—asymmetric conflict perceptions—for the effectiveness of individuals and groups. Tests of our multilevel hypotheses using data on 51 work groups showed that group conflict asymmetry (the degree to which members differ in

The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study.

Science.gov (United States)

Wang, Qin; Hu, Ke-Jie; Ren, Ye-Ping; Dong, Jie; Han, Qing-Feng; Zhu, Tong-Ying; Chen, Jiang-Hua; Zhao, Hui-Ping; Chen, Meng-Hua; Xu, Rong; Wang, Yue; Hao, Chuan-Ming; Zhang, Xiao-Hui; Wang, Mei; Tian, Na; Wang, Hai-Yan

2016-01-01

♦ Research indicates that the socioeconomic status (SES) of individuals and the area where they live are related to initial peritonitis and outcomes in peritoneal dialysis (PD). We conducted a retrospective, multi-center cohort study in China to examine these associations. ♦ Data on 2,171 PD patients were collected from 7 centers, including baseline demographic, socioeconomic, and laboratory data. We explored the potential risk factors for initial peritonitis and outcomes using univariate Cox regression and unadjusted binary logistic regression. Then, we used propensity score matching to balance statistically significant risk factors for initial peritonitis and outcomes, and Kaplan-Meier survival analysis to compare differences in peritonitis-free rates between different groups of participants after matching. ♦ A total of 563 (25.9%) initial episodes of peritonitis occurred during the study period. The Kaplan-Meier peritonitis-free rate curve showed high-income patients had a significantly lower risk than low-income patients (p = 0.007) after matching for age, hemoglobin, albumin, and regional SES and PD center. The risk of treatment failure was significantly lower in the high-income than the low-income group after matching for the organism causing peritonitis and PD center: odds ratio (OR) = 0.27 (0.09 - 0.80, p = 0.018). Regional SES and education were not associated with initial peritonitis and outcomes. ♦ Our study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis. Copyright © 2016 International Society for Peritoneal Dialysis.

Examining health and well-being outcomes associated with mining activity in rural communities of high-income countries: A systematic review.

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Mactaggart, Fiona; McDermott, Liane; Tynan, Anna; Gericke, Christian

2016-08-01

It is recognised internationally that rural communities often experience greater barriers to accessing services and have poorer health outcomes compared to urban communities. In some settings, health disparities may be further exacerbated by mining activity, which can affect the social, physical and economic environment in which rural communities reside. Direct environmental health impacts are often associated with mining activity and are frequently investigated. However, there is evidence of broader, indirect health and well-being implications emerging in the literature. This systematic review examines these health and well-being outcomes in communities living in proximity to mining in high-income countries, and, in doing so, discusses their possible determinants. Four databases were systematically searched. Articles were selected if adult residents in mining communities were studied and outcomes were related to health or individual or community-level well-being. A narrative synthesis was conducted. Sixteen publications were included. Evidence of increased prevalence of chronic diseases and poor self-reported health status was reported in the mining communities. Relationship breakdown and poor family health, lack of social connectedness and decreased access to health services were also reported. Changes to the physical landscape; risky health behaviours; shift work of partners in the mine industry; social isolation and cyclical nature of 'boom and bust' activity contributed to poorer outcomes in the communities. This review highlights the broader health and well-being outcomes associated with mining activity that should be monitored and addressed in addition to environmental health impacts to support co-existence of mining activities and rural communities. © 2016 National Rural Health Alliance Inc.

Serial Measurement of High-Sensitivity Troponin I and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus in the EXAMINE Trial (Examination of Cardiovascular Outcomes With Alogliptin Versus Standard of Care).

Science.gov (United States)

Cavender, Matthew A; White, William B; Jarolim, Petr; Bakris, George L; Cushman, William C; Kupfer, Stuart; Gao, Qi; Mehta, Cyrus R; Zannad, Faiez; Cannon, Christopher P; Morrow, David A

2017-05-16

We aimed to describe the relationship between changes in high-sensitivity cardiac troponin I (hsTnI) and cardiovascular outcomes. The EXAMINE trial (Examination of Cardiovascular Outcomes With Alogliptin Versus Standard of Care) was a phase IIIb clinical outcomes trial designed to evaluate the cardiovascular safety of alogliptin, a nonselective dipeptidyl peptidase 4 inhibitor. Patients with type 2 diabetes mellitus, glycohemoglobin between 6.5% and 11% (or between 7% and 11% if they were on insulin), and a recent acute coronary syndrome (between 15 and 90 days before randomization) were eligible for the trial. hsTnI was measured using the Abbott ARCHITECT assay at baseline and 6 months in patients randomized in the EXAMINE trial. This analysis was restricted to patients randomized ≥30 days after qualifying acute coronary syndrome to mitigate the potential for persistent hsTnI elevation after acute coronary syndrome (n=3808). The primary end point of the trial was cardiovascular death, myocardial infarction, or stroke. Cardiovascular death or heart failure was a prespecified, adjudicated secondary end point. At baseline, hsTnI was detectable (≥1.9 ng/L) in 93% of patients and >99 th percentile upper reference limit in 16%. There was a strong relationship between increasing hsTnI, both at baseline and 6 months, and the incidence of cardiovascular events through 24 months ( P diabetes mellitus without clinically recognized events had dynamic or persistently elevated values and were at high risk of recurrent events. hsTnI may have a role in personalizing preventive strategies in patients with diabetes mellitus based on risk. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00968708. © 2017 American Heart Association, Inc.

Effect of Behavioral Intervention on Dilated Fundus Examination Rates in Older African American Individuals With Diabetes Mellitus: A Randomized Clinical Trial.

Science.gov (United States)

Weiss, David M; Casten, Robin J; Leiby, Benjamin E; Hark, Lisa A; Murchison, Ann P; Johnson, Deiana; Stratford, Shayla; Henderer, Jeffrey; Rovner, Barry W; Haller, Julia A

2015-09-01

African American individuals are at high risk of diabetes mellitus and diabetic retinopathy but have suboptimal rates of dilated fundus examinations (DFEs). Early intervention is crucial for the prevention of diabetic retinopathy in this high-risk population. To test the efficacy of behavioral activation for diabetic retinopathy prevention on rates of DFEs in older African American individuals with diabetes mellitus. Masked randomized clinical trial at 2 urban medical centers from October 1, 2010, to May 31, 2014. Participants included 206 African American individuals 65 years and older with diabetes mellitus who had not obtained a DFE in the preceding 12 months. Participants were randomized to either behavioral activation for diabetic retinopathy prevention, a behavioral intervention designed to provide education, facilitate identifying and addressing health care barriers, and promote goal setting to improve rates of DFEs, or supportive therapy, a control condition. The primary outcome was medical documentation of a DFE at 6 months' follow-up. Secondary outcomes included the Risk Perceptions and Risk Knowledge Survey of Diabetes Mellitus, Diabetes Self-Care Inventory, Patient Health Questionnaire 9, and National Eye Institute Vision Function Questionnaire 25 scores and hemoglobin A1c levels. More participants in the behavioral activation for diabetic retinopathy prevention group (87.9%) obtained a DFE compared with those in the supportive therapy group (34.1%) by the 6-month follow-up assessment (P diabetic retinopathy prevention group were 2.5 times more likely to obtain a DFE compared with those in the supportive therapy group (risk ratio = 2.58; 95% CI, 1.91-3.48; P Knowledge Survey of Diabetes Mellitus or National Eye Institute Vision Function Questionnaire 25 composite scores; however, both groups had improved adherence to diabetes mellitus self-care behaviors from baseline to 6-month follow-up. Behavioral activation for diabetic retinopathy

Language comprehension and brain function in individuals with an optimal outcome from autism

OpenAIRE

Eigsti, Inge-Marie; Stevens, Michael C.; Schultz, Robert T.; Barton, Marianne; Kelley, Elizabeth; Naigles, Letitia; Orinstein, Alyssa; Troyb, Eva; Fein, Deborah A.

2015-01-01

Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO). The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as mo...

Justice as a Dynamic Construct: Effects of Individual Trajectories on Distal Work Outcomes

Science.gov (United States)

Hausknecht, John P.; Sturman, Michael C.; Roberson, Quinetta M.

2011-01-01

Despite an amassing organizational justice literature, few studies have directly addressed the temporal patterning of justice judgments and the effects that changes in these perceptions have on important work outcomes. Drawing from Gestalt characteristics theory (Ariely & Carmon, 2000, 2003), we examine the concept of justice trajectories…

What's your poison? Impact of individual repair capacity on the outcomes of genotoxic therapies in cancer. Part II - information content and validity of biomarkers for individual repair capacity in the assessment of outcomes of anticancer therapy.

Science.gov (United States)

Petkova, Rumena; Chelenkova, Pavlina; Georgieva, Elena; Chakarov, Stoian

2014-01-02

The individual variance in the efficiency of repair of damage induced by genotoxic therapies may be an important factor in the assessment of eligibility for different anticancer treatments, the outcomes of various treatments and the therapy-associated complications, including acute and delayed toxicity and acquired drug resistance. The second part of this paper analyses the currently available information about the possibilities of using experimentally obtained knowledge about individual repair capacity for the purposes of personalised medicine and healthcare.

Summer Treatment Program for Preschoolers with Externalizing Behavior Problems: a Preliminary Examination of Parenting Outcomes.

Science.gov (United States)

Graziano, Paulo A; Ros, Rosmary; Hart, Katie C; Slavec, Janine

2017-11-07

Within an at-risk sample of preschoolers with externalizing behavior problems (EBP), the current study examined the initial promise of a multimodal intervention, the Summer Treatment Program for Pre-Kindergarteners (STP-PreK), in improving parenting outcomes. Using an open trial design, 154 parents and their preschool children (73% male; M age  = 5.06 years; 82% Hispanic/Latino background) with at-risk or clinically elevated levels of EBP (57% of which were referred by schools or mental health/medical professionals) completed a baseline and post-treatment assessment. A subsample of 90 families completed a follow-up assessment approximately 6 to 9 months after treatment completion. Parental measures of parenting stress and discipline strategies were collected across all three assessments. Observational data were also collected across all assessments during a 5-min standardized child-led play situation and a 5-min parent-led clean up task. The parenting component of the STP-PreK included a School Readiness Parenting Program (SRPP) of which the behavioral management component was implemented via a Parent-Child Interaction Therapy (PCIT) adaptation (8 weekly group sessions with 15-20 parents in each group, lack of requirement of "mastery" criteria). All parenting outcomes (both ratings and observed) significantly improved after the intervention (Cohen's d mean effect size across measures 0.89) with all effects being maintained at the 6-9 month follow-up. These findings highlight the initial promise of our SRPP's PCIT adaptation in targeting multiple aspects of parenting while yielding comparable parenting skills acquisition compared to traditional individual PCIT.

Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

OpenAIRE

Schlaudraff, Kai-Uwe; Kiessling, Maren C; Császár, Nikolaus BM; Schmitz, Christoph

2014-01-01

Kai-Uwe Schlaudraff,1 Maren C Kiessling,2 Nikolaus BM Császár,2 Christoph Schmitz21Concept Clinic, Geneva, Switzerland; 2Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, GermanyBackground: Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predict...

Chinese L1 children's English L2 verb morphology over time: individual variation in long-term outcomes.

Science.gov (United States)

Paradis, Johanne; Tulpar, Yasemin; Arppe, Antti

2016-05-01

This study examined accuracy in production and grammaticality judgements of verb morphology by eighteen Chinese-speaking children learning English as a second language (L2) followed longitudinally from four to six years of exposure to English, and who began to learn English at age 4;2. Children's growth in accuracy with verb morphology reached a plateau by six years, where 11/18 children did not display native-speaker levels of accuracy for one or more morphemes. Variation in children's accuracy with verb morphology was predicted by their English vocabulary size and verbal short-term memories primarily, and quality and quantity of English input at home secondarily. This study shows that even very young L2 learners might not all catch up to native speakers in this time frame and that non-age factors play a role in determining individual variation in child L2 learners' long-term outcomes with English morphology.

Examining Information Technology Acceptance by Individual Professionals

Directory of Open Access Journals (Sweden)

Licen Indahwati Darsono

2005-06-01

Full Text Available The mixed results of information technology (IT investment have made the investigation of user acceptance of IT increasingly challenging. A growing body of research in user acceptance of IT literature has limited focus on individual professionals as target users. Therefore, this research investigates how external variables, namely individual differences and system characteristics influence lecturers as individual professionals to accept the internet technology. Technology Acceptance Model (TAM and Theory of Planned Behavior (TPB are used as the main reference in this research. Findings of this research indicate that individual differences (computer self-efficacy, knowledge of search domain and system characteristics (terminology, screen design, relevance have indirect impact through perceived ease of use, perceived usefulness, and attitude on lecturers’ intention to use the internet. Specifically, computer self-efficacy and screen design have direct and indirect impact on intention. One issue concerning with the explanatory power of the proposed research model, which is based on TAM and TPB, compared to the rival model, which is called extended TAM, is also analyzed.

Pharmacy Curriculum Outcomes Assessment for Individual Student Assessment and Curricular Evaluation

OpenAIRE

Scott, Day M.; Bennett, Lunawati L.; Ferrill, Mary J.; Brown, Daniel L.

2010-01-01

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of ...

Negative radiographic examinations: Evaluation of risks from exposure

International Nuclear Information System (INIS)

Frometa Suarez, I.; Jerez Vegueria, S.F.

1997-01-01

The individual dose of radiation per radiological diagnosis is decreasing, which is an important contribution for the number of exposed population. This is a result of a completed study presented by the Manuel Fajardo Surgery Clinic of the Municipality of Havana, which evaluated the behaviour of the negative radiological examinations and their contribution to the collective dose as well as the associated detriment. 486 cases with radiographic examinations are reported over a period of four months. The information on individual cases is classified by type of radiographic examination and whether the outcome of the examination was positive or negative, the absorbed doses per organ and irradiated tissue, dose equivalent, collective and effective doses. The probability of the occurrence of a fatal cancer and associated genetic damage due to the examinations is also considered. 41% of the examinations performed were negative, with a collective dose of 11.35 manSv and 52.9 % of the total doses contributed for all the radiological examinations of the population studied

The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self-directed behavior, and self-discrepancy within the mediation model.

Science.gov (United States)

Peterson, Carol B; Berg, Kelly C; Crosby, Ross D; Lavender, Jason M; Accurso, Erin C; Ciao, Anna C; Smith, Tracey L; Klein, Marjorie; Mitchell, James E; Crow, Scott J; Wonderlich, Stephen A

2017-06-01

The purpose of this investigation was to examine the indirect effects of Integrative Cognitive-Affective Therapy (ICAT-BN) and Cognitive-Behavioral Therapy-Enhanced (CBT-E) on bulimia nervosa (BN) treatment outcome through three hypothesized maintenance variables: emotion regulation, self-directed behavior, and self-discrepancy. Eighty adults with BN were randomized to 21 sessions of ICAT-BN or CBT-E. A regression-based bootstrapping approach was used to test the indirect effects of treatment on outcome at end of treatment through emotion regulation and self-directed behavior measured at mid-treatment, as well as the indirect effects of treatment at follow-up through emotion regulation, self-directed behavior, and self-discrepancy measured at end of treatment. No significant differences in outcome between treatment conditions were observed, and no significant direct or indirect effects were found. Examination of the individual paths within the indirect effects models revealed comparable treatment effects. Across treatments, improvements in emotion regulation and self-directed behavior between baseline and mid-treatment predicted improvements in global eating disorder scores but not binge eating and purging frequency at end of treatment. Baseline to end of treatment improvements in emotion regulation and self-directed behavior also predicted improvements in global eating disorder scores at follow-up. Baseline to end of treatment improvements in emotion regulation predicted improvements in binge eating and baseline to end of treatment increases in positive self-directed behavior predicted improvements in purging at follow-up. These findings suggest that emotion regulation and self-directed behavior are important treatment targets and that ICAT-BN and CBT-E are comparable in modifying these psychological processes among individuals with BN. © 2017 Wiley Periodicals, Inc.

The influence of individual socioeconomic status on the clinical outcomes in ischemic stroke patients with different neighborhood status in Shanghai, China

Science.gov (United States)

Yan, Han; Liu, Baoxin; Meng, Guilin; Shang, Bo; Jie, Qiqiang; Wei, Yidong; Liu, Xueyuan

2017-01-01

Objective: Socioeconomic status (SES) is being recognized as an important factor in both social and medical problems. The aim of present study is to examine the relationship between SES and ischemic stroke and investigate whether SES is a predictor of clinical outcomes among patients with different neighborhood status from Shanghai, China. Methods: A total of 471 first-ever ischemic stroke patients aged 18-80 years were enrolled in this retrospective study. The personal SES of each patient was evaluated using a summed score derived from his or her educational level, household income, occupation, and medical reimbursement rate. Clinical adverse events and all-cause mortality were analyzed to determine whether SES was a prognostic factor, its prognostic impact was then assessed based on different neighborhood status using multivariable Cox proportional hazard models after adjusting for other covariates. Results: The individual SES showed a significant positive correlation with neighborhood status (r = 0.370; P status, Kaplan-Meier analysis showed clinical adverse events and deaths were still higher in the low SES patients (all P status are independent prognostic factors for ischemic stroke (all P status, lower individual SES was significantly associated with clinical adverse events and mortality (all P status are significantly associated with the prognosis after ischemic stroke. A lower personal SES as well as poorer neighborhood status may significantly increase risk for adverse clinical outcomes among ischemic stroke patients. PMID:28138313

Simulation Performance and National Council Licensure Examination for Registered Nurses Outcomes: Field Research Perspectives.

Science.gov (United States)

Brackney, Dana E; Lane, Susan Hayes; Dawson, Tyia; Koontz, Angie

2017-11-01

This descriptive field study examines processes used to evaluate simulation for senior-level Bachelor of Science in Nursing (BSN) students in a capstone course, discusses challenges related to simulation evaluation, and reports the relationship between faculty evaluation of student performance and National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time passing rates. Researchers applied seven terms used to rank BSN student performance (n = 41, female, ages 22-24 years) in a senior-level capstone simulation. Faculty evaluation was correlated with students' NCLEX-RN outcomes. Students evaluated as "lacking confidence" and "flawed" were less likely to pass the NCLEX-RN on the first attempt. Faculty evaluation of capstone simulation performance provided additional evidence of student preparedness for practice in the RN role, as evidenced by the relationship between the faculty assessment and NCLEX-RN success. Simulation has been broadly accepted as a powerful educational tool that may also contribute to verification of student achievement of program outcomes and readiness for the RN role.

Examining the Relation between the Therapeutic Alliance, Treatment Adherence, and Outcome of Cognitive Behavioral Therapy for Children with Anxiety Disorders

Science.gov (United States)

Liber, Juliette M.; McLeod, Bryce D.; Van Widenfelt, Brigit M.; Goedhart, Arnold W.; van der Leeden, Adelinde J. M.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.

2010-01-01

Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for…

Quantity versus Quality: A New Approach to Examine the Relationship between Technology Use and Student Outcomes

Science.gov (United States)

Lei, Jing

2010-01-01

The author argues that to examine the relationship between technology use and student outcomes, the quality of technology use--how, and what, technology is used--is a more significant factor than the quantity of technology use--how much technology is used. This argument was exemplified by an empirical study that used both angles to examine the…

An Examination of Behavioral Rehearsal During Consultation as a Predictor of Training Outcomes

OpenAIRE

Edmunds, Julie M.; Kendall, Philip C.; Ringle, Vanesa A.; Read, Kendra L.; Brodman, Douglas A.; Pimentel, Sandra S.; Beidas, Rinad S.

2013-01-01

The training literature suggests that ongoing support following initial therapist training enhances training outcomes, yet little is known about what occurs during ongoing support and what accounts for its effectiveness. The present study examined consultation sessions provided to 99 clinicians following training in cognitive-behavioral therapy for youth anxiety. The 104 recorded consultation sessions were coded for content and consultative methods. It was hypothesized that behavioral rehears...

Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

Directory of Open Access Journals (Sweden)

Bianca Pinto Cunha

Full Text Available Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax, maximal pinch grip strength (PGSMax, Jebsen-Taylor Hand Function Test (JTHFT and Nine Hole Peg Test (9-HPT. All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50 and between JTHFT and 9-HPT (r = 0.55. Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

Long-Term Influence of Duration and Frequency of Participation in Alcoholics Anonymous on Individuals With Alcohol Use Disorders.

Science.gov (United States)

Moos, Rudolf H.; Moos, Bernice S.

2004-01-01

This study examined the influence of the duration and frequency of a baseline episode of participation in Alcoholics Anonymous (AA) among 473 individuals with alcohol use disorders on 1-year and 8-year outcomes and the effect of additional participation and delayed participation on outcomes. Compared with individuals who did not participate,…

Individual-based versus aggregate meta-analysis in multi-database studies of pregnancy outcomes

DEFF Research Database (Denmark)

Selmer, Randi; Haglund, Bengt; Furu, Kari

2016-01-01

Purpose: Compare analyses of a pooled data set on the individual level with aggregate meta-analysis in a multi-database study. Methods: We reanalysed data on 2.3 million births in a Nordic register based cohort study. We compared estimated odds ratios (OR) for the effect of selective serotonin...... covariates in the pooled data set, and 1.53 (1.19–1.96) after country-optimized adjustment. Country-specific adjusted analyses at the substance level were not possible for RVOTO. Conclusion: Results of fixed effects meta-analysis and individual-based analyses of a pooled dataset were similar in this study...... reuptake inhibitors (SSRI) and venlafaxine use in pregnancy on any cardiovascular birth defect and the rare outcome right ventricular outflow tract obstructions (RVOTO). Common covariates included maternal age, calendar year, birth order, maternal diabetes, and co-medication. Additional covariates were...

Psychophysical sensory examination in individuals with a history of methylmercury exposure

International Nuclear Information System (INIS)

Takaoka, Shigeru; Fujino, Tadashi; Sekikawa, Tomoko; Miyaoka, Tetsu

2004-01-01

Paresthesias are the first symptom that people report following toxic doses of methylmercury. The authors conducted a psychophysical study of tactile sensation to evaluate the somatosensory abilities of subjects living in a methylmercury-polluted area around Minamata City, Japan. The authors examined control subjects and methylmercury-exposed subjects with and without numbness. A history of methylmercury exposure was taken and a neurological examination performed. Aluminum-oxide abrasive papers were used as stimuli in a psychophysical sensory examination of fine-surface-texture discrimination. Difference thresholds from 3 μm were calculated by the two-alternative, forced-choice technique. Difference thresholds in control subjects were also calculated for comparison. The difference threshold was 6.3 μm in exposed subjects with sensory symptoms, 4.9 μm in exposed subjects without sensory symptoms, and 2.7 μm in control subjects. Acuity of fine-surface-texture discrimination was disturbed not only in subjects with clinical complaints of hand numbness, but also in subjects without hand numbness who lived in the district where methylmercury exposure occurred. Sensory testing using a psychophysical test of fine-surface-texture discrimination in this population suggests that the number of individuals affected by methylmercury exposure in the polluted area was greater than previously reported

Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

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Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y

2014-12-10

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P adverse outcome. Mean (SD) in-training examination scores did not significantly change from 2010 to 2013 for first-year residents (499.7 [ 85.2] to 500.5 [84.2], P = .99), for residents from other postgraduate years, or for first-time examinees taking the written or oral board

Neurocognitive outcomes of individuals with a sex chromosome trisomy: XXX, XYY, or XXY: a systematic review*

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LEGGETT, VICTORIA; JACOBS, PATRICIA; NATION, KATE; SCERIF, GAIA; BISHOP, DOROTHY V M

2010-01-01

Aim To review systematically the neurodevelopmental characteristics of individuals with sex chromosome trisomies (SCTs). Method A bibliographic search identified English-language articles on SCTs. The focus was on studies unbiased by clinical referral, with power of at least 0.69 to detect an effect size of 1.0. Results We identified 35 articles on five neonatally identified samples that had adequate power for our review. An additional 11 studies were included where cases had been identified for reasons other than neurodevelopmental concerns. Individuals with an additional X chromosome had mean IQs that were within broadly normal limits but lower than the respective comparison groups, with verbal IQ most affected. Cognitive outcomes were poorest for females with XXX. Males with XYY had normal-range IQs, but all three SCT groups (XXX, XXY, and XYY) had marked difficulties in speech and language, motor skills, and educational achievement. Nevertheless, most adults with SCTs lived independently. Less evidence was available for brain structure and for attention, social, and psychiatric outcomes. Within each group there was much variation. Interpretation Individuals with SCTs are at risk of cognitive and behavioural difficulties. However, the evidence base is slender, and further research is needed to ascertain the nature, severity, and causes of these difficulties in unselected samples. PMID:20059514

Neurocognitive outcomes of individuals with a sex chromosome trisomy: XXX, XYY, or XXY: a systematic review.

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Leggett, Victoria; Jacobs, Patricia; Nation, Kate; Scerif, Gaia; Bishop, Dorothy V M

2010-02-01

To review systematically the neurodevelopmental characteristics of individuals with sex chromosome trisomies (SCTs). A bibliographic search identified English-language articles on SCTs. The focus was on studies unbiased by clinical referral, with power of at least 0.69 to detect an effect size of 1.0. We identified 35 articles on five neonatally identified samples that had adequate power for our review. An additional 11 studies were included where cases had been identified for reasons other than neurodevelopmental concerns. Individuals with an additional X chromosome had mean IQs that were within broadly normal limits but lower than the respective comparison groups, with verbal IQ most affected. Cognitive outcomes were poorest for females with XXX. Males with XYY had normal-range IQs, but all three SCT groups (XXX, XXY, and XYY) had marked difficulties in speech and language, motor skills, and educational achievement. Nevertheless, most adults with SCTs lived independently. Less evidence was available for brain structure and for attention, social, and psychiatric outcomes. Within each group there was much variation. Individuals with SCTs are at risk of cognitive and behavioural difficulties. However, the evidence base is slender, and further research is needed to ascertain the nature, severity, and causes of these difficulties in unselected samples.

Individual air pollution monitors. 2. Examination of some nonoccupational research and regulatory uses and needs

Energy Technology Data Exchange (ETDEWEB)

Morgan, M.G.; Morris, S.C.

1977-01-01

Knowledge of the relationship between ambient air pollution levels measured at fixed monitoring stations and the actual exposure of the population is very limited. Indeed, there is rapidly growing evidence that fixed-station monitors do not provide adequate data for population exposure. This report examines available data for carbon monoxide (CO) and sulfur dioxide (SO/sub 2/) and presents a new analysis. Actual population exposure to CO appears to be consistently higher than expected from fixed-station data, while limited evidence suggests that exposures to SO/sub 2/ are lower. A reported general relationship between indoor and outdoor levels of SO/sub 2/ is not supported by the data. If air pollution represents a threat to public health, then more attention must be given to total population exposure to pollutants. A selective use of individual air pollution monitors that can be worn or carried appears to be required at some stage by any experimental design seeking to uncover the relation between air pollution exposure and health effects. Additionally, potential uses of individual monitoring in air pollution regulation are explored. Current status and research needs for individual air pollution monitors are examined and a first-order evaluation is given of the promise held by the candidate instrumentation technologies. A national program of support for the development of individual air pollution monitors is recommended.

The standardized surgical approach improves outcome of gallbladder cancer

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Igna Dorian

2007-05-01

Full Text Available Abstract Background The objective of this study was to examine the extent of surgical procedures, pathological findings, complications and outcome of patients treated in the last 12 years for gallbladder cancer. Methods The impact of a standardized more aggressive approach compared with historical controls of our center with an individual approach was examined. Of 53 patients, 21 underwent resection for cure and 32 for palliation. Results Overall hospital mortality was 9% and procedure related mortality was 4%. The standardized approach in UICC stage IIa, IIb and III led to a significantly improved outcome compared to patients with an individual approach (Median survival: 14 vs. 7 months, mean+/-SEM: 26+/-7 vs. 17+/-5 months, p = 0.014. The main differences between the standardized and the individual approach were anatomical vs. atypical liver resection, performance of systematic lymph dissection of the hepaticoduodenal ligament and the resection of the common bile duct. Conclusion Anatomical liver resection, proof for bile duct infiltration and, in case of tumor invasion, radical resection and lymph dissection of the hepaticoduodenal ligament are essential to improve outcome of locally advanced gallbladder cancer.

Parent Involvement and Academic Outcomes among Urban Adolescents: Examining the Role of School Engagement

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Dotterer, Aryn M.; Wehrspann, Elizabeth

2016-01-01

The present study examined the extent to which parent involvement in education was directly and indirectly (via school engagement) related to academic outcomes in an effort to more fully understand the school experiences of urban adolescents. Participants (80% racial/ethnic minority; n = 108) were in grades 6, 7 or 8. In the Fall and subsequent…

Evaluating Individual Students' Perceptions of Instructional Quality: An Investigation of their Factor Structure, Measurement Invariance, and Relations to Educational Outcomes.

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Scherer, Ronny; Nilsen, Trude; Jansen, Malte

2016-01-01

Students' perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling), which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics). On the basis of the Programme for International Student Assessment (PISA) 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students), we find support for the distinction between three factors of individual students' perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students' perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed.

Evaluating individual students’ perceptions of instructional quality: An investigation of their factor structure, measurement invariance, and relations to educational outcomes

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Ronny eScherer

2016-02-01

Full Text Available Students’ perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling, which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics. On the basis of the Programme for International Student Assessment (PISA 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students, we find support for the distinction between three factors of individual students’ perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students’ perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed.

Improving perinatal outcome: towards individualized care

NARCIS (Netherlands)

Kazemier, B.M.

2015-01-01

Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish

Evaluation of stroke services in Anglia stroke clinical network to examine the variation in acute services and stroke outcomes

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George Abraham

2011-02-01

Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.

A Cross-Cultural Examination of Typically Developing Children's Attitudes toward Individuals with Special Needs

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Nikolaraizi, Magda; Kumar, Poonam; Favazza, Paddy; Sideridis, Georgios; Koulousiou, Dafni; Riall, Ann

2005-01-01

This study explores children's attitudes toward individuals with special needs in Greece and in the United States. A total of 196 kindergarten-age children participated in the study. Children's attitudes were examined using the "Acceptance Scale for Kindergartners-Revised" (ASK-R) and were further explored with the use of an open-ended…

Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach.

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Marcus J H Huibers

Full Text Available Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT and interpersonal psychotherapy (IPT.134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI, a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach.We found five predictors (gender, employment status, anxiety, personality disorder and quality of life and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51.Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although the utility of the PAI

A critical review of cosmetic treatment outcomes in body dysmorphic disorder.

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Bowyer, Laura; Krebs, Georgina; Mataix-Cols, David; Veale, David; Monzani, Benedetta

2016-12-01

A high proportion of individuals with body dysmorphic disorder (BDD) undergo cosmetic treatments in an attempt to 'fix' perceived defect/s in their physical appearance. Despite the frequency with which such procedures are sought, few studies have prospectively examined the outcomes of cosmetic procedures in individuals with BDD. This article aims to critically review the literature and discuss the current debate that exists on outcomes of cosmetic treatment for individuals with BDD. An emerging literature suggests the majority of individuals with BDD have poor outcomes after cosmetic interventions; however, based on the current literature, it cannot be fully ruled out that certain individuals with mild BDD and localised appearance concerns may benefit from these interventions. Gaps in the current literature are highlighted, alongside recommendations for future research. Carefully conducted longitudinal studies with well-characterised patient populations are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cocaine dependent individuals discount future rewards more than future losses for both cocaine and monetary outcomes.

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Johnson, Matthew W; Bruner, Natalie R; Johnson, Patrick S

2015-01-01

Cocaine dependence and other forms of drug dependence are associated with steeper devaluation of future outcomes (delay discounting). Although studies in this domain have typically assessed choices between monetary gains (e.g., receive less money now versus receive more money after a delay), delay discounting is also applicable to decisions involving losses (e.g., small loss now versus larger delayed loss), with gains typically discounted more than losses (the "sign effect"). It is also known that drugs are discounted more than equivalently valued money. In the context of drug dependence, however, relatively little is known about the discounting of delayed monetary and drug losses and the presence of the sign effect. In this within-subject, laboratory study, delay discounting for gains and losses was assessed for cocaine and money outcomes in cocaine-dependent individuals (n=89). Both cocaine and monetary gains were discounted at significantly greater rates than cocaine and monetary losses, respectively (i.e., the sign effect). Cocaine gains were discounted significantly more than monetary gains, but cocaine and monetary losses were discounted similarly. Results suggest that cocaine is discounted by cocaine-dependent individuals in a systematic manner similar to other rewards. Because the sign effect was shown for both cocaine and money, delayed aversive outcomes may generally have greater impact than delayed rewards in shaping present behavior in this population. Copyright © 2014. Published by Elsevier Ltd.

Methodological Challenges in Examining the Impact of Healthcare Predictive Analytics on Nursing-Sensitive Patient Outcomes.

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Jeffery, Alvin D

2015-06-01

The expansion of real-time analytic abilities within current electronic health records has led to innovations in predictive modeling and clinical decision support systems. However, the ability of these systems to influence patient outcomes is currently unknown. Even though nurses are the largest profession within the healthcare workforce, little research has been performed to explore the impact of clinical decision support on their decisions and the patient outcomes associated with them. A scoping literature review explored the impact clinical decision support systems containing healthcare predictive analytics have on four nursing-sensitive patient outcomes (pressure ulcers, failure to rescue, falls, and infections). While many articles discussed variable selection and predictive model development/validation, only four articles examined the impact on patient outcomes. The novelty of predictive analytics and the inherent methodological challenges in studying clinical decision support impact are likely responsible for this paucity of literature. Major methodological challenges include (1) multilevel nature of intervention, (2) treatment fidelity, and (3) adequacy of clinicians' subsequent behavior. There is currently insufficient evidence to demonstrate efficacy of healthcare predictive analytics-enhanced clinical decision support systems on nursing-sensitive patient outcomes. Innovative research methods and a greater emphasis on studying this phenomenon are needed.

Documenting Program Outcomes of Relationship Education with Incarcerated Adults

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Kate Taylor Harcourt

2015-02-01

Full Text Available The current study examined program outcomes for an understudied population of Relationship Education (RE participants: incarcerated men and women. In addition to relationship functioning, we examined a number of individual and parenting outcomes which had not previously been explored. In a sample of 453 adult inmates, we found improvements in (a trust, (b confidence in the relationship, (c intimacy, (d individual empowerment, (e conflict management, (f help-seeking attitudes, (g self-esteem, (h depression, (i global life stress, (j faulty relationship beliefs, and (k parenting efficacy. Tests of moderation by gender and race indicated minimal differences in change patterns between groups; however, we found a significant time by gender interaction on intimacy and a time by race interaction on parenting efficacy. Implications for research and practice are presented

Making Students Feel Better: Examining the Relationships between Teacher Confirmation and College Students' Emotional Outcomes

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Goldman, Zachary W.; Goodboy, Alan K.

2014-01-01

Guided by broaden-and-build theory and emotional response theory, we examined college students' emotional outcomes in the classroom (i.e., emotional interest, emotional support, emotion work, emotional valence) as a function of teacher confirmation (i.e., responding to questions, demonstrating interest, teaching style). Participants were 159…

Social Aspects of the Workplace Among Individuals With Bipolar Disorder.

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O'Donnell, Lisa; Himle, Joseph A; Ryan, Kelly; Grogan-Kaylor, Andrew; McInnis, Melvin G; Weintraub, Jenna; Kelly, Marisa; Deldin, Patricia

2017-01-01

Bipolar disorder (BD) is characterized by recurrent mood episodes and profound impairments in psychosocial functioning. Occupational disability is one of the most problematic impairments for individuals with BD due to high rates of unemployment and work impairments. Current evidence indicates that social stressors at work-such as social isolation, conflict with others, and stigmas-are common experiences for employed individuals with BD. Yet, few studies have examined the relationship between social stressors at work and overall occupational functioning, instead focusing on individual clinical features of the disorder. This cross-sectional study employed logistic and linear regressions to determine which demographic variables, mood symptoms, and social aspects of the work environment (exclusion, conflict, social support, stigma) were associated with work status (working vs. not working) and work functioning for individuals with bipolar disorder I and II. Greater stigma and exclusion at work ( p < .05) are associated with unemployment among adult individuals with BD, and higher degrees of depression and conflict at work ( p < .05) are associated with work impairments for employed individuals. By examining two distinct measures of work outcomes (work status and work functioning) within the same group of participants, this study provides a unique insight, revealing that predictors of occupational functioning vary based on the specific measure of work outcomes used. This study also emphasizes the need for treatments that address the clinical features of BD and intervene in the work environment to improve functioning and prevent unemployment among individuals with BD.

Once a Utilitarian, Consistently a Utilitarian? Examining Principledness in Moral Judgment via the Robustness of Individual Differences.

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Helzer, Erik G; Fleeson, William; Furr, R Michael; Meindl, Peter; Barranti, Maxwell

2017-08-01

Although individual differences in the application of moral principles, such as utilitarianism, have been documented, so too have powerful context effects-effects that raise doubts about the durability of people's moral principles. In this article, we examine the robustness of individual differences in moral judgment by examining them across time and across different decision contexts. In Study 1, consistency in utilitarian judgment of 122 adult participants was examined over two different survey sessions. In Studies 2A and 2B, large samples (Ns = 130 and 327, respectively) of adult participants made a series of 32 moral judgments across eight different contexts that are known to affect utilitarian endorsement. Contrary to some contemporary theorizing, our results reveal a strong degree of consistency in moral judgment. Across time and experimental manipulations of context, individuals maintained their relative standing on utilitarianism, and aggregated moral decisions reached levels of near-perfect consistency. Results support the view that on at least one dimension (utilitarianism), people's moral judgments are robustly consistent, with context effects tailoring the application of principles to the particulars of any given moral judgment. © 2016 Wiley Periodicals, Inc.

The distributional effects of employer and individual health insurance mandates.

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Holahan, J; Winterbottom, C; Zedlewski, S

This paper assesses the impact of different kinds of employer and individual mandates on the cost to individuals, business, and government. We also examine the distribution of health care expenditures across individuals in different income groups, assuming that individuals ultimately bear the cost of employer payments through lower wages and the cost of government payments through tax contributions. A major conclusion is that net benefits to lower income individuals improve under all alternatives to the current system with relatively small increases in payments by individuals in any income group. Additionally, while employer mandates reduce individuals' direct payments, individual mandates can have lower costs to the government and better distributional outcomes. A 50% employer mandate also has many desirable features.

A method to assess the influence of individual player performance distribution on match outcome in team sports.

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Robertson, Sam; Gupta, Ritu; McIntosh, Sam

2016-10-01

This study developed a method to determine whether the distribution of individual player performances can be modelled to explain match outcome in team sports, using Australian Rules football as an example. Player-recorded values (converted to a percentage of team total) in 11 commonly reported performance indicators were obtained for all regular season matches played during the 2014 Australian Football League season, with team totals also recorded. Multiple features relating to heuristically determined percentiles for each performance indicator were then extracted for each team and match, along with the outcome (win/loss). A generalised estimating equation model comprising eight key features was developed, explaining match outcome at a median accuracy of 63.9% under 10-fold cross-validation. Lower 75th, 90th and 95th percentile values for team goals and higher 25th and 50th percentile values for disposals were linked with winning. Lower 95th and higher 25th percentile values for Inside 50s and Marks, respectively, were also important contributors. These results provide evidence supporting team strategies which aim to obtain an even spread of goal scorers in Australian Rules football. The method developed in this investigation could be used to quantify the importance of individual contributions to overall team performance in team sports.

What Do We Know About Improving Employment Outcomes for Individuals with Autism Spectrum Disorder?

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Carolyn Dudley

2016-01-01

Full Text Available WHY IS THIS AN IMPORTANT ISSUE? An estimated 1 in 86 children are diagnosed with Autism Spectrum Disorder (ASD1 making it the most commonly diagnosed childhood neurological condition in Canada.2 Adults living with ASD3 have the poorest employment outcomes of those with disabilities. Most earn less than the national minimum hourly wage, endure extended periods of joblessness and frequently shuffle between positions, further diminishing their prospects. These poor employment outcomes result in lower quality of life and often lead to steep economic costs. WHAT DOES THE RESEARCH TELL US? Employment success increases quality of life Employment enhances quality of life, cognitive functioning and overall well-being of persons with ASD by increasing economic self-sufficiency, financial security, independent living, community participation and self-esteem.4, 5, 6 Unfortunately, employment outcomes for those living with ASD are poor; only 25 per cent of adults with ASD are employed, most of this group is considered high-functioning and only six per cent are competitively employed.7, 8 Success in employment is attributable to a combination of individual characteristics, external supports and policy enabling employment opportunities.

The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study.

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Hoch, Johanna M; Sinnott, Cori W; Robinson, Kendall P; Perkins, William O; Hartman, Jonathan W

2018-03-01

There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation. To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes. Case control. Laboratory. A total of 20 post-ACLR and 40 healthy control participants. The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05. There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable. Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard

Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls.

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Johnson, Matthew W; Johnson, Patrick S; Herrmann, Evan S; Sweeney, Mary M

2015-01-01

Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event's value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23) and matched non-cocaine-using controls (n = 24) were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task), delay discounting of money, the effect of sexually transmitted infection (STI) risk on likelihood of condom use (Sexual Probability Discounting Task), and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom) significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts) significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and probability

Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls.

Directory of Open Access Journals (Sweden)

Matthew W Johnson

Full Text Available Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event's value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23 and matched non-cocaine-using controls (n = 24 were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task, delay discounting of money, the effect of sexually transmitted infection (STI risk on likelihood of condom use (Sexual Probability Discounting Task, and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and

Examining substance use among rural Appalachian and urban non-Appalachian individuals participating in drug court.

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Shannon, Lisa M; Perkins, Elizabeth B; Neal, Connie

2014-02-01

The study purpose was to examine differences in substance use among individuals in drug court (N = 583) in rural Appalachian (n = 301) and urban non-Appalachian areas (n = 282). A series of logistic regression analyses suggested individuals in the rural Appalachian area were significantly more likely to report lifetime use of cocaine, illicit opiates, and illicit benzodiazepines, but they were less likely to report methamphetamine use when compared with individuals in the urban non-Appalachian area. Regarding past 30-day use, a series of logistic regression analyses suggested individuals in the rural Appalachian area were significantly more likely to use marijuana, illicit opiates, and illicit benzodiazepines, but they were less likely to report crack cocaine use when compared with individuals in the urban non-Appalachian area. Identifying differences which exist in substance use is the first step in generating evidence-based structural changes in treatment drug court programs. Future research should focus on better understanding context in terms of demographic, geographic, and economic conditions, which may be of critical influence on substance use and treatment planning.

Individual Differences and Learning Contexts: A Self-Regulated Learning Perspective

Science.gov (United States)

Ben-Eliyahu, Adar

2017-01-01

This article examines how individual differences (giftedness) interact with learning contexts (favorite versus least favorite courses) to influence learning processes and outcomes. The findings show that gifted and typically developing students differ solely in their expectancies for success and grades among a large variety of measures, including…

Continuous physical examination during subcortical resection in awake craniotomy patients: Its usefulness and surgical outcome.

Science.gov (United States)

Bunyaratavej, Krishnapundha; Sangtongjaraskul, Sunisa; Lerdsirisopon, Surunchana; Tuchinda, Lawan

2016-08-01

To evaluate the value of physical examination as a monitoring tool during subcortical resection in awake craniotomy patients and surgical outcomes. Authors reviewed medical records of patients underwent awake craniotomy with continuous physical examination for pathology adjacent to the eloquent area. Between January 2006 and August 2015, there were 37 patients underwent awake craniotomy with continuous physical examination. Pathology was located in the left cerebral hemisphere in 28 patients (75.7%). Thirty patients (81.1%) had neuroepithelial tumors. Degree of resections were defined as total, subtotal, and partial in 16 (43.2%), 11 (29.7%) and 10 (27.0%) patients, respectively. Median follow up duration was 14 months. The reasons for termination of subcortical resection were divided into 3 groups as follows: 1) by anatomical landmark with the aid of neuronavigation in 20 patients (54%), 2) by reaching subcortical stimulation threshold in 8 patients (21.6%), and 3) by abnormal physical examination in 9 patients (24.3%). Among these 3 groups, there were statistically significant differences in the intraoperative (p=0.002) and early postoperative neurological deficit (p=0.005) with the lowest deficit in neuronavigation group. However, there were no differences in neurological outcome at later follow up (3-months p=0.103; 6-months p=0.285). There were no differences in the degree of resection among the groups. Continuous physical examination has shown to be of value as an additional layer of monitoring of subcortical white matter during resection and combining several methods may help increase the efficacy of mapping and monitoring of subcortical functions. Copyright © 2016 Elsevier B.V. All rights reserved.

An in-depth cognitive examination of individuals with superior face recognition skills.

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Bobak, Anna K; Bennetts, Rachel J; Parris, Benjamin A; Jansari, Ashok; Bate, Sarah

2016-09-01

Previous work has reported the existence of "super-recognisers" (SRs), or individuals with extraordinary face recognition skills. However, the precise underpinnings of this ability have not yet been investigated. In this paper we examine (a) the face-specificity of super recognition, (b) perception of facial identity in SRs, (c) whether SRs present with enhancements in holistic processing and (d) the consistency of these findings across different SRs. A detailed neuropsychological investigation into six SRs indicated domain-specificity in three participants, with some evidence of enhanced generalised visuo-cognitive or socio-emotional processes in the remaining individuals. While superior face-processing skills were restricted to face memory in three of the SRs, enhancements to facial identity perception were observed in the others. Notably, five of the six participants showed at least some evidence of enhanced holistic processing. These findings indicate cognitive heterogeneity in the presentation of superior face recognition, and have implications for our theoretical understanding of the typical face-processing system and the identification of superior face-processing skills in applied settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining exercise dependence symptomatology from a self-determination perspective.

Science.gov (United States)

Edmunds, Jemma; Ntoumanis, Nikos; Duda, Joan L

2006-11-01

Background Pulling from Self-Determination Theory (SDT; Deci & Ryan, 1985), this study examined whether individuals classified as 'nondependent-symptomatic' and 'nondependent-asymptomatic' for exercise dependence differed in terms of reported levels of exercise-related psychological need satisfaction, self-determined versus controlling motivation and exercise behavior. In addition, we examined the type of motivational regulations predicting exercise behavior among these different groups, and their role as mediators between psychological need satisfaction and behavioral outcomes. Methods Participants (N = 339) completed measures of exercise-specific psychological need satisfaction, motivational regulations, exercise behavior and exercise dependence. Results Nondependent-symptomatic individuals reported higher levels of competence need satisfaction and all forms of motivational regulation, compared to nondependent-asymptomatic individuals. Introjected regulation approached significance as a positive predictor of strenuous exercise behavior for symptomatic individuals. Identified regulation was a positive predictor of strenuous exercise, and completely mediated the relationship between competence need satisfaction and strenuous exercise behavior, for asymptomatic individuals. Conclusions The findings reinforce the applicability of SDT to understanding the quantity and quality of engagement in exercise.

Resilience versus "Resilient Individual": What Exactly Do We Study?

Directory of Open Access Journals (Sweden)

Jan Sebastian Novotný

2014-07-01

Full Text Available The nature and definition of resilience, despite the extensive 40 years of research, is still unclear. Currently is resilience seen as a personality trait, sum of the traits/factors, result of adaptation, or as a process. The concept of resilience as personality traits is usually tied to uni-dimensional or "simplex" theories of resistance as Hardiness, Sense of Control, Ego-Resiliency, Self-efficacy, Sense of Coherence, or specific personality traits. Multidimensional concepts see resilience as a complex of personality and social (environmental factors that work in interaction, complement or replace each other, and, in aggregate, create a comprehensive picture of resilience. The concept of resilience as the result of adaptation examines resilience in terms of the presence/absence of adverse/pathological manifestations, consequences and outcomes in relation to the earlier effect of stressful, risky or otherwise unfavorable situations. Finally, the concept of resilience as the process examines individual's response to risk factors or wounds that are present in the environment. Resilience is thus a process consisting of interactions between individual characteristics and the environment. Most experts and a large part of resilience research is based on the first three concepts that however explore how "resilient" the individual is rather than resilience itself, since they are based on "diagnosing" or at best dimensional, at worse dichotomous rating of the individual's resilience (within personality trait approach, or on the evaluation of the presence/absence of factors/source of resilience, thereby they are still holding the "diagnostic" approach (within multidimensional approach. Only the examination of processes, such as the ongoing interaction between these risk factors, resilience factors, outcomes (expressions of personality, behavior, presence of problems, etc. and other variables allows us to understand resilience (the true nature of how

Individual differences in personality masculinity-femininity: Examining the effects of genes, environment, and prenatal hormone transfer

NARCIS (Netherlands)

Verweij, K.J.H.; Mosing, M.A.; Ullén, F.; Madison, G.

2016-01-01

Males and females score differently on some personality traits, but the underlying etiology of these differences is not well understood. This study examined genetic, environmental, and prenatal hormonal influences on individual differences in personality masculinity-femininity (M-F). We used

Examining speed of processing of facial emotion recognition in individuals at ultra-high risk for psychosis

DEFF Research Database (Denmark)

Glenthøj, Louise Birkedal; Fagerlund, Birgitte; Bak, Nikolaj

2018-01-01

Emotion recognition is an aspect of social cognition that may be a key predictor of functioning and transition to psychosis in individuals at ultra-high risk (UHR) for psychosis ( Allott et al., 2014 ). UHR individuals exhibit deficits in accurately identifying facial emotions ( van Donkersgoed et...... al., 2015 ), but other potential anomalies in facial emotion recognition are largely unexplored. This study aimed to extend current knowledge on emotion recognition deficits in UHR individuals by examining: 1) whether UHR would display significantly slower facial emotion recognition than healthy...... controls, 2) whether an association between emotion recognition accuracy and emotion recognition latency is present in UHR, 3) the relationships between emotion recognition accuracy, neurocognition and psychopathology in UHR....

The relative contribution of neurocognition and social cognition to 6-month vocational outcomes following Individual Placement and Support in first-episode psychosis.

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Allott, Kelly A; Cotton, Susan M; Chinnery, Gina L; Baksheev, Gennady N; Massey, Jessica; Sun, Pamela; Collins, Zoe; Barlow, Emma; Broussard, Christina; Wahid, Tasha; Proffitt, Tina-Marie; Jackson, Henry J; Killackey, Eoin

2013-10-01

To examine whether baseline neurocognition and social cognition predict vocational outcomes over 6 months in patients with first-episode psychosis (FEP) enrolled in a randomised controlled trial of Individual Placement and Support (IPS) versus treatment as usual (TAU). 135 FEP participants (IPS n=69; TAU n=66) completed a comprehensive neurocognitive and social cognitive battery. Principal axis factor analysis using PROMAX rotation was used to determine the underlying cognitive structure of the battery. Setwise (hierarchical) logistic and multivariate linear regressions were used to examine predictors of: (a) enrolment in education and employment; and (b) hours of employment over 6 months. Neurocognition and social cognition factors were entered into the models after accounting for premorbid IQ, baseline functioning and treatment group. Six cognitive factors were extracted: (i) social cognition; (ii) information processing speed; (iii) verbal learning and memory; (iv) attention and working memory; (v) visual organisation and memory; and (vi) verbal comprehension. Enrolment in education over 6 months was predicted by enrolment in education at baseline (p=.002) and poorer visual organisation and memory (p=.024). Employment over 6 months was predicted by employment at baseline (p=.041) and receiving IPS (p=.020). Better visual organisation and memory predicted total hours of paid work over 6 months (paccounting for premorbid IQ, baseline functioning and treatment. Social cognition did not contribute to the prediction of vocational outcomes. Neurocognitive interventions may enhance employment duration in FEP. © 2013 Elsevier B.V. All rights reserved.

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

Directory of Open Access Journals (Sweden)

Shama D Ahuja

Full Text Available Treatment of multidrug resistant tuberculosis (MDR-TB is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB.Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1-6.0], ofloxacin (aOR: 2.5 [1.6-3.9], ethionamide or prothionamide (aOR: 1.7 [1.3-2.3], use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3-3.9], and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7-4.1]. Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7-4.3], ofloxacin (aOR: 2.3 [1.3-3.8], ethionamide or prothionamide (aOR: 1.7 [1.4-2.1], use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9-3.9], and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4-6.0].In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment. Please see later in the article for the Editors' Summary.

Impact of individual clinical outcomes on trial participants' perspectives on enrollment in emergency research without consent.

Science.gov (United States)

Whitesides, Louisa W; Baren, Jill M; Biros, Michelle H; Fleischman, Ross J; Govindarajan, Prasanthi R; Jones, Elizabeth B; Pancioli, Arthur M; Pentz, Rebecca D; Scicluna, Victoria M; Wright, David W; Dickert, Neal W

2017-04-01

Evidence suggests that patients are generally accepting of their enrollment in trials for emergency care conducted under exception from informed consent. It is unknown whether individuals with more severe initial injuries or worse clinical outcomes have different perspectives. Determining whether these differences exist may help to structure post-enrollment interactions. Primary clinical data from the Progesterone for the Treatment of Traumatic Brain Injury trial were matched to interview data from the Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study. Answers to three key questions from Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study were analyzed in the context of enrolled patients' initial injury severity (initial Glasgow Coma Scale and Injury Severity Score) and principal clinical outcomes (Extended Glasgow Outcome Scale and Extended Glasgow Outcome Scale relative to initial injury severity). The three key questions from Patients' Experiences in Emergency Research-Progesterone for the Treatment of Traumatic Brain Injury study addressed participants' general attitude toward inclusion in the Progesterone for the Treatment of Traumatic Brain Injury trial (general trial inclusion), their specific attitude toward being included in Progesterone for the Treatment of Traumatic Brain Injury trial under the exception from informed consent (personal exception from informed consent enrollment), and their attitude toward the use of exception from informed consent in the Progesterone for the Treatment of Traumatic Brain Injury trial in general (general exception from informed consent enrollment). Qualitative analysis of interview transcripts was performed to provide contextualization and to determine the extent to which respondents framed their attitudes in terms of clinical experience. Clinical data from Progesterone for the Treatment of Traumatic Brain Injury

Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes

DEFF Research Database (Denmark)

Sørensen, Jette Led; van der Vleuten, Cees; Rosthøj, Susanne

2015-01-01

choice question test. EXPLORATORY OUTCOMES: Individual outcomes: scores on the Safety Attitudes Questionnaire, stress measurements (State-Trait Anxiety Inventory, cognitive appraisal and salivary cortisol), Intrinsic Motivation Inventory and perceptions of simulations. Team outcome: video assessment......OBJECTIVE: To investigate the effect of in situ simulation (ISS) versus off-site simulation (OSS) on knowledge, patient safety attitude, stress, motivation, perceptions of simulation, team performance and organisational impact. DESIGN: Investigator-initiated single-centre randomised superiority...... educational trial. SETTING: Obstetrics and anaesthesiology departments, Rigshospitalet, University of Copenhagen, Denmark. PARTICIPANTS: 100 participants in teams of 10, comprising midwives, specialised midwives, auxiliary nurses, nurse anaesthetists, operating theatre nurses, and consultant doctors...

The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments.

Science.gov (United States)

Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D

2017-02-01

To examine whether resilience has a protective effect in difficult work environments. A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Workers with high resilience have better outcomes in difficult work environments.

Outcomes in transfusion.

Science.gov (United States)

Sherman, L A

1999-07-01

Outcomes data in medicine can be limited by subjective methodologic issues such as poor selection of end points and use of nonvalidated systems for quality adjustment. Blood transfusion analyses are further complicated by the fact that transfusion seldom is primary therapy but is usually supportive or adjunctive. Thus, much of the outcome data in transfusion medicine are either unavailable or in one of two areas. The first area is prevention of bad sequelae of various cytopenias or factor deficiencies. The second is decreasing adverse effects of transfusion itself. A different useful area for outcome and root cause approaches in individual institutions is examining preanalytical and postanalytical processes of their own. Examples are sample labeling accuracy, quality and timeliness of blood suppliers, internal delivery processes and times, and product wastage. Use review can be changed to real time from retrospective time. By reducing complaints about service to objective data, realistic change can be made in internal and external processes.

Effect of workplace incivility on end-of-work negative affect: examining individual and organizational moderators in a daily diary study.

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Zhou, Zhiqing E; Yan, Yu; Che, Xin Xuan; Meier, Laurenz L

2015-01-01

Although previous studies have linked workplace incivility with various negative outcomes, they mainly focused on the long-term effects of chronic exposure to workplace incivility, whereas targets' short-term reactions to incivility episodes have been largely neglected. Using a daily diary design, the current study examined effects of daily workplace incivility on end-of-work negative affect and explored potential individual and organizational moderators. Data collected from 76 full-time employees across 10 consecutive working days revealed that daily workplace incivility positively predicted end-of-work negative affect while controlling for before-work negative affect. Further, the relationship was stronger for people with low emotional stability, high hostile attribution bias, external locus of control, and people experiencing low chronic workload and more chronic organizational constraints, as compared with people with high emotional stability, low hostile attribution bias, internal locus of control, and people experiencing high chronic workload and fewer chronic organizational constraints, respectively. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PsycINFO Database Record (c) 2014 APA, all rights reserved.

Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data

NARCIS (Netherlands)

Zinkstok, Sanne M.; Vergouwen, Mervyn D. I.; Engelter, Stefan T.; Lyrer, Philippe A.; Bonati, Leo H.; Arnold, Marcel; Mattle, Heinrich P.; Fischer, Urs; Sarikaya, Hakan; Baumgartner, Ralf W.; Georgiadis, Dimitrios; Odier, Céline; Michel, Patrik; Putaala, Jukka; Griebe, Martin; Wahlgren, Nils; Ahmed, Niaz; van Geloven, Nan; de Haan, Rob J.; Nederkoorn, Paul J.

2011-01-01

The safety and efficacy of thrombolysis in cervical artery dissection (CAD) are controversial. The aim of this meta-analysis was to pool all individual patient data and provide a valid estimate of safety and outcome of thrombolysis in CAD. We performed a systematic literature search on intravenous

Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

Science.gov (United States)

Bernabeu, Andrea; Goya, Maria; Martra, Miquel; Suy, Anna; Pratcorona, Laia; Merced, Carme; Llurba, Elisa; Casellas, Manel; Carreras, Elena; Cabero, Luis

2016-01-01

To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated. Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth. During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated. Mean gestational age until birth was 35 weeks in singleton and 32 weeks in twin pregnancies. Four cases (7.5%) of immature births and one case (2.0%) of neonatal death were recorded in singleton pregnancies. No cases of immature births or neonatal deaths were recorded in twin pregnancies. Diagnostic amniocentesis was performed IN all cases to rule out possible chorioamnionitis. Physical examination-indicated cerclage for cervical incompetence in women at risk for immature or preterm birth demonstrates good perinatal prognosis without increasing maternal morbidity in either singleton or twin pregnancies. The increase in gestation time in our study may also have been due to the fact that patients with subclinical chorioamnionitis were excluded by diagnostic amniocentesis.

Association between breakfast consumption and educational outcomes in 9?11-year-old children

OpenAIRE

Littlecott, Hannah J; Moore, Graham F; Moore, Laurence; Lyons, Ronan A; Murphy, Simon

2015-01-01

Objective Breakfast consumption has been consistently associated with health outcomes and cognitive functioning in schoolchildren. Evidence of direct links with educational outcomes remains equivocal. We aimed to examine the link between breakfast consumption in 9–11-year-old children and educational outcomes obtained 6–18 months later.\\ud Design Data on individual-level free school meal entitlement and educational outcomes (Statutory Assessment Tests (SATs) at Key Stage 2) were obtained via ...

Reporting individual surgeon outcomes does not lead to risk aversion in abdominal aortic aneurysm surgery.

Science.gov (United States)

Saratzis, A; Thatcher, A; Bath, M F; Sidloff, D A; Bown, M J; Shakespeare, J; Sayers, R D; Imray, C

2017-02-01

INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) of patients offered elective treatment. METHODS Publically available National Vascular Registry data were used to compare the number of AAAs treated in those centres across the UK that reported outcomes for the periods 2008-2012, 2009-2013 and 2010-2014. Furthermore, the number and characteristics of patients referred for consideration of elective AAA repair at a single tertiary unit were analysed yearly between 2010 and 2014. Clinic, casualty and theatre event codes were searched to obtain all AAAs treated. The results of cardiopulmonary exercise testing (CPET) were assessed. RESULTS For the 85 centres that reported outcomes in all three five-year periods, the median number of AAAs treated per unit increased between the periods 2008-2012 and 2010-2014 from 192 to 214 per year (p=0.006). In the single centre cohort study, the proportion of patients offered elective AAA repair increased from 74% in 2009-2010 to 81% in 2013-2014, with a maximum of 84% in 2012-2013. The age, aneurysm size and CPET results (anaerobic threshold levels) for those eventually offered elective treatment did not differ significantly between 2010 and 2014. CONCLUSIONS The results do not support the assumption that reporting individual surgeon outcomes is associated with a risk averse strategy regarding patient selection in aneurysm surgery at present.

Aiding the search: Examining individual differences in multiply-constrained problem solving.

Science.gov (United States)

Ellis, Derek M; Brewer, Gene A

2018-07-01

Understanding and resolving complex problems is of vital importance in daily life. Problems can be defined by the limitations they place on the problem solver. Multiply-constrained problems are traditionally examined with the compound remote associates task (CRAT). Performance on the CRAT is partially dependent on an individual's working memory capacity (WMC). These findings suggest that executive processes are critical for problem solving and that there are reliable individual differences in multiply-constrained problem solving abilities. The goals of the current study are to replicate and further elucidate the relation between WMC and CRAT performance. To achieve these goals, we manipulated preexposure to CRAT solutions and measured WMC with complex-span tasks. In Experiment 1, we report evidence that preexposure to CRAT solutions improved problem solving accuracy, WMC was correlated with problem solving accuracy, and that WMC did not moderate the effect of preexposure on problem solving accuracy. In Experiment 2, we preexposed participants to correct and incorrect solutions. We replicated Experiment 1 and found that WMC moderates the effect of exposure to CRAT solutions such that high WMC participants benefit more from preexposure to correct solutions than low WMC (although low WMC participants have preexposure benefits as well). Broadly, these results are consistent with theories of working memory and problem solving that suggest a mediating role of attention control processes. Published by Elsevier Inc.

Predictive value of the National Institutes of Health Stroke Scale and the Mini-Mental State Examination for neurologic outcome after coronary artery bypass graft surgery.

Science.gov (United States)

Nussmeier, Nancy A; Miao, Yinghui; Roach, Gary W; Wolman, Richard L; Mora-Mangano, Christina; Fox, Mark; Szekely, Andrea; Tommasino, Concezione; Schwann, Nanette M; Mangano, Dennis T

2010-04-01

We intended to define the role of the National Institutes of Health Stroke Scale and the Mini-Mental State Examination in identifying adverse neurologic outcomes in a large international sample of patients undergoing cardiac surgery. We evaluated 4707 patients undergoing cardiac surgery with cardiopulmonary bypass at 72 centers in 17 countries between November 1996 and June 2000. Prespecified overt neurologic outcomes were categorized as type I (clinically diagnosed stroke, transient ischemic attack, encephalopathy, or coma) or type II (deterioration of intellectual function). The National Institutes of Health Stroke Scale and Mini-Mental State Examination were administered preoperatively and on postoperative day 3, 4, or 5. Receiver operating characteristic curves were plotted to determine the predictive value of worsening in National Institutes of Health Stroke Scale and Mini-Mental State Examination scores with respect to type I and II outcomes. The receiver operating characteristic area under the curve for changes in National Institutes of Health Stroke Scale score (n = 4620) was 0.89 for type I outcomes and 0.66 for type II outcomes. A 1-point worsening in National Institutes of Health Stroke Scale score provided excellent discrimination (86% specificity; 84% sensitivity) of type I outcomes. The receiver operating characteristic area under the curve for changes in Mini-Mental State Examination score (n = 4707) was 0.75 for type I outcomes and 0.71 for type II outcomes. A 2-point worsening in Mini-Mental State Examination score provided only fair discrimination (73% specificity; 62% sensitivity) of type II outcomes. We used baseline controls and postoperative worsening in National Institutes of Health Stroke Scale and Mini-Mental State Examination scores to predict both serious adverse neurologic outcome and deterioration of intellectual function. Our findings provide the only reference for evaluating these tests that are used in cardiac surgical clinical

Examining the Impact of Servant Leadership on Workplace Related Outcome (JS) at a Selected Private University

Science.gov (United States)

Guillaume, Oris

2012-01-01

The aim of this study was to examine the impact of Servant Leadership on a workplace related outcome (job satisfaction) at a private University in Atlanta, Georgia. The ten characteristics of Servant Leadership previously identified by Greenleaf (1977) and Spears (1998) played a significant role in job satisfaction. Other researchers (Barbuto…

A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder

Directory of Open Access Journals (Sweden)

Amanda Brignell

2018-05-01

Full Text Available Background Language difficulties are common in autism spectrum disorder, yet little is known about the prognosis of language in children with autism spectrum disorder. The aim of this study was to systematically review studies reporting language outcomes in individuals with autism spectrum disorder. Method A comprehensive search strategy with a well-established sensitive prognosis filter for Medline, adapted for five other databases, was used. Included studies observed individuals diagnosed with autism spectrum disorder for ≥12 months and had ≥30 participants. Risk of bias was assessed. Results Fifty-four studies (N = 5064 met inclusion criteria. Language outcomes were standardised assessments (n = 35, notation of presence/absence of verbal language (n = 11 or both (n = 8. Age at baseline ranged from 17 months to 26 years, duration of follow-up from 1 to 38 years. Most publications (92% were rated medium to high risk of bias. In all but one study individuals had below-average scores at baseline and follow-up. However, in most (n = 24/25; 96% studies reporting standard scores, individuals (aged ≤ 11 years at follow-up progressed at a comparable rate to age-expected norms or demonstrated some ‘catch up’ over time. Meta-analyses found mean standard scores increased over time in three language domains (composite receptive language, composite expressive language and adaptive language. Nineteen to thirty percent of children aged five years and under gained verbal language. For children aged over five years 5–32% gained verbal language over the course of study. Age, baseline language scores, IQ and length of follow-up did not moderate between study differences in composite language or adaptive language growth or the acquisition of verbal language. Conclusion Despite variability in study methods, findings were consistent, with the majority of studies reporting children under 11 years on average progressed at a

Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data.

Science.gov (United States)

Zinkstok, Sanne M; Vergouwen, Mervyn D I; Engelter, Stefan T; Lyrer, Philippe A; Bonati, Leo H; Arnold, Marcel; Mattle, Heinrich P; Fischer, Urs; Sarikaya, Hakan; Baumgartner, Ralf W; Georgiadis, Dimitrios; Odier, Céline; Michel, Patrik; Putaala, Jukka; Griebe, Martin; Wahlgren, Nils; Ahmed, Niaz; van Geloven, Nan; de Haan, Rob J; Nederkoorn, Paul J

2011-09-01

The safety and efficacy of thrombolysis in cervical artery dissection (CAD) are controversial. The aim of this meta-analysis was to pool all individual patient data and provide a valid estimate of safety and outcome of thrombolysis in CAD. We performed a systematic literature search on intravenous and intra-arterial thrombolysis in CAD. We calculated the rates of pooled symptomatic intracranial hemorrhage and mortality and indirectly compared them with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. We applied multivariate regression models to identify predictors of excellent (modified Rankin Scale=0 to 1) and favorable (modified Rankin Scale=0 to 2) outcome. We obtained individual patient data of 180 patients from 14 retrospective series and 22 case reports. Patients were predominantly female (68%), with a mean±SD age of 46±11 years. Most patients presented with severe stroke (median National Institutes of Health Stroke Scale score=16). Treatment was intravenous thrombolysis in 67% and intra-arterial thrombolysis in 33%. Median follow-up was 3 months. The pooled symptomatic intracranial hemorrhage rate was 3.1% (95% CI, 1.3 to 7.2). Overall mortality was 8.1% (95% CI, 4.9 to 13.2), and 41.0% (95% CI, 31.4 to 51.4) had an excellent outcome. Stroke severity was a strong predictor of outcome. Overlapping confidence intervals of end points indicated no relevant differences with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. Safety and outcome of thrombolysis in patients with CAD-related stroke appear similar to those for stroke from all causes. Based on our findings, thrombolysis should not be withheld in patients with CAD.

Relational Intimacy Mediates Sexual Outcomes Associated With Impaired Sexual Function: Examination in a Clinical Sample.

Science.gov (United States)

Witherow, Marta Parkanyi; Chandraiah, Shambhavi; Seals, Samantha R; Sarver, Dustin E; Parisi, Kathryn E; Bugan, Antal

2017-06-01

Relational intimacy is hypothesized to underlie the association between female sexual functioning and various sexual outcomes, and married women and women with sexual dysfunction have been generally absent from prior studies investigating these associations, thus restricting generalizability. To investigate whether relational intimacy mediates sexual outcomes (sexual satisfaction, coital frequency, and sexual distress) in a sample of married women with and without impaired sexual functioning presenting in clinical settings. Using a cross-sectional design, 64 heterosexual married women with (n = 44) and without (n = 20) impaired sexual functioning completed a battery of validated measurements assessing relational intimacy, sexual dysfunction, sexual frequency, satisfaction, and distress. Intimacy measurements were combined using latent factor scores before analysis. Bias-corrected mediation models of the indirect effect were used to test mediation effects. Moderated mediation models examined whether indirect effects were influenced by age and marital duration. Patients completed the Female Sexual Function Index, the Couple's Satisfaction Index, the Sexual Satisfaction Scale for Women, the Inclusion of the Other in the Self Scale, and the Miller Social Intimacy Test. Mediation models showed that impaired sexual functioning is associated with all sexual outcomes directly and indirectly through relational intimacy. Results were predominantly independent of age and marital duration. Findings have important treatment implications for modifying interventions to focus on enhancing relational intimacy to improve the sexual functioning of women with impaired sexual functioning. The importance of the role relational intimacy plays in broad sexual outcomes of women with impaired sexual functioning is supported in clinically referred and married women. Latent factor scores to improve estimation of study constructs and the use of contemporary mediation analysis also are

Improving perinatal outcome: towards individualized care

OpenAIRE

Kazemier, B.M.

2015-01-01

Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish women who require standard care from those requiring special attention. At the moment, we can make some global risk assessments, but are not able to give a women a risk assessment that is adapted for...

Self-esteem and outcome fairness judgments: Differential use of procedural and outcome information

NARCIS (Netherlands)

Vermunt, R; van Knippenberg, D.; van Knippenberg, B.M.; Blaauw, E.

2001-01-01

Results of a survey of 222 detainees in Dutch jails and police stations showed that outcome-fairness judgments of individuals with high self-esteem were more strongly related to outcome considerations than to procedural considerations, whereas outcome-fairness judgments of individuals with low

Development of composite outcomes for individual patient data (IPD) meta-analysis on the effects of diet and lifestyle in pregnancy

DEFF Research Database (Denmark)

Rogozinska, Ewelina; D'Amico, M. I.; Khan, Khalid S

2016-01-01

Objective To develop maternal, fetal, and neonatal composite outcomes relevant to the evaluation of diet and lifestyle interventions in pregnancy by individual patient data (IPD) meta-analysis. Design Delphi survey. Setting The International Weight Management in Pregnancy (i-WIP) collaborative...... by IPD meta-analysis. Tweetable abstract Composite outcomes in IPD meta-analysis on diet and lifestyle in pregnancy. Tweetable abstract Composite outcomes in IPD meta-analysis on diet and lifestyle in pregnancy. This article includes Author Insights, a video abstract available at https...... and the following were included in the final composite: pre-eclampsia or pregnancy-induced hypertension, gestational diabetes mellitus (GDM), elective or emergency caesarean section, and preterm delivery. Of the 27 fetal and neonatal outcomes, nine were further evaluated, with the final composite consisting...

What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials.

Science.gov (United States)

Briani, Ronaldo Valdir; Ferreira, Amanda Schenatto; Pazzinatto, Marcella Ferraz; Pappas, Evangelos; De Oliveira Silva, Danilo; Azevedo, Fábio Mícolis de

2018-03-16

To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA). Systematic review with meta-analysis. Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017. We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included. Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress. Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA. CRD42016047602. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Examining the Job-Related, Psychological, and Physical Outcomes of Workplace Sexual Harassment: A Meta-Analytic Review

Science.gov (United States)

Chan, Darius K-S.; Lam, Chun Bun; Chow, Suk Yee; Cheung, Shu Fai

2008-01-01

This study was designed to examine the job-related, psychological, and physical outcomes of sexual harassment in the workplace. Using a meta-analytic approach, we analyzed findings from 49 primary studies, with a total sample size of 89,382, to obtain estimates of the population mean effect size of the association between sexual harassment and…

An examination of the default mode network in individuals with autonomous sensory meridian response (ASMR).

Science.gov (United States)

Smith, Stephen D; Katherine Fredborg, Beverley; Kornelsen, Jennifer

2017-08-01

Autonomous Sensory Meridian Response (ASMR) is a perceptual condition in which specific visual and auditory stimuli consistently trigger tingling sensations on the scalp and neck, sometimes spreading to the back and limbs. These triggering stimuli are often social, almost intimate, in nature (e.g., hearing whispering, or watching someone brush her hair), and often elicit a calm and positive emotional state. Surprisingly, despite its prevalence in the general population, no published study has examined the neural underpinnings of ASMR. In the current study, the default mode network (DMN) of 11 individuals with ASMR was contrasted to that of 11 matched controls. The results indicated that the DMN of individuals with ASMR showed significantly less functional connectivity than that of controls. The DMN of individuals with ASMR also demonstrated increased connectivity between regions in the occipital, frontal, and temporal cortices, suggesting that ASMR was associated with a blending of multiple resting-state networks. This atypical functional connectivity likely influences the unique sensory-emotional experiences associated with ASMR.

Time to treatment with intravenous alteplase and outcome in stroke

DEFF Research Database (Denmark)

Lees, Kennedy R; Bluhmki, Erich; von Kummer, Rüdiger

2010-01-01

BACKGROUND: Early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischaemic stroke improves outcome. Previous analysis of combined data from individual patients suggested potential benefit beyond 3 h from stroke onset. We re-examined the effect of time to trea...

A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

Science.gov (United States)

Davis, Seth N P; Bergeron, Sophie; Bois, Katy; Sadikaj, Gentiana; Binik, Yitzchak M; Steben, Marc

2015-04-01

Provoked vestibulodynia (PVD) is a common genital pain disorder in women that is associated with sexual dysfunction and lowered sexual satisfaction. A potentially applicable cognitive-behavioral model of chronic pain and disability is the fear-avoidance model (FAM) of pain. The FAM posits that cognitive variables, such as pain catastrophizing, fear, and anxiety lead to avoidance of pain-provoking behaviors (eg, intercourse), resulting in continued pain and disability. Although some of the FAM variables have been shown to be associated with PVD pain and sexuality outcomes, the model as a whole has never been tested in this population. An additional protective factor, pain self-efficacy (SE), is also associated with PVD, but has not been tested within the FAM model. Using a 2-year longitudinal design, we examine (1) whether initial levels (T1) of the independent FAM variables and pain SE were associated with changes in pain, sexual function, and sexual satisfaction over the 2-year time period; (2) the prospective contribution of changes in cognitive-affective (FAM) variables to changes in pain, and sexuality outcomes; and (3) whether these were mediated by behavioral change (avoidance of intercourse). A sample of 222 women with PVD completed self-report measures of FAM variables, SE, pain, sexual function, and sexual satisfaction at time 1 and at a 2-year follow-up. Structural equation modeling with Latent Difference Scores was used to examine changes and to examine mediation between variables. Questionnaires included the Pain Catastrophizing Scale, McGill Pain Questionnaire, Trait Anxiety Inventory, Pain Self-Efficacy Scale, and Global Measure of Sexual Satisfaction, Female Sexual Function Index. Participants who reported higher SE at T1 reported greater declines in pain, greater increases in sexual satisfaction, and greater declines in sexual function over the 2 time points. The overall change model did not support the FAM using negative cognitive

Outcomes of a career planning and development program for registered nurses.

Science.gov (United States)

Hall, Linda McGillis; Waddell, Janice; Donner, Gail; Wheeler, Mary M

2004-01-01

The impact of a career planning and development program (CPDP) for registered nurses (RNs) on nurse and system outcomes was examined. The CPDP was effective as participants were able to create a career vision and individualized career plan.

Associations of Child and Adolescent Mastery Motivation and Self-Regulation With Adult Outcomes: A Longitudinal Study of Individuals With Down Syndrome.

Science.gov (United States)

Gilmore, Linda; Cuskelly, Monica

2017-05-01

This 20-year prospective longitudinal study focuses on the contribution of mastery motivation and self-regulation to adult outcomes for individuals with Down syndrome. In earlier phases of the research, 25 participants completed measures of cognitive ability, mastery motivation and self-regulation in childhood (4 to 6 years) and adolescence (11 to 15 years). In the adult phase reported here, self-determination and adaptive behavior were assessed in 21 of the original participants at age 23 to 26 years. Mastery motivation and self-regulation made unique contributions to adult outcomes, over and above the effects of cognitive ability. The findings provide powerful evidence about the important role of child and adolescent mastery motivation and self-regulation for the adult lives of individuals with Down syndrome.

Employment Outcomes of Vocational Rehabilitation Clients with Autism Spectrum Disorders

Science.gov (United States)

Alverson, Charlotte Y.; Yamamoto, Scott H.

2017-01-01

Research has consistently documented poor employment outcomes for young adults with autism spectrum disorder (ASD). Vocational rehabilitation (VR) services provide substantial federal and state commitments to individuals with disabilities to obtain and maintain employment. To date, little research has examined the relationship between VR services…

Learning outcomes through the cooperative learning team assisted individualization on research methodology’ course

Science.gov (United States)

Pakpahan, N. F. D. B.

2018-01-01

All articles must contain an abstract. The research methodology is a subject in which the materials must be understood by the students who will take the thesis. Implementation of learning should create the conditions for active learning, interactive and effective are called Team Assisted Individualization (TAI) cooperative learning. The purpose of this study: 1) improving student learning outcomes at the course research methodology on TAI cooperative learning. 2) improvement of teaching activities. 3) improvement of learning activities. This study is a classroom action research conducted at the Department of Civil Engineering Universitas Negeri Surabaya. The research subjects were 30 students and lecturer of courses. Student results are complete in the first cycle by 20 students (67%) and did not complete 10 students (33%). In the second cycle students who complete being 26 students (87%) and did not complete 4 students (13%). There is an increase in learning outcomes by 20%. Results of teaching activities in the first cycle obtained the value of 3.15 with the criteria enough well. In the second cycle obtained the value of 4.22 with good criterion. The results of learning activities in the first cycle obtained the value of 3.05 with enough criterion. In the second cycle was obtained 3.95 with good criterion.

Classification of individual well-being scores for the determination of adverse health and productivity outcomes in employee populations.

Science.gov (United States)

Shi, Yuyan; Sears, Lindsay E; Coberley, Carter R; Pope, James E

2013-04-01

Adverse health and productivity outcomes have imposed a considerable economic burden on employers. To facilitate optimal worksite intervention designs tailored to differing employee risk levels, the authors established cutoff points for an Individual Well-Being Score (IWBS) based on a global measure of well-being. Cross-sectional associations between IWBS and adverse health and productivity outcomes, including high health care cost, emergency room visits, short-term disability days, absenteeism, presenteeism, low job performance ratings, and low intentions to stay with the employer, were studied in a sample of 11,702 employees from a large employer. Receiver operating characteristics curves were evaluated to detect a single optimal cutoff value of IWBS for predicting 2 or more adverse outcomes. More granular segmentation was achieved by computing relative risks of each adverse outcome from logistic regressions accounting for sociodemographic characteristics. Results showed strong and significant nonlinear associations between IWBS and health and productivity outcomes. An IWBS of 75 was found to be the optimal single cutoff point to discriminate 2 or more adverse outcomes. Logistic regression models found abrupt reductions of relative risk also clustered at IWBS cutoffs of 53, 66, and 88, in addition to 75, which segmented employees into high, high-medium, medium, low-medium, and low risk groups. To determine validity and generalizability, cutoff values were applied in a smaller employee population (N=1853) and confirmed significant differences between risk groups across health and productivity outcomes. The reported segmentation of IWBS into discrete cohorts based on risk of adverse health and productivity outcomes should facilitate well-being comparisons and worksite interventions.

Religious Affiliation and Attendance Among Immigrants in EightWestern Countries : Individual and Contextual Effects

NARCIS (Netherlands)

Tubergen, Frank van

2006-01-01

This study examines the religious affiliation and participation of immigrants from a large-scale, comparative perspective. I propose a “specific migration” framework, in which immigrants’ religiosity is an outcome of both individual characteristics and contextual properties related to immigrants’

Preliminary perspectives gaines from individual plant examination of external events (IPEEE) seismic and fire submittal review

International Nuclear Information System (INIS)

Chen, J.T.; Connell, E.; Chokshi, N.

1997-01-01

As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals

A systematic review exploring therapist competence, adherence, and therapy outcomes in individual CBT for children and young people.

Science.gov (United States)

Rapley, Hannah A; Loades, Maria E

2018-04-22

Whilst the evidence base for cognitive behavioural therapy (CBT) with children and young people is growing, the mechanisms through which these beneficial effects occur are still unclear. This systematic review seeks to appraise the relationship between therapeutic outcomes in CBT and therapist adherence and competence, within the child and adolescent literature. A systematic review was carried out, with five studies identified as meeting the inclusion criteria. The literature is currently small and inconclusive. Amongst the studies reviewed, there were inconsistent findings, with minimal-to-no effect sizes found between adherence, competence, and outcomes. The current paucity of research in this area means that conclusions are currently limited. The role and impact of adherence and competence on therapeutic outcomes remains unclear within individual CBT in a child population. This is comparable with the current adult literature, where findings also remain inconclusive. Further research avenues are discussed.

Social Cognitive Correlates of Physical Activity in Black Individuals With Multiple Sclerosis.

Science.gov (United States)

Kinnett-Hopkins, Dominique; Motl, Robert W

2016-04-01

To examine variables from social cognitive theory as correlates of physical activity in black and white individuals with multiple sclerosis (MS). Cross-sectional. National survey. Black (n=151) and white (n=185) individuals with MS were recruited through the North American Research Committee on Multiple Sclerosis Registry. Not applicable. The battery of questionnaires included information on demographic and clinical characteristics, physical activity, exercise self-efficacy, function, social support, exercise outcome expectations, and exercise goal setting and planning. Black individuals with MS reported significantly lower levels of physical activity compared with white individuals with MS. Physical activity levels were significantly correlated with self-efficacy, outcome expectations, functional limitations as impediments, and goal setting in black participants with MS. The pattern and magnitude of correlations were comparable with those observed in white participants based on Fisher z tests. Researchers should consider applying behavioral interventions that target social cognitive theory variables for increasing physical activity levels among black individuals with MS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The role of self-esteem for outcome in first-episode psychosis.

Science.gov (United States)

Vracotas, Nadia; Iyer, Srividya N; Joober, Ridha; Malla, Ashok

2012-01-01

Self-esteem may be associated with a wide range of psychiatric disorders, including psychotic disorders. However, the relationship between self-esteem and outcome in psychosis has not been adequately examined, especially early in the course of the illness. The aim of the study was to examine the impact of self-esteem in individuals who presented for treatment of a first episode of psychosis on outcome early in the course of the illness. The Self-Esteem Rating Scale (SERS) was administered to 121 individuals with first-episode psychosis following entry into a specialized programme. Symptoms and the Global Assessment of Functioning (GAF) were assessed at six months after beginning treatment. A correlational analysis was followed by a linear regression controlling for potential confounds. Self-esteem assessed early in the course of treatment was positively correlated with GAF at six months (r = 0.281, p self-esteem as predictors and GAF at six months as the outcome variable revealed only self-esteem to be a significant predictor of GAF at six months (β = 0.290, p self-esteem and remission at six months (β = 0.003, p > 0.05). Self-esteem is associated with global functional outcome at six months but not with remission of symptoms. Efforts should be made to provide interventions that may improve low self-esteem in the attempt to influence functional outcome.

Should I stay or should I go? A prospective investigation examining individual factors impacting employment status among individuals with multiple sclerosis (MS).

Science.gov (United States)

Strober, Lauren B; Chiaravalloti, Nancy; DeLuca, John

2018-01-01

Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. While several factors for such high rates of unemployment have been identified, they do not account for the majority of the variance. This study examines person-specific factors such as personality and coping, which may better account for individuals leaving the workforce. Forty individuals with MS (20 considering reducing work hours or leaving the workforce and 20 remaining employed) were matched on age, gender, education, disease duration, and disease course, and administered a comprehensive survey of factors purported to be related to employment status. Based on multiple, logistic regression analyses certain disease factors and person-specific factors differentiate those who are considering leaving work or reducing work hours and those staying employed. In particular, those expressing the need to reduce work hours or leaving the workforce reported more fatigue, anxiety, depression, and use of behavioral disengagement as a means of coping. In contrast, those staying employed reported greater levels of extraversion, self-efficacy, and use of humor as a means of coping. Together, fatigue, use of humor, and use of behavioral disengagement as a means of coping were the most significant factors, accounting for 44% of the variance. Findings suggest that greater consideration be given to these factors and that interventions tailored to address these factors may assist individuals with MS staying employed and/or making appropriate accommodations.

The interaction of criminal procedure and outcome.

Science.gov (United States)

Laxminarayan, Malini; Pemberton, Antony

2014-01-01

Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examining the burdens of gendered racism: implications for pregnancy outcomes among college-educated African American women.

Science.gov (United States)

Jackson, F M; Phillips, M T; Hogue, C J; Curry-Owens, T Y

2001-06-01

As investigators increasingly identify racism as a risk factor for poor health outcomes (with implications for adverse birth outcomes), research efforts must explore individual experiences with and responses to racism. In this study, our aim was to determine how African American college-educated women experience racism that is linked to their identities and roles as African American women (gendered racism). Four hundred seventy-four (474) African American women collaborated in an iterative research process that included focus groups, interviews, and the administration of a pilot stress instrument developed from the qualitative data. Analysis of the qualitative and quantitative data from the responses of a subsample of 167 college-educated women was conducted to determine how the women experienced racism as a stressor. The responses of the women and the results from correlational analysis revealed that a felt sense of obligations for protecting children from racism and the racism that African American women encountered in the workplace were significant stressors. Strong associations were found between pilot scale items where the women acknowledged concerns for their abilities to provide for their children's needs and to the women's specific experiences with racism in the workplace (r = 0.408, p gendered racism that precede and accompany pregnancy may be risk factors for adverse birth outcomes.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

Science.gov (United States)

Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-06-10

Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching

Individual- and organizational-level consequences of organizational citizenship behaviors: A meta-analysis.

Science.gov (United States)

Podsakoff, Nathan P; Whiting, Steven W; Podsakoff, Philip M; Blume, Brian D

2009-01-01

Although one of the main reasons for the interest in organizational citizenship behaviors (OCBs) is the potential consequences of these behaviors, no study has been reported that summarizes the research regarding the relationships between OCBs and their outcomes. Therefore, the purpose of this study is to provide a meta-analytic examination of the relationships between OCBs and a variety of individual- and organizational-level outcomes. Results, based on 168 independent samples (N = 51,235 individuals), indicated that OCBs are related to a number of individual-level outcomes, including managerial ratings of employee performance, reward allocation decisions, and a variety of withdrawal-related criteria (e.g., employee turnover intentions, actual turnover, and absenteeism). In addition, OCBs were found to be related (k = 38; N = 3,611 units) to a number of organizational-level outcomes (e.g., productivity, efficiency, reduced costs, customer satisfaction, and unit-level turnover). Of interest, somewhat stronger relationships were observed between OCBs and unit-level performance measures in longitudinal studies than in cross-sectional studies, providing some evidence that OCBs are causally related to these criteria. The implications of these findings for both researchers and practitioners are discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

Directory of Open Access Journals (Sweden)

Neeta Kanekar

2013-01-01

Full Text Available Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls. Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index. Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P<0.05. MS group had higher sway velocities and diminished stability limits (P<0.05, significant sensory impairments, high fatigue and disability levels (P<0.05. Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance. Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.

Linking climate change and health outcomes: Examining the relationship between temperature, precipitation and birth weight in Africa

Science.gov (United States)

Grace, Kathryn; Davenport, Frank; Hanson, Heidi; Funk, Christopher C.; Shukla, Shraddhanand

2015-01-01

This paper examined the relationship between birth weight, precipitation, and temperature in 19 African countries. We matched recorded birth weights from Demographic and Health Surveys covering 1986 through 2010 with gridded monthly precipitation and temperature data derived from satellite and ground-based weather stations. Observed weather patterns during various stages of pregnancy were also used to examine the effect of temperature and precipitation on birth weight outcomes. In our empirical model we allowed the effect of weather factors to vary by the dominant food production strategy (livelihood zone) in a given region as well as by household wealth, mother's education and birth season. This allowed us to determine if certain populations are more or less vulnerable to unexpected weather changes after adjusting for known covariates. Finally we measured effect size by observing differences in birth weight outcomes in women who have one low birth weight experience and at least one healthy birth weight baby. The results indicated that climate does indeed impact birth weight and at a level comparable, in some cases, to the impact of increasing women's education or household electricity status.

When power does not corrupt: superior individuation processes among powerful perceivers.

Science.gov (United States)

Overbeck, J R; Park, B

2001-10-01

To examine whether powerful people fail to individuate the less powerful, the authors assigned participants to either a high-power or low-power role for a computer E-mail role play. In 3 studies, participants in the high-power role made decisions and determined the outcomes of interactions; low-power role players had no power and relied on high-power targets for outcome decisions. Studies I and 2 found that high-power perceivers better individuated low-power targets. Study 3 demonstrated that high-power role players' superior judgment can be impaired by including a task that directs their responsibility toward organizational rather than interpersonal concerns. In all, results suggest that the effect of power on social judgment may be more complex and multifaceted than has previously been acknowledged.

Use of social adaptability index to explain self-care and diabetes outcomes.

Science.gov (United States)

Campbell, Jennifer A; Walker, Rebekah J; Smalls, Brittany L; Egede, Leonard E

2017-06-20

To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes. Six hundred fifteen patients were recruited from two primary care settings. A series of multiple linear regression models were run to assess (1) associations between the SAI and diabetes self-care/outcomes, and (2) associations between individual SAI indicator variables and diabetes self-care/outcomes. Separate models were run for each self-care behavior and outcome. Two models were run for each dependent variable to compare associations with the SAI and components of the index. The SAI has a significant association with the mental component of quality of life (0.23, p < 0.01). In adjusted analyses, the SAI score did not have a significant association with any of the self-care behaviors. Individual components from the index had significant associations between self-care and multiple SAI indicator variables. Significant associations also exist between outcomes and the individual SAI indicators for education and employment. In this population, the SAI has low explanatory power and few significant associations with diabetes self-care/outcomes. While the use of a composite index to predict outcomes within a diabetes population would have high utility, particularly for clinical settings, this SAI lacks statistical and clinical significance in a representative diabetes population. Based on these results, the index does not provide a good model fit and masks the relationship of individual components to diabetes self-care and outcomes. These findings suggest that five items alone are not adequate to explain or predict outcomes for patients with type 2 diabetes.

The association between interpersonal problems and treatment outcome in the eating disorders: A systematic review.

Science.gov (United States)

Jones, Allan; Lindekilde, Nanna; Lübeck, Marlene; Clausen, Loa

2015-01-01

To review systematically the eating disorder literature in order to examine the association between pre-treatment interpersonal problems and treatment outcome in people diagnosed with an eating disorder. Six relevant databases were searched for studies in which interpersonal problems prior to treatment were examined in relation to treatment outcome in patients diagnosed with anorexia nervosa (AN), bulimia nervosa (BN) or eating disorders not otherwise specified (EDNOS). Thirteen studies were identified (containing 764 AN, 707 BN and 48 EDNOS). The majority of studies indicated that interpersonal problems at the start of therapy were associated with a detrimental treatment outcome. Individuals with a binge/purge-type of eating disorder may be particularly vulnerable to interpersonal issues and these issues may lead to poorer treatment recovery by reducing the individual's ability to engage in the treatment process on a functional level. The clinical and research implications are discussed.

Examining Equity Sensitivity: An Investigation Using the Big Five and HEXACO Models of Personality.

Science.gov (United States)

Woodley, Hayden J R; Bourdage, Joshua S; Ogunfowora, Babatunde; Nguyen, Brenda

2015-01-01

The construct of equity sensitivity describes an individual's preference about his/her desired input to outcome ratio. Individuals high on equity sensitivity tend to be more input oriented, and are often called "Benevolents." Individuals low on equity sensitivity are more outcome oriented, and are described as "Entitleds." Given that equity sensitivity has often been described as a trait, the purpose of the present study was to examine major personality correlates of equity sensitivity, so as to inform both the nature of equity sensitivity, and the potential processes through which certain broad personality traits may relate to outcomes. We examined the personality correlates of equity sensitivity across three studies (total N = 1170), two personality models (i.e., the Big Five and HEXACO), the two most common measures of equity sensitivity (i.e., the Equity Preference Questionnaire and Equity Sensitivity Inventory), and using both self and peer reports of personality (in Study 3). Although results varied somewhat across samples, the personality variables of Conscientiousness and Honesty-Humility, followed by Agreeableness, were the most robust predictors of equity sensitivity. Individuals higher on these traits were more likely to be Benevolents, whereas those lower on these traits were more likely to be Entitleds. Although some associations between Extraversion, Openness, and Neuroticism and equity sensitivity were observed, these were generally not robust. Overall, it appears that there are several prominent personality variables underlying equity sensitivity, and that the addition of the HEXACO model's dimension of Honesty-Humility substantially contributes to our understanding of equity sensitivity.

Examining Equity Sensitivity: An Investigation Using the Big Five and HEXACO Models of Personality

Science.gov (United States)

Woodley, Hayden J. R.; Bourdage, Joshua S.; Ogunfowora, Babatunde; Nguyen, Brenda

2016-01-01

The construct of equity sensitivity describes an individual's preference about his/her desired input to outcome ratio. Individuals high on equity sensitivity tend to be more input oriented, and are often called “Benevolents.” Individuals low on equity sensitivity are more outcome oriented, and are described as “Entitleds.” Given that equity sensitivity has often been described as a trait, the purpose of the present study was to examine major personality correlates of equity sensitivity, so as to inform both the nature of equity sensitivity, and the potential processes through which certain broad personality traits may relate to outcomes. We examined the personality correlates of equity sensitivity across three studies (total N = 1170), two personality models (i.e., the Big Five and HEXACO), the two most common measures of equity sensitivity (i.e., the Equity Preference Questionnaire and Equity Sensitivity Inventory), and using both self and peer reports of personality (in Study 3). Although results varied somewhat across samples, the personality variables of Conscientiousness and Honesty-Humility, followed by Agreeableness, were the most robust predictors of equity sensitivity. Individuals higher on these traits were more likely to be Benevolents, whereas those lower on these traits were more likely to be Entitleds. Although some associations between Extraversion, Openness, and Neuroticism and equity sensitivity were observed, these were generally not robust. Overall, it appears that there are several prominent personality variables underlying equity sensitivity, and that the addition of the HEXACO model's dimension of Honesty-Humility substantially contributes to our understanding of equity sensitivity. PMID:26779102

Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months.

Science.gov (United States)

Zawertailo, Laurie A; Baliunas, Dolly; Ivanova, Anna; Selby, Peter L

2015-08-01

Individuals with concurrent tobacco dependence and other addictions often report symptoms of low mood and depression and as such may have more difficulty quitting smoking. We hypothesized that current symptoms of depression would be a significant predictor of quit success among a group of smokers receiving individualized treatment for tobacco dependence within addiction treatment settings. Individuals in treatment for other addictions were enrolled in a smoking cessation program involving brief behavioral counseling and individualized dosing of nicotine replacement therapy. The baseline assessment included the Patient Health Questionnaire (PHQ9) for depression. Smoking cessation outcomes were measured at 3 and 6 months post-enrollment. Bivariate associations between cessation outcomes and PHQ9 score were analyzed. Of the 1,196 subjects enrolled to date, 1,171 (98%) completed the PHQ9. Moderate to severe depression (score >9) was reported by 28% of the sample, and another 29% reported mild depression (score between 5 and 9). Contrary to the extant literature and other findings by our own group, there was no association between current depression and cessation outcome at either 3 months (n = 1,171) (17.0% in those with PHQ9 > 9 vs. 19.8% in those with PHQ9 addictions treatment setting. These data indicate that patients in an addictions treatment setting can successfully quit smoking regardless of current depressive symptoms. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Trajectories of Marijuana Use from Adolescence into Adulthood: Environmental and Individual Correlates

Science.gov (United States)

Epstein, Marina; Hill, Karl G.; Nevell, Alyssa M.; Guttmannova, Katarina; Bailey, Jennifer A.; Abbott, Robert D.; Kosterman, Rick; Hawkins, J. David

2015-01-01

This study sought to identify trajectories of marijuana use in the Seattle Social Development Project (n = 808) sample from age 14 through 30, and to examine the extent to which individuals in these trajectories differed in their substance use problems, mental health, problem behavior, economic outcomes, and positive functioning at age 33. In…

Housing and Employment Outcomes for Mental Health Self-Direction Participants.

Science.gov (United States)

Croft, Bevin; İsvan, Nilüfer; Parish, Susan L; Mahoney, Kevin J

2018-05-15

In self-direction, participants control individual budgets, allocating service dollars according to needs and preferences within program parameters to meet self-defined recovery goals. Mental health self-direction is associated with enhanced wellness and recovery outcomes at lower or similar cost than traditional service arrangements. This study compared outcomes of housing independence and employment between individuals who participated in self-direction and those who did not. This quasi-experimental study involved administrative data from 271 self-directing participants. Using coarsened exact matching with observed demographic, diagnostic, and other characteristics, the authors constructed a comparison group of non-self-directing individuals (N=1,099). The likelihood of achieving positive outcomes between first and last assessments during the approximately four-year study period was compared for self-directing and non-self-directing individuals. Self-directing participants were more likely than nonparticipants to increase days worked for pay or maintain days worked at 20 or more days in the past 30 days (number needed to treat [NNT]=18; small effect size) and maintain or attain independent housing (NNT=16; small effect size), when analyses controlled, to the extent possible, for observed individual characteristics. Based on data from the nation's largest and longest-standing program of its kind, results suggest that mental health self-direction is associated with modest improvements or maintenance of positive outcomes in employment and housing independence. This research adds to the literature examining self-direction in the context of mental health and begins to fill the need for a greater understanding of self-direction's relationship to outcomes of interest to service users and families, providers, and system administrators.

Development of composite outcomes for individual patient data (IPD) meta-analysis on the effects of diet and lifestyle in pregnancy: a Delphi survey

DEFF Research Database (Denmark)

Rogozinska, Ewelina; D'Amico, MI; Khan, Khalid S

2016-01-01

care. The final components of the composite outcomes were identified using pre-specified criteria. Main outcome measures Composite outcomes considered to be important for the evaluation of the effect of diet and lifestyle in pregnancy. Results Of the 36 maternal outcomes, nine were prioritised......Objective To develop maternal, fetal, and neonatal composite outcomes relevant to the evaluation of diet and lifestyle interventions in pregnancy by individual patient data (IPD) meta-analysis. Design Delphi survey. Setting The International Weight Management in Pregnancy (i-WIP) collaborative...... of intrauterine death, small for gestational age, large for gestational age, and admission to a neonatal intensive care unit (NICU). Conclusions Our work has identified the components of maternal, fetal, and neonatal composite outcomes required for the assessment of diet and lifestyle interventions in pregnancy...

Interhemispheric Pathways Are Important for Motor Outcome in Individuals with Chronic and Severe Upper Limb Impairment Post Stroke

Directory of Open Access Journals (Sweden)

Kathryn S. Hayward

2017-01-01

Full Text Available Background. Severity of arm impairment alone does not explain motor outcomes in people with severe impairment post stroke. Objective. Define the contribution of brain biomarkers to upper limb motor outcomes in people with severe arm impairment post stroke. Methods. Paretic arm impairment (Fugl-Meyer upper limb, FM-UL and function (Wolf Motor Function Test rate, WMFT-rate were measured in 15 individuals with severe (FM-UL ≤ 30/66 and 14 with mild–moderate (FM-UL > 40/66 impairment. Transcranial magnetic stimulation and diffusion weight imaging indexed structure and function of the corticospinal tract and corpus callosum. Separate models of the relationship between possible biomarkers and motor outcomes at a single chronic (≥6 months time point post stroke were performed. Results. Age (ΔR20.365, p=0.017 and ipsilesional-transcallosal inhibition (ΔR20.182, p=0.048 explained a 54.7% (p=0.009 variance in paretic WMFT-rate. Prefrontal corpus callous fractional anisotropy (PF-CC FA alone explained 49.3% (p=0.007 variance in FM-UL outcome. The same models did not explain significant variance in mild–moderate stroke. In the severe group, k-means cluster analysis of PF-CC FA distinguished two subgroups, separated by a clinically meaningful and significant difference in motor impairment (p=0.049 and function (p=0.006 outcomes. Conclusion. Corpus callosum function and structure were identified as possible biomarkers of motor outcome in people with chronic and severe arm impairment.

Early Therapeutic Alliance and Treatment Outcome in Individual and Family Therapy for Adolescent Behavior Problems

Science.gov (United States)

Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.

2006-01-01

The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…

Irrational Diversification; An Examination of Individual Portfolio Choice

NARCIS (Netherlands)

2011-01-01

textabstractWe study individual portfolio choice in a laboratory experiment and find strong evidence for heuristic behavior. The subjects tend to focus on the marginal distribution of an asset, while largely ignoring its diversification benefits. They follow a conditional 1/n diversification

Postinjury personality and outcome in acquired brain injury: the Millon Behavioral Medicine Diagnostic.

Science.gov (United States)

Beck, Kelley D; Franks, Susan F; Hall, James R

2010-03-01

To examine the relationship between postinjury personality and outcome in individuals with acquired brain injury. It was hypothesized that patients with differing levels of Introversive, Dejected, and Oppositional coping styles as described by Millon's Theory of Personality would show different outcomes after completion of a rehabilitation program. A retrospective chart review and completion of an outcome assessment was undertaken to examine study hypotheses. A postacute brain injury rehabilitation program. Fifty patients who completed the rehabilitation program between 2005 and 2008, who were 18 years of age or older, who possessed at least a sixth-grade reading level, and who completed a valid Millon Behavioral Medicine Diagnostic (MBMD) were selected. Rehabilitation therapists who worked with these patients were also recruited to assess patient outcomes. Charts of patients that met inclusion criteria were reviewed. Rehabilitation therapists completed the outcome measure retrospectively. The MBMD was used to predict outcome. The MBMD is a self-report questionnaire designed to assess psychosocial factors that relate to the course of medical treatment in chronic illness. The Mayo-Portland Adaptability Inventory (MPAI-4) was used to assess patient outcome. It is a 29-item assessment designed to evaluate the common physical, cognitive, emotional, behavioral, and social issues after acquired brain injury. Findings supported our hypotheses that patients with differing levels of Introversive and Oppositional Coping Styles would have significantly different outcomes after rehabilitation. Thus, individuals with mild/moderate to moderate/severe limitations had significantly greater scores on the Introversive and Oppositional coping compared with individuals with more successful outcomes. The results of this study support the idea that postinjury personality is an important factor in understanding outcome after completion of a brain-injury rehabilitation program

The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status.

Science.gov (United States)

Holm, Kristen E; Plaufcan, Melissa R; Ford, Dee W; Sandhaus, Robert A; Strand, Matthew; Strange, Charlie; Wamboldt, Frederick S

2014-08-01

Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that can lead to early-onset chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the impact of age on psychological and clinical outcomes among individuals with AATD-associated COPD. 468 individuals with AATD-associated COPD (age 32-84 at baseline) completed questionnaires at baseline, 1- and 2-year follow-up. Age was examined as a predictor of depression, anxiety, health-related quality of life, and breathlessness at all three time points using linear mixed models. Age was associated with anxiety (b = -0.09, SE = 0.02, p life (b = -0.29, SE = 0.09, p life, and breathlessness. Among individuals who were single, younger age was associated with more symptoms of depression (b = -0.08, SE = 0.03, p life (b = -0.61, SE = 0.16, p < 0.001), and more breathlessness (b = -0.023, SE = 0.009, p < 0.01) throughout the 2-year study. Age was not associated with these three outcomes among individuals who were married/part of an unmarried couple. Results suggest that individuals who develop a chronic illness at a young age, particularly those who are single, may be more likely to have worse psychological and clinical outcomes.

Outcomes of Orbital Floor Reconstruction After Extensive Maxillectomy Using the Computer-Assisted Fabricated Individual Titanium Mesh Technique.

Science.gov (United States)

Zhang, Wen-Bo; Mao, Chi; Liu, Xiao-Jing; Guo, Chuan-Bin; Yu, Guang-Yan; Peng, Xin

2015-10-01

Orbital floor defects after extensive maxillectomy can cause severe esthetic and functional deformities. Orbital floor reconstruction using the computer-assisted fabricated individual titanium mesh technique is a promising method. This study evaluated the application and clinical outcomes of this technique. This retrospective study included 10 patients with orbital floor defects after maxillectomy performed from 2012 through 2014. A 3-dimensional individual stereo model based on mirror images of the unaffected orbit was obtained to fabricate an anatomically adapted titanium mesh using computer-assisted design and manufacturing. The titanium mesh was inserted into the defect using computer navigation. The postoperative globe projection and orbital volume were measured and the incidence of postoperative complications was evaluated. The average postoperative globe projection was 15.91 ± 1.80 mm on the affected side and 16.24 ± 2.24 mm on the unaffected side (P = .505), and the average postoperative orbital volume was 26.01 ± 1.28 and 25.57 ± 1.89 mL, respectively (P = .312). The mean mesh depth was 25.11 ± 2.13 mm. The mean follow-up period was 23.4 ± 7.7 months (12 to 34 months). Of the 10 patients, 9 did not develop diplopia or a decrease in visual acuity and ocular motility. Titanium mesh exposure was not observed in any patient. All patients were satisfied with their postoperative facial symmetry. Orbital floor reconstruction after extensive maxillectomy with an individual titanium mesh fabricated using computer-assisted techniques can preserve globe projection and orbital volume, resulting in successful clinical outcomes. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Are obsessive-compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies.

Science.gov (United States)

Crane, Anna M; Roberts, Marion E; Treasure, Janet

2007-11-01

Obsessive-compulsive personality disorder (OCPD) traits are commonly associated with anorexia nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD traits have an impact on the outcome of AN. A systematic electronic search of the literature (using Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials) was undertaken to identify relevant publications (randomized controlled trials (RCT's) and naturalistic studies), until February 2006. Eleven prospective longitudinal studies and 12 RCT's met criteria for inclusion. A meta-analysis was not feasible as the studies were too heterogeneous. Just over half of published longitudinal studies found that OCPD traits were associated with a negative outcome in AN. Additionally, results from three RCTs suggested that these traits may moderate outcome. OCPD traits were reduced after treatment in five RCTs. There is tentative support to suggest that individuals with AN and concomitant OCPD traits have a poorer prognosis, and that these traits moderate outcome. A reduction in these traits may mediate this change. An individualized case formulation with treatment tailored to OCPD traits may improve the outcome of AN. (c) 2007 by Wiley Periodicals, Inc.

Examining Parents' Preferences for Group and Individual Parent Training for Children with ADHD Symptoms.

Science.gov (United States)

Wymbs, Frances A; Cunningham, Charles E; Chen, Yvonne; Rimas, Heather M; Deal, Ken; Waschbusch, Daniel A; Pelham, William E

2016-01-01

Parent training (PT) programs have been found to reduce some behavioral impairment associated with children's attention deficit hyperactivity disorder (ADHD) as well as improve parenting competence, but poor uptake and participation by parents are formidable barriers that affect service effectiveness. We used a discrete-choice experiment (DCE) to examine how parent preferences for treatment format (i.e., group vs. individual) might influence their participation in PT. Participants were 445 parents seeking mental health services for children with elevated symptoms of ADHD in Ontario, Canada. Parents completed a DCE composed of 30 choice tasks used to gauge PT format preference. Results showed that 58.7% of parents preferred individual PT; these parents were most interested in interventions that would make them feel more informed about their child's problems and in understanding-as opposed to solving-their child's problems. A minority of parents (19.4%) preferred group PT; these parents were most interested in active, skill-building services that would help them solve their child's problems. About one fifth of parents (21.9%) preferred the Minimal Information alternative (i.e., receiving neither individual or group PT); these parents reported the highest levels of depression and the most severe mental health problems in their child. Results highlight the importance of considering parent preferences for format and suggest that alternative formats to standard PT should be considered for multiply stressed families.

Train the Trainer Effectiveness Trials of Behavioral Intervention for Individuals with Autism: A Systematic Review

Science.gov (United States)

Shire, Stephanie Yoshiko; Kasari, Connie

2014-01-01

This systematic review examines train the trainer (TTT) effectiveness trials of behavioral interventions for individuals with autism spectrum disorder (ASD). Published methodological quality scales were used to assess studies including participant description, research design, intervention, outcomes, and analysis. Twelve studies including 9 weak…

The 'gender gap' in final examination results at Oxford University.

Science.gov (United States)

Mellanby, J; Martin, M; O'Doherty, J

2000-08-01

A lower proportion of women than men obtain first class degrees at British universities (the so-called gender gap). At Oxford University, this difference is not seen in all degree subjects but is found both in some Arts and in some Science subjects. We have used a questionnaire administered under supervision to undergraduates 2 to 3 months before their final examination to assess factors which might be expected to affect examination performance. These included measures of verbal and non-verbal reasoning (Alice Heim AH6 test), self-esteem, motivation, responses to stresses of examinations and of personal relationships, happiness, risk-taking and working patterns. We have also obtained a detailed breakdown of the marks the students were given in the examination. Women scored higher on negative emotions while men scored higher on self-esteem, their perception of their own academic efficacy and on risk-taking strategies, but none of these factors predicted outcome. Verbal reasoning ability did predict outcome but there was no gender difference. Hence, it is concluded that the gender gap is not due to any of these individual differences and is more likely to be related to the nature of the academic assessment system.

Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

OpenAIRE

Carpenter, Kristen M.; Andersen, Barbara L.; Fowler, Jeffrey M.; Maxwell, G. Larry

2008-01-01

Abstract Gynecologic cancer patients are at high risk for emotional distress and sexual dysfunction. The present study tested sexual self schema as an individual difference variable that might be useful in identifying those at risk for unfavorable outcomes. First, we tested schema as a predictor of sexual outcomes,including bodychangestress. Second,we examined schema as a contributor to broader quality of life outcomes, specifically as a moderator of the relationship between sexual satisfacti...

Substance Abuse Treatment Outcomes: A Multi-Site Study of Male and Female Prison Programs

Science.gov (United States)

Pelissier, Bernadette; Motivans, Mark; Rounds-Bryant, Jennifer L.

2005-01-01

The present study examined whether there were program differences with respect to post-release outcomes in 20 federal in-prison substance abuse programs which used a cognitive-behavioral treatment approach. Recidivism and post-release drug use were examined for a sample of 1,343 individuals--1,065 men and 278 women. Discrete time proportional…

Proficiency of individuals with autism spectrum disorder at disembedding figures: A systematic review.

Science.gov (United States)

Horlin, Chiara; Black, Melissa; Falkmer, Marita; Falkmer, Torbjorn

2016-01-01

This systematic review examines the proficiency and visual search strategies of individuals with autism spectrum disorders (ASD) while disembedding figures and whether they differ from typical controls and other comparative samples. Five databases, including Proquest, Psychinfo, Medline, CINAHL and Science Direct were used to identify published studies meeting the inclusion and exclusion criteria. Twenty articles were included in the review, the majority of which matched participants by mental age. Outcomes discussed were time taken to identify targets, the number correctly identified, and fixation frequency and duration. Individuals with ASD perform at the same speed or faster than controls and other clinical samples. However, there appear to be no differences between individuals with ASD and controls for number of correctly identified targets. Only one study examined visual search strategies and suggests that individuals with ASD exhibit shorter first and final fixations to targets compared with controls.

Does Collaborative Case Conceptualisation enhance engagement and outcome in the treatment of anorexia nervosa? Rational, design and methods.

Science.gov (United States)

Mitchell, Sarah A; Newton, Richard; Harrison, Philippa; Castle, David; Brennan, Leah

2016-03-01

Anorexia Nervosa (AN) is a severe and potentially chronic disorder characterised by low body weight and persistent behaviours that interfere with weight gain. Individuals with AN are often difficult to engage in treatment and display high rates of drop out. The Collaborative Case Conceptualisation (CCC) assessment approach was developed to target proposed AN maintaining factors with the aim of improving treatment motivation and engagement and consequently treatment outcomes in individuals with AN. The proposed study aims to examine the efficacy of CCC in improving a range of outcomes including Body Mass Index, eating disorder symptomatology, general psychopathology, quality of life and future treatment motivation and participation. Potential mediators will also be explored. Thirty-two participants will be recruited from Melbourne based specialist eating disorder services, community and university clinics, and health practitioner networks. Participants will be randomised to three individual sessions of either CCC or a standardised assessment condition (assessment as usual; AAU). The AAU assessment will include; a mental status examination, assessment of current disordered eating behaviours and cognitions, assessment of clinical history, and a physical examination. The CCC condition combines the AAU assessment components with shared collaborative formulation and tailored psychoeducation highlighting the consequences of the eating disorder on wellbeing and future goals in a supportive and motivating way. This intervention may provide an effective and feasible method of improving treatment engagement and outcomes for individuals suffering from AN, with the ultimate outcome of reducing the negative biopsychosocial impacts of this potentially severe and chronic disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

Linking payment to health outcomes: a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers.

Science.gov (United States)

Carlson, Josh J; Sullivan, Sean D; Garrison, Louis P; Neumann, Peter J; Veenstra, David L

2010-08-01

To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy of scheme types by inductively organizing the schemes identified according to the timing, execution, and health outcomes measured in the schemes. Our search yielded 34 coverage with evidence development schemes, 10 conditional treatment continuation schemes, and 14 performance-linked reimbursement schemes. The majority of schemes are in Europe and Australia, with an increasing number in Canada and the U.S. These schemes have the potential to alter the reimbursement and pricing landscape for medical technology, but significant challenges, including high transaction costs and insufficient information systems, may limit their long-term impact. Future studies regarding experiences and outcomes of implemented schemes are necessary. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Correlation of Internet Use for Health Care Engagement Purposes and HIV Clinical Outcomes Among HIV-Positive Individuals Using Online Social Media.

Science.gov (United States)

Saberi, Parya; Johnson, Mallory O

2015-01-01

The authors aimed to describe cell phone and Internet use and assess the correlation of Internet use for health care engagement purposes and HIV clinical outcomes among HIV-positive individuals. The authors conducted a national survey using online social media to examine cell phone and Internet use, self-reported HIV viral load (detectable vs. undetectable), and antiretroviral adherence rating (excellent vs. less than excellent). Participants (N = 1,494) were asked about their Internet use for health care engagement purposes (including e-mailing health care providers, refilling medications online, and making medical appointments online). Approximately 95% of participants accessed the Internet nearly daily or daily in the past month (mean hours on Internet use per day = 5.2) and 55.5% used the Internet for health care engagement purposes. Those who used the Internet for any health care engagement purposes had a 1.52-fold odds of reporting an undetectable viral load (p = .009) and a 1.49-fold odds of reporting excellent adherence (p = .001). Although Internet access and use were similar across racial/ethnic, educational, and socioeconomic groups, disparities existed with the use of the Internet for health care engagement purposes among racial/ethnic minorities, those with low to moderate financial stability, lower education, and history of incarceration. The authors' data reveal that among HIV-positive users of online social media, use of the Internet for health care engagement purposes is associated with better self-reported virologic and adherence outcomes.

Examining Parents’ Preferences for Group and Individual Parent Training For Children with ADHD Symptoms

Science.gov (United States)

Wymbs, Frances A.; Cunningham, Charles E.; Chen, Yvonne; Rimas, Heather M.; Deal, Ken; Waschbusch, Daniel A.; Pelham, William E.

2015-01-01

Parent training (PT) programs have been found to reduce some behavioral impairment associated with children’s attention deficit hyperactivity disorder (ADHD) as well as improve parenting competence, but poor uptake and participation by parents are formidable barriers that affect service effectiveness. We used a discrete choice experiment (DCE) to examine how parent preferences for treatment format (i.e. group versus individual) might influence their participation in PT. Participants were 445 parents seeking mental health services for children with elevated symptoms of ADHD in Ontario, Canada. Parents completed a discrete-choice experiment (DCE) composed of 30 choice tasks used to gauge PT format preference. Results showed that 58.7% of parents preferred individual PT; these parents were most interested in interventions that would make them feel more informed about their child’s problems and in understanding—as opposed to solving—their child’s problems. A minority of parents (19.4 %) preferred group PT; these parents were most interested in active, skill-building services that would help them solve their child’s problems. About one-fifth of parents (21.9 %) preferred the Minimal Information alternative (i.e. receiving neither individual or group PT); these parents reported the highest levels of depression and the most severe mental health problems in their child. Results highlight the importance of considering parent preferences for format, and suggest that alternative formats to standard PT should be considered for multiply stressed families. PMID:25700219

Age differences in IDA savings outcomes: findings from the American Dream Demonstration.

Science.gov (United States)

Putnam, Michelle; Sherraden, Michael; Zhang, Lin; Morrow-Howell, Nancy

2008-01-01

This study aims to develop a greater understanding of age differences in savings outcomes within Individual Development Accounts (IDAs). Participant data from the American Dream Demonstration (ADD) are examined for age differences in accumulated net deposits, average monthly net deposits, and deposit frequency. ADDprogram data are examined for savings match rates, monthly savings targets, direct deposit, and hours of financial education offered. Results indicate that, on average, older IDA participants have better savings outcomes than younger participants. Findings from this study suggest that impoverished middleaged and older adults can save if provided an opportunity and incentives. However, success will depend on the characteristics of the programs.

Language comprehension and brain function in individuals with an optimal outcome from autism.

Science.gov (United States)

Eigsti, Inge-Marie; Stevens, Michael C; Schultz, Robert T; Barton, Marianne; Kelley, Elizabeth; Naigles, Letitia; Orinstein, Alyssa; Troyb, Eva; Fein, Deborah A

2016-01-01

Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO). The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as most participants with OO received years of intensive therapy that could alter brain networks to align with typical function or work around ASD-related neural dysfunction. Individuals ages 8 to 21 years with high-functioning ASD (n = 23), OO (n = 16), or typical development (TD; n = 20) completed a functional MRI scan while performing a sentence comprehension task. Results indicated similar activations in frontal and temporal regions (left middle frontal, left supramarginal, and right superior temporal gyri) and posterior cingulate in OO and ASD groups, where both differed from the TD group. Furthermore, the OO group showed heightened "compensatory" activation in numerous left- and right-lateralized regions (left precentral/postcentral gyri, right precentral gyrus, left inferior parietal lobule, right supramarginal gyrus, left superior temporal/parahippocampal gyrus, left middle occipital gyrus) and cerebellum, relative to both ASD and TD groups. Behaviorally normalized language abilities in OO individuals appear to utilize atypical brain networks, with increased recruitment of language-specific as well as right homologue and other systems. Early intensive learning and experience may normalize behavioral language performance in OO, but some brain regions involved in language processing may continue to display characteristics that are more similar to ASD than typical development, while others show characteristics not like ASD or typical development.

Language comprehension and brain function in individuals with an optimal outcome from autism

Directory of Open Access Journals (Sweden)

Inge-Marie Eigsti

2016-01-01

Full Text Available Although Autism Spectrum Disorder (ASD is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO. The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as most participants with OO received years of intensive therapy that could alter brain networks to align with typical function or work around ASD-related neural dysfunction. Individuals ages 8 to 21 years with high-functioning ASD (n = 23, OO (n = 16, or typical development (TD; n = 20 completed a functional MRI scan while performing a sentence comprehension task. Results indicated similar activations in frontal and temporal regions (left middle frontal, left supramarginal, and right superior temporal gyri and posterior cingulate in OO and ASD groups, where both differed from the TD group. Furthermore, the OO group showed heightened “compensatory” activation in numerous left- and right-lateralized regions (left precentral/postcentral gyri, right precentral gyrus, left inferior parietal lobule, right supramarginal gyrus, left superior temporal/parahippocampal gyrus, left middle occipital gyrus and cerebellum, relative to both ASD and TD groups. Behaviorally normalized language abilities in OO individuals appear to utilize atypical brain networks, with increased recruitment of language-specific as well as right homologue and other systems. Early intensive learning and experience may normalize behavioral language performance in OO, but some brain regions involved in language processing may continue to display characteristics that are more similar to ASD than typical development, while others show characteristics not like ASD or typical development.

Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care.

Science.gov (United States)

Brumley, Jessica; Cain, M Ashley; Stern, Marilyn; Louis, Judette M

2016-09-01

This study sought to examine the differences in pregnancy outcomes with a focus on gestational weight gain for women attending group prenatal care compared to standard individual prenatal care. A matched case-control study was conducted including 65 women who chose group care and 130 women who chose standard individual care. Women were matched based on prepregnancy body mass index (BMI) category, eligibility for midwifery care, and age within 5 years. Women choosing group prenatal care and women choosing standard individual care had similar gestational weight gain, birth weight, gestational age at birth, and mode of birth. Women choosing group prenatal care did have a significantly higher rate of exclusive breastfeeding at 6 weeks postpartum (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.81-9.15; P care. Group prenatal care participation resulted in equivalent gestational weight gain as well as pregnancy outcomes as compared to standard individual care. Breastfeeding rates were improved for women choosing group prenatal care. Randomized controlled trials are needed in order to eliminate selection bias. © 2016 by the American College of Nurse-Midwives.

Variability in Second Language Learning: The Roles of Individual Differences, Learning Conditions, and Linguistic Complexity

Science.gov (United States)

Tagarelli, Kaitlyn M.; Ruiz, Simón; Vega, José Luis Moreno; Rebuschat, Patrick

2016-01-01

Second language learning outcomes are highly variable, due to a variety of factors, including individual differences, exposure conditions, and linguistic complexity. However, exactly how these factors interact to influence language learning is unknown. This article examines the relationship between these three variables in language learners.…

Bullying development across adolescence, its antecedents, outcomes, and gender-specific patterns.

Science.gov (United States)

Kretschmer, Tina; Veenstra, René; Deković, Maja; Oldehinkel, Albertine J

2017-08-01

In contrast to victimization, prior research on the antecedents and outcomes of bullying perpetration has provided little conclusive knowledge. Some adolescent bullies may be well adjusted and popular among peers, while other bullies are rejected and lack self-control. There is also great variation in the outcomes, with a number of studies (but not all) showing increased risk for externalizing and internalizing problems. We used a developmental framework and data from 2,230 participants of the Dutch Tracking Adolescents' Individual Lives Survey (TRAILS) to examine bullying perpetration across adolescence, to test the links with various antecedents in preadolescence, and to elucidate the outcomes in early adulthood. Latent growth models indicated significant variance in initial bullying perpetration levels and an overall decrease between pre- and late adolescence. Individual, family, and peer factors were associated with initial levels and partially associated with bullying development over time. Bullying perpetration was linked to later maladjustment and substance use, although only in girls. Finally, bullying perpetration appears to function as an intermediate variable between preadolescent individual, family, and peer risk and substance use more than 10 years later. These results have important implications for understanding the gender-specific nature of bullying perpetration and its outcomes and for demonstrating that bullying carries early risk into adulthood.

The effects of frame, appeal, and outcome extremity of antismoking messages on cognitive processing.

Science.gov (United States)

Leshner, Glenn; Cheng, I-Huei

2009-04-01

Research on the impact of antismoking advertisements in countermarketing cigarette advertising is equivocal. Although many studies examined how different message appeal types influence people's attitudes and behavior, there have been few studies that have explored the mechanism of how individuals attend to and remember antismoking information. This study examined how message attributes of antismoking TV ads (frame, appeal type, and outcome extremity) interacted to influence people's attention (secondary task reaction time) and memory (recognition). Antismoking public service announcements were chosen that were either loss- or gain-framed, had either a health or social appeal, or had either a more or less extreme outcome described in the message. Among the key findings were that loss-framed messages with more extreme outcomes required the most processing resources (i.e., had the slowest secondary task reaction times) and were the best remembered (i.e., were best recognized). These findings indicate ways that different message attributes affect individuals' cognitive processing, and they are discussed in light of prior framing and persuasion research.

The use of instrumented gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy

DEFF Research Database (Denmark)

Rasmussen, Helle Mätzke; Pedersen, Niels Wisbech; Overgaard, Søren

2015-01-01

in gait following individually tailored interventions when IGA is used are superior to those following ‘care as usual’. Methods/Design A prospective, single blind, randomised, parallel group study will be conducted. Children aged 5 to 8 years with spastic CP, classified at Gross Motor Function...... Classification System levels I or II, will be included. The interventions under investigation are: 1) individually tailored interdisciplinary interventions based on the use of IGA, and 2) ‘care as usual’. The primary outcome is gait measured by the Gait Deviation Index. Secondary outcome measures are: walking......Abstract Background Children with cerebral palsy (CP) often have an altered gait. Orthopaedic surgery, spasticity management, physical therapy and orthotics are used to improve the gait. Interventions are individually tailored and are planned on the basis of clinical examinations and standardised...

Examining the Relationship Between Individual Characteristics, Community-Level Traits, Multidimensional Empowerment, and Maternal Health Care Utilization in the Islamic Republic of Pakistan.

Science.gov (United States)

Hearld, Kristine R; Anderson, Jami L; Budhwani, Henna

2018-03-06

Introduction The Islamic Republic of Pakistan's maternal mortality ratio is particularly high, and the nation ranks 126 out of 149 countries on the Human Development Report-Gender Inequality Index. This is because Pakistani women have low levels of empowerment, make limited economic contributions, and underutilization of maternal health care. The aim of this study is to create a multidimensional index of women's empowerment and assess the association between this index and maternal health care utilization in Pakistan, controlling for individual characteristics and community-level traits. Methods Data from the 2012-2013 Pakistan Demographic and Health Surveys were employed to investigate the relationship between this index and the latent construct of maternal health care utilization. Results Using exploratory factor analysis, four indicators of maternal health care utilization were loaded onto a single latent factor. Multivariate analyses found support for the association between empowerment and health care utilization, despite adjustments for individual and area level factors. Positive associations between education, wealth, and maternal health care utilization were found. Conclusions Although we find support for the association of educational attainment with maternal health care utilization, the multidimensional women's empowerment index was independently a consistent associate of maternal health care utilization. This illustrates a complex mechanism with both-education and empowerment, being necessary for improved maternal health care utilization. Policy makers seeking to improve outcomes should expand their focus beyond simply improving rates of education to examining effects of cultural norms which constrain the independence of women in making decisions about their own health care.

Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments.

Science.gov (United States)

Townley, Greg; Kloos, Bret

2011-08-01

The psychological sense of community is an important aspect of community life; yet, it remains largely unexamined among individuals with serious mental illness (SMI). Sense of community represents the strength of bonding among community members; and this social phenomenon likely impacts the process by which individuals with SMI integrate into community life. The current study examined sense of community (SOC) for individuals with SMI by assessing the relationships between neighborhood experiences, unique factors related to SMI (e.g., mental illness diagnosis), and sense of community in the neighborhood. Participants were 402 residents of supported housing programs who used mental health services in South Carolina. Hierarchical linear regression was utilized to determine which components of community life helped to explain variability in sense of community. In total, 214 participants reported that it is very important for them to feel a sense of community in their neighborhoods. Neighbor relations, neighborhood safety, neighborhood satisfaction, neighborhood tolerance for mental illness, and housing site type emerged as significant explanatory variables of sense of community. These findings have implications for interventions aimed at enhancing SOC and community integration for individuals with SMI.

Satisfactory patient-based outcomes after surgical treatment for idiopathic clubfoot: includes surgeon's individualized technique.

Science.gov (United States)

Mahan, Susan T; Spencer, Samantha A; Kasser, James R

2014-09-01

Treatment of idiopathic clubfoot has shifted towards Ponseti technique, but previously surgical management was standard. Outcomes of surgery have varied, with many authors reporting discouraging results. Our purpose was to evaluate a single surgeon's series of children with idiopathic clubfoot treated with a la carte posteromedial and lateral releases using the Pediatric Outcomes Data Collection Instrument (PODCI) with a minimum of 2-year follow-up. A total of 148 patients with idiopathic clubfoot treated surgically by a single surgeon over 15 years were identified, and mailed PODCI questionnaires. Fifty percent of the patients were located and responded, resulting in 74 complete questionnaires. Median age at surgery was 10 months (range, 5.3 to 84.7 mo), male sex 53/74 (71.6%), bilateral surgery 31/74 (41.9%), and average follow-up of 9.7 years. PODCI responses were compared with previously published normal healthy controls using t test for each separate category. Included in the methods is the individual surgeon's operative technique. In PODCIs where a parent reports for their child or adolescent, there was no difference between our data and the healthy controls in any of the 5 categories. In PODCI where an adolescent self-reports, there was no difference in 4 of 5 categories; significant difference was only found between our data (mean = 95.2; SD = 7.427) and normal controls (mean = 86.3; SD = 12.5) in Happiness Scale (P = 0.0031). In this group of idiopathic clubfoot patients, treated with judicious posteromedial release by a single surgeon, primarily when surgery was treatment of choice for clubfoot, patient-based outcomes are not different from their normal healthy peers through childhood and adolescence. While Ponseti treatment has since become the treatment of choice for clubfoot, surgical treatment, in some hands, has led to satisfactory results. Level III.

Individual Differences in Personality Masculinity-Femininity: Examining the Effects of Genes, Environment, and Prenatal Hormone Transfer.

Science.gov (United States)

Verweij, Karin J H; Mosing, Miriam A; Ullén, Fredrik; Madison, Guy

2016-04-01

Males and females score differently on some personality traits, but the underlying etiology of these differences is not well understood. This study examined genetic, environmental, and prenatal hormonal influences on individual differences in personality masculinity-femininity (M-F). We used Big-Five personality inventory data of 9,520 Swedish twins (aged 27 to 54) to create a bipolar M-F personality scale. Using biometrical twin modeling, we estimated the influence of genetic and environmental factors on individual differences in a M-F personality score. Furthermore, we tested whether prenatal hormone transfer may influence individuals' M-F scores by comparing the scores of twins with a same-sex versus those with an opposite-sex co-twin. On average, males scored 1.09 standard deviations higher than females on the created M-F scale. Around a third of the variation in M-F personality score was attributable to genetic factors, while family environmental factors had no influence. Males and females from opposite-sex pairs scored significantly more masculine (both approximately 0.1 SD) than those from same-sex pairs. In conclusion, genetic influences explain part of the individual differences in personality M-F, and hormone transfer from the male to the female twin during pregnancy may increase the level of masculinization in females. Additional well-powered studies are needed to clarify this association and determine the underlying mechanisms in both sexes.

Public-private partnerships improve health outcomes in individuals with early stage Alzheimer's disease.

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Galvin, James E; Tolea, Magdalena I; George, Nika; Wingbermuehle, Cheryl

2014-01-01

In a collaborative effort between the Missouri Department of Health, Area Agencies on Aging (AAA), Alzheimer Association, and academic researchers, we tested whether early dementia detection and comprehensive care consultations would improve health outcomes in care receivers (CRs) and their family caregivers (FCGs), therefore addressing an important public health concern. A total of 244 community-dwelling older adults screened for early-stage dementia by the AAA field staff were referred to the Alzheimer Association and participated in Project Learn MORE (Missouri Outreach and Referral Expanded) (PLM) - a 2-year, nonrandomized multisite intervention consisting of comprehensive care consultations to improve coping skills. PLM participants were compared against 96 controls receiving the Alzheimer Association's "usual services" between January 2011 and December 2012. We examined CR and FCG outcomes, including burden, care confidence, and mood, as effects of PLM, on delaying transitions in level of care. CRs showed improved knowledge (P=0.002) and reduced depression (P=0.007), while FCGs demonstrated improved knowledge (P=0.003) and ability to identify sources of support for the CR (P=0.032) and for themselves (P=0.043). However, FCGs were more burdened after PLM (P=0.02), due to increased awareness of Alzheimer's disease. PLM delayed transitions in care (odds ratio [OR] 3.32, 95% confidence level [CI]: 1.25-8.83) with the number needed to treat =6.82. PLM was successful in improving detection of incident cases of dementia in the community and in connecting patients and their families with needed services. Our findings support the use of state agencies and community service partners to detect dementia. Early implementation of psychosocial interventions could have significant impact in improving patient- and family-centered outcomes, potentially providing a cost-efficient alternative to pharmacotherapy.

Adolescent Risk Behaviors: Studying Typical and Atypical Individuals via Multidimensional Scaling Profile Analysis

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Dong, Yang; Ding, Cody

2012-01-01

Within the framework of problem behavior theory, the purpose of this study was to examine risk behavior profiles of typical and atypical adolescents and the differential outcomes of well-beings for these individuals in the United States. Based on the data from the survey of Health Behavior of School-Aged Children by World Health Organization,…

Functional Technology for Individuals with Intellectual Disabilities: Meta-Analysis of Mobile Device-Based Interventions

Science.gov (United States)

Kim, Jemma; Kimm, Christina H.

2017-01-01

This study employs a meta-analysis of single-subject design research to investigate the efficacy of mobile device-based interventions for individuals with intellectual disabilities (ID) and to further examine possible variables that may moderate the intervention outcomes. A total of 23 studies, 78 participants, and 140 observed cases that met the…

An analysis of the procedural components of supported employment programs associated with employment outcomes.

OpenAIRE

McDonnell, J; Nofs, D; Hardman, M; Chambless, C

1989-01-01

This study examined the relation between the procedural components of supported employment programs and employment outcomes for 120 individuals with disabilities. These individuals were involved in supported employment programs established through the Utah Supported Employment Project. The results suggest that successful implementation of supported employment services led to ongoing employment of study participants in community work sites, increased wages, and ongoing opportunities for worker...

Description and predictive factors of individual outcomes in a refugee camp based mental health intervention (Beirut, Lebanon.

Directory of Open Access Journals (Sweden)

Pierre Bastin

Full Text Available BACKGROUND: There is little evidence on the effectiveness of services for the care of people with mental disorders among refugee populations. Médecins sans Frontières (MSF has established a mental health centre in a mixed urban-refugee population in Beirut to respond to the significant burden of mental health problems. Patients received comprehensive care through a multidisciplinary team. A cohort of people with common and severe mental disorders has been analysed between December 2008 and June 2011 to evaluate individual outcomes of treatment in terms of functionality. METHODS: All patients diagnosed with mental disorders were included in the study. The Global Assessment of Functioning (GAF and the Self Reporting Questionnaire-20 items (SRQ 20 were used as tools for baseline assessment, monitoring and evaluation of patients. Predictors of evolution of SRQ20 and GAF over visits were explored using a linear mixed model. RESULTS: Up to June 2011, 1144 patients were followed, 63.7% of them Lebanese, 31.8% Palestinians and 1.2% Iraqis. Females represented 64.2% of the patient population. Mean age was 39.2 years (28.5-46.5. The most frequent primary diagnoses were depressive disorders (28.8%, anxiety disorders (15.6% and psychosis (11.5%. A lower baseline SRQ20 score/higher baseline GAF score (indicators of severity, being diagnosed with anxiety (compared to being diagnosed with depression or psychosis and a higher level of education were associated with better outcomes. DISCUSSION: In this MSF program, we observed a significant decrease of SRQ20 individual scores and a significant increase of individual GAF scores. This corresponded to an improvement in the functionality of our patients. Analysis of the predictors of this positive evolution indicates that we need to adapt our model for the more severe and less educated patients. It also makes us reflect on the length of the individual follow-up. Further research could include a qualitative

Neighborhood Conditions and Psychosocial Outcomes Among Middle-Aged African Americans.

Science.gov (United States)

Tabet, Maya; Sanders, Erin A; Schootman, Mario; Chang, Jen Jen; Wolinsky, Fredric D; Malmstrom, Theodore K; Miller, Douglas K

2017-04-01

We examined associations between observed neighborhood conditions (good/adverse) and psychosocial outcomes (stress, depressive symptoms, resilience, and sense of control) among middle-aged and older African Americans. The sample included 455 middle-aged and older African Americans examined in Wave 10 of the African American Health (AAH) study. Linear regression was adjusted for attrition, self-selection into neighborhoods, and potential confounders, and stratified by the duration at current address (stress (standardized β = -0.18; P = .002) and depressive symptoms (standardized β = -0.12; P = .048). Among those who lived at their current address for stress (standardized β = 0.18; P = .305) or depressive symptoms (standardized β = 0.36; P = .080). Neighborhood conditions appear to have significant, complex associations with psychosocial factors among middle-aged and older African Americans. This holds important policy implications, especially since adverse neighborhood conditions may still result in adverse physical health outcomes in individuals with >5 years at current residence despite being associated with better psychosocial outcomes.

Examining Equity Sensitivity: An Investigation Using the Big Five and HEXACO Models of Personality

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Hayden J. R. Woodley

2016-01-01

Full Text Available The construct of equity sensitivity describes an individual’s preference about his/her desired input to outcome ratio. Individuals high on equity sensitivity tend to be more input oriented, and are often called Benevolents. Individuals low on equity sensitivity are more outcome oriented, and are described as Entitleds. Given that equity sensitivity has often been described as a trait, the purpose of the present study was to examine major personality correlates of equity sensitivity, so as to inform both the nature of equity sensitivity, and the potential processes through which certain broad personality traits may relate to outcomes. We examined the personality correlates of equity sensitivity across three studies (total N = 1170, two personality models (i.e., the Big Five and HEXACO, the two most common measures of equity sensitivity (i.e., the Equity Preference Questionnaire and Equity Sensitivity Inventory, and using both self and peer reports of personality (in Study 3. Although results varied somewhat across samples, the personality variables of Conscientiousness and Honesty-Humility, followed by Agreeableness, were the most robust predictors of equity sensitivity. Individuals higher on these traits were more likely to be Benevolents, whereas those lower on these traits were more likely to be Entitleds. Although some associations between Extraversion, Openness, and Neuroticism and equity sensitivity were observed, these were generally not robust. Overall, it appears that there are several prominent personality variables underlying equity sensitivity, and that the addition of the HEXACO model’s dimension of Honesty-Humility substantially contributes to our understanding of equity sensitivity.

OUTCOMES OF TICK-BORNE ENCEPHALITIS IN THE TOMSK REGION

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T. S. Pinegina

2013-01-01

Full Text Available The results of the study outcomes of tick-borne encephalitis in adults in the Tomsk Region. Patients conducted a comprehensive clinical and laboratory examination. Revealed the prevalence of autonomic disorders in individuals who have had at different periods of tick-borne encephalitis, which is regarded as the effects of tick-borne infection. Residual effects of tick-borne encephalitis occurs mainly in the form of light paresis after suffering a focal forms. Among the chronic (progredient forms of tick-borne encephalitis often formed hyperkinetic options. Most of the study revealed the presence of precipitating factors that could have an influence on the outcome. Fundamental diffe rences in all-clinical and immunological analyses at patients with various outcomes of tick-borne encephalitis it wasn't noted. KEY WORDS: tick-borne encephalitis, Tomsk Region, the outcomes.

What do we Know About Improving Employment Outcomes for Individuals with Autism Spectrum Disorder?

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Carolyn Dudley

2015-09-01

Full Text Available Autism spectrum disorder (ASD is the most commonly diagnosed neurological disorder in children. Adults with ASD have some of the poorest employment outcomes in comparison to others with disabilities. While data in Canada is limited, roughly 25 per cent of Americans living with ASD are employed and no more than six per cent are competitively employed. Most earn less than the national minimum hourly wage, endure extended periods of joblessness and frequently shuffle between positions, further diminishing their prospects. Poor employment outcomes result in lower quality of life and often lead to steep economic costs. Governments are wise to pay attention to the poor employment outcomes as the high numbers of children now diagnosed with ASD will become adults in the future in need of employment opportunities. Improving employment outcomes for those living with ASD is an important policy objective. Work opportunities improve quality of life, economic independence, social integration, and ultimately benefit all. Adults with ASD can succeed with the right supports. Fortunately, there are many emerging policy and program options that demonstrate success. This paper conducts a review of studies and provides policy recommendations based on the literature, to help governments identify appropriate policy options. Some key factors are both those that are unique to the individual and the external supports available; namely school, work, and family. For example, factors that contribute to successful employment for people living with ASD may include IQ, social skills and self-determination, but for all, even for the less advantaged, external assistance from schools, employers and family can help. Inclusive special education programs in high school that offer work experiences are critical as are knowledgeable employers who can provide the right types of accommodation and leadership. In the work environment the use of vocational and rehabilitative supports, from

Examining the impact of alternative power measures on individual time use in American and Danish couple households

DEFF Research Database (Denmark)

Datta Gupta, Nabanita; Stratton, Leslie S.

2010-01-01

We exploit time diary data for couple households in Denmark and the United States to examine the impact alternative measures of intrahousehold bargaining power have upon different measures of individual time use. Power measures have traditionally been based on current earnings, but earnings are d...... and significantly associated with `power' than housework time and that education share performs quite well as a measure of power. These results are particularly strong on non-work days and in the United States....... are determined by past/present time use decisions and hence potentially endogenous. More powerful individuals have been hypothesized to spend less time on housework, however, housework time also depends upon relative preferences for home produced goods and relative productivity in home production. Gendered...

Birth order, individual sex and sex of competitors determine the outcome of conflict among siblings over parental care

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Bonisoli-Alquati, Andrea; Boncoraglio, Giuseppe; Caprioli, Manuela; Saino, Nicola

2011-01-01

Success in competition for limiting parental resources depends on the interplay between parental decisions over allocation of care and offspring traits. Birth order, individual sex and sex of competing siblings are major candidates as determinants of success in sib–sib competition, but experimental studies focusing on the combined effect of these factors on parent–offspring communication and within-brood competitive dynamics are rare. Here, we assessed individual food intake and body mass gain during feeding trials in barn swallow chicks differing for seniority and sex, and compared the intensity of their acoustic and postural solicitation (begging) displays. Begging intensity and success in competition depended on seniority in combination with individual sex and sex of the opponent. Junior chicks begged more than seniors, independently of satiation level (which was also experimentally manipulated), and obtained greater access to food. Females were generally weaker competitors than males. Individual sex and sex of the opponent also affected duration of begging bouts. Present results thus show that competition with siblings can make the rearing environment variably harsh for developing chicks, depending on individual sex, sex of competing broodmates and age ranking within the nest. They also suggest that parental decisions on the allocation of care and response of kin to signalling siblings may further contribute to the outcome of sibling competition. PMID:20943688

Bridge Over an Aging Population: Examining Longitudinal Relations Among Human Resource Management, Social Support, and Employee Outcomes Among Bridge Workers

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Veth, Klaske N.; Van der Heijden, Beatrice I. J. M.; Korzilius, Hubert P. L. M.; De Lange, Annet H.; Emans, Ben J. M.

2018-01-01

This two-wave complete panel study aims to examine human resource management (HRM) bundles of practices in relation to social support [i.e., leader–member exchange (LMX), coworker exchange (CWX)] and employee outcomes (i.e., work engagement, employability, and health), within a context of workers aged 65+. Based upon the social exchange theory and the Job Demands-Resources (JD-R) framework, it was hypothesized that HRM bundles at Time 1 would increase bridge workers' outcomes at Time 2, and that this relationship would be mediated by perceptions of LMX and CWX at Time 2. Using a longitudinal design, hypotheses were tested in a unique sample of Dutch bridge employees (N = 228). Results of several structural equation modeling analyses revealed no significant associations between HRM bundles, and social support, moreover, no significant associations were found in relation to employee outcomes. However, the results of the best-fitting final model revealed the importance of the impact of social support on employee (65+) outcomes over time. PMID:29755386

Bridge Over an Aging Population: Examining Longitudinal Relations Among Human Resource Management, Social Support, and Employee Outcomes Among Bridge Workers.

Science.gov (United States)

Veth, Klaske N; Van der Heijden, Beatrice I J M; Korzilius, Hubert P L M; De Lange, Annet H; Emans, Ben J M

2018-01-01

This two-wave complete panel study aims to examine human resource management (HRM) bundles of practices in relation to social support [i.e., leader-member exchange (LMX), coworker exchange (CWX)] and employee outcomes (i.e., work engagement, employability, and health), within a context of workers aged 65+. Based upon the social exchange theory and the Job Demands-Resources (JD-R) framework, it was hypothesized that HRM bundles at Time 1 would increase bridge workers' outcomes at Time 2, and that this relationship would be mediated by perceptions of LMX and CWX at Time 2. Using a longitudinal design, hypotheses were tested in a unique sample of Dutch bridge employees ( N = 228). Results of several structural equation modeling analyses revealed no significant associations between HRM bundles, and social support, moreover, no significant associations were found in relation to employee outcomes. However, the results of the best-fitting final model revealed the importance of the impact of social support on employee (65+) outcomes over time.

Bridge Over an Aging Population: Examining Longitudinal Relations Among Human Resource Management, Social Support, and Employee Outcomes Among Bridge Workers

Directory of Open Access Journals (Sweden)

Klaske N. Veth

2018-04-01

Full Text Available This two-wave complete panel study aims to examine human resource management (HRM bundles of practices in relation to social support [i.e., leader–member exchange (LMX, coworker exchange (CWX] and employee outcomes (i.e., work engagement, employability, and health, within a context of workers aged 65+. Based upon the social exchange theory and the Job Demands-Resources (JD-R framework, it was hypothesized that HRM bundles at Time 1 would increase bridge workers' outcomes at Time 2, and that this relationship would be mediated by perceptions of LMX and CWX at Time 2. Using a longitudinal design, hypotheses were tested in a unique sample of Dutch bridge employees (N = 228. Results of several structural equation modeling analyses revealed no significant associations between HRM bundles, and social support, moreover, no significant associations were found in relation to employee outcomes. However, the results of the best-fitting final model revealed the importance of the impact of social support on employee (65+ outcomes over time.

Preoperative neutrophil response as a predictive marker of clinical outcome following open heart surgery and the impact of leukocyte filtration.

LENUS (Irish Health Repository)

Soo, Alan W

2010-11-01

Open heart surgery is associated with a massive systemic inflammatory response. Neutrophils, are the main mediator of this response. We hypothesised that the degree of neutrophil activation and inflammatory response to open heart surgery varies individually and correlates with clinical outcome. The aim of this study was to determine if individual clinical outcome can be predicted preoperatively through assessment of in-vitro stimulated neutrophil responses. Following that, the effects of neutrophil depletion through leukocyte filters are examined.

The Associations Between Physical Therapy and Long-Term Outcomes for Individuals with Lumbar Spinal Stenosis in the SPORT study

Science.gov (United States)

Fritz, Julie M.; Lurie, Jon D.; Zhao, Wenyan; Whitman, Julie M.; Delitto, Anthony; Brennan, Gerard P.; Weinstein, James N.

2013-01-01

Background/Context A period of non-surgical management is advocated prior to surgical treatment for most patients with lumbar spinal stenosis. Currently, little evidence is available to define optimal non-surgical management. Physical therapy is often used, however its use and effectiveness relative to other non-surgical strategies has not been adequately explored. Purpose Describe the utilization of physical therapy and other non-surgical interventions by patients with lumbar spinal stenosis and examine the relationship between physical therapy and long-term prognosis. Study Design Secondary analysis of the Spine Patient Outcomes Research Trial (SPORT) combining data from randomized and observational studies. Setting 13 spine clinics in 11 states in the United States. Patient Sample Patients with lumbar spinal stenosis receiving non-surgical management including those who did or did not receive physical therapy within 6 weeks of enrollment. Outcome Measures Primary outcome measures included cross-over to surgery, the bodily pain and physical function scales changes from the Survey Short Form 36 (SF-36), and the modified Oswestry Disability Index. Secondary outcome measures were patient satisfaction and the Sciatica Bothersomeness Index. Methods Baseline characteristics and rates of cross-over to surgery were compared between patients who did or did not receive physical therapy. Baseline factors predictive of receiving physical therapy were examined with logistic regression. Mixed effects models were used to compare outcomes between groups at 3 and 6 months, and 1 year after enrollment adjusted for baseline severity and patient characteristics. Results Physical therapy was used in the first 6 weeks by 90 of 244 patients (37%) and was predicted by the absence of radiating pain and being single instead of married. Physical therapy was associated with a reduced likelihood of cross-over to surgery after 1 year (21% vs 33%, p=0.045), and greater reductions on the SF-36

Rehabilitation-Related Research on Disability and Employer Practices Using Individual-Based National and Administrative Data Sets

Science.gov (United States)

Nazarov, Zafar E.; Erickson, William A.; Bruyère, Susanne M.

2014-01-01

Objective: It is useful to examine workplace factors influencing employment outcomes of individuals with disabilities and the interplay of disability, employment-related, and employer characteristics to inform rehabilitation practice. Design: A number of large national survey and administrative data sets provide information on employers and can…

Comparison of cystatin C and creatinine to determine the incidence of composite adverse outcomes in HIV-infected individuals.

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Yanagisawa, Naoki; Sasaki, Shugo; Suganuma, Akihiko; Imamura, Akifumi; Ajisawa, Atsushi; Ando, Minoru

2015-02-01

Cystatin C is an overall biomarker of pathophysiologic abnormalities that accompany chronic kidney disease (CKD). The utility of cystatin C is not fully understood in an HIV-infected population. This prospective study investigated 661 HIV-infected individuals for 4 years to determine the incidence of adverse outcomes, including all-cause mortality, cardiovascular disease, and renal dysfunction. The risk of developing the outcomes was discriminated with a 4 color-coded classification in a 3 × 6 contingency table, that combined 3 grades of dipstick proteinuria with 6 grades of estimated glomerular filtration rate (eGFR) calculated using either serum creatinine (eGFRcr) or cystatin C (eGFRcy): green, low risk; yellow, moderately increased risk; orange, high risk; and red, very high risk. The cumulative incidence of the outcomes was assessed by the Kaplan-Meier method, and the association between color-coded risk and the time to outcome was evaluated using multivariate proportional hazards analysis. Compared with eGFRcr, the use of eGFRcy reduced the prevalence of risk ≥ orange by 0.8%. The adverse outcomes were significantly more likely to occur to the patients with baseline risk category ≥orange than those with ≤ yellow, independent of risk categories based on eGFRcr or eGFRcy. However, in multivariate analysis, risk category ≥orange with eGFRcy-based classification was significantly associated with adverse outcomes, but not the one with eGFRcr. Replacing creatinine by cystatin C in the CKD color-coded risk classification may be appropriate to discriminate HIV-infected patients at increased risk of a poor prognosis. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

An experiment on individual 'parochial altruism' revealing no connection between individual 'altruism' and individual 'parochialism'.

Science.gov (United States)

Corr, Philip J; Hargreaves Heap, Shaun P; Seger, Charles R; Tsutsui, Kei

2015-01-01

Is parochial altruism an attribute of individual behavior? This is the question we address with an experiment. We examine whether the individual pro-sociality that is revealed in the public goods and trust games when interacting with fellow group members helps predict individual parochialism, as measured by the in-group bias (i.e., the difference in these games in pro-sociality when interacting with own group members as compared with members of another group). We find that it is not. An examination of the Big-5 personality predictors of each behavior reinforces this result: they are different. In short, knowing how pro-social individuals are with respect to fellow group members does not help predict their parochialism.

Academic Deans and Suicidal Individuals: Comparison and Contrast of Selected Behavioral Outcomes.

Science.gov (United States)

DiNapoli, Joan B.

The research question for this dissertation study was: Do behavioral outcomes identified in people who commit suicide exist in people who publicly exhibit productive behavioral outcomes and have not attempted suicide? More specifically, do selective affective and physiological behavioral outcomes identified in people who kill themselves exist is…

Individual Music Therapy for Agitation in Dementia

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner; Stige, Brynjulf; Qvale, Liv Gunnhild

2013-01-01

Objectives: Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been...... methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. Method: In a crossover trial, 42 participants...... with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. Results: Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at −6...

Clinical outcomes of individualized botulinum neurotoxin type A injection techniques in patients with essential blepharospasm.

Science.gov (United States)

Sung, Youngje; Nam, Sang Min; Lew, Helen

2015-04-01

To assess the clinical outcomes following botulinum neurotoxin type A (BoNT-A) treatment with an individualized injection technique based on the types of spasms and to compare the results of the individualized injection technique with those of the conventional injection technique in the same patients. From November 2011 to July 2013, 77 BoNT-A injections were performed in 38 patients. Eighteen patients were treated with conventional BoNT-A injections before 2011, and 20 patients were referred to our hospital for unsatisfactory results after a conventional injection technique. We classified the patients by spasm-dominant sites: the lateral orbital area, representing the orbital orbicularis-dominant group (ODG); the glabella, representing the corrugator-dominant group (CDG); and the ptosis, representing the palpebral part of the orbicularis-dominant group (PDG). We increased the injection dose into the spasm-dominant sites of the blepharospasm groups. We assessed subjective symptom scores (functional disability score, FDS) after treatment. This study included 38 patients (26 women, 12 men; mean age, 60.6 ± 10.9 years). There were 21 patients in the ODG, 10 patients in the CDG, and 7 patients in the PDG. Mean ages were 59.7 ± 12.6, 59.8 ± 8.5, and 66.8 ± 9.0 years, and mean BoNT-A injection dose was 38.8 ± 11.2, 38.8 ± 11.2, and 38.8 ± 10.8 U in each group, respectively (p = 0.44, 0.82 Kruskal-Wallis test). Mean FDS after injection was 1.7 ± 0.7 in the ODG, 1.4 ± 0.8 in the CDG, and 1.2 ± 0.3 in the PDG. There were significant differences in reading and job scale among the three groups. In a comparison between the conventional and individualized injection techniques, there was a significant improvement in mean FDS and in the reading scale in the PDG with the individualized injection technique. The success rate was 92.1% in the conventional injection group and 94.1% in the individualized injection group. The individualized injection technique of Bo

Depression, social support, and clinical outcomes following lung transplantation: a single-center cohort study.

Science.gov (United States)

Smith, Patrick J; Snyder, Laurie D; Palmer, Scott M; Hoffman, Benson M; Stonerock, Gregory L; Ingle, Krista K; Saulino, Caroline K; Blumenthal, James A

2018-05-01

Depressive symptoms are common among lung transplant candidates and have been associated with poorer clinical outcomes in some studies. Previous studies have been plagued by methodologic problems, including small sample sizes, few clinical events, and uncontrolled confounders, particularly perioperative complications. In addition, few studies have examined social support as a potential protective factor. We therefore examined the association between pretransplant depressive symptoms, social support, and mortality in a large sample of lung transplant recipients. As a secondary aim, we also examined the associations between psychosocial factors, perioperative outcomes [indexed by hospital length of stay (LOS)], and mortality. We hypothesized that depression would be associated with longer LOS and that the association between depression, social support, and mortality would be moderated by LOS. Participants included lung transplant recipients, transplanted at Duke University Medical Center from January 2009 to December 2014. Depressive symptoms were evaluated using the Beck Depression Inventory (BDI-II) and social support using the Perceived Social Support Scale (PSSS). Medical risk factors included forced vital capacity (FVC), partial pressure of carbon dioxide (PCO 2 ), donor age, acute rejection, and transplant type. Functional status was assessed using six-minute walk distance (6MWD). We also controlled for demographic factors, including age, gender, and native disease. Transplant hospitalization LOS was examined as a marker of perioperative clinical outcomes. Participants included 273 lung recipients (174 restrictive, 67 obstructive, 26 cystic fibrosis, and six "other"). Pretransplant depressive symptoms were common, with 56 participants (21%) exhibiting clinically elevated levels (BDI-II ≥ 14). Greater depressive symptoms were associated with longer LOS [adjusted b = 0.20 (2 days per 7-point higher BDI-II score), P social support (P social support were

Family caregivers of individuals with frontotemporal dementia: examining the relationship between coping and caregiver physical and mental health.

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Wong, Cindy C; Wallhagen, Margaret I

2014-01-01

To identify strategies to assist family caregivers of individuals with frontotemporal dementia (FTD) in dealing with their caregiving demands, nurses must understand these family members' unique needs and how they currently deal with their demands. The purpose of this study was to examine the relationship between coping and caregiver physical and mental health among FTD family caregivers. Participants were primary caregivers of individuals with FTD (with behavioral symptoms) living at home (N = 61). A small positive association was noted between problem-focused coping and caregiver physical health (r = 0.29, p caregiver mental health (r = 0.21, p = 0.10). However, multiple regression analysis showed that emotion-focused coping (β = 0.46, p caregiver mental health and explained approximately 14% of its variance. These findings support the potential value of emotion-focused coping strategies when dealing with behavioral symptoms manifested by individuals with FTD. Copyright 2014, SLACK Incorporated.

Factors associated with health care access and outcome.

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Paek, Min-So; Lim, Jung-Won

2012-01-01

This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.

Examining weight concern and delay discounting in adolescent females.

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Thamotharan, Sneha; Lange, Krista; Ramos, Ashley; Fields, Sherecce

2016-04-01

Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, pconcerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Diet, age, and prior injury status differentially alter behavioral outcomes following concussion in rats.

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Mychasiuk, Richelle; Hehar, Harleen; van Waes, Linda; Esser, Michael J

2015-01-01

Mild traumatic brain injury (mTBI) or concussion affects a large portion of the population and although many of these individuals recover completely, a small subset of people experience lingering symptomology and poor outcomes. Little is known about the factors that affect individual susceptibility or resilience to poor outcomes after mTBI and there are currently no biomarkers to delineate mTBI diagnosis or prognosis. Based upon the growing literature associated with caloric intake and altered neurological aging and the ambiguous link between repetitive mTBI and progressive neurodegeneration, the current study was designed to examine the effect of a high fat diet (HFD), developmental age, and repetitive mTBI on behavioral outcomes following a mTBI. In addition, telomere length was examined before and after experimental mTBI. Sprague Dawley rats were maintained on a HFD or standard rat chow throughout life (including the prenatal period) and then experienced an mTBI/concussion at P30, P30 and P60, or only at P60. Behavioral outcomes were examined using a test battery that was administered between P61-P80 and included; beam-walking, open field, elevated plus maze, novel context mismatch, Morris water task, and forced swim task. Animals with a P30 mTBI often demonstrated lingering symptomology that was still present during testing at P80. Injuries at P30 and P60 rarely produced cumulative effects, and in some tests (i.e., beam walking), the first injury may have protected the brain from the second injury. Exposure to the high fat diet exacerbated many of the behavioral deficits associated with concussion. Finally, telomere length was shortened following mTBI and was influenced by the animal's dietary intake. Diet, age at the time of injury, and the number of prior concussion incidents differentially contribute to behavioral deficits and may help explain individual variations in susceptibility and resilience to poor outcomes following an mTBI. Copyright © 2014

Clinical Outcome Metrics for Optimization of Robust Training

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Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M.; Reyes, D.; Young, M.

2016-01-01

Introduction: The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capability's (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-Flight Medical Capabilities." Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes. Methods: Medical simulations will systematically compare success of individual diagnostic and therapeutic procedure simulations performed by physician and non-physician crew medical officer (CMO) analogs using clearly defined short-term (individual procedure) outcome metrics. In the subsequent step of the project, the procedure simulation outcomes will be used as input to a modified version of the NASA Integrated Medical Model (IMM) to analyze the effect of the outcome (degree of success) of individual procedures (including successful, imperfectly performed, and failed procedures) on overall long-term clinical outcomes and the consequent mission impacts. The procedures to be simulated are endotracheal intubation, fundoscopic examination, kidney/urinary ultrasound, ultrasound-guided intravenous catheter insertion, and a differential diagnosis exercise. Multiple assessment techniques will be used, centered on medical procedure simulation studies occurring at 3, 6, and 12 months after initial training (as depicted in the following flow diagram of the experiment design). Discussion: Analysis of procedure outcomes in the physician and non-physician groups and their subsets (tested at different elapsed times post training) will allow the team to 1) define differences between physician and non-physician CMOs in terms of both procedure performance

Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

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Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

2013-10-15

Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index

Perspectives on Individual Differences Affecting Therapeutic Change in Communication Disorders. New Directions in Communication Disorders Research

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Weiss, Amy L., Ed.

2009-01-01

This volume examines the ramifications of individual differences in therapy outcomes for a wide variety of communication disorders. In an era where evidence-based practice is the clinical profession's watchword, each chapter attacks this highly relevant issue from a somewhat different perspective. In some areas of communication disorders,…

Factor Structure of Individual Consequences for Teleworking Professionals

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John Campbell

2016-06-01

Full Text Available Despite the increasing popularity of telework, little is known about individual outcomes that arise particularly for teleworking professionals. We build on earlier research by examining the conceptual constructs of individual consequences from telework. We initially categorized consequences identified in the extant literature into five areas. However, this model was not supported by confirmatory factor analysis of survey data collected from 250 teleworking accounting professionals. Subsequent exploratory factor analysis revealed a more complex six-factor structure relating to (1 Effectiveness; (2 Self-assurance; (3 Working with Others; (4 Work Pressure; (5 Professional Image; and (6 Physicality. The results extend our understanding of latent constructs underlying telework by professional knowledge workers, and provide a basis for further refinement of our model based on empirical research and theoretical development.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

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Piovesan, Chaiana; Ardenghi, Thiago Machado; Mendes, Fausto Medeiros; Agostini, Bernardo Antonio; Michel-Crosato, Edgard

2017-03-30

The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Examining the Effects of Mexican Serial Migration and Family Separations on Acculturative Stress, Depression, and Family Functioning

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Rusch, Dana; Reyes, Karina

2013-01-01

This study examined the role of parent-child separations during serial migration to the United States in predicting individual- and family-level outcomes in Mexican immigrant families. We assessed parents' subjective appraisals of their family's separation and reunion experiences to explore associations with self-reported acculturative stress,…

Pediatric sexual assault nurse examiner care: trace forensic evidence, ano-genital injury, and judicial outcomes.

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Hornor, Gail; Thackeray, Jonathan; Scribano, Philip; Curran, Sherry; Benzinger, Elizabeth

2012-09-01

Although pediatric sexual assault nurse examiners (P-SANEs) have been providing care for over two decades there remain major gaps in the literature describing the quality of P-SANE care and legal outcomes associated with their cases. The purpose of this study was to compare quality indicators of care in a pediatric emergency department (PED) before and after the implementation of a P-SANE program described in terms of trace forensic evidence yield, identification of perpetrator DNA, and judicial outcomes in pediatric acute sexual assault. A retrospective review of medical and legal records of all patients presenting to the PED at Nationwide Children's Hospital with concerns of acute sexual abuse/assault requiring forensic evidence collection from 1/1/04 to 12/31/07 was conducted. Detection and documentation of ano-genital injury, evaluation and documentation of pregnancy status, and testing for N. gonorrhea and C. trachomatis was significantly improved since implementation of the P-SANE Program compared to the historical control. The addition of a P-SANE to the emergency department (ED) provider team improved the quality of care to child/adolescent victims of acute sexual abuse/assault. © 2012 International Association of Forensic Nurses.

Factors contributing to outcome following traumatic brain injury.

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Ponsford, Jennie

2013-01-01

Traumatic brain injury results in some distinctive patterns of cognitive, behavioural and physical impairment which impact significantly on independent living skills and participation in work or study, social and leisure activities and interpersonal relationships. There is, however, still considerable variability in outcome across individuals in each of the reported domains. This has led to a significant body of research examining factors associated with outcome. A range of injury-related, personal and social factors have been shown to influence survival, as well as cognitive, functional and employment outcome. This paper reviews the factors associated with each of these aspects of outcome specifically injury-related factors, including neuroimaging findings, GCS and PTA, other injuries, and cognitive and behavioural impairments; demographic factors, including age, gender, genetic status, education, pre-injury IQ and employment status; and social factors including family and other social support, cultural factors, pre-injury psychiatric history and coping style. The paper identifies contributions and complex interrelationships of all of these factors to outcome following TBI. It concludes with a brief discussion of the implications of these factors for the rehabilitation process.

Organisational stressors, coping, and outcomes in competitive sport.

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Arnold, Rachel; Fletcher, David; Daniels, Kevin

2017-04-01

Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

Thermography Examination of Abdominal Area Skin Temperatures in Individuals With and Without Focal-Onset Epilepsy.

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King, Hollis H; Cayce, Charles Thomas; Herrin, Jeph

Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures. Following two hypotheses were formulated to evaluate any abdominal temperature phenomena: (1) an abdominal quadrant division analysis would find one or more quadrants "colder" in the focal-onset epilepsy group (ICD9-CM 345.4 and 345.5) compared to controls. (2) Total abdominal areas of individuals with focal-onset epilepsy wound be colder than a control group. Overall, 50 patients with the diagnosis of focal-onset epilepsy were recruited from the office of the Epilepsy Foundation of Florida and 50 control subjects with no history of epilepsy were recruited through advertising to the public. Under controlled room conditions all subjects had infrared thermographic images made and recorded by Med-Hot Model MH-731 FLIR equipment. There were no significant demographic difference between experimental patients and control subjects, though the control group tended to be younger and more often male; however, these were controlled for in all analyses. In the quadrant analysis, there were significant differences in that more epileptic patients had colder left upper abdominal quadrant temperatures than the control group (66.8% versus 44.9%; P = .030). In the total abdominal analysis, however, there were no significant differences. The results support the hypothesis that individuals with focal-onset epilepsy have colder abdominal areas. If substantiated in further research, present study results will require further examination of the mechanisms of

Peer-to-peer mentoring for individuals with early inflammatory arthritis: feasibility pilot

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Sandhu, Sharron; Veinot, Paula; Embuldeniya, Gayathri; Brooks, Sydney; Sale, Joanna; Huang, Sicong; Zhao, Alex; Richards, Dawn; Bell, Mary J

2013-01-01

Objectives To examine the feasibility and potential benefits of early peer support to improve the health and quality of life of individuals with early inflammatory arthritis (EIA). Design Feasibility study using the 2008 Medical Research Council framework as a theoretical basis. A literature review, environmental scan, and interviews with patients, families and healthcare providers guided the development of peer mentor training sessions and a peer-to-peer mentoring programme. Peer mentors were trained and paired with a mentee to receive (face-to-face or telephone) support over 12 weeks. Setting Two academic teaching hospitals in Toronto, Ontario, Canada. Participants Nine pairs consisting of one peer mentor and one mentee were matched based on factors such as age and work status. Primary outcome measure Mentee outcomes of disease modifying antirheumatic drugs (DMARDs)/biological treatment use, self-efficacy, self-management, health-related quality of life, anxiety, coping efficacy, social support and disease activity were measured using validated tools. Descriptive statistics and effect sizes were calculated to determine clinically important (>0.3) changes. Peer mentor self-efficacy was assessed using a self-efficacy scale. Interviews conducted with participants examined acceptability and feasibility of procedures and outcome measures, as well as perspectives on the value of peer support for individuals with EIA. Themes were identified through constant comparison. Results Mentees experienced improvements in the overall arthritis impact on life, coping efficacy and social support (effect size >0.3). Mentees also perceived emotional, informational, appraisal and instrumental support. Mentors also reported benefits and learnt from mentees’ fortitude and self-management skills. The training was well received by mentors. Their self-efficacy increased significantly after training completion. Participants’ experience of peer support was informed by the unique

Predictors of seizure outcomes in children with tuberous sclerosis complex and intractable epilepsy undergoing resective epilepsy surgery: an individual participant data meta-analysis.

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Aria Fallah

Full Text Available OBJECTIVE: To perform a systematic review and individual participant data meta-analysis to identify preoperative factors associated with a good seizure outcome in children with Tuberous Sclerosis Complex undergoing resective epilepsy surgery. DATA SOURCES: Electronic databases (MEDLINE, EMBASE, CINAHL and Web of Science, archives of major epilepsy and neurosurgery meetings, and bibliographies of relevant articles, with no language or date restrictions. STUDY SELECTION: We included case-control or cohort studies of consecutive participants undergoing resective epilepsy surgery that reported seizure outcomes. We performed title and abstract and full text screening independently and in duplicate. We resolved disagreements through discussion. DATA EXTRACTION: One author performed data extraction which was verified by a second author using predefined data fields including study quality assessment using a risk of bias instrument we developed. We recorded all preoperative factors that may plausibly predict seizure outcomes. DATA SYNTHESIS: To identify predictors of a good seizure outcome (i.e. Engel Class I or II we used logistic regression adjusting for length of follow-up for each preoperative variable. RESULTS: Of 9863 citations, 20 articles reporting on 181 participants were eligible. Good seizure outcomes were observed in 126 (69% participants (Engel Class I: 102(56%; Engel class II: 24(13%. In univariable analyses, absence of generalized seizure semiology (OR = 3.1, 95%CI = 1.2-8.2, p = 0.022, no or mild developmental delay (OR = 7.3, 95%CI = 2.1-24.7, p = 0.001, unifocal ictal scalp electroencephalographic (EEG abnormality (OR = 3.2, 95%CI = 1.4-7.6, p = 0.008 and EEG/Magnetic resonance imaging concordance (OR = 4.9, 95%CI = 1.8-13.5, p = 0.002 were associated with a good postoperative seizure outcome. CONCLUSIONS: Small retrospective cohort studies are inherently prone to bias, some of which are overcome using individual participant data. The

Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society.

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Evensen, Stig; Ueland, Torill; Lystad, June Ullevoldsæter; Bull, Helen; Klungsøyr, Ole; Martinsen, Egil W; Falkum, Erik

2017-04-01

Employment is an important part of recovery for individuals with schizophrenia. The employment rate for this group is as low as 10% in Norway, and major system related barriers to employment are evident. This study reports the competitive employment outcome at 2-year follow-up of a vocational rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning, self-esteem, and depression at baseline predicts employment outcome, and if change in these variables during the intervention period is associated with employment outcome. One hundred and forty-eight participants with schizophrenia spectrum disorders in six Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n = 84) or CR (n = 64). Both competitive and sheltered workplaces were used. Participants were assessed at baseline, at the end of the intervention period, and at 2-year follow-up. At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work placements in competitive workplaces. Significant improvements were found in global functioning, self-esteem, and depression during the intervention period, but no significant differences between the two intervention groups. High baseline global functioning and self-esteem, as well as positive change in these variables during the intervention period, were significantly associated with higher competitive employment outcome at 2-year follow-up. The results add to existing evidence that competitive employment is attainable for individuals with schizophrenia. High global functioning and self-esteem were strongly associated with competitive employment outcome.

Racial and ethnic disparities in functional, psychosocial, and neurobehavioral outcomes after brain injury.

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Arango-Lasprilla, Juan Carlos; Kreutzer, Jeffrey S

2010-01-01

Because of the growing minority population in the past 3 decades in the United States and the increasing numbers of individuals who sustain a traumatic brain injury (TBI), researchers and clinicians have started to pay more attention to the role of race and ethnicity in outcomes after TBI, with the goal of better serving this population. The aim of this article is to review the literature on the influence of race/ethnicity on functional, psychosocial, and neurobehavioral outcomes after TBI. Specifically, the following 8 areas of outcomes will be examined: (1) treatment outcomes, (2) neuropsychological outcomes, (3) employment/productivity, (4) functional outcomes, (5) community integration, (6) marital status, (7) quality of life/life satisfaction, and (8) emotional/neurobehavioral outcomes. To conclude this review, suggestions for improvements in professional competency, research, systems of care, and training are proposed.

Cooperative context is a determinant of the social influence on outcome evaluation: An electrophysiological study.

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Kimura, Kenta; Katayama, Jun'ichi

2016-02-01

The present study examined whether or not a cooperative context is a determinant of the social influence on the evaluation of two action outcomes: a monetary outcome and a conflict of opinion with other group members. In the present study, three-person groups were randomly assigned to be either a cooperative or individual group and asked to perform a gambling task. The monetary outcomes in the cooperative group were interrelated among group members, whereas those in the individual group did not influence each other. The present results showed that monetary outcomes elicited feedback-related negativity (FRN) and a conflict of opinion with other group members elicited FRN-like negativity, which reflect an evaluation of the motivational significance of action outcomes. The FRN elicited by monetary outcomes was reduced when participants shared decisions with other group members only in the cooperative group, indicating that the cooperative context reduced the motivational significance of monetary outcomes through the diffusion of responsibility. The FRN-like negativity elicited by a conflict of opinion showed a different pattern between the cooperative and individual groups, indicating that the cooperative context can influence the evaluation of a conflict of opinion, possibly via the modulation of group cohesiveness or conflict processing. The present results suggest that a cooperative context, rather than the social setting, is a determinant of the social influence on outcome evaluation. Copyright © 2015 Elsevier B.V. All rights reserved.

Psychosexual Outcome Among Iranian Individuals With 5α-Reductase Deficiency Type 2 and Its Relationship With Parental Sexism.

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Khorashad, Behzad S; Aghili, Zahra; Kreukels, Baudewijntje P C; Hiradfar, Mehran; Roshan, Ghasem M; Afkhamizadeh, Mozhgan; Abbaszadegan, Mohammad Reza; Ghaemi, Nosrat; Khazai, Behnaz; Cohen-Kettenis, P T

2016-11-01

Few studies exist on the psychosexual outcome of homogeneous groups of individuals with 5α-reductase deficiency type 2 (5α-RD-2) and the relation between gender changes and parental hostile and benevolent sexism, which are two components of ambivalent sexism that assume a stereotypical approach toward women in an overtly negative way or a chivalrous, seemingly positive way. To report on the psychosexual outcome of individuals with 5α-RD-2 and to investigate its relation to the level of parental sexism in a relatively large sample of Iranians with 5α-RD-2. Twenty participants (mean age = 19.5 years, SD = 6.345) with a molecularly confirmed diagnosis of 5α-RD-2 who were assigned the female gender at birth and raised as female were included in the study. Participants and their parents were interviewed and their medical records were assessed. Parents also completed the Ambivalent Sexism Inventory (ASI), which includes hostile and benevolent sexism subscales. Psychosexual outcome and parental hostile and benevolent sexism measurements. Twelve of 20 participants (60%) were diagnosed with gender identity disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). Ten of these transitioned to the male gender. The other 10 participants (50%), including the two diagnosed with gender identity disorder not otherwise specified, continued living in a female gender role. When comparing the ASI subscale scores between families of participants who changed their gender and those who did not, no significant difference was found for ASI total and hostile sexism scores, but there was a difference for benevolent sexism (P = .049): those whose daughters had changed their gender had higher benevolent sexism scores. The high prevalence of gender change and gender dysphoria reported in the literature was confirmed in this relatively large and homogeneous sample of Iranians with 5-α-RD-2 raised as female. Prenatal exposure

Measuring health outcomes of a multidisciplinary care approach in individuals with chronic environmental conditions using an abbreviated symptoms questionnaire

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Roy Fox

2008-12-01

Full Text Available Roy Fox1, Tara Sampalli1, Jonathan Fox11Nova Scotia Environmental Health Centre, Fall River, NS, CanadaAbstract: The Nova Scotia Environmental Health Centre is a treatment facility for individuals with chronic environmental conditions such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, chronic respiratory conditions and in some cases chronic pain. The premise of care is to provide a patient-centred multidisciplinary care approach leading to self-management strategies. In order to measure the outcome of the treatment in these complex problems, with overlapping diagnoses, symptoms in many body systems and suspected environmental triggers, a detailed symptoms questionnaire was developed specifically for this patient population and validated. Results from a pilot study in which an abbreviated symptoms questionnaire based on the top reported symptoms captured in previous research was used to measure the efficacy of a multidisciplinary care approach in individuals with multiple chemical sensitivity are presented in this paper. The purpose of this study was to examine the extent, type and patterns of changes over time in the top reported symptoms with treatment measured using the abbreviated symptoms questionnaire. A total of 183 active and 109 discharged patients participated in the study where the health status was measured at different time periods of follow up since the commencement of treatment at the Centre. The findings from this study were successful in generating an initial picture of the nature and type of changes in these symptoms. For instance, symptoms such as difficulty concentrating, sinus conditions and tiredness showed early improvement, within the first 6 months of being in treatment, while others, such as fatigue, hoarseness or loss of voice, took longer while others showed inconsistent changes warranting further enquiry. A controlled longitudinal study is planned to confirm the findings of the pilot study

Rehabilitation Outcomes for Alcohol Impaired Drivers Referred for Assessment in Two Wisconsin Counties.

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Gurnack, Anne M.

1989-01-01

Examined 2,379 records of individuals accused of operating motor vehicle while intoxicated (OWI). Identified predictors for rehabilitation outcomes and compliance to provisions of driver safety program among OWIs: repeat offense, use of other human services, employment status, and race. Findings suggest that more is known about factors related to…

Team-Based Learning in a Community Health Nursing Course: Improving Academic Outcomes.

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Miles, Jane M; Larson, Kim L; Swanson, Melvin

2017-07-01

Population health concepts, such as upstream thinking, present challenging ideas to undergraduate nursing students grounded in an acute care orientation. The purpose of this study was to describe how team-based learning (TBL) influenced academic outcomes in a community health nursing course. A descriptive correlational design examined the relationship among student scores on individual readiness assurance tests (iRATs), team readiness assurance tests (tRATs), and the final examination. The sample included 221 nursing students who had completed the course. A large positive correlation was found between iRAT and final examination scores. For all students, the mean tRAT score was higher than the mean iRAT score. A moderate positive correlation existed between tRAT and final examination scores. The study contributes to understanding the effects of TBL pedagogy on student academic outcomes in nursing education. TBL is a valuable teaching method in a course requiring the application of challenging concepts. [J Nurs Educ. 2017;56(7):425-429.]. Copyright 2017, SLACK Incorporated.

An Examination of Incentive Strategies to Increase Participation in Outcomes Research for an Adolescent Inpatient Unit.

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Ha, Carolyn; Madan, Alok; Long, Tessa A; Sharp, Carla

2016-05-01

Tracking adolescent outcomes after inpatient hospitalization is important in informing clinical care for this age group, as inpatient care is one of the most expensive treatment modalities. This study examined 4 incentive strategies used to maintain adolescent participation in follow-up research (at 6, 12, and 18 mo) after their discharge from the hospital (N=267). A generalized estimation equation approach was taken to investigate whether different incentive strategies predicted adolescent completion of the follow-up assessments at each time point. Findings demonstrate that implementation of social worker contact significantly differed from other incentive strategies in increasing adolescent completion of follow-up assessments (Z=2.51, P=0.012) over the 3 time points, even when controlling for age and sex. Although these findings ultimately need to be confirmed through a randomized controlled study of incentive strategies, they provide preliminary support for the notion that relational incentives, such as maintaining contact with a member of the clinical team at the hospital, may be particularly important in promoting adolescent participation in outcomes research.

Can Trainees Effectively Deliver Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder? Outcomes From a Training Clinic.

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Rizvi, Shireen L; Hughes, Christopher D; Hittman, Alexandra D; Vieira Oliveira, Pedro

2017-12-01

The aim of the current study was to evaluate the effectiveness of a 6-month course of comprehensive dialectical behavior therapy (DBT) provided in a training clinic with doctoral students as therapists and assessors. Clinical outcomes for 50 individuals with borderline personality disorder (80% female, M age = 29.52 [SD = 9.64]) are reported. Reliable change indices and clinical significance were calculated for measures. Finally, our results were benchmarked against a "gold standard" randomized clinical trial (RCT; McMain et al., 2009). Analyses with both the full sample and the treatment completers indicate significant reductions in mental health symptomatology that were reliable, clinically and statistically significant, and comparable in effect size to the benchmarked RCT. This DBT training clinic produced good outcomes, comparable to that of a large RCT. Results have implications for who can provide DBT treatment, as well as improving access to DBT in community settings where training clinics may be located. © 2017 Wiley Periodicals, Inc.

Individual factors and GP approach as predictors for the outcome of rehabilitation among long-term sick listed cases

DEFF Research Database (Denmark)

Rasmussen, Kurt; Andersen, Johan H

2005-01-01

There appears to be a lack of evidence concerning the effect of rehabilitation programmes for the long-term sick. More focus in this area would supplement an approach that has been directed toward process evaluation of rehabilitation programmes. It was the purpose of this study to shed light...... on sick leave or social benefits at this time. Individual background variables, as well as psychological well-being, mental health, pain level, and pain coping, seemed to have little effect on the outcome of rehabilitation, whilst clients' own evaluations of competence and ability of the involved health...

Individual Characteristics, Family Factors, and Classroom Experiences as Predictors of Low-Income Kindergarteners’ Social Skills

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Griffith, Shayl; Arnold, David; Voegler-Lee, Mary-Ellen; Kupersmidt, Janis

2017-01-01

There has been increasing awareness of the need for research and theory to take into account the intersection of individual characteristics and environmental contexts when examining predictors of child outcomes. The present longitudinal, multi-informant study examined the cumulative and interacting contributions of child characteristics (language skills, inattention/hyperactivity, and aggression) and preschool and family contextual factors in predicting kindergarten social skills in 389 low-income preschool children. Child characteristics and classroom factors, but not family factors, predicted teacher-rated kindergarten social skills, while child characteristics alone predicted change in teacher-rated social skills from preschool to kindergarten. Child characteristics and family factors, but not classroom factors, predicted parent-rated kindergarten social skills. Family factors alone predicted change in parent-rated social skills from preschool to kindergarten. Individual child characteristics did not interact with family or classroom factors in predicting parent- or teacher-rated social skills, and support was therefore found for an incremental, rather than an interactive, predictive model of social skills. The findings underscore the importance of assessing outcomes in more than one context, and of considering the impact of both individual and environmental contextual factors on children’s developing social skills when designing targeted intervention programs to prepare children for kindergarten. PMID:28804528

Individual Characteristics, Family Factors, and Classroom Experiences as Predictors of Low-Income Kindergarteners' Social Skills.

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Griffith, Shayl; Arnold, David; Voegler-Lee, Mary-Ellen; Kupersmidt, Janis

2016-01-01

There has been increasing awareness of the need for research and theory to take into account the intersection of individual characteristics and environmental contexts when examining predictors of child outcomes. The present longitudinal, multi-informant study examined the cumulative and interacting contributions of child characteristics (language skills, inattention/hyperactivity, and aggression) and preschool and family contextual factors in predicting kindergarten social skills in 389 low-income preschool children. Child characteristics and classroom factors, but not family factors, predicted teacher-rated kindergarten social skills, while child characteristics alone predicted change in teacher-rated social skills from preschool to kindergarten. Child characteristics and family factors, but not classroom factors, predicted parent-rated kindergarten social skills. Family factors alone predicted change in parent-rated social skills from preschool to kindergarten. Individual child characteristics did not interact with family or classroom factors in predicting parent- or teacher-rated social skills, and support was therefore found for an incremental, rather than an interactive, predictive model of social skills. The findings underscore the importance of assessing outcomes in more than one context, and of considering the impact of both individual and environmental contextual factors on children's developing social skills when designing targeted intervention programs to prepare children for kindergarten.

Distribution and outcome of ocular lesions in snakes examined at a veterinary teaching hospital: 67 cases (1985-2010).

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Hausmann, Jennifer C; Hollingsworth, Steven R; Hawkins, Michelle G; Kass, Philip H; Maggs, David J

2013-07-15

To determine the distribution and clinical outcome of ocular lesions in snakes. Retrospective case series. 67 snakes with ocular lesions. Signalment, lesion duration, diagnosis, treatment, and clinical outcome were recorded for all snakes with ocular lesions that were examined at a veterinary teaching hospital from 1985 to 2010. 71 ocular lesions were detected in 67 of 508 (13%) snakes examined. Affected snakes were of the families Boidae, Pythonidae, Colubridae, and Viperidae. The distribution of ocular lesions did not vary by taxonomic family, age, or sex; however, snakes from the genus Epicrates with ocular lesions were overrepresented in the population. The most commonly diagnosed ocular lesions were retained spectacle (n = 41), pseudobuphthalmos or subspectacular abscess (13), trauma (8), and cataracts (4). Pseudobuphthalmos or subspectacular abscess developed more frequently in Colubridae than in non-Colubridae snakes. Of the 16 snakes with retained spectacles for which data were available, the lesion recurred once in 4 snakes and multiple times in 5 snakes. Results indicated that retained spectacle was the most common ocular lesion diagnosed in snakes. Compared with other snakes with ocular lesions, snakes of the genus Epicrates had a higher than expected frequency of ocular lesions in general and snakes of the family Colubridae had a higher than expected frequency of pseudobuphthalmos or subspectacular abscess.

Structural contingency theory and individual differences: examination of external and internal person-team fit.

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Hollenbeck, John R; Moon, Henry; Ellis, Aleksander P J; West, Bradley J; Ilgen, Daniel R; Sheppard, Lori; Porter, Christopher O L H; Wagner, John A

2002-06-01

This article develops and tests a structurally based, integrated theory of person-team fit. The theory developed is an extension of structural contingency theory and considers issues of external fit simultaneously with its examination of internal fit at the team level. Results from 80 teams working on an interdependent team task indicate that divisional structures demand high levels of cognitive ability on the part of teammembers. However, the advantages of high cognitive ability in divisional structures are neutralized when there is poor external fit between the structure and the environment. Instead, emotional stability becomes a critical factor among teammembers when a divisional structure is out of alignment with its environment. Individual differences seem to play little or no role in functional structures, regardless of the degree of external fit.

Newcomer Immigrant Adolescents: A Mixed-Methods Examination of Family Stressors and School Outcomes

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Patel, Sita G.; Clarke, Annette V.; Eltareb, Fazia; Macciomei, Erynn E.; Wickham, Robert E.

2016-01-01

Family stressors predict negative psychological outcomes for immigrant adolescents, yet little is known about how such stressors interact to predict school outcomes. The purpose of this study was to explore the interactive role of family stressors on school outcomes for newcomer adolescent immigrants. Using a convergent parallel mixed-methods…

Informal Workplace Learning among Nurses: Organisational Learning Conditions and Personal Characteristics That Predict Learning Outcomes

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Kyndt, Eva; Vermeire, Eva; Cabus, Shana

2016-01-01

Purpose: This paper aims to examine which organisational learning conditions and individual characteristics predict the learning outcomes nurses achieve through informal learning activities. There is specific relevance for the nursing profession because of the rapidly changing healthcare systems. Design/Methodology/Approach: In total, 203 nurses…

Financial stress and outcomes after acute myocardial infarction.

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Sachin J Shah

Full Text Available Little is known about the association between financial stress and health care outcomes. Our objective was to examine the association between self-reported financial stress during initial hospitalization and long-term outcomes after acute myocardial infarction (AMI.We used prospective registry evaluating myocardial infarction: Event and Recovery (PREMIER data, an observational, multicenter US study of AMI patients discharged between January 2003 and June 2004. Primary outcomes were disease-specific and generic health status outcomes at 1 year (symptoms, function, and quality of life (QoL, assessed by the Seattle Angina Questionnaire [SAQ] and Short Form [SF]-12. Secondary outcomes included 1-year rehospitalization and 4-year mortality. Hierarchical regression models accounted for patient socio-demographic, clinical, and quality of care characteristics, and access and barriers to care.Among 2344 AMI patients, 1241 (52.9% reported no financial stress, 735 (31.4% reported low financial stress, and 368 (15.7% reported high financial stress. When comparing individuals reporting low financial stress to no financial stress, there were no significant differences in post-AMI outcomes. In contrast, individuals reporting high financial stress were more likely to have worse physical health (SF-12 PCS mean difference -3.24, 95% Confidence Interval [CI]: -4.82, -1.66, mental health (SF-12 MCS mean difference: -2.44, 95% CI: -3.83, -1.05, disease-specific QoL (SAQ QoL mean difference: -6.99, 95% CI: -9.59, -4.40, and be experiencing angina (SAQ Angina Relative Risk = 1.66, 95%CI: 1.19, 2.32 at 1 year post-AMI. While 1-year readmission rates were increased (Hazard Ratio = 1.50; 95%CI: 1.20, 1.86, 4-year mortality was no different.High financial stress is common and an important risk factor for worse long-term outcomes post-AMI, independent of access and barriers to care.

Individual differences in reactivity to daily events: examining the roles of stability and level of self-esteem.

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Greenier, K D; Kernis, M H; McNamara, C W; Waschull, S B; Berry, A J; Herlocker, C E; Abend, T A

1999-02-01

Unstable self-esteem is thought to reflect fragile and vulnerable feelings of self-worth that are affected by specific positive and negative events. Direct evidence for this contention is lacking, however. To redress this situation, we examined the extent to which level and stability of self-esteem predicted the impact that everyday positive and negative events had on individuals' feelings about themselves. Participants recorded the most positive and most negative event that occurred each day Monday through Thursday for a period of 2 weeks. They then indicated the extent to which each event made them feel better or worse about themselves. As anticipated, negative and positive events had a greater impact on the self-feelings of individuals with unstable as opposed to stable self-esteem (although the effect for positive events was marginal). Additional findings indicated that event qualities (i.e., self-esteem relevance and concerns about social acceptance/rejection) could account for the unstable self-esteem/greater reactivity link for negative events, but not for positive events. Negative, but not positive, events had a greater impact on the self-feelings of individuals with low as compared to high levels of self-esteem. Theoretical implications are discussed.

Indicators of a balanced long-term service and support system: examining the impact on individuals aging with a lifelong disability.

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Ruiz, Sarah; Urdapilleta, Oswaldo; Clark-Shirley, Leanne J; Howard, Jennifer; Poey, Judith

2012-01-01

This article explores how rebalancing efforts can support the needs of individuals aging with a lifelong disability. The National Balancing Indicator project examined the overall long-term supports and services system (LTSS) progress in five indicators within the Sustainability, Coordination and Transparency, and Prevention principles toward a balanced LTSS system for those aging with a lifelong disability. In assessing state efforts to create a balanced participant-directed LTSS system with the National Balancing Indicators, the findings suggest states are better equipping the system to handle a burgeoning population of individuals aging with a lifelong disability, but more progress is still needed. Overall, states need to continue to create a seamless system that allows individuals with lifelong disabilities to transition smoothly through the life course.

A retrospective outcomes study examining the effect of interactive metronome on hand function.

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Shank, Tracy M; Harron, Wendy

2015-01-01

Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Examining the Effects of Perceived Relevance and Work-Related Subjective Well-Being on Individual Performance for Co-Op Students

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Drewery, Dave; Pretti, T. Judene; Barclay, Sage

2016-01-01

The purpose of this study was to examine the relationships between co-op students' perceived relevance of their work term, work-related subjective well-being (SWB), and individual performance at work. Data were collected using a survey of co-op students (n = 1,989) upon completion of a work term. Results of regression analyses testing a…

Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

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Turyakira Eleanor

2011-10-01

Full Text Available Abstract Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%, malpresentation or malposition (36.4% and hydrocephalus (0.3%. The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86, with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78, having delivered once before (AOR 1.57, 95% CI: 1.30-1.91 and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45. The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08 and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22. Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by

Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review.

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Cummings, Greta G; Tate, Kaitlyn; Lee, Sarah; Wong, Carol A; Paananen, Tanya; Micaroni, Simone P M; Chatterjee, Gargi E

2018-05-03

Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to

Police interviewing and interrogation of juvenile suspects: a descriptive examination of actual cases.

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Cleary, Hayley M D

2014-06-01

Although empirical attention to police interrogation has gained traction in recent years, comparatively few studies have examined interrogation of juvenile suspects, and virtually none have examined actual interrogations. Despite a growing literature on youths' interrogation-related capacities, we still know very little about what actually transpires when police question youth. The present study examines electronically recorded police interviews with juveniles to describe the characteristics, processes, and outcomes that occur in actual juvenile interrogations, including interview duration, individuals present, and confessions. Fifty-seven electronic recordings from 17 police departments were analyzed using observational research software. The median juvenile interrogation lasted 46 min, though the range was extensive (6 min to nearly 5 hr). Youth frequently submitted to questioning without a parent or advocate present, and disruptions to the interview process were common. Interrogation outcomes varied and included full confessions, partially incriminating admissions, and denials of guilt. Results from this study provide context for interrogation research using other methods and suggest that youth may frequently consent to interrogation in the absence of important legal protections.

Gender Differences in Vocational Rehabilitation Service Predictors of Successful Competitive Employment for Transition-Aged Individuals with Autism

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Sung, Connie; Sánchez, Jennifer; Kuo, Hung-Jen; Wang, Chia-Chiang; Leahy, Michael J.

2015-01-01

As males and females with autism spectrum disorder (ASD) experience different symptomology, their needs for vocational rehabilitation (VR) are unique as they transition into adulthood. This study examined the effects of gender differences in VR service predictors on employment outcomes for transition-aged individuals with ASD. A total of 1696…

Socialization of Culture and Coping with Discrimination Among American Indian Families: Examining Cultural Correlates of Youth Outcomes.

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Yasui, Miwa; Dishion, Thomas J; Stormshak, Elizabeth; Ball, Alison

2015-01-01

The current study examines the interrelations between observed parental cultural socialization and socialization of coping with discrimination, and youth outcomes among a sample of 92 American Indian adolescents and their parents in a rural reservation. Path analysis is used to examine the relationships among observed parental socialization (cultural socialization and socialization of coping with discrimination), and youth-reported perceived discrimination, ethnic identity and depression. Findings reveal that higher levels of observed parental cultural socialization and socialization of coping with discrimination predict lower levels of depression as reported by youth 1 year later. Path analyses also show that observed parental cultural socialization and socialization of coping with discrimination are positively associated with youth ethnic identity. These findings point to the importance of integrating familial socialization of culture and coping with discrimination in fostering resilience among American Indian youth.

Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

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Li, Cui-ling; Zhao, Kai; Li, Hui; Farah, Omar Ibrahim; Wang, Jiao-jiao; Sun, Rong-ze; Zhang, Hui-ping

2014-01-01

This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be

Individual Differences on the McGurk Effect: An Examination with the Autism Trait and Schizotypal Personality

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Yuta Ujiie

2011-10-01

Full Text Available The McGurk effect is a perceptual phenomenon that demonstrates interaction between hearing and vision in speech perception. This effect may be experienced when a visual of the production of a phoneme is dubbed with a sound recording of a different phoneme being spoken wherein the perceived phoneme is often the third intermediate phoneme. In the present study we examined the potential individual differences in the McGurk effect among 51 healthy students. The results suggested that people with higher scores for schizophrenic or autistic traits, respectively, might report less /ka/ responses (visually captured responses but more /ta/ responses (vision-audio mixed responses in the McGurk condition (visually /pa/ but auditor/ka/. This indicates that such people might show a preference for auditory information over visual information. Both schizophrenia and autism might have deficits in social functioning. If an individual has a poor level of interpersonal skills this would reflect in the result since he/she might not be able to read others' lips automatically.

A randomised controlled trial of blended learning to improve the newborn examination skills of medical students.

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Stewart, Alice; Inglis, Garry; Jardine, Luke; Koorts, Pieter; Davies, Mark William

2013-03-01

To evaluate the hypotheses that a blended learning approach would improve the newborn examination skills of medical students and yield a higher level of satisfaction with learning newborn examination. Undergraduate medical students at a tertiary teaching hospital were individually randomised to receive either a standard neonatology teaching programme (control group), or additional online access to the PENSKE Baby Check Learning Module (blended learning group). The primary outcome was performance of newborn examination on standardised assessment by blinded investigators. The secondary outcomes were performance of all 'essential' items of the examination, and participant satisfaction. The recruitment rate was 88% (71/81). The blended learning group achieved a significantly higher mean score than the control group (p=0.02) for newborn examination. There was no difference for performance of essential items, or satisfaction with learning newborn examination. The blended learning group rated the module highly for effective use of learning time and ability to meet specific learning needs. A blended learning approach resulted in a higher level of performance of newborn examination on standardised assessment. This is consistent with published literature on blended learning and has implications for all neonatal clinicians including junior doctors, midwifes and nurse practitioners.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

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Chaiana PIOVESAN

2017-03-01

Full Text Available Abstract The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children’s Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children’s dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers’ associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children’s ages, family income, parents’ schooling, mothers’ participation in their children’s school activities, dental caries, and presence of workers’ associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Sharing and reuse of individual participant data from clinical trials

DEFF Research Database (Denmark)

Ohmann, Christian; Banzi, Rita; Canham, Steve

2017-01-01

: The adoption of the recommendations in this document would help to promote and support data sharing and reuse among researchers, adequately inform trial participants and protect their rights, and provide effective and efficient systems for preparing, storing and accessing data. The recommendations now need......OBJECTIVES: We examined major issues associated with sharing of individual clinical trial data and developed a consensus document on providing access to individual participant data from clinical trials, using a broad interdisciplinary approach. DESIGN AND METHODS: This was a consensus...... Research Infrastructures Building Enduring Life-science Services) and coordinated by the European Clinical Research Infrastructure Network. Thus, the focus was on non-commercial trials and the perspective mainly European. OUTCOME: We developed principles and practical recommendations on how to share data...

Examining perceived stereotype threat among overweight/obese adults using a multi-threat framework.

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Carels, Robert A; Domoff, Sarah E; Burmeister, Jacob M; Koball, Afton M; Hinman, Nova G; Davis, Alan K; Wagner Oehlhof, Marissa; Leroy, Michelle; Bannon, Erin; Hoffmann, Debra A

2013-01-01

The Multi-Threat Framework accounts for potentially different forms of stereotype threat that differ in target (i.e., the individual or the group) and source (i.e., the self or others). This investigation examined how these different forms of perceived stereotype threat were related to concepts, such as group identity, stereotype endorsement, stigma consciousness, etc., among overweight and obese individuals. 216 adults completed an online survey. Participants' mean age was 23.6 (SD 10.1; range 18-64) years and mean BMI was 31.6 (SD 7.5) kg/m². Participants reported a history of feeling threatened by stereotypes related to weight. When reflecting on past experiences of perceived stereotype threat, participants reported greater levels of self/own stereotype threat compared to group stereotype threat. Level of stereotype threat was related to a number of personal characteristics (i.e., sex, BMI) and individual factors (i.e., group identity, stigma consciousness, fear of fat). Individuals who are overweight report a history of being threatened by negative stereotypes. The findings support the Multi-Threat Framework for stereotype threat based on body weight. Overweight individuals' susceptibility to stereotype threat may vary systematically depending on several factors. Future research should examine weight-related stereotypes' impact on cognitive and behavioral outcomes. Copyright © 2013 S. Karger GmbH, Freiburg

Examining Perceived Stereotype Threat among Overweight/Obese Adults Using a Multi-Threat Framework

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Robert A. Carels

2013-05-01

Full Text Available Objective: The Multi-Threat Framework accounts for potentially different forms of stereotype threat that differ in target (i.e., the individual or the group and source (i.e., the self or others. This investigation examined how these different forms of perceived stereotype threat were related to concepts, such as group identity, stereotype endorsement, stigma consciousness, etc., among overweight and obese individuals. Method: 216 adults completed an online survey. Participants' mean age was 23.6 (SD 10.1; range 18-64 years and mean BMI was 31.6 (SD 7.5 kg/m2. Results: Participants reported a history of feeling threatened by stereotypes related to weight. When reflecting on past experiences of perceived stereotype threat, participants reported greater levels of self/own stereotype threat compared to group stereotype threat. Level of stereotype threat was related to a number of personal characteristics (i.e., sex, BMI and individual factors (i.e., group identity, stigma consciousness, fear of fat. Conclusion: Individuals who are overweight report a history of being threatened by negative stereotypes. The findings support the Multi-Threat Framework for stereotype threat based on body weight. Overweight individuals' susceptibility to stereotype threat may vary systematically depending on several factors. Future research should examine weight-related stereotypes' impact on cognitive and behavioral outcomes.

Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.

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Aidala, Angela A; Wilson, Michael G; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K; Caban, Maria; Rourke, Sean B

2016-01-01

Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking "upstream" economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual's control that affect housing and residential environments and the health resources or risk exposures such contexts provide. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include

An Examination of the Outcomes of the Undergraduate Leadership Teaching Assistant (ULTA) Experience as a High-Impact Practice in Leadership Education

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Odom, Summer F.; Ho, Sarah P.; Moore, Lori L.

2015-01-01

The Undergraduate Leadership Teaching Assistant (ULTA) experience offers students a high-impact opportunity to develop, practice, and evaluate their leadership knowledge, skills, and abilities. The purpose of this qualitative study was to examine outcomes of the ULTA experience as a high-impact practice for students studying leadership. Weekly…

Examining the relationships between posttraumatic stress disorder symptoms, positive smoking outcome expectancies, and cigarette smoking in people with substance use disorders: a multiple mediator model.

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Hruska, Bryce; Bernier, Jennifer; Kenner, Frank; Kenne, Deric R; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

2014-01-01

Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to

Semiotic individuation and Ernst Cassirer’s challenge

DEFF Research Database (Denmark)

Hoffmeyer, Jesper

2015-01-01

. In this understanding, individuation becomes narrowly connected to learning. And since learning necessarily depends on what is already learned, the trajectory of learning-based individuation is necessarily indefinite and dependent on the concrete chance events and steps whereby the process has proceeded. Semiotic...... individuation is a historical process, and this fact explains why systems biology, as established by Ludwig van Bertalanffy, has not been capable of meeting the hope, expressed long ago by Ernst Cassirer, of bridging the mechanicist-vitalist gap in biology. Instead, a semiotic approach is called for. Human...... be defined by its uniqueness as a particular genetic combination, but must be instead be defined by its uniqueness as a temporal outcome of semiotic individuation. Accordingly, this doubletracked character of human semiotic individuation implies that it is cast as just one particular outcome...

Examining Success of Communication Strategies Used by Formal Caregivers Assisting Individuals with Alzheimer's Disease during an Activity of Daily Living

Science.gov (United States)

Wilson, Rozanne; Rochon, Elizabeth; Mihailidis, Alex; Leonard, Carol

2012-01-01

Purpose: To examine how formal (i.e., employed) caregivers' use verbal and nonverbal communication strategies while assisting individuals with moderate to severe Alzheimer's disease (AD) during the successful completion of an activity of daily living (ADL). Based on the literature, the authors hypothesized that caregivers' use of 1 proposition,…

An experiment on individual ‘parochial altruism’ revealing no connection between individual ‘altruism’ and individual ‘parochialism’

Science.gov (United States)

Corr, Philip J.; Hargreaves Heap, Shaun P.; Seger, Charles R.; Tsutsui, Kei

2015-01-01

Is parochial altruism an attribute of individual behavior? This is the question we address with an experiment. We examine whether the individual pro-sociality that is revealed in the public goods and trust games when interacting with fellow group members helps predict individual parochialism, as measured by the in-group bias (i.e., the difference in these games in pro-sociality when interacting with own group members as compared with members of another group). We find that it is not. An examination of the Big-5 personality predictors of each behavior reinforces this result: they are different. In short, knowing how pro-social individuals are with respect to fellow group members does not help predict their parochialism. PMID:26347703

Marital quality and self-efficacy: influence on disease management among individuals with rheumatoid arthritis.

Science.gov (United States)

Tewary, Sweta; Farber, Naomi

2014-01-01

Individuals with rheumatoid arthritis (RA) struggle to maintain improved functional ability and reduced pain levels. Health education emphasizing self-efficacy helps individuals to adjust with the disease outcome and progression. As a basis to develop comprehensive evidence-based patient education programs, the aim of the study was to examine the role of marriage as a predictor of pain and functional self-efficacy among individuals with RA. Review of the regression analysis did not provide support for the relationships between marital quality and self-efficacy. Relationships were not observed between marital quality, length of marriage, and self-efficacy as predicted by the first hypothesis. Additional regression analysis examination found that marital quality, length of marriage, pain, and health assessment together reported significant variance in self-efficacy. However, only health assessment significantly predicted self-efficacy. Other nonexamined variables could have influenced the independent marital quality effects. Future longitudinal studies with larger sample sizes can further validate the current findings.

Postprandial Monocyte Activation in Individuals With Metabolic Syndrome

Science.gov (United States)

Khan, Ilvira M.; Pokharel, Yashashwi; Dadu, Razvan T.; Lewis, Dorothy E.; Hoogeveen, Ron C.; Wu, Huaizhu

2016-01-01

Context: Postprandial hyperlipidemia has been suggested to contribute to atherogenesis by inducing proinflammatory changes in monocytes. Individuals with metabolic syndrome (MS), shown to have higher blood triglyceride concentration and delayed triglyceride clearance, may thus have increased risk for development of atherosclerosis. Objective: Our objective was to examine fasting levels and effects of a high-fat meal on phenotypes of monocyte subsets in individuals with obesity and MS and in healthy controls. Design, Setting, Participants, Intervention: Individuals with obesity and MS and gender- and age-matched healthy controls were recruited. Blood was collected from participants after an overnight fast (baseline) and at 3 and 5 hours after ingestion of a high-fat meal. At each time point, monocyte phenotypes were examined by multiparameter flow cytometry. Main Outcome Measures: Baseline levels of activation markers and postprandial inflammatory response in each of the three monocyte subsets were measured. Results: At baseline, individuals with obesity and MS had higher proportions of circulating lipid-laden foamy monocytes than controls, which were positively correlated with fasting triglyceride levels. Additionally, the MS group had increased counts of nonclassical monocytes, higher CD11c, CX3CR1, and human leukocyte antigen-DR levels on intermediate monocytes, and higher CCR5 and tumor necrosis factor-α levels on classical monocytes in the circulation. Postprandial triglyceride increases in both groups were paralleled by upregulation of lipid-laden foamy monocytes. MS, but not control, subjects had significant postprandial increases of CD11c and percentages of IL-1β+ and tumor necrosis factor-α+ cells in nonclassical monocytes. Conclusions: Compared to controls, individuals with obesity and MS had increased fasting and postprandial monocyte lipid accumulation and activation. PMID:27575945

Ratings of Broader Autism Phenotype and Personality Traits in Optimal Outcomes from Autism Spectrum Disorder

Science.gov (United States)

Suh, Joyce; Orinstein, Alyssa; Barton, Marianne; Chen, Chi-Ming; Eigsti, Inge-Marie; Ramirez-Esparza, Nairan; Fein, Deborah

2016-01-01

The study examines whether "optimal outcome" (OO) children, despite no longer meeting diagnostic criteria for Autism Spectrum Disorder (ASD), exhibit personality traits often found in those with ASD. Nine zero acquaintance raters evaluated Broader Autism Phenotype (BAP) and Big Five personality traits of 22 OO individuals, 27 high…

Genders and Individual Treatment Progress in (Non-)Binary Trans Individuals.

Science.gov (United States)

Koehler, Andreas; Eyssel, Jana; Nieder, Timo O

2018-01-01

Health care for transgender and transsexual (ie, trans) individuals has long been based on a binary understanding of gender (ie, feminine vs masculine). However, the existence of non-binary or genderqueer (NBGQ) genders is increasingly recognized by academic and/or health care professionals. To gain insight into the individual health care experiences and needs of binary and NBGQ individuals to improve their health care outcomes and experience. Data were collected using an online survey study on experiences with trans health care. The non-clinical sample consisted of 415 trans individuals. An individual treatment progress score was calculated to report and compare participants' individual progress toward treatment completion and consider the individual treatment needs and definitions of completed treatment (ie, amount and types of different treatments needed to complete one's medical transition). Main outcome measures were (i) general and trans-related sociodemographic data and (ii) received and planned treatments. Participants reported binary (81.7%) and different NBGQ (18.3%) genders. The 2 groups differed significantly in basic demographic data (eg, mean age; P < .05). NBGQ participants reported significantly fewer received treatments compared with binary participants. For planned treatments, binary participants reported more treatments related to primary sex characteristics only. Binary participants required more treatments for a completed treatment than NBGQ participants (6.0 vs 4.0). There were no differences with regard to individual treatment progress score. Because traditional binary-focused treatment practice could have hindered NBGQ individuals from accessing trans health care or sufficiently articulating their needs, health care professionals are encouraged to provide a holistic and individual treatment approach and acknowledge genders outside the gender binary to address their needs appropriately. Because the study was made inclusive for non

Effects of Adolescent Sport Practice on Health Outcomes of Adult Amateur Endurance Cyclists: Adulthood Is Not Too Late to Start.

Science.gov (United States)

Munguia-Izquierdo, Diego; Mayolas-Pi, Carmen; Peñarrubia-Lozano, Carlos; Paris-Garcia, Federico; Bueno-Antequera, Javier; Oviedo-Caro, Miguel Angel; Legaz-Arrese, Alejandro

2017-11-01

We investigated the effects of adolescent sport practice on the training, performance, and health outcomes of adult amateur endurance cyclists and compared health outcomes of 3 adult groups: amateur endurance cyclists who practiced sports during adolescence, amateur endurance cyclists who did not practice sports during adolescence, and inactive individuals. In 859 (751 men and 108 women) adult cyclists and 718 inactive subjects (307 men and 411 women), we examined adolescent sport practice, current training status, quality of life, quality of sleep, anxiety and depression, and cardiometabolic risk: body mass index, physical activity, physical fitness, adherence to Mediterranean diet, and alcohol and tobacco consumption. Independent of gender, no significant differences in training, performance, or health outcomes were observed between amateur endurance cyclists who practiced sports during adolescence and those who did not. Independent of gender, cyclists reported significantly better health outcomes than inactive individuals in all variables, except depression. Training, performance, and health outcomes did not differ between adult amateur endurance cyclists who practiced sports during adolescence and those who did not, but their health outcomes were significantly improved compared with inactive individuals, except for depression.

Managing disclosure following recent-onset psychosis: utilizing the individual placement and support model.

Science.gov (United States)

Allott, Kelly A; Turner, Luana R; Chinnery, Gina L; Killackey, Eoin J; Nuechterlein, Keith H

2013-08-01

Individual Placement and Support is the most defined and evidence-based approach to supported employment for severe mental illness, including recent-onset psychosis. However, there is limited evidence or detailed guidelines informing the management of mental illness disclosure to educators or employers when delivering individual placement and support. In this paper, we describe the initial disclosure preferences of young people with recent-onset psychosis enrolled in individual placement and support and provide guidance for managing disclosure when delivering Individual Placement and Support with this population. Drawing from sites in Melbourne, Australia and Los Angeles, USA, clients' initial disclosure preferences were examined. We describe approaches to providing individual placement and support when no disclosure is permitted compared with when disclosure is permitted, including two illustrative case vignettes. No disclosure of mental illness or disability was requested by 54-59% of clients; 41-46% of clients permitted partial or complete disclosure. The 'no disclosure' scenario required the individual placement and support worker to provide support 'behind the scenes', whereas when disclosure was permitted, the individual placement and support worker could have contact with instructors/employers and work 'on the front lines'. The case vignettes illustrate how both approaches can lead to successful vocational outcomes. We found that Individual Placement and Support can be provided in an educative, flexible, creative and collaborative manner according to client disclosure preferences. We suggest that disclosure preferences do not prevent successful vocational outcomes, although this supposition requires empirical investigation. © 2013 Wiley Publishing Asia Pty Ltd.

The impact of substance use disorders on clinical outcomes in older-adult psychiatric inpatients.

Science.gov (United States)

Lane, Scott D; da Costa, Sabrina C; Teixeira, Antonio L; Reynolds, Charles F; Diniz, Breno S

2018-02-01

To examine associations among substance use disorder (SUD) and measures of length of stay (LOS) and non-psychiatric medical comorbidity (MEDCO) in older-adult inpatients with serious mental illness (SMI), hypothesizing SUD would be related to worse clinical outcomes. A cross-sectional study analyzed medical records from 2010 to 2016 of 7258 inpatients with SMI ≥ age 50, obtained from a 274-bed psychiatric hospital. Descriptive analyses examined prevalence rates for SUD status (+/-), individual drug classes, and total number of SUDs (polysubstance use disorders). Regression models examined the influence of 2 independent variables of interest: (1) SUD status (+/-) and (2) type of SUD (ie, specific drug), controlling for demographic factors and additional (non-SUD) psychiatric disorders. Two dependent (outcome) variables were examined: LOS and MEDCO. The overall SUD rate was 26%; cocaine was the most common SUD (≈ 10%). SUD status and additional (non-SUD) psychiatric diagnoses were significantly associated with longer LOS (both P < 0.001). For individual SUDs, cocaine, marijuana, opiates, and alcohol were all significantly associated with LOS (all P < 0.01). SUD status, age, sex, admission status, and race were significantly associated with MEDCO (all P < 0.002). For individual SUDs, barbiturates, opiates, and alcohol were all significantly associated with MEDCO (P < 0.01). The prevalence of SUD in this sample underscores concerns related to treating older adults presenting providers with comorbid SUD and SMI. This combination may increase the burden and complexity of care, warranting further investigation into mechanisms and long-term consequences. Copyright © 2017 John Wiley & Sons, Ltd.

Biobehavioral pain profile in individuals with chronic spine pain.

Science.gov (United States)

Matteliano, Deborah; Scherer, Yvonne Krall; Chang, Yu-Ping

2014-03-01

Pain in the spine is the most frequently described pain problem in primary care, afflicting at least 54 million Americans. When spinal pain becomes chronic, the prognosis for recovery is poor, often leading to disability and reduced quality of life. Clinical treatment is inadequate, often focusing on physical pathology alone. To improve treatment outcomes for chronic pain as recommended by current guidelines, the Biobehavioral Pain Profile (BPP), which includes six pain response subscales, was developed to guide cognitive behavioral therapy (CBT). The purpose of this study was to describe the BPP in 100 individuals with chronic spine pain and examine the associations between the BPP and important clinical outcomes, including chronic pain, disability, and quality of life. Participants reported a high level of pain, a low quality of life, and a high level of disability despite receiving treatment with opioids. Scores on BPP subscales including evaluating loss of control, past and current experience, physiologic responsivity, and thoughts of disease progression were elevated, indicating a need for CBT. Five of the six BPP subscales had a significant association with quality of life, chronic pain, and disability with the thought of disease progression being a strong factor for most of the clinical outcome variables. By identifying BPP, clinicians can provide appropriate treatments to improve individuals' quality of life and prevent further disability. Further study using the BPP to guide CBT is needed. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Who Believes in the Giant Skeleton Myth? An Examination of Individual Difference Correlates

Directory of Open Access Journals (Sweden)

Viren Swami

2016-01-01

Full Text Available This study examined individual difference correlates of belief in a narrative about the discovery of giant skeletal remains that contravenes mainstream scientific explanations. A total of 364 participants from Central Europe completed a survey that asked them to rate their agreement with a short excerpt describing the giant skeleton myth. Participants also completed measures of the Big Five personality factors, New Age orientation, anti-scientific attitudes, superstitious beliefs, and religiosity. Results showed that women, as compared with men, and respondents with lower educational qualifications were significantly more likely to believe in the giant skeleton myth, although effect sizes were small. Correlational analysis showed that stronger belief in the giant skeleton myth was significantly associated with greater anti-scientific attitudes, stronger New Age orientation, greater religiosity, stronger superstitious beliefs, lower Openness to Experience scores, and higher Neuroticism scores. However, a multiple regression showed that the only significant predictors of belief in myth were Openness, New Age orientation, and anti-scientific attitudes. These results are discussed in relation to the potential negative consequences of belief in myths.

Fenofibrate-associated changes in renal function and relationship to clinical outcomes among individuals with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) experience.

Science.gov (United States)

Bonds, D E; Craven, T E; Buse, J; Crouse, J R; Cuddihy, R; Elam, M; Ginsberg, H N; Kirchner, K; Marcovina, S; Mychaleckyj, J C; O'Connor, P J; Sperl-Hillen, J-A

2012-06-01

Fenofibrate has been noted to cause an elevation in serum creatinine in some individuals. Participants in the Action to Control Cardiovascular Risk in Diabetes Lipid Study were studied to better characterise who is at risk of an increase in creatinine level and to determine whether those with creatinine elevation have a differential risk of adverse renal or cardiovascular outcomes. A fenofibrate-associated creatinine increase (FACI) was defined as an increase in serum creatinine of at least 20% from baseline to month 4 in participants assigned to fenofibrate. Baseline patient characteristics, and baseline and 4-month drug, clinical, laboratory characteristics and study outcomes were examined by FACI status. Of the sample, 48% of those randomised to receive fenofibrate had at least a 20% increase in serum creatinine within 4 months. In multivariable analysis, participants who were older, male, used an ACE inhibitor at baseline, used a thiazolidinedione (TZD) at 4 months post-randomisation, had baseline CVD, and had lower baseline serum creatinine and LDL-cholesterol levels were all more likely to meet the criteria for FACI. Participants in the FACI group were also more likely to have a decrease in their serum triacylglycerol level from baseline to 4 months. No differences in study outcomes were seen by FACI criteria. Several characteristics predict a rapid rise in serum creatinine upon starting fenofibrate. Participants who met the criteria for FACI also had a greater change in triacylglycerol levels. In the setting of careful renal function surveillance and reduction of fenofibrate dose as indicated, no increase in renal disease or cardiovascular outcome was seen in those individuals demonstrating FACI. ClincalTrials.gov: NCT00000620. The ACCORD Trial was supported by grants (N01-HC-95178, N01-HC-95179, N01-HC-95180, N01-HC-95181, N01-HC-95182, N01-HC-95183, N01-HC-95184, IAA-Y1-HC-9035 and IAA-Y1-HC-1010) from the National Heart, Lung, and Blood Institute; by the

Subclinical thyrotoxicosis in an outpatient population - predictors of outcome.

Science.gov (United States)

Schouten, Belinda J; Brownlie, Bevan E W; Frampton, Chris M; Turner, John G

2011-02-01

Individuals with endogenous subclinical thyrotoxicosis (SCT) may subsequently require treatment for overt disease. We aimed to evaluate the frequency of progression to hyperthyroidism and factors influencing this outcome. This is a retrospective analysis of outcome in 96 consecutive patients (aged 16-91 years) diagnosed with SCT over a 6-year period. Individuals with secondary causes of TSH suppression were excluded. Mean follow-up was 3·8 years. The significance of age, gender, family history of thyrotoxicosis, symptoms at presentation, thyroid nodule(s) on clinical examination, entry TSH level, antithyroid antibody status and (99m) Tc pertechnetate thyroid imaging results on subsequent development of overt thyrotoxicosis was assessed. Progression to overt thyrotoxicosis was seen in 8% at 1 year, 16% at 2 years, 21% at 3 years and 26% at 5 years. Multivariate analysis determined that diagnosis as determined by scintiscan to be the only independent predictor of outcome (P = 0·003) with the cumulative percentage requiring therapy at 5 years being 9% for subclinical Graves' disease, 21% for multinodular goitre and 61% for the autonomous nodule subgroup. Progression of SCT to overt hyperthyroidism occurred at a rate of 5-8% per year with disease aetiology, as determined by thyroid scintigraphy, significantly influencing risk of progression. © 2011 Blackwell Publishing Ltd.

Examination of the association between lifestyle behavior changes and weight outcomes in preschoolers receiving treatment for obesity.

Science.gov (United States)

Kuhl, Elizabeth S; Clifford, Lisa M; Bandstra, Nancy F; Filigno, Stephanie S; Yeomans-Maldonado, Gloria; Rausch, Joseph R; Stark, Lori J

2014-01-01

Preschoolers (ages 2-5 years) have been significantly underrepresented in the obesity treatment outcome literature, despite estimates that 12.1% are already obese. As such, little is known about the most important intervention targets for weight management within this age group. The aims of this study were (a) to examine lifestyle behavior changes for 30 obese preschoolers participating in a weight-control intervention and (b) to explore which lifestyle behavior changes predicted changes in body mass index (BMI) z score. Preschooler height, weight, diet (three 24-hr recalls), physical activity (accelerometry), and television use (parent report) were measured at baseline and posttreatment (6 months). A linear regression was conducted to examine pre- to posttreatment changes in diet (i.e., intake of calories, sugar-sweetened beverages, fruits and vegetables, and sweet and salty snacks) and activity (i.e., moderate-to-vigorous activity and television use) behaviors on changes in BMI z score. Despite significant reductions in sugar-sweetened beverage intake and television use, and increases in fruit and vegetable intake, only reductions in absolute caloric intake significantly predicted reductions in BMI z score. Our findings suggest that attaining healthy caloric goals may be the most important component of weight-control interventions for preschoolers. Future research using innovative methodologies, such as the Multiphase Optimization Strategy, may be helpful to prospectively identifying the lifestyle behavior changes that are most effective in helping families to achieve healthy weight outcomes for preschoolers and thereby improve intervention efficiency and decrease treatment burden for families. 2014 APA, all rights reserved

Using GIS Mapping to Target Public Health Interventions: Examining Birth Outcomes Across GIS Techniques.

Science.gov (United States)

MacQuillan, E L; Curtis, A B; Baker, K M; Paul, R; Back, Y O

2017-08-01

With advances in spatial analysis techniques, there has been a trend in recent public health research to assess the contribution of area-level factors to health disparity for a number of outcomes, including births. Although it is widely accepted that health disparity is best addressed by targeted, evidence-based and data-driven community efforts, and despite national and local focus in the U.S. to reduce infant mortality and improve maternal-child health, there is little work exploring how choice of scale and specific GIS visualization technique may alter the perception of analyses focused on health disparity in birth outcomes. Retrospective cohort study. Spatial analysis of individual-level vital records data for low birthweight and preterm births born to black women from 2007 to 2012 in one mid-sized Midwest city using different geographic information systems (GIS) visualization techniques [geocoded address records were aggregated at two levels of scale and additionally mapped using kernel density estimation (KDE)]. GIS analyses in this study support our hypothesis that choice of geographic scale (neighborhood or census tract) for aggregated birth data can alter programmatic decision-making. Results indicate that the relative merits of aggregated visualization or the use of KDE technique depend on the scale of intervention. The KDE map proved useful in targeting specific areas for interventions in cities with smaller populations and larger census tracts, where they allow for greater specificity in identifying intervention areas. When public health programmers seek to inform intervention placement in highly populated areas, however, aggregated data at the census tract level may be preferred, since it requires lower investments in terms of time and cartographic skill and, unlike neighborhood, census tracts are standardized in that they become smaller as the population density of an area increases.

Trichotillomania: the impact of treatment history on the outcome of an Internet-based intervention.

Science.gov (United States)

Weidt, Steffi; Bruehl, Annette Beatrix; Delsignore, Aba; Zai, Gwyneth; Kuenburg, Alexa; Klaghofer, Richard; Rufer, Michael

2017-01-01

Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention. We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire. Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL) was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms ( P =0.002). Treatment history demonstrated no impact on the outcome of Internet-based interventions. Results demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders.

Clinical outcomes of interactive, intensive and individual (3i) play therapy for children with ASD: a two-year follow-up study.

Science.gov (United States)

Tilmont Pittala, Elodie; Saint-Georges-Chaumet, Yann; Favrot, Claire; Tanet, Antoine; Cohen, David; Saint-Georges, Catherine

2018-05-12

The outcomes of psycho-educational interventions for Autism Spectrum Disorders (ASDs) comorbid with severe to moderate intellectual disability (ID) are insufficiently documented. In this prospective study, we examined a developmental individual, interactive and intensive approach, called the '3i method', which is based on play therapy. Twenty DSM-IV-TR ASD subjects (mean chronological age 63.8 ± 37.8 months; mean developmental age 19.5 ± 6.6 months) were included and followed the 3i method for 24 months. Developmental and behavioural skills were assessed at baseline and after 24 months using the VABS, PEP-R and Nadel Imitation scale. Autism severity was evaluated using the Child Autism Rating Scale (CARS) and the Autism Diagnostic Interview (ADI-R). After 2 years of the 3i method, our 3 primary outcome variables significantly increased (VABS developmental age of socialization increased by 83%, age of communication by 34%, and Nadel Imitation score by 53%). Almost all VABS and PEP-R domains significantly improved. Additionally, increases in the VABS socialization score were positively correlated with the total number of treatment hours and CARS score; all ADI-R areas significantly decreased; and diagnoses had changed in 47.5% of the subjects (37% for PDD-NOS and even 10.5% for ID without PDD). Children who followed the 3i method for 2 years had significantly improved behavioural and developmental skills and showed a clear decrease in autism severity. These results suggest that the 3i method may be useful for autistic children by improving their daily interactions with their social environment. was retrospectively registered on May 20th, 2014 by the French Agency for drug and health (ANSM) under number ID-RCB 2014-A00542-45, reference: B148558-31.

An experiment on individual ‘parochial altruism’ revealing no connection between individual ‘altruism’ and individual ‘parochialism’

Directory of Open Access Journals (Sweden)

Shaun eHargreaves Heap

2015-08-01

Full Text Available Is parochial altruism an attribute of individual behaviour? This is the question we address with an experiment. We examine whether the individual pro-sociality that is revealed in the public goods and trust games when interacting with fellow group members helps predict individual parochialism, as measured by the in-group bias (i.e., the difference in these games in pro-sociality when interacting with own group members as compared with members of another group. We find that it is not. An examination of the Big 5 personality predictors of each behaviour reinforces this result: they are different. In short, knowing how ‘nice’ individuals are with respect to fellow group members does not help predict their parochialism.

Seeing Green: Mere Exposure to Money Triggers a Business Decision Frame and Unethical Outcomes

Science.gov (United States)

Kouchaki, Maryam; Smith-Crowe, Kristin; Brief, Arthur P.; Sousa, Carlos

2013-01-01

Can mere exposure to money corrupt? In four studies, we examined the likelihood of unethical outcomes when the construct of money was activated through the use of priming techniques. The results of Study 1 demonstrated that individuals primed with money were more likely to demonstrate unethical intentions than those in the control group. In Study…

Individual and community factors associated with geographic clusters of poor HIV care retention and poor viral suppression.

Science.gov (United States)

Eberhart, Michael G; Yehia, Baligh R; Hillier, Amy; Voytek, Chelsea D; Fiore, Danielle J; Blank, Michael; Frank, Ian; Metzger, David S; Brady, Kathleen A

2015-05-01

Previous analyses identified specific geographic areas in Philadelphia (hotspots) associated with negative outcomes along the HIV care continuum. We examined individual and community factors associated with residing in these hotspots. Retrospective cohort of 1404 persons newly diagnosed with HIV in 2008-2009 followed for 24 months after linkage to care. Multivariable regression examined associations between individual (age, sex, race/ethnicity, HIV transmission risk, and insurance status) and community (economic deprivation, distance to care, access to public transit, and access to pharmacy services) factors and the outcomes: residence in a hotspot associated with poor retention-in-care and residence in a hotspot associated with poor viral suppression. In total, 24.4% and 13.7% of persons resided in hotspots associated with poor retention and poor viral suppression, respectively. For persons residing in poor retention hotspots, 28.3% were retained in care compared with 40.4% of those residing outside hotspots (P care, and longer distance to pharmacies. Factors significantly associated with residence in poor viral suppression hotspots included female sex, higher economic deprivation, and shorter distance to pharmacies. Individual and community-level associations with geographic hotspots may inform both content and delivery strategies for interventions designed to improve retention-in-care and viral suppression.

Negative radiographic examinations: Evaluation of risks from exposure; Examenes radiograficos negativos evaluacion de los riesgos por su exposicion

Energy Technology Data Exchange (ETDEWEB)

Frometa Suarez, I; Jerez Vegueria, S F [Departamento Higiene de las Radiociones, Inst. de Medicina del Trabajo, La Habana (Cuba)

1997-11-01

The individual dose of radiation per radiological diagnosis is decreasing, which is an important contribution for the number of exposed population. This is a result of a completed study presented by the Manuel Fajardo Surgery Clinic of the Municipality of Havana, which evaluated the behaviour of the negative radiological examinations and their contribution to the collective dose as well as the associated detriment. 486 cases with radiographic examinations are reported over a period of four months. The information on individual cases is classified by type of radiographic examination and whether the outcome of the examination was positive or negative, the absorbed doses per organ and irradiated tissue, dose equivalent, collective and effective doses. The probability of the occurrence of a fatal cancer and associated genetic damage due to the examinations is also considered. 41% of the examinations performed were negative, with a collective dose of 11.35 manSv and 52.9 % of the total doses contributed for all the radiological examinations of the population studied. 7 refs, 3 tabs.

Experience affects the outcome of agonistic contests without affecting the selective advantage of size.

Science.gov (United States)

Kasumovic, Michael M; Elias, Damian O; Punzalan, David; Mason, Andrew C; Andrade, Maydianne C B

2009-06-01

In the field, phenotypic determinants of competitive success are not always absolute. For example, contest experience may alter future competitive performance. As future contests are not determined solely on phenotypic attributes, prior experience could also potentially alter phenotype-fitness associations. In this study, we examined the influence of single and multiple experiences on contest outcomes in the jumping spider Phidippus clarus. We also examined whether phenotype-fitness associations altered as individuals gained more experience. Using both size-matched contests and a tournament design, we found that both winning and losing experience affected future contest success; males with prior winning experience were more likely to win subsequent contests. Although experience was a significant determinant of success in future contests, male weight was approximately 1.3 times more important than experience in predicting contest outcomes. Despite the importance of experience in determining contest outcomes, patterns of selection did not change between rounds. Overall, our results show that experience can be an important determinant in contest outcomes, even in short-lived invertebrates, and that experience alone is unlikely to alter phenotype-fitness associations.

Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

Science.gov (United States)

McDonald, Furman S; Zeger, Scott L; Kolars, Joseph C

2008-07-01

Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies. To examine associations of previous standardized test scores on subsequent standardized test scores. Retrospective cohort study. One hundred ninety-five internal medicine residents. Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores. In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29). No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.

Waging a Living: Career Development and Long-Term Employment Outcomes for Young Adults with Disabilities

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Lindstrom, Lauren; Doren, Bonnie; Miesch, Jennifer

2011-01-01

Youth with disabilities face many barriers in making the transition from high school to stable long-term employment. Researchers used case study methodology to examine the career development process and postschool employment outcomes for a sample of individuals with disabilities who were working in living wage occupations 7 to 10 years after…

Hope in Adolescent Careers: Mediating Effects of Work Motivation on Career Outcomes in Swiss Apprentices

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Valero, Domingo; Hirschi, Andreas; Strauss, Karoline

2015-01-01

Being hopeful is critical for individuals who are engaged in vocational pursuits. However, the empirical research examining how and why hope is related to work and career outcomes remains sparse. We evaluate a model that proposes that dispositional hope affects job performance and turnover intentions through increased work motivation in terms of…

Individual-level factors related to better mental health outcomes following child maltreatment among adolescents.

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Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Fortier, Janique; Sareen, Jitender; MacMillan, Harriet L; Boyle, Michael H; Afifi, Tracie O

2018-05-01

Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

The effectiveness and safety of antifibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis.

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Ker, Katharine; Prieto-Merino, David; Sprigg, Nikola; Mahmood, Abda; Bath, Philip; Kang Law, Zhe; Flaherty, Katie; Roberts, Ian

2017-01-01

Introduction : The Antifibrinolytic Trialists Collaboration aims to increase knowledge about the effectiveness and safety of antifibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials. This article presents the statistical analysis plan for an IPD meta-analysis of the effects of antifibrinolytics for acute intracranial haemorrhage. Methods : The protocol for the IPD meta-analysis has been registered with PROSPERO (CRD42016052155). We will conduct an individual patient data meta-analysis of randomised controlled trials with 1000 patients or more assessing the effects of antifibrinolytics in acute intracranial haemorrhage. We will assess the effect on two co-primary outcomes: 1) death in hospital at end of trial follow-up, and 2) death in hospital or dependency at end of trial follow-up. The co-primary outcomes will be limited to patients treated within three hours of injury or stroke onset. We will report treatment effects using odds ratios and 95% confidence intervals. We use logistic regression models to examine how the effect of antifibrinolytics vary by time to treatment, severity of intracranial bleeding, and age. We will also examine the effect of antifibrinolytics on secondary outcomes including death, dependency, vascular occlusive events, seizures, and neurological outcomes. Secondary outcomes will be assessed in all patients irrespective of time of treatment. All analyses will be conducted on an intention-to-treat basis. Conclusions : This IPD meta-analysis will examine important clinical questions about the effects of antifibrinolytic treatment in patients with intracranial haemorrhage that cannot be answered using aggregate data. With IPD we can examine how effects vary by time to treatment, bleeding severity, and age, to gain better understanding of the balance of benefit and harms on which to base recommendations for practice.

Vocational rehabilitation services and employment outcomes for adults with cerebral palsy in the United States.

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Huang, I-Chun; Holzbauer, Jerome J; Lee, Eun-Jeong; Chronister, Julie; Chan, Fong; O'Neil, John

2013-11-01

The aim of this study was to examine the relationship between vocational rehabilitation services provided and work outcomes among people with cerebral palsy (CP), taking in to account demographic characteristics. From the US Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) database, data from 3162 individuals with CP (1820 males [57.6%] and 1342 females [42.4% age range 16-54 y) whose cases were closed in 2009, were used in this study. A total of 1567 cases (49.6%) were closed with clients being categorized as 'successful employment' and 1595 cases (50.4%) were closed with clients being classified as unemployed. Multivariate logistic regression was used to examine the relationship between services provided and work outcomes with regard to demographic characteristics. Males aged between 26 and 54 years old with higher education attainment were more likely to be employed. Individuals receiving disability benefits were less likely to be employed. After controlling for the effect of demographic and work disincentive variables, five vocational rehabilitation services significantly predicted employment outcomes (pemployability, to address their much needed work adjustment skills, to establish independent living, and to eventually reach their full potential in participation in society. © 2013 Mac Keith Press.

Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety.

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Davies, Carolyn D; Niles, Andrea N; Pittig, Andre; Arch, Joanna J; Craske, Michelle G

2015-03-01

Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders. Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline. Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome. Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables. Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

The 2008-2009 Great Recession and employment outcomes among older workers.

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Axelrad, Hila; Sabbath, Erika L; Hawkins, Summer Sherburne

2018-03-01

This study examined whether economic changes related to the 2008-2009 Recession were associated with employment status and job quality indicators among older workers in Europe and Israel. Data were derived from 4917 respondents (16,090 observations both before and after the recession) from 13 countries who participated in the Survey of Health, Ageing and Retirement in Europe. Annual data on gross domestic product (GDP) per capita, life expectancy, and quarterly unemployment rates were assigned to employment assessments from 2004 to 2013. Using difference-in-differences models, we assessed the recession's implications on individual employment outcomes, while isolating cyclical variation within countries and individual changes over time. Among older workers, decreases in GDP were associated with an increase in the likelihood of being unemployed and a decrease in the likelihood of being retired. An increasing country-level unemployment rate had a significant effect on aspects of job quality: lower prospects for job advancement, lower job security, and higher job satisfaction. Economic recessions are thus negatively associated with employment outcomes for older workers. However, malleable policy-related factors such as longer tenure and improved general health can limit the negative employment and job quality outcomes following a recession.

Prospective impact of illness uncertainty on outcomes in chronic lung disease.

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Hoth, Karin F; Wamboldt, Frederick S; Strand, Matthew; Ford, Dee W; Sandhaus, Robert A; Strange, Charlie; Bekelman, David B; Holm, Kristen E

2013-11-01

To determine which aspect of illness uncertainty (i.e., ambiguity or complexity) has a stronger association with psychological and clinical outcomes over a 2-year period among individuals with a genetic subtype of chronic obstructive pulmonary disease (COPD). Ambiguity reflects uncertainty about physical cues and symptoms, and complexity reflects uncertainty about treatment and the medical system. Four-hundred and 7 individuals with alpha-1 antitrypsin deficiency-associated COPD completed questionnaires at baseline, 1- and 2-year follow-up. Uncertainty was measured using the Mishel Uncertainty in Illness Scale. Outcomes were measured using the Hospital Anxiety and Depression Scale, St. George's Respiratory Questionnaire, and MMRC Dyspnea Scale. Ambiguity and complexity were examined as predictors of depressive symptoms, anxiety, quality of life, and breathlessness using linear mixed models adjusting for demographic and health characteristics. Ambiguity was associated with more depressive symptoms (b = 0.09, SE = 0.02, p life (b = 0.57, SE = 0.10, p life, and breathlessness. Thus, ambiguity should be targeted in psychosocial interventions. Time since diagnosis did not affect the association between ambiguity and outcomes, suggesting that the impact of ambiguity is equally strong throughout the course of COPD.

Social inclusion of individuals with intellectual disabilities in the military.

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Werner, Shirli; Hochman, Yael

2017-06-01

Despite policies advocating the social inclusion of persons with disabilities in all settings that are a part of everyday life within society, individuals with intellectual disabilities (ID) are usually excluded from service in the military. This study examined the meaning of service in the military for individuals with ID from the perspective of various stakeholder groups. Semi-structured qualitative interviews were conducted with 31 individuals with ID, 36 relatives, and 28 commanders. The recent model for social inclusion developed by Simplican et al. (2015) served as the basis for analyses. Findings suggest a successful social inclusion process for individuals with ID, which resulted in them feeling as an integral part and as contributing members of the military unit and of society at large. Social inclusion in the military was described with reference to two overlapping and interacting domains of interpersonal relationships and community participation. The interaction between interpersonal relationships within the military and community participation has led to positive outcomes for soldiers with ID. Recommendations are provided for the continued inclusion of individuals with ID in the military and in other everyday settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Geospatial exposure to point-of-sale tobacco: real-time craving and smoking-cessation outcomes.

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Kirchner, Thomas R; Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Ganz, Ollie; Vallone, Donna M; Abrams, David B

2013-10-01

Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes. © 2013 American Journal of Preventive Medicine.

"Waiting on the words": procedures and outcomes of a drama class for individuals with aphasia.

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Cherney, Leora R; Oehring, Ann K; Whipple, Keith; Rubenstein, Ted

2011-08-01

Drama therapy offers an authentic medium through which people with aphasia can interact and share their experiences. We describe the rationale and procedures of a drama class, informed by the principles and practices of drama therapy, in which individuals with chronic aphasia conceptualized, wrote, and produced a play addressing their experiences of having, living with, and coping with the effects of aphasia. Sessions were cofacilitated by a speech-language pathologist and a drama therapist. We describe the drama activities and techniques in each of four distinct stages of a drama therapy process through which the group transitioned. We also summarize patient-reported outcomes of a representational group of seven participants. Subscales of the Burden of Stroke Scale and the Communication Confidence Rating Scale for Aphasia were administered before and after participation in the 18-week class. Means, standard deviations, and effect sizes were computed. Results indicated perceived improvements in both communication and mood. © Thieme Medical Publishers.

Peer-to-peer mentoring for individuals with early inflammatory arthritis: feasibility pilot.

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Sandhu, Sharron; Veinot, Paula; Embuldeniya, Gayathri; Brooks, Sydney; Sale, Joanna; Huang, Sicong; Zhao, Alex; Richards, Dawn; Bell, Mary J

2013-03-01

To examine the feasibility and potential benefits of early peer support to improve the health and quality of life of individuals with early inflammatory arthritis (EIA). Feasibility study using the 2008 Medical Research Council framework as a theoretical basis. A literature review, environmental scan, and interviews with patients, families and healthcare providers guided the development of peer mentor training sessions and a peer-to-peer mentoring programme. Peer mentors were trained and paired with a mentee to receive (face-to-face or telephone) support over 12 weeks. Two academic teaching hospitals in Toronto, Ontario, Canada. Nine pairs consisting of one peer mentor and one mentee were matched based on factors such as age and work status. Mentee outcomes of disease modifying antirheumatic drugs (DMARDs)/biological treatment use, self-efficacy, self-management, health-related quality of life, anxiety, coping efficacy, social support and disease activity were measured using validated tools. Descriptive statistics and effect sizes were calculated to determine clinically important (>0.3) changes. Peer mentor self-efficacy was assessed using a self-efficacy scale. Interviews conducted with participants examined acceptability and feasibility of procedures and outcome measures, as well as perspectives on the value of peer support for individuals with EIA. Themes were identified through constant comparison. Mentees experienced improvements in the overall arthritis impact on life, coping efficacy and social support (effect size >0.3). Mentees also perceived emotional, informational, appraisal and instrumental support. Mentors also reported benefits and learnt from mentees' fortitude and self-management skills. The training was well received by mentors. Their self-efficacy increased significantly after training completion. Participants' experience of peer support was informed by the unique relationship with their peer. All participants were unequivocal about the need for

Cognitive Remediation for Individuals with Psychosis in a Supported Education Setting: A Pilot Study

Directory of Open Access Journals (Sweden)

Sean A. Kidd

2012-01-01

Full Text Available Cognitive remediation (CR is a treatment approach that is being increasingly examined as a means through which the cognitive impacts of schizophrenia might be ameliorated. While CR has demonstrated good outcomes when paired with supported employment, little is known regarding how it might be integrated within supported education contexts. In this study CR was examined in a supported education context with 16 individuals with psychosis. The findings indicated that CR aligned well with the academic curriculum with very low attrition, was found useful by students, and showed similar pre-post differences on cognitive measures as those found in previous work.

Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder.

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Price, Matthew; Anderson, Page L

2012-06-01

Outcome expectancy, the extent that clients anticipate benefiting from therapy, is theorized to be an important predictor of treatment response for cognitive-behavioral therapy. However, there is a relatively small body of empirical research on outcome expectancy and the treatment of social anxiety disorder. This literature, which has examined the association mostly in group-based interventions, has yielded mixed findings. The current study sought to further evaluate the effect of outcome expectancy as a predictor of treatment response for public-speaking fears across both individual virtual reality and group-based cognitive-behavioral therapies. The findings supported outcome expectancy as a predictor of the rate of change in public-speaking anxiety during both individual virtual reality exposure therapy and group cognitive-behavioral therapy. Furthermore, there was no evidence to suggest that the impact of outcome expectancy differed across virtual reality or group treatments. PsycINFO Database Record (c) 2012 APA, all rights reserved.

The impact of rape acknowledgment on survivor outcomes: The moderating effects of rape myth acceptance.

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Wilson, Laura C; Newins, Amie R; White, Susan W

2017-11-13

Little is known about how rape acknowledgment relates to posttrauma functioning; recent research suggests the effect may depend on additional factors. In the current study, the moderating effect of rape myth acceptance (RMA) on the relationships between rape acknowledgment and mental health outcomes was examined. A sample of 181 female rape survivors recruited from a university completed an online survey assessing RMA, rape acknowledgment, depression symptoms, and alcohol use. Generally, the results supported that RMA moderated the influence of rape acknowledgment on depression symptoms and average quantity per drinking episode, but not frequency of alcohol use. The findings demonstrated that when individuals endorsed high levels of RMA, acknowledged rape survivors reported worse outcomes than unacknowledged rape survivors. Among individuals low on RMA, unacknowledged rape survivors reported worse outcomes than acknowledged rape survivors. It is recommended that clinicians recognize the role of survivor beliefs, such as RMA, in the relationship between labeling sexual assault experiences and mental health consequences. © 2017 Wiley Periodicals, Inc.

Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

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Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

2016-01-01

Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in

[A school-level longitudinal study of clinical performance examination scores].

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Park, Jang Hee

2015-06-01

This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

Fertility outcome and information on fertility issues in individuals with different forms of disorders of sex development: findings from the dsd-LIFE study.

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Słowikowska-Hilczer, Jolanta; Hirschberg, Angelica Lindén; Claahsen-van der Grinten, Hedi; Reisch, Nicole; Bouvattier, Claire; Thyen, Ute; Cohen Kettenis, Peggy; Roehle, Robert; Köhler, Birgit; Nordenström, Anna

2017-11-01

To investigate fertility outcome in individuals with different forms of disorders of sex development (DSD), if assisted reproductive technology (ART) was used, and the patients' satisfaction with the information they had received. A cross-sectional multicenter study, dsd-LIFE. Not applicable. A total of 1,040 patients aged ≥16 years with different DSD diagnoses participated. A web-based questionnaire was filled out by all participants. The participants could chose to take part in somatic investigations including ultrasonography. Information on partner, number of children, ART, adoption and step-children, general health, presence of gonads and uterus, current education and economic situation, received information on fertility issues, and satisfaction with the information, was collected. In the total cohort, mean age 32 years, 33% lived with a partner, but only 14% reported having at least one child including 7% with ART, 4% adopted. Only 3.5% of the total cohort had been able to reproduce without ART, most frequently women with congenital adrenal hyperplasia, and only 0.7% of participants with other diagnoses. Of the participants, 72% had received information on fertility, but 17% were not satisfied with the information. Fertility outcome is significantly reduced in all types of DSD; however, fertility potential should be assessed individually. The satisfaction with how fertility problems have been discussed can be improved. The care of patients with DSD is complex, should be individualized, and new treatment possibilities incorporated. A close collaboration in multidisciplinary teams is therefore essential to improve the situation for individuals with DSD. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Do American and Korean Education Systems Converge? Tracking School Reform Policies and Outcomes in Korea and the USA

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Lee, Jaekyung; Park, Daekwon

2014-01-01

This study examines key school reform policies and outcomes of the USA and Korea over the past three decades from comparative perspectives. Since the two nations' unique educational problems brought divergent educational reform paths--standardization versus differentiation, high-stakes testing versus individualized assessment, and centralization…

Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review

Science.gov (United States)

Merlin, Jessica S.; Bulls, Hailey W.; Vucovich, Lee A.; Edelman, E. Jennifer; Starrels, Joanna L.

2016-01-01

Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients’ chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research. PMID:27267445

Individual and group based parenting programmes for improving psychosocial outcomes for teenage parents and their children

Science.gov (United States)

Barlow, Jane; Smailagic, Nadja; Bennett, Cathy; Huband, Nick; Jones, Hannah; Coren, Esther

2014-01-01

Background Parenting programmes are a potentially important means of supporting teenage parents and improving outcomes for their children, and parenting support is a priority across most Western countries. This review updates the previous version published in 2001. Objectives To examine the effectiveness of parenting programmes in improving psychosocial outcomes for teenage parents and developmental outcomes in their children. Search methods We searched to find new studies for this updated review in January 2008 and May 2010 in CENTRAL, MEDLINE, EMBASE, ASSIA, CINAHL, DARE, ERIC, PsycINFO, Sociological Abstracts and Social Science Citation Index. The National Research Register (NRR) was last searched in May 2005 and UK Clinical Research Network Portfolio Database in May 2010. Selection criteria Randomised controlled trials assessing short-term parenting interventions aimed specifically at teenage parents and a control group (no-treatment, waiting list or treatment-as-usual). Data collection and analysis We assessed the risk of bias in each study. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. Main results We included eight studies with 513 participants, providing a total of 47 comparisons of outcome between intervention and control conditions. Nineteen comparisons were statistically significant, all favouring the intervention group. We conducted nine meta-analyses using data from four studies in total (each meta-analysis included data from two studies). Four meta-analyses showed statistically significant findings favouring the intervention group for the following outcomes: parent responsiveness to the child post-intervention (SMD −0.91, 95% CI −1.52 to −0.30, P = 0.04); infant responsiveness to mother at follow-up (SMD −0.65, 95% CI −1.25 to −0.06, P = 0.03); and an overall measure of parent

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

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

2016-01-01

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

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

Science.gov (United States)

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

2016-04-01

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

A modified model of pharmacists' job stress: the role of organizational, extra-role, and individual factors on work-related outcomes.

Science.gov (United States)

Gaither, Caroline A; Kahaleh, Abir A; Doucette, William R; Mott, David A; Pederson, Craig A; Schommer, Jon C

2008-09-01

Understanding the effects of job stress continues to be a concern for health-care providers as workload and personnel needs increase. The overall objective of this study was to test a direct effects model of job stress that examines the characteristics of the organizational environment (interpersonal interactions, environmental aspects, the level of compensation and advancement, role stress, and availability of alternative jobs); extra-role factors (work-home conflict); job stress; individual factors (career commitment); and the work-related psychological outcomes of job satisfaction, organizational commitment, and job turnover intention. A cross-sectional mail survey was sent to a nationwide random sample of 4895 licensed pharmacists in the United States. Previously validated summated Likert-type scales measured each of the study variables. Data analyses included descriptive statistics, and exploratory and confirmatory factor analyses. Structural equation modeling was used to estimate the final model. A response rate of 46% was achieved. Psychometric analyses indicated acceptable reliability and validity. The study model fit the data well (CFI[comparative fit index] = 0.90, RMSEA[root mean square error of approximation] = 0.05). Organizational factors in the form of role overload (standardized beta = 0.45) and conflict (0.31) and ease of finding a job with better interpersonal characteristics (0.26) had the largest effects on job stress. Interpersonal characteristics were also one of the strongest predictors of job satisfaction (-0.61) and organizational commitment (-0.70). Work-home conflict directly affected job turnover intention (0.11) and career commitment (-0.16). Other significant, but sometimes, opposite direct effects were found. Job satisfaction and organizational commitment directly affected job turnover intention. Given the increased demand for pharmacy services, health-care organizations will benefit from increasing positive and reducing negative work

Responsiveness of the individual work performance questionnaire.

NARCIS (Netherlands)

Koopmans, L.; Coffeng, J.K.; Bernaards, C.M.; Boot, C.R.L.; Hildebrandt, V.H.; Vet, H.C.W. de; Beek, A.J. van der

2014-01-01

Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed.

Responsiveness of the individual work performance questionnaire

NARCIS (Netherlands)

Koopmans, L.; Coffeng, J.K.; Bernaards, C.M.; Boot, C.R.; Hildebrandt, V.H.; Vet, H.C. de; Beek, A.J. van der

2014-01-01

Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed.

Group Facial Width-to-Height Ratio Predicts Intergroup Negotiation Outcomes.

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Yang, Yu; Tang, Chen; Qu, Xiaofei; Wang, Chao; Denson, Thomas F

2018-01-01

Past studies have found that the facial width-to-height ratio (FWHR) is associated with a range of traits and behaviors that are possibly important to dyadic negotiations. However, it is unknown whether the FWHR would have an impact on intergroup negotiations, which happen frequently and often have higher stakes in the real world. To examine this question, in the current study, we randomly assigned 1,337 Chinese business executives into 288 groups and they completed a multi-issue negotiation exercise against each other. Results showed that groups with larger maximum individual FWHRs achieved objectively better negotiation outcomes. We conclude that groups containing individuals with relatively large FWHRs can claim more value in negotiations between groups.

Association of Individual and Neighborhood Factors with Home Food Availability: Evidence from the National Health and Nutrition Examination Survey.

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Chai, Weiwen; Fan, Jessie X; Wen, Ming

2018-05-01

Accumulating evidence suggests the important role of the home food environment in an individual's dietary intake. This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. The analysis included 8,975 participants aged 19 to 65 years. Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES' complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1

Developing a Learning Outcome-Based Question Examination Paper Tool for Universiti Putra Malaysia

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Hassan, Sa'adah; Admodisastro, Novia Indriaty; Kamaruddin, Azrina; Baharom, Salmi; Pa, Noraini Che

2016-01-01

Much attention is now given on producing quality graduates. Therefore, outcome-based education (OBE) in teaching and learning is now being implemented in Malaysia at all levels of education especially at higher education institutions. For implementing OBE, the design of curriculum and courses should be based on specified outcomes. Thus, the…

Monitoring of Individual Needs in Diabetes (MIND)-2

DEFF Research Database (Denmark)

Snoek, Frank J; Kersch, Nancy Y A; Eldrup, Ebbe

2012-01-01

To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences.......To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences....

Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

Directory of Open Access Journals (Sweden)

Cui-ling Li

Full Text Available OBJECTIVE: This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. METHODS: Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. RESULTS: A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM and Toxoplasma gondii (IgM, respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. CONCLUSION: Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of

Smoking and long-term labour market outcomes.

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Böckerman, Petri; Hyytinen, Ari; Kaprio, Jaakko

2015-07-01

To examine the long-term effects of smoking on labour market outcomes using twin data matched to register-based individual information on earnings. Twin data for Finnish men born 1945-1957 was used to remove the shared environmental and genetic factors. The results were subjected to extensive robustness testing. Lifetime cigarette consumption was measured by (cumulative) cigarette pack-years in early adulthood. The average of an individual's earnings (and, alternatively, taxable income) was measured over a subsequent 15-year period in later adulthood. Smokers have lower long-term income and earnings. For example, controlling for the shared environmental and genetic factors using the data on genetically identical twins, smoking is negatively associated with lifetime income (p=0.015). The negative association was also robust to the use of various covariates, such as education, health indicators and extraversion. Smoking is negatively related to long-term labour market outcomes. The provision of information about the indirect monetary costs of smoking may thus complement the policy efforts that aim at educating consumers about the health costs of smoking. 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.

Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination.

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Ostlie, Kristin; Franklin, Rosemary J; Skjeldal, Ola H; Skrondal, Anders; Magnus, Per

2011-10-01

To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining self-assessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. postal questionnaires and clinical examinations. Norwegian ULA population. Clinical examinations performed at 3 clinics. Questionnaires: population-based sample (n=224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (n=70; 83.3% of those invited). SURVEY inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Not applicable. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0-48.4); and in unilateral amputees, 22.1 (95% CI, 19.8-24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]=-5.40, P=.033; vs students: aB=-13.88, P=.022), increasing postamputation time (aB=-.27, P=.001), and Norwegian ethnicity (aB=-14.45, P<.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (P<.006) and with reduced shoulder abduction strength (P=.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aB=12.19, P=.001) and shoulder abduction (ipsilateral: aB=12.01, P=.005; contralateral: aB=28.82, P=.004

The impact of individual and organizational resources on nurse outcomes and intent to quit.

Science.gov (United States)

Brunetto, Yvonne; Rodwell, John; Shacklock, Kate; Farr-Wharton, Rod; Demir, Defne

2016-12-01

To examine the impact of an individual resource factor (psychological capital) and an organizational resource (management support) on nurses' intentions to quit. Nursing work can be stressful and as a consequence, nurses suffer greater stress and stress-related sickness, including depression, than the general population. Stress can be mitigated in the workplace depending on the availability of resources in the workplace. Resources can come from the organization or the individual themselves. The study is quantitative using a cross-sectional design. The study analysed data from 242 nurses working in five Australian hospitals in the one regional network during 2013. The predictors explained almost half of the variance of nurses' intent to quit. Psychological capital had the dual benefits of reducing nurses' perceptions of psychological distress and simultaneously increasing their job satisfaction. Psychological capital is an example of the personal resources a nurse brings to work. Nurse managers can now understand the impact of a new form of protective resources that influence the levels of strain felt by nurses. If nurses present with low psychological capital, then up-skilling nurses with these personal attributes will positively impact on their health and well-being and, in turn, enhance the care of patients. © 2016 John Wiley & Sons Ltd.

A friend request from dear old dad: associations between parent-child social networking and adolescent outcomes.

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Coyne, Sarah M; Padilla-Walker, Laura M; Day, Randal D; Harper, James; Stockdale, Laura

2014-01-01

This study examined the relationship between parent-child social networking, connection, and outcomes for adolescents. Participants (491 adolescents and their parents) completed a number of questionnaires on social networking use, feelings of connection, and behavioral outcomes. Social networking with parents was associated with increased connection between parents and adolescents. Feelings of connection then mediated the relationship between social networking with parents and behavioral outcomes, including higher prosocial behavior and lower relational aggression and internalizing behavior. Conversely, adolescent social networking use without parents was associated with negative outcomes, such as increased relational aggression, internalizing behaviors, delinquency, and decreased feelings of connection. These results indicate that although high levels of social networking use may be problematic for some individuals, social networking with parents may potentially strengthen parent-child relationships and then lead to positive outcomes for adolescents.

Exploring longitudinal course and treatment-baseline severity interactions in secondary outcomes of smoking cessation treatment in individuals with attention-deficit hyperactivity disorder.

Science.gov (United States)

Luo, Sean X; Wall, Melanie; Covey, Lirio; Hu, Mei-Chen; Scodes, Jennifer M; Levin, Frances R; Nunes, Edward V; Winhusen, Theresa

2018-01-25

A double blind, placebo-controlled randomized trial (NCT00253747) evaluating osmotic-release oral system methylphenidate (OROS-MPH) for smoking-cessation revealed a significant interaction effect in which participants with higher baseline ADHD severity had better abstinence outcomes with OROS-MPH while participants with lower baseline ADHD severity had worse outcomes. This current report examines secondary outcomes that might bear on the mechanism for this differential treatment effect. Longitudinal analyses were conducted to evaluate the effect of OROS-MPH on three secondary outcomes (ADHD symptom severity, nicotine craving, and withdrawal) in the total sample (N = 255, 56% Male), and in the high (N = 134) and low (N = 121) baseline ADHD severity groups. OROS-MPH significantly improved ADHD symptoms and nicotine withdrawal symptoms in the total sample, and exploratory analyses showed that in both higher and lower baseline severity groups, OROS-MPH statistically significantly improved these two outcomes. No effect on craving overall was detected, though exploratory analyses showed statistically significantly decreased craving in the high ADHD severity participants on OROS-MPH. No treatment by ADHD baseline severity interaction was detected for the outcomes. Methylphenidate improved secondary outcomes during smoking cessation independent of baseline ADHD severity, with no evident treatment-baseline severity interaction. Our results suggest divergent responses to smoking cessation treatment in the higher and lower severity groups cannot be explained by concordant divergence in craving, withdrawal and ADHD symptom severity, and alternative hypotheses may need to be identified.

The impact of nutritional supplement intake on diet behavior and obesity outcomes.

Directory of Open Access Journals (Sweden)

Sven Anders

Full Text Available After decades-old efforts to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are on the rise. In addition, a growing share of U.S. consumers proactively chooses nutritional supplements as an alternative preventative way of maintaining good health, a $25.5 billion industry in the United States. This paper investigates possible linkages between the economics of consumer supplement choices and the relationship to important dietary and health outcomes. We use National Health and Nutrition Examination Survey (NHANES data to estimate the impact of nutritional supplements intake on respondent's body weight outcomes, controlling for diet quality.: The focus of this article is to determine whether nutritional supplements takers differ from non-takers with regard to their health outcomes when controlling for differences in diet quality, based on individual Healthy Eating Index (HEI-2010 score. The analysis applies treatment effects estimators that account for the selection bias and endogeneity of self-reported behavior and diet-health outcomes. The analysis demonstrates a negative association between supplement intake and BMI but no significant effect on an individual's diet quality. Our findings suggest that individuals proactively invest into their health by taking nutritional supplements instead of improving diet quality through more nutritious food choices. Our results provide important contributions to the literature on a key food policy issue. Knowledge of the determinants of supplement demand in the context of strong diet-health trends should also be helpful to stakeholders in the U.S. produce sector in their competition over consumer market share.

Examining the associations between daily caregiving discontinuity and children's social-emotional outcomes.

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Le, Vi-Nhuan; Schaack, Diana; Setodji, Claude Messan

2015-05-01

Many child care centers temporarily move children and teachers in and out of their assigned classrooms throughout the day. Such practices create frequent discontinuity in children's experiences in child care, including discontinuity in their peer and teacher relationships. This study examined the prevalence and patterns of teacher and child movement between classrooms, the characteristics of teachers and children who were more likely to move between classrooms on a daily basis, and the associations between children's and teachers' rate of daily movement between classrooms with children's social-emotional outcomes. A moderate to high prevalence of child and teacher movement between classrooms was observed (29% and 83%, respectively). Children who were younger, considered solitary, and who had been enrolled in their classroom for shorter periods of time were less likely to transition between classrooms. Children's rate of movement was a positive predictor of teachers' perceived conflict with children in their care, and a negative predictor of teachers' perceived closeness. In addition, the more frequently teachers moved, the less children were inclined to indicate liking their teachers or centers. However, the more frequently children moved, the more likely children were to indicate liking their peers and for their peers to indicate liking them. Results are interpreted in light of additional research avenues that can inform sensible daily teacher continuity practices. (c) 2015 APA, all rights reserved).

Review of cytomegalovirus coinfection in HIV-infected individuals in Africa

DEFF Research Database (Denmark)

Grønborg, Helene Ladefoged; Jespersen, Sanne; Hønge, Bo Langhoff

2016-01-01

reported CMV manifestations in HIV‐infected individuals. Among patients with pulmonary symptoms, the prevalence of CMV pneumonitis varied from 20% to over 60%, whereas CMV was found in 0% to 14% of patients with gastrointestinal manifestations. Cytomegalovirus retinitis was found in 0% to 2.6% of examined......Background: Cytomegalovirus (CMV) infection among HIV‐infected individuals may cause end‐organ disease, which is an AIDS‐defining condition. Evidence from high‐income countries suggests that CMV may alter the outcome of HIV infection, other than causing end‐organ diseases. We reviewed literature...... on HIV and CMV coinfection in Africa. Methods: Systematic review of published studies on HIV and CMV coinfection in Africa using the PubMed database. Results: High CMV seroprevalence was found throughout Africa, exceeding 90% in most populations. Retinitis, pneumonia, and colitis were the most commonly...

Childhood family income and life outcomes in adulthood: findings from a 30-year longitudinal study in New Zealand.

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Gibb, Sheree J; Fergusson, David M; Horwood, L John

2012-06-01

The aims of this study were to use data gathered over the course of a 30-year longitudinal study to examine the linkages between economic circumstances in childhood and subsequent developmental outcomes spanning educational achievement; economic circumstances; crime; mental health; and teenage pregnancy. All of these outcomes have been linked with childhood economic conditions and it is frequently argued that reducing income inequalities will mitigate psychosocial risks of children reared in families facing economic hardship. Alternatively it may be suggested that the associations between childhood family economic circumstances and later outcomes are mediated by individual, family and social factors that are correlated with low family income and contribute to later outcomes. To examine these issues, data were drawn from a birth cohort of New Zealand children born in 1977 and followed to age 30. Declining childhood family income was associated with a range of negative outcomes in adulthood, including: lower educational achievement; poorer economic circumstances; higher rates of criminal offending; higher rates of mental health problems; and higher rates of teenage pregnancy. After covariate adjustment, childhood family income remained significantly associated with educational achievement and economic circumstances, but was no longer significantly associated with the mental health, offending and teenage pregnancy outcomes. These findings suggest that, after due allowance has been made for social, family and individual contextual factors, low family income during childhood is associated with a range of educational and economic disadvantages in adulthood but is not directly related to increased risks of crime, mental health problems or teen pregnancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

The influence of attention biases and adult attachment style on treatment outcome for adults with social anxiety disorder.

Science.gov (United States)

Byrow, Yulisha; Peters, Lorna

2017-08-01

Attention biases figure prominently in CBT models of social anxiety and are thought to maintain symptoms of social anxiety disorder (SAD). Studies have shown that individual differences in pre-treatment attention biases predict cognitive behavioural therapy (CBT) outcome. However, these findings have been inconsistent as to whether vigilance towards threat predicts better or poorer treatment outcome. Adult attachment style is an individual characteristic that may influence the relationship between attention bias and SAD. This study investigates the relationship between attention biases and CBT treatment outcome for SAD. Furthermore, we examined the influence of adult attachment style on this relationship. Participants with a primary diagnosis of SAD completed a passive viewing (measuring vigilance towards threat) and a novel difficulty to disengage (measuring difficulty to disengage attention) eye-tracking task prior to attending 12 CBT group sessions targeting SAD. Symptom severity was measured at pre- and post-treatment. Regression analyses were conducted on a sample of 50 participants. Greater vigilance for threat than avoidance of threat at pre-treatment predicted poorer treatment outcomes. Greater difficulty disengaging from happy faces, compared to neutral faces, predicted poorer treatment outcomes. Attachment style did not moderate these relationships. The associations between attention biases and specific components of CBT treatment were not examined. The novel findings regarding difficulty to disengage attention require replication. The findings have implications for the theoretical models of SAD and for the treatment of SAD. Copyright © 2017 Elsevier B.V. All rights reserved.

Microcredit participation and nutrition outcomes among women in Peru.

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Hamad, Rita; Fernald, Lia C H

2012-06-01

Microcredit services--the awarding of small loans to individuals who are too poor to take advantage of traditional financial services--are an increasingly popular scheme for poverty alleviation. Several studies have examined the ability of microcredit programmes to influence the financial standing of borrowers, but only a few studies have examined whether the added household income improves health and nutritional outcomes among household members. This study examined the hypothesis that longer participation in microcredit services would be associated with better nutritional status in women. Cross-sectional data were obtained in February 2007 from 1593 female clients of a microcredit organisation in Peru. The primary predictor variable was length of time as a microcredit client measured in number of completed loan cycles (range 0 to 5.5 years, average loan size US$350). The outcome variables were age-adjusted body mass index (BMI), haemoglobin levels (g/dl) and food insecurity measured using the US household food security survey module. Extensive data on demographic and socioeconomic status were also collected. Longer microcredit participation was associated with higher BMI (β=0.05, p=0.06), higher haemoglobin levels (β=0.07, pmicrocredit participation has positive effects on the nutritional status of female clients. Further research should explore more definitive causal pathways through which these effects may occur and should examine the effects on other household members.

Smooth individual level covariates adjustment in disease mapping.

Science.gov (United States)

Huque, Md Hamidul; Anderson, Craig; Walton, Richard; Woolford, Samuel; Ryan, Louise

2018-05-01

Spatial models for disease mapping should ideally account for covariates measured both at individual and area levels. The newly available "indiCAR" model fits the popular conditional autoregresssive (CAR) model by accommodating both individual and group level covariates while adjusting for spatial correlation in the disease rates. This algorithm has been shown to be effective but assumes log-linear associations between individual level covariates and outcome. In many studies, the relationship between individual level covariates and the outcome may be non-log-linear, and methods to track such nonlinearity between individual level covariate and outcome in spatial regression modeling are not well developed. In this paper, we propose a new algorithm, smooth-indiCAR, to fit an extension to the popular conditional autoregresssive model that can accommodate both linear and nonlinear individual level covariate effects while adjusting for group level covariates and spatial correlation in the disease rates. In this formulation, the effect of a continuous individual level covariate is accommodated via penalized splines. We describe a two-step estimation procedure to obtain reliable estimates of individual and group level covariate effects where both individual and group level covariate effects are estimated separately. This distributed computing framework enhances its application in the Big Data domain with a large number of individual/group level covariates. We evaluate the performance of smooth-indiCAR through simulation. Our results indicate that the smooth-indiCAR method provides reliable estimates of all regression and random effect parameters. We illustrate our proposed methodology with an analysis of data on neutropenia admissions in New South Wales (NSW), Australia. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Assessment of two culturally competent diabetes education methods: individual versus individual plus group education in Canadian Portuguese adults with type 2 diabetes.

Science.gov (United States)

Gucciardi, Enza; Demelo, Margaret; Lee, Ruth N; Grace, Sherry L

2007-04-01

To examine the impact of two culturally competent diabetes education methods, individual counselling and individual counselling in conjunction with group education, on nutrition adherence and glycemic control in Portuguese Canadian adults with type 2 diabetes over a three-month period. The Diabetes Education Centre is located in the urban multicultural city of Toronto, Ontario, Canada. We used a three-month randomized controlled trial design. Eligible Portuguese-speaking adults with type 2 diabetes were randomly assigned to receive either diabetes education counselling only (control group) or counselling in conjunction with group education (intervention group). Of the 61 patients who completed the study, 36 were in the counselling only and 25 in the counselling with group education intervention. We used a per-protocol analysis to examine the efficacy of the two educational approaches on nutrition adherence and glycemic control; paired t-tests to compare results within groups and analysis of covariance (ACOVA) to compare outcomes between groups adjusting for baseline measures. The Theory of Planned Behaviour was used to describe the behavioural mechanisms that influenced nutrition adherence. Attitudes, subjective norms, perceived behaviour control, and intentions towards nutrition adherence, self-reported nutrition adherence and glycemic control significantly improved in both groups, over the three-month study period. Yet, those receiving individual counselling with group education showed greater improvement in all measures with the exception of glycemic control, where no significant difference was found between the two groups at three months. Our study findings provide preliminary evidence that culturally competent group education in conjunction with individual counselling may be more efficacious in shaping eating behaviours than individual counselling alone for Canadian Portuguese adults with type 2 diabetes. However, larger longitudinal studies are needed to

A manual-based phenomenological art therapy for individuals diagnosed with moderate to severe depression (PATd): A randomized controlled study.

Science.gov (United States)

Blomdahl, Christina; Guregård, Suzanne; Rusner, Marie; Wijk, Helle

2018-05-14

This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Examining the life history of an individual from Solcor 3, San Pedro de Atacama: Combining bioarchaeology and archaeological chemistry

International Nuclear Information System (INIS)

Torres-Rouff, Cristina; Knudson, Kelly J

2007-01-01

Detailed life history information using multiple lines of evidence including the identification of geographic origins, health, and body use indicators, can be used to elucidate the complex process of acculturation in the San Pedro de Atacama oases of northern Chile during the Middle Horizon. This paper presents the results of bioarchaeological and archaeological chemical analyses of the skeletal remains of an adult male (tomb 50, catalog number 1948) from the cemetery of Solcor 3 (ca. AD 500-900). Strontium isotope ratios in human tooth enamel reveal information about where a person lived during their childhood, when enamel was being formed. Individual 1948 showed strontium isotope ratios decidedly outside the range of the local San Pedro de Atacama strontium isotope signature. Given these data implying that individual 1948 was originally from elsewhere, an examination of his health status, social role, and mortuary context provides insight into the treatment of foreigners in San Pedro de Atacama. Our data support the argument that individual 1948's foreign birth did not hinder his later assimilation into Atacameno society. He was buried in a local cemetery with a typical mortuary assemblage for a male of this time and no strong evidence of possible foreign origin. Skeletal indicators of diet and activity patterns do not distinguish individual 1948 from the local population, suggesting that his lifestyle was similar to that of other Atacamenos. Therefore, our analyses suggest that individual 1948's acculturation into Atacameno society during his adult life was nearly complete and he retained little to no indication of his probable foreign birth

From Drinking Group Norms to Individual Drinking Consequences: A Moderated Mediation Model Examining the Role of Members' Status, Identification with the Group and with Emerging Adulthood.

Science.gov (United States)

Dumas, Tara M; Davis, Jordan P; Maxwell-Smith, Matthew A; Bell, Angelica

2018-07-03

Emerging adults consume alcohol most often with their peer drinking groups. Yet, little is known about the role of drinking group norms on individual members' drinking consequences, nor about the mechanisms that underlie this association. We examined the indirect relationship between drinking group descriptive norms (perceived frequency of group heavy episodic drinking; HED) and individual drinking consequences via individual HED. We also examined key moderators, including the extent to which individuals occupied high status positions within their drinking groups, the strength of their identification with the group, and the degree to which they identified with emerging adulthood, a developmental period associated with heightened alcohol consumption. Participants were 280 and 340 (replication study) emerging adults (18-29 years) who were recruited via an online crowdsourcing site to complete a survey. Across studies, higher status was associated with more individual HED and drinking consequences. Further, group identification and identification with emerging adulthood strengthened the relation between group and individual HED. Finally, the indirect relation between group HED and individual drinking consequences was significant and stronger for individuals who identified more with their drinking groups and with emerging adulthood. Conclusions/Importance: Findings contribute to a more nuanced understanding of the impact of descriptive peer norms on heavy drinking and related consequences in emerging adulthood and help identify drinking group members most at risk for internalizing descriptive group norms for HED. Key implications for prevention and intervention programming are discussed.

The Role of Individualism-Collectivism in the Individual Creative Process

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Yao, Xiang; Wang, Shuhong; Dang, Junhua; Wang, Lei

2012-01-01

This study is among the first to examine how individuals' cultural value orientations impact 2 separate stages of creativity: idea generation and idea implementation. A total of 247 Chinese employees completed questionnaires including individualism-collectivism culture orientation and their idea generation behavior. Supervisor ratings of idea…

Same-sex parenting and children's outcomes: A closer examination of the American psychological association's brief on lesbian and gay parenting.

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Marks, Loren

2012-07-01

In 2005, the American Psychological Association (APA) issued an official brief on lesbian and gay parenting. This brief included the assertion: "Not a single study has found children of lesbian or gay parents to be disadvantaged in any significant respect relative to children of heterosexual parents" (p. 15). The present article closely examines this assertion and the 59 published studies cited by the APA to support it. Seven central questions address: (1) homogeneous sampling, (2) absence of comparison groups, (3) comparison group characteristics, (4) contradictory data, (5) the limited scope of children's outcomes studied, (6) paucity of long-term outcome data, and (7) lack of APA-urged statistical power. The conclusion is that strong assertions, including those made by the APA, were not empirically warranted. Recommendations for future research are offered. Copyright © 2012 Elsevier Inc. All rights reserved.

Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records.

Science.gov (United States)

Ingram, Maia; Doubleday, Kevin; Bell, Melanie L; Lohr, Abby; Murrieta, Lucy; Velasco, Maria; Blackburn, John; Sabo, Samantha; Guernsey de Zapien, Jill; Carvajal, Scott C

2017-10-01

To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes. Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact. Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.

Longitudinal Associations between Physical Activity and Educational Outcomes.

Science.gov (United States)

Kari, Jaana T; Pehkonen, Jaakko; Hutri-Kähönen, Nina; Raitakari, Olli T; Tammelin, Tuija H

2017-11-01

This longitudinal study examined the role of leisure-time physical activity in academic achievement at the end of compulsory basic education and educational attainment in adulthood. The data were drawn from the ongoing longitudinal Cardiovascular Risk in Young Finns Study, which was combined with register-based data from Statistics Finland. The study consisted of children who were 12 yr (n = 1723, 49% boys) and 15 yr (n = 2445, 48% boys) of age at the time when physical activity was measured. The children were followed up until 2010, when their mean age was 40 yr. Physical activity was self-reported and included several measurements: overall leisure-time physical activity outside school hours, participation in sports club training sessions, and participation in sports competitions. Individuals' educational outcomes were measured with the self-reported grade point average at age 15 yr and register-based information on the years of completed postcompulsory education in adulthood. Ordinary least squares models and the instrumental variable approach were used to analyze the relationship between physical activity and educational outcomes. Physical activity in adolescence was positively associated with educational outcomes. Both the physical activity level at age 15 yr and an increase in the physical activity level between the ages of 12 and 15 yr were positively related to the grade point average at age 15 yr and the years of postcompulsory education in adulthood. The results were robust to the inclusion of several individual and family background factors, including health endowments, family income, and parents' education. The results provide evidence that physical activity in adolescence may not only predict academic success during compulsory basic education but also boost educational outcomes later in life.

From basic to applied research to improve outcomes for individuals who require augmentative and alternative communication: potential contributions of eye tracking research methods.

Science.gov (United States)

Light, Janice; McNaughton, David

2014-06-01

In order to improve outcomes for individuals who require AAC, there is an urgent need for research across the full spectrum--from basic research to investigate fundamental language and communication processes, to applied clinical research to test applications of this new knowledge in the real world. To date, there has been a notable lack of basic research in the AAC field to investigate the underlying cognitive, sensory perceptual, linguistic, and motor processes of individuals with complex communication needs. Eye tracking research technology provides a promising method for researchers to investigate some of the visual cognitive processes that underlie interaction via AAC. The eye tracking research technology automatically records the latency, duration, and sequence of visual fixations, providing key information on what elements attract the individual's attention (and which ones do not), for how long, and in what sequence. As illustrated by the papers in this special issue, this information can be used to improve the design of AAC systems, assessments, and interventions to better meet the needs of individuals with developmental and acquired disabilities who require AAC (e.g., individuals with autism spectrum disorders, Down syndrome, intellectual disabilities of unknown origin, aphasia).

Team Performance and Error Management in Chinese and American Simulated Flight Crews: The Role of Cultural and Individual Differences

Science.gov (United States)

Davis, Donald D.; Bryant, Janet L.; Tedrow, Lara; Liu, Ying; Selgrade, Katherine A.; Downey, Heather J.

2005-01-01

This report describes results of a study conducted for NASA-Langley Research Center. This study is part of a program of research conducted for NASA-LARC that has focused on identifying the influence of national culture on the performance of flight crews. We first reviewed the literature devoted to models of teamwork and team performance, crew resource management, error management, and cross-cultural psychology. Davis (1999) reported the results of this review and presented a model that depicted how national culture could influence teamwork and performance in flight crews. The second study in this research program examined accident investigations of foreign airlines in the United States conducted by the National Transportation Safety Board (NTSB). The ability of cross-cultural values to explain national differences in flight outcomes was examined. Cultural values were found to covary in a predicted way with national differences, but the absence of necessary data in the NTSB reports and limitations in the research method that was used prevented a clear understanding of the causal impact of cultural values. Moreover, individual differences such as personality traits were not examined in this study. Davis and Kuang (2001) report results of this second study. The research summarized in the current report extends this previous research by directly assessing cultural and individual differences among students from the United States and China who were trained to fly in a flight simulator using desktop computer workstations. The research design used in this study allowed delineation of the impact of national origin, cultural values, personality traits, cognitive style, shared mental model, and task workload on teamwork, error management and flight outcomes. We briefly review the literature that documents the importance of teamwork and error management and its impact on flight crew performance. We next examine teamwork and crew resource management training designed to improve

Phonetic imitation from an individual-difference perspective: subjective attitude, personality and "autistic" traits.

Science.gov (United States)

Yu, Alan C L; Abrego-Collier, Carissa; Sonderegger, Morgan

2013-01-01

Numerous studies have documented the phenomenon of phonetic imitation: the process by which the production patterns of an individual become more similar on some phonetic or acoustic dimension to those of her interlocutor. Though social factors have been suggested as a motivator for imitation, few studies has established a tight connection between language-external factors and a speaker's likelihood to imitate. The present study investigated the phenomenon of phonetic imitation using a within-subject design embedded in an individual-differences framework. Participants were administered a phonetic imitation task, which included two speech production tasks separated by a perceptual learning task, and a battery of measures assessing traits associated with Autism-Spectrum Condition, working memory, and personality. To examine the effects of subjective attitude on phonetic imitation, participants were randomly assigned to four experimental conditions, where the perceived sexual orientation of the narrator (homosexual vs. heterosexual) and the outcome (positive vs. negative) of the story depicted in the exposure materials differed. The extent of phonetic imitation by an individual is significantly modulated by the story outcome, as well as by the participant's subjective attitude toward the model talker, the participant's personality trait of openness and the autistic-like trait associated with attention switching.

Phonetic imitation from an individual-difference perspective: subjective attitude, personality and "autistic" traits.

Directory of Open Access Journals (Sweden)

Alan C L Yu

Full Text Available Numerous studies have documented the phenomenon of phonetic imitation: the process by which the production patterns of an individual become more similar on some phonetic or acoustic dimension to those of her interlocutor. Though social factors have been suggested as a motivator for imitation, few studies has established a tight connection between language-external factors and a speaker's likelihood to imitate. The present study investigated the phenomenon of phonetic imitation using a within-subject design embedded in an individual-differences framework. Participants were administered a phonetic imitation task, which included two speech production tasks separated by a perceptual learning task, and a battery of measures assessing traits associated with Autism-Spectrum Condition, working memory, and personality. To examine the effects of subjective attitude on phonetic imitation, participants were randomly assigned to four experimental conditions, where the perceived sexual orientation of the narrator (homosexual vs. heterosexual and the outcome (positive vs. negative of the story depicted in the exposure materials differed. The extent of phonetic imitation by an individual is significantly modulated by the story outcome, as well as by the participant's subjective attitude toward the model talker, the participant's personality trait of openness and the autistic-like trait associated with attention switching.

Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials

NARCIS (Netherlands)

Lees, Kennedy R.; Bluhmki, Erich; von Kummer, Rüdiger; Brott, Thomas G.; Toni, Danilo; Grotta, James C.; Albers, Gregory W.; Kaste, Markku; Marler, John R.; Hamilton, Scott A.; Tilley, Barbara C.; Davis, Stephen M.; Donnan, Geoffrey A.; Hacke, Werner; Allen, Kathryn; Mau, Jochen; Meier, Dieter; del Zoppo, Gregory; de Silva, D. A.; Butcher, K. S.; Parsons, M. W.; Barber, P. A.; Levi, C.; Bladin, C.; Byrnes, G.; Klingelhöfer, J.; Krauseneck, P.; Schneider, D.; Hielscher, A.N.; Büttner, Th; Hennen, G.; Marx, P.; Lücking, C. H.; Felgenhaner, K.; Hacke, W.; Müllges, W.; Krieter, G.; Schwartz, A.; Krämer, G.; Diener, H. C.; Busse, O.; Wiersbitzky, M.; Ferbert, A.; Druschky, K.-F.; Lechner, H.; Ladurner, G.; Schmutzhard, W.; Rogousslavsky, J.; Vignolo, A.; Regesta, G.; Re, G.; Pecorari, L.; Lagi, A.; Argentino, C.; Ferrari, G.; Mamoli, A.; Mironi, F.; Erilä, T.; Sivenius, I.; Murros, K.; Liukkonen, H.; Hedman, Ch; Muuronen, A.; Sotaniemi, K.; Thomassen, L.; Rosjo, O.; Brautaset, N.; Indredavik, B.; Sandset, P. M.; Petersson, J.; Radberg, H.; Térent, A.; Carlström, Ch; Kjällman, Lena; Overgaard, K.; Boysen, G.; Enevoldsen, E.; Munck, O.; St Jensen, T.; Campbell, M.; Hawkins, S. A.; Franke, C. L.; Vos, J.; Frenken, W. G. M.; Op de Coul, A. A. W.; Verslegers, W.; Cras, P.; Laloux, P.; Blecic, A.N.; Marchau, M.; Féve, J. -R.; Rancurel, G.; Weber, M.; Mahagne, M.-H.; Larrue, A.N.; Trouillas, A.N.; Blard, J. M.; Caussanel, A.N.; Chollet, A.N.; Orgogozo, J. M.; Arnoud, A.N.; Cunha, L.; Castillo, J.; Tejedor, D.; Chomorro, A.; Sancho, H.; Davalos, A.; Fieschi, Cesare; Verstraete, Marc; Lesaffre, Emmanuel; Feuerer, Werner; Sanset, P. M.; Wahlgren, N. G.; Boysen, Gudrun; Hijdra, Albert H. J.; Bes, André; Hennerici, Michael; Bozzao, Luigi; Manelfe, Calude; Peock, Klaus; Zeumer, Hermann; Lenzi, Gian-Luigi; Crimmins, D.; Donnan, G.; Davis, S.; Gerraty, R.; Hankey, G.; Niederkorn, K.; Brainin, M.; Deisenhammer, E.; Baumhackl, U.; Grisold, W.; Podreka, I.; Alf, C.; Sluga, E.; Brücke, B.; Kristoferitsch, W.; Magnussen, I.; Vorstrup, S.; Olesen, J.; Kaste, M.; Rissanen, A.; Sivenius, J.; Hedman, C.; Numminen, H.; Liukkonen, J.; Kolvisto, K.; Erila, T.; Caussanel, J. P.; Dumas, R.; Trouillas, P.; Feve, J.-R.; Amarenco, P.; Zuber, M.; Chollet, F.; Larrue, V.; Saudeau, D.; Villringer, A.; Buttner, T.; Heiss, W. D.; Gond, M.; Reichmann, H.; Klotz, J.; Prange, H.; Steiner, T.; Kaps, M.; Lowitzsch, K.; Tettenborn, B.; Hamann, G.; Klingelhofer, J.; Bogdahn, U.; Mullgers, W.; Bottacchi, E.; Cappelletti, C.; Solime, F.; Toso, V.; Ricevuti, G.; Stam, J.; de Keijzer, J. H. A.; Koudstaal, P.; de Kort, P. L. M.; Hammond-Tooke, G. D.; Timmings, P.; Thomassen, I.; Rygh, J.; Cunha, I.; Correia, C.; Rubio, F.; Chamorro, A.; Sabin, J. Alvarez; Vilata, J. L. Marti; Zarranz, J. J.; Diez-Tejedor, E.; Egido, A.; Mora, J. Vivancos; Delgado, G.; Gil-Peralta, A.; Lainez, J. M.; Mostacero, E.; Radberg, J.; Prantare, H.; Carlstrom, C.; Costulas, V.; Wahlgren, N.-G.; Malm, J.; Terent, A.; Lyrer, P.; Bogousslavsky, J.; Hawkins, S.; Campbell, M. J.; Ford, G. A.; Mendelow, A. D.; Davalos, Antoni; Donnan, Geoffrey; Larrue, Vincent; Poeck, Klaus; Asplund, Kjell; Lenzi, Gian Luigi; Marler, John; Martinez-Vila, Eduardo; del Zoppo, Gregory J.; Dávalos, A.; von Kummer, R.; Toni, D.; Wahlgren, N.; Lees, K. R.; Lesaffre, E.; Bastianello, S.; Wardlaw, J. M.; Peyrieux, J.-C.; Sauce, C.; Medeghri, Z.; Mazenc, R.; Machnig, T.; Bluhmki, E.; Aichner, F.; Eggers, C.; Gruber, F.; Noistering, G.; Willeit, J.; Vanhooren, G.; Blecic, S.; Bruneel, B.; Caekebeke, J.; Simons, P. J.; Thijs, V.; Bar, M.; Dvorakova, H.; Vaclavik, D.; Andersen, G.; Iversen, H. K.; Traberg-Kristensen, B.; Marttila, R.; Bouillat, J.; Ducrocq, X.; Giroud, M.; Jaillard, A.; Larrieu, J.-M.; Leys, D.; Magne, C.; Milhaud, D.; Sablot, D.; Berrouschot, J.; Faiss, J. H.; Glahn, J.; Görtler, M.; Grau, A.; Grond, M.; Haberl, R.; Hennerici, M.; Koch, H.; Marx, J.; Meves, S.; Meyding-Lamadé, U.; Ringleb, P.; Schwarz, A.; Sobesky, J.; Urban, P.; Karageorgiou, K.; Komnos, A.; Csányi, A.; Csiba, L.; Valikovics, A.; Agnelli, G.; Billo, G.; Bovi, P.; Comi, G.; Gigli, G.; Guidetti, D.; Inzitari, D.; Marcello, N.; Marini, C.; Orlandi, G.; Pratesi, M.; Rasura, M.; Semplicini, A.; Serrati, C.; Tassinari, T.; Brouwers, P. J. A. M.; Naess, H.; Kloster, R.; Czlonkowska, A.; Kuczyńska-Zardzewialy, A.; Nyka, W.; Opala, G.; Romanowicz, S.; Cruz, V.; Pinho e Melo, T.; Brozman, M.; Dvorak, M.; Garay, R.; Krastev, G.; Kurca, E.; Alvarez-Sabin, J.; Guerrero, M. del Mar Freijo; Herrero, J. A. E.; Leira, R.; Martí-Vilalta, J. L.; Vallejo, J. Masjuan; Millán, M.; Molina, C.; Segura, T.; Serena, J.; Danielsson, E.; Cederin, B.; von Zweigberg, E.; Welin, L.; Hungerbühler, H.-J.; Weder, B.; Jenkinson, D.; MacLeod, M. J.; MacWalter, R. S.; Markus, H. S.; Muir, K. W.; Sharma, A. K.; Walters, M. R.; Warburton, E. A.; Albakri, Erfan; Albers, Gregory; Alberts, Mark; Atkinson, Richard; Bell, Rodney; Jefferson, Thomas; Black, Sandra; Blumenfeld, Andrew; Brooks, William; Brott, Thomas; Bruno, Askiel; Buchan, Alastair; Bumgartner, James; Carpenter, David; Castellani, Daniel; Chaturvedi, Seemant; Clark, Wayne; Coccia, Craig; Cohen, Stanley; Comber, John; Coull, Bruce; Culebras, Antonio; Curfman, T.; Curtin, Jeffrey; Dayno, Jeffrey; DeMatteis, James; Desai, Hiren; Dietrich, Dennis; Dissin, Jonathan; Driscoll, Paul; Duke, Robert; Edelsohn, Lanny; Feinberg, William; Ford, Stephen; Gasecki, Andrew; Gilbert, Gordon; Gray, Lenora; Grayum, Brad; Grindal, Alan; Grotta, James; Hachinski, Vladimir; Hakim, Antoine; Hassan, Rizwan; Hess, David; Hidalgo, Andrea; Homer, Daniel; Horowitz, Deborah; Horowitz, Steven; Hsu, Chung; Hughes, Richard; Hurtig, Howard; Huang, Te-Long; Jacoby, Michael; Jhamandas, Jack; Karlsberg, Ronald; Kelley, Roger; Koller, Richard; Kirshner, Howard; Krieger, Derk; LaFranchise, Francis; LaMonte, Marian; Lebrun, Louise-Helene; Levine, Steven; Lyden, Partick; Madden, Kenneth; Mallenbaum, Sidney; Mandelbaum, Mark; Mattio, Thomas; Mirsen, Thomas; Morris, Dexter; Munschauer, Frederick; Murthy, Kolar; Newman, George; Pelligrino, Richard; Pettigrew, Creed; Raps, Eric; Rosa, Louis; Rowe, Vernon; Sauter, Michael; Scott, Phillip; Sergay, Steven; Sheppard, George; Shuaib, Ashfaq; Silliman, Scott; Simard, Denis; Simon, Roger; Sloan, Michael; Smith, Wade; Smith, Richard; Steel, J. Griffith; Stobbe, Gary; Strunk, Brian; Tabbaa, Mutaz; Tarrel, Ronald; Taylor, Lynne; Tolge, Celina; Turel, Anthony; Verro, Piero; Wilterdink, Janet; Wissman, Stanley; Wohlberg, Christopher; Brott, T.; Broderick, J.; Kothari, R.; O'Donoghue, M.; Barsan, W.; Tomsick, T.; Spilker, J.; Miller, R.; Sauerbeck, L.; Farrell, J.; Kelly, J.; Perkins, T.; McDonald, T.; Rorick, M.; Hickey, C.; Armitage, J.; Perry, C.; Thalinger, K.; Rhude, R.; Schill, J.; Becker, P. S.; Heath, R. S.; Adams, D.; Reed, R.; Klei, M.; Hughes, A.; Anthony, J.; Baudendistel, D.; Zadicoff, C.; Rymer, M.; Bettinger, I.; Laubinger, P.; Schmerler, M.; Meirose, G.; Lyden, P.; Rapp, K.; Babcock, T.; Daum, P.; Persona, D.; Brody, M.; Jackson, C.; Lewis, S.; Liss, J.; Mahdavi, Z.; Rothrock, J.; Tom, T.; Zweifler, R.; Dunford, J.; Zivin, J.; Kobayashi, R.; Kunin, J.; Licht, J.; Rowen, R.; Stein, D.; Grisolia, J.; Martin, F.; Chaplin, E.; Kaplitz, N.; Nelson, J.; Neuren, A.; Silver, D.; Chippendale, T.; Diamond, E.; Lobatz, M.; Murphy, D.; Rosenberg, D.; Ruel, T.; Sadoff, M.; Schim, J.; Schleimer, J.; Atkinson, R.; Wentworth, D.; Cummings, R.; Frink, R.; Heublein, P.; Grotta, J. C.; DeGraba, T.; Fisher, M.; Ramirez, A.; Hanson, S.; Morgenstern, L.; Sills, C.; Pasteur, W.; Yatsu, F.; Andrews, K.; Villar-Cordova, C.; Pepe, P.; Bratina, P.; Greenberg, L.; Rozek, S.; Simmons, K.; Kwiatkowski, T. G.; Horowitz, S. H.; Libman, R.; Kanner, R.; Silverman, R.; LaMantia, J.; Mealie, C.; Duarte, R.; Donnarumma, R.; Okola, M.; Cullin, V.; Mitchell, E.; Levine, S. R.; Lewandowski, C. A.; Tokarski, G.; Ramadan, N. M.; Mitsias, P.; Gorman, M.; Zarowitz, B.; Kokkinos, J.; Dayno, J.; Verro, P.; Gymnopoulos, C.; Dafer, R.; D'Olhaberriague, L.; Sawaya, K.; Daley, S.; Mitchell, M.; Frankel, M.; Mackay, B.; Barch, C.; Braimah, J.; Faherty, B.; MacDonald, J.; Sailor, S.; Cook, A.; Karp, H.; Nguyen, B.; Washington, J.; Weissman, J.; Williams, M.; Williamson, T.; Kozinn, M.; Hellwick, L.; Haley, E. C.; Bleck, T. P.; Cail, W. S.; Lindbeck, G. H.; Granner, M. A.; Wolf, S. S.; Gwynn, M. W.; Mettetal, R. W.; Chang, C. W. J.; Solenski, N. J.; Brock, D. G.; Ford, G. F.; Kongable, G. L.; Parks, K. N.; Wilkinson, S. S.; Davis, M. K.; Sheppard, G. L.; Zontine, D. W.; Gustin, K. H.; Crowe, N. M.; Massey, S. L.; Meyer, M.; Gaines, K.; Payne, A.; Bales, C.; Malcolm, J.; Barlow, R.; Wilson, M.; Cape, C.; Bertorini, T.; Misulis, K.; Paulsen, W.; Shepard, D.; Tilley, B. C.; Welch, K. M. A.; Fagan, S. C.; Lu, M.; Patel, S.; Masha, E.; Verter, J.; Boura, J.; Main, J.; Gordon, L.; Maddy, N.; Chociemski, T.; Windham, J.; Zadeh, H. Soltanian; Alves, W.; Keller, M. F.; Wenzel, J. R.; Raman, N.; Cantwell, L.; Warren, A.; Smith, K.; Bailey, E.; Welch, C.; Marler, J. R.; Froehlich, J.; Breed, J.; Easton, J. D.; Hallenbeck, J. F.; Lan, G.; Marsh, J. D.; Walker, M. D.; Davis, S. M.; Donnan, G. A.; Butcher, K.; Peeters, A.; Chalk, J. B.; Fink, J. N.; Kimber, T. E.; Schultz, D.; Hand, P. J.; Frayne, J.; Muir, K.; Tress, B. M.; Attia, J.; D'Este, C.; McNeil, J.; Burns, R.; Johnston, C.; Stark, R.; Desmond, P. M.; Christensen, S.; Ebinger, M.; Jackson, D.; Kimber, T.; Peeteis, A.; Fink, J.

2010-01-01

BACKGROUND: Early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischaemic stroke improves outcome. Previous analysis of combined data from individual patients suggested potential benefit beyond 3 h from stroke onset. We re-examined the effect of time to

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

Science.gov (United States)

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery.

Science.gov (United States)

Asher, Anthony L; Chotai, Silky; Devin, Clinton J; Speroff, Theodore; Harrell, Frank E; Nian, Hui; Dittus, Robert S; Mummaneni, Praveen V; Knightly, John J; Glassman, Steven D; Bydon, Mohamad; Archer, Kristin R; Foley, Kevin T; McGirt, Matthew J

2016-08-01

MCID at 3 and 12 months. The discordance rates of achieving or not achieving MCID for ODI were in the range of 19% to 27% for all diagnoses and treatments (decompression with and without fusion). The positive and negative predictive value of 3-months ODI to predict 12-month ODI was 86% and 60% for MCID and 82% and 67% for SCB. CONCLUSIONS Based on their findings, the authors conclude the following: 1) Predictive methods for functional outcome based on early patient experience (i.e., baseline and/or 3-month data) should be used to help evaluate the effectiveness of procedures in patient populations, rather than serving as a proxy for long-term individual patient experience. 2) Prospective longitudinal registries need to span at least 12 months to determine the effectiveness of spine care at the individual patient and practitioner level.

Exploring the relation between online case-based discussions and learning outcomes in dental education.

Science.gov (United States)

Koole, Sebastiaan; Vervaeke, Stijn; Cosyn, Jan; De Bruyn, Hugo

2014-11-01

Online case-based discussions, parallel to theoretical dental education, have been highly valued by students and supervisors. This study investigated the relation between variables of online group discussions and learning outcomes. At Ghent University in Belgium, undergraduate dental students (years two and three) are required to participate in online case-based discussion groups (five students/group) in conjunction with two theoretical courses on basic periodontics and related therapy. Each week, a patient case is discussed under supervision of a periodontist, who authored the case and performed the treatment. Each case includes treatment history and demand, intra- and extraoral images, and full diagnostic information with periodontal and radiographic status. For this retrospective study, data were obtained for all 252 students in forty-three discussion groups between 2009 and 2012. Spearman's rank correlations were calculated to investigate the relation among group dynamics (number of group posts and views), individual student contributions (number of individual posts, newly introduced elements, questions, and reactions to other posts), supervisors' interventions (number of posts and posed questions), and learning outcomes (examination result). The results showed that learning outcomes were significantly related to the number of student posts (Spearman's rho (ρ)=0.19), newly introduced elements (ρ=0.21), reactions to other posts (ρ=0.14), number of supervisors' interventions (ρ=0.12), and supervisors' questions (ρ=0.20). These results suggest that individual student contributions during online case-based discussions and the provided supervision were related to learning outcomes.

Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012

OpenAIRE

Hwang, Jongnam; Shon, Changwoo

2014-01-01

Objective To examine the relationship between socioeconomic status (SES) and type 2 diabetes using the Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012. Design A pooled sample cross-sectional study. Setting A nationally representative population survey data. Participants A total of 14 330 individuals who participated in the KNHANES 2010–2012 were included in our analysis. Primary outcome Prevalence of type 2 diabetes. Results The relationship between SES and type 2 d...

Change in Individual Chronotype Over a Lifetime: A Retrospective Study

Directory of Open Access Journals (Sweden)

Jung Hie Lee

2011-08-01

Full Text Available Background and Objective Sleep disturbances resulting from a mismatch between the sleep-wake schedule and an individual’s chronotype can influence work or school performance and numerous health outcomes. Individual chronotype can be determined by genetic factors, and is influenced by environmental factors which could change throughout life. We aimed to examine self-reported changes in chronotype during three different periods of life (childhood, teenage years, and adulthood. Methods Three hundred forty-three (age: 37.8 ± 11.6 years, range: 18–82; F: M = 214: 129 adult visitors to a National Museum in Korea were recruited for this study. The Korean version of the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ-K was administered and standard MEQ-K scores were used to categorize subjects as morning type (MT, evening type (ET, or neither type (NT. Binary logistic regression analyses were applied to examine the relationships of gender, current age, and childhood/teenager ME type with change in chronotype between childhood, teenage years, and adulthood. Results The ages, gender distribution, and years of education were different between the chronotype groups (p < 0.01. Individuals who reported childhood MT or ET had a lower probability of changing their chronotype between childhood and their teenage years compared with individuals reporting childhood NT (p < 0.0001, whereas individuals reporting teenage MT or ET had a higher probability (p < 0.0001. Furthermore, older individuals had a lower probability of reporting a chronotype change between childhood or teenage years and adulthood (p < 0.01. Conclusions Most individuals reported the same chronotype from childhood to their teenage years but a different chronotype between the teenage years and adulthood. Older age was associated with a lower probability of reporting a different chronotype during childhood or teenage years.

Are we armed with the right data? Pooled individual data review of biomarkers in people with severe upper limb impairment after stroke

Directory of Open Access Journals (Sweden)

Kathryn S Hayward, PhD

2017-01-01

Full Text Available To build an understanding of the neurobiology underpinning arm recovery in people with severe arm impairment due to stroke, we conducted a pooled individual data systematic review to: 1 characterize brain biomarkers; 2 determine relationship(s between biomarkers and motor outcome; and 3 establish relationship(s between biomarkers and motor recovery. Three electronic databases were searched up to October 2, 2015. Eligible studies included adults with severe arm impairment after stroke. Descriptive statistics were calculated to characterize brain biomarkers, and pooling of individual patient data was performed using mixed-effects linear regression to examine relationships between brain biomarkers and motor outcome and recovery. Thirty-eight articles including individual data from 372 people with severe arm impairment were analysed. The majority of individuals were in the chronic (>6 months phase post stroke (51% and had a subcortical stroke (49%. The presence of a motor evoked potential (indexed by transcranial magnetic stimulation was the only biomarker related to better motor outcome (p = 0.02. There was no relationship between motor outcome and stroke volume (cm3, location (cortical, subcortical, mixed or side (left vs. right, and corticospinal tract asymmetry index (extracted from diffusion weighted imaging. Only one study had longitudinal data, thus no data pooling was possible to address change over time (preventing our third objective. Based on the available evidence, motor evoked potentials at rest were the only biomarker that predicted motor outcome in individuals with severe arm impairment following stroke. Given that few biomarkers emerged, this review highlights the need to move beyond currently known biomarkers and identify new indices with sufficient variability and sensitivity to guide recovery models in individuals with severe motor impairments following stroke. PROSPERO: CRD42015026107.

Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia.

Science.gov (United States)

Roberts, Bayard; Murphy, Adrianna; Chikovani, Ivdity; Makhashvili, Nino; Patel, Vikram; McKee, Martin

2014-01-01

The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia. A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs) and former IDPs. Two alcohol use disorder outcomes were measured: (i) having at least hazardous alcohol use (AUDIT score ≥ 8); (ii) episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week). Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only). Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386), 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use). The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for stronger

Individual and community level risk-factors for alcohol use disorder among conflict-affected persons in Georgia.

Directory of Open Access Journals (Sweden)

Bayard Roberts

Full Text Available The evidence on alcohol use disorder among conflict-affected civilian populations remains extremely weak, despite a number of potential risk-factors. The aim of this study is to examine patterns of alcohol use disorder among conflict-affected persons in the Republic of Georgia.A cross-sectional survey of 3600 randomly selected internally displaced persons (IDPs and former IDPs. Two alcohol use disorder outcomes were measured: (i having at least hazardous alcohol use (AUDIT score ≥ 8; (ii episodic heavy drinking (consuming >60 grams of pure alcohol per drinking session at least once a week. Individual level demographic and socio-economic characteristics were also recorded, including mental disorders. Community level alcohol environment characteristics relating to alcohol availability, marketing and pricing were recorded in the respondents' communities and a factor analysis conducted to produce a summary alcohol environment factor score. Logistic regression analyses examined associations between individual and community level factors with the alcohol use disorder outcomes (among men only.Of the total sample, 71% of men and 16% of women were current drinkers. Of the current drinkers (N = 1386, 28% of men and 1% of women were classified as having at least hazardous alcohol use; and 12% of men and 2% of women as episodic heavy drinkers. Individual characteristics significantly associated with both outcomes were age and experiencing a serious injury, while cumulative trauma events and depression were also associated with having at least hazardous alcohol use. For the community level analysis, a one unit increase in the alcohol environment factor was associated with a 1.27 fold increase in episodic heavy drinking among men (no significant association with hazardous alcohol use.The findings suggest potential synergies for treatment responses for alcohol use disorder and depression among conflict-affected populations in Georgia, as well as the need for

Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries

DEFF Research Database (Denmark)

Aldridge, Robert W.; Story, Alistair; Hwang, Stephen W.

2018-01-01

, and observational studies that had morbidity and mortality outcomes, were published in English, from high-income countries, and were done in populations with a history of homelessness, imprisonment, sex work, or substance use disorder (excluding cannabis and alcohol use). Studies with only perinatal outcomes...... use disorders, sex workers, and imprisoned individuals. Methods: For this systematic review and meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library for studies published between Jan 1, 2005, and Oct 1, 2015. We included only systematic reviews, meta-analyses, interventional studies...... and studies of individuals with a specific health condition or those recruited from intensive care or high dependency hospital units were excluded. We screened studies using systematic review software and extracted data from published reports. Primary outcomes were measures of morbidity (prevalence...

Support Vector Machine Analysis of Functional Magnetic Resonance Imaging of Interoception Does Not Reliably Predict Individual Outcomes of Cognitive Behavioral Therapy in Panic Disorder with Agoraphobia

Directory of Open Access Journals (Sweden)

Benedikt Sundermann

2017-06-01

Full Text Available BackgroundThe approach to apply multivariate pattern analyses based on neuro imaging data for outcome prediction holds out the prospect to improve therapeutic decisions in mental disorders. Patients suffering from panic disorder with agoraphobia (PD/AG often exhibit an increased perception of bodily sensations. The purpose of this investigation was to assess whether multivariate classification applied to a functional magnetic resonance imaging (fMRI interoception paradigm can predict individual responses to cognitive behavioral therapy (CBT in PD/AG.MethodsThis analysis is based on pretreatment fMRI data during an interoceptive challenge from a multicenter trial of the German PANIC-NET. Patients with DSM-IV PD/AG were dichotomized as responders (n = 30 or non-responders (n = 29 based on the primary outcome (Hamilton Anxiety Scale Reduction ≥50% after 6 weeks of CBT (2 h/week. fMRI parametric maps were used as features for response classification with linear support vector machines (SVM with or without automated feature selection. Predictive accuracies were assessed using cross validation and permutation testing. The influence of methodological parameters and the predictive ability for specific interoception-related symptom reduction were further evaluated.ResultsSVM did not reach sufficient overall predictive accuracies (38.0–54.2% for anxiety reduction in the primary outcome. In the exploratory analyses, better accuracies (66.7% were achieved for predicting interoception-specific symptom relief as an alternative outcome domain. Subtle information regarding this alternative response criterion but not the primary outcome was revealed by post hoc univariate comparisons.ConclusionIn contrast to reports on other neurofunctional probes, SVM based on an interoception paradigm was not able to reliably predict individual response to CBT. Results speak against the clinical applicability of this technique.

The delinquency outcomes of boys with ADHD with and without comorbidity.

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Sibley, Margaret H; Pelham, William E; Molina, Brooke S G; Gnagy, Elizabeth M; Waschbusch, Daniel A; Biswas, Aparajita; MacLean, Michael G; Babinski, Dara E; Karch, Kathryn M

2011-01-01

This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5-12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M = 17.26, SD = 3.17). Participants were 288 males with childhood ADHD and 209 demographically similar males without ADHD who were recruited into the follow-up study. Delinquency information gathered yearly during the second through eighth follow-up provided a comprehensive history of juvenile delinquency for all participants. Four childhood diagnostic groups [ADHD-only (N = 47), ADHD + ODD (N = 135), ADHD + CD (N = 106), and comparison (N = 209)] were used to examine group differences on delinquency outcomes. Analyses were conducted across three dimensions of delinquency (i.e., severity, age of initiation, and variety). Individuals with childhood ADHD + CD displayed significantly worse delinquency outcomes than the other three groups, across almost all indices of offending. When compared to comparison participants, boys with ADHD-only and ADHD + ODD in childhood displayed earlier ages of delinquency initiation, a greater variety of offending, and higher prevalence of severe delinquency. These findings suggest that although childhood ADHD + CD creates the greatest risk for delinquency, boys with ADHD-only and ADHD + ODD also appear at a higher risk for later offending. The patterns of offending that emerged from the PALS are discussed in the context of the relationship between ADHD, comorbidity, and delinquency.

Interpersonal Attraction and Organizational Outcomes: A Field Examination.

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Ross, Jerry; Ferris, Kenneth R.

1981-01-01

A cross-sectional study of 306 male accountants and managers at two public accounting firms examined the relationship of physical attractiveness, attitude similarity, and social background to performance ratings and salaries. Results suggest that physical attractiveness leads to higher ratings and salaries but that attitudes and background have…

Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis.

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Chama-Chiliba, Chitalu M; Koch, Steven F

2015-02-01

We examine the individual- and community-level factors associated with the utilization of antenatal care, following the adoption of the focused antenatal care (FANC) approach in Zambia. Using the 2007 Zambia Demographic and Health Survey, linked with administrative and health facility census data, we specify two multilevel logistic models to assess the factors associated with (1) the inadequate use of antenatal care (ANC) (defined as three or fewer visits) and (2) the non-use of ANC in the first trimester of pregnancy. Although all women in the selected sample had at least one ANC visit, 40% did not have the minimum number required (four), whereas more than 80% of the initial check-ups did not occur in the first trimester. At the individual level, the woman's employment status, quality of ANC received and the husband's educational attainment are negatively associated, while parity, the household childcare burden and wealth are positively associated with inadequate utilization of ANC. Both individual- and community-level characteristics influence inadequate use and non-use of ANC in the first trimester; however, community-level factors are relatively stronger in rural areas. The results suggest that improving the content of care during ANC visits may foster adequate use of ANC and encourage early initiation of ANC visits. Furthermore, health promotion programmes need to further encourage male involvement in pregnant women's decision to seek ANC to encourage adequate use of services. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Relationship Between Self-Assessed Fidelity and Self-Reported Employment in the Individual Placement and Support Model of Supported Employment.

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Margolies, Paul J; Humensky, Jennifer L; Chiang, I-Chin; Covell, Nancy H; Jewell, Thomas C; Broadway-Wilson, Karen; Gregory, Raymond; Scannevin, Gary; Dixon, Lisa B

2018-05-01

A growing body of literature demonstrates that high-fidelity implementation of the individual placement and support (IPS) model of supported employment increases the chances of achieving desired outcomes. This study examined the relationship between IPS fidelity, as self-reported by program sites, and employment outcomes and determined whether this relationship was maintained over time. A total of 78 outpatient programs in New York State provided data on self-reported IPS fidelity and employment outcomes. Pearson correlations were used to determine the relationship between fidelity scores and competitive employment rates. A mixed-effects model examined the relationship between repeated fidelity and employment measures over time. A significant positive relationship was found between better self-reported IPS fidelity and greater employment. The relationship between IPS fidelity and employment was sustained over time (up to one year). Higher-fidelity implementation of the IPS model, as self-assessed by program sites, was associated with higher employment rates, which were sustained over time.

Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials

DEFF Research Database (Denmark)

Lees, Kennedy R; Bluhmki, Erich; von Kummer, Rüdiger

2010-01-01

Early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischaemic stroke improves outcome. Previous analysis of combined data from individual patients suggested potential benefit beyond 3 h from stroke onset. We re-examined the effect of time to treatment with i...

Income inequality, individual income, and mortality in Danish adults: analysis of pooled data from two cohort studies

DEFF Research Database (Denmark)

Osler, Merete; Prescott, Eva; Grønbaek, Morten

2002-01-01

) and individual mortality was examined with Cox proportional hazard analyses. SETTING: Two population studies conducted in Copenhagen, Denmark. PARTICIPANTS: 13 710 women and 12 018 men followed for a mean of 12.8 years. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: Age standardised mortality was highest...... (adjusted hazard ratio for men 0.51 (95% confidence interval 0.45 to 0.59) and for women 0.60 (0.54 to 0.68)). CONCLUSION: Area income inequality is not in itself associated with all cause mortality in this Danish population. Adjustment for individual risk factors makes the apparent effect disappear...... in the parishes with the least equal income distribution. After adjustment for individual risk factors, parish income inequality was not associated with mortality, whereas individual household income was. Thus, individuals in the highest income quarter had lower mortality than those in the lowest quarter...

Physical examination of swine.

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Masters, B J; Hamilton, M; Masters, P G

1992-07-01

Swine may be examined to evaluate a disease state or a lowered economic performance or as a herd health consultation. As much of the examination as possible should be performed without handling the animal. A thorough history, evaluation of herd records, environmental examination, and herd examination should be performed prior to the evaluation of an individual animal. All necessary equipment should be available when starting the individual examination. The animals is then restrained and examined, and necessary samples are taken. Post-mortem examinations or slaughter house evaluations are a very frequent part of a health examination on swine. All samples taken should be in accordance with the standards of the laboratory that you use. You should work closely with the laboratory to obtain the best results. Physical examination of swine can be rewarding for the veterinarian as well as the producer. The most important aspect to remember is to have enough information and the proper equipment available to handle the animals for the minimal amount of time to gain the maximum benefits. Vietnamese pot-bellied pigs are similar to domestic swine in terms of their diseases and health but are dissimilar in management; pot-bellied pigs are frequently brought to the veterinarian for individual examinations. History is the most valuable part of the examination, followed by observation. Pot-bellied pigs prefer to be held securely with a hand under the chin and rump. The examination is conducted similarly to the examination of any companion animal. Chemical restraint often is necessary for sampling or minor surgical procedures. Owners should be consulted prior to the use of any restraint. This will help win their approval and confidence when working on their pets. While performing the physical examination, look at the pig's overall health as well as specific breed characteristics. Try to stay abreast of swine vaccination recommendations; you may be consulted in this regard. Most

Individual Placement and Support in Spinal Cord Injury: A Longitudinal Observational Study of Employment Outcomes.

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Ottomanelli, Lisa; Goetz, Lance L; Barnett, Scott D; Njoh, Eni; Dixon, Thomas M; Holmes, Sally Ann; LePage, James P; Ota, Doug; Sabharwal, Sunil; White, Kevin T

2017-08-01

To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI). Longitudinal, observational multisite study of a single-arm, nonrandomized cohort. SCI centers in the Veterans Health Administration (n=7). Veterans with SCI (N=213) enrolled during an episode of either inpatient hospital care (24.4%) or outpatient care (75.6%). More than half the sample (59.2%) had a history of traumatic brain injury (TBI). IPS SE for 24 months. Competitive employment. Over the 24-month period, 92 of 213 IPS participants obtained competitive jobs for an overall employment rate of 43.2%. For the subsample of participants without TBI enrolled as outpatients (n=69), 36 obtained competitive jobs for an overall employment rate of 52.2%. Overall, employed participants averaged 38.2±29.7 weeks of employment, with an average time to first employment of 348.3±220.0 days. Nearly 25% of first jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI history enrolled as outpatients. Almost half of the veterans with SCI participating in the 24-month IPS program as part of their ongoing SCI care achieved competitive employment, consistent with their expressed preferences at the start of the study. Among a subsample of veterans without TBI history enrolled as outpatients, employment rates were >50%. Time to first employment was highly variable, but quite long in many instances. These findings support offering continued IPS services as part of ongoing SCI care to achieve positive employment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study

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Nabi, Hermann; Kivimäki, Mika; Batty, G. David; Shipley, Martin J.; Britton, Annie; Brunner, Eric J.; Vahtera, Jussi; Lemogne, Cédric; Elbaz, Alexis; Singh-Manoux, Archana

2013-01-01

International audience; Response to stress can vary greatly between individuals. However, it remains unknown whether perceived impact of stress on health is associated with adverse health outcomes. We examined whether individuals who report that stress adversely affects their health are at increased risk of coronary heart disease (CHD) compared with those who report that stress has no adverse health impact. Analyses are based on 7268 men and women (mean age: 49.5 years, interquartile range: 1...

Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation.

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Williams, Valerie J; Piva, Sara R; Irrgang, James J; Crossley, Chad; Fitzgerald, G Kelley

2012-08-01

Secondary analysis, pretreatment-posttreatment observational study. To compare the reliability and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Outcome Survey activities of daily living subscale (KOS-ADL), and the Lower Extremity Functional Scale (LEFS) in individuals with knee osteoarthritis (OA). The WOMAC is the current standard in patient-reported measures of function in patients with knee OA. The KOS-ADL and LEFS were designed for potential use in patients with knee OA. If the KOS-ADL and LEFS are to be considered viable alternatives to the WOMAC for measuring patient-reported function in individuals with knee OA, they should have measurement properties comparable to the WOMAC. It would also be important to determine whether either of these instruments may be superior to the WOMAC in terms of reliability or responsiveness in this population. Data from 168 subjects with knee OA, who participated in a rehabilitation program, were used in the analyses. Reliability and responsiveness of each outcome measure were estimated at follow-ups of 2, 6, and 12 months. Reliability was estimated by calculating the intraclass correlation coefficient (ICC2,1) for subjects who were unchanged in status from baseline at each follow-up time, based on a global rating of change score. To examine responsiveness, the standard error of the measurement, minimal detectable change, minimal clinically important difference, and the Guyatt responsiveness index were calculated for each outcome measure at each follow-up time. All 3 outcome measures demonstrated reasonable reliability and responsiveness to change. Reliability and responsiveness tended to decrease somewhat with increasing follow-up time. There were no substantial differences between outcome measures for reliability or any of the 3 measures of responsiveness at any follow-up time. The results do not indicate that one outcome measure is more reliable or responsive than

Moderators of smoking cessation outcomes in a randomized-controlled trial of varenicline versus placebo.

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Littlewood, Rae A; Claus, Eric D; Wilcox, Claire E; Mickey, Jessica; Arenella, Pamela B; Bryan, Angela D; Hutchison, Kent E

2017-12-01

Varenicline has gained a reputation as the optimal intervention for treatment resistant smokers, yet more than half of those who try it do not succeed. To better understand individual differences in the effectiveness of varenicline, this study evaluates the effectiveness of varenicline for smoking cessation in a double-blind, placebo-controlled, randomized clinical trial and examines the influence of psychological factors on treatment outcome. Two hundred five cigarette smokers interested in quitting were randomly assigned to 12 weeks of varenicline or placebo. Outcomes examined were CO-confirmed continuous abstinence for the past month, average number of cigarettes smoked per day, and 7-day point prevalence. Varenicline-treated participants were more likely than placebo to achieve continuous abstinence at the end of treatment (OR = 3.29; RR = 2.62), and 7-day point prevalence rates showed an effect of medication at each time point. Participants in both groups significantly reduced their smoking during the course of treatment and follow-up, and the medication by visit interaction was significant in the expected direction. Impulsivity and personality style emerged as moderators of the relationship between medication condition and treatment outcome. In addition to replicating efficacy results for varenicline versus placebo, the present study shows that the efficacy of pharmacotherapy is influenced by psychological factors. In an era where pharmacotherapy is often perceived as the "silver bullet," we are reminded that smoking cessation is a dynamic process and intervention must be adaptable to address individual differences.

Vocational interests assessed at the end of high school predict life outcomes assessed 10 years later over and above IQ and Big Five personality traits.

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Stoll, Gundula; Rieger, Sven; Lüdtke, Oliver; Nagengast, Benjamin; Trautwein, Ulrich; Roberts, Brent W

2017-07-01

Vocational interests are important aspects of personality that reflect individual differences in motives, goals, and personal strivings. It is therefore plausible that these characteristics have an impact on individuals' lives not only in terms of vocational outcomes, but also beyond the vocational domain. Yet the effects of vocational interests on various life outcomes have rarely been investigated. Using Holland's RIASEC taxonomy (Holland, 1997), which groups vocational interests into 6 broad domains, the present study examined whether vocational interests are significant predictors of life outcomes that show incremental validity over and above the Big Five personality traits. For this purpose, a cohort of German high school students (N = 3,023) was tracked over a period of 10 years after graduating from school. Linear and logistic regression analyses were used to examine the predictive validity of RIASEC interests and Big Five personality traits. Nine outcomes from the domains of work, relationships, and health were investigated. The results indicate that vocational interests are important predictors of life outcomes that show incremental validity over the Big Five personality traits. Vocational interests were significant predictors of 7 of the 9 investigated outcomes: full-time employment, gross income, unemployment, being married, having children, never having had a relationship, and perceived health status. For work and relationship outcomes, vocational interests were even stronger predictors than the Big Five personality traits. For health-related outcomes, the results favored the personality traits. Effects were similar across gender for all outcomes-except 2 relationship outcomes. Possible explanations for these effects are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Examination of the inventory of drug use consequences with individuals with serious and persistent mental illness and co-occurring substance use disorders.

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Bennett, Melanie E; Nidecker, Melissa; Strong Kinnaman, Joanna E; Li, Lan; Bellack, Alan S

2009-01-01

The Inventory of Drug Use Consequences (InDUC) ( [1] ) is a 50-item measure that evaluates lifetime and recent consequences of substance use. This study examined the psychometric properties of a modified version of the Inventory of Drug Use Consequences (InDUC-M) in individuals with serious and persistent mental illness (SPMI) and co-occurring substance use disorders (SUDs). We examined self-reported consequences in the sample, evaluated internal consistency, identified items for a brief form of the InDUC-M, and explored relationships with indicators of substance use severity. InDUC-M Lifetime and Recent subscales showed good internal consistency and were related to other measures of substance use and problems. A brief version of the InDUC-M Recent (SIP-M) showed excellent internal consistency and was highly correlated with both Lifetime and Recent subscales. The InDUC-M and the SIP-M performed well in individuals with SPMI and SUDs. Overall, these findings are a useful first step in determining the utility of the InDUC-M in people with SPMI and SUDs.

The likelihood of Latino women to seek help in response to interpersonalvictimization: An examination of individual, interpersonal and socioculturalinfluences

Directory of Open Access Journals (Sweden)

Chiara Sabina

2014-07-01

Full Text Available Help-seeking is a process that is influenced by individual, interpersonal, and sociocultural factors. Thecurrent study examined these influences on the likelihood of seeking help (police, pressing charges,medical services, social services, and informal help for interpersonal violence among a national sample ofLatino women. Women living in high-density Latino neighborhoods in the USA were interviewed by phonein their preferred language. Women reporting being, on average, between "somewhat likely" and "verylikely" to seek help should they experience interpersonal victimization. Sequential linear regression resultsindicated that individual (age, depression, interpersonal (having children, past victimization, andsociocultural factors (immigrant status, acculturation were associated with the self-reported likelihood ofseeking help for interpersonal violence. Having children was consistently related to a greater likelihood toseek all forms of help. Overall, women appear to respond to violence in ways that reflects their ecologicalcontext. Help-seeking is best understood within a multi-layered and dynamic context.

Phonetic Imitation from an Individual-Difference Perspective: Subjective Attitude, Personality and “Autistic” Traits

Science.gov (United States)

Yu, Alan C. L.; Abrego-Collier, Carissa; Sonderegger, Morgan

2013-01-01

Numerous studies have documented the phenomenon of phonetic imitation: the process by which the production patterns of an individual become more similar on some phonetic or acoustic dimension to those of her interlocutor. Though social factors have been suggested as a motivator for imitation, few studies has established a tight connection between language-external factors and a speaker’s likelihood to imitate. The present study investigated the phenomenon of phonetic imitation using a within-subject design embedded in an individual-differences framework. Participants were administered a phonetic imitation task, which included two speech production tasks separated by a perceptual learning task, and a battery of measures assessing traits associated with Autism-Spectrum Condition, working memory, and personality. To examine the effects of subjective attitude on phonetic imitation, participants were randomly assigned to four experimental conditions, where the perceived sexual orientation of the narrator (homosexual vs. heterosexual) and the outcome (positive vs. negative) of the story depicted in the exposure materials differed. The extent of phonetic imitation by an individual is significantly modulated by the story outcome, as well as by the participant’s subjective attitude toward the model talker, the participant’s personality trait of openness and the autistic-like trait associated with attention switching. PMID:24098665

Coping with perceived weight discrimination: testing a theoretical model for examining the relationship between perceived weight discrimination and depressive symptoms in a representative sample of individuals with obesity.

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Spahlholz, J; Pabst, A; Riedel-Heller, S G; Luck-Sikorski, C

2016-12-01

The association between obesity and perceived weight discrimination has been investigated in several studies. Although there is evidence that perceived weight discrimination is associated with negative outcomes on psychological well-being, there is a lack of research examining possible buffering effects of coping strategies in dealing with experiences of weight discrimination. The present study aims to fill that gap. We examined the relationship between perceived weight discrimination and depressive symptoms and tested whether problem-solving strategies and/or avoidant coping strategies mediated this effect. Using structural equation modeling, we analyzed representative cross-sectional data of n=484 German-speaking individuals with obesity (BMI⩾30 kg m -2 ), aged 18 years and older. Results revealed a direct effect of perceived weight discrimination on depressive symptoms. Further, the data supported a mediational linkage for avoidant coping strategies, not for problem-solving strategies. Higher scores of perceived weight discrimination experiences were associated with both coping strategies, but only avoidant coping strategies were positively linked to more symptoms of depression. Perceived weight discrimination was associated with increased depressive symptoms both directly and indirectly through situational coping strategies. Avoidant coping has the potential to exacerbate depressive symptoms, whereas problem-solving strategies were ineffective in dealing with experiences of weight discrimination. We emphasize the importance of coping strategies in dealing with experiences of weight discrimination and the need to distinguish between using a strategy and benefiting from it without detriment.

The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

OpenAIRE

Marioni, Riccardo E.; Chatfield, Mark; Brayne, Carol; Matthews, Fiona E.; Med Res Council

2011-01-01

Abstract Background Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE) have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach) has not been fully explored. Methods MMSE data were collected on a subset of 2,275 older participants (≥ 65 years) from the population-based Medical Research Cou...

Impact of socioeconomic factors on outcome of total knee arthroplasty.

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Barrack, Robert L; Ruh, Erin L; Chen, Jiajing; Lombardi, Adolph V; Berend, Keith R; Parvizi, Javad; Della Valle, Craig J; Hamilton, William G; Nunley, Ryan M

2014-01-01

Few data exist regarding the impact of socioeconomic factors on results of current TKA in young patients. Predictors of TKA outcomes have focused primarily on surgical technique, implant details, and individual patient clinical factors. The relative importance of these factors compared to patient socioeconomic status is not known. We determined whether (1) socioeconomic factors, (2) demographic factors, or (3) implant factors were associated with satisfaction and functional outcomes after TKA in young patients. We surveyed 661 patients (average age, 54 years; range, 18-60 years; 61% female) 1 to 4 years after undergoing modern primary TKA for noninflammatory arthritis at five orthopaedic centers. Data were collected by an independent third party with expertise in collecting healthcare data for state and federal agencies. We examined specific questions regarding satisfaction, pain, and function after TKA and socioeconomic (household income, education, employment) and demographic (sex, minority status) factors. Multivariable analysis was conducted to examine the relative importance of these factors for each outcome of interest. Patients reporting incomes of less than USD 25,000 were less likely to be satisfied with TKA outcomes and more likely to have functional limitations after TKA than patients with higher incomes; no other socioeconomic factors were associated with satisfaction. Women were less likely to be satisfied and more likely to have functional limitations than men, and minority patients were more likely to have functional limitations than nonminority patients. Implants were not associated with outcomes after surgery. Socioeconomic factors, in particular low income, are more strongly associated with satisfaction and functional outcomes in young patients after TKA than demographic or implant factors. Future studies should be directed to determining the causes of this association, and studies of clinical results after TKA should consider stratifying patients

Is nutritional labeling associated with individual health? The effects of labeling-based awareness on dyslipidemia risk in a South Korean population.

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Kim, Jong Yeob; Kweon, Ki Hong; Kim, Min Jae; Park, Eun-Cheol; Jang, Suk-Yong; Kim, Woorim; Han, Kyu-Tae

2016-09-15

In 1995, the South Korean government made nutrition labeling compulsory, which has positively impacted patients with certain chronic diseases, such as dyslipidemia. We investigated the association between nutrition labeling-based awareness and the risk of dyslipidemia among individuals not yet diagnosed. Our study used data from the fifth Korea National Health and Nutrition Examination Surveys administered during 2010-2014 (n = 17,687). We performed multiple or logistic regression analysis to examine the association between nutritional analysis and various outcome variables. Approximately 70 % of the respondents (n = 11,513) were familiar with nutrition labeling, of which 20 % (n = 3172) decided what food to buy based on that information. This awareness yielded mostly positive results on outcome indicators, such as triglyceride and high-density lipoprotein cholesterol levels. In general, individuals who used nutritional labels to make decisions regarding food purchases had a lower risk of dyslipidemia than individuals who did not (OR: 0.806, 95 % CI: 0.709-0.917). Utilizing nutrition labels for making food choices correlated with a lower risk of dyslipidemia in certain subgroups. Based on our findings, we recommend that health policymakers and medical professionals consider promoting nutrition labeling as an alternative method for managing certain chronic diseases in South Korean patients.

Predictors and moderators of treatment outcome in a randomized clinical trial for adults with symptoms of bulimia nervosa.

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Accurso, Erin C; Wonderlich, Stephen A; Crosby, Ross D; Smith, Tracey L; Klein, Marjorie H; Mitchell, James E; Crow, Scott J; Berg, Kelly C; Peterson, Carol B

2016-02-01

This study examined predictors and moderators of outcome in 2 treatments for bulimia nervosa (BN). Eighty adults with BN symptoms at 1 of 2 sites were randomized to 21 sessions of integrative cognitive-affective therapy for BN (ICAT-BN) or enhanced cognitive behavior therapy (CBT-E). Generalized linear models examined predictors and moderators of improvements in bulimic behavior and eating disorder psychopathology at end of treatment (EOT) and 4-month follow-up (FU). At EOT, individuals with higher dietary restraint had greater reductions in bulimic behavior. At FU, individuals with higher weight and shape concern had greater reductions in bulimic behavior, whereas those with greater baseline depression had less improvement in eating disorder psychopathology. Individuals higher in stimulus seeking had greater reductions in bulimic behavior and eating disorder psychopathology at follow up in ICAT-BN than in CBT-E, whereas individuals lower in stimulus seeking had greater reductions in bulimic behavior in CBT-E than in ICAT-BN. Finally, individuals with higher affective lability had greater reductions in eating disorder psychopathology in ICAT-BN than in CBT-E, whereas improvements were comparable across treatments for individuals with lower affective lability. This study identified 3 nonspecific predictors of outcome (i.e., dietary restraint, weight and shape concern, and depression) and 2 moderators (i.e., affective lability and stimulus seeking). All moderator effects emerged at FU rather than at EOT, suggesting that the moderating effects of treatment were not immediately apparent. These results suggest that individuals with higher affective lability and stimulus seeking may benefit more from treatment with a greater focus on affective states and self-regulation. (c) 2016 APA, all rights reserved).

Maternal psychological distress during pregnancy does not increase the risk for adverse birth outcomes.

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Staneva, Aleksandra A; Morawska, Alina; Bogossian, Fiona; Wittkowski, Anja

2018-01-01

Maternal psychological distress during pregnancy is a potential risk factor for various birth complications. This study aimed to explore psychological factors associated with adverse birth outcomes. Symptoms of psychological distress, individual characteristics, and medical complications were assessed at two time points antenatally in 285 women from Australia and New Zealand; birth outcomes were assessed postpartum, between January 2014 and September 2015. Hierarchical multiple regression analyses were conducted to examine the relation of psychological distress to adverse birth outcomes. Medical complications during pregnancy, such as serious infections, placental problems and preeclampsia, and antenatal cannabis use, were the factors most strongly associated with adverse birth outcomes, accounting for 22 percent of the total variance (p pregnancy and an orientation toward a Regulator mothering style were associated with adverse birth outcomes; however, after controlling for medical complications, these were no longer associated. Our study results indicate that antenatal depressive and/or anxiety symptoms were not independently associated with adverse birth outcomes, a reassuring finding for women who are already psychologically vulnerable during pregnancy.