WorldWideScience

Sample records for negative outcome expectancies

  1. Feedback-related negativity codes outcome valence, but not outcome expectancy, during reversal learning.

    Science.gov (United States)

    von Borries, A K L; Verkes, R J; Bulten, B H; Cools, R; de Bruijn, E R A

    2013-12-01

    Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model predicts an FRN on negative prediction errors, as well as implying a role for the FRN in learning and the adaptation of behavior. However, these predictions have recently been challenged. Notably, studies so far have used tasks in which the outcomes have been contingent on the response. In these paradigms, the need to adapt behavioral responses is present only for negative, not for positive feedback. The goal of the present study was to investigate the effects of positive as well as negative violations of expectancy on FRN amplitudes, without the usual confound of behavioral adjustments. A reversal-learning task was employed in which outcome value and outcome expectancy were orthogonalized; that is, both positive and negative outcomes were equally unexpected. The results revealed a double dissociation, with effects of valence but not expectancy on the FRN and, conversely, effects of expectancy but not valence on the P300. While FRN amplitudes were largest for negative-outcome trials, irrespective of outcome expectancy, P300 amplitudes were largest for unexpected-outcome trials, irrespective of outcome valence. These FRN effects were interpreted to reflect an evaluation along a good-bad dimension, rather than reflecting a negative prediction error or a role in behavioral adaptation. By contrast, the P300 reflects the updating of information relevant for behavior in a changing context.

  2. Feedback-related negativity codes outcome valence, but not outcome expectancy, during reversal learning

    NARCIS (Netherlands)

    Borries, A.K.L. von; Verkes, R.J.; Bulten, B.H.; Cools, R.; Bruijn, E.R.A. de

    2013-01-01

    Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures-that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model

  3. Feedback-related negativity codes outcome valence, but not outcome expectancy, during reversal learning

    NARCIS (Netherlands)

    Borries, A.K.L. von; Verkes, R.J.; Bulten, B.H.; Cools, R.

    2013-01-01

    Optimal behavior depends on the ability to assess the predictive value of events and to adjust behavior accordingly. Outcome processing can be studied by using its electrophysiological signatures--that is, the feedback-related negativity (FRN) and the P300. A prominent reinforcement-learning model

  4. Drinking motives and alcohol outcome expectancies as mediators of the association between negative urgency and alcohol consumption.

    Science.gov (United States)

    Anthenien, Amber M; Lembo, Jordanna; Neighbors, Clayton

    2017-03-01

    To determine whether the effects of negative urgency, a unique facet of impulsivity marked by engaging in potentially unhealthy and rash behaviors in order to cope with anxiety or negative moods, on drinking behavior can be explained by positive and negative alcohol outcome expectancies and specific drinking motives (i.e., coping and enhancement). College students (N=194) completed web-based surveys in exchange for course credit. Students completed measures of negative urgency, comprehensive effects of alcohol, drinking motives, and alcohol use behaviors. Results of path analysis indicated significant indirect effects of negative urgency and alcohol use through both alcohol outcome expectancies and enhancement motives. The effects of enhancement motives on drinking were mediated by positive alcohol outcome expectancies. The effects of coping motives on drinking were not attributable to negative expectancies. Individuals high on negative urgency may consume alcohol in order to ameliorate their emotional distress due to strong desires to increase positive and decrease negative experiences associated with drinking. Emotion-focused impulsivity's influence on drinking outcomes can be ascribed to enhancement motives for drinking as well as positive and negative alcohol outcome expectancies. Prevention efforts should target drinking motives and alcohol outcome expectancies among those higher in negative urgency. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Positive smoking outcome expectancies mediate the association between negative affect and smoking urge among women during a quit attempt.

    Science.gov (United States)

    Cano, Miguel Ángel; Lam, Cho Y; Chen, Minxing; Adams, Claire E; Correa-Fernández, Virmarie; Stewart, Diana W; McClure, Jennifer B; Cinciripini, Paul M; Wetter, David W

    2014-08-01

    Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.

  6. Healthcare provider counseling to quit smoking and patient desire to quit: The role of negative smoking outcome expectancies.

    Science.gov (United States)

    Tucker, Joan S; Stucky, Brian D; Edelen, Maria Orlando; Shadel, William G; Klein, David J

    2018-05-21

    The U.S. Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends providing advice to quit to every tobacco user seen in a healthcare setting. However, the mechanism through which counseling encourages patients to quit has not been adequately studied. This study tests whether the association between receiving healthcare provider counseling and desire to quit is accounted for by negative health and psychosocial outcome expectancies of smoking. Data were collected online from 721 adult smokers who had seen a healthcare provider in the past 12 months. Associations between counseling to quit, negative outcome expectancies of smoking, and desire to quit were tested, as well as whether outcome expectancies and desire to quit differed by type of counseling (counseling only vs. counseling plus assistance) and level of smoking. Bivariate associations indicated a stronger desire to quit among patients receiving counseling, particularly when it included healthcare provider assistance to quit. SEM results indicated that the association between counseling and desire to quit was fully accounted for by patients' negative health and psychosocial outcome expectancies for smoking. These associations were found across levels of smoking in the case of health expectancies, but were limited to moderate and heavy smokers in the case of psychosocial expectancies. Results suggest that the time devoted to counseling patients about smoking should include providing some assistance to quit, such as recommending a product, prescription or program. Regardless of smoking level, this counseling should incorporate techniques to elicit patients' negative health and psychosocial expectancies of smoking. Copyright © 2018. Published by Elsevier Ltd.

  7. Normative evaluations and frequency expectations regarding positive versus negative outcome allocations between groups

    NARCIS (Netherlands)

    Blanz, M; Mummendey, A; Otten, S

    1997-01-01

    Data from several recent studies consistently show a positive-negative asymmetry in social discrimination: within a minimal social situation tendencies cowards ingroup favouritism which usually appear in allocations of positively valenced resources are absent in the domain of negatively valenced

  8. The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

    Science.gov (United States)

    Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

    2008-08-01

    Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

  9. The Context Matters: Outcome Probability and Expectation Mismatch Modulate the Feedback Negativity When Self-Evaluation of Response Correctness Is Possible.

    Science.gov (United States)

    Leue, Anja; Cano Rodilla, Carmen; Beauducel, André

    2015-01-01

    Individuals typically evaluate whether their performance and the obtained feedback match. Previous research has shown that feedback negativity (FN) depends on outcome probability and feedback valence. It is, however, less clear to what extent previous effects of outcome probability on FN depend on self-evaluations of response correctness. Therefore, we investigated the effects of outcome probability on FN amplitude in a simple go/no-go task that allowed for the self-evaluation of response correctness. We also investigated effects of performance incompatibility and feedback valence. In a sample of N = 22 participants, outcome probability was manipulated by means of precues, feedback valence by means of monetary feedback, and performance incompatibility by means of feedback that induced a match versus mismatch with individuals' performance. We found that the 100% outcome probability condition induced a more negative FN following no-loss than the 50% outcome probability condition. The FN following loss was more negative in the 50% compared to the 100% outcome probability condition. Performance-incompatible loss resulted in a more negative FN than performance-compatible loss. Our results indicate that the self-evaluation of the correctness of responses should be taken into account when the effects of outcome probability and expectation mismatch on FN are investigated.

  10. Comparison of outcome expectancies for synthetic cannabinoids and botanical marijuana.

    Science.gov (United States)

    Lauritsen, Kirstin J; Rosenberg, Harold

    2016-07-01

    Although initially developed for medical purposes, synthetic cannabinoids have also been consumed for recreational purposes. To evaluate whether agreement with positive and negative outcome expectancies differed for synthetic cannabinoids versus botanical marijuana, and assess reported reasons for using synthetic cannabinoids. Using a web-based recruitment and data collection procedure, 186 adults who had used both synthetic cannabinoids and botanical marijuana and 181 adults who had used botanical marijuana but not synthetic cannabinoids, completed measures of outcome expectancies and other relevant questionnaires. A significant interaction revealed that participants who had used both synthetic cannabinoids and botanical marijuana indicated lower agreement with positive expectancies for synthetic cannabinoids, and higher agreement with positive expectancies for botanical marijuana, than did those participants who used only botanical marijuana. There was no interaction between type of drug and use history on agreement with negative expectancies, and participants agreed more strongly with negative outcome expectancies for synthetic cannabinoids than for botanical marijuana whether they had used one or both types of these drugs. The most frequently provided reasons for using synthetic cannabinoids included availability, perceived legality, cost, curiosity, and social interaction. Given growing public acceptance of recreational and medical marijuana, coupled with negative perceptions and increasing regulation of synthetic cannabinoid compounds, botanical marijuana is likely to remain more available and more popular than synthetic cannabinoids.

  11. Alternative outcomes create biased expectations regarding the received outcome: Evidence from event-related potentials.

    Science.gov (United States)

    Marciano, Déborah; Bentin, Shlomo; Deouell, Leon Y

    2018-05-01

    After choosing between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option (the alternative). Behavioral research has shown that in such cases people engage in outcome comparison, and that the alternative outcome influences the way one evaluates his own received outcome. Moreover, this influence differs whether one was responsible or not for the choice made. In two studies, we looked for the electrophysiological correlates of outcome comparison. Subjects chose one of two boxes shown on the screen, each box contained a gain or a loss. The alternative outcome was always revealed first, followed by the received outcome. In half of the trials the software picked one box instead of subjects. We tested whether the feedback-related negativity (FRN) and the P3 elicited by the received reflect outcome comparison. As expected, we found that the FRN and P3 were more positive when the received outcome was a gain (vs. a loss). The FRN and P3 were also sensitive to the value of the alternative outcome, but contrary to our predictions, they were more positive when the alternative outcome was a gain (vs. a loss). As the FRN and P3 are sensitive to expectations, we hypothesized that our findings might result from subjects' biased expectations: subjects might have wrongly believed that a good (bad) alternative outcome signaled a bad (good) received outcome. This hypothesis, coined as the Alternative Omen Effect, was confirmed in parallel in a series of behavioral experiments: people see an illusory negative correlation between the uncorrelated outcomes of choice options (reported in Marciano-Romm et al. (2016)). A challenge for future research will be to disentangle the effects of expectation from those of outcome comparison. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Heterogeneous inflation expectations, learning, and market outcomes

    OpenAIRE

    Madeira, Carlos; Zafar, Basit

    2012-01-01

    Using the panel component of the Michigan Survey of Consumers, we show that individuals, in particular women and ethnic minorities, are highly heterogeneous in their expectations of inflation. We estimate a model of inflation expectations based on learning from experience that also allows for heterogeneity in both private information and updating. Our model vastly outperforms existing models of inflation expectations in explaining the heterogeneity in the data. We find that women, ethnic mino...

  13. Heterogeneus Inflation Expectations Learning and Market Outcomes

    OpenAIRE

    Carlos Madeira; Basit Zafar

    2012-01-01

    Using the panel component of the Michigan Survey of Consumers we estimate a learning model of inflation expectations, allowing for heterogeneous use of both private information and lifetime inflation experience. We find that women, ethnic minorities, and less educated agents have a higher degree of heterogeneity in their private information, and are slower to update their expectations. During the 2000s, consumers believe inflation to be more persistent in the short term, but temporary fluctua...

  14. Electrophysiological Correlates of Cue-Related Processing in a Gambling Task: Early Outcome Evaluation or Outcome Expectation?

    Directory of Open Access Journals (Sweden)

    Xiaoyi Zhang

    2017-06-01

    Full Text Available Several recent studies have suggested that cues that predict outcomes elicit a feedback-related-like negativity (FRN-like negativity reflecting initial appraisals of whether desired outcomes are probable. Some other studies, however, have found that the cues that predict outcomes elicited event-related potentials (ERPs that reflect the expectation to outcomes (e.g., outcome expectations. Given these mixed findings, this study aimed to examine whether the brain activity elicited by predictive cues in a gambling task reflected the initial evaluations of the outcomes, the outcome expectations, or both. We used a gambling task in which the participants were told to guess which of two doors hid a reward. At the beginning of each trial, a cue was presented to inform the participants of how many doors hid a reward. We found that these predictive cues elicited a FRN-like negativity at the frontal sites within around 200–300 ms. However, this negativity did not significantly differ between the cues that fully predicted gains and the cues that fully predicted losses. Furthermore, predictive cues elicited an expectation-related slow wave, and cues that predicted gains with a 50% probability elicited a larger expectation-related slow wave than cues that fully predicted gains or losses. Our results suggest that cues predicting outcomes reflect outcome expectations rather than initial evaluations of the forthcoming outcomes.

  15. Bilateral Cochlear Implants: Maximizing Expected Outcomes.

    Science.gov (United States)

    Wallis, Kate E; Blum, Nathan J; Waryasz, Stephanie A; Augustyn, Marilyn

    Sonia is a 4 years 1 month-year-old girl with Waardenburg syndrome and bilateral sensorineural hearing loss who had bilateral cochlear implants at 2 years 7 months years of age. She is referred to Developmental-Behavioral Pediatrics by her speech/language pathologist because of concerns that her language skills are not progressing as expected after the cochlear implant. At the time of the implant, she communicated using approximately 20 signs and 1 spoken word (mama). At the time of the evaluation (18 months after the implant) she had approximately 70 spoken words (English and Spanish) and innumerable signs that she used to communicate. She could follow 1-step directions in English but had more difficulty after 2-step directions.Sonia was born in Puerto Rico at 40 weeks gestation after an uncomplicated pregnancy. She failed her newborn hearing test and was given hearing aids that did not seem to help.At age 2 years, Sonia, her mother, and younger sister moved to the United States where she was diagnosed with bilateral severe-to-profound hearing loss. Genetic testing led to a diagnosis of Waardenburg syndrome (group of genetic conditions that can cause hearing loss and changes in coloring [pigmentation] of the hair, skin, and eyes). She received bilateral cochlear implants 6 months later.Sonia's mother is primarily Spanish-speaking and mostly communicates with her in Spanish or with gestures but has recently begun to learn American Sign Language (ASL). In a preschool program at a specialized school for the deaf, Sonia is learning both English and ASL. Sonia seems to prefer to use ASL to communicate.Sonia receives speech and language therapy (SLT) 3 times per week (90 minutes total) individually in school and once per week within a group. She is also receiving outpatient SLT once per week. Therapy sessions are completed in English, with the aid of an ASL interpreter. Sonia's language scores remain low, with her receptive skills in the first percentile, and her

  16. Expected long-term outcome after a tibial shaft fracture

    DEFF Research Database (Denmark)

    Faergemann, C; Frandsen, P A; Röck, N D

    1999-01-01

    OBJECTIVE: A prospective study of 207 laymen and professionals answered a questionnaire regarding the expectations of the long-term outcome 6 months after a unilateral tibial shaft fracture. The aim was (1) to disclose the expected outcome after unilateral tibial shaft fracture, and (2) to compare...... these expectations with the outcome measured in patients. METHODS: There were five groups of nonpatients: (1) 42 orthopedic surgeons, (2) 36 physiotherapists, (3) 42 students, (4) 49 white collar workers, and (5) 38 blue collar workers. Outcome was measured by Sickness Impact Profile (SIP). The SIP scores were...

  17. Development of the Social Efficacy and Social Outcome Expectations Scale

    Science.gov (United States)

    Wright, Stephen L.; Wright, Dorothy A.; Jenkins-Guarnieri, Michael A.

    2013-01-01

    The current study developed an 18-item scale measuring individuals' social expectations in relationships related to their efficacy expectations (Subscale 1) and outcome expectations (Subscale 2) based on Bandura's self-efficacy theory. Results from exploratory and confirmatory factor analyses, using an undergraduate sample ("N" = 486),…

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

    Science.gov (United States)

    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.

  19. Updating expected action outcome in the medial frontal cortex involves an evaluation of error type.

    Science.gov (United States)

    Maier, Martin E; Steinhauser, Marco

    2013-10-02

    Forming expectations about the outcome of an action is an important prerequisite for action control and reinforcement learning in the human brain. The medial frontal cortex (MFC) has been shown to play an important role in the representation of outcome expectations, particularly when an update of expected outcome becomes necessary because an error is detected. However, error detection alone is not always sufficient to compute expected outcome because errors can occur in various ways and different types of errors may be associated with different outcomes. In the present study, we therefore investigate whether updating expected outcome in the human MFC is based on an evaluation of error type. Our approach was to consider an electrophysiological correlate of MFC activity on errors, the error-related negativity (Ne/ERN), in a task in which two types of errors could occur. Because the two error types were associated with different amounts of monetary loss, updating expected outcomes on error trials required an evaluation of error type. Our data revealed a pattern of Ne/ERN amplitudes that closely mirrored the amount of monetary loss associated with each error type, suggesting that outcome expectations are updated based on an evaluation of error type. We propose that this is achieved by a proactive evaluation process that anticipates error types by continuously monitoring error sources or by dynamically representing possible response-outcome relations.

  20. Framing and personalizing informed consent to prevent negative expectations: An experimental pilot study.

    Science.gov (United States)

    Heisig, Sarah R; Shedden-Mora, Meike C; Hidalgo, Pablo; Nestoriuc, Yvonne

    2015-10-01

    Informing patients about medical treatments and their possible side effects is ethically and legally obligatory but may trigger negative expectations and nocebo-related side effects. This pilot study aims to investigate the effect of different informed consent procedures on treatment expectations for adjuvant breast cancer treatments (Study 1: endocrine therapy; Study 2: chemotherapy). Using an experimental 2-factorial design, healthy women were informed about endocrine therapy (n = 60) or chemotherapy (n = 64) within a hypothetical scenario. Information was framed with or without treatment benefit information and delivered in a personalized or standardized interaction. Primary outcomes were necessity-concern beliefs about the treatment and side-effect expectations, secondary outcomes were decisional conflicts. In Study 1, side-effect expectations (η²p= .08) and decisional conflicts (η²p = .07) were lower when framed treatment information was given. Providing personalized information resulted in more functional necessity-concern beliefs (η²p = .06) and lower decisional conflicts (η²p = .07). Personalizing and framing of information resulted in more functional necessity-concern beliefs (η²p = .10) and lower decisional conflicts. In Study 2, necessity-concern beliefs were more functional with framing (η²p = .06). Participants in the personalized groups reported lower decisional conflicts (η²p = .06). No differences in side-effect expectations were revealed. This is the first study to provide evidence for optimized treatment expectations through altered informed consent strategies. The results emphasize that framing and personalizing informed consent can positively influence treatment expectations and reduce decisional conflicts. However, generalizations are impaired by the study's pilot character. The potential to prevent nocebo responses in clinical practice should be analyzed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  1. The Relationships Between Female Adolescents' Media Use, Indoor Tanning Outcome Expectations, and Behavioral Intentions.

    Science.gov (United States)

    Myrick, Jessica Gall; Noar, Seth M; Kelley, Dannielle; Zeitany, Alexandra E

    2017-06-01

    Unlike other types of cancer, skin cancer incidence rates are on the rise and adolescent females are particularly likely to tan indoors, a major risk factor. However, little research has examined the role of media use in encouraging or discouraging this dangerous behavior in this population. To empirically assess the links between media use, indoor tanning-related outcome expectations, and behavioral intentions. A survey of adolescent females ( N = 510) ages 15 to 18 in the Southeastern United States assessed demographics, types of media use, and indoor tanning intentions. Significant correlations between media use and indoor tanning outcome expectations were found. Use of interpersonal and social media (i.e., talking on the phone, texting, and online social media) were positively associated with positive outcome expectations about indoor tanning and negatively associated with negative outcome expectations. A path analysis revealed that interpersonal/social media use had indirect associations with indoor tanning intentions via tanning outcome expectations. Mass media use (e.g., news media, entertainment media, and magazines) was not significantly associated with most indoor tanning outcome expectations but did have a direct negative association with behavioral intentions. There are important relationships between media use, indoor tanning outcome expectations, and behavioral intentions. Interpersonal and social media use may help cultivate outcome expectations that encourage indoor tanning, which in turn may increase intentions to tan, while news media consumption in particular may reduce intentions to tan. These findings highlight the social nature of adolescent females and point to specific intervention channels for reducing indoor tanning among this population.

  2. The expected-outcome model of two-player games

    CERN Document Server

    Abramson, Bruce

    1990-01-01

    The Expected-Outcome Model of Two-Player Games deals with the expected-outcome model of two-player games, in which the relative merit of game-tree nodes, rather than board positions, is considered. The ambiguity of static evaluation and the problems it generates in the search system are examined and the development of a domain-independent static evaluator is described. Comprised of eight chapters, this book begins with an overview of the rationale for the mathematical study of games, followed by a discussion on some previous artificial intelligence (AI) research efforts on game-trees. The nex

  3. Paradoxical effects of alcohol information on alcohol outcome expectancies.

    Science.gov (United States)

    Krank, Marvin D; Ames, Susan L; Grenard, Jerry L; Schoenfeld, Tara; Stacy, Alan W

    2010-07-01

    Cognitive associations with alcohol predict both current and future use in youth and young adults. Much cognitive and social cognitive research suggests that exposure to information may have unconscious influences on thinking and behavior. The present study assessed the impact of information statements on the accessibility of alcohol outcome expectancies. The 2 studies reported here investigated the effects of exposure to alcohol statements typical of informational approaches to prevention on the accessibility of alcohol outcome expectancies. High school and university students were presented with information statements about the effects of alcohol and other commercial products. The alcohol statements were taken from expectancy questionnaires. Some of these statements were presented as facts and others as myths. The retention of detailed information about these statements was manipulated by (i) divided attention versus focused attention or (ii) immediate versus delayed testing. Accessibility of personal alcohol outcome expectancies was subsequently measured using an open-ended question about the expected effects of alcohol. Participants reported more alcohol outcomes seen during the information task as personal expectations about the effects of alcohol use than similar unseen items. Paradoxically, myth statements were also more likely to be reported as expectancies than unseen items in all conditions. Additionally, myth statements were generated less often than fact statements only under the condition of immediate testing with strong content processing instructions. These observations are consistent with findings from cognitive research where familiarity in the absence of explicit memory can have an unconscious influence on performance. In particular, the exposure to these items in an informational format increases accessibility of the seen items even when the participants were told that they were myths. The findings have implications for the development of

  4. Patients' Preoperative Expectation and Outcome of Cataract Surgery ...

    African Journals Online (AJOL)

    BACKGROUND: Patient's satisfaction for a given treatment is an important clinical outcome because a satisfied patient is more likely to comply with treatments, attend follow-ups and advocate the service to others. Therefore, knowing patients' expectations before a planned procedure or treatment and the actual level of ...

  5. Goal Internalization and Outcome Expectancy in Adolescent Anxiety

    Science.gov (United States)

    Dickson, Joanne M.; Moberly, Nicholas J.

    2013-01-01

    Anxiety has been conceptualized in terms of increased avoidance motivation and higher expectancies of undesirable outcomes. However, anxiety research has hitherto not examined an important qualitative aspect of motivation: the degree to which reasons for goal pursuit are experienced as controlling and originating outside the core self. We asked 70…

  6. Service-Learning in Nonprofit Organizations: Motivations, Expectations, and Outcomes

    Science.gov (United States)

    Basinger, Nancy; Bartholomew, Keith

    2006-01-01

    This article applies theories of giving from philanthropic studies to enhance understanding of service-learning relationships between students and community partners. Focusing on the participation motivations, outcome expectations, and satisfaction levels of community partners who have recently completed work with service-learning students, the…

  7. Moderated mediation of the relationships between masculinity ideology, outcome expectations, and energy drink use.

    Science.gov (United States)

    Levant, Ronald F; Parent, Mike C; McCurdy, Eric R; Bradstreet, Tyler C

    2015-11-01

    The consumption of energy drinks is a growing health-risk behavior for young men in the United States. The present study investigated the relationship between masculinity ideology, outcome expectations, energy drink use, and sleep disturbances. The authors recruited 467 adult males from universities and the Internet who provided data on their endorsement of traditional masculinity ideology, outcome expectations for use of energy drinks, use of energy drinks, and sleep disturbances. A theoretical model positing moderated mediation was tested using structural equation modeling and conditional process modeling. The results supported the hypothesized model in which endorsement of traditional masculinity ideology was linked with increased outcome expectations for benefits of energy drinks, which in turn was linked with increased energy drink consumption, and which finally was linked with greater sleep disturbance symptoms. The relationship between masculinity ideology and energy drink outcome expectations was moderated by age (significant for younger men but not for older men), and the relationship between energy drink outcome expectations and energy drink use was moderated by race (significant for White men but not for racial minority men). The present study adds to the literature on potential negative health implications of the endorsement of traditional masculinity ideology by offering a link between predictors of energy drink use (masculinity ideology, outcome expectations) and health outcomes of energy drink use (e.g., sleep disturbance). (c) 2015 APA, all rights reserved).

  8. The Role of Depression and Negative Affect Regulation Expectancies in Tobacco Smoking among College Students

    Science.gov (United States)

    Schleicher, Holly E.; Harris, Kari Jo; Catley, Delwyn; Nazir, Niaman

    2009-01-01

    Objective: Expectancies about nicotine's ability to alleviate negative mood states may play a role in the relationship between smoking and depression. The authors examined the role of negative affect regulation expectancies as a potential mediator of depression (history of depression and depressive symptoms) and smoking among college students.…

  9. Linking masculinity to negative drinking consequences: the mediating roles of heavy episodic drinking and alcohol expectancies.

    Science.gov (United States)

    Wells, Samantha; Flynn, Andrea; Tremblay, Paul F; Dumas, Tara; Miller, Peter; Graham, Kathryn

    2014-05-01

    This study extends previous research on masculinity and negative drinking consequences among young men by considering mediating effects of heavy episodic drinking (HED) and alcohol expectancies. We hypothesized that masculinity would have a direct relationship with negative consequences from drinking as well as indirect relationships mediated by HED and alcohol expectancies of courage, risk, and aggression. A random sample of 1,436 college and university men ages 19-25 years completed an online survey, including conformity to masculine norms, alcohol-related expectancies, HED, and negative drinking consequences. Regression analyses and structural equation modeling were used. Six of seven dimensions of masculinity and the alcohol expectancy scales were significantly associated with both HED and negative consequences. In multivariate regression models predicting HED and negative consequences, the playboy and violence dimensions of masculinity and the risk/aggression alcohol expectancy remained significant. HED and the risk-taking dimension of masculinity were also significant in the model predicting negative consequences. The structural equation model indicated that masculinity was directly associated with HED and negative consequences but also influenced negative consequences indirectly through HED and alcohol expectancies. The findings suggest that, among young adult male college and university students, masculinity is an important factor related to both HED and drinking consequences, with the latter effect partly mediated by HED and alcohol expectancies. Addressing male norms about masculinity may help to reduce HED and negative consequences from drinking.

  10. Alcohol Outcome Expectancies and Drinking to Cope with Social Situations

    OpenAIRE

    Carrigan, Maureen H.; Ham, Lindsay S.; Thomas, Suzanne E.; Randall, Carrie L.

    2008-01-01

    Repeated use of alcohol as a coping strategy to reduce anxiety or discomfort increases one's risk of developing alcohol dependence. Previous studies have found alcohol outcome expectancies (AOE) strongly predict drinking behavior, in general, and also are related to drinking to cope. The purpose of the current study was to examine AOE that may be related to drinking to cope with discomfort in social situations. It was hypothesized that positive AOE, especially related to assertion and tension...

  11. Psychometric evaluations of the efficacy expectations and Outcome Expectations for Exercise Scales in African American women.

    Science.gov (United States)

    Murrock, Carolyn J; Gary, Faye

    2014-01-01

    This secondary analysis tested the reliability and validity of the Self-Efficacy for Exercise (SEE) and the Outcome Expectations for Exercise (OEE) scales in 126 community dwelling, middle aged African American women. Social Cognitive Theory postulates self-efficacy is behavior age, gender and culture specific. Therefore, it is important to determine ifself-efficacy scales developed and tested in older Caucasian female adults are reliable and valid in middle aged, minority women. Cronbach's alpha and construct validity using hypothesis testing and confirmatory factor analysis supported the reliability and validity of the SEE and OEE scales in community dwelling, middle aged African American women.

  12. Positive and negative eating expectancies in disordered eating among women and men.

    Science.gov (United States)

    Hayaki, Jumi; Free, Sarah

    2016-08-01

    Deficits in emotion regulation are known to characterize disordered eating patterns including binge eating, purging, and dietary restraint, though much of this work has been conducted exclusively on women. Eating expectancies, or expectations regarding reinforcement from food and eating, constitute one cognitive mechanism that is thought to serve as a proximal influence on eating behavior. Previous research shows that eating to manage negative affect (a negative eating expectancy) is associated with eating pathology in women, but less is known about eating as a reward or for pleasure (a positive eating expectancy). In addition, no prior work has examined eating expectancies among men. This study examines the role of emotion regulation and eating expectancies on disordered eating in women and men. Participants were 121 female and 80 male undergraduates who completed self-report measures of emotion regulation, eating expectancies, and disordered eating. In women, body mass index (BMI), emotion regulation, and eating to manage negative affect directly predicted disordered eating in the final multivariate model, whereas eating for pleasure or reward was inversely associated with disordered eating. However, in men, emotion regulation predicted disordered eating, but not when eating expectancies were added to the model. In the final model, only BMI and eating to manage negative affect contributed significantly to the variance in disordered eating. These findings suggest that some correlates of eating pathology, particularly eating expectancies, may vary by gender. Future research should continue to examine gender differences in the explanatory mechanisms underlying disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Depression Vulnerability Predicts Cigarette Smoking among College Students: Gender and Negative Reinforcement Expectancies as Contributing Factors

    OpenAIRE

    Morrell, Holly E. R.; Cohen, Lee M.; McChargue, Dennis E.

    2010-01-01

    This study examined the association between vulnerability to depression and smoking behavior in college students in 1214 college students (54% female), and evaluated gender and expectancies of negative affect reduction as moderators or mediators of this relationship. Depression vulnerability predicted smoking in females, but not males. The relationship between depression vulnerability and smoking status was mediated by expectancies of negative affect reduction in females only. Female college ...

  14. Most negative and most positive expectation values of the spin operator

    International Nuclear Information System (INIS)

    Zamick, Larry

    2011-01-01

    Formulas for the most positive and most negative values of the expectation of the spin operator are given and compared with single-particle values. The Nilsson model is used to evaluate these expectations and a scenario is discussed where the value is greater than one.

  15. Gender, Ethnicity, and Their Intersectionality in the Prediction of Smoking Outcome Expectancies in Regular Cigarette Smokers.

    Science.gov (United States)

    Aguirre, Claudia G; Bello, Mariel S; Andrabi, Nafeesa; Pang, Raina D; Hendricks, Peter S; Bluthenthal, Ricky N; Leventhal, Adam M

    2016-01-01

    The current study utilized the intersectionality framework to explore whether smoking outcome expectancies (i.e., cognitions about the anticipated effects of smoking) were predicted by gender and ethnicity, and the gender-by-ethnicity interaction. In a cross-sectional design, daily smokers from the general community (32.2% women; non-Hispanic African American [n = 175], non-Hispanic White [n = 109], or Hispanic [n = 26]) completed self-report measures on smoking expectancies and other co-factors. Results showed that women reported greater negative reinforcement (i.e., anticipated smoking-induced negative affect reduction) and weight control (i.e., anticipated smoking-induced appetite/weight suppression) expectancies than men. Hispanic (vs. African American or White) smokers endorsed greater negative reinforcement expectancies. A gender-by-ethnicity interaction was found for weight control expectancies, such that White women reported greater weight control expectancies than White men, but no gender differences among African American and Hispanic smokers were found. These findings suggest that gender, ethnicity, and their intersectionality should be considered in research on cognitive mechanisms that may contribute to tobacco-related health disparities. © The Author(s) 2015.

  16. Did I Do That? Expectancy Effects of Brain Stimulation on Error-related Negativity and Sense of Agency.

    Science.gov (United States)

    Hoogeveen, Suzanne; Schjoedt, Uffe; van Elk, Michiel

    2018-06-19

    This study examines the effects of expected transcranial stimulation on the error(-related) negativity (Ne or ERN) and the sense of agency in participants who perform a cognitive control task. Placebo transcranial direct current stimulation was used to elicit expectations of transcranially induced cognitive improvement or impairment. The improvement/impairment manipulation affected both the Ne/ERN and the sense of agency (i.e., whether participants attributed errors to oneself or the brain stimulation device): Expected improvement increased the ERN in response to errors compared with both impairment and control conditions. Expected impairment made participants falsely attribute errors to the transcranial stimulation. This decrease in sense of agency was correlated with a reduced ERN amplitude. These results show that expectations about transcranial stimulation impact users' neural response to self-generated errors and the attribution of responsibility-especially when actions lead to negative outcomes. We discuss our findings in relation to predictive processing theory according to which the effect of prior expectations on the ERN reflects the brain's attempt to generate predictive models of incoming information. By demonstrating that induced expectations about transcranial stimulation can have effects at a neural level, that is, beyond mere demand characteristics, our findings highlight the potential for placebo brain stimulation as a promising tool for research.

  17. Negative Control Outcomes and the Analysis of Standardized Mortality Ratios.

    Science.gov (United States)

    Richardson, David B; Keil, Alexander P; Tchetgen Tchetgen, Eric; Cooper, Glinda

    2015-09-01

    In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to noncomparability of the occupational cohort and reference population with respect to unmeasured risk factors for the outcome of interest. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for such bias. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR = 1.9; 95% confidence interval [CI] = 1.3, 2.7) but not among monthly-paid males (SMR = 1.0; 95% CI = 0.67, 1.3). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR = 2.2; 95% CI = 1.5, 3.2; and, aSMR = 2.0; 95% CI = 1.4, 2.8, respectively). The proposed adjusted SMR offers a complement to typical SMR analyses.

  18. South Korean alcohol free associations: negative expectancy not predicting drinks per occasion.

    Science.gov (United States)

    Mahoney, Benjamin J; Graham, Deborah; Cottrell, David; Kim, Kyung-Yong

    2012-06-01

    Cultural and biological particulars existing in East Asian countries are likely to mediate differences in the alcohol consumption experience. Despite this no research to date has directly explored the alcohol free association or expectancy of any East Asian nations. The current research aims to provide a set of South Korean alcohol expectancies. Two hundred and thirty-seven South Koreans participated in an alcohol free association test and completed a demographic survey. The results both confirmed and contradicted areas of past alcohol expectancy research. There appears to be differences in associates with high probability of recall and alcohol expectancy, where negative, negative sedating and sedating expectancy categories were not found to be predictors of South Korean drinker level. The results suggest that South Koreans have a more even level of negative expectancy across all drinker categories, possibly due to a combination of linguistic, cultural and biological difference found among this population. The results provide a list of South Korean alcohol free association norms for future alcohol research in the region, with the results also underlining the need for alcohol free association tests among East Asian nations. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  19. Music education and musicians: Expectations, course and outcomes

    Directory of Open Access Journals (Sweden)

    Bogunović Blanka

    2012-01-01

    Full Text Available Considering the long-term talent development, from the moment of its recognition to the moment when an adult is confronted with the necessity of integration in the professional music and life streams, we wonder whether education satisfies the needs of talents and provides, in the long run, the necessary knowledge and skills. The aim of this research was to investigate: (1 the initial motivation for learning music and expectations from music education; (2 the course of development of young musicians (the degree of self-actualisation, developmental perspectives, evaluation of music education and (3 outcomes of music education and development of the professional career. The sample (N=487 consisted of five subsamples: music kindergarten pupils, students of primary music schools, students of secondary music schools, university students of music and teachers at music schools and universities. The paper analyses psychological, educational and professional aspects of education of musically gifted pupils and students, as well as music teachers in five successive age groups. The results indicate that with an increase in age there is a considerable increase in the variety and scope of expectations and a higher aspiration towards personal, educational and professional lifelong improvement, while, at the same time, there is a considerable decrease in the level of fulfilment of expectations and the level of assessment of self-actualisation. This is indicative of a continuously present feeling of “hidden underachievement” in the group of (relatively successful young musicians and professionals. Analysis of respondents’ answers points out to the existence of still traditional system of music education, which lacks flexibility and innovation and fails to provide a sufficient level of transferable knowledge and skills. The findings point out to a whole cluster of controversies demanding further reconsideration and (redesigning of the curriculum of (high

  20. Gender differences in adolescent smoking: mediator and moderator effects of self-generated expected smoking outcomes.

    Science.gov (United States)

    Vidrine, Jennifer Irvin; Anderson, Cheryl B; Pollak, Kathryn I; Wetter, David W

    2006-01-01

    To examine relations among gender, self-generated smoking-outcome expectancies, and smoking in adolescents. Students from one all-girls' (n=350; 53%) and one all-boys' (n=315; 47%) Catholic high school participated. Analyses included binary and ordinal logistic regression. For boys, smoking behavior was associated with buzz (odds radio [OR] = 1.92, 95% confidence interval [CI]: 1.31-2.83, p exercise/sport impairment (OR = 2.84, 95% CI: 1.68-4.81, p gender-smoking relationship. Moderators included negative social (beta = -0.45, p = .021) and enhance self-esteem (beta = -1.07, p = .024). Interventions might benefit from tailoring on gender differences in smoking-outcome expectancies.

  1. Caregiving decision making by older mothers and adult children: process and expected outcome.

    Science.gov (United States)

    Cicirelli, Victor G

    2006-06-01

    Dyadic caregiving decision making was studied in 30 mother-son and 29 mother-daughter pairs (mother's age=65-94 years) who responded to a vignette depicting a caregiving decision situation. The observed decision-making process of mother-child pairs was largely naturalistic, with few alternatives proposed and quick convergence to a decision followed by a postdecision justification; a degree of more rational decision making was seen in some pairs. Among significant findings, adult children, especially sons, dominated the decision process, doing more talking and introducing more alternatives than did their mothers, who played a more subordinate role. Mother-son pairs expected more negative outcomes and greater regrets regarding their decisions than mother-daughter pairs. Closeness of the parent-child relationship influenced the decision-making process, expected outcomes, and regrets. Copyright (c) 2006 APA, all rights reserved.

  2. Associations between ADHD symptoms and smoking outcome expectancies in a non-clinical sample of daily cigarette smokers.

    Science.gov (United States)

    Goldenson, Nicholas I; Pang, Raina D; Leventhal, Adam M

    2016-03-01

    Smoking outcome expectancies for positive reinforcement (PR: beliefs that smoking produces desirable outcomes) and negative reinforcement (NR: beliefs that smoking alleviates negative affect) are modifiable cognitive manifestations of affect-mediated smoking motivation. Based on prior data and theory, we hypothesized that NR and PR expectancies are associated with ADHD symptom levels in a non-clinical sample of cigarette smokers. (Am J Addict 2016; XX:XX -XX) METHODS: Daily cigarette smokers (N = 256) completed self-report measures of ADHD symptoms and smoking outcome expectancies. Cross-sectional associations of overall ADHD symptomatology and the ADHD symptom dimensions of inattention (IN: difficulty concentrating and distractibility) and hyperactivity impulsivity (HI: poor inhibitory control and motor activity restlessness) with PR and NR smoking outcome expectancies were examined. Higher levels of overall, IN and HI ADHD symptoms were positively associated with NR smoking expectancies after statistically controlling for anxiety, depression, alcohol/drug use problems, nicotine dependence, and other smoking expectancies. Although neither HI nor IN symptom dimensions exhibited empirically unique relations to NR expectancies over and above one another, the collective variance across IN and HI was associated with NR expectancies. PR expectancies were not associated with ADHD symptoms. Although PR and NR expectancies may be important etiological influences in the overall population of smokers, NR outcome expectancies appear to be disproportionately expressed in smokers with elevated ADHD symptoms. Cognitive manifestations of NR motivation, which may be modifiable via intervention, are prominent in smokers with elevated ADHD symptoms. Beliefs that smoking alleviates negative affect may underlie ADHD-smoking comorbidity. © American Academy of Addiction Psychiatry.

  3. The Relationship between Parent Expectations and Postschool Outcomes of Adolescents with Disabilities

    Science.gov (United States)

    Doren, Bonnie; Gau, Jeff M.; Lindstrom, Lauren E.

    2012-01-01

    A secondary analysis was conducted of the National Longitudinal Transition Study-2 to examine (a) main effects of parents' school and postschool outcome expectations on the actual outcomes achieved, (b) demographic moderators, and (c) adolescent autonomy as a mediator of parent expectations and outcomes. Parent expectations were found to…

  4. When feeling bad is expected to be good: emotion regulation and outcome expectancies in social conflicts.

    Science.gov (United States)

    Tamir, Maya; Ford, Brett Q

    2012-08-01

    According to the instrumental approach to emotion regulation, people may want to experience even unpleasant emotions to attain instrumental benefits. Building on value-expectancy models of self-regulation, we tested whether people want to feel bad in certain contexts specifically because they expect such feelings to be useful to them. In two studies, participants were more likely to try to increase their anger before a negotiation when motivated to confront (vs. collaborate with) a negotiation partner. Participants motivated to confront (vs. collaborate with) their partner expected anger to be more useful to them, and this expectation in turn, led them to try to increase their anger before negotiating. The subsequent experience of anger, following random assignment to emotion inductions (Study 1) or engagement in self-selected emotion regulation activities (Study 2), led participants to be more successful at getting others to concede to their demands, demonstrating that emotional preferences have important pragmatic implications.

  5. Unexpected and just missed: the separate influence of the appraisals of expectancy and proximity on negative emotions.

    Science.gov (United States)

    Bossuyt, Evelien; Moors, Agnes; De Houwer, Jan

    2014-04-01

    Previous research has suggested that a goal-incongruent outcome leads to more intense negative emotions when it is unexpected and close to a goal-congruent outcome. Until now, however, no studies have disentangled the influence of the appraisals of expectancy and proximity on emotions. We experimentally manipulated each of these variables in 3 slot machine experiments and measured emotions via differences in motivation (i.e., the tendency to repair the goal incongruence) and feelings (i.e., disappointment, frustration, and anger). The experiments consisted of a series of trials that each started with the sequential presentation of 3 symbols. In case of a win trial, all symbols were equal (e.g., AAA) and the participant gained 10 cents; in case of a loss trial, one or more of the symbols differed and the participant gained 0 cents. Three different loss trials were compared: unexpected proximal ones (e.g., AAB), expected proximal ones (e.g., ABA), and expected distal ones (e.g., ABC). The tendency to repair was measured online via behavior as well as retrospectively via self-reports; feelings were measured retrospectively (Experiments 1 and 2) or online (Experiment 3). Unexpected losses seemed to increase the tendency to repair as well as feelings of disappointment (in all experiments) and feelings of frustration and anger (in Experiments 1 and 3). Proximal losses increased only the tendency to repair (in all experiments). This suggests that the appraisals of expectancy and proximity have a distinct influence on emotions.

  6. Expectations

    DEFF Research Database (Denmark)

    depend on the reader’s own experiences, individual feelings, personal associations or on conventions of reading, interpretive communities and cultural conditions? This volume brings together narrative theory, fictionality theory and speech act theory to address such questions of expectations...

  7. Outcome expectancy and self-efficacy: theoretical implications of an unresolved contradiction.

    Science.gov (United States)

    Williams, David M

    2010-11-01

    According to self-efficacy theory, self-efficacy--defined as perceived capability to perform a behavior--causally influences expected outcomes of behavior, but not vice versa. However, research has shown that expected outcomes causally influence self-efficacy judgments, and some authors have argued that this relationship invalidates self-efficacy theory. Bandura has rebutted those arguments saying that self-efficacy judgments are not invalidated when influenced by expected outcomes. This article focuses on a contradiction in Bandura's rebuttal. Specifically, Bandura has argued (a) expected outcomes cannot causally influence self-efficacy, but (b) self-efficacy judgments remain valid when causally influenced by expected outcomes. While the debate regarding outcome expectancies and self-efficacy has subsided in recent years, the inattention to this contradiction has led to a disproportionate focus on self-efficacy as a causal determinant of behavior at the expense of expected outcomes.

  8. Negative reinforcement eating expectancies, emotion dysregulation, and symptoms of bulimia nervosa.

    Science.gov (United States)

    Hayaki, Jumi

    2009-09-01

    Research suggests that emotion dysregulation or difficulties in the modulation of emotional experience constitute risk for eating disorders. Recent work has also highlighted the role of certain eating-related cognitions, specifically expectations of negative emotional reinforcement from eating, in the development of disturbed eating patterns. However, it is unclear whether these expectancies are merely a dimension of a general inability to regulate emotions effectively or rather a unique cognitive-affective risk factor for the development of an eating disorder. This study examines the unique contribution of eating expectancies to symptoms of bulimia nervosa (BN) after controlling for two dimensions of emotion dysregulation (alexithymia and experiential avoidance) previously implicated in the phenomenology of eating disorders. Participants were 115 undergraduate women who self-reported demographics, alexithymia, experiential avoidance, eating expectancies, and symptoms of BN. Eating expectancies uniquely contributed 12.4% of the variance in symptoms of BN, F(2, 108) = 11.74, p symptoms of BN. These results suggest that individuals who expect eating to provide emotional relief may be especially susceptible to disordered eating. Findings are discussed in terms of emotional risk models and clinical interventions for BN.

  9. Greater expectations: using hierarchical linear modeling to examine expectancy for treatment outcome as a predictor of treatment response.

    Science.gov (United States)

    Price, Matthew; Anderson, Page; Henrich, Christopher C; Rothbaum, Barbara Olasov

    2008-12-01

    A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n=72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.

  10. Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston.

    Science.gov (United States)

    Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Magid, Leah M; Rigotti, Nancy A

    2016-06-01

    Cigarette smoking and traumatic life experiences are each common among homeless adults, but the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among homeless smokers are not known. We assessed symptoms of PTSD and their association with smoking outcome expectancies in a sample of homeless smokers in Boston. We used time-location sampling to conduct an in-person survey of homeless adult smokers using Boston Health Care for the Homeless Program clinical services. We assessed symptoms of PTSD with the PTSD Checklist-Civilian version and considered scores at least 14 as positive. We used the Smoking Effects Questionnaire to assess positive and negative smoking outcome expectancies. We modeled the associations between PTSD screening status and smoking expectancies using design-adjusted linear regression. Eighty-six percent of eligible individuals participated (N = 306). Sixty-eight percent of participants screened positive for PTSD. Screen-positive respondents were younger (P = .001), more likely to report fair/poor health (P = .01), chronic obstructive pulmonary disease (P = .02), and past-month hallucinations (P = .004), and had greater drug (P smokers and strongly associated with positive smoking outcome expectancies. Tobacco cessation programs for this population should consider screening for PTSD and fostering a trauma-sensitive treatment environment. In this study of homeless cigarette smokers in Boston, over two-thirds of participants screened positive for PTSD. PTSD screen-positive respondents more strongly endorsed multiple positive smoking outcome expectancies than screen-negative individuals. These findings suggest that the psychological sequelae of trauma may be a pervasive but under-recognized factor impacting the persistence of smoking among homeless people. Tobacco cessation programs for this population should consider screening for PTSD, fostering a trauma-sensitive treatment environment, and incorporating strategies that have

  11. Contamination vs. harm-relevant outcome expectancies and covariation bias in spider phobia

    NARCIS (Netherlands)

    de Jong, Peter J.; Peters, Madelon L.

    There is increasing evidence that spiders are not feared because of harmful outcome expectancies but because of disgust and contamination-relevant outcome expectancies. This study investigated the relative strength of contamination- and harm-relevant UCS expectancies and covariation bias in spider

  12. Do Alcohol Expectancy Outcomes and Valuations Mediate Peer Influences and Lifetime Alcohol Use among Early Adolescents?

    Science.gov (United States)

    Zamboanga, Byron L.; Schwartz, Seth J.; Ham, Lindsay S.; Jarvis, Lorna Hernandez; Olthuis, Janine V.

    2009-01-01

    Building on the theory of reasoned action (I. Ajzen & M. Fishbein, 1973, 1980; M. Fishbein & I. Ajzen, 1975) and expectancy theory, the authors examined the mediating role of alcohol expectancies in adolescent drinking behaviors by testing whether alcohol expectancy outcomes and valuations (the extent to which these outcomes are perceived…

  13. Too good to be true: rhesus monkeys react negatively to better-than-expected offers.

    Directory of Open Access Journals (Sweden)

    Emily J Knight

    Full Text Available To succeed in a dynamically changing world, animals need to predict their environments. Humans, in fact, exhibit such a strong desire for consistency that one of the most well-established findings in social psychology is the effort people make to maintain consistency among their beliefs, attitudes, and behavior. However, displeasure with unpredictability leads to a potential paradox, because a positive outcome that exceeds one's expectations often leads to increased subjective value and positive affect, not the opposite. We tested the hypothesis that two evolutionarily-conserved evaluation processes underlie goal-directed behavior: (1 consistency, concerned with prediction errors, and (2 valuation, concerned with outcome utility. Rhesus monkeys (Macaca mulatta viewed a food item and then were offered an identical, better, or worse food, which they could accept or reject. The monkeys ultimately accepted all offers, attesting to the influence of the valuation process. However, they were slower to accept the unexpected offers, and they exhibited aversive reactions, especially to the better-than-expected offers, repeatedly turning their heads and looking away before accepting the food item. Our findings (a provide evidence for two separable evaluation processes in primates, consistency and value assessment, (b reveal a direct relationship between consistency assessment and emotional processes, and (c show that our wariness with events that are much better than expected is shared with other social primates.

  14. The power of positive and negative expectations to influence reported symptoms and mood during exposure to wind farm sound.

    Science.gov (United States)

    Crichton, Fiona; Dodd, George; Schmid, Gian; Gamble, Greg; Cundy, Tim; Petrie, Keith J

    2014-12-01

    Wind farm developments have been hampered by claims that sound from wind turbines causes symptoms and negative health reports in nearby residents. As scientific reviews have failed to identify a plausible link between wind turbine sound and health effects, psychological expectations have been proposed as an explanation for health complaints. Building on recent work showing negative expectations can create symptoms from wind turbines, we investigated whether positive expectations can produce the opposite effect, in terms of a reduction in symptoms and improvements in reported health. 60 participants were randomized to either positive or negative expectation groups and subsequently exposed to audible wind farm sound and infrasound. Prior to exposure, negative expectation participants watched a DVD incorporating TV footage about health effects said to be caused by infrasound produced by wind turbines. In contrast, positive expectation participants viewed a DVD that outlined the possible therapeutic effects of infrasound exposure. During exposure to audible windfarm sound and infrasound, symptoms and mood were strongly influenced by the type of expectations. Negative expectation participants experienced a significant increase in symptoms and a significant deterioration in mood, while positive expectation participants reported a significant decrease in symptoms and a significant improvement in mood. The study demonstrates that expectations can influence symptom and mood reports in both positive and negative directions. The results suggest that if expectations about infrasound are framed in more neutral or benign ways, then it is likely reports of symptoms or negative effects could be nullified.

  15. Conservatives Anticipate and Experience Stronger Emotional Reactions to Negative Outcomes.

    Science.gov (United States)

    Joel, Samantha; Burton, Caitlin M; Plaks, Jason E

    2014-02-01

    The present work examined whether conservatives and liberals differ in their anticipation of their own emotional reactions to negative events. In two studies, participants imagined experiencing positive or negative outcomes in domains that do not directly concern politics. In Study 1, 190 American participants recruited online (64 male, Mage  = 32 years) anticipated their emotional responses to romantic relationship outcomes. In Study 2, 97 Canadian undergraduate students (26 male, Mage  = 21 years) reported on their anticipated and experienced emotional responses to academic outcomes. In both studies, more conservative participants predicted they would feel stronger negative emotions following negative outcomes than did more liberal participants. Furthermore, a longitudinal follow-up of Study 2 participants revealed that more conservative participants actually felt worse than more liberal participants after receiving a lower-than-desired exam grade. These effects remained even when controlling for the Big Five traits, prevention focus, and attachment style (Study 1), and optimism (Study 2). We discuss how the relationship between political orientation and anticipated affect likely contributes to differences between conservatives and liberals in styles of decision and policy choices. © 2013 Wiley Periodicals, Inc.

  16. Expectations from different perspectives on future work outcome of young adults with intellectual and developmental disabilities

    NARCIS (Netherlands)

    Holwerda, Anja; Brouwer, Sandra; de Boer, Michiel R.; Groothoff, Johan W.; van der Klink, Jac J. L.

    2015-01-01

    Purpose Expectations strongly influence future employment outcomes and social networks seem to mediate employment success of young adults with intellectual and developmental disabilities. The aim of this study is to examine the expectations of young adults with intellectual and developmental

  17. Expectations from Different Perspectives on Future Work Outcome of Young Adults with Intellectual and Developmental Disabilities

    NARCIS (Netherlands)

    Holwerda, A.; Brouwer, S.; de Boer, M.R.; Groothoff, J.W.; van der Klink, J.J.L.

    2015-01-01

    Purpose Expectations strongly influence future employment outcomes and social networks seem to mediate employment success of young adults with intellectual and developmental disabilities. The aim of this study is to examine the expectations of young adults with intellectual and developmental

  18. Expectations from Different Perspectives on Future Work Outcome of Young Adults with Intellectual and Developmental Disabilities

    NARCIS (Netherlands)

    Holwerda, Anja; Brouwer, Sandra; de Boer, Michiel R.; Groothoff, Johan W.; van der Klink, Jac J. L.

    Purpose Expectations strongly influence future employment outcomes and social networks seem to mediate employment success of young adults with intellectual and developmental disabilities. The aim of this study is to examine the expectations of young adults with intellectual and developmental

  19. Reducing negative affect and increasing rapport improve interracial mentorship outcomes.

    Science.gov (United States)

    Leitner, Jordan B; Ayduk, Özlem; Boykin, C Malik; Mendoza-Denton, Rodolfo

    2018-01-01

    Research suggests that interracial mentoring relationships are strained by negative affect and low rapport. As such, it stands to reason that strategies that decrease negative affect and increase rapport should improve these relationships. However, previous research has not tested this possibility. In video-chats (Studies 1 and 2) and face-to-face meetings (Study 3), we manipulated the degree of mutual self-disclosure between mentees and mentors, a strategy that has been shown to reduce negative affect and increase rapport. We then measured negative affect and rapport as mediators, and mentee performance (quality of speech delivered; Studies 1 and 3) and mentor performance (warmth and helpfulness; Studies 2 and 3) as key outcomes. Results revealed that increased self-disclosure decreased negative affect and increased rapport for both mentees and mentors. Among mentees, decreased negative affect predicted better performance (Studies 1 and 3). Among mentors, increased rapport predicted warmer feedback (Studies 2 and 3). These effects remained significant when we meta-analyzed data across studies (Study 4), and also revealed the relationship of rapport to more helpful feedback. Findings suggest that affect and rapport are key features in facilitating positive outcomes in interracial mentoring relationships.

  20. Retail competition in electricity markets. Expectations, outcomes and economics

    International Nuclear Information System (INIS)

    Littlechild, Stephen

    2009-01-01

    In 'Retail competition in electricity markets' (Energy Policy, 37(2), February 2009, Pages 377-386) it is argued by Defeuilly that the introduction of retail competition into electricity markets gave rise to great expectations that it failed to meet, and that this was primarily the fault of Austrian economic thinking. The main purpose of this note is to explain why both of these propositions are incorrect. A few further comments challenge his subsequent suggestion that the competitive process in electricity is so constrained by the limitations of consumer decision-making and electricity technology as to cast doubt on the policy of opening the retail market to competition

  1. Expectations and outcome skills of a generalist health care administrator.

    Science.gov (United States)

    Jones, V B; Taylor, L C

    1990-01-01

    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. 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.

    Science.gov (United States)

    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

  3. The positive bystander effect: passive bystanders increase helping in situations with high expected negative consequences for the helper.

    Science.gov (United States)

    Fischer, Peter; Greitemeyer, Tobias

    2013-01-01

    The present field study investigated the interplay between the presence of a passive bystander (not present versus present) in a simulated bike theft and expected negative consequences (low versus high) in predicting intervention behavior when no physical victim is present. It was found that an additional bystander increases individual intervention in situations where the expected negative consequences for the helper in case of intervention were high (i.e., when the bike thief looks fierce) compared to situations where the expected negative consequences for the helper were low (i.e., when the bike thief does not look fierce). In contrast, no such effect for high vs. low expected negative consequences was observed when no additional bystander observed the critical situation. The results are discussed in light of previous laboratory findings on expected negative consequences and bystander intervention.

  4. THE IMPACT OF HOPE IN MEDIATING PSYCHOTHERAPY EXPECTATIONS AND OUTCOMES: A STUDY OF BRAZILIAN CLIENTS

    Directory of Open Access Journals (Sweden)

    Nicki L. Aubuchon-Endsley

    2015-12-01

    Full Text Available Client treatment expectations and hope are robustly associated with treatment outcome. Despite this, no known studies have examined client hope as a mediator to the relationship between expectancies and psychotherapy session outcomes. In addition, recent literature also supports cross-cultural differences in relations between treatment expectancies and outcomes. This article presents a cross-sectional study with a sample of Brazilian psychotherapy clients collected via referral sampling, in which existing clients referred potential participants. Participants were asked about their symptomatology and expectations of psychotherapy. The current study found that, within this Brazilian sample, trait hope partially mediated relations between expectancies and treatment session outcomes. Further studies are needed to investigate these effects and session outcomes in a culturally competent manner.

  5. Depressive symptoms, perceived stress, self-efficacy, and outcome expectations: Predict fitness among adolescents with obesity.

    Science.gov (United States)

    Tulloch, Heather; Heenan, Adam; Sweet, Shane; Goldfield, Gary S; Kenny, Glen P; Alberga, Angela S; Sigal, Ronald J

    2017-10-01

    The objective of the present study was to test if outcome expectancy mediated the relationship between fitness and self-efficacy, perceived stress, and depressive symptoms.Adolescents with obesity ( n = 228) completed measures of perceived stress and depressive symptoms at baseline, self-efficacy and outcome expectancy at baseline and 3 months, and fitness at baseline and 6 months. Structural equation modeling was used to analyze the data. Results showed that self-efficacy was positively associated with fitness via outcome expectancies. For females, fewer depressive symptoms were linked to fitness via self-efficacy and outcome expectancies. Exercise interventions that enhance exercise self-efficacy, outcome expectancy, and reduce depressive symptoms may increase fitness.

  6. An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: comparison of clinician, self-report, and biological measures.

    Science.gov (United States)

    Price, Matthew; Maples, Jessica L; Jovanovic, Tanja; Norrholm, Seth D; Heekin, Mary; Rothbaum, Barbara O

    2015-06-01

    Outcome expectancy, or the degree to which a client believes that therapy will result in improvement, is related to improved treatment outcomes for multiple disorders. There is a paucity of research investigating this relation in regards to posttraumatic stress disorder (PTSD). Additionally, the bulk of the research on outcome expectancy and treatment outcomes has relied mostly on self-report outcome measures. The relation between outcome expectancy on self-report measures, clinician-rated measures, and two biological indices (fear-potentiated startle and cortisol reactivity) of PTSD symptoms was explored. The sample included combat veterans (N = 116) treated with virtual reality exposure therapy for PTSD. Results supported a negative association between outcome expectancy and both self-report and clinician-rated symptoms at the conclusion of treatment, but outcome expectancy was related to the magnitude of change during treatment for self-report measures only. Outcome expectancy was unrelated to biological measures of treatment response. These findings suggest that outcome expectancy may be related to patient and clinician perceptions of outcomes, but not biological indices of outcome for PTSD. © 2015 Wiley Periodicals, Inc.

  7. Negative relationship behavior is more important than positive: Correlates of outcomes during stressful life events.

    Science.gov (United States)

    Rivers, Alannah Shelby; Sanford, Keith

    2018-04-01

    When people who are married or cohabiting face stressful life situations, their ability to cope may be associated with two separate dimensions of interpersonal behavior: positive and negative. These behaviors can be assessed with the Couple Resilience Inventory (CRI). It was expected that scales on this instrument would correlate with outcome variables regarding life well-being, stress, and relationship satisfaction. It was also expected that effects for negative behavior would be larger than effects for positive and that the effects might be curvilinear. Study 1 included 325 married or cohabiting people currently experiencing nonmedical major life stressors and Study 2 included 154 married or cohabiting people with current, serious medical conditions. All participants completed an online questionnaire including the CRI along with an alternate measure of couple behavior (to confirm scale validity), a measure of general coping style (to serve as a covariate), and measures of outcome variables regarding well-being, quality of life, perceived stress, and relationship satisfaction. The effects for negative behavior were larger than effects for positive in predicting most outcomes, and many effects were curvilinear. Notably, results remained significant after controlling for general coping style, and scales measuring positive and negative behavior demonstrated comparable levels of validity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Negative outcomes evoke cyclic irrational decisions in Rock, Paper, Scissors.

    Science.gov (United States)

    Dyson, Benjamin James; Wilbiks, Jonathan Michael Paul; Sandhu, Raj; Papanicolaou, Georgios; Lintag, Jaimie

    2016-02-04

    Rock, Paper, Scissors (RPS) represents a unique gaming space in which the predictions of human rational decision-making can be compared with actual performance. Playing a computerized opponent adopting a mixed-strategy equilibrium, participants revealed a non-significant tendency to over-select Rock. Further violations of rational decision-making were observed using an inter-trial analysis where participants were more likely to switch their item selection at trial n + 1 following a loss or draw at trial n, revealing the strategic vulnerability of individuals following the experience of negative rather than positive outcome. Unique switch strategies related to each of these trial n outcomes were also identified: after losing participants were more likely to 'downgrade' their item (e.g., Rock followed by Scissors) but after drawing participants were more likely to 'upgrade' their item (e.g., Rock followed by Paper). Further repetition analysis revealed that participants were more likely to continue their specific cyclic item change strategy into trial n + 2. The data reveal the strategic vulnerability of individuals following the experience of negative rather than positive outcome, the tensions between behavioural and cognitive influences on decision making, and underline the dangers of increased behavioural predictability in other recursive, non-cooperative environments such as economics and politics.

  9. Outcome Expectations and Osteoarthritis: Association of Perceived Benefits of Exercise With Self-Efficacy and Depression.

    Science.gov (United States)

    Marszalek, Jolanta; Price, Lori Lyn; Harvey, William F; Driban, Jeffrey B; Wang, Chenchen

    2017-04-01

    Outcome expectancy is recognized as a determinant of exercise engagement and adherence. However, little is known about which factors influence outcome expectations for exercise among people with knee osteoarthritis (OA). This is the first study to examine the association of outcome expectations for exercise with demographic, physical, and psychosocial outcomes in individuals with knee OA. We performed a cross-sectional analysis of the baseline data from a randomized trial of tai chi versus physical therapy in participants with symptomatic knee OA. Knee pain was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcome expectations for exercise, self-efficacy, depression, anxiety, stress, and social support were measured using standard instruments. Logistic regression models were utilized to determine associations with outcome expectations. There were 262 participants, with a mean age of 59.8 years and a mean body mass index of 32.1 kg/m 2 ; 69.1% of the participants were female, 51.5% were white, the mean disease duration was 8.6 years, and the mean WOMAC knee pain and function scores were 260.8 and 906.8, respectively. Higher outcome expectations for exercise were associated with greater self-efficacy (odds ratio [OR] 1.25 [95% confidence interval (95% CI) 1.11-1.41]; P = 0.0004), as well as with fewer depressive symptoms (OR 0.84 for each 5-point increase [95% CI 0.73-0.97]; P = 0.01). Outcome expectancy was not significantly associated with sex, race, education, pain, function, radiographic severity, social support, anxiety, or stress. Our results suggest significant associations between outcome expectations for exercise and self-efficacy and depression. Future studies should examine how these relationships longitudinally affect long-term clinical outcomes of exercise-based treatment for knee OA. © 2016, American College of Rheumatology.

  10. Individuals with clinically significant insomnia symptoms are characterised by a negative sleep-related expectancy bias: Results from a cognitive-experimental assessment.

    Science.gov (United States)

    Courtauld, Hannah; Notebaert, Lies; Milkins, Bronwyn; Kyle, Simon D; Clarke, Patrick J F

    2017-08-01

    Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). The task involved the presentation of scenarios describing the consequences of poor sleep, and non-sleep related activities, which could be resolved in a benign or a negative manner. The results demonstrated that the high insomnia symptoms group were disproportionately fast to resolve sleep-related scenarios in line with negative outcomes, as compared to benign outcomes, relative to the low insomnia symptoms group. The two groups did not differ in their pattern of resolving non-sleep related scenarios. This pattern of findings is entirely consistent with a sleep-specific expectancy bias operating in individuals with clinically significant insomnia symptoms, and highlights the potential of cognitive-experimental assessment tasks to objectively index patterns of biased cognition in insomnia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Preoperative Expectations and Postoperative Outcomes of Visual Functioning among Cataract Patients in Urban Southern China.

    Directory of Open Access Journals (Sweden)

    Ziyan Chen

    Full Text Available To investigate the relationship between preoperative expectations and actual postoperative outcomes of visual function (VF among patients undergoing first eye cataract surgery.A longitudinal study of 182 patients from hospitals in urban Southern China were surveyed prior to surgery and 3 month after cataract surgery regarding their preoperative, expected postoperative and actual postoperative VF for each of the items on the Catquest-9SF and their satisfaction with cataract surgery. In addition, detailed clinical data were collected preoperatively and postoperatively.The majority of cataract patients in urban Southern China had high expectations for VF outcomes after cataract surgery and in most cases postoperative outcomes achieved the expected level of improvement. The mean (standard deviation, SD preoperative Catquest-9SF score was 15.7 (5.86 and the mean (SD expected postoperative score was 26.3 (2.93. The discrepancy between actual and expected improvement was significantly correlated with patients' health literacy, presence of systemic and ocular comorbidity, preoperative visual acuity of the surgery eye, LOCS III nuclear opalescence and cortical cataract grading.Cataract patients in urban Southern China had high expectations for surgery outcomes. Patients with low level of health literacy and the presence of systemic and ocular comorbidity may need a comprehensive counseling to decrease the discrepancy regarding expected and actual outcomes.

  12. Expected Utility Illustrated: A Graphical Analysis of Gambles with More than Two Possible Outcomes

    Science.gov (United States)

    Chen, Frederick H.

    2010-01-01

    The author presents a simple geometric method to graphically illustrate the expected utility from a gamble with more than two possible outcomes. This geometric result gives economics students a simple visual aid for studying expected utility theory and enables them to analyze a richer set of decision problems under uncertainty compared to what…

  13. Expectancy-Value and Cognitive Process Outcomes in Mathematics Learning: A Structural Equation Analysis

    Science.gov (United States)

    Phan, Huy P.

    2014-01-01

    Existing research has yielded evidence to indicate that the expectancy-value theoretical model predicts students' learning in various achievement contexts. Achievement values and self-efficacy expectations, for example, have been found to exert positive effects on cognitive process and academic achievement outcomes. We tested a conceptual model…

  14. Gender gaps in life expectancy: generalized trends and negative associations with development indices in OECD countries.

    Science.gov (United States)

    Liu, Yan; Arai, Asuna; Kanda, Koji; Lee, Romeo B; Glasser, Jay; Tamashiro, Hiko

    2013-08-01

    Life expectancy (LE) is a major marker of individual survival. It also serves as a guide to highlight both the progress and the gaps in total social and societal health. Comparative LE in concert with measures of gender-specific experience, indices of empowerment and societal happiness and development offer a comparative tool to examine trends and similarities of societal progress as seen through the lens of cross-national experience. To determine the gender gaps in LE (GGLE) trends, we performed a longitudinal analysis, covering a period of 49 years (1960-2008). To examine the association of GGLE with development indices, we used the 2007 GGLE data, the newest happiness data mostly drawn from 2006; the 2006 Human Development Index (HDI) data and the 2006 Gender Empowerment Measure (GEM) data. It revealed that most of the Organization for Economic Co-operation and Development (OECD) countries had a GGLE trend that occurred in an inverted U-curve fashion. We divided them into three subgroups based on the peak years of respective GGLE. The earlier the peak year, the happier the countries, the higher the HDI and the smaller the current GGLE are. Association analysis indicates that Happiness, HDI and GEM are all negatively associated with GGLE. This pattern suggests that GGLE undergoes three phases of growth, peak and stability and decline. Japan will soon be seeing its GGLE gradually shrinking in the foreseeable future. The continuing increases in Happiness, HDI and GEM are associated with a decrease in GGLE, which should be carefully taken into consideration.

  15. Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Haanstra Tsjitske M

    2012-12-01

    Full Text Available Abstract Objective This systematic review aims to summarise all the available evidence related to the association between pre-operative patient expectations (outcome expectations, process expectations and self efficacy expectations and 5 different treatment outcomes (overall improvement, pain, function, stiffness and satisfaction in patients with total knee or total hip arthroplasty at three different follow-op periods (>6 weeks; >6 weeks- ≤6 months; >6 months. Methods English and Dutch language articles were identified through PubMed, EMBASE.com, PsycINFO, CINAHL and The Cochrane Library from inception to September 2012. Articles assessing the association between pre-operative patient expectations and treatment outcomes for TKA/THA in either adjusted or unadjusted analysis were included. Two reviewers, working independently, determined eligibility, rated methodological quality and extracted data on study design, population, expectation measurements, outcome measurements and strength of the associations. Methodological quality was rated by the same reviewers on a 19 item scale. The scores on the quality assessment were taken into account when drawing final conclusions. Results The search strategy generated 2252 unique references, 18 articles met inclusion criteria. Scores on the methodological quality assessment ranged between 6% and 79%. Great variety was seen in definitions and measurement methods of expectations. No significant associations were found between patient expectations and overall improvement, satisfaction and stiffness. Both significant positive and non-significant associations were found for the association between expectations and pain and function. Conclusions There was no consistency in the association between patients’ pre-operative expectations and treatment outcomes for TKA and THA indentified in this systematic review. There exists a need for a sound theoretical framework underlying the construct of

  16. Perceived Social Support and Locus of Control as the Predictors of Vocational Outcome Expectations

    Science.gov (United States)

    Isik, Erkan

    2013-01-01

    The purpose of this study was to examine the relationships of vocational outcome expectation to social support which is an environmental factor and locus of control which is a personal factor. With this purpose, using Social Cognitive Career Theory as the theoretical framework, 263 undergraduate students completed Vocational Outcome Expectations…

  17. Parent Expectations Mediate Outcomes for Young Adults with Autism Spectrum Disorder.

    Science.gov (United States)

    Kirby, Anne V

    2016-05-01

    Understanding the complex relationships among factors that may predict the outcomes of young adults with autism spectrum disorder (ASD) is of utmost importance given the increasing population undergoing and anticipating the transition to adulthood. With a sample of youth with ASD (n = 1170) from the National Longitudinal Transition Study-2, structural equation modeling techniques were used to test parent expectations as a mediator of young adult outcomes (i.e., employment, residential independence, social participation) in a longitudinal analysis. The mediation hypothesis was confirmed; family background and functional performance variables significantly predicted parent expectations which significantly predicted outcomes. These findings add context to previous studies examining the role of parent expectations on young adult outcomes and inform directions for family-centered interventions and future research.

  18. Surgical outcome of MRI-negative refractory extratemporal lobe epilepsy.

    Science.gov (United States)

    Shi, Jianguo; Lacuey, Nuria; Lhatoo, Samden

    2017-07-01

    The aim of this study is to determine outcome of resective epilepsy surgery in MRI-negative extratemporal lobe epilepsy (MNETLE) patients who underwent invasive evaluations and to determine factors governing outcome. We studied 28 patients who underwent resective epilepsy surgery for MNETLE from August 2006 to November 2015, in whom complete follow-up information was available. Electro-clinical, pathological and surgical data were evaluated. 24 patients (82.8%) were explored with intracranial EEG (9 stereoelectroencephalography (SEEG), 7 subdural grids and 8 both). All patients were followed for at least 6 months. During a mean follow up period of 32 [6-113] months, 13 (46.4%) patients became seizure-free (ILAE 1) and 18 (64.3%) had a good (ILAE 1, 2, 3) outcome. 21 (75.0%) patients had focal cortical dysplasia (FCD). Univariate analysis showed that more restricted (regional) interictal and ictal epileptiform discharges in surface EEG were significantly associated with seizure freedom (P=0.016 and P=0.024). Multivariate analysis confirmed that having ≥120 electrode contacts in the evaluation is an independent variable predicting seizure freedom (HR=4.283, 95% CI=1.342-13.676, P=0.014). Invasive EEG is a powerful tool in the pre-surgical evaluation of patients with MNETLE. Invasive EEG implantation that include the irritative zone and EEG onset zone as indicated by surface EEG, as well as wider brain coverage predict seizure freedom, contingent upon a sound anatomo-electro-clinical hypothesis for implantation. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Posttraumatic stress symptoms and tobacco abstinence effects in a non-clinical sample: evaluating the mediating role of negative affect reduction smoking expectancies.

    Science.gov (United States)

    Langdon, Kirsten J; Leventhal, Adam M

    2014-11-01

    The relation between posttraumatic stress symptoms and smoking is well documented but poorly understood. The present investigation sought to evaluate the impact of posttraumatic stress symptoms on subjective and behavioral tobacco abstinence effects both directly and indirectly through negative affect reduction smoking outcome expectancies. Participants included 275 (68.7% male; Mage =43.9, 10+ cig/day) adult non-treatment seeking smokers, who attended two counterbalanced laboratory sessions (16 h of smoking deprivation vs ad libitum smoking), during which they completed self-report measures of withdrawal symptoms and mood followed by a smoking lapse task in which they could earn money for delaying smoking and purchase cigarettes to smoke. Results supported a mediational pathway whereby higher baseline symptoms of posttraumatic stress predicted greater endorsement of expectancies that smoking will effectively reduce negative affect, which in turn predicted greater abstinence-provoked exacerbations in nicotine withdrawal symptoms and negative affect. Posttraumatic stress symptoms also predicted number of cigarettes purchased independent of negative affect reduction expectancies, but did not predict delaying smoking for money. Findings highlight tobacco abstinence effects as a putative mechanism underlying posttraumatic stress disorder (PTSD)-smoking comorbidity, indicate an important mediating role of beliefs for smoking-induced negative affect reduction, and shed light on integrated treatment approaches for these two conditions. © The Author(s) 2014.

  20. High intensity exercise or conventional exercise for patients with rheumatoid arthritis? Outcome expectations of patients, rheumatologists, and physiotherapists

    NARCIS (Netherlands)

    Munneke, M.; de Jong, Z.; Zwinderman, A. H.; Ronday, H. K.; van den Ende, C. H. M.; Vliet Vlieland, T. P. M.; Hazes, J. M. W.

    2004-01-01

    OBJECTIVE: To examine the outcome expectations of RA patients, rheumatologists, and physiotherapists regarding high intensity exercise programmes compared with conventional exercise programmes. METHODS: An exercise outcome expectations questionnaire was administered to 807 RA patients, 153

  1. Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

    Directory of Open Access Journals (Sweden)

    Maria Di Blasi

    2017-11-01

    Full Text Available The relationship between social anxiety (SA and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test and SA symptoms (Social Interaction Anxiety Scale and Social Phobia Scale. A multiple mediation analysis was used to test whether marijuana effect expectancies mediate SA effect on problematic cannabis use. SA was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationship between SA and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.

  2. Positively versus negatively charged moral emotion expectancies in adolescence: the role of situational context and the developing moral self.

    Science.gov (United States)

    Krettenauer, Tobias; Johnston, Megan

    2011-09-01

    The study analyses adolescents' positively charged versus negatively charged moral emotion expectancies. Two hundred and five students (M= 14.83 years, SD= 2.21) participated in an interview depicting various situations in which a moral norm was either regarded or transgressed. Emotion expectancies were assessed for specific emotions (pride, guilt) as well as for overall strength and valence. In addition, self-importance of moral values was measured by a questionnaire. Results revealed that positively charged emotion expectancies were more pronounced in contexts of prosocial action than in the context of moral transgressions, whereas the opposite was true for negatively charged emotions. At the same time, expectations of guilt and pride were substantially related to the self-importance of moral values. ©2010 The British Psychological Society.

  3. Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety.

    Science.gov (United States)

    Di Blasi, Maria; Cavani, Paola; Pavia, Laura; Tosto, Crispino; La Grutta, Sabina; Lo Baido, Rosa; Giordano, Cecilia; Schimmenti, Adriano

    2017-01-01

    The relationship between social anxiety (SA) and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male) who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test) and SA symptoms (Social Interaction Anxiety Scale and Social Phobia Scale). A multiple mediation analysis was used to test whether marijuana effect expectancies mediate SA effect on problematic cannabis use. SA was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationship between SA and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.

  4. Expectations from different perspectives on future work outcome of young adults with intellectual and developmental disabilities.

    Science.gov (United States)

    Holwerda, Anja; Brouwer, Sandra; de Boer, Michiel R; Groothoff, Johan W; van der Klink, Jac J L

    2015-03-01

    Expectations strongly influence future employment outcomes and social networks seem to mediate employment success of young adults with intellectual and developmental disabilities. The aim of this study is to examine the expectations of young adults with intellectual and developmental disabilities from special needs education, their parents and their school teachers regarding future work and the extent to which these expectations predict work outcome. Data on 341 young adults with intellectual or developmental disabilities, coming from special needs education, aged 17-20 years, and with an ability to work according to the Social Security Institute were examined. The school teacher's expectation was the only perspective that significantly predicted entering competitive employment, with a complementary effect of the expectation of parents and a small additional effect of the expectation of the young adult. Expectations of school teachers and parents are valuable in predicting work outcome. Therefore, it is important for professionals working with the young adult in the transition from school to work to incorporate the knowledge of school teachers and parents regarding the abilities of the young adult to enter competitive employment as a valuable source of information.

  5. Association between perceived self-efficacy, outcome expectations and outcome evaluation and fruit and vegetables consumption in adolescent girls

    Directory of Open Access Journals (Sweden)

    Ali Ramezankhani

    2017-05-01

    Full Text Available Unfortunately just a few number of children and adolescents use sufficient amounts of fruit and vegetables. This study aimed to investigate the association between fruit and vegetables consumption and perceived self-efficacy, outcome expectations and outcome evaluation in adolescent girls in Shahrekord city.This is a descriptive analytic study conducted on 308 high school girls (first grade who were selected by cluster sampling method in Shahrekord, Iran in 2013-2014. A researcher made questionnaire was used to collect the needed data like demographic variables, substructures of perceived self-efficacy, outcome expectations and outcome evaluation. In order to investigate the fruit and vegetables consumption status, the standard questionnaire of FFQ was used. The collected data was analyzed by SPSS 18 software, using descriptive and analytic tests such as one way variance analysis, Pearson and Spearman correlation. The mean scores of fruit and vegetables consumption and vegetables consumption were reported as 1.45±0.68 and 1.47±0.95 respectively as well. There was a direct significant association between adolescents’ perceived self-efficacy and outcome expectations. A direct significant association was also observed between fruit consumption and both outcome evaluation and perceived self-efficacy Regarding the status of fruit and vegetables consumption and the mean scores of outcome evaluation, outcome expectations and perceived self-efficacy in adolescents which was low, and also the importance of promoting healthy diet in the critical period of adolescence, it seems necessary to use efficient patterns and theories of health education and promotion in which the roles of individuals, family and environment has been considered.

  6. Development of the outcome expectancy scale for self-care among periodontal disease patients.

    Science.gov (United States)

    Kakudate, Naoki; Morita, Manabu; Fukuhara, Shunichi; Sugai, Makoto; Nagayama, Masato; Isogai, Emiko; Kawanami, Masamitsu; Chiba, Itsuo

    2011-12-01

    The theory of self-efficacy states that specific efficacy expectations affect behaviour. Two types of efficacy expectations are described within the theory. Self-efficacy expectations are the beliefs in the capacity to perform a specific behaviour. Outcome expectations are the beliefs that carrying out a specific behaviour will lead to a desired outcome. To develop and examine the reliability and validity of an outcome expectancy scale for self-care (OESS) among periodontal disease patients. A 34-item scale was tested on 101 patients at a dental clinic. Accuracy was improved by item analysis, and internal consistency and test-retest stability were investigated. Concurrent validity was tested by examining associations of the OESS score with the self-efficacy scale for self-care (SESS) score and plaque index score. Construct validity was examined by comparing OESS scores between periodontal patients at initial visit (group 1) and those continuing maintenance care (group 2). Item analysis identified 13 items for the OESS. Factor analysis extracted three factors: social-, oral- and self-evaluative outcome expectancy. Cronbach's alpha coefficient for the OESS was 0.90. A significant association was observed between test and retest scores, and between the OESS and SESS and plaque index scores. Further, group 2 had a significantly higher mean OESS score than group 1. We developed a 13-item OESS with high reliability and validity which may be used to assess outcome expectancy for self-care. A patient's psychological condition with regard to behaviour and affective status can be accurately evaluated using the OESS with SESS. © 2011 Blackwell Publishing Ltd.

  7. Expectancies for Social Support and Negative Mood Regulation Mediate the Relationship between Childhood Maltreatment and Self-Injury

    Directory of Open Access Journals (Sweden)

    Fiona Tresno

    2016-07-01

    Full Text Available Nonsuicidal self-injury (NSSI is common among young people. A majority of individuals who injure themselves do so to alleviate negative affect, as most self-injurers report difficulties with mood regulation. Trauma in childhood is an important risk factor that may cause individuals to develop poor interpersonal relations and impaired emotion-regulation, leading to the use of non-adaptive coping strategies such as NSSI. This study examined factors contributing to self-injury, focusing on the link from childhood maltreatment, through mood regulation expectancies and expectancies for social support (father, mother, and friends, to self-injury. Understanding how these variables relate to NSSI is crucial for early identification of individuals at risk of NSSI. Participants were 377 Japanese university students. Lifetime prevalence of self-injury was 20% among the sample. Results showed childhood maltreatment is a strong predictor that increases the risk for NSSI. However, expectancies for social support and mood regulation seem to be potential protective factors. Mood regulation expectancies mediate the relationship between childhood maltreatment and self-injury. In addition, expectancies for social support were indirectly linked with NSSI through negative mood regulation expectancies. It appears that perceived support from father and friends increases one's confidence in regulating difficult emotions, which in turn reduces risk for NSSI. Results suggest that strong expectancies for social support, especially from friends, increase one's confidence in regulating emotion, which contributes as a protective factor against self-injury.

  8. Trustworthy Tricksters: Violating a Negative Social Expectation Affects Source Memory and Person Perception When Fear of Exploitation Is High.

    Science.gov (United States)

    Süssenbach, Philipp; Gollwitzer, Mario; Mieth, Laura; Buchner, Axel; Bell, Raoul

    2016-01-01

    People who are high in victim-sensitivity-a personality trait characterized by a strong fear of being exploited by others-are more likely to attend to social cues associated with untrustworthiness rather than to cues associated with trustworthiness compared with people who are low in victim-sensitivity. But how do these people react when an initial expectation regarding a target's trustworthiness turns out to be false? Results from two studies show that victim-sensitive compared with victim-insensitive individuals show enhanced source memory and greater change in person perception for negatively labeled targets that violated rather than confirmed negative expectations (the "trustworthy trickster"). These findings are in line with recent theorizing on schema inconsistency and expectancy violation effects in social cognition and with research on the different facets of justice sensitivity in personality psychology.

  9. outcome of foam versus gauze dressings in negative pressure

    African Journals Online (AJOL)

    2013-07-30

    Jul 30, 2013 ... Negative pressure wound therapy (NPWT) is one of .... Presence of necrotic material. If present ..... an alternative dressing interface and other vacuum sources .... edge micro-vascular blood flow: Effects of negative pressure ...

  10. Students' Outcome Expectation on Spiritual and Religious Competency: A Hierarchical Regression Analysis

    Science.gov (United States)

    Lu, Junfei; Woo, Hongryun

    2017-01-01

    In this study, 74 master's-level counseling students from various programs completed a questionnaire inquiring about their perceived program environment in relation to the topics of spirituality and religion (S/R), program emphasis on nine specific S/R competencies, as well as their outcome expectations toward being S/R competent through training.…

  11. Learning More than Expected: The Influence of Teachers' Attitudes on Children's Learning Outcomes

    Science.gov (United States)

    Youn, Minjong

    2016-01-01

    This study employed the concept of teachers' sense of responsibility for students' learning to examine the extent to which the gap in math learning growth is reduced and whether such attitudes can improve children's learning outcomes to a degree that is above and beyond their expected achievement relative to their initial academic skills. Analysis…

  12. Expectations and outcome: The role of Proposer features in the Ultimatum Game

    NARCIS (Netherlands)

    Marchetti, A.; Castelli, I.; Harlé, K.M.; Sanfey, A.G.

    2011-01-01

    In social decision-making individuals make choices in an interactive context and their decisions may therefore be influenced by information they receive about features of the other player. These features may 'frame' the other player in particular ways and generate expectations about the outcome.

  13. Personality Traits' Effects on Self-Efficacy and Outcome Expectations for High School Major Choice

    Science.gov (United States)

    Brown, Dikla; Cinamon, Rachel Gali

    2016-01-01

    The current study focuses on the contribution of the Big Five personality traits to the development of self-efficacy and outcome expectations regarding selection of a high school major among 368 Israeli adolescents (Mage = 16.07, SD = 0.41). Structural equation analyses showed that higher levels of conscientiousness and extraversion and lower…

  14. The contribution of self-efficacy and outcome expectations in the ...

    African Journals Online (AJOL)

    This study examined the effectiveness of Bandura's self-efficacy theory to predict exercise adherence. A sample of new members at a gymnasium was assessed on a Physical Self-Efficacy Scale, an Adherence Efficacy Scale and an Outcome Expectancy Scale. The dependent variable, exercise adherence, was assessed by ...

  15. Connecting High School Physics Experiences, Outcome Expectations, Physics Identity, and Physics Career Choice: A Gender Study

    Science.gov (United States)

    Hazari, Zahra; Sonnert, Gerhard; Sadler, Philip M.; Shanahan, Marie-Claire

    2010-01-01

    This study explores how students' physics identities are shaped by their experiences in high school physics classes and by their career outcome expectations. The theoretical framework focuses on physics identity and includes the dimensions of student performance, competence, recognition by others, and interest. Drawing data from the Persistence…

  16. The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

    Science.gov (United States)

    Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

    2015-05-01

    Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. Published by Oxford University Press on behalf of Medical Council on Alcohol 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  17. Corrupt practices negatively influenced food security and live expectancy in developing countries

    Science.gov (United States)

    Uchendu, Florence Ngozi; Abolarin, Thaddeus Olatunbosun

    2015-01-01

    Malnutrition is a global public health problem more prevalent in developing countries than in developed countries. Indicators of malnutrition include household food security and life expectancy. Corruption might be one of socio-political problems fuelling malnutrition in developing countries. The aim of this paper is to compare influence of corruption on food security, live expectancy (LE) and population in developed and developing countries. Thirty two least corrupt countries (LCC) and most corrupt countries (MCC) representing developed and developing countries were systematically selected using Corruption Perceptions Index (CPI). Countries’ data on population, food security index (FSI) and LE scores were obtained from Global food security index (GFSI) and Population reference bureau. T-test, Multivariate (Wilks’ Lambda), Pearson product moment analysis were performed to determine relationship between CPI, FSI, LE, and population in LCC and MCC at pcorrupt practices and promoting good governance should be embraced to eradicate malnutrition in developing countries. PMID:26090058

  18. Peer and cyber aggression in secondary school students: the role of moral disengagement, hostile attribution bias, and outcome expectancies.

    Science.gov (United States)

    Pornari, Chrisa D; Wood, Jane

    2010-01-01

    This study investigated the relationship between cognitive mechanisms, applied by people to rationalize and justify harmful acts, and engagement in traditional peer and cyber aggression among school children. We examined the contribution of moral disengagement (MD), hostile attribution bias, and outcome expectancies, and we further explored the individual contribution of each MD mechanism. Our aim was to identify shared and unique cognitive factors of the two forms of aggression. Three hundred and thirty-nine secondary school children completed self-report measures that assessed MD, hostile attribution bias, outcome expectancies, and their roles and involvement in traditional and cyber aggression. We found that the MD total score positively related to both forms of peer-directed aggression. Furthermore, traditional peer aggression positively related to children's moral justification, euphemistic language, displacement of responsibility and outcome expectancies, and negatively associated with hostile attribution bias. Moral justification also related positively to cyber aggression. Cyber aggression and cyber victimization were associated with high levels of traditional peer aggression and victimization, respectively. The results suggest that MD is a common feature of both traditional and cyber peer aggression, but it seems that traditional forms of aggression demand a higher level of rationalization or justification. Moreover, the data suggest that the expectation of positive outcomes from harmful behavior facilitates engagement in traditional peer aggression. The differential contribution of specific cognitive mechanisms indicates the need for future research to elaborate on the current findings, in order to advance theory and inform existing and future school interventions tackling aggression and bullying. (c) 2009 Wiley-Liss, Inc.

  19. Mapping clinical outcomes expectations to treatment decisions: an application to vestibular schwannoma management.

    Science.gov (United States)

    Cheung, Steven W; Aranda, Derick; Driscoll, Colin L W; Parsa, Andrew T

    2010-02-01

    Complex medical decision making obligates tradeoff assessments among treatment outcomes expectations, but an accessible tool to perform the necessary analysis is conspicuously absent. We aimed to demonstrate methodology and feasibility of adapting conjoint analysis for mapping clinical outcomes expectations to treatment decisions in vestibular schwannoma (VS) management. Prospective. Tertiary medical center and US-based otologists/neurotologists. Treatment preference profiles among VS stakeholders-61 younger and 74 older prospective patients, 61 observation patients, and 60 surgeons-were assessed for the synthetic VS case scenario of a 10-mm tumor in association with useful hearing and normal facial function. Treatment attribute utility. Conjoint analysis attribute levels were set in accordance to the results of a meta-analysis. Forty-five case series were disaggregated to formulate microsurgery facial nerve and hearing preservation outcomes expectations models. Attribute utilities were computed and mapped to the realistic treatment choices of translabyrinthine craniotomy, middle fossa craniotomy, and gamma knife radiosurgery. Among the treatment attributes of likelihoods of causing deafness, temporary facial weakness for 2 months, and incurable cancer within 20 years, and recovery time, permanent deafness was less important to tumor surgeons, and temporary facial weakness was more important to tumor surgeons and observation patients (Wilcoxon rank-sum, p knife radiosurgery. Mapping clinical outcomes expectations to treatment decisions for a synthetic clinical scenario revealed inhomogeneous drivers of choice selection among study cohorts. Medical decision engines that analyze personal preferences of outcomes expectations for VS and many other diseases may be developed to promote shared decision making among health care stakeholders and transparency in the informed consent process.

  20. Great expectations and what comes of it: the effects of unmet expectations on work motivation and outcomes among newcomers

    NARCIS (Netherlands)

    Taris, T.W.; Feij, J.A.; Capel, S.

    2006-01-01

    The present research focused on newcomers' socialization process in a three-wave study among 1477 newcomers from seven Western (mainly European) countries. Based on previous research, we expected that unmet expectations regarding selected intrinsic work aspects would have adverse effects on work

  1. You have my word: reciprocity expectation modulates feedback-related negativity in the trust game.

    Directory of Open Access Journals (Sweden)

    Qingguo Ma

    Full Text Available Promise is one of the most powerful tools producing trust and facilitating cooperation, and sticking to the promise is deemed as a key social norm in social interactions. The present study explored the extent to which promise would influence investors' decision-making in the trust game where promise had no predictive value regarding trustees' reciprocation. In addition, we examined the neural underpinnings of the investors' outcome processing related to the trustees' promise keeping and promise breaking. Consistent with our hypothesis, behavioral results indicated that promise could effectively increase the investment frequency of investors. Electrophysiological results showed that, promise induced larger differentiated-FRN responses to the reward and non-reward discrepancy. Taken together, these results suggested that promise would promote cooperative behavior, while breach of promise would be regarded as a violation of the social norm, corroborating the vital role of non-enforceable commitment in social decision making.

  2. You have my word: reciprocity expectation modulates feedback-related negativity in the trust game.

    Science.gov (United States)

    Ma, Qingguo; Meng, Liang; Shen, Qiang

    2015-01-01

    Promise is one of the most powerful tools producing trust and facilitating cooperation, and sticking to the promise is deemed as a key social norm in social interactions. The present study explored the extent to which promise would influence investors' decision-making in the trust game where promise had no predictive value regarding trustees' reciprocation. In addition, we examined the neural underpinnings of the investors' outcome processing related to the trustees' promise keeping and promise breaking. Consistent with our hypothesis, behavioral results indicated that promise could effectively increase the investment frequency of investors. Electrophysiological results showed that, promise induced larger differentiated-FRN responses to the reward and non-reward discrepancy. Taken together, these results suggested that promise would promote cooperative behavior, while breach of promise would be regarded as a violation of the social norm, corroborating the vital role of non-enforceable commitment in social decision making.

  3. Community attitudes toward a proposed nuclear power generating facility as a function of expected outcomes

    International Nuclear Information System (INIS)

    Sundstrom, E.; Lounsbury, J.W.; Schuller, C.R.; Fowler, J.R.; Mattingly, T.J. Jr.

    1977-01-01

    The relationship between attitudes toward a proposed nuclear power generating facility and the outcomes expected to accompany it are examined. In a survey of 350 residents of a small rural community, approximately 2/3 expressed favorable attitudes toward the proposed nuclear plant. A principal components factor analysis of the anticipated likelihoods of outcomes of the plant revealed five factors: hazards, economic growth, lower costs, social disruption, and community visibility. Using these factors as predictors, a simple multiple regression equation accounted for 52% of the variation in attitudes toward the plant. The strongest predictor was the perceived likelihood of hazards. These findings are discussed in terms of the relationship between attitudes and expectations, and in relation to decisions regarding public policy

  4. Great expectations, predictable outcomes and the G20's response to the recent global financial crisis

    OpenAIRE

    Ojo, Marianne

    2011-01-01

    The meeting of the Governors and Heads of Supervision on the 12 September 2010, their decisions in relation to the new capital framework known as Basel III, as well as the endorsement of the agreements reached on the 26 July 2010, once again, reflect the typical situation where great expectations with rather unequivocal, and in a sense, disappointing results are delivered. The outcome of various consultations by the Basel Committee on Banking Supervision, consultations which culminated in the...

  5. Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Victoria, E-mail: drvictoriac@gmail.com; Tse, Donald, E-mail: donald.tse@gmail.com; Dixon, Shaheen, E-mail: shaheen7noorani@gmail.com [John Radcliffe Hospital, Department of Radiology, Level 2 (United Kingdom); Shrivastava, Vivek, E-mail: vivshriv@yahoo.com [Hull Royal Infirmary, Department of Radiology (United Kingdom); Bratby, Mark, E-mail: mark.bratby@ouh.nhs.uk; Anthony, Suzie, E-mail: suzie.anthony@ouh.nhs.uk; Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk; Tapping, Charles, E-mail: charles.tapping@ouh.nhs.uk; Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliffe Hospital, Department of Radiology, Level 2 (United Kingdom)

    2015-04-15

    ObjectiveThis study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage.MethodsA review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient’s clinical notes.ResultsA total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32–0.95).ConclusionsPatients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed.

  6. Outcome Following a Negative CT Angiogram for Gastrointestinal Hemorrhage

    International Nuclear Information System (INIS)

    Chan, Victoria; Tse, Donald; Dixon, Shaheen; Shrivastava, Vivek; Bratby, Mark; Anthony, Suzie; Patel, Rafiuddin; Tapping, Charles; Uberoi, Raman

    2015-01-01

    ObjectiveThis study was designed to evaluate the role of a negative computed tomography angiogram (CTA) in patients who present with gastrointestinal (GI) hemorrhage.MethodsA review of all patients who had CTAs for GI hemorrhage over an 8-year period from January 2005 to December 2012 was performed. Data for patient demographics, location of hemorrhage, hemodynamic stability, and details of angiograms and/or the embolization procedure were obtained from the CRIS/PACS database, interventional radiology database, secure electronic medical records, and patient’s clinical notes.ResultsA total of 180 patients had 202 CTAs during the 8-year period: 87 CTAs were performed for upper GI hemorrhage (18 positive for active bleeding, 69 negative) and 115 for lower GI hemorrhage (37 positive for active bleeding, 78 negative); 58.7 % (37/63) of patients with upper GI bleed and 77.4 % (48/62) of patients with lower GI bleed who had an initial negative CTA did not rebleed without the need for radiological or surgical intervention. This difference was statistically significant (p = 0.04). The relative risk of rebleeding, following a negative CTA, in lower GI bleeding versus upper GI bleeding patients is 0.55 (95 % confidence interval 0.32–0.95).ConclusionsPatients with upper GI bleed who had negative CTAs usually require further intervention to stop the bleeding. In contrast, most patients presenting with lower GI hemorrhage who had a negative first CTA were less likely to rebleed

  7. Positive Outcome Expectancy Mediates the Relationship Between Peer Influence and Internet Gaming Addiction Among Adolescents in Taiwan.

    Science.gov (United States)

    Wu, Jo Yung Wei; Ko, Huei-Chen; Wong, Tsui-Yin; Wu, Li-An; Oei, Tian Po

    2016-01-01

    The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

  8. PLANNING AND ESTIMATION OF EXPECTED COMPETENCES LEARNING OUTCOMES FOR FSES HPE

    Directory of Open Access Journals (Sweden)

    V. N. Vasilev

    2013-03-01

    Full Text Available The article deals with approach for planning and estimation of competences learning outcomes for Federal State Educational Standard of Higher Professional Education (FSES HPE in the framework of information and educational environment development of the higher education institution, based on the discipline content structuring for formation of the standard competences learning results and the principle of interdisciplinary training. Connection of FSES HPE competences learning outcomes with types and forms of students’ trainings, types and forms of their control in a discipline is analyzed. Techniques of estimation means development for the current, module and intermediate control of expected competences learning outcomes for FSES HPE are considered. Examples of the developed techniques application are given.

  9. The Relationship Between Psychological Distress, Negative Cognitions, and Expectancies on Problem Drinking: Exploring a Growing Problem Among University Students.

    Science.gov (United States)

    Obasi, Ezemenari M; Brooks, Jessica J; Cavanagh, Lucia

    2016-01-01

    Few studies have sought to understand the concurrent relationship between cognitive and affective processes on alcohol use and negative alcohol-related consequences, despite both being identified as predictive risk factors in the college population. More research is needed to understand the relationships between identified factors of problem drinking among this at-risk population. The purpose of this study was to test if the relationship between psychological distress and problem drinking among university students (N = 284; M-age = 19.77) was mediated by negative affect regulation strategies and positive alcohol-related expectancies. Two latent mediation models of problem drinking were tested using structural equation modeling (SEM). The parsimonious three-path mediated latent model was supported by the data, as evidenced by several model fit indices. Furthermore, the alternate saturated model provided similar fit to the data, but contained several direct relationships that were not statistically significant. The relationship between psychological distress and problem drinking was mediated by an extended contributory chain, including negative affect regulation and positive alcohol-related expectancies. Implications for prevention and treatment, as well as future directions, are discussed. © The Author(s) 2015.

  10. Great expectations - and what comes of it: The effects of unmet expectations on work motivation and outcomes among newcomers

    NARCIS (Netherlands)

    Taris, T.W.; Feij, J.A.; Capel, S.

    2006-01-01

    Purpose - Examines how the socialization of new employees affects their future work performance, studying the impact of unmet expectations on their later motivation for learning, effort and turnover. Design/methodology/approach - Uses data from the Work Socialization of Youth study, which studied

  11. Promoting parent academic expectations predicts improved school outcomes for low-income children entering kindergarten.

    Science.gov (United States)

    Loughlin-Presnal, John E; Bierman, Karen L

    2017-06-01

    This study explored patterns of change in the REDI (Research-based Developmentally Informed) Parent program (REDI-P), designed to help parents support child learning at the transition into kindergarten. Participants were 200 prekindergarten children attending Head Start (55% European-American, 26% African American, 19% Latino, 56% male, M age =4.45years, SD=0.29) and their primary caregivers, who were randomized to a 16-session home-visiting intervention (REDI-P) or a control group. Extending beyond a prior study documenting intervention effects on parenting behaviors and child kindergarten outcomes, this study assessed the impact of REDI-P on parent academic expectations, and then explored the degree to which intervention gains in three areas of parenting (parent-child interactive reading, parent-child conversations, parent academic expectations) predicted child outcomes in kindergarten (controlling for baseline values and a set of child and family characteristics). Results showed that REDI-P promoted significant gains in parent academic expectations, which in turn mediated intervention gains in child emergent literacy skills and self-directed learning. Results suggest a need to attend to the beliefs parents hold about their child's academic potential, as well as their behavioral support for child learning, when designing interventions to enhance the school success of children in low-income families. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  12. The neural coding of expected and unexpected monetary performance outcomes: dissociations between active and observational learning.

    Science.gov (United States)

    Bellebaum, C; Jokisch, D; Gizewski, E R; Forsting, M; Daum, I

    2012-02-01

    Successful adaptation to the environment requires the learning of stimulus-response-outcome associations. Such associations can be learned actively by trial and error or by observing the behaviour and accompanying outcomes in other persons. The present study investigated similarities and differences in the neural mechanisms of active and observational learning from monetary feedback using functional magnetic resonance imaging. Two groups of 15 subjects each - active and observational learners - participated in the experiment. On every trial, active learners chose between two stimuli and received monetary feedback. Each observational learner observed the choices and outcomes of one active learner. Learning performance as assessed via active test trials without feedback was comparable between groups. Different activation patterns were observed for the processing of unexpected vs. expected monetary feedback in active and observational learners, particularly for positive outcomes. Activity for unexpected vs. expected reward was stronger in the right striatum in active learning, while activity in the hippocampus was bilaterally enhanced in observational and reduced in active learning. Modulation of activity by prediction error (PE) magnitude was observed in the right putamen in both types of learning, whereas PE related activations in the right anterior caudate nucleus and in the medial orbitofrontal cortex were stronger for active learning. The striatum and orbitofrontal cortex thus appear to link reward stimuli to own behavioural reactions and are less strongly involved when the behavioural outcome refers to another person's action. Alternative explanations such as differences in reward value between active and observational learning are also discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. The Smoking Outcome Expectation Scale and Anti-Smoking Self-Efficacy Scale for Early Adolescents: Instrument Development and Validation

    Science.gov (United States)

    Chen, Chen-Ju; Yeh, Ming-Chen; Tang, Fu-In; Yu, Shu

    2015-01-01

    Smoking-related outcome expectation and self-efficacy have been found to be associated with adolescent smoking initiation. There is, however, a lack of appropriate instruments to investigate early adolescents' smoking outcome expectations and antismoking self-efficacy. The purpose of this study was to develop and validate the Smoking Outcome…

  14. The Relationship between Career Decision-Making Self-Efficacy and Vocational Outcome Expectations of Preservice Special Education Teachers

    Science.gov (United States)

    Baglama, Basak; Uzunboylu, Huseyin

    2017-01-01

    Social cognitive career theory, which is one of the most studied career approaches, recently proposed that self-efficacy and outcome expectations are important determinants of the career choice process. Career self-efficacy and vocational outcome expectations might both result in avoiding or having greater motivation levels in terms of career…

  15. Self-Efficacy and Outcome Expectancy in Beginning Weight Training Class: Their Relations to Students' Behavioral Intention and Actual Behavior

    Science.gov (United States)

    Gao, Zan; Xiang, Ping; Lee, Amelia M.; Harrison, Louis, Jr.

    2008-01-01

    This study was an initial attempt to investigate the relationships among self-efficacy, outcome expectancy, behavioral intention, and actual behavior over time in a beginning weight training class. A total of 109 participants completed questionnaires assessing their self-efficacy, outcome expectancy, and intentions for future weight training.…

  16. In high school and pregnant: the importance of educational and fertility expectations for subsequent outcomes.

    Science.gov (United States)

    Yakusheva, Olga

    2011-01-01

    This study uses the High School and Beyond data (1980–1992) to examine the importance of educational and fertility expectations in explaining the achievement gap of adolescent mothers for over 5,500 young women from different socioeconomic backgrounds. Using a non-parametric local propensity score regression, the study finds that the economic disadvantage associated with having a child in high school is particularly large in poor socioeconomic environments; however, this disadvantage is a result of preexisting differences in the educational and fertility expectations and is not because of a diminished capacity of the socioeconomic environment to mediate the effect of an unplanned childbirth. The findings suggest that childcare assistance and other policies designed to alleviate the burden of child rearing for young mothers of low means may not produce the desired improvement in their subsequent educational and labor market outcomes. A much earlier policy intervention with a focus on fostering young women's outlook for the future is needed.

  17. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Hui-yan Sun

    2015-01-01

    Full Text Available Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury.

  18. Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital.

    Science.gov (United States)

    Plöderl, Martin; Kunrath, Sabine; Cramer, Robert J; Wang, Jen; Hauer, Larissa; Fartacek, Clemens

    2017-05-15

    Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome of heterosexual and SM patients at risk for suicide was the primary aim of this study. The secondary aim was to compare treatment expectation and working alliance as two common factors. We report on 633 patients from a suicide prevention inpatient department within a public psychiatric hospital. Most patients were at risk for suicide due to a recent suicide attempt or warning signs for suicide, usually in the context of a severe psychiatric disorder. At least one indicator of SM status was reported by 21% of patients. We assessed the treatment outcome by calculating the quantitative change in suicide ideation, hopelessness, and depression. We also ran related treatment responder analyses. Treatment expectation and working alliance were the assessed common factors. Contrary to the primary hypothesis, SM and heterosexual patients were comparable in their improvement in suicide ideation, hopelessness, or depression, both quantitatively and in treatment responder analysis. Contrary to the secondary hypothesis, there were no significant sexual orientation differences in treatment expectation and working alliance. When adjusting for sociodemographics, diagnosis, and length of stay, some sexual orientation differences became significant, indicating that SM

  19. Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder.

    Science.gov (United States)

    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.

  20. Development and Validation of the EXPECT Questionnaire: Assessing Patient Expectations of Outcomes of Complementary and Alternative Medicine Treatments for Chronic Pain.

    Science.gov (United States)

    Jones, Salene M W; Lange, Jane; Turner, Judith; Cherkin, Dan; Ritenbaugh, Cheryl; Hsu, Clarissa; Berthoud, Heidi; Sherman, Karen

    2016-11-01

    Patient expectations may be associated with outcomes of complementary and alternative medicine (CAM) treatments for chronic pain. However, a psychometrically sound measure of such expectations is needed. The purpose of this study was to develop and evaluate a questionnaire to assess individuals' expectations regarding outcomes of CAM treatments for chronic low back pain (CLBP), as well as a short form of the questionnaire. An 18-item draft questionnaire was developed through literature review, cognitive interviews with individuals with CLBP, CAM practitioners, and expert consultation. Two samples completed the questionnaire: (1) a community sample (n = 141) completed it via an online survey before or soon after starting a CAM treatment for CLBP, and (2) participants (n = 181) in randomized clinical trials evaluating CAM treatments for CLBP or fibromyalgia completed it prior to or shortly after starting treatment. Factor structure, internal consistency, test-retest reliability, and criterion validity were examined. Based on factor analyses, 10 items reflecting expectations (used to create a total score) and three items reflecting hopes (not scored) were selected for the questionnaire. The questionnaire had high internal consistency, moderate test-retest reliability, and moderate correlations with other measures of expectations. A three-item short form also had adequate reliability and validity. The Expectations for Complementary and Alternative Medicine Treatments (EXPECT) questionnaire can be used in research to assess individuals' expectations of treatments for chronic pain. It is recommended that the three hope questions are included (but not scored) to help respondents distinguish between hopes and expectations. The short form may be appropriate for clinical settings and when expectation measurement is not a primary focus.

  1. Caffeinated alcohol consumption profiles and associations with use severity and outcome expectancies.

    Science.gov (United States)

    Lau-Barraco, Cathy; Milletich, Robert J; Linden, Ashley N

    2014-01-01

    Growing evidence suggests that the consumption of caffeinated alcoholic beverages (CAB) may be riskier than alcohol alone. Efforts to identify patterns of CAB use and the correlates of such drinking patterns could further our conceptualization of and intervention for this health issue. Consequently, the current study aimed to (1) identify distinct classes of CAB users, (2) examine differences between classes on measures of alcohol and caffeine problems, and (3) compare distinct classes of CAB users on caffeine and alcohol outcome expectancies. Participants were 583 (31% men) undergraduate students from a psychology research pool. Latent profile analysis models were derived using four indicators: CAB use quantity, CAB use frequency, alcohol use quantity, and alcohol use frequency. Finding revealed four classes of drinkers: High Alcohol/High CAB (6.00%), High Alcohol/Moderate CAB (5.15%), High Alcohol/Low CAB (22.99%), and Low Alcohol/Low CAB (65.87%). The Low Alcohol/Low CAB class reported the lowest relative levels of caffeine dependence symptoms, caffeine withdrawal, alcohol use problems, and heavy episodic drinking frequency. Further, results indicated differential expectancy endorsement based on use profiles. CAB users in the High Alcohol/Low CAB class endorsed more positive alcohol expectancies than the Low Alcohol/Low CAB group. Those in the High Alcohol/High CAB class endorsed stronger withdrawal symptom caffeine expectancies than all other classes. Inclusion of substance-specific expectancies into larger theoretical frameworks in future work of CAB use may be beneficial. Findings may inform intervention efforts for those at greatest risk related to CAB consumption. © 2013.

  2. Irrational reactions to negative outcomes: evidence for two conceptual systems.

    Science.gov (United States)

    Epstein, S; Lipson, A; Holstein, C; Huh, E

    1992-02-01

    According to cognitive-experiential self-theory (CEST), individuals have 2 systems for processing information, a rational system and an experiential system. Research conducted under norm theory (NT) has provided impressive evidence of an if only (IO) effect associated with postoutcome processing of aversive events that are highly consistent with formulations in CEST. Two studies involving vignettes adapted from NT were conducted that tested 4 hypotheses and corollaries derived from CEST. It was demonstrated, in support of hypotheses, that the IO effect can be obtained with ratings of one's own and of a protagonist's specific behaviors, as well as with ratings of a protagonist's diffuse emotions (the usual procedure); that a rational orientation decreases the IO effect; that increasing the intensity of outcomes increases it; and that priming the experiential system reduces people's ability to subsequently think rationally. The theoretical and research implications of these findings are discussed.

  3. Outcome Expectancy as a Predictor of Treatment Response in Cognitive Behavioral Therapy for Public Speaking Fears Within Social Anxiety Disorder

    OpenAIRE

    Price, Matthew; Anderson, Page L.

    2011-01-01

    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 exp...

  4. Blatant Stereotype Threat and Women's Math Performance: Self-Handicapping as a Strategic Means To Cope with Obtrusive Negative Performance Expectations.

    Science.gov (United States)

    Keller, Johannes

    2002-01-01

    Examined the impact of increased salience of negative stereotypic expectations on math performance among high school students. Results indicated that female students in the condition of heightened salience of negative stereotypic expectations underperformed in comparison to their control group counterparts. The effect of blatant stereotype threat…

  5. Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination Theory.

    Science.gov (United States)

    Wilson, Philip M; Blanchard, Chris M; Nehl, Eric; Baker, Frank

    2006-07-01

    The purpose of this study was to examine the contributions of autonomous and controlled motives drawn from Self-Determination Theory (SDT; Intrinsic Motivation and Self-determination in Human Behavior. Plenum Press: New York, 1985; Handbook of Self-determination Research. University of Rochester Press: New York, 2002) towards predicting physical activity behaviours and outcome expectations in adult cancer survivors. Participants were cancer-survivors (N=220) and a non-cancer comparison cohort (N=220) who completed an adapted version of the Treatment Self-Regulation Questionnaire modified for physical activity behaviour (TSRQ-PA), an assessment of the number of minutes engaged in moderate-to-vigorous physical activity (MVPA) weekly, and the anticipated outcomes expected from regular physical activity (OE). Simultaneous multiple regression analyses indicated that autonomous motives was the dominant predictor of OEs across both cancer and non-cancer cohorts (R(2adj)=0.29-0.43), while MVPA was predicted by autonomous (beta's ranged from 0.21 to 0.34) and controlled (beta's ranged from -0.04 to -0.23) motives after controlling for demographic considerations. Cancer status (cancer versus no cancer) did not moderate the motivation-physical activity relationship. Collectively, these findings suggest that the distinction between autonomous and controlled motives is useful and compliments a growing body of evidence supporting SDT as a framework for understanding motivational processes in physical activity contexts with cancer survivors.

  6. Association of Self-Efficacy and Outcome Expectations with Physical Activity in Adults with Arthritis

    Directory of Open Access Journals (Sweden)

    Thelma J. Mielenz

    2013-01-01

    Full Text Available Background and Purpose. The purpose of this study is to determine whether higher baseline levels of (a self-efficacy for physical activity, (b self-efficacy for arthritis self-management, and (c outcome expectations for exercise are associated with higher physical activity levels following an exercise intervention for adults with arthritis. Methods. A secondary analysis of the intervention cohort (n=130 within a randomized controlled trial of the People with Arthritis Can Exercise program was performed. Multiple linear regression evaluated the relationship between physical activity at a time point three months after the completion of an exercise intervention and three main explanatory variables. Results. After controlling for baseline physical activity, neither self-efficacy for arthritis self-management nor outcome expectations for exercise related to three-month physical activity levels. There was a relationship between three-month physical activity and self-efficacy for physical activity. Conclusions. Future research is needed to evaluate the ability of self-efficacy-enhancing programs to increase physical activity in adults with arthritis.

  7. Evaluating expected outcomes of acid remediation in an intensively mined Appalachian watershed.

    Science.gov (United States)

    Watson, Andrew S; Merovich, George T; Petty, J Todd; Gutta, J Brady

    2017-07-01

    Assessments of watershed-based restoration efforts are rare but are essential for the science of stream restoration to advance. We conducted a watershed scale assessment of Abram Creek before and after implementation of a watershed-based plan designed to maximize ecological recovery from acid mine drainage (AMD) impairment. We surveyed water chemistry, physical habitat, benthic macroinvertebrates, and fish community structure in three stream types: AMD-impacted (14 streams), AMD-treated (13 streams), and unimpaired reference (4 streams). We used in-stream measurements to quantify ecological loss from AMD, the amount of ecological recovery expected through remediation, and the observed degree of post-treatment recovery. Sites impaired by AMD improved in water quality with AMD treatment. Dissolved metals and acidity declined significantly in treated streams, but sulfate and specific conductance did not. Likewise, sites impaired by AMD improved in bio-condition scores with AMD treatment. EPT genera increased significantly but were lower compared to unimpaired streams. We found fish at nine treated sites that had none before treatment. Community-level analyses indicated improved but altered assemblages with AMD treatment. Analysis of pre-treatment conditions indicated that only 30% of the historic fishery remained. Remediation was expected to recover 66% of the historic fishery value, and assessment of post-treatment conditions indicates that 52% of the historic fishery has been recovered after 3 years. Developing expected endpoints for restoration outcomes provides a tool to objectively evaluate successes and can guide adaptive management strategies.

  8. Nutrition knowledge, outcome expectations, self-efficacy, and eating behaviors by calcium intake level in Korean female college students.

    Science.gov (United States)

    Kim, Min Ju; Kim, Kyung Won

    2015-10-01

    Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory. Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or χ(2)-test. Subjects were categorized into two groups, high calcium intake (HC, ≥ 650 mg/day) and low calcium intake (LC, benefits of consuming calcium-rich foods, including 'taste' (P eating dairy foods for snacks' (P eating dairy foods every day' (P eating calcium-rich side dishes at meals' (P Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P foods (P foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.

  9. Risk factors and short-term outcome in patients with angiographically negative subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Dalbjerg, Sara Maria; Larsen, Carl Christian; Romner, Bertil

    2013-01-01

    The objective of this study was to identify prognostic factors for clinical outcome in patients with non-traumatic, angiographically negative subarachnoid hemorrhage. Furthermore, the aim was to investigate if patients on anticoagulant therapy may have a more unfavorable outcome than patients...

  10. Meeting Teacher Expectations in a DL Professional Development Programme--A Case Study for Sustained Applied Competence as Programme Outcome

    Science.gov (United States)

    Kruger, Cornè Gerda; Van Rensburg, Ona Janse; De Witt, Marike W.

    2016-01-01

    Meeting teacher expectations for a professional development programme (PDP) is expected to strengthen sustainable applied competence as programme outcome since teachers will be more motivated to apply the programme content in practice. A revised distance learning (DL) programme was augmented by a practical component comprising a work-integrated…

  11. Differential UCS expectancy bias in spider fearful individuals : Evidence toward an association between spiders and disgust-relevant outcomes

    NARCIS (Netherlands)

    van Overveld, M; de Jong, PJ; Peters, ML

    Recently, differential UCS expectancies were found for high- and low-predatory fear-relevant animals [Davey, G. C. L., Cavanagh, K., & Lamb, A. (2003). Differential aversive outcome expectancies for high- and low-predation fear-relevant animals. Journal of Behavior Therapy and Experimental

  12. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance

    Science.gov (United States)

    Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

    2016-01-01

    Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others’ access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed. PMID:27824909

  13. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance.

    Directory of Open Access Journals (Sweden)

    Fengqiu Xiao

    Full Text Available Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others' access to clean water and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water. We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed.

  14. Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

    Science.gov (United States)

    Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

    2018-01-01

    Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating

  15. Does adherence to treatment mediate the relationship between patients' treatment outcome expectancies and the outcomes of pain intensity and recovery from acute low back pain?

    Science.gov (United States)

    Haanstra, Tsjitske M; Kamper, Steven J; Williams, Christopher M; Spriensma, Alette S; Lin, Chung-Wei Christine; Maher, Christopher G; de Vet, Henrica C W; Ostelo, Raymond W J G

    2015-08-01

    It is believed that patients' expectancies about the effectiveness of treatment influence their treatment outcomes, but the working mechanism is rarely studied in patients with low back pain. Theoretical models suggest that adherence to treatment may be an important pathway. The aim of this study was to assess the mediating role of adherence to treatment in the relationship between expectancies and the outcomes of recovery and pain intensity in patients with acute low back pain. This study used data from a randomized placebo-controlled trial of paracetamol for acute low back pain. Expectancies were measured with the Credibility Expectancy Questionnaire. Adherence was measured with a medication diary. Pain intensity was recorded daily in a diary on a 0 to 10 pain scale, and recovery was defined as the first of 7 consecutive days scoring 0 or 1 on a 6-point pain scale. Cox regression (dependent variable: recovery) and linear mixed-model analyses (dependent variable: daily pain intensity scores) were performed. The "difference in coefficients" approach was used to establish mediation. A total of 1573 participants were included in current analyses. There was a small but highly significant relationship between expectancies and outcomes; 3.3% of the relationship between expectancies and recovery and 14.2% of the relationship between expectancies and pain intensity were mediated by adherence to treatment. This study does not convincingly support the theory that adherence is a key pathway in the relationship between treatment outcome expectancies and recovery and pain intensity in this acute low back pain population.

  16. Negative life events have detrimental effects on in-vitro fertlization outcome.

    Science.gov (United States)

    Yilmaz, Nafiye; Kahyaoglu, İnci; İnal, Hasan Ali; Görkem, Ümit; Devran, Aysun; Mollamahmutoglu, Leyla

    2015-09-01

    The aim of this study was to investigate the effect of negative life events on in-vitro-fertilization (IVF) outcome. Depression and negative life events were measured using Beck Depression Inventory (BDI) and List of Recent Events in 83 women attending the IVF clinic of a tertiary research and education hospital with the diagnosis of unexplained infertility between January 2013 and August 2013. Demographic features, stimulation parameters, depression scores, and negative life events of pregnant and non-pregnant participants were compared and the relation between negative life events, depression scores, and IVF outcome was investigated. Women who did not achieve a pregnancy experienced more negative life events than women who became pregnant (77.2% vs. 23.1%) (p > 0.001). The number of patients with moderate-to-severe depression (BDI scores > 16) was higher in the non-pregnant group than pregnant group (49.1% vs. 26.9%), however the difference was not statistically significant (p = 0.057). Clinical pregnancy showed a significant moderate negative correlation with the number of negative life events (r = -0.513, p = 0.001), but the correlation between clinical pregnancy and BDI scores was not statistically significant (r = -0.209, p = 0.059). Stressful life events have a negative influence on the quality of life, which eventually affects in IVF outcome, possibly through maladaptive lifestyle behavior.

  17. Illustrated Examples of the Effects of Risk Preferences and Expectations on Bargaining Outcomes.

    Science.gov (United States)

    Dickinson, David L.

    2003-01-01

    Describes bargaining examples that use expected utility theory. Provides example results that are intuitive, shown graphically and algebraically, and offer upper-level student samples that illustrate the usefulness of the expected utility theory. (JEH)

  18. Regulatory focus, self-efficacy and outcome expectations as drivers of motivation to consume healthy food products.

    Science.gov (United States)

    Tudoran, Ana Alina; Scholderer, Joachim; Brunsø, Karen

    2012-10-01

    In this paper we apply the principle of Regulatory Focus Theory to investigate the interaction between self-efficacy and outcome expectations on individuals' intentions to adopt health behaviors. The participants, 959 individuals (Survey 1) and 2400 individuals (Survey 2), reported self-efficacy beliefs and outcome expectations with regard to the consumption of omega-3 supplements and omega-3-enriched food products. We found that the relationship prevention outcome expectations-intention was significantly attenuated at low levels of self-efficacy and strengthened at high levels of self-efficacy, respectively; whereas, the relationship promotion outcome expectations-intention was unaffected by the perceived levels of self-efficacy. The implications suggest that consumers' motivation to adopt healthy food products, such as omega-3 supplements and omega-3 enriched products, should be encouraged by stimulating promotion outcome expectations. However, when a prevention frame is used, the individuals' motivation should be significantly enhanced by self-efficacy beliefs. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Instagram Unfiltered: Exploring Associations of Body Image Satisfaction, Instagram #Selfie Posting, and Negative Romantic Relationship Outcomes.

    Science.gov (United States)

    Ridgway, Jessica L; Clayton, Russell B

    2016-01-01

    The purpose of this study was to examine the predictors and consequences associated with Instagram selfie posting. Thus, this study explored whether body image satisfaction predicts Instagram selfie posting and whether Instagram selfie posting is then associated with Instagram-related conflict and negative romantic relationship outcomes. A total of 420 Instagram users aged 18 to 62 years (M = 29.3, SD = 8.12) completed an online survey questionnaire. Analysis of a serial multiple mediator model using bootstrapping methods indicated that body image satisfaction was sequentially associated with increased Instagram selfie posting and Instagram-related conflict, which related to increased negative romantic relationship outcomes. These findings suggest that when Instagram users promote their body image satisfaction in the form of Instagram selfie posts, risk of Instagram-related conflict and negative romantic relationship outcomes might ensue. Findings from the current study provide a baseline understanding to potential and timely trends regarding Instagram selfie posting.

  20. Expectancies, working alliance, and outcome in transdiagnostic and single diagnosis treatment for anxiety disorders: An investigation of mediation.

    Science.gov (United States)

    Sauer-Zavala, Shannon; Boswell, James F; Bentley, Kate H; Thompson-Hollands, Johanna; Farchione, Todd J; Barlow, David H

    2018-04-01

    Patients' outcome expectancies and the working alliance are two psychotherapy process variables that researchers have found to be associated with treatment outcome, irrespective of treatment approach and problem area. Despite this, little is known about the mechanisms accounting for this association, and whether contextual factors (e.g., psychotherapy type) impact the strength of these relationships. The primary aim of this study was to examine whether patient-rated working alliance quality mediates the relationship between outcome expectancies and pre- to post-treatment change in anxiety symptoms using data from a recent randomized clinical trial comparing a transdiagnostic treatment (the Unified Protocol [UP]; Barlow et al., 2011a; Barlow, Sauer-Zavala, et al., in press) to single diagnosis protocols (SDPs) for patients with a principal heterogeneous anxiety disorder ( n = 179). The second aim was to explore whether cognitive-behavioral treatment condition (UP versus SDP) moderated this indirect relationship. Results from mediation and moderated mediation models indicated that, when collapsing across the two treatment conditions, the relationship between expectancies and outcome was partially mediated by the working alliance ( B = .037, SE = .05, 95% CI [.005, .096]). Interestingly, within-condition analyses showed that this conditional indirect effect was only present for SDP patients, whereas in the UP condition, working alliance did not account for the association between expectancies and outcome. These findings suggest that outcome expectancies and working alliance quality may interact to influence treatment outcomes, and that the nature and strength of the relationships among these constructs may differ as a function of the specific cognitive-behavioral treatment approach utilized.

  1. The sequential pathway between trauma-related symptom severity and cognitive-based smoking processes through perceived stress and negative affect reduction expectancies among trauma exposed smokers.

    Science.gov (United States)

    Garey, Lorra; Cheema, Mina K; Otal, Tanveer K; Schmidt, Norman B; Neighbors, Clayton; Zvolensky, Michael J

    2016-10-01

    Smoking rates are markedly higher among trauma-exposed individuals relative to non-trauma-exposed individuals. Extant work suggests that both perceived stress and negative affect reduction smoking expectancies are independent mechanisms that link trauma-related symptoms and smoking. Yet, no work has examined perceived stress and negative affect reduction smoking expectancies as potential explanatory variables for the relation between trauma-related symptom severity and smoking in a sequential pathway model. Methods The present study utilized a sample of treatment-seeking, trauma-exposed smokers (n = 363; 49.0% female) to examine perceived stress and negative affect reduction expectancies for smoking as potential sequential explanatory variables linking trauma-related symptom severity and nicotine dependence, perceived barriers to smoking cessation, and severity of withdrawal-related problems and symptoms during past quit attempts. As hypothesized, perceived stress and negative affect reduction expectancies had a significant sequential indirect effect on trauma-related symptom severity and criterion variables. Findings further elucidate the complex pathways through which trauma-related symptoms contribute to smoking behavior and cognitions, and highlight the importance of addressing perceived stress and negative affect reduction expectancies in smoking cessation programs among trauma-exposed individuals. (Am J Addict 2016;25:565-572). © 2016 American Academy of Addiction Psychiatry.

  2. The outcome of infected total knee arthroplasty: culture-positive versus culture-negative.

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kim, Dong-Jin

    2015-10-01

    We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA). We retrospectively reviewed 140 patients with culture-positive and 102 patients with culture-negative infected TKAs. We determined the infection control rate and clinical outcome after repeated debridement, and repeated 2-stage TKA in the culture-positive and culture-negative groups. The mean follow-up was 9.3 years (range 5-14 years) in the culture-positive group and 10.6 years (5-22) in the culture-negative group. The overall infection control rate was 56 % in both groups after the first treatment. The overall infection control rate was 90 % in the culture-positive group and 95 % in the culture-negative group. A functional knee was obtained in 90 % in the culture-positive group and 95 % in the culture-negative group. The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.

  3. Effect of physical activity on frailty and associated negative outcomes: the LIFE randomized trial

    Science.gov (United States)

    Background: Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large, long-term, randomized trials are lacking. Objective: To determine whether a long-term structured moderate-intensity physical activity (PA) p...

  4. Working Alliance and Stages of Change for Employment: The Intermediary Role of Autonomous Motivation, Outcome Expectancy and Vocational Rehabilitation Engagement.

    Science.gov (United States)

    Iwanaga, Kanako; Chan, Fong; Tansey, Timothy N; Strauser, David; Ritter, Ellen; Bishop, Malachy; Brooks, Jessica

    2018-05-30

    Purpose Working alliance is one of the most important common factors for successful counseling/psychotherapy outcomes. Based on the empirical literature about working alliance, it seems that self-determination and self-efficacy theory (SDT/SET) can potentially be used as a motivational model to explain the relationship between working alliance and vocational rehabilitation (VR) outcomes. The purpose of this study is to evaluate three primary SDT/SET constructs, autonomous motivation, expectancy and engagement, as mediators for the relationship between working alliance and stages of change (SOC) for employment. Methods A serial multiple mediation analysis (SMMA) was computed to evaluate autonomy, outcome expectancy, and VR engagement as mediators of the relationship between working alliance and SOC for employment in a sample of 277 people with chronic illness and disability (CID) receiving services from state VR agencies in the United States. Results The SMMA results indicated that working alliance was positively associated with SOC for employment (total effect), while the direct effect between working alliance and SOC for employment was not significant after controlling for the effects of the mediators, indicating significant mediation effects. The mediation effects were estimates of the indirect effects for working alliance on SOC for employment through (a) autonomous motivation, (b) outcome expectancy, (c) VR engagement, and (d) autonomous motivation, outcome expectancy and VR engagement together. Conclusions The results indicated that a strong working alliance has the benefit of helping consumers develop autonomous motivation to work and increasing their vocational outcome expectancy and engagement in VR services, leading to employment.

  5. Hypnotherapy to Reduce Hot Flashes: Examination of Response Expectancies as a Mediator of Outcomes

    Science.gov (United States)

    Sliwinski, Jim R.; Elkins, Gary R.

    2017-01-01

    The mechanism of action responsible for hypnotherapy’s effect in reducing hot flashes is not yet known. The purpose of this study was to examine the role of response expectancies as a potential mediator. Hypnotizability was also tested as an effect moderator. Data were collected from a sample of 172 postmenopausal women, who had been randomized to receive either a 5-week hypnosis intervention or structured attention counseling. Measures of response expectancies were analyzed to determine if the relationship between group assignment and hot flashes frequency was mediated by expectancies for treatment efficacy. A series of simple mediation and conditional process analyses did not support mediation of the relationship between treatment condition and hot flash frequency through response expectancy. The effect of hypnotherapy in reducing hot flashes does not appear to be due to placebo effects as determined by response expectancies. Implications for clinical practice and future research are discussed. PMID:28528570

  6. Relationship between drug interactions and drug-related negative clinical outcomes in two community pharmacies

    Directory of Open Access Journals (Sweden)

    Gonzalo M

    2009-03-01

    Full Text Available Drug interactions may represent an iatrogenic risk that should be controlled in community pharmacies at the dispensing level. Aim: We analyzed the association between potential drug-drug interactions (DDIs and negative clinical outcomes.Methods: We used dispensing data from two community pharmacies: instances where drug dispensing was associated with a potential DDI and a comparison group of randomized dispensing operations with no potential DDI. In cases where potential DDIs were detected, we analyzed the underlying negative clinical outcomes. Age and gender data were included in the analysis.Results: During the study period, we registered 417 potential DDIs. The proportion of women and age were higher in the study group than in the comparison group. The average potential DDIs per patient was 1.31 (SD=0.72. The Consejo General de Colegios Oficiales de Farmacéuticos (CGCOF database did not produce an alert in 2.4% of the cases. Over-the-counter medication use was observed in 5% of the potential DDI cases. The drugs most frequently involved in potential DDIs were acenocoumarol, calcium salts, hydrochlorothiazide, and alendronic acid, whereas the most predominant potential DDIs were calcium salts and bisphosphonates, oral antidiabetics and thiazide diuretics, antidiabetics and glucose, and oral anticoagulant and paracetamol. The existence of a drug-related negative clinical outcome was observed only in 0.96% of the potential DDI cases (50% safety cases and 50% effectiveness cases. Conclusions: Only a small proportion of the detected potential DDIs lead to medication negative outcomes. Considering the drug-related negative clinical outcomes encountered, tighter control would be recommended in potential DDIs with NSAIDs or benzodiazepines.

  7. Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

    International Nuclear Information System (INIS)

    Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Chae, Eun Young; Myung, Seung Jae; Ko, Gi Young; Gwon, Dong Il; Sung, Kyu Bo

    2009-01-01

    To evaluate the incidence, predictive factors, and clinical outcomes of angiographically negative acute arterial upper and lower gastrointestinal (GI) bleeding. From 2001 to 2008, 143 consecutive patients who underwent an angiography for acute arterial upper or lower GI bleeding were examined. The angiographies revealed a negative bleeding focus in 75 of 143 (52%) patients. The incidence of an angiographically negative outcome was significantly higher in patients with a stable hemodynamic status (p < 0.001), or in patients with lower GI bleeding (p = 0.032). A follow-up of the 75 patients (range: 0-72 months, mean: 8 ± 14 months) revealed that 60 of the 75 (80%) patients with a negative bleeding focus underwent conservative management only, and acute bleeding was controlled without rebleeding. Three of the 75 (4%) patients underwent exploratory surgery due to prolonged bleeding; however, no bleeding focus was detected. Rebleeding occurred in 12 of 75 (16%) patients. Of these, six patients experienced massive rebleeding and died of disseminated intravascular coagulation within four to nine hours after the rebleeding episode. Four of the 16 patients underwent a repeat angiography and the two remaining patients underwent a surgical intervention to control the bleeding. Angiographically negative results are relatively common in patients with acute GI bleeding, especially in patients with a stable hemodynamic status or lower GI bleeding. Most patients with a negative bleeding focus have experienced spontaneous resolution of their condition

  8. Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Chae, Eun Young; Myung, Seung Jae; Ko, Gi Young; Gwon, Dong Il; Sung, Kyu Bo [Asan Medical Center, Seoul (Korea, Republic of)

    2009-08-15

    To evaluate the incidence, predictive factors, and clinical outcomes of angiographically negative acute arterial upper and lower gastrointestinal (GI) bleeding. From 2001 to 2008, 143 consecutive patients who underwent an angiography for acute arterial upper or lower GI bleeding were examined. The angiographies revealed a negative bleeding focus in 75 of 143 (52%) patients. The incidence of an angiographically negative outcome was significantly higher in patients with a stable hemodynamic status (p < 0.001), or in patients with lower GI bleeding (p = 0.032). A follow-up of the 75 patients (range: 0-72 months, mean: 8 {+-} 14 months) revealed that 60 of the 75 (80%) patients with a negative bleeding focus underwent conservative management only, and acute bleeding was controlled without rebleeding. Three of the 75 (4%) patients underwent exploratory surgery due to prolonged bleeding; however, no bleeding focus was detected. Rebleeding occurred in 12 of 75 (16%) patients. Of these, six patients experienced massive rebleeding and died of disseminated intravascular coagulation within four to nine hours after the rebleeding episode. Four of the 16 patients underwent a repeat angiography and the two remaining patients underwent a surgical intervention to control the bleeding. Angiographically negative results are relatively common in patients with acute GI bleeding, especially in patients with a stable hemodynamic status or lower GI bleeding. Most patients with a negative bleeding focus have experienced spontaneous resolution of their condition.

  9. Linking Affective Commitment, Career Self-Efficacy, and Outcome Expectations: A Test of Social Cognitive Career Theory

    Science.gov (United States)

    Conklin, Amanda M.; Dahling, Jason J.; Garcia, Pablo A.

    2013-01-01

    The authors tested a model based on the satisfaction model of social cognitive career theory (SCCT) that links college students' affective commitment to their major (the emotional identification that students feel toward their area of study) with career decision self-efficacy (CDSE) and career outcome expectations. Results indicate that CDSE…

  10. When outcome expectations become habitual : explaining vs. predicting new media technology use from a social cognitive perspective

    NARCIS (Netherlands)

    Peters, O.

    2007-01-01

    This study examined the triadic relationship between expected outcomes, habit strength, and media technology use within the model of media attendance (Larose & Eastin, 2004). Mobile phone users (N = 664) were divided into two groups using a stratified random sampling method. Respondents of group one

  11. Young adult e-cigarette use outcome expectancies: Validity of a revised scale and a short scale.

    Science.gov (United States)

    Pokhrel, Pallav; Lam, Tony H; Pagano, Ian; Kawamoto, Crissy T; Herzog, Thaddeus A

    2018-03-01

    The revised youth e-cigarette outcome expectancies measure adds new items informed by recent qualitative research with young adult e-cigarette users, especially in the domain of positive "smoking" experience. Positive "smoking" experience represents beliefs that use of e-cigarettes provides outcomes associated with a better "smoking" alternative: for example, an alternative that is more socially approved, more suitable for indoor use, and that provides a safer means of enjoying nicotine. In addition, we tested a short, 8-item version of the measure which may be more easily incorporated into surveys. We tested the validity of the revised measure, both long and short versions, in terms of factor structure and associations of the expectancy factors with current e-cigarette use, e-cigarette use susceptibility, and e-cigarette use dependence. Participants were young adults (N=470; 65% women; mean age=20.9, SD=2.1). Results replicated the findings of the previous study as well as highlighted the importance of the added domain of positive "smoking" experience and the validity of the short scale. Furthermore, results showed that positive outcome expectancies are strongly associated with e-cigarette use dependence. The long and short versions of the revised youth e-cigarette outcome expectancies scale appear to be valid and useful for application not only among cigarette smokers and e-cigarette users but also among never smokers and never e-cigarette users. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Working Alliance as a Mediator and Moderator between Expectations for Counseling Success and Counseling Outcome among Korean Clients

    Science.gov (United States)

    Yoo, Sung-Kyung; Hong, Sehee; Sohn, Nanhee; O'Brien, Karen M.

    2014-01-01

    The study examined client's perceptions of working alliance as a mediator and moderator between client expectations of counseling success and counseling outcome. Participants were 284 adult clients in counseling in university or community counseling centers or private practices in South Korea. Level of functioning at the start of counseling was…

  13. Expectancies Mediate the Relations Among Pain Catastrophizing, Fear of Movement, and Return to Work Outcomes After Whiplash Injury.

    Science.gov (United States)

    Carriere, Junie S; Thibault, Pascal; Milioto, Maria; Sullivan, Michael J L

    2015-12-01

    Pain catastrophizing and fear of movement have been identified as key predictors of prolonged work disability after whiplash injury. However, little is known about the processes by which pain catastrophizing and fear of movement affect return to work. This study investigated the mediating role of expectancies on the relations between pain catastrophizing and return to work, and between fear of movement and return to work after whiplash injury. The study sample consisted of 154 individuals with whiplash injury who were enrolled in a multidisciplinary pain rehabilitation program. Participants completed measures of pain catastrophizing, fear of movement, and return-to-work expectancies after admission to a rehabilitation program. A follow-up telephone interview was used to assess work status 1 year after discharge. Consistent with previous research, analyses revealed that expectancies, pain catastrophizing, and fear of movement were significant predictors of return to work at 1-year follow-up. Regression analyses (bootstrapping) revealed that expectancies partially mediated the relation between catastrophizing and return to work. Expectancies completely mediated the relation between fear of movement and return to work. The significant predictive and mediating role of expectancies on return to work argues for the inclusion of expectancies as a specific target of intervention for individuals with whiplash injury. The findings suggest that expectancies might be part of the pathways by which pain catastrophizing and fear of movement affect return-to-work outcomes after whiplash injury. The findings argue for greater attention to return-to-work expectancies as a risk factor for problematic recovery outcomes as well as a target of intervention. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. Adolescents’ Pain Coping Profiles: Expectations for Treatment, Functional Outcomes and Adherence to Psychological Treatment Recommendations

    Directory of Open Access Journals (Sweden)

    Robyn Lewis Claar

    2011-01-01

    Full Text Available OBJECTIVES: To explore how adolescents’ pain coping profiles relate to their expectations regarding psychological treatment recommendations, and to examine patients’ functioning and engagement in psychological treatment three months following a multidisciplinary pain clinic evaluation.

  15. Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders

    DEFF Research Database (Denmark)

    Wahlbeck, Kristian; Westman, Jeanette; Nordentoft, Merete

    2011-01-01

    People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision.......People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision....

  16. Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

    NARCIS (Netherlands)

    Zijlstra, H.; Larsen, J.K.; Ridder, D.T.D. de; Ramshorst, B. van; Geenen, R.

    2009-01-01

    A premise of this study was that different psychological processes would predict the initiation and maintenance of weight loss after surgery for morbid obesity. Our aim was to examine whether more favorable preoperative expectations of psychosocial outcomes predict weight loss in the first year

  17. Stuttering Thoughts: Negative Self-Referent Thinking Is Less Sensitive to Aversive Outcomes in People with Higher Levels of Depressive Symptoms.

    Science.gov (United States)

    Iijima, Yudai; Takano, Keisuke; Boddez, Yannick; Raes, Filip; Tanno, Yoshihiko

    2017-01-01

    Learning theories of depression have proposed that depressive cognitions, such as negative thoughts with reference to oneself, can develop through a reinforcement learning mechanism. This negative self-reference is considered to be positively reinforced by rewarding experiences such as genuine support from others after negative self-disclosure, and negatively reinforced by avoidance of potential aversive situations. The learning account additionally predicts that negative self-reference would be maintained by an inability to adjust one's behavior when negative self-reference no longer leads to such reward. To test this prediction, we designed an adapted version of the reversal-learning task. In this task, participants were reinforced to choose and engage in either negative or positive self-reference by probabilistic economic reward and punishment. Although participants were initially trained to choose negative self-reference, the stimulus-reward contingencies were reversed to prompt a shift toward positive self-reference (Study 1) and a further shift toward negative self-reference (Study 2). Model-based computational analyses showed that depressive symptoms were associated with a low learning rate of negative self-reference, indicating a high level of reward expectancy for negative self-reference even after the contingency reversal. Furthermore, the difficulty in updating outcome predictions of negative self-reference was significantly associated with the extent to which one possesses negative self-images. These results suggest that difficulty in adjusting action-outcome estimates for negative self-reference increases the chance to be faced with negative aspects of self, which may result in depressive symptoms.

  18. Stuttering Thoughts: Negative Self-Referent Thinking Is Less Sensitive to Aversive Outcomes in People with Higher Levels of Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Yudai Iijima

    2017-08-01

    Full Text Available Learning theories of depression have proposed that depressive cognitions, such as negative thoughts with reference to oneself, can develop through a reinforcement learning mechanism. This negative self-reference is considered to be positively reinforced by rewarding experiences such as genuine support from others after negative self-disclosure, and negatively reinforced by avoidance of potential aversive situations. The learning account additionally predicts that negative self-reference would be maintained by an inability to adjust one’s behavior when negative self-reference no longer leads to such reward. To test this prediction, we designed an adapted version of the reversal-learning task. In this task, participants were reinforced to choose and engage in either negative or positive self-reference by probabilistic economic reward and punishment. Although participants were initially trained to choose negative self-reference, the stimulus-reward contingencies were reversed to prompt a shift toward positive self-reference (Study 1 and a further shift toward negative self-reference (Study 2. Model-based computational analyses showed that depressive symptoms were associated with a low learning rate of negative self-reference, indicating a high level of reward expectancy for negative self-reference even after the contingency reversal. Furthermore, the difficulty in updating outcome predictions of negative self-reference was significantly associated with the extent to which one possesses negative self-images. These results suggest that difficulty in adjusting action-outcome estimates for negative self-reference increases the chance to be faced with negative aspects of self, which may result in depressive symptoms.

  19. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel during the First Tour of Duty

    National Research Council Canada - National Science Library

    Boyer, Cherrie B; Shafer, Mary-Ann

    2007-01-01

    .... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...

  20. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel During the First Tour of Duty

    National Research Council Canada - National Science Library

    Boyer, Cherrie B; Shafer, Mary-Ann

    2006-01-01

    .... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...

  1. Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes.

    Science.gov (United States)

    Méndez-Aparicio, M Dolores; Izquierdo-Yusta, Alicia; Jiménez-Zarco, Ana I

    2017-01-01

    Today, the customer-brand relationship is fundamental to a company's bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1) to know which factors influence the formation of an individual's service expectations in an online environment; and (2) to establish the influence of these expectations on customers' likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992), the TRA model (Fishbein and Ajzen, 1975), the extended UTAUT model (Venkatesh et al., 2012), and the approach described by Alloza (2011), this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers' expectations with regard to the intention to recommend the "private area" of the company's website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm.

  2. Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes

    Directory of Open Access Journals (Sweden)

    M. Dolores Méndez-Aparicio

    2017-07-01

    Full Text Available Today, the customer-brand relationship is fundamental to a company’s bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1 to know which factors influence the formation of an individual’s service expectations in an online environment; and (2 to establish the influence of these expectations on customers’ likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992, the TRA model (Fishbein and Ajzen, 1975, the extended UTAUT model (Venkatesh et al., 2012, and the approach described by Alloza (2011, this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers’ expectations with regard to the intention to recommend the “private area” of the company’s website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm.

  3. Development of a measure of hypodontia patients' expectations of the process and outcome of combined orthodontic and restorative treatment.

    Science.gov (United States)

    Gassem, Afnan Ben; Foxton, Richard; Bister, Dirk; Newton, Tim

    2016-12-01

    To devise and assess the psychometric properties of a measure that investigates hypodontia patients' expectations of the process and outcome of combined orthodontic/restorative treatment. Specialised secondary care facility for individuals with hypodontia. Mixed research design with three phases: (a) Thematic analysis of data from individual interviews with 25 hypodontia patients/16 parents to generate the questionnaire items. (b) Questionnaire design, assessment of readability and face/content validity with 10 patients. (c) Survey of 32 new hypodontia patients to determine the internal consistency of the measure. Three main themes related to the treatment process emerged from the qualitative data: 'hypodontia clinic', 'orthodontic treatment' and 'restorative treatment'. Three main themes were also revealed relating to treatment outcome: 'changes in appearance', 'psychosocial changes' and 'functional changes'. A 28 item questionnaire was constructed using a mix of visual analogue scale (VAS) and categorical response format. The Flesch reading ease score of the measure was 78, equivalent to a reading age of 9-10 years. Face and content validity were good. The overall Cronbach's alpha was 0.80 while for the treatment process and treatment outcome subscales it was 0.71 and 0.88 respectively. A patient-based measure of the process and outcome of combined orthodontic/restorative treatment for hypodontia patients has been developed which has good face and construct validity and satisfactory internal consistency. Patient expectations of treatment are important in determining not only their satisfaction with treatment outcomes but also their engagement with the clinical process. This questionnaire is a first step in operationalising the expectations of hypodontia patients through assessment tools that can then determine whether pre-treatment counselling is required and aid the consent and treatment planning process, thus improving the quality of treatment provided by

  4. Infant Attachment Moderates Paths From Early Negativity to Preadolescent Outcomes for Children and Parents.

    Science.gov (United States)

    Boldt, Lea J; Kochanska, Grazyna; Jonas, Katherine

    2017-03-01

    Although infant attachment has been long seen as key for development, its long-term effects may be complex. Attachment may be a catalyst or moderator of future developmental sequelae rather than a source of main effects. In 102 mothers, fathers, and infants, attachment was assessed at 15 months; children's negativity (rejection of parental rules and modeling attempts) at 25, 38, 52, and 67 months; and developmental outcomes (the child's parent-rated externalizing problems and the parent-child observed relationship quality) at ages 10 and 12. In both mother-child and father-child relationships, children's higher negativity was associated with more detrimental outcomes but only in dyads with formerly insecure infants. Infant insecurity appears to amplify detrimental cascades, whereas infant security appears to defuse such risks. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

  5. 3 Tesla MRI-negative focal epilepsies: Presurgical evaluation, postoperative outcome and predictive factors.

    Science.gov (United States)

    Kogias, Evangelos; Klingler, Jan-Helge; Urbach, Horst; Scheiwe, Christian; Schmeiser, Barbara; Doostkam, Soroush; Zentner, Josef; Altenmüller, Dirk-Matthias

    2017-12-01

    To investigate presurgical diagnostic modalities, clinical and seizure outcome as well as predictive factors after resective epilepsy surgery in 3 Tesla MRI-negative focal epilepsies. This retrospective study comprises 26 patients (11 males/15 females, mean age 34±12years, range 13-50 years) with 3 Tesla MRI-negative focal epilepsies who underwent resective epilepsy surgery. Non-invasive and invasive presurgical diagnostic modalities, type and localization of resection, clinical and epileptological outcome with a minimum follow-up of 1year (range 1-11 years, mean 2.5±2.3years) after surgery as well as outcome predictors were evaluated. All patients underwent invasive video-EEG monitoring after implantation of intracerebral depth and/or subdural electrodes. Ten patients received temporal and 16 extratemporal or multilobar (n=4) resections. There was no perioperative death or permanent morbidity. Overall, 12 of 26 patients (46%) were completely seizure-free (Engel IA) and 65% had a favorable outcome (Engel I-II). In particular, seizure-free ratio was 40% in the temporal and 50% in the extratemporal group. In the temporal group, long duration of epilepsy correlated with poor seizure outcome, whereas congruent unilateral FDG-PET hypometabolism correlated with a favorable outcome. In almost two thirds of temporal and extratemporal epilepsies defined as "non-lesional" by 3 Tesla MRI criteria, a favorable postoperative seizure outcome (Engel I-II) can be achieved with accurate multimodal presurgical evaluation including intracranial EEG recordings. In the temporal group, most favorable results were obtained when FDG-PET displayed congruent unilateral hypometabolism. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Impact of Expectancy-Value and Situational Interest Motivation Specificity on Physical Education Outcomes

    Science.gov (United States)

    Ding, Haiyong; Sun, Haichun; Chen, Ang

    2013-01-01

    To be successful in learning, students need to be motivated to engage and learn. The domain-specificity motivation theory articulates that student motivation is often determined by the content being taught to them. The purpose of this study was to extend the theory by determining domain-specificity of situational interest and expectancy-value…

  7. From outcomes to acts : a non-standard axiomatization of the expected utility principle

    NARCIS (Netherlands)

    Peterson, M.B.

    2004-01-01

    This paper presents an axiomatization of the principle of maximizing expected utility that does not rely on the independence axiom or sure-thing principle. Perhaps more importantly the new axiomatization is based on an ex ante approach, instead of the standard ex post approach. An ex post approach

  8. A confirmatory analysis of the hierarchical structure of positive and negative dose-related alcohol expectancies in alcoholics and the associations with family history of alcoholism

    NARCIS (Netherlands)

    Wiers, R. W.; Hartgers, C.; van den Brink, W.; Gunning, W. B.; Sergeant, J. A.

    2000-01-01

    The usefulness of measuring four types of alcohol-outcome expectancies in alcoholics was investigated. The investigation was conducted in three steps. First, a measurement model previously fitted in a general population sample was fitted in the present sample of alcoholics, using confirmative factor

  9. Outcomes following negative prostate biopsy for patients with persistent disease after radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Jacob H. Cohen

    2010-02-01

    Full Text Available PURPOSE: When faced with biochemical recurrence after definitive radiotherapy for prostate cancer, clinicians must determine whether the recurrence is local or systemic. Post radiotherapy prostate biopsies to detect persistent local disease are difficult to interpret histopathologically and are subject to sampling error. Our study examines outcomes for patients with a negative prostate biopsy performed for rising prostate-specific antigen (PSA levels after prostate radiation. MATERIALS AND METHODS: We performed a retrospective review of 238 prostate cancer patients with a negative biopsy following definitive radiotherapy. Seventy-five of these patients had biochemical recurrence at the time of biopsy. A negative biopsy was defined as the absence of prostate cancer without radiation-treatment effect in the specimen. RESULTS: Patients underwent biopsy at a mean of 41 months after the completion of radiation. They had a mean PSA of 6. Patients were followed for an average of 63 months. Thirty-two patients (43% developed metastasis, and 11 (15% died of prostate cancer despite a negative post-radiation biopsy. Five of nine patients (56% with sequential biopsies had a positive second biopsy. CONCLUSIONS: Patients with PSA recurrence and a negative post-radiation biopsy have a high chance of persistent local disease, progression, and death from prostate cancer. Furthermore, an initial negative biopsy does not rule-out local recurrence. Patients with biochemical recurrence after radiotherapy for prostate cancer need to be evaluated earlier for local recurrence.

  10. The relationship between interpersonal problems, negative cognitions, and outcomes from cognitive behavioral group therapy for depression.

    Science.gov (United States)

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

    2013-09-05

    Interpersonal functioning is a key determinant of psychological well-being, and interpersonal problems (IPs) are common among individuals with psychiatric disorders. However, IPs are rarely formally assessed in clinical practice or within cognitive behavior therapy research trials as predictors of treatment attrition and outcome. The main aim of this study was to investigate the relationship between IPs, depressogenic cognitions, and treatment outcome in a large clinical sample receiving cognitive behavioral group therapy (CBGT) for depression in a community clinic. Patients (N=144) referred for treatment completed measures of IPs, negative cognitions, depression symptoms, and quality of life (QoL) before and at the completion of a 12-week manualized CBGT protocol. Two IPs at pre-treatment, 'finding it hard to be supportive of others' and 'not being open about problems,' were associated with higher attrition. Pre-treatment IPs also predicted higher post-treatment depression symptoms (but not QoL) after controlling for pre-treatment symptoms, negative cognitions, demographics, and comorbidity. In particular, 'difficulty being assertive' and a 'tendency to subjugate one's needs' were associated with higher post-treatment depression symptoms. Changes in IPs did not predict post-treatment depression symptoms or QoL when controlling for changes in negative cognitions, pre-treatment symptoms, demographics, and comorbidity. In contrast, changes in negative cognitions predicted both post-treatment depression and QoL, even after controlling for changes in IPs and the other covariates. Correlational design, potential attrition bias, generalizability to other disorders and treatments needs to be evaluated. Pre-treatment IPs may increase risk of dropout and predict poorer outcomes, but changes in negative cognitions during treatment were most strongly associated with improvement in symptoms and QoL during CBGT. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

    OpenAIRE

    DI BLASI, M.; Cavani, P.; Pavia, L.; Tosto, C.; LA GRUTTA, S.; LO BAIDO, R.; Giordano, C.; Schimmenti, A.

    2017-01-01

    The relationship between social anxiety (SA) and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male) who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test) and SA symptoms (Social Interaction Anxiety Sc...

  12. Assessment of Scientific Communication Self-Efficacy, Interest, and Outcome Expectations for Career Development in Academic Medicine

    Science.gov (United States)

    Anderson, Cheryl B.; Lee, Hwa Young; Byars-Winston, Angela; Baldwin, Constance D.; Cameron, Carrie; Chang, Shine

    2015-01-01

    Competency in forms of scientific communication, both written and spoken, is essential for success in academic science. This study examined the psychometric properties of three new measures, based on social cognitive career theory, that are relevant to assessment of skill and perseverance in scientific communication. Pre- and postdoctoral trainees in biomedical science (N = 411) completed online questionnaires assessing self-efficacy in scientific communication, career outcome expectations, and interest in performing tasks in scientific writing, oral presentation, and impromptu scientific discourse. Structural equation modeling was used to evaluate factor structures and model relations. Confirmatory factor analysis supported a 22-item, 3-factor measure of self-efficacy, an 11-item, 2-factor measure of outcome expectations, and a 12-item, 3-factor measure of interest in scientific communication activities. Construct validity was further demonstrated by theory-consistent inter-factor relations and relations with typical communications performance behaviors (e.g., writing manuscripts, abstracts, presenting at national meetings). PMID:26924920

  13. Parent Expectations Mediate Outcomes for Young Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Kirby, Anne V.

    2016-01-01

    Understanding the complex relationships among factors that may predict the outcomes of young adults with autism spectrum disorder (ASD) is of utmost importance given the increasing population undergoing and anticipating the transition to adulthood. With a sample of youth with ASD (n = 1170) from the National Longitudinal Transition Study-2,…

  14. What Older Adolescents Expect from Physical Activity: Implicit Cognitions Regarding Health and Appearance Outcomes

    Science.gov (United States)

    McFadden, K.; Berry, T. R.; McHugh, T. F.; Rodgers, W. M.

    2018-01-01

    Objective: To explore older adolescents' reflective and impulsive thoughts about health- and social/appearance-related physical activity (PA) outcomes and investigate how those thoughts relate to their PA behavior. Participants: One hundred and forty-four undergraduate students (109 women; 35 men) aged 17-19 years (M = 18.11, SD = 0.65)…

  15. Expect With Me: development and evaluation design for an innovative model of group prenatal care to improve perinatal outcomes.

    Science.gov (United States)

    Cunningham, Shayna D; Lewis, Jessica B; Thomas, Jordan L; Grilo, Stephanie A; Ickovics, Jeannette R

    2017-05-18

    Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally. Expect With Me follows clinical guidelines from the American Congress of Obstetricians and Gynecologists. Expect With Me incorporates the best evidence-based features of existing models of group care with a novel integrated IT platform designed to improve patient engagement and support, enhance health behaviors and decision making, connect providers and patients, and improve health service delivery. A multisite prospective longitudinal cohort study is being conducted to examine the impact of Expect With Me on perinatal and postpartum outcomes, and to identify and address barriers to national scalability. Process and outcome evaluation will include quantitative and qualitative data collection at patient, provider, and organizational levels. Mixed-method data collection includes patient surveys, medical record reviews, patient focus groups; provider surveys, session evaluations, provider focus groups and in-depth interviews; an online tracking system; and clinical site visits. A two-to-one matched cohort of women receiving individual care from each site will provide a comparison group (n = 1,000 Expect With Me patients; n = 2,000 individual care patients) for outcome and cost analyses. By bundling prevention and care services into a high-touch, high-tech group prenatal care model

  16. Accuracy gains of adding vote expectation surveys to a combined forecast of US presidential election outcomes

    Directory of Open Access Journals (Sweden)

    Andreas Graefe

    2015-02-01

    Full Text Available In averaging forecasts within and across four-component methods (i.e. polls, prediction markets, expert judgment and quantitative models, the combined PollyVote provided highly accurate predictions for the US presidential elections from 1992 to 2012. This research note shows that the PollyVote would have also outperformed vote expectation surveys, which prior research identified as the most accurate individual forecasting method during that time period. Adding vote expectations to the PollyVote would have further increased the accuracy of the combined forecast. Across the last 90 days prior to the six elections, a five-component PollyVote (i.e. including vote expectations would have yielded a mean absolute error of 1.08 percentage points, which is 7% lower than the corresponding error of the original four-component PollyVote. This study thus provides empirical evidence in support of two major findings from forecasting research. First, combining forecasts provides highly accurate predictions, which are difficult to beat for even the most accurate individual forecasting method available. Second, the accuracy of a combined forecast can be improved by adding component forecasts that rely on different data and different methods than the forecasts already included in the combination.

  17. Direct and indirect effects of alcohol expectancies through drinking motives on alcohol outcomes among students in Vietnam.

    Science.gov (United States)

    Diep, Pham Bich; Schelleman-Offermans, K; Kuntsche, E; De Vries, Nanne; Knibbe, Ronald A

    2016-01-01

    To investigate whether the links between alcohol expectancies (tension reduction; global positive change; improved cognitive and motor abilities; and change in social behavior) and alcohol outcomes (drinking volume, 6+ drinks, alcohol problems, and symptoms of alcohol dependence) are mediated by drinking motives (social, enhancement, conformity, and coping). A multi-stage sampling strategy was used in four Vietnamese provinces, resulting in a final sample of 4756 students (43.2% females) with mean age 20.6 (SD 1.8) years. Structural equation models, including indirect effects, were estimated for women and men separately. Overall, there were many cases of full mediation (indirect effects range from -0.006 to 0.083 and p-values from alcohol outcomes. Among men, enhancement motives and, to a lesser extent, social motives also played a role in mediating the effects of expectancies on alcohol outcomes. Among women, full mediation was found far less often and less consistently. By confirming that, in Vietnam, motives mediate the link between expectancies and drinking behavior, this study supports the cultural robustness of a key assumption of the motivational model (i.e. that drinking motives are more closely associated with alcohol use than expectancies). Enhancement, coping and social motives are most frequently found as mediators among male students whereas coping motive only is most frequently found as a mediator among female students. As most of the effects of expectancies were mediated by motives, drinking motives appear to be a promising factor for interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Doripenem: an expected arrival in the treatment of infections caused by multidrug-resistant Gram-negative pathogens.

    Science.gov (United States)

    Poulakou, Garyphallia; Giamarellou, Helen

    2008-05-01

    Potent new drugs against multidrug-resistant Gram-negative bacteria, namely Pseudomonas aeruginosa and Acinetobacter spp. and pan-drug-resistant Klebsiella pneumoniae, which constitute an increasing medical threat, are almost absent from the future pharmaceutical pipeline. This drug evaluation focuses on the position of doripenem, a novel forthcoming carbapenem. Mechanisms of resistance and new drugs with anti-Gram-negative activity are also briefly reviewed. Literature search was performed for new carbapenems, new antibiotics, doripenem, metallo-beta-lactamase inhibitors, multidrug-resistant pathogens, antipseudomonal antibiotics and multidrug-resistant epidemiology. Doripenem possesses a broad spectrum of activity against Gram-negative bacteria, similar to that of meropenem, while retaining the spectrum of imipenem against Gram-positive pathogens. Against P. aeruginosa, doripenem exhibits rapid bactericidal activity with 2 - 4-fold lower MIC values, compared to meropenem. Exploitation of pharmacokinetic/pharmacodynamic applications could offer a treatment opportunity against strains exhibiting borderline resistance to doripenem. Stability against numerous beta-lactamases, low adverse event potential and more potent in vitro antibacterial activity against P. aeruginosa and A. baumanni compared to the existing carbapenems, are its principal features.

  19. The response strategy and the place strategy in a plus-maze have different sensitivities to devaluation of expected outcome.

    Science.gov (United States)

    Kosaki, Yutaka; Pearce, John M; McGregor, Anthony

    2018-04-10

    Previous studies have suggested that spatial navigation can be achieved with at least two distinct learning processes, involving either cognitive map-like representations of the local environment, referred to as the "place strategy", or simple stimulus-response (S-R) associations, the "response strategy". A similar distinction between cognitive/behavioral processes has been made in the context of non-spatial, instrumental conditioning, with the definition of two processes concerning the sensitivity of a given behavior to the expected value of its outcome as well as to the response-outcome contingency ("goal-directed action" and "S-R habit"). Here we investigated whether these two versions of dichotomist definitions of learned behavior, one spatial and the other non-spatial, correspond to each other in a formal way. Specifically, we assessed the goal-directed nature of two navigational strategies, using a combination of an outcome devaluation procedure and a spatial probe trial frequently used to dissociate the two navigational strategies. In Experiment 1, rats trained in a dual-solution T-maze task were subjected to an extinction probe trial from the opposite start arm, with or without prefeeding-induced devaluation of the expected outcome. We found that a non-significant preference for the place strategy in the non-devalued condition was completely reversed after devaluation, such that significantly more animals displayed the use of the response strategy. The result suggests that the place strategy is sensitive to the expected value of the outcome, while the response strategy is not. In Experiment 2, rats with hippocampal lesions showed significant reliance on the response strategy, regardless of whether the expected outcome was devalued or not. The result thus offers further evidence that the response strategy conforms to the definition of an outcome-insensitive, habitual form of instrumental behavior. These results together attest a formal correspondence between

  20. Dissociation between judgments and outcome-expectancy measures in covariation learning: a signal detection theory approach.

    Science.gov (United States)

    Perales, José C; Catena, Andrés; Shanks, David R; González, José A

    2005-09-01

    A number of studies using trial-by-trial learning tasks have shown that judgments of covariation between a cue c and an outcome o deviate from normative metrics. Parameters based on trial-by-trial predictions were estimated from signal detection theory (SDT) in a standard causal learning task. Results showed that manipulations of P(c) when contingency (deltaP) was held constant did not affect participants' ability to predict the appearance of the outcome (d') but had a significant effect on response criterion (c) and numerical causal judgments. The association between criterion c and judgment was further demonstrated in 2 experiments in which the criterion was directly manipulated by linking payoffs to the predictive responses made by learners. In all cases, the more liberal the criterion c was, the higher judgments were. The results imply that the mechanisms underlying the elaboration of judgments and those involved in the elaboration of predictive responses are partially dissociable.

  1. Diagnostic terminology is not associated with contact-sport players' expectations of outcome from mild traumatic brain injury.

    Science.gov (United States)

    Edmed, Shannon L; Sullivan, Karen A

    2015-01-01

    To investigate the influence of the diagnostic terms 'concussion' and 'mild traumatic brain injury' (mTBI) on contact-sport players' injury perceptions and expected symptoms from a sport-related mTBI. It was hypothesized that contact-sport players would hold more negative injury perceptions and expect greater symptom disturbance from a sport-related injury that was diagnosed as an 'mTBI' compared to 'concussion' or an undiagnosed injury. One hundred and twenty-two contact-sport players were randomly allocated to one of three conditions in which they read a sport-related mTBI vignette that varied only according to whether the person depicted in the vignette was diagnosed with concussion (n = 40), mTBI (n = 41) or received no diagnosis (control condition; n = 41). After reading the vignette, participants rated their injury perceptions (perceived undesirability, chronicity and consequences) and expectations of post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD) symptoms 6 months post-injury. There were no significant differences in contact-sport players' injury perceptions or symptom expectations from a sport-related mTBI when it was diagnosed as an mTBI, concussion or when no diagnosis was given. Diagnostic terminology does not appear to have a potent influence on symptom expectation and injury perceptions in contact-sport players.

  2. The influence of multicultural counseling competence and anti-Black prejudice on therapists' outcome expectancies.

    Science.gov (United States)

    Katz, Andrew D; Hoyt, William T

    2014-04-01

    The broad goal of this study was to examine multiple potential predictors of anti-Black bias among counselors. Specifically, in an online survey of 173 trainees and professionals in mental health, this study used 3 measures related to cultural sensitivity as predictors of therapists' expectancies for bond and prognosis with African American clients compared with White clients. The Multicultural Counseling Inventory (MCI; Sodowsky, Taffe, Gutkin, & Wise, 1994) was used to measure global multicultural competence. The Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) served as a measure of automatic prejudice toward Blacks. Additionally, a new self-report measure of anti-Black clinical prejudice was created specifically for this study. The Balanced Inventory of Desirable Responding (Paulhus, 1984) was included to control for socially desirable responding. Each predictor of cultural sensitivity uniquely explained variance in anti-Black bias in bond ratings, with the IAT accounting for more variance than the 2 self-reports. Our novel measure of clinical prejudice accounted for anti-Black bias in prognosis ratings, but the MCI and the IAT did not. Researchers studying cultural competence are encouraged to consider the roles of automatic and deliberate prejudice in determining disparities in clinical expectancies and cross-racial therapeutic alliances. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  3. Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

    Full Text Available Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a patients with subclinical depressive symptoms at least once during follow-up (DPG, and (b patients without subclinical depressive symptoms during follow-up (NDPG. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms using the Hamilton Depression Rating Scale (HDRS-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF. A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001 and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009.Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

  4. Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

    Science.gov (United States)

    Husain, Fatima T; Gander, Phillip E; Jansen, Jaclyn N; Shen, Sa

    2018-04-01

    Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling. This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients' and audiologists' expectations for tinnitus care were in agreement and areas in which they differed. The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format. We received 230 completed Patient Surveys and 68 completed Audiologist Surveys. All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (http://www.surveymonkey.com/). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success. Differences were noted between the two groups' responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly

  5. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

    Energy Technology Data Exchange (ETDEWEB)

    Kim, David H.; Pooler, B.D.; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Weiss, Jennifer M. [University of Wisconsin School of Medicine and Public Health, Section of Gastroenterology, Department of Internal Medicine, Madison, WI (United States)

    2012-07-15

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [{+-}SD] age 56.9 {+-} 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 {+-} 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  6. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

    International Nuclear Information System (INIS)

    Kim, David H.; Pooler, B.D.; Pickhardt, Perry J.; Weiss, Jennifer M.

    2012-01-01

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [±SD] age 56.9 ± 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 ± 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  7. Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation.

    Science.gov (United States)

    Haddad, Bassam; Deis, Stéphanie; Goffinet, François; Paniel, Bernard J; Cabrol, Dominique; Siba, Baha M

    2004-06-01

    This study was undertaken to determine maternal and perinatal outcomes after expectant management of severe preeclampsia between 24 and 33 weeks' gestation. A prospective observational study of 239 women with severe preeclamptic and undelivered after antenatal steroid prophylaxis was performed. Pregnancy prolongation and maternal and perinatal morbidities were analyzed according to the gestational age at time of expectant management: 24 to 28, 29 to 31, and 32 to 33 weeks. Statistical analysis was performed by Student t test and chi(2) test. The days of pregnancy prolongation were significantly higher among those managed at less than 29 weeks (6) compared with the other groups (4). There were 13 perinatal deaths: 12 in those managed at less than 29 weeks and 1 in those managed at 29 to 31 weeks. Neonatal morbidities were significantly higher among those managed at less than 29 weeks compared with the other groups. There were no instances of maternal death or eclampsia. Maternal morbidities were similar among the groups. Expectant management of severe preeclampsia at 24 to 33 weeks in a tertiary care center is associated with good perinatal outcome with a minimal risk for the mother.

  8. Incidence and Outcome of BRCA Mutations in Unselected Patients with Triple Receptor-Negative Breast Cancer.

    LENUS (Irish Health Repository)

    Gonzalez-Angulo, Ana M

    2011-03-01

    To investigate the incidence of germline and somatic BRCA1\\/2 mutations in unselected patients with triple-negative breast cancer (TNBC) and determine the prognostic significance of carrying a mutation. Methods: DNA was obtained from 77 TNBC and normal tissues. BRCA1\\/2 exons\\/flanking regions were sequenced from tumor and patients classified as mutant or wild type (WT). Sequencing was repeated from normal tissue to identify germline and somatic mutations. Patient characteristics were compared with chi-square. Survival was estimated by Kaplan-Meier method and compared with log-rank. Cox proportional hazards models were fit to determine the independent association of mutation status with outcome.

  9. Outcomes of Expectant Management in HIV-Infected Pregnancy with Preterm Premature Rupture of Membranes at Less Than 34-Week Gestation: A Case Series

    Directory of Open Access Journals (Sweden)

    Nalat Sompagdee, M.D.

    2018-01-01

    Full Text Available Objective: To present outcomes of expectant management (EM in HIV-infected pregnancy with preterm premature rupture of membranes (PPROM at less than 34-week gestation. Case presentation: During January 2008-December 2015, there were 513 HIV-infected pregnant women giving birth at Siriraj Hospital, Thailand. Ten of them presented with PPROM at GA <34 weeks and six women received EM. The deliveries took place at GA 28 2/7 - 33 5/7 weeks. The longest interval of ROM was 15 days and the highest on-admission viral load was 633,000 copies/mL. Three of them had antepartum highly active antiretroviral therapy (HAART for at least four weeks prior to the delivery. Mode of delivery included 3 vaginal deliveries and 3 caesarean sections. All infants’ HIV molecular tests were negative at birth. The longest follow-up interval was 12 months and HIV vertical transmission remained negative. Conclusion: Expectant management in HIV-infected women with PPROM at GA <34 weeks may be sensible because complications of prematurity outweigh the risk of vertical HIV transmission.

  10. Motivational mechanisms and outcome expectancies underlying the approach bias towards addictive substances

    Directory of Open Access Journals (Sweden)

    Poppy eWatson

    2012-10-01

    Full Text Available Human behavior can be paradoxical, in that actions can be initiated that are seemingly incongruent with an individual’s explicit desires. This is most commonly observed in drug addiction, where maladaptive behavior (i.e. drug seeking appears to be compulsive, continuing at great personal cost. Approach biases towards addictive substances have been correlated with actual drug-use in a number of studies, suggesting that this measure can, in some cases, index everyday maladaptive tendencies. At present it is unclear whether this bias to drug cues is a Pavlovian conditioned approach response, a habitual response, the result of a Pavlovian-instrumental transfer process or a goal-directed action in the sense that expectancy of the rewarding effects of drugs controls approach. We consider this question by combining the theoretical framework of associative learning with the available evidence from approach bias research. Although research investigating the relative contributions of these mechanisms to the approach bias is to date relatively limited, we review existing studies and also outline avenues for future research.

  11. Motivational Mechanisms and Outcome Expectancies Underlying the Approach Bias toward Addictive Substances.

    Science.gov (United States)

    Watson, P; de Wit, S; Hommel, Bernhard; Wiers, R W

    2012-01-01

    Human behavior can be paradoxical, in that actions can be initiated that are seemingly incongruent with an individual's explicit desires. This is most commonly observed in drug addiction, where maladaptive behavior (i.e., drug seeking) appears to be compulsive, continuing at great personal cost. Approach biases toward addictive substances have been correlated with actual drug-use in a number of studies, suggesting that this measure can, in some cases, index everyday maladaptive tendencies. At present it is unclear whether this bias to drug cues is a Pavlovian conditioned approach response, a habitual response, the result of a Pavlovian-instrumental transfer process, or a goal-directed action in the sense that expectancy of the rewarding effects of drugs controls approach. We consider this question by combining the theoretical framework of associative learning with the available evidence from approach bias research. Although research investigating the relative contributions of these mechanisms to the approach bias is to date relatively limited, we review existing studies and also outline avenues for future research.

  12. Bridging the Gaps Between Students’ Prior Knowledge and Skills in Writing and the Expected Thesis Outcomes

    Directory of Open Access Journals (Sweden)

    Restu Mufanti

    2017-10-01

    Full Text Available This research aimed to seek the light on how the advisors made a use of feedback during supervisory panel and find out how different ways and types of feedback impacted on student-writers’ thesis outcomes. Qualitative study was applied by involving three tenured lecturers at College of Islamic Studies, in Java as the research subjects. Two data collection techniques were applied, such as interview and documentation, to trace evidence on what types of feedback used, how students noticed, and how they impacted on subsequent drafts. This study revealed that indirect feedback using error codes and commentary was the most frequent form used during the advisory session. However, the mere use of feedback could only serve a short-term impact on the development of writing, and even it seemed only to spoon-feed them which could create burdens in writing. It was quite evident that engaging them in such self-regulated and interdependence group works, through problem-solving discussion and peer review, was much worthier as compared to only ask them to process the feedback themselves.

  13. The association of parent's outcome expectations for child TV viewing with parenting practices and child TV viewing: an examination using path analysis.

    Science.gov (United States)

    Johnson, Lauren; Chen, Tzu-An; Hughes, Sheryl O; O'Connor, Teresia M

    2015-05-28

    Television (TV) viewing has been associated with many undesirable outcomes for children, such as increased risk of obesity, but TV viewing can also have benefits. Although restrictive parenting practices are effective in reducing children's TV viewing, not all parents use them and it is currently unclear why. The current study examined parenting practices related to TV viewing in the context of social- cognitive theory. Specifically, we hypothesized that positive and negative Parental Outcome Expectations for child's TV Viewing (POETV) would be associated with social co-viewing and restrictive parenting practices, and that POETV and parenting practices influence the amount of TV viewed by child. Data were collected from an internet survey of 287 multi-ethnic parents and their 6-12 year old children on participants' sociodemographic information, parenting practices related to TV use, POETV, and parent and child TV viewing. Path analysis was used to examine the relationship amongst variables in separate models for weekday and weekend TV viewing. controlling for child age, household education, and parental TV viewing. The results provided partial support for the hypotheses, with notable differences between weekday and weekend viewing. The models explained 13.6% and 23.4% of the variance in children's TV viewing on weekdays and weekends respectively. Neither positive nor negative POETV were associated with restrictive TV parenting in either model. One subscale each from positive and negative POETV were associated with social co-viewing parenting on both weekends and weekdays in the expected direction. Restrictive parenting practices were directly negatively associated with children's TV viewing on weekdays, but not weekends. Social co-viewing parenting was directly positively associated with children's TV viewing on weekends, but not weekdays. The strongest influence on children's TV viewing was having a TV in the child's bedroom. Negative POETV was weakly associated

  14. Models of Workplace Incivility: The Relationships to Instigated Incivility and Negative Outcomes

    Directory of Open Access Journals (Sweden)

    Kristoffer Holm

    2015-01-01

    Full Text Available The aim of the study was to investigate workplace incivility as a social process, examining its components and relationships to both instigated incivility and negative outcomes in the form of well-being, job satisfaction, turnover intentions, and sleeping problems. The different components of incivility that were examined were experienced and witnessed incivility from coworkers as well as supervisors. In addition, the organizational factors, social support, control, and job demands, were included in the models. A total of 2871 (2058 women and 813 men employees who were connected to the Swedish Hotel and Restaurant Workers Union completed an online questionnaire. Overall, the results from structural equation modelling indicate that whereas instigated incivility to a large extent was explained by witnessing coworker incivility, negative outcomes were to a high degree explained by experienced supervisor incivility via mediation through perceived low social support, low control, and high job demands. Unexpectedly, the relationships between incivility (experienced coworker and supervisor incivility, as well as witnessed supervisor incivility and instigated incivility were moderated by perceived high control and high social support. The results highlight the importance of including different components of workplace incivility and organizational factors in future studies of the area.

  15. Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

    Science.gov (United States)

    Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

    2011-11-01

    Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

    2011-01-01

    Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

  17. Models of Workplace Incivility: The Relationships to Instigated Incivility and Negative Outcomes.

    Science.gov (United States)

    Holm, Kristoffer; Torkelson, Eva; Bäckström, Martin

    2015-01-01

    The aim of the study was to investigate workplace incivility as a social process, examining its components and relationships to both instigated incivility and negative outcomes in the form of well-being, job satisfaction, turnover intentions, and sleeping problems. The different components of incivility that were examined were experienced and witnessed incivility from coworkers as well as supervisors. In addition, the organizational factors, social support, control, and job demands, were included in the models. A total of 2871 (2058 women and 813 men) employees who were connected to the Swedish Hotel and Restaurant Workers Union completed an online questionnaire. Overall, the results from structural equation modelling indicate that whereas instigated incivility to a large extent was explained by witnessing coworker incivility, negative outcomes were to a high degree explained by experienced supervisor incivility via mediation through perceived low social support, low control, and high job demands. Unexpectedly, the relationships between incivility (experienced coworker and supervisor incivility, as well as witnessed supervisor incivility) and instigated incivility were moderated by perceived high control and high social support. The results highlight the importance of including different components of workplace incivility and organizational factors in future studies of the area.

  18. Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence.

    Science.gov (United States)

    Collamati, Agnese; Martone, Anna Maria; Poscia, Andrea; Brandi, Vincenzo; Celi, Michela; Marzetti, Emanuele; Cherubini, Antonio; Landi, Francesco

    2016-02-01

    The use of medication with anticholinergic properties is widespread among older subjects. Many drugs of common use such as antispasmodics, bronchodilators, antiarrhythmics, antihistamines, anti-hypertensive drugs, antiparkinson agents, skeletal muscle relaxants, and psychotropic drugs have been demonstrated to have an anticholinergic activity. The most frequent adverse effects are dry mouth, nausea, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment such as confusion, agitation and coma. A growing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment in the elderly population. However, the morbidity and management issues associated with unwanted anticholinergic activity are underestimated and frequently overlooked. Moreover, their possible relation with specific negative outcome in the elderly population is still not firmly established. The aim of the present review was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older persons. We searched PubMed and Cochrane combining the search terms "anticholinergic", "delirium", "cognitive impairment", "falls", "mortality" and "discontinuation". Medicines with anticholinergic properties may increase the risks of functional and cognitive decline, morbidity, institutionalization and mortality in older people. However, such evidences are still not conclusive probably due to possible confounding factors. In particular, more studies are needed to investigate the effects of discontinuation of drug with anticholinergic properties. Overall, minimizing anticholinergic burden should always be encouraged in clinical practice to improve short-term memory, confusion and delirium, quality of life and daily functioning.

  19. Tibial internal rotation negatively affects clinical outcomes in total knee arthroplasty: a systematic review.

    Science.gov (United States)

    Panni, Alfredo Schiavone; Ascione, Francesco; Rossini, Marco; Braile, Adriano; Corona, Katia; Vasso, Michele; Hirschmann, Michael T

    2017-12-15

    The aim of this systematic review is to analyze the effect of tibial rotational alignment after total knee arthroplasty (TKA) on clinical outcomes and assess the eventual cut-off values for tibial TKA rotation leading to poor outcomes. A detailed and systematic search from 1997 to 2017 of the Pubmed, Medline, Cochrane Reviews, and the Google Scholar databases was performed using the keyword terms "total knee arthroplasty", "total knee replacement", "tibial alignment", "tibial malalignement", "tibial rotation", "rotational error", "axis", "angle", "tibial malrotation", "clinical outcome", in several combinations. The modified Coleman scoring methodology (mCMS) was used. All the primary TKAs studies analyzing correlation between clinical results and tibial rotation were included. Five articles met the inclusion criteria. A total of 333 arthroplasties were included in this review; 139 had tibial component malalignment, while 194 were in control groups. The mean age of patients was 67.3 (SD 0.57) years. The mean average postoperative follow-up delay was 34.7 months (range 21-70). The mean mCMS score was 59.2 points indicating good methodological quality in the included studies. Functional outcomes were assessed through KSS, OKS, KOOS and VAS, negatively related to tibial internal rotation. Our review confirmed that excessive internal rotation of the tibial TKA component represents a significant risk factor for pain and inferior functional outcomes after TKA (> 10° of internal rotation demonstrated the common value), since external rotation does not affect the results. However, a universal precise cut-off value has not been found in the available literature and there remains a debate about CT rotation assessment and surgical intra-operative landmarks. III.

  20. New perspectives on patient expectations of treatment outcomes: results from qualitative interviews with patients seeking complementary and alternative medicine treatments for chronic low back pain.

    Science.gov (United States)

    Hsu, Clarissa; Sherman, Karen J; Eaves, Emery R; Turner, Judith A; Cherkin, Daniel C; Cromp, DeAnn; Schafer, Lisa; Ritenbaugh, Cheryl

    2014-07-30

    Positive patient expectations are often believed to be associated with greater benefits from complementary and alternative medicine (CAM) treatments. However, clinical studies of CAM treatments for chronic pain have not consistently supported this assumption, possibly because of differences in definitions and measures of expectations. The goal of this qualitative paper is to provide new perspectives on the outcome expectations of patients prior to receiving CAM therapies for chronic low back pain. We conducted semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. Interviews were recorded and transcribed. Transcripts were analyzed by a team of experienced qualitative researchers using an immersion/crystallization approach to coding and analysis. Overall, participants' expectations of treatment outcomes tended to cluster in four key domains: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment. Furthermore, outcome expectations were complex on several levels. First, the concept of expectations overlapped with several related concepts; in particular, hopes. Participants sometimes used expectations and hopes interchangeably and at other times made clear distinctions between these two terms depending on context. A related finding was that participants were cautious about stating that they expected positive outcomes. Finally, participants articulated strong interrelationships among the four key domains and often discussed how changes in one domain might affect other domains. Overall, these findings contribute to a growing body of literature exploring the role of expectations in patient outcomes. This paper provides important guidance that may help refine the way treatment expectations are

  1. Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

    Science.gov (United States)

    Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2014-01-01

    This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

  2. Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

    Directory of Open Access Journals (Sweden)

    Wilson Lee-Ann

    2011-04-01

    Full Text Available Abstract Background Pregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland. Methods We examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, highways and main roads. Results There were no associations with distance to road. A greater number of freeways and main roads around the home were associated with a shorter gestation time. There were no negative impacts on birth weight, birth length or head circumference after adjusting for gestation. The negative effects on gestation were largely due to main roads within 400 metres of the home. For every 10 extra main roads within 400 metres of the home, gestation time was reduced by 1.1% (95% CI: -1.7, -0.5; p-value = 0.001. Conclusions Our results add weight to the association between exposure to traffic and reduced gestation time. This effect may be due to the chemical toxins in traffic pollutants, or because of disturbed sleep due to traffic noise.

  3. Outcome of intracranial electroencephalography monitoring and surgery in magnetic resonance imaging-negative temporal lobe epilepsy.

    Science.gov (United States)

    Lee, Ricky W; Hoogs, Marietta M; Burkholder, David B; Trenerry, Max R; Drazkowski, Joseph F; Shih, Jerry J; Doll, Karey E; Tatum, William O; Cascino, Gregory D; Marsh, W Richard; Wirrell, Elaine C; Worrell, Gregory A; So, Elson L

    2014-07-01

    We evaluated the outcomes of intracranial electroencephalography (iEEG) recording and subsequent resective surgery in patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE). Thirty-two patients were identified from the Mayo Clinic Epilepsy Surgery Database (Arizona, Florida, and Minnesota). Eight (25.0%) had chronic iEEG monitoring that recorded neocortical temporal seizure onsets; 12 (37.5%) had mesial temporal seizure onsets; 5 (15.6%) had independent neocortical and mesial temporal seizure onsets; and 7 (21.9%) had simultaneous neocortical and mesial seizure onsets. Neocortical temporal lobe seizure semiology was the only factor significantly associated with neocortical temporal seizure onsets on iEEG. Only 33.3% of patients who underwent lateral temporal neocorticectomy had an Engel class 1 outcome, whereas 76.5% of patients with iEEG-guided anterior temporal lobectomy that included the amygdala and the hippocampus had an Engel class 1 outcome. Limitations in cohort size precluded statistical analysis of neuropsychological test data. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Association between changes on the Negative Symptom Assessment scale (NSA-16) and measures of functional outcome in schizophrenia.

    Science.gov (United States)

    Velligan, Dawn I; Alphs, Larry; Lancaster, Scott; Morlock, Robert; Mintz, Jim

    2009-09-30

    We examined whether changes in negative symptoms, as measured by scores on the 16-item Negative Symptom Assessment scale (NSA-16), were associated with changes in functional outcome. A group of 125 stable outpatients with schizophrenia were assessed at baseline and at 6 months using the NSA-16, the Brief Psychiatric Rating Scale, and multiple measures of functional outcome. Baseline adjusted regression coefficients indicated moderate correlations between negative symptoms and functional outcomes when baseline values of both variables were controlled. Results were nearly identical when we controlled for positive symptoms. Cross-lag panel correlations and Structural Equation Modeling were used to examine whether changes in negative symptoms drove changes in functional outcomes over time. Results indicated that negative symptoms drove the changes in the Social and Occupational Functioning Scale (SOFAS) rather than the reverse. Measures of Quality of Life and measures of negative symptoms may be assessing overlapping constructs or changes in both may be driven by a third variable. Negative symptoms were unrelated over time to scores on a performance-based measure of functional capacity. This study indicates that the relationship between negative symptom change and the change in functional outcomes is complex, and points to potential issues in selection of assessments.

  5. Reality television predicts both positive and negative outcomes for adolescent girls.

    Science.gov (United States)

    Ferguson, Christopher J; Salmond, Kimberlee; Modi, Kamla

    2013-06-01

    To assess the influence of media, specifically reality television, on adolescent behavior. A total of 1141 preteen and adolescent girls (age range 11-17) answered questions related to their reality television viewing, personality, self-esteem, relational aggression, appearance focus, and desire for fame. Our results indicated that the influence of reality television on adolescent behavior is complex and potentially related to the adolescents' intended uses and gratifications for using reality television. Reality television viewing was positively related to increased self-esteem and expectations of respect in dating relationships. However, watching reality television also was related to an increased focus on appearance and willingness to compromise other values for fame. Reality television viewing did not predict relational aggression. The potential influences of reality television use on adolescent girls are both positive and negative, defying easy categorization. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. The Feedback-Related Negativity and the P300 Brain Potential Are Sensitive to Price Expectation Violations in a Virtual Shopping Task.

    Science.gov (United States)

    Schaefer, Alexandre; Buratto, Luciano G; Goto, Nobuhiko; Brotherhood, Emilie V

    A large body of evidence shows that buying behaviour is strongly determined by consumers' price expectations and the extent to which real prices violate these expectations. Despite the importance of this phenomenon, little is known regarding its neural mechanisms. Here we show that two patterns of electrical brain activity known to index prediction errors-the Feedback-Related Negativity (FRN) and the feedback-related P300 -were sensitive to price offers that were cheaper than participants' expectations. In addition, we also found that FRN amplitude time-locked to price offers predicted whether a product would be subsequently purchased or not, and further analyses suggest that this result was driven by the sensitivity of the FRN to positive price expectation violations. This finding strongly suggests that ensembles of neurons coding positive prediction errors play a critical role in real-life consumer behaviour. Further, these findings indicate that theoretical models based on the notion of prediction error, such as the Reinforcement Learning Theory, can provide a neurobiologically grounded account of consumer behavior.

  7. The Feedback-Related Negativity and the P300 Brain Potential Are Sensitive to Price Expectation Violations in a Virtual Shopping Task

    Science.gov (United States)

    Schaefer, Alexandre; Buratto, Luciano G.; Goto, Nobuhiko; Brotherhood, Emilie V.

    2016-01-01

    A large body of evidence shows that buying behaviour is strongly determined by consumers’ price expectations and the extent to which real prices violate these expectations. Despite the importance of this phenomenon, little is known regarding its neural mechanisms. Here we show that two patterns of electrical brain activity known to index prediction errors–the Feedback-Related Negativity (FRN) and the feedback-related P300 –were sensitive to price offers that were cheaper than participants’ expectations. In addition, we also found that FRN amplitude time-locked to price offers predicted whether a product would be subsequently purchased or not, and further analyses suggest that this result was driven by the sensitivity of the FRN to positive price expectation violations. This finding strongly suggests that ensembles of neurons coding positive prediction errors play a critical role in real-life consumer behaviour. Further, these findings indicate that theoretical models based on the notion of prediction error, such as the Reinforcement Learning Theory, can provide a neurobiologically grounded account of consumer behavior. PMID:27658301

  8. Expect the best, prepare for the worst: surgeon and patient expectation of the outcome of primary total hip and knee replacement.

    Science.gov (United States)

    Moran, M.; Khan, A.; Sochart, D. H.; Andrew, G.

    2003-01-01

    A cross-sectional study of 100 surgeons and 370 patients awaiting primary total hip or knee replacement was carried out. Oxford hip or knee score questionnaires were sent to the surgeons and patients. They were asked to predict the level of symptoms expected 6 months following surgery. The Oxford scores derive a value of 12-60, with a greater score indicating worsening symptoms. The mean pre-operative score was 45.12 for the hip patients and 42.96 for the knee patients, and the patients expected this to drop to 23.70 and 25.66, respectively, 6 months' postoperatively. This was a significant difference for both groups. The surgeons expected the patients to have a mean postoperative score of 20.91 for the hip group and 22.19 for the knee group. The surgeons' scores were significantly lower than those from the patients. There was a significant difference between the patients' and surgeons' expectations of the results of total knee and hip replacement surgery. The surgeons expected better results than the patients. We believe that this is the first study that directly compares surgeon and patient expectations of lower limb arthroplasty. PMID:12831497

  9. Do fibrin sealants impact negative outcomes after robot-assisted partial nephrectomy?

    Science.gov (United States)

    Cohen, Jason; Jayram, Gautam; Mullins, Jeffrey K; Ball, Mark W; Allaf, Mohamad E

    2013-10-01

    Contemporary rates of postoperative hemorrhage after partial nephrectomy (PN) are low. Commercially available hemostatic agents are commonly used during this surgery to reduce this risk despite a paucity of data supporting the practice. We assessed the impact of fibrin sealant hemostatic agents, a costly addition to surgeries, during robot-assisted partial nephrectomy (RAPN). Between 2007 and 2011, 114 consecutive patients underwent RAPN by a single surgeon (MEA). Evicel fibrin sealant was used in the first 74 patients during renorraphy. The last 40 patients had renorraphy performed without the use of any hemostatic agents. Clinicopathologic, operative, and complication data were compared between groups. Multivariate and univariate logistic regression analysis was performed to test the association between the use of fibrin sealants and operative outcomes. Patient demographic data and clinical tumor characteristics were similar between groups. The use of fibrin sealant did not increase operative time (166.3 vs 176.1 minutes, P=0.28), warm ischemia time (WIT) (14.4 vs 16.1 minutes, P=0.18), or length of hospital stay (2.6 vs 2.4 days, P=0.35). The omission of these agents did not increase estimated blood loss (116.6 vs 176.1 mL, P=0.8) or postoperative blood transfusion (0% vs 2.5%, P=0.17). Univariate analysis demonstrated no association between use of fibrin sealants and increased complications (P>0.05). Multivariable logistic regression showed no statistically significant predictive value of omission of hemostatic agents for perioperative outcomes (P>0.05). Perioperative hemorrhage and other major complications after contemporary RAPN are rare in experienced hands. In our study, the use of fibrin sealants during RAPN does not decrease the rate of complications, blood loss, or hospital stay. Furthermore, no impact is seen on operative time, WIT, or other negative outcomes. Omitting these agents during RAPN could be a safe, effective, cost-saving measure.

  10. Comorbidity negatively influences the outcomes of diagnostic tests for musculoskeletal pain in the orofacial region.

    Science.gov (United States)

    Koutris, Michail; Visscher, Corine M; Lobbezoo, Frank; Naeije, Machiel

    2013-06-01

    The aim of this study was to investigate whether diagnostic tests for musculoskeletal pain in the orofacial region [temporomandibular disorder (TMD) pain] are influenced by the presence of comorbid conditions, and to determine whether this influence decreases when the presence of "familiar pain" is used as outcome measure. In total, 117 patients (35 men, 82 women; 75 TMD-pain patients, 42 pain-free patients; mean age ± SD = 42.94 ± 14.17 years) were examined with palpation tests and dynamic/static tests. After each test, they were asked whether any pain was provoked and whether this pain response was familiar or not. For four clinical outcome measures (pain on palpation, familiar pain on palpation, pain on dynamic/static tests, and familiar pain on dynamic/static tests), multiple logistic regression analyses were performed with the presence of TMD pain as the primary predictor and regional (neck/shoulder) pain, widespread pain, depression, and somatization as comorbid factors. Pain on palpation was not associated with the primary predictor but with regional pain [P = 0.02, odds ratio (OR) = 4.59] and somatization (P = 0.011, OR = 8.47), whereas familiar pain on palpation was associated with the primary predictor (P = 0.003, OR = 5.23), but also with widespread pain (P = 0.001, OR = 2.02). Pain on dynamic/static tests was associated with the primary predictor (P pain on dynamic/static tests was only associated with the primary predictor (P diagnostic tests are negatively influenced by the presence of comorbidity. This influence decreases when the presence of familiar pain is used as outcome measure. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. Impact of Statin Use on Outcomes in Triple Negative Breast Cancer

    Science.gov (United States)

    Shaitelman, Simona F.; Stauder, Michael C.; Allen, Pamela; Reddy, Sangeetha; Lakoski, Susan; Atkinson, Bradley; Reddy, Jay; Amaya, Diana; Guerra, William; Ueno, Naoto; Caudle, Abigail; Tereffe, Welela; Woodward, Wendy A.

    2017-01-01

    Purpose: We sought to investigate if the use of HMG Co-A reductase inhibitors (statins) has an impact on outcomes among patients with triple negative breast cancer (TNBC). Methods: We reviewed the cases of women with invasive, non-metastatic TNBC, diagnosed 1997-2012. Clinical outcomes were compared based on statin use (defined as ever use during treatment vs. never use). We identified a subset of women for whom a 5-value lipid panel (5VLP) was available, including total cholesterol, low density lipoprotein, high density lipoprotein, very low density lipoprotein, and triglycerides. The Kaplan-Meier method was used to estimate median overall survival (OS), distant metastases-free survival (DMFS), and local-regional recurrence-free survival (LRRFS). A Cox proportional hazards regression model was used to test the statistical significance of prognostic factors. Results: 869 women were identified who met inclusion criteria, with a median follow-up time of 75.1 months (range 2.4-228.9 months). 293 (33.7%) patients used statins and 368 (42.3%) had a 5VLP. OS, DMFS, and LRRFS were not significant based on statin use or type. Controlling for the 5VLP values, on multivariable analysis, statin use was significantly associated with OS (HR 0.10, 95% CI 0.01-0.76), but not with DMFS (HR 0.14, 95% CI 0.01-1.40) nor LRRFS (HR 0.10 95% CI 0.00-3.51). Conclusions: Statin use among patients with TNBC is not associated with improved OS, although it may have a benefit for a subset of patients. Prospective assessment would be valuable to better assess the potential complex correlation between clinical outcome, lipid levels, and statin use. PMID:28819403

  12. Anxiety Sensitivity and Pre-Cessation Smoking Processes: Testing the Independent and Combined Mediating Effects of Negative Affect–Reduction Expectancies and Motives

    Science.gov (United States)

    Farris, Samantha G.; Leventhal, Adam M.; Schmidt, Norman B.; Zvolensky, Michael J.

    2015-01-01

    Objective: Anxiety sensitivity appears to be relevant in understanding the nature of emotional symptoms and disorders associated with smoking. Negative-reinforcement smoking expectancies and motives are implicated as core regulatory processes that may explain, in part, the anxiety sensitivity–smoking interrelations; however, these pathways have received little empirical attention. Method: Participants (N = 471) were adult treatment-seeking daily smokers assessed for a smoking-cessation trial who provided baseline data; 157 participants provided within-treatment (pre-cessation) data. Anxiety sensitivity was examined as a cross-sectional predictor of several baseline smoking processes (nicotine dependence, perceived barriers to cessation, severity of prior withdrawal-related quit problems) and pre-cessation processes including nicotine withdrawal and smoking urges (assessed during 3 weeks before the quit day). Baseline negative-reinforcement smoking expectancies and motives were tested as simultaneous mediators via parallel multiple mediator models. Results: Higher levels of anxiety sensitivity were related to higher levels of nicotine dependence, greater perceived barriers to smoking cessation, more severe withdrawal-related problems during prior quit attempts, and greater average withdrawal before the quit day; effects were indirectly explained by the combination of both mediators. Higher levels of anxiety sensitivity were not directly related to pre-cessation smoking urges but were indirectly related through the independent and combined effects of the mediators. Conclusions: These empirical findings bolster theoretical models of anxiety sensitivity and smoking and identify targets for nicotine dependence etiology research and cessation interventions. PMID:25785807

  13. Impacts of Professional Development in Integrated STEM Education on Teacher Self-Efficacy, Outcome Expectancy, and Stem Career Awareness

    Science.gov (United States)

    Knowles, J. Geoff

    This research analyzed the effects of teacher professional development and lesson implementation in integrated Science, Technology, Engineering, and Math (STEM) on: 1.) Teacher self-efficacy and their confidence to teach specific STEM subjects; 2.) Teaching outcome expectancy beliefs concerning the impact of actions by teachers on student learning; and 3.) Teacher awareness of STEM careers. High school science and technology education teachers participating in the Teachers and Researchers Advancing Integrated Lessons in STEM (TRAILS) project experimental group attended a ten-day summer professional development institute designed to educate teachers in using an integrated STEM education model to implement integrated STEM lessons. The research design utilized a quasi-experimental nonequivalent comparison group design that incorporated an experimental group and an untreated comparison group with both pretest, posttest, and delayed posttest assessments on non-randomized participants. Teacher self-efficacy has been identified as a key factor in effective teaching and student learning, and teacher awareness of STEM careers impacts students as they consider career choices. The T-STEM Survey for teachers was given for the pretest and posttest assessments to measure attitudes and beliefs toward the specific constructs of this study. Significant effects of the TRAILS professional development were found in the teacher group (experimental or comparison) and teacher subject (technology or science) in pretest and posttest scores using cumulative link models for the constructs of teacher self-efficacy and beliefs to teach STEM subjects, teacher outcome expectancy beliefs, and teacher awareness of STEM careers. Effect sizes ranged from small to large varying by construct and assessment time. Highly significant p-values and effect sizes revealed impacts on science teachers were greater when teacher subject groups were analyzed separately.

  14. Obstetric and perinatal outcome in induction of labor compared with expectant management for prelabor rupture of the membranes at term

    International Nuclear Information System (INIS)

    Yaqoob, U.; Mushtaq, R.; Mushtaq, M.

    2015-01-01

    To compare the management outcome of induction of labor with expectant management in patients with term pre labor rupture of membranes (PROM). Study Design: Randomized controlled trial. Place and Duration of Study: This study was conducted in the department of Obstetrics and Gynaecology; Combined Military Hospital Rawalpindi from 25th July 2010 to 25th January 2011. Methods: A total of 384 patients were selected for this study, which were divided into two groups by lottery method. Patients in group A were induced with tablet prostaglandin E2 and group B patients were managed expectantly for 24 hours. The outcome of mothers and neonates was recorded on a pre-designed proforma. Results: The mean duration between PROM to onset of active labor in group A was significantly less (8.4 ± 2.3 hours) as compared to group B in which it was (9.6±2.1 hours) (p = 0.000). The mean duration between PROM to delivery in group A was significantly less in group A (17.4 ± 2.0) versus group B (22.2 ± 2.0 hours) (p = 0.000). The spontaneous vaginal delivery (SVD) rate was considerably higher (p=0.056) in group A in which 161 (83.8%) patients delivered by SVD and 31 (16.1%) patients by LSCS. In group B, 146 (76.0%) patients delivered by SVD and 46 (23.9%) patients by LSCS. In group A, 8 (4.1%) patients developed chorioamnionitis and 13 (6.7%) patients in group B (p = 0.262). In group A there were 178 (92.7%) neonates with APGAR score of > 5 at 1 minute in contrast to 173 (90.1%) in group B with (p = 0.363). Similarly in group A at 5 minutes, there were 178 (92.7%) neonates with APGAR score of > 7 and 173 (90.1%) in group B (p = 0.460). There were 9 (4.6%) cases of neonatal sepsis in group A, in comparison with 12 (6.2%) patients in group B (p = 0.501). Conclusion: The mean duration of labor in induced patients was less as compared to patients with expectant management. (author)

  15. Midtrimester preterm prelabour rupture of membranes (PPROM): expectant management or amnioinfusion for improving perinatal outcomes (PPROMEXIL – III trial)

    Science.gov (United States)

    2014-01-01

    Background Babies born after midtrimester preterm prelabour rupture of membranes (PPROM) are at risk to develop neonatal pulmonary hypoplasia. Perinatal mortality and morbidity after this complication is high. Oligohydramnios in the midtrimester following PPROM is considered to cause a delay in lung development. Repeated transabdominal amnioinfusion with the objective to alleviate oligohydramnios might prevent this complication and might improve neonatal outcome. Methods/Design Women with PPROM and persisting oligohydramnios between 16 and 24 weeks gestational age will be asked to participate in a multi-centre randomised controlled trial. Intervention: random allocation to (repeated) abdominal amnioinfusion (intervention) or expectant management (control). The primary outcome is perinatal mortality. Secondary outcomes are lethal pulmonary hypoplasia, non-lethal pulmonary hypoplasia, survival till discharge from NICU, neonatal mortality, chronic lung disease (CLD), number of days ventilatory support, necrotizing enterocolitis (NEC), periventricular leucomalacia (PVL) more than grade I, severe intraventricular hemorrhage (IVH) more than grade II, proven neonatal sepsis, gestational age at delivery, time to delivery, indication for delivery, successful amnioinfusion, placental abruption, cord prolapse, chorioamnionitis, fetal trauma due to puncture. The study will be evaluated according to intention to treat. To show a decrease in perinatal mortality from 70% to 35%, we need to randomise two groups of 28 women (two sided test, β-error 0.2 and α-error 0.05). Discussion This study will answer the question if (repeated) abdominal amnioinfusion after midtrimester PPROM with associated oligohydramnios improves perinatal survival and prevents pulmonary hypoplasia and other neonatal morbidities. Moreover, it will assess the risks associated with this procedure. Trial registration NTR3492 Dutch Trial Register (http://www.trialregister.nl). PMID:24708702

  16. Midtrimester preterm prelabour rupture of membranes (PPROM): expectant management or amnioinfusion for improving perinatal outcomes (PPROMEXIL - III trial).

    Science.gov (United States)

    van Teeffelen, Augustinus S P; van der Ham, David P; Willekes, Christine; Al Nasiry, Salwan; Nijhuis, Jan G; van Kuijk, Sander; Schuyt, Ewoud; Mulder, Twan L M; Franssen, Maureen T M; Oepkes, Dick; Jansen, Fenna A R; Woiski, Mallory D; Bekker, Mireille N; Bax, Caroline J; Porath, Martina M; de Laat, Monique W M; Mol, Ben W; Pajkrt, Eva

    2014-04-04

    Babies born after midtrimester preterm prelabour rupture of membranes (PPROM) are at risk to develop neonatal pulmonary hypoplasia. Perinatal mortality and morbidity after this complication is high. Oligohydramnios in the midtrimester following PPROM is considered to cause a delay in lung development. Repeated transabdominal amnioinfusion with the objective to alleviate oligohydramnios might prevent this complication and might improve neonatal outcome. Women with PPROM and persisting oligohydramnios between 16 and 24 weeks gestational age will be asked to participate in a multi-centre randomised controlled trial. random allocation to (repeated) abdominal amnioinfusion (intervention) or expectant management (control). The primary outcome is perinatal mortality. Secondary outcomes are lethal pulmonary hypoplasia, non-lethal pulmonary hypoplasia, survival till discharge from NICU, neonatal mortality, chronic lung disease (CLD), number of days ventilatory support, necrotizing enterocolitis (NEC), periventricular leucomalacia (PVL) more than grade I, severe intraventricular hemorrhage (IVH) more than grade II, proven neonatal sepsis, gestational age at delivery, time to delivery, indication for delivery, successful amnioinfusion, placental abruption, cord prolapse, chorioamnionitis, fetal trauma due to puncture. The study will be evaluated according to intention to treat. To show a decrease in perinatal mortality from 70% to 35%, we need to randomise two groups of 28 women (two sided test, β-error 0.2 and α-error 0.05). This study will answer the question if (repeated) abdominal amnioinfusion after midtrimester PPROM with associated oligohydramnios improves perinatal survival and prevents pulmonary hypoplasia and other neonatal morbidities. Moreover, it will assess the risks associated with this procedure. NTR3492 Dutch Trial Register (http://www.trialregister.nl).

  17. Malnutrition is prevalent in patients with cardiorenal syndrome and negatively influences clinical outcome.

    Science.gov (United States)

    Gigante, A; Rosato, E; Barbano, B; Di Mario, F; Di Lazzaro-Giraldi, G; Gasperini, M L; Pofi, R; Laviano, A

    2018-01-01

    Cardiorenal syndrome (CRS) describes the concurrent failure of cardiac and renal function, each influencing the other. Malnutrition and cachexia frequently develop in patients with heart failure or kidney failure. However, no information is currently available on the prevalence of malnutrition in CRS patients. We studied CRS patients admitted to an internal medicine ward during a 5-month period and evaluated their clinical characteristics and nutritional status. Malnutrition risk was assessed by using the validated screening tool NRS-2002 whilst body composition was assessed by bioimpedance analysis and muscle function was measured by handgrip (HG) strength. Cardiac mass was also recorded. Length of stay, hospital readmission and 6-month mortality were registered. During the study period, 22 CRS patients were studied. Twenty patients were diagnosed with either CRS type 1 or CRS type 5. In CRS patients, fat-free mass showed a trend toward representing a protective factor for 6-month mortality (OR=0.904; p=0.06). Also, fat-free mass correlated with HG strength and cardiac ejection fraction. Malnutrition risk was diagnosed in 45% of the patients, whereas 8 patients met the definition of cachexia. Even without statistical significance, CRS patients with malnutrition had lower BMI (Body Mass Index) (p=0.038) and fat-free mass (p= n.s.). However, CRS malnutrition was associated to higher 6-month mortality (p= 0.05), and appears to negatively influence the outcome in CRS (OR= 9; p= 0.06). Our results show that malnutrition is prevalent in CRS patients and influences the clinical outcome. The assessment of nutritional status, and particularly body composition, should be implemented in daily practice of patients with CRS.

  18. Relationship between negative social reactions to sexual assault disclosure and mental health outcomes of Black and White female survivors.

    Science.gov (United States)

    Hakimi, Dehnad; Bryant-Davis, Thema; Ullman, Sarah E; Gobin, Robyn L

    2018-05-01

    This study investigates the effect of race on the relationship between negative reactions to sexual assault disclosure and the psychological sequelae such as posttraumatic stress disorder (PTSD), depression, and problem drinking in female sexual assault survivors. Using hierarchical regression in an ethnically diverse community sample of 622 female adult sexual assault victims, we assessed for sexual assault; negative reactions to sexual assault disclosure; and symptom severity for PTSD, depression, and problem drinking. Negative social reactions to sexual assault disclosures were significantly associated with negative mental health outcomes across race. Race moderated the influence of negative disclosure reactions on psychological symptoms; however, the moderation was not similar across racial groups and psychological outcome measures. Although Black and White survivors evidenced distress through depression, PTSD, and substance use, Black women who received low to moderate negative reactions to their disclosures of assault were more likely to show increases in PTSD and depression whereas high negative reactions to disclosure were related to higher PTSD and depression similarly for both Black and White women. In addition, Black and White women who experienced more negative social reactions had greater substance abuse, with no difference by race. The results provide further support for detrimental effects of negative reactions on Black and White survivors and highlight the importance of educating people in the community about sexual assault and how to respond in more supportive ways. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. SPECIFIC COURSE OF PREGNANCY, PERINATAL OUTCOMES AND TREATMENT RESULTS IN HIV NEGATIVE FEMALE PATIENTS

    Directory of Open Access Journals (Sweden)

    A. V. Nesterenko

    2017-01-01

    Full Text Available The objective of the study is to investigate the specific course of pregnancy, perinatal outcomes and treatment results in HIV negative female patients.Subjects and Methods. Medical files of 109 pregnant tuberculosis patients were analyzed who were followed up in Krasnoyarsk Regional TB Dispensary no. 1 from 2010 to 2014.Results. The part of children prematurely born by mothers ill with tuberculosis was practically compatible with the overall national cohort of live-born children (6.8% in the analyzed group versus 5.7% in the national cohort for 2014. The part of children with congenital abnormalities born by mothers suffering from tuberculosis turned out to be twice lower versus the overall national cohort of live-born children (1.4% versus 3.0% in 2010 and 2.9% in 2014.The efficiency of the main treatment course in pregnant women without multiple drug resistant tuberculosis, of which 3.8 ± 0.3 months of tuberculosis treatment coincided with pregnancy was practically the same as treatment efficiency for the overall cohort of patients in Krasnoyarsky Kray (66.2% in the analyzed cohort versus 60.3-72.7% in the regional cohort for 2010-2014. In the pregnant with multiple drug resistant forms of tuberculosis, treatment efficiency was lower versus the regional cohort (30.4% in the analyzed cohort versus 41.1-60.2% in the regional cohort for 2010-2014. 

  20. Pyruvate dehydrogenase expression is negatively associated with cell stemness and worse clinical outcome in prostate cancers

    Science.gov (United States)

    Zhong, Yali; Li, Xiaoli; Ji, Yasai; Li, Xiaoran; Li, Yaqing; Yu, Dandan; Yuan, Yuan; Liu, Jian; Li, Huixiang; Zhang, Mingzhi; Ji, Zhenyu; Fan, Dandan; Wen, Jianguo; Goscinski, Mariusz Adam; Yuan, Long; Hao, Bin; Nesland, Jahn M; Suo, Zhenhe

    2017-01-01

    Cells generate adenosine-5′-triphosphate (ATP), the major currency for energy-consuming reactions, through mitochondrial oxidative phosphorylation (OXPHOS) and glycolysis. One of the remarkable features of cancer cells is aerobic glycolysis, also known as the “Warburg Effect”, in which cancer cells rely preferentially on glycolysis instead of mitochondrial OXPHOS as the main energy source even in the presence of high oxygen tension. One of the main players in controlling OXPHOS is the mitochondrial gatekeeperpyruvate dehydrogenase complex (PDHc) and its major subunit is E1α (PDHA1). To further analyze the function of PDHA1 in cancer cells, it was knock out (KO) in the human prostate cancer cell line LnCap and a stable KO cell line was established. We demonstrated that PDHA1 gene KO significantly decreased mitochondrial OXPHOS and promoted anaerobic glycolysis, accompanied with higher stemness phenotype including resistance to chemotherapy, enhanced migration ability and increased expression of cancer stem cell markers. We also examined PDHA1 protein expression in prostate cancer tissues by immunohistochemistry and observed that reduced PDHA1 protein expression in clinical prostate carcinomas was significantly correlated with poor prognosis. Collectively, our results show that negative PDHA1 gene expressionis associated with significantly higher cell stemness in prostate cancer cells and reduced protein expression of this gene is associated with shorter clinical outcome in prostate cancers. PMID:28076853

  1. Association of Academic Performance with Outcome Expectations and Its Domains in Nursing and Midwifery Students at Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Sepideh Bakhtiari

    2014-09-01

    Full Text Available Introduction: Outcome expectation is considered as a basic and significant variable in education. It is a cognitive-motivational component that takes the individual into account as an active and sensible decision-maker. The present study was conducted to investigate the correlation of outcome expectations with academic performance of students of nursing and midwifery in Kermanshah University of Medical Sciences. Methods: In this descriptive cross-sectional study, the sample size included 218 nursing and midwifery students selected through convenient random sampling method. The instrument for data collection was the questionnaire of “outcome expectations of career decision-making and discovery targets”, which comprised of 13 questions in three domains of future orientation, job satisfaction and personal expectations. The questionnaires were coded after being completed and the obtained data were fed into SPSS-16 software and analyzed by descriptive statistics, t-test, Kolmogrov-Smirnov, ANOVA and Mann-Whitney tests. Results: The findings indicated no statistically significant difference between place of living (dormitory or home and outcome expectations along with its domains (39.4% and 60-6%. However, a significant correlation was reported between discipline, gender, admittance year and academic performance of the students (p0.05. Conclusion: The findings of this study indicated a positively positive significant relationship between students’ academic performance and outcome expectations along with its domains.

  2. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

    Science.gov (United States)

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21-57 years (M=35.27; SD=8.13). Polish versions of the Impact of Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

  3. LGB and questioning students in schools: the moderating effects of homophobic bullying and school climate on negative outcomes.

    Science.gov (United States)

    Birkett, Michelle; Espelage, Dorothy L; Koenig, Brian

    2009-08-01

    Lesbian, gay, and bisexual students (LGB) and those questioning their sexual orientation are often at great risk for negative outcomes like depression, suicidality, drug use, and school difficulties (Elliot and Kilpatrick, How to Stop Bullying, A KIDSCAPE Guide to Training, 1994; Mufoz-Plaza et al., High Sch J 85:52-63, 2002; Treadway and Yoakam, J School Health 62(7):352-357, 1992). This study examined how school contextual factors such as homophobic victimization and school climate influence negative outcomes in LGB and questioning middle school students. Participants were 7,376 7th and 8th grade students from a large Midwestern county (50.7% Female, 72.7% White, 7.7% Biracial, 6.9% Black, 5.2% Asian, 3.7% Hispanic, and 2.2% reported "other"). LGB and sexually questioning youth were more likely to report high levels of bullying, homophobic victimization, and various negative outcomes than heterosexual youth. Students who were questioning their sexual orientation reported the most bullying, the most homophobic victimization, the most drug use, the most feelings of depression and suicidality, and more truancy than either heterosexual or LGB students. A positive school climate and a lack of homophobic victimization moderated the differences among sexual orientation status and outcomes. Results indicate that schools have the ability to lessen negative outcomes for LGB and sexually questioning students through creating positive climates and reducing homophobic teasing.

  4. Preoperative cow-side lactatemia measurement predicts negative outcome in Holstein dairy cattle with right abomasal disorders.

    Science.gov (United States)

    Boulay, G; Francoz, D; Doré, E; Dufour, S; Veillette, M; Badillo, M; Bélanger, A-M; Buczinski, S

    2014-01-01

    The objectives of the current study were (1) to determine the gain in prognostic accuracy of preoperative l-lactate concentration (LAC) measured on farm on cows with right displaced abomasum (RDA) or abomasal volvulus (AV) for predicting negative outcome; and (2) to suggest clinically relevant thresholds for such use. A cohort of 102 cows with on-farm surgical diagnostic of RDA or AV was obtained from June 2009 through December 2011. Blood was drawn from coccygeal vessels before surgery and plasma LAC was immediately measured by using a portable clinical analyzer. Dairy producers were interviewed by phone 30 d following surgery and the outcome was determined: a positive outcome if the owner was satisfied of the overall evolution 30 d postoperatively, and a negative outcome if the cow was culled, died, or if the owner reported being unsatisfied 30 d postoperatively. The area under the curve of the receiver operating characteristic curve for LAC was 0.92 and was significantly greater than the area under the curve of the receiver operating characteristic curve of heart rate (HR; 0.77), indicating that LAC, in general, performed better than HR to predict a negative outcome. Furthermore, the ability to predict a negative outcome was significantly improved when LAC measurement was considered in addition to the already available HR data (area under the curve: 0.93 and 95% confidence interval: 0.87, 0.99). Important inflection points of the misclassification cost term function were noted at thresholds of 2 and 6 mmol/L, suggesting the potential utility of these cut-points. The 2 and 6 mmol/L thresholds had a sensitivity, specificity, positive predictive value, and negative predictive value for predicting a negative outcome of 76.2, 82.7, 53.3, and 93.1%, and of 28.6, 97.5, 75, and 84%, respectively. In terms of clinical interpretation, LAC ≤2 mmol/L appeared to be a good indicator of positive outcome and could be used to support a surgical treatment decision. The

  5. Outcome of triple negative breast cancer: comparison of sporadic and BRCA1-associated cancers.

    Science.gov (United States)

    Tung, Nadine; Gaughan, Elizabeth; Hacker, Michele R; Lee, Larissa J; Alexander, Brian; Poles, Emily; Schnitt, Stuart J; Garber, Judy E

    2014-07-01

    The majority of breast cancers developing in BRCA1 mutation carriers are triple negative breast cancers (TNBC), an aggressive subtype that accounts for 15-20 % of sporadic breast cancer. We compare the clinical outcome and sites of relapse of TNBC in BRCA1 mutation carriers and non-carriers who received adjuvant chemotherapy. Women with stage I-III TNBC who had BRCA1 testing within 36 months of diagnosis and received adjuvant chemotherapy were identified from clinical databases at two academic institutions. Sites of relapse, freedom from distant metastasis (FFDM), and breast cancer-specific survival (BCSS) were determined. RCA1 carriers (n = 89) were significantly younger at diagnosis (P < 0.0001) than non-carriers (n = 175). FFDM at 5 years was 80.5 % for carriers and 76.9 % for non-carriers; with median follow-up of 55 months, hazard ratio (HR) was 0.90, P = 0.71. Sites of recurrence, including brain, did not differ significantly. BCSS at 5 years was 88.1 % for carriers and 81.4 % for non-carriers; HR 0.60; P = 0.15 at 55 months follow-up. BRCA1 carriers who underwent oophorectomy had a significantly lower rate of death from TNBC, with an adjusted HR of 0.30 (95 % CI 0.10-0.94). Adjusting for age, oophorectomy, and prophylactic mastectomy, BRCA1 mutation status was not an independent predictor of survival (HR 2.1; P = 0.13). BRCA1 mutation carriers with TNBC had similar survival rates and sites of recurrence to non-carriers after treatment with conventional chemotherapy. Carriers who underwent oophorectomy had a significantly lower rate of breast cancer-related death; this finding should be studied further in all women with TNBC.

  6. Neurobehavioral dysfunction in ALS has a negative effect on outcome and use of PEG and NIV.

    Science.gov (United States)

    Chiò, A; Ilardi, A; Cammarosano, S; Moglia, C; Montuschi, A; Calvo, A

    2012-04-03

    To assess the effect of neurobehavioral dysfunction on amyotrophic lateral sclerosis (ALS) survival and on the use of life-prolonging therapies in a population-based setting. Of the 132 patients diagnosed with ALS in the province of Torino, Italy, between January 1, 2007, and June 30, 2008, 128 participated in the study. Neurobehavioral dysfunction was assessed with the Frontal Systems Behavior Scale (FrSBe), using the Family Rating forms, administered within 4 months from diagnosis. The 128 patients included 71 men and 57 women, with a mean age at onset of 64.7 (SD 11) years. Forty-one patients (32.0%) had a neurobehavioral dysfunction and 9 (7.0%) an isolated dysexecutive behavior. Enteral nutrition (EN) and noninvasive ventilation (NIV) were performed with similar frequencies in patients with and without neurobehavioral dysfunction. Patients with neurobehavioral dysfunction had a significantly shorter survival than those with a normal FrSBe score (median survival, 3.3 vs 4.3 years; p = 0.02). Patients with isolated dysexecutive behavior had a shorter survival than those without neurobehavioral dysfunction (median survival, 2.5 vs 4.5 years; p = 0.03). Patients with neurobehavioral dysfunction had a shorter survival after EN and NIV, while patients with isolated dysexecutive behavior had a shorter survival after NIV but not after EN. The negative effect of comorbid neurobehavioral dysfunction and of isolated dysexecutive behavior on survival persisted under the Cox multivariate model. The presence of neurobehavioral dysfunction or of isolate dysexecutive behavior in ALS at diagnosis is a strong predictor of a poor outcome, partially related to a reduced efficacy of life-prolonging therapies.

  7. Outcomes of single organism peritonitis in peritoneal dialysis: gram negatives versus gram positives in the Network 9 Peritonitis Study.

    Science.gov (United States)

    Bunke, C M; Brier, M E; Golper, T A

    1997-08-01

    The use of the "peritonitis rate" in the management of patients undergoing peritoneal dialysis is assuming importance in comparing the prowess of facilities, care givers and new innovations. For this to be a meaningful outcome measure, the type of infection (causative pathogen) must have less clinical significance than the number of infections during a time interval. The natural history of Staphylococcus aureus, pseudomonas, and fungal peritonitis would not support that the outcome of an episode of peritonitis is independent of the causative pathogen. Could this concern be extended to other more frequently occurring pathogens? To address this, the Network 9 Peritonitis Study identified 530 episodes of single organism peritonitis caused by a gram positive organism and 136 episodes caused by a single non-pseudomonal gram negative (NPGN) pathogen. Coincidental soft tissue infections (exit site or tunnel) occurred equally in both groups. Outcomes of peritonitis were analyzed by organism classification and by presence or absence of a soft tissue infection. NPGN peritonitis was associated with significantly more frequent catheter loss, hospitalization, and technique failure and was less likely to resolve regardless of the presence or absence of a soft tissue infection. Hospitalization and death tended to occur more frequently with enterococcal peritonitis than with other gram positive peritonitis. The outcomes in the NPGN peritonitis group were significantly worse (resolution, catheter loss, hospitalization, technique failure) compared to coagulase negative staphylococcal or S. aureus peritonitis, regardless of the presence or absence of a coincidental soft tissue infection. Furthermore, for the first time, the poor outcomes of gram negative peritonitis are shown to be independent of pseudomonas or polymicrobial involvement or soft tissue infections. The gram negative organism appears to be the important factor. In addition, the outcome of peritonitis caused by S. aureus

  8. Performance monitoring in the anterior cingulate is not all error related: expectancy deviation and the representation of action-outcome associations.

    Science.gov (United States)

    Oliveira, Flavio T P; McDonald, John J; Goodman, David

    2007-12-01

    Several converging lines of evidence suggest that the anterior cingulate cortex (ACC) is selectively involved in error detection or evaluation of poor performance. Here we challenge this notion by presenting event-related potential (ERP) evidence that the feedback-elicited error-related negativity, an ERP component attributed to the ACC, can be elicited by positive feedback when a person is expecting negative feedback and vice versa. These results suggest that performance monitoring in the ACC is not limited to error processing. We propose that the ACC acts as part of a more general performance-monitoring system that is activated by violations in expectancy. Further, we propose that the common observation of increased ACC activity elicited by negative events could be explained by an overoptimistic bias in generating expectations of performance. These results could shed light into neurobehavioral disorders, such as depression and mania, associated with alterations in performance monitoring and also in judgments of self-related events.

  9. Severity and Justness Do Not Moderate the Relation between Corporal Punishment and Negative Child Outcomes: A Multicultural and Longitudinal Study

    Science.gov (United States)

    Alampay, Liane Peña; Godwin, Jennifer; Lansford, Jennifer E.; Bombi, Anna Silvia; Bornstein, Marc H.; Chang, Lei; Deater-Deckard, Kirby; Giunta, Laura Di; Dodge, Kenneth A.; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana M. Uribe; Zelli, Arnaldo; Al-Hassan, Suha M.; Bacchini, Dario

    2017-01-01

    There is strong evidence of a positive association between corporal punishment and negative child outcomes, but previous studies have suggested that the manner in which parents implement corporal punishment moderates the effects of its use. This study investigated whether severity and justness in the use of corporal punishment moderate the…

  10. Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes.

    Science.gov (United States)

    Holubcikova, Jana; Kolarcik, Peter; Madarasova Geckova, Andrea; Joppova, Eva; van Dijk, Jitse P; Reijneveld, Sijmen A

    2017-04-01

    To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent. We analysed data on a representative sample of Slovak adolescents 8502 adolescents (mean age 13.21, 49.4 % boys) from the 2014 Health Behaviour in School-aged Children cross-sectional study. We assessed the associations of alcohol and energy drinks consumption with negative outcomes and their potential synergy, as measured by the synergy index (SI). Adolescents consuming both alcohol and energy drinks were at higher risk of negative behavioural outcomes than their peers who drank only alcohol or energy drinks or were non-consumers. Consumers of alcohol and energy drinks were highly prone to be involved in fighting-the joint association of alcohol and energy drinks consumption was greater than sum of its associations separately in relation to fighting (SI 1.49; 95 % confidence interval 1.03-2.16). Preventive strategies should aim at increasing awareness of negative behavioural outcomes-especially aggressive behaviour associated with alcohol and energy drinks consumption among young adolescents.

  11. Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes

    NARCIS (Netherlands)

    Holubcikova, Jana; Kolarcik, Peter; Geckova, Andrea Madarasova; Joppova, Eva; van Dijk, Jitse P.; Reijneveld, Sijmen A.

    To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent. We analysed data on a representative sample of Slovak adolescents 8502 adolescents

  12. Predicting Negative Life Outcomes from Early Aggressive-Disruptive Behavior Trajectories: Gender Differences in Maladaptation across Life Domains

    Science.gov (United States)

    Bradshaw, Catherine P.; Schaeffer, Cindy M.; Petras, Hanno; Ialongo, Nicholas

    2010-01-01

    Transactional theories of development suggest that displaying high levels of antisocial behavior early in life and persistently over time causes disruption in multiple life domains, which in turn places individuals at risk for negative life outcomes. We used longitudinal data from 1,137 primarily African American urban youth (49.1% female) to…

  13. The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults.

    Science.gov (United States)

    Kugler, Brittany B; Phares, Vicky; Salloum, Alison; Storch, Eric A

    2016-01-01

    The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. PTS severity was positively correlated with depressive symptom severity (r = 0.54, p effects were found for PTS severity (β = -0.38, p life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02-0.08). This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.

  14. Does Self-Esteem Moderate the Associations between Protective Behavioral Strategies and Negative Outcomes Associated with Alcohol Consumption?

    Science.gov (United States)

    Zeigler-Hill, Virgil; Madson, Michael B.; Ricedorf, Amy

    2012-01-01

    Previous research has shown that protective behavioral strategies tend to be associated with lower levels of alcohol consumption and fewer negative alcohol-related consequences. The purpose of the present study was to examine whether self-esteem would moderate the association between protective behavioral strategies and alcohol-related outcomes.…

  15. Neural markers of negative symptom outcomes in distributed working memory brain activity of antipsychotic-naive schizophrenia patients

    DEFF Research Database (Denmark)

    Nejad, Ayna B.; Madsen, Kristoffer H.; Ebdrup, Bjørn H.

    2013-01-01

    Since working memory deficits in schizophrenia have been linked to negative symptoms, we tested whether features of the one could predict the treatment outcome in the other. Specifically, we hypothesized that working memory-related functional connectivity at pre-treatment can predict improvement...

  16. Spanking, corporal punishment and negative long-term outcomes: a meta-analytic review of longitudinal studies.

    Science.gov (United States)

    Ferguson, Christopher J

    2013-02-01

    Social scientists continue to debate the impact of spanking and corporal punishment (CP) on negative child outcomes including externalizing and internalizing behavior problems and cognitive performance. Previous meta-analytic reviews have mixed long- and short-term studies and relied on bivariate r, which may inflate effect sizes. The current meta-analysis focused on longitudinal studies, and compared effects using bivariate r and better controlled partial r coefficients controlling for time-1 outcome variables. Consistent with previous findings, results based on bivariate r found small but non-trivial long-term relationships between spanking/CP use and negative outcomes. Spanking and CP correlated .14 and .18 respectively with externalizing problems, .12 and .21 with internalizing problems and -.09 and -.18 with cognitive performance. However, when better controlled partial r coefficients (pr) were examined, results were statistically significant but trivial (at or below pr = .10) for externalizing (.07 for spanking, .08 for CP) and internalizing behaviors (.10 for spanking, insufficient studies for CP) and near the threshold of trivial for cognitive performance (-.11 for CP, insufficient studies for spanking). It is concluded that the impact of spanking and CP on the negative outcomes evaluated here (externalizing, internalizing behaviors and low cognitive performance) are minimal. It is advised that psychologists take a more nuanced approach in discussing the effects of spanking/CP with the general public, consistent with the size as well as the significance of their longitudinal associations with adverse outcomes.

  17. Poor Renal Outcome of Antineutrophil Cytoplasmic Antibody Negative Pauci-immune Glomerulonephritis in Taiwanese

    Directory of Open Access Journals (Sweden)

    Peir-Haur Hung

    2006-01-01

    Conclusion: This study illustrates the necessity for pathologic diagnosis of pauci-immune GN despite ANCA negativity. The poor prognosis associated with ANCA negativity in this study may be partly due to delayed diagnosis since these patients frequently lacked systemic involvement.

  18. Negative decision outcomes are more common among people with lower decision-making competence: An item-level analysis of the Decision Outcome Inventory (DOI

    Directory of Open Access Journals (Sweden)

    Andrew M Parker

    2015-04-01

    Full Text Available Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI. The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy to minor (e.g., blisters from sunburn. The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making.

  19. Avoiding negative vs. achieving positive outcomes in hard and prosperous economic times

    NARCIS (Netherlands)

    Millet, K.; Lamey, L.; Van den Bergh, B.

    2012-01-01

    Three studies suggest that business cycle fluctuations trigger distinct motivational orientations that selectively affect economic judgment and decision making. Economic contractions induce avoidance motivation and affect negative economic sentiment, but leave approach motivation and positive

  20. Between- and within-person associations between negative life events and alcohol outcomes in adolescents with ADHD.

    Science.gov (United States)

    King, Kevin M; Pedersen, Sarah L; Louie, Kristine T; Pelham, William E; Molina, Brooke S G

    2017-09-01

    Escalations in alcohol use during adolescence may be linked with exposure to negative life events, but most of this research has focused on between-person associations. Moreover, adolescents with attention-deficit hyperactivity disorder (ADHD) may be an especially vulnerable population, reporting more life events and alcohol involvement and may even be more sensitive to the effects of life events on alcohol outcomes compared with those without ADHD. We tested the between- and within-person effects of the number and perceptions of negative life events on the development of alcohol use outcomes from age 14 to 17 years in 259 adolescents with and without ADHD using generalized estimating equations. Between-person differences in exposure to negative life events across adolescence, but not the perception of those events, were associated with a higher likelihood of alcohol use and drunkenness at age 17 years. Within-person differences in life events were associated with alcohol use above and beyond that predicted by an adolescents' typical trajectory over time. Parent- and teacher-reported ADHD symptoms were associated with more negative perceptions of life events and with greater alcohol use and drunkenness at age 17 years, but symptoms did not moderate the life event-alcohol association. Interventions should consider the variables that produce vulnerability to life events as well as the immediate impact of life events. That the accumulation of life events, rather than their perceived negativity, was associated with alcohol outcomes indicates that interventions targeting the reduction of negative events, rather than emotional response, may be more protective against alcohol use in adolescence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Expectativas de resultados frente ao uso de álcool, maconha e tabaco Outcome expectancy considering the use of alcohol, cannabis and tobacco

    Directory of Open Access Journals (Sweden)

    Rosemeri Siqueira Pedroso

    2006-08-01

    Full Text Available Este artigo teve como objetivo realizar uma revisão teórica acerca do construto expectativas de resultados frente ao uso de álcool, maconha e tabaco. As expectativas de resultados são determinadas a partir do que as pessoas acreditam acerca dos efeitos de determinada droga, sendo uma variável importante no tratamento de dependentes químicos. Foram realizadas buscas de artigos publicados nas bases de dados MEDLINE, PsycINFO, ProQuest, Ovid, LILACS e Cork, usando os descritores belief, expectancy, expectation, drugs, psychoactive e effect. Os resultados demonstraram que as expectativas de resultados frente ao uso dessas substâncias podem surgir de fontes como: exposição a estímulos condicionados, dependência física, crenças pessoais e culturais e fatores situacionais e ambientais. Conclui-se que ainda há necessidade de novas pesquisas quanto às expectativas relacionadas às diferentes substâncias psicoativas e faixas etárias para uma melhor compreensão deste construto.This article aims to perform a theoretical review about the outcome expectancy construct considering the use of alcohol, cannabis and tobacco. Outcome expectancy is determined by people's belief about the effects of a drug. It is an important variable for the treatment of chemically dependent patients. Searches in the electronic databases MEDLINE, PsycINFO, ProQuest, Ovid, LILACS and Cork were carried out, using the following descriptors: belief, expectancy, expectation, drugs, psychoactive, and effect. Results showed that outcome expectancy considering the use of those substances can be generated from: exposure to conditioning stimuli, physical dependence, personal and cultural beliefs, and situational and environmental factors. In conclusion, there is the need of new researches on expectancies related to psychoactive substances and age groups in order to have a better understanding of this construct.

  2. Negative effects of paternal age on children's neurocognitive outcomes can be explained by maternal education and number of siblings.

    Directory of Open Access Journals (Sweden)

    Ryan D Edwards

    2010-09-01

    Full Text Available Recent findings suggest advanced paternal age may be associated with impaired child outcomes, in particular, neurocognitive skills. Such patterns are worrisome given relatively universal trends in advanced countries toward delayed nuptiality and fertility. But nature and nurture are both important for child outcomes, and it is important to control for both when drawing inferences about either pathway.We examined cross-sectional patterns in six developmental outcome measures among children in the U.S. Collaborative Perinatal Project (n = 31,346. Many of these outcomes at 8 mo, 4 y, and 7 y of age (Bayley scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort Test, Wechsler Intelligence Scale for Children, Wide Range Achievement Test are negatively correlated with paternal age when important family characteristics such as maternal education and number of siblings are not included as covariates. But controlling for family characteristics in general and mother's education in particular renders the effect of paternal age statistically insignificant for most developmental measures.Assortative mating produces interesting relationships between maternal and paternal characteristics that can inject spurious correlation into observational studies via omitted variable bias. Controlling for both nature and nurture reveals little residual evidence of a link between child neurocognitive outcomes and paternal age in these data. Results suggest that benefits associated with the upward trend in maternal education may offset any negative effects of advancing paternal age.

  3. Mismatch negativity is a stronger indicator of functional outcomes than neurocognition or theory of mind in patients with schizophrenia.

    Science.gov (United States)

    Lee, Seung-Hwan; Sung, Kyongae; Lee, Kyong-Sang; Moon, Eunok; Kim, Chang-Gyu

    2014-01-03

    Mismatch negativity (MMN) is known to be associated with neurocognition, social cognition, and functional outcomes. The present study explored the relationships of MMN with neurocognition, theory of mind, and functional outcomes in patients with schizophrenia, first-degree relatives of patients with schizophrenia, and healthy controls. Twenty-five patients with schizophrenia, 21 first-degree relatives of patients with schizophrenia, and 29 healthy controls were recruited. We examined symptom severity, neurocognition, theory of mind, functional outcomes, and MMN. MMN amplitudes decreased in order of patients with schizophrenia, then first-degree relatives, then healthy controls. MMN amplitude was significantly correlated with measures of neurocognition, theory of mind, and functional outcome measurements in patients with schizophrenia. However, the most powerful correlations were those between MMN in the frontal region and measures of functional outcomes. The power and frequency of the correlations were weaker in first-degree relatives and healthy controls than in patients with schizophrenia. Hierarchical regression analysis revealed that functional outcomes (relative to measures of neurocognition and theory of mind) constituted the most powerful predictor of MMN. Our results suggest that MMN reflects functional outcomes more efficiently than do measures of neurocognition and theory of mind in patients with schizophrenia. © 2013.

  4. Playing it safe but losing anyway-Serotonergic signaling of negative outcomes in dorsomedial prefrontal cortex in the context of risk-aversion

    DEFF Research Database (Denmark)

    Macoveanu, Julian; Rowe, James B; Hornboll, Bettina

    2013-01-01

    and the response to a negative outcome. Using pharmacological fMRI, we manipulated the availability of serotonin in healthy volunteers while performing a gambling task. The same group of participants was studied in three fMRI sessions: (i) during intravenous administration of the SSRI citalopram to increase...... and citalopram decreased the neural response to negative outcomes in dmPFC. Conversely, ATD decreased and citalopram increased the neural response to negative outcomes in left amygdala. Critically, these pharmacological effects were restricted to negative outcomes that were caused by low-risk decisions and led...

  5. MRI-negative focal cortical dysplasias and seizure outcome after epilepsy surgery

    International Nuclear Information System (INIS)

    Minkin, K; Dimova, P.; Penkov, M.; Nachev, G.; Kostadinova, I.; Zlatareva, D.; Gabrovsky, K.; Naydenov, E.; Romansky, K.; Marinov, M.

    2012-01-01

    Full text: Introduction: The focal cortical dysplasias (FCD) are a main cause of drug-resistant epilepsies. The MRI appearance of FCD is specific but some FCD remain hidden for the MRI. Aim: The aim of this study was to investigate the success rate of epilepsy surgery in patients with FCD and especially MRI-negative FCD during the first 6 years of the epilepsy surgery program of University Hospital 'St. Ivan Rilski', Sofia. Material and methods: Fourteen patients with drug resistant epilepsy and focal cortical dysplasias were operated on from January 2006 to april 2012. The mean age at surgery was 13 years (7-35 years) and the mean age of epilepsy onset was 7 years (1 year - 19 years). The presurgical work-up have included preoperative MRI (1.5T, GE) and seizures registration with video- EEG in all patients, PET-CT in 4 patients and invasive EEG in 5 patients. Eleven patients have MRI-positive cortical dysplasia and 3 patients were MRI negative. Results: Complete seizure control (Engel class I) was achieved in 9 patients, significant improvement (Engel class II) was observed in 3 patients and two patients remain without improvement (Engel class IV). In the small group of 3 patients with MRI-negative FCD, complete seizure control was achieved in two patients. No significant improvement was observed in one patient with MRI-negative FCD and one patient with MRI-positive FCD. Discussion: FCD type I are frequently invisible for the MRI and the localization of the epileptogenic zone is a difficult problem. Many studies have demonstrated the negative predictive value of MRI-negative FCD regarding seizure control after epilepsy surgery for drug-resistant epilepsy. Conclusions: Patients with drug-resistant epilepsy and MRI-negative FCD are good candidates for epilepsy surgery but need comprehensive presurgical workup including PET-CT and invasive-EEG.

  6. Expectation versus Reality: The Impact of Utility on Emotional Outcomes after Returning Individualized Genetic Research Results in Pediatric Rare Disease Research, a Qualitative Interview Study.

    Science.gov (United States)

    Cacioppo, Cara N; Chandler, Ariel E; Towne, Meghan C; Beggs, Alan H; Holm, Ingrid A

    2016-01-01

    Much information on parental perspectives on the return of individual research results (IRR) in pediatric genomic research is based on hypothetical rather than actual IRR. Our aim was to understand how the expected utility to parents who received IRR on their child from a genetic research study compared to the actual utility of the IRR received. We conducted individual telephone interviews with parents who received IRR on their child through participation in the Manton Center for Orphan Disease Research Gene Discovery Core (GDC) at Boston Children's Hospital (BCH). Five themes emerged around the utility that parents expected and actually received from IRR: predictability, management, family planning, finding answers, and helping science and/or families. Parents expressing negative or mixed emotions after IRR return were those who did not receive the utility they expected from the IRR. Conversely, parents who expressed positive emotions were those who received as much or greater utility than expected. Discrepancies between expected and actual utility of IRR affect the experiences of parents and families enrolled in genetic research studies. An informed consent process that fosters realistic expectations between researchers and participants may help to minimize any negative impact on parents and families.

  7. Contribution of Personality to Self-Efficacy and Outcome Expectations in Selecting a High School Major among Adolescents with Learning Disabilities

    Science.gov (United States)

    Brown, Dikla; Cinamon, Rachel Gali

    2016-01-01

    The current study focuses on the contribution of five personality traits to the development of self-efficacy and outcome expectations regarding selecting a high school major among adolescents with learning disabilities (LD). Social cognitive career theory and the Big Five personality traits model served as the theoretical framework. Participants…

  8. Workaholism, work engagement and work-home outcomes: exploring the mediating role of positive and negative emotions.

    Science.gov (United States)

    Clark, Malissa A; Michel, Jesse S; Stevens, Gregory W; Howell, Julia W; Scruggs, Ross S

    2014-10-01

    This study examines the mechanisms through which workaholism and work engagement impact work-home conflict and enrichment, respectively. Specifically, we examine the mediating role of positive and negative emotions (e.g. joviality and guilt) in the relationship between workaholism, work engagement and work-home outcomes. Results, based on a sample of 340 working adults participating in a two-wave study, indicate that negative emotions-particularly anxiety, anger and disappointment-mediate the relationship between workaholism and work-home conflict and positive emotions-particularly joviality and self-assurance-mediate the relationship between work engagement and work-home enrichment. These results provide further evidence that workaholism and work engagement are related to distinct sets of emotional variables and disparate work and home outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Reliability and Validity of the Self-Efficacy for Exercise in Epilepsy and the Outcome Expectations for Exercise in Epilepsy Scales.

    Science.gov (United States)

    Dustin, Irene; Resnick, Barbara; Galik, Elizabeth; Klinedinst, N Jennifer; Michael, Kathleen; Wiggs, Edythe

    2017-04-01

    The purpose of this study was to test the psychometric properties of the revised Self-Efficacy for Exercise With Epilepsy (SEE-E) and Outcome Expectations for Exercise with Epilepsy (OEE-E) when used with people with epilepsy. The SEE-E and OEE-E were given in face-to-face interviews to 26 persons with epilepsy in an epilepsy clinic. There was some evidence of validity based on Rasch analysis INFIT and OUTFIT statistics. There was some evidence of reliability for the SEE-E and OEE-E based on person and item separation reliability indexes. These measures can be used to identify persons with epilepsy who have low self-efficacy and outcome expectations for exercise and guide design of interventions to strengthen these expectations and thereby improve exercise behavior.

  10. Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

    Science.gov (United States)

    Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

    2014-08-01

    While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Glucose variability negatively impacts long-term functional outcome in patients with traumatic brain injury.

    Science.gov (United States)

    Matsushima, Kazuhide; Peng, Monica; Velasco, Carlos; Schaefer, Eric; Diaz-Arrastia, Ramon; Frankel, Heidi

    2012-04-01

    Significant glycemic excursions (so-called glucose variability) affect the outcome of generic critically ill patients but has not been well studied in patients with traumatic brain injury (TBI). The purpose of this study was to evaluate the impact of glucose variability on long-term functional outcome of patients with TBI. A noncomputerized tight glucose control protocol was used in our intensivist model surgical intensive care unit. The relationship between the glucose variability and long-term (a median of 6 months after injury) functional outcome defined by extended Glasgow Outcome Scale (GOSE) was analyzed using ordinal logistic regression models. Glucose variability was defined by SD and percentage of excursion (POE) from the preset range glucose level. A total of 109 patients with TBI under tight glucose control had long-term GOSE evaluated. In univariable analysis, there was a significant association between lower GOSE score and higher mean glucose, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL but not POE 80 to 110. After adjusting for possible confounding variables in multivariable ordinal logistic regression models, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL were significantly associated with lower GOSE score. Glucose variability was significantly associated with poorer long-term functional outcome in patients with TBI as measured by the GOSE score. Well-designed protocols to minimize glucose variability may be key in improving long-term functional outcome. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Positive and negative volume-outcome relationships in the geriatric trauma population.

    Science.gov (United States)

    Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

    2014-04-01

    In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

  13. Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia.

    Science.gov (United States)

    Perez, Katherine K; Olsen, Randall J; Musick, William L; Cernoch, Patricia L; Davis, James R; Peterson, Leif E; Musser, James M

    2014-09-01

    An intervention for Gram-negative bloodstream infections that integrated mass spectrometry technology for rapid diagnosis with antimicrobial stewardship oversight significantly improved patient outcomes and reduced hospital costs. As antibiotic resistance rates continue to grow at an alarming speed, the current study was undertaken to assess the impact of this intervention in a challenging patient population with bloodstream infections caused by antibiotic-resistant Gram-negative bacteria. A total of 153 patients with antibiotic-resistant Gram-negative bacteremia hospitalized prior to the study intervention were compared to 112 patients treated post-implementation. Outcomes assessed included time to optimal antibiotic therapy, time to active treatment when inactive, hospital and intensive care unit length of stay, all-cause 30-day mortality, and total hospital expenditures. Integrating rapid diagnostics with antimicrobial stewardship improved time to optimal antibiotic therapy (80.9 h in the pre-intervention period versus 23.2 h in the intervention period, P Gram-negatives. The intervention decreased hospital and intensive care unit length of stay, total hospital costs, and reduced all-cause 30-day mortality. Copyright © 2014. Published by Elsevier Ltd.

  14. Comparison of expected treatment outcomes, obtained using risk models and international guidelines, with observed treatment outcomes in a Dutch cohort of patients with non-muscle-invasive bladder cancer treated with intravesical chemotherapy.

    Science.gov (United States)

    Lammers, Rianne J M; Palou, Joan; Witjes, Wim P J; Janzing-Pastors, Maria H D; Caris, Christien T M; Witjes, J Alfred

    2014-08-01

    To compare the risks according to the American Urological Association (AUA), EAU, European Organization for Research and Treatment of Cancer (EORTC) and Club Urológico Español de Tratamiento Oncologico (CUETO) classifications with real outcomes in a cohort of patients in the Netherlands, and to confirm that patients who were undertreated according to these risk models have worse outcomes than adequately treated patients. Patients treated with complete transurethral resection of bladder tumour and intravesical chemotherapy were included. Not all patients would have received intravesical chemotherapy had they been treated to current standards, and thus comparison of the observed outcomes in our Dutch cohort vs expected outcomes based on the EORTC risk tables and CUETO scoring model was possible. The cohort was reclassified according to the definitions of five index patients (IPs), as defined by the AUA guidelines, and three risk groups, defined according to the EAU guidelines, to compare the outcomes of undertreated patients with those of adequately treated patients. A total of 1001 patients were available for comparison with the AUA definitions and 728 patients were available for comparison with the EORTC and CUETO models. There was a large overlap between the observed outcomes and expected recurrence and progression probabilities when comparison was made using the EORTC risk tables. The observed recurrence outcomes were in general higher than the expected probabilities according to the CUETO risk classification, especially in the long term. No differences in progression were found when comparing these two models to the Dutch cohort. Patients who were undertreated according to the guidelines showed, in general, a higher risk of developing recurrence and progression. Limitations are i.a. its retrospective nature and the differences in grading system. Comparisons between the observed outcomes in our Dutch cohort and the expected outcomes based on EAU and CUETO risk

  15. Clinico-pathological profile and treatment outcome in smear negative pulmonary tuberculosis patients at a teaching hospital

    International Nuclear Information System (INIS)

    Shabir, I.; Iqbal, R.; Khan, S.U.; Munir, K.; Nazir, A.

    2010-01-01

    Tuberculosis remains the single highest contributor to the world's morbidity and mortality. Early diagnosis and prompt treatment is essential to prevent its transmission. To see the treatment response of anti tuberculosis drugs in smear negative patients and study the predictors of culture positive among smear negative tuberculosis patients. Ninety four sputum smear negative patients clinically and radiologically suggestive of tuberculosis were selected. These patients were put on anti tuberculosis drugs without waiting for their culture results. They were then followed for 8 months to see their treatment outcome. A total of 94 smear negative patients were selected and given anti tuberculosis treatment. Of these 37(39%) were culture positive and 57(61%) were culture negative. Of the 37 culture positive patients 36(97%) showed clinical or radiological improvement as compared to 46(81%) out of 57 in culture negative cases. Symptoms of cough with sputum production was significantly associated with culture positivity. On x-ray chest moderate lesion with diffuse infiltration was more common finding in 64% while extensive and cavitatory lesion was seen in 24% of all cases. Association of extensive and cavitatory lesion were seen in culture positive group. Response to anti tuberculosis drugs in sputum smear negative tubercolosis suspects was found to be effective in majority of the patients. Cough, sputum and extensive cavitatory lung lesion were the predictors of culture positive cases. There is need to train physicians on the use of anti tuberculosis therapy in smear negative suspected pulmonary tuberculosis cases, especially if they have productive cough and cavitatory lung lesions. (author)

  16. Foster Care Placement, Poor Parenting, and Negative Outcomes among Homeless Young Adults

    Science.gov (United States)

    Tyler, Kimberly A.; Melander, Lisa A.

    2010-01-01

    Although homeless youth with and without foster care histories both face adverse life circumstances, little is known about how these two groups compare in terms of their early histories and whether they face similar outcomes. As such, we compared those with and without a history of foster care placement to determine if the associations between a…

  17. Metacognitive deficits predict future levels of negative symptoms in schizophrenia controlling for neurocognition, affect recognition, and self-expectation of goal attainment.

    Science.gov (United States)

    Lysaker, Paul H; Kukla, Marina; Dubreucq, Julien; Gumley, Andrew; McLeod, Hamish; Vohs, Jenifer L; Buck, Kelly D; Minor, Kyle S; Luther, Lauren; Leonhardt, Bethany L; Belanger, Elizabeth A; Popolo, Raffaele; Dimaggio, Giancarlo

    2015-10-01

    The recalcitrance of negative symptoms in the face of pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. Accordingly, this study investigated whether deficits in metacognition, or the ability to form integrated ideas about oneself, others, and the world, prospectively predicted levels of negative symptoms independent of deficits in neurocognition, affect recognition and defeatist beliefs. Participants were 53 adults with a schizophrenia spectrum disorder. Prior to entry into a rehabilitation program, all participants completed concurrent assessments of metacognition with the Metacognitive Assessment Scale-Abbreviated, negative symptoms with the Positive and Negative Syndrome Scale, neurocognition with the MATRICS battery, affect recognition with the Bell Lysaker Emotion Recognition Task, and one form of defeatist beliefs with the Recovery Assessment Scale. Negative symptoms were then reassessed one week, 9weeks, and 17weeks after entry into the program. A mixed effects regression model revealed that after controlling for baseline negative symptoms, a general index of neurocognition, defeatist beliefs and capacity for affect recognition, lower levels of metacognition predicted higher levels of negative symptoms across all subsequent time points. Poorer metacognition was able to predict later levels of elevated negative symptoms even after controlling for initial levels of negative symptoms. Results may suggest that metacognitive deficits are a risk factor for elevated levels of negative symptoms in the future. Clinical implications are also discussed. Published by Elsevier B.V.

  18. A prospective study of the association of patient expectations with changes in health-related quality of life outcomes, following total joint replacement.

    Science.gov (United States)

    Gonzalez Saenz de Tejada, Marta; Escobar, Antonio; Bilbao, Amaia; Herrera-Espiñeira, Carmen; García-Perez, Lidia; Aizpuru, Felipe; Sarasqueta, Cristina

    2014-07-23

    Patient expectations regarding surgery may be related to outcomes in total joint replacement (TJR). The aim of this study was to determine the association of patient expectations with health related quality of life (HRQoL) outcomes measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 12 (SF-12) and satisfaction with current symptoms measured on a 4-point Likert scale, one year after surgery, adjusting for Body Mass Index (BMI), age, gender, joint, education, previous intervention and baseline scores. Consecutive patients preparing for TJR of the knee or hip due to primary osteoarthritis (OA) in 15 hospitals in Spain were recruited for the study. Patients completed questionnaires before surgery and 12 months afterwards: five questions about expectations before surgery; an item to measure satisfaction; two HRQoL instruments-WOMAC and SF-12; as well as questions about sociodemographic information. To determine the association of patient expectations at baseline, with changes in HRQoL 12 months after surgery and with satisfaction, general linear models and logistic regression analysis were performed. A total of 892 patients took part in the study. Patients who had higher pain relief or ability to walk expectations improved more in HRQoL at 12 months. Moreover, patients with high daily activity expectations were more satisfied. Patients with higher baseline expectations for TJR, improved more in HRQoL at one year and had more likelihood to be satisfied than patients with lower expectations, adjusted for BMI, age, gender, joint, education, previous intervention and HRQoL baseline scores.

  19. Clinical outcome of node‐negative oligometastatic non–small cell lung cancer

    Science.gov (United States)

    Sakai, Kiyohiro; Hayashi, Hidetoshi; Tanaka, Kaoru; Okuda, Takeshi; Kato, Amami; Nishimura, Yasumasa; Mitsudomi, Tetsuya; Koyama, Atsuko; Nakagawa, Kazuhiko

    2016-01-01

    Introduction The concept of “oligometastasis” has emerged as a basis on which to identify patients with stage IV non–small cell lung cancer (NSCLC) who might be most amenable to curative treatment. Limited data have been available regarding the survival of patients with node‐negative oligometastatic NSCLC. Patients and methods Consecutive patients with advanced NSCLC who attended Kindai University Hospital between January 2007 and January 2016 were recruited to this retrospective study. Patients with regional lymph node–negative disease and a limited number of metastatic lesions (≤5) per organ site and a limited number of affected organ sites (1 or 2) were eligible. Results Eighteen patients were identified for analysis during the study period. The most frequent metastatic site was the central nervous system (CNS, 72%). Most patients (83%) received systemic chemotherapy, with only three (17%) undergoing surgery, for the primary lung tumor. The CNS failure sites for patients with CNS metastases were located outside of the surgery or radiosurgery field. The median overall survival for all patients was 15.9 months, with that for EGFR mutation–positive patients tending to be longer than that for EGFR mutation–negative patients. Conclusion Cure is difficult to achieve with current treatment strategies for NSCLC patients with synchronous oligometastases, although a few long‐term survivors and a smaller number of patients alive at last follow‐up were present among the study cohort. There is an urgent clinical need for prospective evaluation of surgical resection as a treatment for oligometastatic NSCLC, especially negative for driver mutations. PMID:27755813

  20. The Role of Social Capital in Reducing Negative Health Outcomes among Police Officers

    OpenAIRE

    GÄCHTER, Martin; SAVAGE, David A; TORGLER, Benno

    2010-01-01

    This paper investigates the role of social capital on the reduction of short and long run negative health effects associated with stress, as well as indicators of burnout among police officers. Despite the large volume of research on either social capital or the health effects of stress, the interaction of these factors remains an underexplored topic. In this empirical analysis we aim to reduce such a shortcoming focusing on a highly stressful and emotionally draining work environment, namely...

  1. Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation.

    Science.gov (United States)

    Kim, Paul J; Attinger, Christopher E; Oliver, Noah; Garwood, Caitlin; Evans, Karen K; Steinberg, John S; Lavery, Larry A

    2015-11-01

    Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds. This was a prospective, randomized, effectiveness study comparing 0.9% normal saline versus 0.1% polyhexanide plus 0.1% betaine for the adjunctive treatment of infected wounds that required hospital admission and operative débridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up. There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038). The authors' results suggest that 0.9% normal saline may be as effective as an antiseptic (0.1% polyhexanide plus 0.1% betaine) for negative-pressure wound therapy with instillation for the adjunctive inpatient management of infected wounds. Therapeutic, II.

  2. A regressional analysis of maladaptive rumination, illness perception and negative emotional outcomes in Asian patients suffering from depressive disorder.

    Science.gov (United States)

    Lu, Yanxia; Tang, Catherine; Liow, Chiew Shan; Ng, Winnie Wei Ni; Ho, Cyrus Su Hui; Ho, Roger Chun Mun

    2014-12-01

    Although illness perception has been shown to be associated with illness outcomes in various chronic physical diseases, the association of illness perception and rumination are not well elucidated in mental disorders. This study aims to investigate the mediational effects of adaptive and maladaptive rumination in the relationship between illness perception and negative emotions (depression, anxiety and stress) in male and female patients (N=110) suffering from depressive disorders. The results showed that maladaptive rumination mediated the relationship between illness perception and negative emotions in both male and female depressive patients. However, no mediating effects of adaptive rumination were found in the relationship between illness perception and negative emotion. Maladaptive rumination mediated the relationship between perceived identity, chronicity of illness, consequences of illness and emotional representation of illness and negative emotions in males. It also mediated the relationship between perceived identity and emotional representation of illness and negative emotions in females. The results, possible clinical implications and limitations of this study are also discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder.

    Science.gov (United States)

    Stiekema, Annemarie P M; Islam, Md Atiqul; Liemburg, Edith J; Castelein, Stynke; van den Heuvel, Edwin R; van Weeghel, Jaap; Aleman, André; Bruggeman, Richard; van der Meer, Lisette

    2018-03-01

    The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes. Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses. SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups. In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Changes in Preservice Elementary Teachers' Personal Science Teaching Efficacy and Science Teaching Outcome Expectancies: The Influence of Context

    Science.gov (United States)

    Hechter, Richard P.

    2011-01-01

    This study investigated contextual changes in perceptions of science teaching self-efficacy through pre-, post- and retrospective administrations of the Science Teaching Expectancy Belief Instrument (STEBI-B) among preservice elementary teachers when exposed to a science teaching methods course. Findings revealed that the number of postsecondary…

  5. Self-regulation as a mediator between sibling relationship quality and early adolescents' positive and negative outcomes.

    Science.gov (United States)

    Padilla-Walker, Laura M; Harper, James M; Jensen, Alexander C

    2010-08-01

    The current study examined the role of adolescents' self-regulation as a mediator between sibling relationship quality and adolescent outcomes, after controlling for the quality of the parent-child relationship. Participants were 395 families (282 two parent; 113 single parent) with an adolescent child (M age of child at Time 1 = 11.15, SD = .96, 49% female) who took part in [project name masked for blind review] at both Time 1 and Time 2. Path analysis via structural equation modeling suggested that sibling affection was longitudinally and positively related to self-regulation and prosocial behaviors, and negatively related to externalizing behaviors; while sibling hostility was positively, and having a sister was negatively related to internalizing behaviors (in general, paths were stronger for adolescents from two- vs. single-parent families). There was also evidence that adolescents' self-regulation partially mediated the relation between sibling affection and positive and negative adolescent outcomes. The discussion focuses on the importance of continued research examining the mechanisms through which the sibling relationship influences development during adolescence.

  6. The Predictive Role of Self-efficacy, Outcome Expectancies, Past Behavior and Attitudes on Condom Use in a Sample of Female College Students

    Directory of Open Access Journals (Sweden)

    Daniele Artistico

    2014-12-01

    Full Text Available This study investigated the impact of self-efficacy in relation to condom use. A sample of 87 female college students completed self-report measures related to their sexual history, attitudes towards condoms and past condom use, as well as their outcome expectancy and intention to use condoms in the future. The results showed a positive correlation between self-efficacy and positive attitudes towards condom use, as well as correlations between past behavior, self-efficacy and intention to use condoms in the future. Multiple linear regression models were used to further explore the relationship between self-efficacy, past condom use, outcome expectancy and attitudes toward condoms, with the intention to use condoms in the future. The results demonstrated that both self-efficacy and past condom use are significant predictors of an individual’s intention to use condoms in the future.

  7. Tuning-AHELO Conceptual Framework of Expected and Desired Learning Outcomes in Economics. OECD Education Working Papers No. 59

    Science.gov (United States)

    OECD Publishing (NJ1), 2011

    2011-01-01

    The Organisation for Economic Cooperation and Development (OECD) Secretariat, at the invitation of the AHELO Group of National Experts, contracted the Tuning Association to undertake initial development work on learning outcomes to be used for valid and reliable assessments of students from diverse institutions and countries. The two disciplines…

  8. Should schools expect poor physical and mental health, social adjustment, and participation outcomes in students with disability?

    Science.gov (United States)

    Vaz, Sharmila; Cordier, Reinie; Falkmer, Marita; Ciccarelli, Marina; Parsons, Richard; McAuliffe, Tomomi; Falkmer, Torbjorn

    2015-01-01

    The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs.

  9. Treatment outcome in patients with triple negative early stage breast cancers compared with other molecular subtypes

    International Nuclear Information System (INIS)

    Kim, Ja Young; Chang, Sei Kyung; Lee, Bo Mi; Shin, Hyun Soo; Park, Heily

    2012-01-01

    To determine whether triple negative (TN) early stage breast cancers have poorer survival rates compared with other molecular types. Between August 2000 and July 2006, patients diagnosed with stage I, II early stage breast cancers, in whom all three markers (estrogen receptor, progesterone receptor, and human epidermal growth factor receptor [HER]-2) were available and treated with modified radical mastectomy or breast conserving surgery followed by radiotherapy, were retrospectively reviewed. Of 446 patients, 94 (21.1%) were classified as TN, 57 (12.8%) as HER-2 type, and 295 (66.1%) as luminal. TN was more frequently associated with young patients younger than 35 years old (p = 0.002), higher histologic grade (p 0.05). We found that patients with TN early stage breast cancers had no difference in survival rates compared with other molecular subtypes. Prospective study in homogeneous treatment group will need for a prognosis of TN early stage breast cancer.

  10. The TFPI-2 derived peptide EDC34 improves outcome of gram-negative sepsis.

    Science.gov (United States)

    Papareddy, Praveen; Kalle, Martina; Sørensen, Ole E; Malmsten, Martin; Mörgelin, Matthias; Schmidtchen, Artur

    2013-01-01

    Sepsis is characterized by a dysregulated host-pathogen response, leading to high cytokine levels, excessive coagulation and failure to eradicate invasive bacteria. Novel therapeutic strategies that address crucial pathogenetic steps during infection are urgently needed. Here, we describe novel bioactive roles and therapeutic anti-infective potential of the peptide EDC34, derived from the C-terminus of tissue factor pathway inhibitor-2 (TFPI-2). This peptide exerted direct bactericidal effects and boosted activation of the classical complement pathway including formation of antimicrobial C3a, but inhibited bacteria-induced activation of the contact system. Correspondingly, in mouse models of severe Escherichia coli and Pseudomonas aeruginosa infection, treatment with EDC34 reduced bacterial levels and lung damage. In combination with the antibiotic ceftazidime, the peptide significantly prolonged survival and reduced mortality in mice. The peptide's boosting effect on bacterial clearance paired with its inhibiting effect on excessive coagulation makes it a promising therapeutic candidate for invasive Gram-negative infections.

  11. Treatment credibility, expectancy, and preference: Prediction of treatment engagement and outcome in a randomized clinical trial of hatha yoga vs. health education as adjunct treatments for depression.

    Science.gov (United States)

    Uebelacker, Lisa A; Weinstock, Lauren M; Battle, Cynthia L; Abrantes, Ana M; Miller, Ivan W

    2018-06-02

    Hatha yoga may be helpful for alleviating depression symptoms. The purpose of this analysis is to determine whether treatment program preference, credibility, or expectancy predict engagement in depression interventions (yoga or a control class) or depression symptom severity over time. This is a secondary analysis of a randomized controlled trial (RCT) of hatha yoga vs. a health education control group for treatment of depression. Depressed participants (n = 122) attended up to 20 classes over a period of 10 weeks, and then completed additional assessments after 3 and 6 months. We assessed treatment preference prior to randomization, and treatment credibility and expectancy after participants attended their first class. Treatment "concordance" indicated that treatment preference matched assigned treatment. Treatment credibility, expectancy, and concordance were not associated with treatment engagement. Treatment expectancy moderated the association between treatment group and depression. Depression severity over time differed by expectancy level for the yoga group but not for the health education group. Controlling for baseline depression, participants in the yoga group with an average or high expectancy for improvement showed lower depression symptoms across the acute intervention and follow-up period than those with a low expectancy for improvement. There was a trend for a similar pattern for credibility. Concordance was not associated with treatment outcome. This is a secondary, post-hoc analysis and should be considered hypothesis-generating. Results suggest that expectancy improves the likelihood of success only for a intervention thought to actively target depression (yoga) and not a control intervention. Copyright © 2018. Published by Elsevier B.V.

  12. Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital

    OpenAIRE

    Pl?derl, Martin; Kunrath, Sabine; Cramer, Robert J.; Wang, Jen; Hauer, Larissa; Fartacek, Clemens

    2017-01-01

    Background Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as ...

  13. Spinal cord anomalies in patients with anorectal malformations without severe sacral abnormalities or meningomyelocele: outcomes after expectant, conservative management.

    Science.gov (United States)

    Kyrklund, Kristiina; Pakarinen, Mikko P; Taskinen, Seppo; Kivisaari, Reetta; Rintala, Risto J

    2016-12-01

    OBJECTIVE The goal of this study was to determine the significance of spinal cord anomalies (SCAs) in patients with anorectal malformations (ARMs) by comparing the outcomes for bowel function, lower urinary tract symptoms (LUTS), and lower-limb neurological abnormalities to these outcomes in patients with similar ARMs and a normal spinal cord. METHODS The spinal cord MRI records of female patients treated for vestibular and perineal fistula (VF/PF) and male patients with rectourethral fistula (RUF) at a single center between 1983 and 2006 were reviewed. Bowel function and LUTS were assessed by questionnaire. Patients with extensive sacral anomalies or meningomyelocele were excluded. RESULTS Of 89 patients (median age 15 years, range 5-29 years), MRI was available in 90% (n = 80; 40 male patients with RUF), and 80% of patients returned the questionnaire (n = 64; 31 male patients with RUF). Spinal cord anomalies were found in 34%, comprising a filum terminale lipoma in 30%, low conus medullaris in 10%, and thoracolumbar syrinx in 6%. Bowel functional outcomes between patients with SCAs (n = 23) and those with a normal spinal cord (n = 41) were not significantly different for soiling (70% vs 63%), fecal accidents (43% vs 34%), and constipation (57% vs 39%; p = not significant for all). The LUTS, including urge (65% vs 54%), urge incontinence (39% vs 24%), stress incontinence (17% vs 22%), and straining (32% vs 29%) were also comparable between groups (p = not significant for all). No patients developed lower-limb neurological abnormalities. CONCLUSIONS The results suggest that the long-term functional outcomes for patients with SCAs who had VF/PF and RUF may not differ significantly from patients with the same type of ARMs and a normal spinal cord. The results favor a conservative approach to their management in the absence of abnormal neurological findings in the lower limbs.

  14. [Negative prognostic impact of female gender on oncological outcomes following radical cystectomy].

    Science.gov (United States)

    Dabi, Y; Rouscoff, Y; Delongchamps, N B; Sibony, M; Saighi, D; Zerbib, M; Peyraumore, M; Xylinas, E

    2016-02-01

    To confirm gender specific differences in pathologic factors and survival rates of urothelial bladder cancer patients treated with radical cystectomy. We conducted a retrospective monocentric study on 701 patients treated with radical cystectomy and pelvic lymphadenectomy for muscle invasive bladder cancer. Impact of gender on recurrence rate, specific and non-specific mortality rate were evaluated using Cox regression models in univariate and multivariate analysis. We collected data on 553 males (78.9%) and 148 females (21.1%) between 1998 and 2011. Both groups were comparable at inclusion regarding age, pathologic stage, nodal status and lymphovascular invasion. Mean follow-up time was 45 months (interquartile 23-73) and by that time, 163 patients (23.3%) had recurrence of their tumor and 127 (18.1%) died from their disease. In multivariable Cox regression analyses, female gender was independently associated with disease recurrence (RR: 1.73; 95% CI 1.22-2.47; P=0.02) and cancer-specific mortality (RR=2.50, 95% CI=1.71-3.68; P<0.001). We confirmed female gender to be an independent negative prognosis factor for patients following a radical cystectomy and lymphadenectomy for an invasive muscle bladder cancer. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. The TFPI-2 derived peptide EDC34 improves outcome of gram-negative sepsis.

    Directory of Open Access Journals (Sweden)

    Praveen Papareddy

    Full Text Available Sepsis is characterized by a dysregulated host-pathogen response, leading to high cytokine levels, excessive coagulation and failure to eradicate invasive bacteria. Novel therapeutic strategies that address crucial pathogenetic steps during infection are urgently needed. Here, we describe novel bioactive roles and therapeutic anti-infective potential of the peptide EDC34, derived from the C-terminus of tissue factor pathway inhibitor-2 (TFPI-2. This peptide exerted direct bactericidal effects and boosted activation of the classical complement pathway including formation of antimicrobial C3a, but inhibited bacteria-induced activation of the contact system. Correspondingly, in mouse models of severe Escherichia coli and Pseudomonas aeruginosa infection, treatment with EDC34 reduced bacterial levels and lung damage. In combination with the antibiotic ceftazidime, the peptide significantly prolonged survival and reduced mortality in mice. The peptide's boosting effect on bacterial clearance paired with its inhibiting effect on excessive coagulation makes it a promising therapeutic candidate for invasive Gram-negative infections.

  16. Expectancies and Self-Efficacy Mediate the Effects of Impulsivity on Marijuana Use Outcomes: An Application of the Acquired Preparedness Model

    OpenAIRE

    Hayaki, Jumi; Herman, Debra S.; Hagerty, Claire E.; de Dios, Marcel A.; Anderson, Bradley J.; Stein, Michael D.

    2010-01-01

    This study tests the acquired preparedness model (APM) to explain associations among trait impulsivity, social learning principles, and marijuana use outcomes in a community sample of female marijuana users. The APM states that individuals with high-risk dispositions are more likely to acquire certain types of learning that, in turn, instigate problematic substance use behaviors. In this study, three domains of psychosocial learning were tested: positive and negative marijuana use expectancie...

  17. The association of parent?s outcome expectations for child TV viewing with parenting practices and child TV viewing: an examination using path analysis

    OpenAIRE

    Johnson, Lauren; Chen, Tzu-An; Hughes, Sheryl O; O?Connor, Teresia M

    2015-01-01

    Background Television (TV) viewing has been associated with many undesirable outcomes for children, such as increased risk of obesity, but TV viewing can also have benefits. Although restrictive parenting practices are effective in reducing children?s TV viewing, not all parents use them and it is currently unclear why. The current study examined parenting practices related to TV viewing in the context of social- cognitive theory. Specifically, we hypothesized that positive and negative Paren...

  18. Parents' self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: instrument reliability and validity.

    Science.gov (United States)

    Mitchell, Amy E; Fraser, Jennifer A

    2011-02-01

    Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the

  19. Combining usability evaluations to highlight the chain that leads from usability flaws to usage problems and then negative outcomes.

    Science.gov (United States)

    Watbled, Ludivine; Marcilly, Romaric; Guerlinger, Sandra; Bastien, J-M Christian; Beuscart-Zéphir, Marie-Catherine; Beuscart, Régis

    2018-02-01

    Poor usability of health technology is thought to diminish work system performance, increase error rates and, potentially, harm patients. The present study (i) used a combination of usability evaluation methods to highlight the chain that leads from usability flaws to usage problems experienced by users and, ultimately, to negative patient outcomes, and (ii) validated this approach by studying two different discharge summary production systems. To comply with quality guidelines, the process of drafting and sending discharge summaries is increasingly being automated. However, the usability of these systems may modify their impact (or the absence thereof) in terms of production times and quality, and must therefore be evaluated. Here, we applied three successive techniques for usability evaluation (heuristic evaluation, user testing and field observation) to two discharge summary production systems (underpinned by different technologies). The systems' main usability flaws led respectively to an increase in the time need to produce a discharge summary and the risk of patient misidentification. Our results are discussed with regard to the possibility of linking the usability flaws, usage problems and the negative outcomes by successively applying three methods for evaluating usability (heuristic evaluation, user testing and in situ observations) throughout the system development life cycle. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Cosmic Rays and Clouds, 1. Formation of Lead Mesoatoms In Neutron Monitor By Soft Negative Muons and Expected Atmospheric Electric Field Effect In The Cosmic Ray Neutron Component

    Science.gov (United States)

    Dorman, L. I.; Dorman, I. V.

    We extend our model (Dorman and Dorman, 1995) of cosmic ray atmospheric electric field effect on the case of neutron monitor. We take into account that about 0.07 of neu- tron monitor counting rate caused by negative soft muons captured by lead nucleons and formed mesoatoms with generation of several MeV energy neutrons from lead. In this case the neutron monitor or neutron supermonitor works as analyzer which de- tects muons of only one, negative sign. It is very important because the atmospheric electric field effect have opposite signs for positive and negative muons that main part of this effect in the muon telescope or in ionization chamber is compensated and we can observe only small part of total effect of one sign muons. On the basis of our gen- eral theory of cosmic ray meteorological effects with taking into account of negative soft muon acceleration and deceleration in the Earth atmosphere (in dependence of di- rection and intensity of electric field) we discuss the possibility of existing this effect in cosmic ray neutron component and made some rough estimations. REFERENCES: Dorman L.I. and Dorman I.V., 1995. "Cosmic-ray atmospheric electric field effects". Canadian J. of Physics, Vol. 73, pp. 440-443.

  1. Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Chacham

    2016-07-01

    Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

  2. Interval lung cancer after a negative CT screening examination: CT findings and outcomes in National Lung Screening Trial participants

    International Nuclear Information System (INIS)

    Gierada, David S.; Pinsky, Paul F.; Duan, Fenghai; Garg, Kavita; Hart, Eric M.; Kazerooni, Ella A.; Nath, Hrudaya; Watts, Jubal R.; Aberle, Denise R.

    2017-01-01

    This study retrospectively analyses the screening CT examinations and outcomes of the National Lung Screening Trial (NLST) participants who had interval lung cancer diagnosed within 1 year after a negative CT screen and before the next annual screen. The screening CTs of all 44 participants diagnosed with interval lung cancer (cases) were matched with negative CT screens of participants who did not develop lung cancer (controls). A majority consensus process was used to classify each CT screen as positive or negative according to the NLST criteria and to estimate the likelihood that any abnormalities detected retrospectively were due to lung cancer. By retrospective review, 40/44 cases (91%) and 17/44 controls (39%) met the NLST criteria for a positive screen (P < 0.001). Cases had higher estimated likelihood of lung cancer (P < 0.001). Abnormalities included pulmonary nodules ≥4 mm (n = 16), mediastinal (n = 8) and hilar (n = 6) masses, and bronchial lesions (n = 6). Cancers were stage III or IV at diagnosis in 32/44 cases (73%); 37/44 patients (84%) died of lung cancer, compared to 225/649 (35%) for all screen-detected cancers (P < 0.0001). Most cases met the NLST criteria for a positive screen. Awareness of missed abnormalities and interpretation errors may aid lung cancer identification in CT screening. (orig.)

  3. Interval lung cancer after a negative CT screening examination: CT findings and outcomes in National Lung Screening Trial participants

    Energy Technology Data Exchange (ETDEWEB)

    Gierada, David S. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, Box 8131, St. Louis, MO (United States); Pinsky, Paul F. [National Cancer Institute, Bethesda, MD (United States); Duan, Fenghai [Brown University School of Public Health, Department of Biostatistics and Center for Statistical Sciences, Providence, RI (United States); Garg, Kavita [University of Colorado School of Medicine, Mail Stop F726, Box 6510, Aurora, CO (United States); Hart, Eric M. [Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Kazerooni, Ella A. [University of Michigan Health System, Department of Radiology, Ann Arbor, MI (United States); Nath, Hrudaya; Watts, Jubal R. [University of Alabama at Birmingham School of Medicine, Department of Radiology-JTN370, Birmingham, AL (United States); Aberle, Denise R. [David Geffen School of Medicine at UCLA, Department of Radiological Sciences, Los Angeles, CA (United States)

    2017-08-15

    This study retrospectively analyses the screening CT examinations and outcomes of the National Lung Screening Trial (NLST) participants who had interval lung cancer diagnosed within 1 year after a negative CT screen and before the next annual screen. The screening CTs of all 44 participants diagnosed with interval lung cancer (cases) were matched with negative CT screens of participants who did not develop lung cancer (controls). A majority consensus process was used to classify each CT screen as positive or negative according to the NLST criteria and to estimate the likelihood that any abnormalities detected retrospectively were due to lung cancer. By retrospective review, 40/44 cases (91%) and 17/44 controls (39%) met the NLST criteria for a positive screen (P < 0.001). Cases had higher estimated likelihood of lung cancer (P < 0.001). Abnormalities included pulmonary nodules ≥4 mm (n = 16), mediastinal (n = 8) and hilar (n = 6) masses, and bronchial lesions (n = 6). Cancers were stage III or IV at diagnosis in 32/44 cases (73%); 37/44 patients (84%) died of lung cancer, compared to 225/649 (35%) for all screen-detected cancers (P < 0.0001). Most cases met the NLST criteria for a positive screen. Awareness of missed abnormalities and interpretation errors may aid lung cancer identification in CT screening. (orig.)

  4. Patient characteristics and outcomes in adolescents and young adults with classical Philadelphia chromosome-negative myeloproliferative neoplasms.

    Science.gov (United States)

    Boddu, Prajwal; Masarova, Lucia; Verstovsek, Srdan; Strati, Paolo; Kantarjian, Hagop; Cortes, Jorge; Estrov, Zeev; Pierce, Sherry; Pemmaraju, Naveen

    2018-01-01

    Little is known about the outcomes of Philadelphia-negative myeloproliferative neoplasms (MPNs) in adolescents and young adults (AYA). We reviewed all patients with essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF) treated at our institution from 1988 to 2016 who were aged 16 to 39 years (AYA) and described their outcomes in comparison to older MPN population. Of 2206 patients, 185 (8.3%) were identified as AYA: 105 (57%) ET, 43 (23%) PV, and 37 (20%) MF. The median age was 33 years [range, 16-39], and median follow-up time 3 years [range, 0.04-25]. JAK2 allele burdens were significantly lower among AYA JAK2V617F-mutated patients in both PV (p = 0.001) and MF (p = 0.005). Seven percent of MPN AYA patients were diagnosed with a thrombotic event at, or prior to, diagnosis. Over the short median follow-up, 4 thrombotic (PV = 1, MF = 3) and 3 leukemia (ET = 2, MF = 1) events occurred. In multivariate analysis, AYA did not predict for thrombotic or transformational events across three cohorts. In the MF cohort, there was a reduced frequency of negative prognostic variables of anemia (p = 0.011) and leukocytosis (p = 0.048) in AYA when compared with non-AYA. Overall survival was significantly superior in the AYA cohorts in all three MPN groups, namely MF (p < 0.001), PV (p < 0.001), and ET (p = 0.002). Our findings suggest that MPN AYA patients exhibit an indolent clinical phenotype characterized by favorable survival outcomes.

  5. Clinical manifestations and treatment outcomes of syphilitic uveitis in HIV-negative patients in China: A retrospective case study.

    Science.gov (United States)

    Zhu, Jiang; Jiang, Yuan; Shi, Yewen; Zheng, Bo; Xu, Zhiguo; Jia, Wei

    2017-10-01

    Syphilitic chorioretinitis should be included in differential diagnosis of any form of ocular inflammation. A significantly higher proportion of human immunodeficiency virus (HIV)-positive patients with ocular syphilis as compared to HIV-negative cases have been reported in published studies. However, the clinical signs and symptoms are more insidious in HIV-negative patients who are easily misdiagnosed. We report a series of cases of ocular syphilis and describe the clinical manifestations and treatment outcomes of syphilitic chorioretinitis in HIV-negative patients in China.This was a retrospective case series study. The clinical records of patients with syphilis chorioretinitis were reviewed. Demographic information and findings of fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT) were analyzed. All patients received the standard treatment. Ophthalmology examination and laboratory evaluation were repeated every 3 months. All changes were recorded. The treatment was considered successful if the patients had no inflammation in both eyes and rapid plasma reagin titer was negative after therapy.The study examined 41 eyes of 28 HIV-negative patients. The main complaints were blurry vision, floaters, and visual field defect. Twenty-seven eyes presented with panuveitis, and all had posterior involvement, including uveitis, vasculitis, chorioretinitis, and optic neuritis. The most common manifestations were uveitis and retinal vasculitis. Disc hyperfluorescence and persistent dark spots were the most common findings on FFA and ICGA. The ill-defined inner segment/outer segment junction was the most frequent manifestation on SD-OCT. Patients were diagnosed with syphilitic uveitis based on positive serological tests. Best-corrected visual acuity (BCVA) was improved in 34 eyes after treatment. Eleven patients were misdiagnosed before serological tests were performed. The delay in treatment

  6. Treatment and Outcome of Carbapenem-Resistant Gram-Negative Bacilli Blood-Stream Infections in a Tertiary Care Hospital.

    Science.gov (United States)

    Shah, Pooja G; Shah, Sweta R

    2015-07-01

    Infections caused by carbapenem-resistant bacteria constitute a major challenge for current medical practice. To describe treatment and outcome of carbapenem-resistant Gram-negative bacilli (GNB) blood-stream infection (BSI) caused by these organisms at a tertiary care hospital in Mumbai. Carbapenem-resistant isolates from blood cultures were collected from January 2013 to April 2013. Identification and antimicrobial susceptibility testing were performed using Vitek 2 analyzer (Biomerieux Ltd.). Carbapenemase production was detected by modified Hodge's test (MHT). Patient's medical history, treatment and co-morbid conditions were noted. Outcomes of BSIs were evaluated. Forty-two isolates of carbapenem-resistant GNB isolated from BSIs were Enterobacteriaceae spp. (19), Acinetobacter baumannii (15), and Pseudomonas aeruginosa (8). Colistin had maximum in vitro activity with 97% against Enterobacteriaceae, 100% against Acinetobacter, and 100% activity against Pseudomonas aeruginosa isolates. Positivity of MHT was 92.9%. Outcome of colistin mono and combination therapy was comparable with 83% and 79%, respectively. Outcome of colistin and carbapenem combination therapy was found to be 100 percent. High incidences of bacteremia by carbapenem-resistant GNB including Enterobacteriaceae is a worrisome trend. Treatment options are compromised and only available option is colistin which has its own limitation. Colistin monotherapy may be non-inferior compared to combination therapy for treating BSIs caused by isolates with minimum inhibitory concentration (MIC) for colistin as ≤0.5 mg/l. Combined use of the colistin and carbapenem may provide good therapeutic options for BSI caused by carbapenem-resistant GNB and warrants further investigations.

  7. Playing it safe but losing anyway--serotonergic signaling of negative outcomes in dorsomedial prefrontal cortex in the context of risk-aversion.

    Science.gov (United States)

    Macoveanu, Julian; Rowe, James B; Hornboll, Bettina; Elliott, Rebecca; Paulson, Olaf B; Knudsen, Gitte M; Siebner, Hartwig R

    2013-08-01

    Risk avoidance is an important determinant of human behavior. The neurotransmitter serotonin has been implicated in processing negative outcomes caused by risky decisions. However, it is unclear whether serotonin provides a neurobiological link between making a risk aversive decision and the response to a negative outcome. Using pharmacological fMRI, we manipulated the availability of serotonin in healthy volunteers while performing a gambling task. The same group of participants was studied in three fMRI sessions: (i) during intravenous administration of the SSRI citalopram to increase the serotonergic tone, (ii) after acute tryptophan depletion (ATD) to reduce central serotonin levels, or (iii) without interventions. ATD and citalopram had opposite effects on outcome related activity in dorsomedial prefrontal cortex (dmPFC) and amygdala. Relative to the control condition, ATD increased and citalopram decreased the neural response to negative outcomes in dmPFC. Conversely, ATD decreased and citalopram increased the neural response to negative outcomes in left amygdala. Critically, these pharmacological effects were restricted to negative outcomes that were caused by low-risk decisions and led to a high missed reward. ATD and citalopram did not alter the neural response to positive outcomes in dmPFC, but relative to ATD, citalopram produced a bilateral increase in the amygdala response to large wins caused by high-risk choices. The results show a selective involvement of the serotonergic system in neocortical processing of negative outcomes resulting from risk-averse decisions, thereby linking risk aversion and processing of negative outcomes in goal-directed behaviors. Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

  8. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    Energy Technology Data Exchange (ETDEWEB)

    Itatani, R., E-mail: banguliao@gmail.com [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Namimoto, T. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Atsuji, S.; Katahira, K.; Morishita, S. [Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitani, K.; Hamada, Y. [Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitaoka, M. [Department of Pathology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Nakaura, T. [Department of Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto 863-0046 (Japan); Yamashita, Y. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan)

    2014-10-15

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy.

  9. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    International Nuclear Information System (INIS)

    Itatani, R.; Namimoto, T.; Atsuji, S.; Katahira, K.; Morishita, S.; Kitani, K.; Hamada, Y.; Kitaoka, M.; Nakaura, T.; Yamashita, Y.

    2014-01-01

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy

  10. Biological characteristics and clinical outcome of triple negative primary breast cancer in older women - comparison with their younger counterparts.

    Directory of Open Access Journals (Sweden)

    Binafsha M Syed

    Full Text Available Triple negative (ER, PgR and HER2 negative breast cancers (TNBCs are often considered as a poor prognostic phenotype. There is dearth of evidence showing the prevalence and biological behaviour of TNBCs in older women. This study aimed to analyse their biological characteristics in comparison with a well characterised younger series from a single centre with long term clinical follow-up. Over 37 years (1973-2010, 1,758 older (≥70 years women with early operable (<5 cm primary breast cancer were managed in a dedicated clinic and have complete clinical information available. Of these 813 patients underwent primary surgery and 575 had good quality tumour samples available for tissue microarray analysis using indirect immunohistochemistry. A total of 127 patients (22.1% had TNBCs and full biological analysis of 15 biomarkers was performed. The results were compared with those of their younger (<70 years counterparts 342 (18.9% from a previously characterised, consecutive series of primary breast cancer treated in the same unit (1986-1998. The 127 older patients with TNBCs showed lower rates of Ki67 and CK 7/8 positivity and high rates of bcl2 and CK18 positivity when compared with their younger counterparts (p<0.05. There was no significant difference in the long term clinical outcome between the two age groups, despite the fact that 47% of the younger patients had adjuvant chemotherapy, while none in the older cohort received such treatment. EGFR, axillary stage and pathological size showed prognostic significance in older women with TNBCs on univariate analysis. Despite not having received adjuvant chemotherapy, the older series had clinical outcome similar to the younger patients almost half of whom had chemotherapy. This appears to be related to other biomarkers (in addition to ER/PgR/HER2 eg Ki67, bcl2 and cytokeratins which have different expression patterns influencing prognosis.

  11. A review of expectancy theory and alcohol consumption.

    Science.gov (United States)

    Jones, B T; Corbin, W; Fromme, K

    2001-01-01

    Research is reviewed on the association between alcohol outcome expectancies and consumption which has led many to argue that manipulating expectancies might be a route to manipulating consumption for problem prevention and treatment. Studies indirectly and directly evaluating this latter position are reviewed. Expectancies predicting treatment outcome: two studies have shown that the more positive expectancies held at treatment, the poorer is treatment outcome, but five other studies have failed to find this. Three related studies have shown that the more negative expectancies held at treatment, the better the treatment outcome. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited support for negative. Expectancy manipulations and ad libitum consumption: three studies in the laboratory have shown that increasing positive expectancies through word priming increases subsequent consumption and two studies have shown that increasing negative expectancies decreases it. A single study in the field showed a similar relationship. This evaluation provides evidence consistent with the main position but is limited by measuring consumption changes over only 1-2 hours. Prevention programmes with expectancy components: seven projects are reviewed in which positive expectancies were targeted, but only two report an expectancy change analysis and in both cases the expectancy change did not relate to subsequent consumption. This evaluation provides evidence inconsistent with the main position. Expectancy challenge: two related studies are reviewed in which positive expectancy challenges reduce subsequent consumption but changes in expectancy were not evaluated as predictors of consumption change. Two studies are reviewed which found a reduction in positive expectancy following expectancy challenge but no reduction in consumption. One study is reviewed in which when negative expectancy was increased in treatment there was a

  12. Gram-negative prosthetic joint infection: outcome of a debridement, antibiotics and implant retention approach. A large multicentre study.

    Science.gov (United States)

    Rodríguez-Pardo, D; Pigrau, C; Lora-Tamayo, J; Soriano, A; del Toro, M D; Cobo, J; Palomino, J; Euba, G; Riera, M; Sánchez-Somolinos, M; Benito, N; Fernández-Sampedro, M; Sorli, L; Guio, L; Iribarren, J A; Baraia-Etxaburu, J M; Ramos, A; Bahamonde, A; Flores-Sánchez, X; Corona, P S; Ariza, J

    2014-11-01

    We aim to evaluate the epidemiology and outcome of gram-negative prosthetic joint infection (GN-PJI) treated with debridement, antibiotics and implant retention (DAIR), identify factors predictive of failure, and determine the impact of ciprofloxacin use on prognosis. We performed a retrospective, multicentre, observational study of GN-PJI diagnosed from 2003 through to 2010 in 16 Spanish hospitals. We define failure as persistence or reappearance of the inflammatory joint signs during follow-up, leading to unplanned surgery or repeat debridement>30 days from the index surgery related death, or suppressive antimicrobial therapy. Parameters predicting failure were analysed with a Cox regression model. A total of 242 patients (33% men; median age 76 years, interquartile range (IQR) 68-81) with 242 episodes of GN-PJI were studied. The implants included 150 (62%) hip, 85 (35%) knee, five (2%) shoulder and two (1%) elbow prostheses. There were 189 (78%) acute infections. Causative microorganisms were Enterobacteriaceae in 78%, Pseudomonas spp. in 20%, and other gram-negative bacilli in 2%. Overall, 19% of isolates were ciprofloxacin resistant. DAIR was used in 174 (72%) cases, with an overall success rate of 68%, which increased to 79% after a median of 25 months' follow-up in ciprofloxacin-susceptible GN-PJIs treated with ciprofloxacin. Ciprofloxacin treatment exhibited an independent protective effect (adjusted hazard ratio (aHR) 0.23; 95% CI, 0.13-0.40; pInfection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  13. Organizational Justice and Perceived Organizational Support: Impact on Negative Work-Home Interference and Well-being Outcomes

    Directory of Open Access Journals (Sweden)

    Audrey Babic

    2015-10-01

    Full Text Available It is well established that negative work-home interference (NegWHI impacts upon several work attitudes and behaviors. In the interests of both organizational effectiveness and employee well-being, it is important to identify concepts related to NegWHI and investigate their effects on well-being outcomes. This study examines the mediating role of (1 perceived organizational support (POS in the relationship between organizational justice (OJ and NegWHI; and (2 NegWHI in the relationships between POS and four well-being outcomes. A total of 509 employees of a Belgian hospital were surveyed. Data were analyzed using structural equation modeling and the bootstrapping method. Results showed that POS partially mediates the relationships between distributive and passive procedural justice and NegWHI, and fully mediates the relationship between the other justice dimensions and NegWHI. NegWHI partially mediates the relationships between POS and both job satisfaction and intention to quit, and fully mediates the relationship between POS and job strain. Furthermore, POS is positively related to job engagement. This study showed that organizations can help employees to better manage their work and family lives and reduce the impact of NegWHI by enhancing employees’ feeling that they are supported by their organization. In order to increase POS, organizations need to promote justice in the workplace.

  14. The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

    Science.gov (United States)

    Smokowski, Paul R; Bacallao, Martica L; Cotter, Katie L; Evans, Caroline B R

    2015-06-01

    The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

  15. A 10-Day Developmental Voyage: Converging Evidence from Three Studies Showing that Self-Esteem May Be Elevated and Maintained without Negative Outcomes

    Science.gov (United States)

    Kafka, S.; Hunter, J. A.; Hayhurst, J.; Boyes, M.; Thomson, R. L.; Clarke, H.; Grocott, A. M.; Stringer, M.; O'Brien, K. S.

    2012-01-01

    Empirical evidence shows that educational experiences in the context of the outdoors lead to elevated self-esteem. Although elevated self-esteem is widely assumed to promote beneficial outcomes, recent evidence suggests that elevated self-esteem may also facilitate a variety of negative outcomes (i.e., increased prejudice, aggression, drug and…

  16. The influence of a patient-counseling course on the communication apprehension, outcome expectations, and self-efficacy of first-year pharmacy students.

    Science.gov (United States)

    Rogers, Erica R; King, Sean R

    2012-10-12

    To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course. First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters. Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion. Communication apprehension may be decreased and self-efficacy for communication increased in first-year PharmD students through a 15-week Nonprescription Drugs/Patient-Counseling course using small-group practice sessions, case studies, and role-play exercises in conjunction with classroom lectures.

  17. Variation in the SLC23A1 gene does not influence cardiometabolic outcomes to the extent expected given its association with l-ascorbic acid1234

    Science.gov (United States)

    Wade, Kaitlin H; Forouhi, Nita G; Cook, Derek G; Johnson, Paul; McConnachie, Alex; Morris, Richard W; Rodriguez, Santiago; Ye, Zheng; Ebrahim, Shah; Padmanabhan, Sandosh; Watt, Graham; Bruckdorfer, K Richard; Wareham, Nick J; Whincup, Peter H; Chanock, Stephen; Sattar, Naveed; Lawlor, Debbie A; Davey Smith, George; Timpson, Nicholas J

    2015-01-01

    Background: Observational studies showed that circulating l-ascorbic acid (vitamin C) is inversely associated with cardiometabolic traits. However, these studies were susceptible to confounding and reverse causation. Objectives: We assessed the relation between l-ascorbic acid and 10 cardiometabolic traits by using a single nucleotide polymorphism in the solute carrier family 23 member 1 (SLC23A1) gene (rs33972313) associated with circulating l-ascorbic acid concentrations. The observed association between rs33972313 and cardiometabolic outcomes was compared with that expected given the rs33972313-l-ascorbic acid and l-ascorbic acid–outcome associations. Design: A meta-analysis was performed in the following 5 independent studies: the British Women's Heart and Health Study (n = 1833), the MIDSPAN study (n = 1138), the Ten Towns study (n = 1324), the British Regional Heart Study (n = 2521), and the European Prospective Investigation into Cancer (n = 3737). Results: With the use of a meta-analysis of observational estimates, inverse associations were shown between l-ascorbic acid and systolic blood pressure, triglycerides, and the waist-hip ratio [the strongest of which was the waist-hip ratio (−0.13-SD change; 95% CI: −0.20-, −0.07-SD change; P = 0.0001) per SD increase in l-ascorbic acid], and a positive association was shown with high-density lipoprotein (HDL) cholesterol. The variation at rs33972313 was associated with a 0.18-SD (95% CI: 0.10-, 0.25-SD; P = 3.34 × 10−6) increase in l-ascorbic acid per effect allele. There was no evidence of a relation between the variation at rs33972313 and any cardiometabolic outcome. Although observed estimates were not statistically different from expected associations between rs33972313 and cardiometabolic outcomes, estimates for low-density lipoprotein cholesterol, HDL cholesterol, triglycerides, glucose, and body mass index were in the opposite direction to those expected. Conclusions: The nature of the genetic

  18. Variation in the SLC23A1 gene does not influence cardiometabolic outcomes to the extent expected given its association with L-ascorbic acid.

    Science.gov (United States)

    Wade, Kaitlin H; Forouhi, Nita G; Cook, Derek G; Johnson, Paul; McConnachie, Alex; Morris, Richard W; Rodriguez, Santiago; Ye, Zheng; Ebrahim, Shah; Padmanabhan, Sandosh; Watt, Graham; Bruckdorfer, K Richard; Wareham, Nick J; Whincup, Peter H; Chanock, Stephen; Sattar, Naveed; Lawlor, Debbie A; Davey Smith, George; Timpson, Nicholas J

    2015-01-01

    Observational studies showed that circulating L-ascorbic acid (vitamin C) is inversely associated with cardiometabolic traits. However, these studies were susceptible to confounding and reverse causation. We assessed the relation between L-ascorbic acid and 10 cardiometabolic traits by using a single nucleotide polymorphism in the solute carrier family 23 member 1 (SLC23A1) gene (rs33972313) associated with circulating L-ascorbic acid concentrations. The observed association between rs33972313 and cardiometabolic outcomes was compared with that expected given the rs33972313-L-ascorbic acid and L-ascorbic acid-outcome associations. A meta-analysis was performed in the following 5 independent studies: the British Women's Heart and Health Study (n = 1833), the MIDSPAN study (n = 1138), the Ten Towns study (n = 1324), the British Regional Heart Study (n = 2521), and the European Prospective Investigation into Cancer (n = 3737). With the use of a meta-analysis of observational estimates, inverse associations were shown between L-ascorbic acid and systolic blood pressure, triglycerides, and the waist-hip ratio [the strongest of which was the waist-hip ratio (-0.13-SD change; 95% CI: -0.20-, -0.07-SD change; P = 0.0001) per SD increase in L-ascorbic acid], and a positive association was shown with high-density lipoprotein (HDL) cholesterol. The variation at rs33972313 was associated with a 0.18-SD (95% CI: 0.10-, 0.25-SD; P = 3.34 × 10⁻⁶) increase in L-ascorbic acid per effect allele. There was no evidence of a relation between the variation at rs33972313 and any cardiometabolic outcome. Although observed estimates were not statistically different from expected associations between rs33972313 and cardiometabolic outcomes, estimates for low-density lipoprotein cholesterol, HDL cholesterol, triglycerides, glucose, and body mass index were in the opposite direction to those expected. The nature of the genetic association exploited in this study led to limited

  19. Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: a cross-sectional study in rural Kenya.

    Science.gov (United States)

    Gewa, Constance A; Chepkemboi, Joan

    2016-03-09

    Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers' knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers' knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. In addition to knowledge levels, mothers' beliefs play an important role in mothers' decisions to practice exclusive breastfeeding. Mother's beliefs on the impact of exclusive breastfeeding on the mother's health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.

  20. Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: a cross-sectional study in rural Kenya

    Directory of Open Access Journals (Sweden)

    Constance A. Gewa

    2016-03-01

    Full Text Available Abstract Background Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers’ knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers’ knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. Methods A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. Results Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. Conclusion In addition to knowledge levels, mothers’ beliefs play an important role in mothers’ decisions to practice exclusive breastfeeding. Mother’s beliefs on the impact of exclusive breastfeeding on the mother’s health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.

  1. Direct and indirect influences of fate control belief, gambling expectancy bias, and self-efficacy on problem gambling and negative mood among Chinese college students: a multiple mediation analysis.

    Science.gov (United States)

    Tang, Catherine So-Kum; Wu, Anise M S

    2010-12-01

    A multiple mediation model was proposed to integrate core concepts of the social axioms framework and the social cognitive theory in order to understand gambling behavior. It was hypothesized that the influence of general fate control belief on problem gambling and negative mood would be mediated by gambling-specific beliefs. Data from 773 Chinese college recreational gamblers were collected. The bootstrapping procedure was used to test the multiple mediation hypotheses. Significant indirect effects of fate control belief on problem gambling and negative mood through two gambling-specific mediators were found. Gambling expectancy bias was a more salient mediator than gambling self-efficacy. Fate control belief was also found to have a significant direct effect on negative mood. In general, a high level of general fate control belief was related to greater gambling expectancy bias and lower self-efficacy in resisting gambling, which were in turn related to problem gambling and negative mood. Limitations and implications of the study were discussed.

  2. Reported positive and negative outcomes associated with a self-practice/self-reflection cognitive-behavioural therapy exercise for CBT trainees.

    Science.gov (United States)

    Spendelow, Jason S; Butler, Lisa J

    2016-09-01

    The aim of the current study was to identify outcomes of a self-practice/self-reflection (SP/SR) exercise for trainee clinical psychologists. Thirty-two trainees enrolled in their first year of a UK university doctoral clinical psychology training programme completed an online questionnaire following an eight-week exercise. Findings indicated an endorsement of many previously reported benefits of exercise participation, but also the identification of negative outcomes. Thematic analysis of qualitative data revealed that outcomes could be grouped into two main thematic domains (individual task outcomes and task organization issues) along with several subordinate themes. SP/SR is a useful tool in the development of trainee CBT therapist competences. There has been limited previous recognition of potential negative outcomes from this type of exercise. However, these can provide additional impetus for therapist skill development.

  3. Outcomes in Young Women With Breast Cancer of Triple-Negative Phenotype: The Prognostic Significance of CK19 Expression

    International Nuclear Information System (INIS)

    Parikh, Rahul R.; Yang Qifeng; Higgins, Susan A.; Haffty, Bruce G.

    2008-01-01

    Purpose: Basal-like carcinoma of the breast is associated with genetic instability and aggressive behavior. In this study, we evaluated the luminal cytokeratin marker CK-19 in young women with breast cancer treated with conservative surgery and radiation therapy (CS+RT). Methods: Primary tumor specimens from a cohort of 158 young premenopausal women (range, 25-49 years) treated with CS+RT with a median follow-up of 6.25 years were constructed into a tissue microarray. The array was stained for ER, PR, HER2, CK19, and p53. The molecular profiles were correlated with clinical-pathologic factors, overall, local, and distant relapse-free survival. The association between CK19, other co-variables, and outcome was assessed in a multivariate model. Results: Positive expression of ER, PR, HER-2/neu, CK19, and p53 were 33.1%, 34.5%, 10.0%, 79.5%, and 20.9%, respectively. With 20 local relapses and 38 distant metastases, the 10-year overall, breast relapse-free, and distant relapse-free survival were 79.65%, 87.29%, and 67.35%, respectively. Tumor stage and nodal status were associated with distant relapse-free and overall survival. In multivariate analysis, CK19 negativity was a predictor poor local (RR, 3.54; 95% CI, 1.87-7.65; p < 0.01) distant (RR, 1.44; 95% CI, 0.86-2.70; p = 0.17), and overall survival (RR, 1.89; 95% CI, 1.04-3.55; p = 0.03). Conclusions: Lack of CK19 expression identifies a subset of patients with a significantly higher risk of local relapse. Distant relapse and overall survival rates also correlated with CK19 negativity. Further evaluation of the prognostic significance of basal and luminal cytokeratins in young women with breast cancer is warranted

  4. Expectancy Theory Modeling

    Science.gov (United States)

    1982-08-01

    accomplish the task, (2) the instrumentality of task performance for job outcomes, and (3) the instrumentality of outcomes for need satisfaction . We...in this discussion: effort, performance , outcomes, and needs. In order to present briefly the conventional approach to the Vroom models, another...Presumably, this is the final event in the sequence of effort, performance , outcome, and need satisfaction . The actual research reported in expectancy

  5. Severity and Justness Do Not Moderate the Relation Between Corporal Punishment and Negative Child Outcomes: A Multicultural and Longitudinal Study.

    Science.gov (United States)

    Alampay, Liane Peña; Godwin, Jennifer; Lansford, Jennifer E; Bombi, Anna Silvia; Bornstein, Marc H; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana M; Zelli, Arnaldo; Al-Hassan, Suha; Bacchini, Dario

    2017-07-01

    There is strong evidence of a positive association between corporal punishment and negative child outcomes, but previous studies have suggested that the manner in which parents implement corporal punishment moderates the effects of its use. This study investigated whether severity and justness in the use of corporal punishment moderate the associations between frequency of corporal punishment and child externalizing and internalizing behaviors. This question was examined using a multicultural sample from eight countries and two waves of data collected one year apart. Interviews were conducted with 998 children aged 7-10 years, and their mothers and fathers, from China, Colombia, Italy, Jordan, Kenya, Philippines, Thailand, and the United States. Mothers and fathers responded to questions on the frequency, severity, and justness of their use of corporal punishment; they also reported on the externalizing and internalizing behavior of their child. Children reported on their aggression. Multigroup path models revealed that across cultural groups, and as reported by mothers and fathers, there is a positive relation between the frequency of corporal punishment and externalizing child behaviors. Mother-reported severity and father-reported justness were associated with child-reported aggression. Neither severity nor justness moderated the relation between frequency of corporal punishment and child problem behavior. The null result suggests that more use of corporal punishment is harmful to children regardless of how it is implemented, but requires further substantiation as the study is unable to definitively conclude that there is no true interaction effect.

  6. Reassessment of Allied Health Professionals' Level of Self-Efficacy in, Outcome Expectancy in, and Use of Evidence-Based Practice.

    Science.gov (United States)

    Wilkinson, Shelley A; Hills, Andrew P; Street, Steven J; Hinchliffe, Fiona

    2016-01-01

    Evidence-based practice (EBP) is fundamental to improving patient outcomes. Factors affecting EBP capabilities are linked with institutional culture and barriers, personal self-belief, and individual ability. To effect change in capabilities, interventions must target barriers and be informed by behaviour change theory. This study measured the effect of training and organisational change on EBP measures amongst allied health professionals. All allied health staff (n=196) employed across the Mater Health Services (Brisbane, Queensland) were invited to complete a survey assessing EBP self-efficacy, outcome expectancy and use, as well as EBP training undertaken. Data were compared with those of surveys from 2010 and 2011. Response rate was 70.9% (n=139/196); 32 staff completed all surveys. Significant improvements were observed in staff undertaking training (EBP, p=0.008; research design and analysis, p=0.003) since the first survey. The significant increase in EBP self-efficacy that occurred from T1 to T2 remained at T3 (p=0.008). Fewer between-department differences were observed over time. This study identified sustained EBP self-efficacy improvements in this cohort and found that between-department differences have virtually disappeared. Ongoing interventions are required to sustain and improve staff's belief in their ability to deliver EBP.

  7. Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study

    Directory of Open Access Journals (Sweden)

    Ali Ailia W

    2008-12-01

    Full Text Available Abstract Background Ascitic fluid infection (AFI in cirrhotic patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP and culture negative neutrocytic ascites (CNNA. The aim of this study was to determine the outcome in cirrhotic patients with culture positive (SBP and culture negative neutrocytic ascites. Methods We analyzed 675 consecutive hepatitis B and/or C related cirrhosis patients with ascites admitted in our hospital from November 2005 to December 2007. Of these, 187 patients had AFI; clinical and laboratory parameters of these patients including causes of cirrhosis, Child Turcotte Pugh (CTP score were recorded. Results Out of 187 patients with AFI, 44 (23.5% had SBP while 143 (76.4% had CNNA. Hepatitis C virus (HCV infection was the most common cause of cirrhosis in 139 (74.3% patients. Patients with SBP had high CTP score as compared to CNNA (12.52 ± 1.45 vs. 11.44 ± 1.66; p 9/L as compared to CNNA (132 ± 91 × 109/L, p = 0.005. We found a high creatinine (mg/dl (1.95 ± 1.0 vs. 1.44 ± 0.85, (p = 0.003 and high prothrombin time (PT in seconds (24.8 ± 6.6 vs. 22.4 ± 7.2 (p = 0.04 in SBP as compared to CNNA. More patients with SBP (14/44; 31.8% had blood culture positivity as compare to CNNA (14/143; 9.8%, p = 0.002. Escherichia. Coli was the commonest organism in blood culture in 15/28 (53.5% patients. SBP group had a higher mortality (11/44; 25% as compared to CNNA (12/143; 8.4%, p = 0.003. On multiple logistic regression analysis, creatinine >1.1 mg/dl and positive blood culture were the independent predictors of mortality in patients with SBP. Conclusion Patients with SBP have a higher mortality than CNNA. Independent predictors of mortality in SBP are raised serum creatinine and a positive blood culture.

  8. Infection with multidrug-resistant gram-negative bacteria in a pediatric oncology intensive care unit: risk factors and outcomes.

    Science.gov (United States)

    Costa, Patrícia de Oliveira; Atta, Elias Hallack; Silva, André Ricardo Araújo da

    2015-01-01

    This study aimed at evaluating the predictors and outcomes associated with multidrug-resistant gram-negative bacterial (MDR-GNB) infections in an oncology pediatric intensive care unit (PICU). Data were collected relating to all episodes of GNB infection that occurred in a PICU between January of 2009 and December of 2012. GNB infections were divided into two groups for comparison: (1) infections attributed to MDR-GNB and (2) infections attributed to non-MDR-GNB. Variables of interest included age, gender, presence of solid tumor or hematologic disease, cancer status, central venous catheter use, previous Pseudomonas aeruginosa infection, healthcare-associated infection, neutropenia in the preceding 7 days, duration of neutropenia, length of hospital stay before ICU admission, length of ICU stay, and the use of any of the following in the previous 30 days: antimicrobial agents, corticosteroids, chemotherapy, or radiation therapy. Other variables included initial appropriate antimicrobial treatment, definitive inadequate antimicrobial treatment, duration of appropriate antibiotic use, time to initiate adequate antibiotic therapy, and the 7- and 30-day mortality. Multivariate logistic regression analyses showed significant relationships between MDR-GNB and hematologic diseases (odds ratio [OR] 5.262; 95% confidence interval [95% CI] 1.282-21.594; p=0.021) and healthcare-associated infection (OR 18.360; 95% CI 1.778-189.560; p=0.015). There were significant differences between MDR-GNB and non-MDR-GNB patients for the following variables: inadequate initial empirical antibiotic therapy, time to initiate adequate antibiotic treatment, and inappropriate antibiotic therapy. Hematologic malignancy and healthcare-associated infection were significantly associated with MDR-GNB infection in this sample of pediatric oncology patients. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Overt leptin response to controlled ovarian hyperstimulation negatively correlates with pregnancy outcome in in vitro fertilization--embryo transfer cycle

    Directory of Open Access Journals (Sweden)

    Jana Chakrabarti

    2012-01-01

    Full Text Available Context: A critical body mass of adipose tissue is essential for the normal development of female reproductive functions. Leptin, an adipocyte-derived hormone encoded by the ′Ob′ gene has been proposed as a peripheral signal indicating the adequacy of nutritional status for reproductive functions. It is reported as a direct regulator of gametogenic and steroidogenic potential of ovary. Though leptin is widely present in reproductive tissues, its relationship to reproductive hormones is still poorly understood. Aims: Present investigation attempts to explore ovarian response to secretory profile of leptin and its impact on pregnancy outcome in women undergoing controlled ovarian hyperstimulation for in vitro fertilization and embryo transfer (IVF-ET. Settings and Design: Patients enrolled for IVF-ET underwent pituitary-ovarian suppression by ′Long Protocol′ GnRH-agonist downregulation followed by ovarian stimulation. Materials and Methods: Sera were procured at different phases of IVF-ET for the assay of estradiol, progesterone, human chorionic gonadotropin, and for leptin. Ovarian follicular fluids were also assayed for leptin. Luteinized granulosa cells were cultured in vitro to evaluate their steroidogenic potential. Statistical Analysis Used: Statistical analyses were done by student′s t-test, ANOVA, and Chi-square tests as applicable. All results were expressed as Mean ± SE. P values < 0.05 were considered significant. Results: Positive correlation was observed between serum and ovarian follicular fluid leptin. A negative correlation was noted between the serum leptin levels and endometrial thickness. Conclusions: Elevated leptin response may exert adverse impacts on pregnancy success during IVF-ET possibly by modulating uterine receptivity.

  10. Retrospective study of the effect of disease progression on patient reported outcomes in HER-2 negative metastatic breast cancer patients

    Directory of Open Access Journals (Sweden)

    Yu Elaine

    2011-06-01

    Full Text Available Abstract Background This retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs that assess symptom burden and health related quality of life (HRQoL in women with metastatic breast cancer (mBC. Methods HER-2 negative mBC patients (n = 102 were enrolled from 7 U.S. community oncology practices. Demographic, disease and treatment characteristics were abstracted from electronic medical records and linked to archived Patient Care Monitor (PCM assessments. The PCM is a self-report measure of symptom burden and HRQoL administered as part of routine care in participating practices. Linear mixed models were used to examine change in PCM scores over time. Results Mean age was 57 years, with 72% of patients Caucasian, and 25% African American. Median time from mBC diagnosis to first disease progression was 8.8 months. Metastasis to bone (60%, lung (28% and liver (26% predominated at initial metastatic diagnosis. Results showed that PCM items assessing fatigue, physical pain and trouble sleeping were sensitive to either general effects of disease progression or to effects associated with specific sites of metastasis. Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores. In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress. Conclusions Disease progression has a detrimental impact on cancer-related symptoms. Delaying disease progression may have a positive impact on patients' HRQoL.

  11. The Qualitative Expectations Hypothesis

    DEFF Research Database (Denmark)

    Frydman, Roman; Johansen, Søren; Rahbek, Anders

    2017-01-01

    We introduce the Qualitative Expectations Hypothesis (QEH) as a new approach to modeling macroeconomic and financial outcomes. Building on John Muth's seminal insight underpinning the Rational Expectations Hypothesis (REH), QEH represents the market's forecasts to be consistent with the predictions...... of an economistís model. However, by assuming that outcomes lie within stochastic intervals, QEH, unlike REH, recognizes the ambiguity faced by an economist and market participants alike. Moreover, QEH leaves the model open to ambiguity by not specifying a mechanism determining specific values that outcomes take...

  12. The Qualitative Expectations Hypothesis

    DEFF Research Database (Denmark)

    Frydman, Roman; Johansen, Søren; Rahbek, Anders

    We introduce the Qualitative Expectations Hypothesis (QEH) as a new approach to modeling macroeconomic and financial outcomes. Building on John Muth's seminal insight underpinning the Rational Expectations Hypothesis (REH), QEH represents the market's forecasts to be consistent with the predictions...... of an economist's model. However, by assuming that outcomes lie within stochastic intervals, QEH, unlike REH, recognizes the ambiguity faced by an economist and market participants alike. Moreover, QEH leaves the model open to ambiguity by not specifying a mechanism determining specific values that outcomes take...

  13. Faculty Perceptions of Conflict with Administrators: An Analysis of the Associations between the Nature of Conflict and Positive and Negative Outcomes

    Science.gov (United States)

    Hancks, Meredith L.

    2013-01-01

    This study examines the perceptions of faculty members regarding conflict experiences with administrators. It is driven by the question, "To what extent are faculty perceptions of positive and negative outcomes of faculty-administrator conflict associated with domain, nature and disciplinary context of the conflict," where domain refers…

  14. Family Rejection, Social Isolation, and Loneliness as Predictors of Negative Health Outcomes (Depression, Suicidal Ideation, and Sexual Risk Behavior) among Thai Male-to-Female Transgender Adolescents

    Science.gov (United States)

    Yadegarfard, Mohammadrasool; Meinhold-Bergmann, Mallika E.; Ho, Robert

    2014-01-01

    This study examined the influence of family rejection, social isolation, and loneliness on negative health outcomes among Thai male-to-female transgender adolescents. The sample consisted of 260 male respondents, of whom 129 (49.6%) were self-identified as transgender and 131 (50.4%) were self-identified as cisgender (nontransgender). Initial…

  15. Evolutionary Expectations

    DEFF Research Database (Denmark)

    Nash, Ulrik William

    2014-01-01

    , they are correlated among people who share environments because these individuals satisfice within their cognitive bounds by using cues in order of validity, as opposed to using cues arbitrarily. Any difference in expectations thereby arise from differences in cognitive ability, because two individuals with identical...... cognitive bounds will perceive business opportunities identically. In addition, because cues provide information about latent causal structures of the environment, changes in causality must be accompanied by changes in cognitive representations if adaptation is to be maintained. The concept of evolutionary......The concept of evolutionary expectations descends from cue learning psychology, synthesizing ideas on rational expectations with ideas on bounded rationality, to provide support for these ideas simultaneously. Evolutionary expectations are rational, but within cognitive bounds. Moreover...

  16. Unequal Expectations

    DEFF Research Database (Denmark)

    Karlson, Kristian Bernt

    the role of causal inference in social science; and it discusses the potential of the findings of the dissertation to inform educational policy. In Chapters II and III, constituting the substantive contribution of the dissertation, I examine the process through which students form expectations...... of the relation between the self and educational prospects; evaluations that are socially bounded in that students take their family's social position into consideration when forming their educational expectations. One important consequence of this learning process is that equally talented students tend to make...... for their educational futures. Focusing on the causes rather than the consequences of educational expectations, I argue that students shape their expectations in response to the signals about their academic performance they receive from institutionalized performance indicators in schools. Chapter II considers...

  17. Resistance in gram-negative bacilli in a cardiac intensive care unit in India: Risk factors and outcome

    Directory of Open Access Journals (Sweden)

    Pawar Mandakini

    2008-01-01

    Full Text Available The objective of this study was to compare the risk factors and outcome of patients with preexisting resistant gram-negative bacilli (GNB with those who develop sensitive GNB in the cardiac intensive care unit (ICU. Of the 3161 patients ( n = 3,161 admitted to the ICU during the study period, 130 (4.11% developed health care-associated infections (HAIs with GNB and were included in the cohort study. Pseudomonas aeruginosa (37.8% was the most common organism isolated followed by Klebsiella species (24.2%, E. coli (22.0%, Enterobacter species (6.1%, Stenotrophomonas maltophilia (5.7%, Acinetobacter species (1.3%, Serratia marcescens (0.8%, Weeksella virosa (0.4% and Burkholderia cepacia (0.4%. Univariate analysis revealed that the following variables were significantly associated with the antibiotic-resistant GNB: females ( P = 0.018, re-exploration ( P = 0.004, valve surgery ( P = 0.003, duration of central venous catheter ( P < 0.001, duration of mechanical ventilation ( P < 0.001, duration of intra-aortic balloon counter-pulsation ( P = 0.018, duration of urinary catheter ( P < 0.001, total number of antibiotic exposures prior to the development of resistance ( P < 0.001, duration of antibiotic use prior to the development of resistance ( P = 0.014, acute physiology and age chronic health evaluation score (APACHE II, receipt of anti-pseudomonal penicillins (piperacillin-tazobactam ( P = 0.002 and carbapenems ( P < 0.001. On multivariate analysis, valve surgery (adjusted OR = 2.033; 95% CI = 1.052-3.928; P = 0.035, duration of mechanical ventilation (adjusted OR = 1.265; 95% CI = 1.055-1.517; P = 0.011 and total number of antibiotic exposure prior to the development of resistance (adjusted OR = 1.381; 95% CI = 1.030-1.853; P = 0.031 were identified as independent risk factors for HAIs in resistant GNB. The mortality rate in patients with resistant GNB was significantly higher than those with sensitive GNB (13.9% vs. 1.8%; P = 0.03. HAI with

  18. The influence of self-efficacy and outcome expectations on the relationship between perceived environment and physical activity in the workplace

    Directory of Open Access Journals (Sweden)

    Plotnikoff Ronald C

    2004-03-01

    Full Text Available Abstract Background Recent research and commentary contends that ecological approaches may be particularly useful for understanding and promoting physical activity participation in various settings including the workplace. Yet within the physical activity domain there is a lack of understanding of how ecological environment factors influence behaviour. Thus, the purpose of this study was to examine the relationships between perceived environment, social-cognitive variables, and physical activity behaviour. Methods Participants (N = 897 were employees from three large worksites who completed self-report inventories containing measures of self-efficacy, outcome expectations, perceptions of the workplace environment (PWES, and physical activity behaviour during both leisure-time and incorporated throughout the workday. Results Results of both bivariate and multiple regression analyses indicated the global PWES scores had a limited association with leisure-time physical activity (R2adj =.01. Sequential regression analyses supported a weak association between physical activity incorporated in the workplace and PWES (R2adj = .04 and the partial mediation of self-efficacy on the relationship between PWES and workplace physical activity (variance accounted for reduced to R2adj = .02 when self-efficacy was controlled. Conclusion Overall, the results of the present investigation indicate that self-efficacy acted as a partial mediator of the relationship between perceived environment and workplace physical activity participation. Implications of the findings for physical activity promotion using ecological-based approaches, and future directions for research from this perspective in worksite settings are discussed.

  19. Evidence that COMT genotype and proline interact on negative-symptom outcomes in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Clelland, C L; Drouet, V; Rilett, K C; Smeed, J A; Nadrich, R H; Rajparia, A; Read, L L; Clelland, J D

    2016-09-13

    Elevated peripheral proline is associated with psychiatric disorders, and there is evidence that proline is a neuromodulator. The proline dehydrogenase (PRODH) gene, which encodes the enzyme that catalyzes proline catabolism, maps to human chromosome 22q11.2, a region conferring risk of schizophrenia. In the Prodh-null mouse, an interaction between elevated peripheral proline and another 22q11.2 gene, catechol-O-methyltransferase (COMT), on neurotransmission and behavior has been reported. We explored the relationship between fasting plasma proline levels and COMT Val(158)Met genotype on symptoms (positive, negative and total) in schizophrenia patients. In an exploratory study we also examined symptom change in patients with bipolar disorder. There was a significant interaction between peripheral proline and COMT on negative symptoms in schizophrenia (PScale for the Assessment of Negative Symptom (SANS) scores. In contrast, high proline was associated with high SANS scores in patients carrying a Met allele. The relationship between proline and COMT also appears to modify negative symptoms across psychiatric illness. In bipolar disorder, a significant interaction was also observed on negative-symptom change (P=0.007, n=43). Negative symptoms are intractable and largely unaddressed by current medications. These data indicate a significant interaction between peripheral proline and COMT genotype, influencing negative symptoms in schizophrenia and bipolar disorder. That high proline has converse effects on symptoms by COMT genotype, may have implications for therapeutic decisions.

  20. The relationship between negative responses to HIV status disclosure and psychosocial outcomes among people living with HIV.

    Science.gov (United States)

    Cama, Elena; Brener, Loren; Slavin, Sean; de Wit, John

    2017-07-01

    This report examines rates of HIV status disclosure and negative responses to disclosure among people living with HIV in Australia. Among 697 people living with HIV, most (>90%) had disclosed their status to friends, sexual partners and health providers. Almost a third had not disclosed to family, and half had not told any work colleagues. Negative responses to disclosure (e.g. blame, rejection) by all groups were associated with increased HIV-related stigma, psychological distress and diminished social support and health satisfaction. These results shed light on rates of disclosure among people living with HIV in Australia and the adverse health impacts of negative responses to disclosure.

  1. Evaluation of the negative expectations and type of suicide risk in students of 9°, 10° and 11° grade of an educational institution of the department of Quindío

    Directory of Open Access Journals (Sweden)

    Juan Gonzales-Portillo

    2016-02-01

    Full Text Available This empirical and analytical study follows a descriptive - transversal design in order to assess the negative expectations and risk of suicide in students of 9°, 10° and 11° year of an educational institution in the Department of Quindío, counting with a personal questionnaire and the Beck hopelessness scale as tools to do so. The risk of suicide is an issue of local, national and global public health that affects the quality of life of teenagers and youngsters from the “Eje Cafetero” area. The research showed that 8 out of every 10 students have a moderate risk, and the ages of prevalence are 15 and 16 years old. Bullying, domestic violence and permanent sadness contribute to increase this risk.

  2. Great Expectations

    NARCIS (Netherlands)

    Dickens, Charles

    2005-01-01

    One of Dickens's most renowned and enjoyable novels, Great Expectations tells the story of Pip, an orphan boy who wishes to transcend his humble origins and finds himself unexpectedly given the opportunity to live a life of wealth and respectability. Over the course of the tale, in which Pip

  3. Monitoring treatment expectations in patients with an implantable cardioverter-defibrillator using the EXPECT-ICD scale

    DEFF Research Database (Denmark)

    Habibovic, Mirela; Pedersen, Susanne S.; van den Broek, Krista C

    2014-01-01

    AIMS: Patient treatment expectations may affect cardiac outcomes; however, till date, no validated instruments have been developed to monitor treatment expectations in patients with an implantable cardioverter-defibrillator (ICD). This study evaluates the predictive value of the newly developed 10...... with a two-factor model involving both negative (α = 0.84) and positive expectations (α = 0.77) with a score range of 0-20 for each factor. Negative treatment expectations were associated with higher levels of anxiety (β = 0.443; P ...-item EXPECtations Towards ICD therapy (EXPECT-ICD) in relation to anxiety, depression, and ICD related concerns 3 months post-implant.METHODS AND RESULTS: Consecutive implanted ICD patients were included as part of the WEB-based distress management programme for ICD patients (WEBCARE) trial from six...

  4. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)

    HUGO KARLING MORESCHI

    2015-02-01

    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  5. Experiments expectations

    OpenAIRE

    Gorini, B; Meschi, E

    2014-01-01

    This paper presents the expectations and the constraints of the experiments relatively to the commissioning procedure and the running conditions for the 2015 data taking period. The views about the various beam parameters for the p-p period, like beam energy, maximum pileup, bunch spacing and luminosity limitation in IP2 and IP8, are discussed. The goals and the constraints of the 2015 physics program are also presented, including the heavy ions period as well as the special...

  6. Give what you get: capuchin monkeys (Cebus apella and 4-year-old children pay forward positive and negative outcomes to conspecifics.

    Directory of Open Access Journals (Sweden)

    Kristin L Leimgruber

    Full Text Available The breadth of human generosity is unparalleled in the natural world, and much research has explored the mechanisms underlying and motivating human prosocial behavior. Recent work has focused on the spread of prosocial behavior within groups through paying-it-forward, a case of human prosociality in which a recipient of generosity pays a good deed forward to a third individual, rather than back to the original source of generosity. While research shows that human adults do indeed pay forward generosity, little is known about the origins of this behavior. Here, we show that both capuchin monkeys (Cebus apella and 4-year-old children pay forward positive and negative outcomes in an identical testing paradigm. These results suggest that a cognitively simple mechanism present early in phylogeny and ontogeny leads to paying forward positive, as well as negative, outcomes.

  7. Prognostic factors for seizure outcome in patients with MRI-negative temporal lobe epilepsy: A meta-analysis and systematic review.

    Science.gov (United States)

    Wang, Xiu; Zhang, Chao; Wang, Yao; Hu, Wenhan; Shao, Xiaoqiu; Zhang, Jian-Guo; Zhang, Kai

    2016-05-01

    To perform a systematic review and meta-analysis to identify predictors of postoperative seizure freedom in patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy. Publications were screened from electronic databases (MEDLINE, EMBASE), epilepsy archives, and bibliographies of relevant articles that were written in English. We recorded all possible risk factors that might predict seizure outcome after surgery. We calculated odds ratio (OR) with corresponding 95% confidence intervals (95% CI) of predictors for postoperative seizure freedom. Heterogeneity was assessed with I(2). All meta-analyses were performed using Review Manager. Epilepsy duration (OR=2.57, 95% CI=1.21-5.47, ptemporal lobe (OR=3.89, 95% CI=1.66-9.08, pepilepsy duration and scalp electroencephalogram (EEG) signals localized precisely in the temporal lobe predicted a better seizure outcome in patients with MRI-negative temporal lobe epilepsy. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. Do Job Demands of Chinese Manufacturing Employees Predict Positive or Negative Outcomes? A Test of Competing Hypotheses.

    Science.gov (United States)

    Cheung, Janelle H; Sinclair, Robert R; Shi, Junqi; Wang, Mo

    2015-12-01

    Karasek's job demands-control (JDC) model posits that job control can buffer against the harmful effects of demands experienced by employees. A large volume of JDC research has obtained support for the main effects of demands and control, but not the interactive effects. Recent research on the challenge-hindrance stressors framework, however, found that work stressors may not always be deleterious, suggesting alternative hypotheses about the effects of demands and control. The present study therefore examined competing hypotheses concerning the effects of job demands on occupational health outcomes. Using a sample of 316 employees in a Chinese manufacturing company, we found that, consistent with the challenge-hindrance framework, production demands were challenge stressors associated with favourable outcomes (i.e. job satisfaction and psychological well-being). In addition, results showed that the interactive role of job control depended on the nature of outcome variables. Future recommendations and implications of findings are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Therapeutic rationale to target highly expressed CDK7 conferring poor outcomes in triple-negative breast cancer

    NARCIS (Netherlands)

    Li, Bo; Chonghaile, Triona Ni; Fan, Yue; Madden, Stephen F.; Klinger, Rut; O'Connor, Aisling E.; Walsh, Louise; O'Hurley, Gillian; Udupi, Girish Mallya; Joseph, Jesuchristopher; Tarrant, Finbarr; Conroy, Emer; Gaber, Alexander; Chin, Suet-Feung; Bardwell, Helen A; Provenzano, Elena; Crown, John; Dubois, Thierry; Linn, Sabine; Jirstrom, Karin; Caldas, Carlos; O'Connor, Darran P; Gallagher, William M

    2017-01-01

    Triple-negative breast cancer (TNBC) patients commonly exhibit poor prognosis and high relapse after treatment, but there remains a lack of biomarkers and effective targeted therapies for this disease. Here, we report evidence highlighting the cell-cycle–related kinase CDK7 as a driver and candidate

  10. Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder

    NARCIS (Netherlands)

    Stiekema, A.P.M.; Islam, M.A.; Liemburg, E.J.; Castelein, S.; van den Heuvel, E.R.; van Weeghel, J.; Aleman, A.; Bruggeman, R.; van der Meer, L.

    2018-01-01

    Background: The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores

  11. The Effect of Negative School Climate on Academic Outcomes for LGBT Youth and the Role of In-School Supports

    Science.gov (United States)

    Kosciw, Joseph G.; Palmer, Neal A.; Kull, Ryan M.; Greytak, Emily A.

    2013-01-01

    For many lesbian, gay, bisexual, and transgender (LGBT) youth, intolerance and prejudice make school a hostile and dangerous place. This study examined simultaneously the effects of a negative school climate on achievement and the role that school-based supports--safe school policies, supportive school personnel, and gay-straight alliance (GSA)…

  12. Long-term outcome of acute prosthetic joint infections due to gram-negative bacilli treated with retention of prosthesis.

    Science.gov (United States)

    Jaén, N; Martínez-Pastor, J C; Muñoz-Mahamud, E; García-Ramiro, S; Bosch, J; Mensa, J; Soriano, A

    2012-09-01

    To update the clinical information of the 47 patients with a prosthetic joint infection due to Gram-negative bacilli included in a previous study and to reassess the predictors of failure after a longer follow-up. Using the electronic files of our hospital, all the information regarding readmissions to the hospital, new surgical procedures and the reason for the new surgery (infection, aseptic loosening), and the last visit in the hospital were registered. The medical chart of the 35 patients that were considered in remission in the previous publication was reviewed. In 30 patients no clinical evidence of failure was detected and no additional surgery on the previously infected prosthesis was necessary and they were considered in long-term remission. In 5 cases a late complication was identified. One case had a reinfection due to coagulase-negative staphylococci after 22 months from the open debridement and required a 2-stage revision surgery. The other 4 cases developed an aseptic loosening and it was necessary to perform a 1-stage exchange. Receiving a fluoroquinolone when all the Gram-negatives involved in the infection were susceptible to fluoroquinolones was the only factor associated with remission in the univariate analysis (p=0.002). After a long-term follow-up, our results support the importance of using fluoroquinolones in acute PJI due to Gram-negative bacilli.

  13. Psychiatric comorbidity and aspects of cognitive coping negatively predict outcome in cognitive behavioral treatment of psychophysiological insomnia

    NARCIS (Netherlands)

    Laar, M. van de; Pevernagie, D.; Mierlo, P. van; Overeem, S.

    2015-01-01

    Cognitive behavioral treatment is the gold standard treatment for insomnia, although a substantial group does not respond. We examined possible predictors for treatment outcome in psychophysiological insomniacs, with a focus on the presence of clearly defined psychiatric comorbidity. This was a

  14. MiR-34b is associated with clinical outcome in triple-negative breast cancer patients

    Directory of Open Access Journals (Sweden)

    Svoboda Marek

    2012-03-01

    Full Text Available Abstract Background Breast cancer is the most common malignancy with the highest incidence rates among women worldwide. Triple-negative breast cancer (TNBC represents the major phenotype of basal-like molecular subtype of breast cancer, characterized by higher incidence in young women and a very poor prognosis. MicroRNAs (miRNAs are small non-coding RNAs playing significant role in the pathogenesis of many cancers including breast cancer. Therefore, miRNAs are also potential prognostic and/or predictive biomarkers in triple-negative breast cancer patients. Methods Thirty-nine TNBC patients with available formalin-fixed paraffin-embedded (FFPE tissues were enrolled in the study. MiR-34a, miR-34b, and miR-34c were analyzed using qRT-PCR and correlated to clinico-pathological features of TNBC patients. Results Expression levels of miR-34b significantly correlate with disease free survival (DFS (p = 0.0020, log-rank test and overall survival (OS (p = 0.0008, log-rank test of TNBC patients. No other significant associations between miR-34a, miR-34b, and miR-34c with available clinical pathological data were observed. Conclusions MiR-34b expression negatively correlates with disease free survival and overall survival in TNBC patients. Thus, miR-34b may present a new promising prognostic biomarker in TNBC patients, but independent validations are necessary.

  15. Caesarean section rates and adverse neonatal outcomes after induction of labour versus expectant management in women with an unripe cervix : a secondary analysis of the HYPITAT and DIGITAT trials

    NARCIS (Netherlands)

    Bernardes, T. P.; Broekhuijsen, K.; Koopmans, C. M.; Boers, K. E.; van Wyk, L.; Tajik, P.; van Pampus, M. G.; Scherjon, S. A.; Mol, B. W.; Franssen, M. T.; Berg, van den P. P.; Groen, Henk

    Objective To evaluate caesarean section and adverse neonatal outcome rates after induction of labour or expectant management in women with an unripe cervix at or near term. Design Secondary analysis of data from two randomised clinical trials. Setting Data were collected in two nationwide Dutch

  16. Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

    Science.gov (United States)

    Caissutti, Claudia; Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

    2018-02-01

    The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus (GDM) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM-negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM-positive by the One Step, but not the Two Step. Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM-negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Long-term outcomes of brief, intensive CBT for specific phobias: The negative impact of ADHD symptoms.

    Science.gov (United States)

    Halldorsdottir, Thorhildur; Ollendick, Thomas H

    2016-05-01

    The objectives were twofold: (a) examine long-term treatment effects in youth receiving 1-session treatment (OST) or educational support (EST) for a specific phobia (SP) and (b) examine the differential predictive and moderation effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on immediate and long-term outcomes following the interventions. Eighty-three children (ages 6-15, 47% female, 89% White) with a SP were randomly assigned to receive OST or EST. Follow up assessments occurred at 1 week, 6 months, 1 year, and 4 years. Hierarchical linear growth modeling (HLGM) was used to explore the association of parent-reported ADHD symptoms, the 2 treatment conditions (i.e., OST vs. EST), and the trajectory of change in the severity of the SP from pretreatment to the 4-year follow-up. Age, conduct problems and learning problems were controlled for in all analyses. A greater immediate reduction in severity rating of the SP was observed in the OST compared to EST, whereas the trajectory of long-term outcomes was similar across conditions over time. Higher levels of ADHD symptoms predicted poor immediate and long-term treatment outcomes across treatment conditions. ADHD symptoms, however, did not moderate the relationship between treatment condition and immediate or long-term treatment outcomes. The results of the study need to be interpreted in light of several study limitations. However, if confirmed, the findings suggest that anxious youth with comorbid ADHD symptoms are less likely to benefit from brief, intensive psychotherapy and may require either longer, standard CBT treatment or adjunctive pharmacotherapy. (c) 2016 APA, all rights reserved).

  18. Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome

    DEFF Research Database (Denmark)

    Pedersen, Martin Bjerregård; Hamilton-Dutoit, Stephen Jacques; Bendix, Knud

    2014-01-01

    Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome.......Identification of a subset of perpheral T-cell lymphoma, not otherwise specified, characterized by FOXP3-positive regulatory T-cell phenotype, HTLV-1 negativity and poor outcome....

  19. The AA genotype of the regulatory BCL2 promoter polymorphism ( 938C>A) is associated with a favorable outcome in lymph node negative invasive breast cancer patients.

    Science.gov (United States)

    Bachmann, Hagen S; Otterbach, Friedrich; Callies, Rainer; Nückel, Holger; Bau, Maja; Schmid, Kurt W; Siffert, Winfried; Kimmig, Rainer

    2007-10-01

    Expression of the antiapoptotic and antiproliferative protein Bcl-2 has been repeatedly shown to be associated with better clinical outcome in breast cancer. We recently showed a novel regulatory (-938C>A) single-nucleotide polymorphism (SNP) in the inhibitory P2 BCL2 gene promoter generating significantly different BCL2 promoter activities. Paraffin-embedded neoplastic and nonneoplastic tissues from 274 patients (161 still alive after a follow-up period of at least 80 months) with primary unilateral invasive breast carcinoma were investigated. Bcl-2 expression of tumor cells was shown by immunohistochemistry; nonneoplastic tissues were used for genotyping. Both the Bcl-2 expression and the (-938C>A) genotypes were correlated with the patients' survival. Kaplan-Meier curves revealed a significant association of the AA genotype with increased survival (P = 0.030) in lymph node-negative breast cancer patients, whereas no genotype effect could be observed in lymph node-positive cases. Ten-year survival rates were 88.6% for the AA genotype, 78.4% for the AC genotype, and 65.8% for the CC genotype. Multivariable Cox regression identified the BCL2 (-938CC) genotype as an independent prognostic factor for cancer-related death in lymph node-negative breast carcinoma patients (hazard ratio, 3.59; P = 0.032). Immunohistochemical Bcl-2 expression was significantly associated with the clinical outcome of lymph node-positive but not of lymph node-negative breast cancer patients. In lymph node-negative cases, the (-938C>A) SNP was both significantly related with the immunohistochemically determined level of Bcl-2 expression (P = 0.044) and the survival of patients with Bcl-2-expressing carcinomas (P = 0.006). These results suggest the (-938C>A) polymorphism as a survival prognosticator as well as indicator of a high-risk group within patients with lymph node-negative breast cancer.

  20. Unsupported or Turned Against: Understanding How Two Types of Negative Social Reactions to Sexual Assault Relate to Post-Assault Outcomes.

    Science.gov (United States)

    Relyea, Mark; Ullman, Sarah

    2015-03-01

    Social reactions to disclosures of sexual assault have significant effects on women's post-assault outcomes (see Ullman, 2010, for a review). The Social Reactions Questionnaire (SRQ; Ullman, 2000) measures these reactions (as reported by survivors) and aggregates them into positive and negative scales. However, studies indicate that only some "negative" reactions have a negative valence for survivors whereas others produce a mixed (positive and negative) valence. The current study compares a one-primary-factor model of "negative reactions" to a model with two primary factors that we have labeled "turning against" and "unsupportive acknowledgement." Results showed that although one primary factor was plausible, two primary factors provided a better fit to the data. To assess the discriminant validity of the two factors, we performed regressions predicting social support, psychological adjustment, and coping behaviors. Analyses supported the hypotheses that reactions of being turned against were related to social withdrawal, increased self-blame, and decreased sexual assertiveness whereas reactions of unsupportive acknowledgment were related to both adaptive and maladaptive coping. Against predictions, depression and PTSD were more related to receiving unsupportive acknowledgment than to receiving turning against reactions. Implications for interventions and research are discussed. Importantly, almost all women (94%) in our sample received reactions that acknowledged that an assault occurred but failed to provide support, and this lack of support was associated with worse coping than even more hostile reactions such as being blamed or stigmatized. Therefore, there seems a great need for effective programs to train community members to respond to survivors with the kind of emotional and tangible support that promotes better outcomes.

  1. Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Loch AA

    2014-04-01

    Full Text Available Alexandre Andrade LochLaboratory of Neurosciences, Department and Institute of Psychiatry, University of São Paulo, BrazilAbstract: Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue.Keywords: suicide, stigma, rehabilitation, relapse, rehospitalisation

  2. Community expectations

    International Nuclear Information System (INIS)

    Kraemer, L.

    2004-01-01

    Historically, the relationship between the nuclear generator and the local community has been one of stability and co-operation. However in more recent times (2000-2003) the nuclear landscape has had several major issues that directly effect the local nuclear host communities. - The associations mandate is to be supportive of the nuclear industry through ongoing dialogue, mutual cooperation and education, - To strengthen community representation with the nuclear industry and politically through networking with other nuclear host communities. As a result of these issues, the Mayors of a number of communities started having informal meetings to discuss the issues at hand and how they effect their constituents. These meetings led to the official formation of the CANHC with representation from: In Canada it is almost impossible to discuss decommissioning and dismantling of Nuclear Facilities without also discussing Nuclear Waste disposal for reasons that I will soon make clear. Also I would like to briefly touch on how and why expectation of communities may differ by geography and circumstance. (author)

  3. Is There a Downside to Anticipating the Upside? Children's and Adults' Reasoning About How Prior Expectations Shape Future Emotions.

    Science.gov (United States)

    Lara, Karen Hjortsvang; Lagattuta, Kristin Hansen; Kramer, Hannah J

    2017-11-24

    Four- to 10-year-olds and adults (N = 205) responded to vignettes involving three individuals with different expectations (high, low, and no) for a future event. Participants judged characters' pre-outcome emotions, as well as predicted and explained their feelings following three events (positive, attenuated, and negative). Although adults rated high-expectation characters more negatively than low-expectation characters after all outcomes, children shared this intuition starting at 6-7 years for negative outcomes, 8-10 years for attenuated, and never for positive. Comparison to baseline (no expectation) indicated that understanding the costs of high expectations emerges first and remains more robust across age than recognition that low expectations carry benefits. Explanation analyses further clarified this developing awareness about the relation between thoughts and emotions over time. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  4. Outcomes of CSF spectrophotometry in cases of suspected subarachnoid haemorrhage with negative CT: two years retrospective review in a Birmingham hospital.

    Science.gov (United States)

    Bakr, A; Silva, D; Cramb, R; Flint, G; Foroughi, M

    2017-04-01

    The aim of this study was to evaluate the adherence to current guidelines for the investigation of suspected subarachnoid haemorrhage and the prevalence and outcome of computed tomography (CT)-negative aneurysmal subarachnoid haemorrhage. A retrospective review in a single large tertiary referral centre. A total of 796 patients, aged 16-90 years, who underwent lumbar puncture (LP) for suspected subarachnoid haemorrhage (SAH) following a negative or equivocal CT scan between January 2012 and November 2013 (23 months). Xanthochromia reports were obtained using the hospital's department of biochemistry database and clinical data for these patients were reviewed using patient notes. Of 796 CSF reports reviewed, 728 (91%) were negative for xanthochromia, 31 (4%) were positive and 37 (5%) were equivocal. Only 2 out of the 31 patients with positive spectrophotometry results were subsequently found to have an underlying aneurysm on CT angiography. A further 9 out of these 31 patients underwent digital subtraction angiography, with no cerebral aneurysms being detected. Amongst the 37 patients with equivocal xanthochromia reports, 13 underwent CT angiography and only 1 cerebral aneurysm was detected. In patients with clinically suspected SAH but who have negative or questionable CT findings, CSF analysis is likely to be negative in the vast majority of cases, which was 91% in our series. In patients yielding positive or equivocal CSF results the likelihood of an aneurysm being detected is low, amounting to three out of 68 or approximately one in 23 (approximately 4%). Overall in suspected SAH cases where CT scan has been negative, the rate for the detection of cerebral aneurysm is three out of 796 cases (0.4%).

  5. Ureteral stenting can be a negative predictor for successful outcome following shock wave lithotripsy in patients with ureteral stones

    Directory of Open Access Journals (Sweden)

    Dong Hyuk Kang

    2016-11-01

    Full Text Available Purpose: To evaluate ureteral stenting as a negative predictive factor influencing ureteral stone clearance and to estimate the probability of one-session success in shock wave lithotripsy (SWL patients with a ureteral stone. Materials and Methods: We retrospectively reviewed the medical records of 1,651 patients who underwent their first SWL. Among these patients, 680 had a ureteral stone measuring 4–20 mm and were thus eligible for our study. The 57 patients who underwent ureteral stenting during SWL were identified. Maximal stone length (MSL, mean stone density (MSD, skin-to-stone distance (SSD, and stone heterogeneity index (SHI were determined by pre-SWL noncontrast computed tomography. Results: After propensity score matching, 399 patients were extracted from the total patient cohort. There were no significant differences between stenting and stentless groups after matching, except for a higher one-session success rate in the stentless group (78.6% vs. 49.1%, p=0.026. In multivariate analysis, shorter MSL, lower MSD, higher SHI, and absence of a stent were positive predictors for one-session success in patients who underwent SWL. Using cutoff values of MSL and MSD obtained from receiver operator curve analysis, in patients with a lower MSD (≤784 HU, the success rate was lower in those with a stent (61.1% than in those without (83.5% (p=0.001. However, in patients with a higher MSL (>10 mm, the success rate was lower in those with a stent (23.6% than in those without (52.2% (p=0.002. Conclusions: Ureteral stenting during SWL was a negative predictor of one-session success in patients with a ureteral stone.

  6. Positive and Negative Syndrome Scale as a long-term outcome measurement tool in patients receiving clozapine ODT- A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Shankar G

    2007-03-01

    Full Text Available Objective: This pilot, twelve-week, open-label study examined the effect of clozapine orally disintegrating tablet or ODT in patients with schizophrenia and schizoaffective disorder utilizing Positive and Negative Syndrome Scale (PANSS as a long-term outcome measurement tool.Methods: The final study sample consisted of nineteen subjects who were residents a long-term care psychiatric facility in Pomona, California. Subjects were using clozapine ODT (FazaClo® at the most clinically effective dosage depending on their symptoms and at the discretion of the psychiatrist and psychopharm consultant. PANSS were administered at baseline, week-4, week-8 and week-12. Paired sample t-tests were used to calculate the statistical significance of the mean differences for scores at baseline and week-12. Results: Mean differences from baseline indicated significant improvement on total score, as well as positive, negative, cognitive and general psychopathology subscales after twelve weeks of treatment. The greater average reduction in the negative syndrome subscale across the twelve weeks possibly illustrates the ability of clozapine ODT in improving negative symptoms, including cognitive function which is their ability to participate in their personal care and creative expressions in dance, arts, games, poetry to a greater extent their overall, quality of life and living along with the effect on positive symptoms.Conclusion: Overall, clozapine proved to affect a broad range of psychopathology including cognitive functions in this schizophrenic sample.

  7. Does previous failed ESWL have a negative impact of on the outcome of ureterorenoscopy? A matched pair analysis.

    Science.gov (United States)

    Philippou, Prodromos; Payne, David; Davenport, Kim; Timoney, Anthony G; Keeley, Francis X

    2013-11-01

    This study aims to evaluate the outcome of ureteroscopy/ureterorenoscopy (URS) as a salvage procedure for stones resistant to extracorporeal shock wave lithotripsy (ESWL). Between January 2009 and January 2012, 313 patients with upper tract lithiasis were treated by URS. Among them, 87 (27.8 %) had undergone URS after prior ESWL failed to achieve stone clearance (Salvage group). These patients were matched with a group of patients who underwent URS as first-line modality (Primary group). Stone-free rates and adjuvant procedures represented the primary points for comparison. Secondary points for comparison included complications, procedure duration, total laser energy used and length of hospitalization. Matching was possible in all cases. Stone clearance rates were 73.6 and 82.8 % for the Salvage and Primary group, respectively. The difference in stone clearance rates between the two groups was not statistically significant (p = 0.186). A total of 11 patients (12.6 %) in the Primary group and 18 patients (20.7 %) in the Salvage group underwent an adjuvant procedure (p = 0.154). No statistically significant differences were noted in terms of complications, procedure duration and length of hospitalization. In the Primary group, the laser energy used for stone fragmentation was higher (p = 0.043). The rate of ureteric stenting at the end of the procedure was higher for the Salvage group (p = 0.030). Previous failed ESWL is not a predictor for unfavorable outcome of URS. Salvage URS is associated, however, with an increased need for ureteric stenting at the end of the procedure.

  8. Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria.

    Science.gov (United States)

    Mularoni, A; Bertani, A; Vizzini, G; Gona, F; Campanella, M; Spada, M; Gruttadauria, S; Vitulo, P; Conaldi, P; Luca, A; Gridelli, B; Grossi, P

    2015-10-01

    Donor-derived infections due to multidrug-resistant bacteria are a growing problem in solid organ transplantation, and optimal management options are not clear. In a 2-year period, 30/214 (14%) recipients received an organ from 18/170 (10.5%) deceased donors with infection or colonization caused by a carbapenem-resistant gram-negative bacteria that was unknown at the time of transplantation. Among them, 14/30 recipients (47%) received a transplant from a donor with bacteremia or with infection/colonization of the transplanted organ and were considered at high risk of donor-derived infection transmission. The remaining 16/30 (53%) recipients received an organ from a nonbacteremic donor with colonization of a nontransplanted organ and were considered at low risk of infection transmission. Proven transmission occurred in 4 of the 14 high-risk recipients because donor infection was either not recognized, underestimated, or not communicated. These recipients received late, short or inappropriate posttransplant antibiotic therapy. Transmission did not occur in high-risk recipients who received appropriate and prompt antibiotic therapy for at least 7 days. The safe use of organs from donors with multidrug-resistant bacteria requires intra- and inter-institutional communication to allow appropriate management and prompt treatment of recipients in order to avoid transmission of infection. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  9. Patent foramen ovale does not have a negative impact on early outcomes in patients undergoing liver transplantation.

    Science.gov (United States)

    Alba, Ana Carolina; Verocai Flaman, F; Granton, J; Delgado, D H

    2011-01-01

    To identify the impact of the presence of patent foramen ovale (PFO) in patients undergoing liver transplantation. Twenty-seven pre-liver transplant patients who had a PFO (PFO group) were identified and compared with 61 patients without PFO (NoPFO group). Patients were matched according to age, gender and cause of liver disease. The diagnosis of PFO was made by transthoracic echocardiography prior to liver transplantation. Patient baseline characteristics and complications during the early post-transplant period were analyzed. The mean age in the PFO group was 47 ± 14 (range 18-68) yr and 50 ± 11 (range 12-65) yr in the NoPFO group. The PFO group had a mean model for end-stage liver disease (MELD) score of 15 ± 10 whereas in the NoPFO group the MELD score was 19 ± 10 (p = 0.08). There were non-significant differences in echocardiographic parameters between groups. Duration of mechanical ventilation and the incidence of neurological complications were similar. Thirty-day mortality rate was similar in both groups; only one patient in the NoPFO group died within the first 30 days post-transplantation. The presence of PFO in patients with end-stage liver disease undergoing liver transplantation does not appear to affect patient outcomes during the peri-operative period. © 2010 John Wiley & Sons A/S.

  10. The transition from medical student to doctor: perceptions of final year students and preregistration house officers related to expected learning outcomes.

    Science.gov (United States)

    Lempp, H; Seabrook, M; Cochrane, M; Rees, J

    2005-03-01

    In this prospective qualitative study over 12 months, we evaluated the educational and clinical effectiveness of a new final year undergraduate programme in a London medical school (Guy's, King's and St Thomas'). A stratified sample of 17/360 final year students were interviewed four times, and the content was assessed against 32 amalgamated learning outcomes identified in 1997 in The New Doctor. At the beginning of the preregistration year, eight of the learning outcomes were already met, 10 partly, eight remained to be attained and for six, insufficient evidence existed. Preregistration house officers who have been through the final year student house officer programme expressed competence in many of the outcomes of the General Medical Council's New Doctor. The study identified areas such as prescribing where further developments are needed and will help in planning the new foundation programme.

  11. Outcome correlation of smear-positivity but culture-negativity during standard anti-tuberculosis treatment in Taiwan.

    Science.gov (United States)

    Chao, Wen-Cheng; Huang, Yi-Wen; Yu, Ming-Chih; Yang, Wen-Ta; Lin, Chou-Jui; Lee, Jen-Jyh; Huang, Ruay-Ming; Shieh, Chi-Chang; Chien, Shun-Tien; Chien, Jung-Yien

    2015-02-18

    The appearance of smear-positivity but culture-negativity (SPCN) for acid-fast bacilli among sputum specimen is frequently found in pulmonary tuberculosis (TB) patients during treatment. This study aimed to investigate clinical risk factors, impacts on treatment course, and relapse pattern associated with sputum SPCN. We retrospectively enrolled 800 patients with culture-proven pulmonary TB who were receiving standard treatment and follow-up at six TB-referral hospitals in Taiwan between January 2006 and December 2007. Relevant patient characteristics and chemotherapy data were analyzed for associations with incidence of SPCN. Data from patients who relapsed within 3 years after completing treatment were analyzed for associations with SPCN during treatment. Of the 800 subjects, 111 (13.8%) had sputum SPCN during treatment. Three factors were found to predict the development of SPCN; namely, high initial acid-fast staining grading (OR, 3.407; 95% CI, 2.090-5.553), cavitation on chest-X ray films (OR, 2.217; 95% CI, 1.359-3.615), and smoking (OR, 1.609; 95% CI, 1.006-2.841). Patients with SPCN had longer treatment duration (rifampicin: 284 ± 91 vs. 235 ± 69 days, P <0.001; isoniazid: 289 ± 90 vs. 234 ± 69 days, P < 0.001) than those without SPCN. Finally, the rate of relapse within 3 years of completing treatment was similar for groups with/without SPCN (2.7%, 3/111 vs. 1.0%, 7/689, respectively; P = 0.15). In conclusion, severity of infection was a major risk factor for SPCN during treatment; however, the relapse rate within 3 years of completing treatment was not affected by the appearance of SPCN.

  12. Recreational use of marijuana during pregnancy and negative gestational and fetal outcomes: An experimental study in mice.

    Science.gov (United States)

    Benevenuto, Sarah G; Domenico, Marlise D; Martins, Marco Antônio G; Costa, Natália S; de Souza, Ana Rosa L; Costa, Jose L; Tavares, Marina F M; Dolhnikoff, Marisa; Veras, Mariana Matera

    2017-02-01

    The prevalence of marijuana use among pregnant women is high. However, the effects on gestation and fetal development are not well known. Epidemiological and experimental studies present conflicting results because of the route of administration, dose, time of exposure, species used, and how Cannabis toxicity is tested (prepared extracts, specific components, or by pyrolysis). In this study, we experimentally investigated the effects of maternal inhalation of Cannabis sativa smoke representing as nearly as possible real world conditions of human marijuana use. Pregnant mice (n=20) were exposed (nose-only) daily for 5min to marijuana smoke (0.2g of Cannabis) from gestational day (GD) 5.5 to GD17.5 or filtered air. Food intake and maternal weight gain were recorded. Ultrasound biomicroscopy was performed on 10.5 and 16.5dpc.On GD18.5, half of the dams were euthanized for the evaluation of term fetus, placenta, and resorptions. Gestation length, parturition, and neonatal outcomes were evaluated in the other half. Five minutes of daily (low dose) exposure during pregnancy resulted in reduced birthweight, and litter size was not altered; however, the number of male pups per litter was higher. Besides, placental wet weight was increased and fetal to placental weight ratio was decreased in male fetuses, showing a sex-specific effect. At the end of gestation, females from the Cannabis group presented reduced maternal net body weight gain, despite a slight increase in their daily food intake compared to the control group. In conclusion, our results indicate that smoking marijuana during pregnancy even at low doses can be embryotoxic and fetotoxic. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. The Human Anatomy Teacher-Scholar: Meeting the Expectations of Educational Outcomes Research, Course Content Innovation, and Textbook Innovation for Educational Scholarship

    Science.gov (United States)

    Eckel, Christine Marie

    2009-01-01

    A human anatomy teacher-scholar is a scholar whose area of expertise includes content knowledge of the anatomical sciences (gross anatomy, histology, embryology, and/or neuroanatomy) and whose research interests and focus are centered in medical educational outcomes. The projects described in this dissertation represent endeavors I engaged in to…

  14. Targeting brain serotonin synthesis: insights into neurodevelopmental disorders with long-term outcomes related to negative emotionality, aggression and antisocial behaviour.

    Science.gov (United States)

    Lesch, Klaus-Peter; Araragi, Naozumi; Waider, Jonas; van den Hove, Daniel; Gutknecht, Lise

    2012-09-05

    Aggression, which comprises multi-faceted traits ranging from negative emotionality to antisocial behaviour, is influenced by an interaction of biological, psychological and social variables. Failure in social adjustment, aggressiveness and violence represent the most detrimental long-term outcome of neurodevelopmental disorders. With the exception of brain-specific tryptophan hydroxylase-2 (Tph2), which generates serotonin (5-HT) in raphe neurons, the contribution of gene variation to aggression-related behaviour in genetically modified mouse models has been previously appraised (Lesch 2005 Novartis Found Symp. 268, 111-140; Lesch & Merschdorf 2000 Behav. Sci. Law 18, 581-604). Genetic inactivation of Tph2 function in mice led to the identification of phenotypic changes, ranging from growth retardation and late-onset obesity, to enhanced conditioned fear response, increased aggression and depression-like behaviour. This spectrum of consequences, which are amplified by stress-related epigenetic interactions, are attributable to deficient brain 5-HT synthesis during development and adulthood. Human data relating altered TPH2 function to personality traits of negative emotionality and neurodevelopmental disorders characterized by deficits in cognitive control and emotion regulation are based on genetic association and are therefore not as robust as the experimental mouse results. Mouse models in conjunction with approaches focusing on TPH2 variants in humans provide unexpected views of 5-HT's role in brain development and in disorders related to negative emotionality, aggression and antisocial behaviour.

  15. Expectation-based intelligent control

    International Nuclear Information System (INIS)

    Zak, Michail

    2006-01-01

    New dynamics paradigms-negative diffusion and terminal attractors-are introduced to control noise and chaos. The applied control forces are composed of expectations governed by the associated Fokker-Planck and Liouville equations. The approach is expanded to a general concept of intelligent control via expectations. Relevance to control in livings is emphasized and illustrated by neural nets with mirror neurons

  16. Simultaneous alcohol and cannabis expectancies predict simultaneous use

    Directory of Open Access Journals (Sweden)

    Earleywine Mitch

    2006-10-01

    Full Text Available Abstract Background Simultaneous use of alcohol and cannabis predicts increased negative consequences for users beyond individual or even concurrent use of the two drugs. Given the widespread use of the drugs and common simultaneous consumption, problems unique to simultaneous use may bear important implications for many substance users. Cognitive expectancies offer a template for future drug use behavior based on previous drug experiences, accurately predicting future use and problems. Studies reveal similar mechanisms underlying both alcohol and cannabis expectancies, but little research examines simultaneous expectancies for alcohol and cannabis use. Whereas research has demonstrated unique outcomes associated with simultaneous alcohol and cannabis use, this study hypothesized that unique cognitive expectancies may underlie simultaneous alcohol and cannabis use. Results: This study examined a sample of 2600 (66% male; 34% female Internet survey respondents solicited through advertisements with online cannabis-related organizations. The study employed known measures of drug use and expectancies, as well as a new measure of simultaneous drug use expectancies. Expectancies for simultaneous use of alcohol and cannabis predicted simultaneous use over and above expectancies for each drug individually. Discussion Simultaneous expectancies may provide meaningful information not available with individual drug expectancies. These findings bear potential implications on the assessment and treatment of substance abuse problems, as well as researcher conceptualizations of drug expectancies. Policies directing the treatment of substance abuse and its funding ought to give unique consideration to simultaneous drug use and its cognitive underlying factors.

  17. Pharmacological and Expectancy Effects of a Low Amount of Alcohol Drinking on Outcome Valuation and Risk Perception in Males and Females

    Science.gov (United States)

    Tsurugizawa, Tomokazu; Tokuda, Shinsuke; Harada, Tokiko; Takahashi, Taiki; Sadato, Norihiro

    2016-01-01

    The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol) on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration) and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol). The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper–pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens’ law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo) could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine). Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making. PMID

  18. Pharmacological and Expectancy Effects of a Low Amount of Alcohol Drinking on Outcome Valuation and Risk Perception in Males and Females.

    Directory of Open Access Journals (Sweden)

    Tomokazu Tsurugizawa

    Full Text Available The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol. The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper-pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens' law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine. Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making.

  19. Predicting Problem Behaviors with Multiple Expectancies: Expanding Expectancy-Value Theory

    Science.gov (United States)

    Borders, Ashley; Earleywine, Mitchell; Huey, Stanley J.

    2004-01-01

    Expectancy-value theory emphasizes the importance of outcome expectancies for behavioral decisions, but most tests of the theory focus on a single behavior and a single expectancy. However, the matching law suggests that individuals consider expected outcomes for both the target behavior and alternative behaviors when making decisions. In this…

  20. Agreeing on expectations

    DEFF Research Database (Denmark)

    Nielsen, Christian; Bentsen, Martin Juul

    Commitment and trust are often mentioned as important aspects of creating a perception of reliability between counterparts. In the context of university-industry collaborations (UICs), agreeing on ambitions and expectations are adamant to achieving outcomes that are equally valuable to all parties...... involved. Despite this, our initial probing indicated that such covenants rarely exist. As such, this paper draws on project management theory and proposes the possibility of structuring assessments of potential partners before university-industry collaborations are brought to life. Our analysis suggests...

  1. Modifying alcohol expectancies of Hispanic children: examining the effects of expectancy-targeted, developmentally congruous prevention videos.

    Science.gov (United States)

    Weinstein, Allison; Lisman, Stephen A; Johnson, Matthew D

    2015-03-01

    Children's expectations about the effects of alcohol consumption are known to predict the amount of alcohol they consume as adults. Previous research has used videotaped interventions to modify children's alcohol expectancies and found that puppet actors had the expected effect of decreasing children's positive alcohol expectancies, whereas adult actors did not. The current study sought to enhance the methods and outcomes of previous research by developing brief prevention videos that focus on pre-selected negative and sedating alcohol expectancies and include youth actors and age-relevant scenarios. Using a 2 × 2 factorial design (actor's age [youth or adult] × scenario relevance [youth or adult]), we examined the alcohol expectancies of 183 Hispanic third-, fourth-, and fifth-grade students (50% girls) in a public school setting. Expectancies were assessed before, immediately following the intervention, and 1 month later. The intervention consisted of four 8-minute videos based on beliefs associated with expectancies related to low alcohol consumption and a control group video about school bus safety. Positive alcohol expectancies were significantly lower directly after the intervention than at baseline. At 1-month follow-up, this effect decreased but was still significant. The current study adds to existing findings that expectancies can be modified in children, using interventions that are extremely brief, low-cost, and linked to research in children's cognitive and social development. In addition, it appears that children of different ages and genders respond differently to varying components of prevention media.

  2. Outcome disparities in African American women with triple negative breast cancer: a comparison of epidemiological and molecular factors between African American and Caucasian women with triple negative breast cancer

    International Nuclear Information System (INIS)

    Sturtz, Lori A; Melley, Jen; Mamula, Kim; Shriver, Craig D; Ellsworth, Rachel E

    2014-01-01

    Although diagnosed less often, breast cancer in African American women (AAW) displays different characteristics compared to breast cancer in Caucasian women (CW), including earlier onset, less favorable clinical outcome, and an aggressive tumor phenotype. These disparities may be attributed to differences in socioeconomic factors such as access to health care, lifestyle, including increased frequency of obesity in AAW, and tumor biology, especially the higher frequency of triple negative breast cancer (TNBC) in young AAW. Improved understanding of the etiology and molecular characteristics of TNBC in AAW is critical to determining whether and how TNBC contributes to survival disparities in AAW. Demographic, pathological and survival data from AAW (n = 62) and CW (n = 98) with TNBC were analyzed using chi-square analysis, Student’s t-tests, and log-rank tests. Frozen tumor specimens were available from 57 of the TNBC patients (n = 23 AAW; n = 34 CW); RNA was isolated after laser microdissection of tumor cells and was hybridized to HG U133A 2.0 microarrays. Data were analyzed using ANOVA with FDR <0.05, >2-fold difference defining significance. The frequency of TNBC compared to all BC was significantly higher in AAW (28%) compared to CW (12%), however, significant survival and pathological differences were not detected between populations. Gene expression analysis revealed the tumors were more similar than different at the molecular level, with only CRYBB2P1, a pseudogene, differentially expressed between populations. Among demographic characteristics, AAW consumed significantly lower amounts of caffeine and alcohol, were less likely to breastfeed and more likely to be obese. These data suggest that TNBC in AAW is not a unique disease compared to TNBC in CW. Rather, higher frequency of TNBC in AAW may, in part, be attributable to the effects of lifestyle choices. Because these risk factors are modifiable, they provide new opportunities for the development of risk

  3. Outcome of Acute Prosthetic Joint Infections Due to Gram-Negative Bacilli Treated with Open Debridement and Retention of the Prosthesis▿

    Science.gov (United States)

    Martínez-Pastor, Juan C.; Muñoz-Mahamud, Ernesto; Vilchez, Félix; García-Ramiro, Sebastián; Bori, Guillem; Sierra, Josep; Martínez, José A.; Font, Lluis; Mensa, Josep; Soriano, Alex

    2009-01-01

    The aim of our study was to evaluate the outcome of acute prosthetic joint infections (PJIs) due to gram-negative bacilli (GNB) treated without implant removal. Patients with an acute PJI due to GNB diagnosed from 2000 to 2007 were prospectively registered. Demographics, comorbidity, type of implant, microbiology data, surgical treatment, antimicrobial therapy, and outcome were recorded. Classification and regression tree analysis, the Kaplan-Meier survival method, and the Cox regression model were applied. Forty-seven patients were included. The mean age was 70.7 years, and there were 15 hip prostheses and 32 knee prostheses. The median number of days from the time of arthroplasty was 20. The most frequent pathogens were members of the Enterobacteriaceae family in 41 cases and Pseudomonas spp. in 20 cases. Among the Enterobacteriaceae, 14 were resistant to ciprofloxacin, while all Pseudomonas aeruginosa isolates were susceptible to ciprofloxacin. The median durations of intravenous and oral antibiotic treatment were 14 and 64 days, respectively. A total of 35 (74.5%) patients were in remission after a median follow-up of 463 days (interquartile range, 344 to 704) days. By use of the Kaplan-Meier survival curve, a C-reactive protein (CRP) concentration of ≤15 mg/dl (P = 0.03) and receipt of a fluoroquinolone, when all GNB isolated were susceptible (P = 0.0009), were associated with a better outcome. By use of a Cox regression model, a CRP concentration of ≤15 mg/dl (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.05 to 12.5; P = 0.043) and receipt of a fluoroquinolone (OR, 9.09; 95% CI, 1.96 to 50; P = 0.005) were independently associated with better outcomes. Open debridement without removal of the implant had a success rate of 74.5%, and the factors associated with good prognosis were a CRP concentration at the time of diagnosis ≤15 mg/dl and treatment with a fluoroquinolone. PMID:19687237

  4. CD20 positivity and white blood cell count predict treatment outcomes in Philadelphia chromosome-negative acute lymphoblastic leukemia patients ineligible for pediatric-inspired chemotherapy.

    Science.gov (United States)

    Isshiki, Yusuke; Ohwada, Chikako; Sakaida, Emiko; Onoda, Masahiro; Aotsuka, Nobuyuki; Tanaka, Hiroaki; Fukazawa, Motoharu; Cho, Ryuko; Sugawara, Takeaki; Kawaguchi, Takeharu; Hara, Satoru; Yokota, Akira

    2017-11-01

    The efficacy of conventional chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been controversial as post-remission therapies for adult Philadelphia chromosome-negative acute lymphoblastic leukemia patients. We retrospectively analyzed 96 adolescent and adult cases of Philadelphia chromosome-negative acute lymphoblastic leukemia to evaluate whether allo-HSCT should be performed after first complete remission (1CR). In total, 34 patients received chemotherapy followed by allo-HSCT (HSCT group) and 62 received chemotherapy alone (chemotherapy group). No significant differences in the event-free survival (EFS) or overall survival were observed between the two groups. In the chemotherapy group, use of pediatric regimens was significantly associated with favorable EFS, while high white blood cell (WBC) count and CD20 positivity were associated with poor outcome. In patients who received pediatric regimens, subsequent allo-HSCT did not influence EFS. In patients who received conventional chemotherapy (adult regimen), subsequent allo-HSCT did not improve EFS. High WBC count and CD20 positivity were also significantly associated with poor EFS in patients who received adult regimens. Patients with low WBC count and absence of CD20 who received adult regimens did not benefit from allo-HSCT. Allo-HSCT may not be required in the pediatric regimen-eligible patients; however, pediatric regimen-ineligible patients with either CD20 positivity or high WBC count should receive allo-HSCT after achieving 1CR. This study was registered at http://www.umin.ac.jp/ctr/ as #C000016287. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Retrospective study of the influence of HPV persistence on outcomes among women with high-risk HPV infections and negative cytology.

    Science.gov (United States)

    Bogani, Giorgio; Taverna, Francesca; Lombardo, Claudia; Borghi, Chiara; Martinelli, Fabio; Signorelli, Mauro; Leone Roberti Maggiore, Umberto; Chiappa, Valentina; Scaffa, Cono; Ditto, Antonino; Lorusso, Domenica; Raspagliesi, Francesco

    2017-07-01

    To evaluate the outcomes of women diagnosed with high-risk HPV without cytology evidence of cervical dysplasia. The present retrospective observational study enrolled consecutive women aged at least 18 years diagnosed with high-risk HPV types with negative cytology results at the National Cancer Institute, Milan, Italy, between January 1, 2005, and December 31, 2015. The development of cervical intraepithelial neoplasia (CIN) was assessed. There were 212 patients with high-risk HPV infections with negative cytology included in the analysis. After a mean ± SD follow-up period of 48 ± 33 months, 65 (30.7%) and 26 (12.3%) patients had developed cytologic or histologic cervical dysplasia (low-grade squamous intraepithelial lesion [LSIL]/CIN1+) and high-grade cervical dysplasia (CIN2+), respectively. No patients had invasive cancer. No correlations were observed between type-specific HPV infections and LSIL/CIN1+ and CIN2+. HPV persistence correlated with both LSIL/CIN1+ (P<0.001) and CIN2+ (P<0.001) in univariate analyses; a 6-month increase in HPV persistence was associated with increased risk of developing LSIL/CIN1+ (P=0.010) and CIN2+ (P=0.012) in multivariate analyses. Regardless of cytology findings, patients diagnosed with high-risk HPV types should receive strict colposcopy follow-up, particularly with persistent HPV infections. Further prospective studies are needed to defined optimal surveillance strategies for these patients. © 2017 International Federation of Gynecology and Obstetrics.

  6. Minimal Residual Disease at First Achievement of Complete Remission Predicts Outcome in Adult Patients with Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia.

    Directory of Open Access Journals (Sweden)

    Mingming Zhang

    Full Text Available We evaluated the prognostic effect of minimal residual disease at first achievement of complete remission (MRD at CR1 in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL. A total of 97 patients received treatment in our center between 2007 and 2012 were retrospectively reviewed in this study. Patients were divided into two arms according to the post-remission therapy (chemotherapy alone or allogeneic hematopoietic stem cell transplantation (allo-HSCT they received. MRD was detected by four-color flow cytometry. We chose 0.02% and 0.2% as the cut-off points of MRD at CR1 for risk stratification using receiver operating characteristic analysis. The 3-year overall survival (OS and leukemia free survival (LFS rates for the whole cohort were 46.2% and 40.5%. MRD at CR1 had a significantly negative correlation with survival in both arms. Three-year OS rates in the chemotherapy arm were 70.0%, 25.2%, 0% (P = 0.003 for low, intermediate, and high levels of MRD at CR1, respectively. Three-year OS rates in the transplant arm were 81.8%, 64.3%, 27.3% (P = 0.005 for low, intermediate, and high levels of MRD at CR1, respectively. Multivariate analysis confirmed that higher level of MRD at CR1 was a significant adverse factor for OS and LFS. Compared with chemotherapy alone, allo-HSCT significantly improved LFS rates in patients with intermediate (P = 0.005 and high (P = 0.022 levels of MRD at CR1, but not patients with low level of MRD at CR1 (P = 0.851. These results suggested that MRD at CR1 could strongly predict the outcome of adult ALL. Patients with intermediate and high levels of MRD at CR1 would benefit from allo-HSCT.

  7. Expectations from the child

    Directory of Open Access Journals (Sweden)

    Erdal Atabek

    2018-05-01

    Full Text Available Transition from agricultural society to industry society, from industrial society to science society has taken place. In all these societies, expectations from children also vary. In the agricultural community, human labor is based on arm power. For this reason, expectation from children is to increase work power. Having more children is the basis for the expectations in this community to see that the boy is valuable because he has increased his work power. In the industrial society, the power of the arm changed its place with the machine power. The knowledgeable person is not a family grown-up but a foreman. Childhood was distinguished during this period. It has been investigated that the child has a separate development.  In the information society, communication and information has never been as fast as it is in this period.  The widespread use of the Internet, and the use of social networks such as Facebook and Twitter are in this period. In this society, families are panicked to prepare a future in their own heads for their children. Because the parents thought of their children, they decided about the child's life instead of the child making these decisions. This has had a negative impact on children's sense of autonomy and their ability to take responsibility. To change this, parents should train their children in auto control and develop children's impulse control skills. The children should be able to understand their emotions and make decisions by reasoning and reasoning.

  8. The Positive Outcome of MRI-Guided Vacuum Assisted Core Needle Breast Biopsies Is Not Influenced by a Prior Negative Targeted Second-Look Ultrasound.

    Science.gov (United States)

    Ferré, Romuald; AlSharif, Shaza; Aldis, Ann; Mesurolle, Benoît

    2017-11-01

    The study sought to investigate the outcome of breast magnetic resonance-guided biopsies as a function of the indication for magnetic resonance imaging (MRI), the MRI features of the lesions, and the performance or not of a targeted second-look ultrasound (SLUS) prior breast MRI-guided biopsy. We identified 158 women with MRI-detected breast lesions scheduled for MRI-guided biopsy (2007-2013). Patient demographics, performance of targeted SLUS, imaging characteristics, and subsequent pathology results were reviewed. Three biopsies were deferred, and 155 lesions were biopsied under MRI guidance (155 women; median age 55.14 years; range 27-80 years). Ninety-eight women underwent a SLUS prior to the MRI-guided biopsy (63%). Of the 155 biopsied lesions, 23 (15%) were malignant, 106 (68%) were benign, and 26 (17%) were high risk. Four of 15 surgically excised high-risk lesions were upgraded to malignancy (27%). Most of the biopsied lesions corresponded to non-mass-like enhancement (81%, 126 of 155) and most of the biopsies (52%, 81 of 155) were performed in a screening context. No demographic or MRI features were associated with malignancy. No differences were noted between the 2 subgroups (prior SLUS vs no prior SLUS) except for the presence of a synchronous carcinoma associated with a likelihood of targeted SLUS before MRI-guided biopsy (P = .001). A negative SLUS does not influence the pathology outcome of a suspicious lesion biopsied under MR guidance. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  9. Association between African American race and outcomes in patients with nonmetastatic triple-negative breast cancer: a retrospective analysis by using results from the Georgia Cancer Specialist Database.

    Science.gov (United States)

    Christiansen, Neal; Chen, Lei; Gilmore, James; Pechar, David; Szabo, Stephen

    2012-08-01

    The objective of this study was to evaluate, in a real-world context, the impact of race on disease recurrence and survival in patients with nonmetastatic triple-negative breast cancer (TNBC) treated with adjuvant chemotherapy. The study selected patients from the 2003-2008 Georgia Cancer Specialist Database with stage I-III confirmed TNBC who had received adjuvant chemotherapy. These patients were followed-up from initial diagnosis to death, cancer recurrence, or loss to follow-up. The primary outcome was disease-free survival (DFS). Kaplan-Meier curves compared DFS and recurrence between African American and non-African American groups. The impact of African American status was examined further through multivariate Cox models by adjusting for age, comorbidity, body mass index (BMI), smoking status, initial TNBC stage, surgery, and radiation therapy. Among 209 patients with TNBC, 89 (42.6%) were African American. The 2 groups (African American vs. non-African American) were similar in mean age at diagnosis (53.2 vs. 54.4 years; P =.487) and with surgery and radiation rates (98.9% vs. 100%; P = .244; 68.5% vs. 62.5%; P = .365, respectively). Compared with non-African Americans, African American patients had a higher BMI (30.4 vs. 28.6 kg/m(2); P = .0477) and were less likely to be diagnosed at stage I (31.5% vs. 51.7%; P = .0107). The African American patients had a lower 5-year DFS rate (45.2% vs. 79.7%; P = .0005) and a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) compared with the non-African American patients. Among patients with TNBC treated with adjuvant chemotherapy, African American race was associated with a worse outcome irrespective of later stage at presentation or higher BMI. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Expectancy Effects on Self-Reported Attention-Deficit/Hyperactivity Disorder Symptoms in Simulated Neurofeedback: A Pilot Study.

    Science.gov (United States)

    Lee, Grace J; Suhr, Julie A

    2018-03-31

    Expectancy is a psychological factor that can impact treatment effectiveness. Research on neurofeedback for attention-deficit/hyperactivity disorder (ADHD) suggests expectancy may contribute to treatment outcomes, though evidence for expectancy as an explanatory factor is sparse. This pilot study investigated the effects of expectancies on self-reported ADHD symptoms in simulated neurofeedback. Forty-six adults who were concerned that they had ADHD expected to receive active neurofeedback, but were randomly assigned to receive a placebo with false feedback indicating attentive (positive false feedback) or inattentive (negative false feedback) states. Effects of the expectancy manipulation were measured on an ADHD self-report scale. Large expectancy effects were found, such that individuals who received positive false feedback reported significant decreases in ADHD symptoms, whereas individuals who received negative false feedback reported significant increases in ADHD symptoms. Findings suggest that expectancy should be considered as an explanatory mechanism for ADHD symptom change in response to neurofeedback.

  11. Time and outcome framing in intertemporal tradeoffs.

    Science.gov (United States)

    Scholten, Marc; Read, Daniel

    2013-07-01

    A robust anomaly in intertemporal choice is the delay-speedup asymmetry: Receipts are discounted more, and payments are discounted less, when delayed than when expedited over the same interval. We developed 2 versions of the tradeoff model (Scholten & Read, 2010) to address such situations, in which an outcome is expected at a given time but then its timing is changed. The outcome framing model generalizes the approach taken by the hyperbolic discounting model (Loewenstein & Prelec, 1992): Not obtaining a positive outcome when expected is a worse than expected state, to which people are over-responsive, or hypersensitive, and not incurring a negative outcome when expected is a better than expected state, to which people are under-responsive, or hyposensitive. The time framing model takes a new approach: Delaying a positive outcome or speeding up a negative one involves a loss of time to which people are hypersensitive, and speeding up a positive outcome or delaying a negative one involves a gain of time to which people are hyposensitive. We compare the models on their quantitative predictions of indifference data from matching and preference data from choice. The time framing model systematically outperforms the outcome framing model. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. Macroeconomic Expectations of Households and Professional Forecasters

    OpenAIRE

    Christopher D Carroll

    2002-01-01

    Economists have long emphasized the importance of expectations in determining macroeconomic outcomes Yet there has been almost no recent effort to model actual empirical expectations data; instead macroeconomists usually simply assume expectations are rational This paper shows that while empirical household expectations are not rational in the usual sense expectational dynamics are well captured by a model in which households' views derive from news reports of the views of professional foreca...

  13. Flexible Expectations of Learning Outcomes in Science

    Science.gov (United States)

    Binstead, Ayla; Campbell, Kirsty; Guasch, Susana Fraile; Sullivan, Claire; Williams, Lydia

    2014-01-01

    In this article five trainee teachers specialising in science at the University of Winchester describe their experience teaching science for three consecutive Fridays within a 2 year class (ages 6-7). They were given the task of teaching food and nutrition through the class topic of "turrets and tiaras," a medieval history focus. Their…

  14. From Expectations to Outcomes in Education Systems.

    Science.gov (United States)

    Dale, Roger

    1981-01-01

    Correspondence theories imply that the social relations of education correspond to the social relations of dominance and subordination in the economic sphere. One limitation of the criticisms of this principle is that they are restricted to the relationship between school and work and do not investigate the link between education and the wider…

  15. Hospitalized Smokers’ Expectancies for Electronic Cigarettes versus Tobacco Cigarettes

    Science.gov (United States)

    Hendricks, Peter S.; Cases, Mallory G.; Thorne, Christopher B.; Cheong, JeeWon; Harrington, Kathleen F.; Kohler, Connie L.; Bailey, William C.

    2016-01-01

    Introduction To compare hospitalized smokers’ expectancies for electronic cigarettes (e-cigarettes) against their expectancies for tobacco cigarettes and evaluate relationships between e-cigarette expectancies and intention to use e-cigarettes. Methods Analysis of baseline data from a one-year longitudinal observational study. The setting was a tertiary care academic center hospital in the Southeastern U.S. Participants were 958 hospitalized tobacco cigarette smokers. A questionnaire of e-cigarette expectancies based on the Brief Smoking Consequences Questionnaire-Adult (BSCQ-A) was developed and administered along with the original, tobacco-specific, BSCQ-A. Intention to use e-cigarettes was assessed with a single 10-point Likert scale item. Results Participants reported significantly weaker expectancies for e-cigarettes relative to tobacco cigarettes on all 10 BSCQ-A scales. Participants held sizably weaker expectancies for the health risks of e-cigarettes (p < .001, Cohen's d = −2.07) as well as the ability of e-cigarettes to relieve negative affect (p < .001, Cohen's d = −1.01), satisfy the desire for nicotine (p < .001, Cohen's d = −.83), and taste pleasant (p < .001, Cohen's d = −.73). Among the strongest predictors of intention to use e-cigarettes were greater expectancies that e-cigarettes taste pleasant (p < .001, adjusted β = .34), relieve negative affect (p < .001, adjusted β = .32), and satisfy the desire for nicotine (p < .001, adjusted β = .31). Conclusions Hospitalizedtobacco smokers expect fewer negative and positive outcomes from e-cigarettes versus tobacco cigarettes. This suggests that e-cigarettes might be viable though imperfect substitutes for tobacco cigarettes. PMID:25452052

  16. Obesity and type 2 diabetes, not a diet high in fat, sucrose, and cholesterol, negatively impacts bone outcomes in the hyperphagic Otsuka Long Evans Tokushima Fatty rat.

    Science.gov (United States)

    Ortinau, Laura C; Linden, Melissa A; Dirkes, Rebecca; Rector, R Scott; Hinton, Pamela S

    2017-12-01

    Obesity and type 2 diabetes (T2D) increase fracture risk; however, the association between obesity/T2D may be confounded by consumption of a diet high in fat, sucrose, and cholesterol (HFSC). The study objective was to determine the main and interactive effects of obesity/T2D and a HFSC diet on bone outcomes using hyperphagic Otuska Long Evans Tokushima Fatty (OLETF) rats and normophagic Long Evans Tokushima Otsuka (LETO) controls. At 8weeks of age, male OLETF and LETO rats were randomized to either a control (CON, 10 en% from fat as soybean oil) or HFSC (45 en% from fat as soybean oil/lard, 17 en% sucrose, and 1wt%) diet, resulting in four treatment groups. At 32weeks, total body bone mineral content (BMC) and density (BMD) and body composition were measured by dual-energy X-ray absorptiometry, followed by euthanasia and collection of blood and tibiae. Bone turnover markers and sclerostin were measured using ELISA. Trabecular microarchitecture of the proximal tibia and geometry of the tibia mid-diaphysis were measured using microcomputed tomography; whole-bone and tissue-level biomechanical properties were evaluated using torsional loading of the tibia. Two-factor ANOVA was used to determine main and interactive effects of diet (CON vs. HFSC) and obesity/T2D (OLETF vs. LETO) on bone outcomes. Hyperphagic OLEFT rats had greater final body mass, body fat, and fasting glucose than normophagic LETO, with no effect of diet. Total body BMC and serum markers of bone formation were decreased, and bone resorption and sclerostin were increased in obese/T2D OLETF rats. Trabecular bone volume and microarchitecture were adversely affected by obesity/T2D, but not diet. Whole-bone and tissue-level biomechanical properties of the tibia were not affected by obesity/T2D; the HFSC diet improved biomechanical properties only in LETO rats. Obesity/T2D, regardless of diet, negatively impacted the balance between bone formation and resorption and trabecular bone volume and

  17. Brain-derived neurotrophic factor (BDNF) -TrKB signaling modulates cancer-endothelial cells interaction and affects the outcomes of triple negative breast cancer.

    Science.gov (United States)

    Tsai, Yi-Fang; Tseng, Ling-Ming; Hsu, Chih-Yi; Yang, Muh-Hwa; Chiu, Jen-Hwey; Shyr, Yi-Ming

    2017-01-01

    triple negative breast cancer cell. In addition, BDNF can function in either an autocrine or a paracrine manner to increase the migration ability of both MDA-MB-231 cells and HUVEC cells. Finally, overexpression of TrkB, but not of BDNF, is significantly associated with a poor survival outcome for TNBC patients.

  18. Clinical outcomes in patients with node-negative breast cancer treated based on the recurrence score results: evidence from a large prospectively designed registry.

    Science.gov (United States)

    Stemmer, Salomon M; Steiner, Mariana; Rizel, Shulamith; Soussan-Gutman, Lior; Ben-Baruch, Noa; Bareket-Samish, Avital; Geffen, David B; Nisenbaum, Bella; Isaacs, Kevin; Fried, Georgeta; Rosengarten, Ora; Uziely, Beatrice; Svedman, Christer; McCullough, Debbie; Maddala, Tara; Klang, Shmuel H; Zidan, Jamal; Ryvo, Larisa; Kaufman, Bella; Evron, Ella; Karminsky, Natalya; Goldberg, Hadassah; Shak, Steven; Liebermann, Nicky

    2017-01-01

    The 21-gene Recurrence Score® (RS) assay is a validated prognostic/predictive tool in ER + early-stage breast cancer. However, clinical outcome data from prospective studies in RS ≥ 11 patients are lacking, as are relevant real-life clinical practice data. In this retrospective analysis of a prospectively designed registry, we evaluated treatments/clinical outcomes in patients undergoing RS-testing through Clalit Health Services. The analysis included N0 ER + HER2-negative breast cancer patients who were RS-tested from 1/2006 through 12/2010. Medical records were reviewed to verify treatments/recurrences/survival. The cohort included 1801 patients (median follow-up, 6.2 years). Median age was 60 years, 50.4% were grade 2 and 81.1% had invasive ductal carcinoma; 48.9% had RS < 18, 40.7% RS 18-30, and 10.4% RS ≥ 31, with chemotherapy use of 1.4, 23.7, and 87.2%, respectively. The 5-year Kaplan-Meier estimates for distant recurrence were 0.8, 3.0, and 8.6%, for patients with RS < 18, RS 18-30 and RS ≥ 31, respectively; the corresponding 5-year Kaplan-Meier estimates for breast cancer death were 0.0, 0.9, and 6.2%. Chemotherapy-untreated patients with RS < 11 ( n  = 304) and 11-25 ( n  = 1037) (TAILORx categorizatio n ) had 5-year Kaplan-Meier estimates for distant recurrence risk/breast cancer death of 1.0%/0.0% and 1.3%/0.4%, respectively. Our results extend those of the prospective TAILORx trial: the 5-year Kaplan-Meier estimates for distant recurrence and breast cancer death rate for the RS < 18 patients were very low supporting the use of endocrine therapy alone. Furthermore, in chemotherapy-untreated patients with RS 11-25 (where TAILORx patients were randomized to chemoendocrine or endocrine therapy alone), 5-year distant recurrence rates were also very low, suggesting that chemotherapy would not have conferred clinically meaningful benefit.

  19. HbA1c level cannot predict the treatment outcome of smear-positive non-multi-drug-resistant HIV-negative pulmonary tuberculosis inpatients

    Science.gov (United States)

    Tashiro, Ken; Horita, Nobuyuki; Nagai, Kenjiro; Ikeda, Misako; Shinkai, Masaharu; Yamamoto, Masaki; Sato, Takashi; Hara, Yu; Nagakura, Hideyuki; Shibata, Yuji; Watanabe, Hiroki; Nakashima, Kentaro; Ushio, Ryota; Nagashima, Akimichi; Narita, Atsuya; Kobayashi, Nobuaki; Kudo, Makoto; Kaneko, Takeshi

    2017-01-01

    We conducted a single-center retrospective cohort study to evaluate whether the HbA1c level on admission could predict the in-hospital treatment outcome of smear-positive non-multi-drug-resistant HIV-negative culture-proven pulmonary tuberculosis inpatients. Our standard regimens under the direct observation were HRZE or HRE for the first two months followed by combination therapy with isoniazid and rifampicin. Our cohort consisted of consecutive 239 patients consisted of 147 men and 92 women with a median age of 73 years. The HbA1c level of patients whose HbA1c was above 7.0% on admission showed clear declining trends after admission. HbA1c on admission had no Spearman’s rank correlation with time to discharge alive (r = 0.17) and time to becoming non-infective (r = 0.17). By Kaplan-Meier curves and a log-rank trend test, HbA1c quartile subgroups showed no association with times to discharge alive (p = 0.431), becoming non-infective (p = 0.113), and in-hospital death (p = 0.427). Based on multi-variate Cox analysis, HbA1c on admission had no significant impact on time to discharge alive (hazard ratio = 1.03, 95% CI 0.89–1.20, p = 0.659), becoming non-infective (hazard ratio = 0.93, 95% CI 0.80–1.06, p = 0.277), and in-hospital death (hazard ratio = 0.68, 0.43–1.07, p = 0.097). In conclusion, the HbA1c level on admission did not seem to affect in-hospital tuberculosis treatment outcomes in Japanese cohort. PMID:28406247

  20. Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype

    International Nuclear Information System (INIS)

    Yi, Seong Yoon; Cho, Eun Yoon; La Choi, Yoon; Park, Yeon Hee; Im, Young-Hyuck; Ahn, Jin Seok; Uhm, Ji Eun; Lim, Do Hyoung; Ji, Sang Hoon; Jun, Hyun Jung; Kim, Kyoung Ha; Chang, Myung Hee; Park, Min Jae

    2010-01-01

    We analyzed the responses to first line treatment and clinical outcomes of metastatic breast cancer patients treated with palliative doxorubicin/cyclophosphamide (AC) according to molecular cancer subtype. A retrospective analysis was performed for 110 metastatic breast cancer patients selected on the basis of palliative AC treatment and the availability of immunohistochemical data for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2/neu) status. Of the 110 patients analyzed, 71 (64.5%) were hormone receptor positive (HR+), 14 (12.7%) were HER2+, and 25 (22.7%) were triple negative (TN). There were no differences in age, stage at diagnosis, total number of cycles of palliative chemotherapy, incidence of visceral metastasis, and metastatic sites with the exception of liver among breast cancer subtypes. The overall response rates to AC were 55.9% for the HR+ subgroup, 42.9% for the HER2+ subgroup, and 56.5% for the TN subgroup. The progression-free survival (PFS) in patients with HER2+ and TN were significantly shorter than in the HR+ (median PFS, 9.1 vs 8.1 vs 11.5 months, respectively; p = 0.0002). The overall survival (OS) was 25.4 months in the TN subgroup and 27.3 months in HER2+ subgroup. The median OS for these two groups was significantly shorter than for patients in the HR+ subgroup (median, 38.5 months; 95% CI, 30.1-46.9 months; p < 0.0001). The response to palliative AC chemotherapy did not differ among breast cancer subtypes. Despite chemosensitivity for palliative AC, the TN subtype has a shorter overall survival than non-TN subtypes. Innovative treatment strategies should be developed to slow the course of disease

  1. Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype

    Directory of Open Access Journals (Sweden)

    La Choi Yoon

    2010-10-01

    Full Text Available Abstract Background We analyzed the responses to first line treatment and clinical outcomes of metastatic breast cancer patients treated with palliative doxorubicin/cyclophosphamide (AC according to molecular cancer subtype. Methods A retrospective analysis was performed for 110 metastatic breast cancer patients selected on the basis of palliative AC treatment and the availability of immunohistochemical data for estrogen receptor (ER, progesterone receptor (PR, and human epidermal growth factor receptor-2 (HER-2/neu status. Results Of the 110 patients analyzed, 71 (64.5% were hormone receptor positive (HR+, 14 (12.7% were HER2+, and 25 (22.7% were triple negative (TN. There were no differences in age, stage at diagnosis, total number of cycles of palliative chemotherapy, incidence of visceral metastasis, and metastatic sites with the exception of liver among breast cancer subtypes. The overall response rates to AC were 55.9% for the HR+ subgroup, 42.9% for the HER2+ subgroup, and 56.5% for the TN subgroup. The progression-free survival (PFS in patients with HER2+ and TN were significantly shorter than in the HR+ (median PFS, 9.1 vs 8.1 vs 11.5 months, respectively; p = 0.0002. The overall survival (OS was 25.4 months in the TN subgroup and 27.3 months in HER2+ subgroup. The median OS for these two groups was significantly shorter than for patients in the HR+ subgroup (median, 38.5 months; 95% CI, 30.1-46.9 months; p Conclusions The response to palliative AC chemotherapy did not differ among breast cancer subtypes. Despite chemosensitivity for palliative AC, the TN subtype has a shorter overall survival than non-TN subtypes. Innovative treatment strategies should be developed to slow the course of disease.

  2. Impact of imipenem and amikacin pharmacokinetic/pharmacodynamic parameters on microbiological outcome of Gram-negative bacilli ventilator-associated pneumonia.

    Science.gov (United States)

    Pajot, O; Burdet, C; Couffignal, C; Massias, L; Armand-Lefevre, L; Foucrier, A; Da Silva, D; Lasocki, S; Laouénan, C; Mentec, H; Mentré, F; Wolff, M

    2015-05-01

    Despite recent advances, antibiotic therapy of ventilator-associated pneumonia (VAP) in ICU patients is still challenging. We assessed the impact of imipenem and amikacin pharmacokinetic and pharmacodynamic parameters on microbiological outcome in these patients. Patients with Gram-negative bacilli (GNB) VAP were prospectively included. Blood samples for pharmacokinetic analysis were collected after empirical administration of a combination of imipenem three times daily and one single dose of amikacin. MICs were estimated for each GNB obtained from respiratory samples. Microbiological success was defined as a ≥10(3) cfu/mL decrease in bacterial count in quantitative cultures between baseline and the third day of treatment. Thirty-nine patients [median (min-max) age = 60 years (28-84) and median SAPS2 at inclusion = 40 (19-73)] were included. Median MICs of imipenem and amikacin were 0.25 mg/L (0.094-16) and 2 mg/L (1-32), respectively. Median times over MIC and over 5× MIC for imipenem were 100% (8-100) and 74% (3-100), respectively. The median C1/MIC ratio for amikacin was 23 (1-76); 34 patients (87%) achieved a C1/MIC ≥10. Microbiological success occurred in 29 patients (74%). No imipenem pharmacodynamic parameter was significantly associated with the microbiological success. For amikacin, C1/MIC was significantly higher in the microbiological success group: 26 (1-76) versus 11 (3-26) (P = 0.004). In ICU patients with VAP, classic imipenem pharmacodynamic targets are easily reached with usual dosing regimens. In this context, for amikacin, a higher C1/MIC ratio than previously described might be necessary. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Influence of internal mammary node irradiation on long-term outcome and contralateral breast cancer incidence in node-negative breast cancer patients

    International Nuclear Information System (INIS)

    Courdi, Adel; Chamorey, Emmanuel; Ferrero, Jean-Marc; Hannoun-Lévi, Jean-Michel

    2013-01-01

    Background and purpose: There is no general consensus concerning irradiation (RT) of internal mammary nodes (IMN) in axillary node-negative breast cancer. Based on a large series of patients treated in a single institute and followed up for a long period of time, we looked at the influence of IMN RT on late outcome of these patients as well as the development of contralateral breast cancer (CBC). Patients and methods: The study was based on 1630 node-negative breast cancer patients treated in our institution between 1975 and 2008 with primary conservative surgery and axillary dissection or sentinel node examination. All patients received post-operative breast RT. IMN RT was more frequent in inner or central tumours. Kaplan–Meier (K–M) overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS) according to IMN RT were calculated for all patients and for patients with inner/central tumours. The K–M rate of contralateral breast cancer (CBC) was also analysed and correlated with IMN RT. Results: Prognostic variables such as tumour size, histological grade, and hormone receptors were not significantly different in the groups having received IMN RT or not. Considering all patients, OS was strictly comparable in the 2 groups: 10-year values were 85% (IMN RT) and 86% (no IMN RT), respective values at 20 years were 66.6% and 61.0% (p = 0.95). However, in patients presenting with inner/central tumours, OS was significantly improved in the IMN RT group with respective values of 92.5% and 87.2% at 10 years, and 80.2% and 63.3% at 20 years: Hazard ratio (HR) = 0.56 (0.37–0.85); p = 0.0052. Again, CSS was improved in patients with inner/central tumours having received IMN RT, with 20-year rates of 89.5% versus 79.1% in patients not receiving IMN RT (p = 0.047). No difference in DFS was noticed. The actuarial rate of CBC development was comparable between patients having received IMN RT and other patients. However, considering only patients

  4. Expected utility with lower probabilities

    DEFF Research Database (Denmark)

    Hendon, Ebbe; Jacobsen, Hans Jørgen; Sloth, Birgitte

    1994-01-01

    An uncertain and not just risky situation may be modeled using so-called belief functions assigning lower probabilities to subsets of outcomes. In this article we extend the von Neumann-Morgenstern expected utility theory from probability measures to belief functions. We use this theory...

  5. Common TNF-alpha, IL-1 beta, PAI-1, uPA, CD14 and TLR4 polymorphisms are not associated with disease severity or outcome from Gram negative sepsis

    DEFF Research Database (Denmark)

    Jessen, Kirstine Marie; Lindboe, Sarah Bjerre; Petersen, Anncatrine Luisa

    2007-01-01

    consecutive adult patients with culture proven Gram negative bacteremia admitted to a Danish hospital between 2000 and 2002. Analysis for commonly described SNPs of tumor necrosis-alpha, (TNF-alpha), interleukin-1 beta (IL-1 beta), plasminogen activator-1 (PAI-1), urokinase plasminogen activator (uPA), CD14...... hazard regression analysis, increasing age, polymicrobial infection and haemoglobin levels were associated with in-hospital mortality. CONCLUSION: We did not find any association between TNF-alpha, IL-1 beta, PAI-1, uPA, CD14 and TLR4 polymorphisms and outcome of Gram negative sepsis. Other host factors...... appear to be more important than the genotypes studied here in determining the severity and outcome of Gram negative sepsis....

  6. Minimal and mild endometriosis negatively impact on pregnancy outcome Endometriose mínima e leve e seu impacto negativo sobre a gravidez

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Pina Carvalho

    2012-10-01

    Full Text Available Endometriosis, a highly prevalent gynecological disease, can lead to infertility in moderate to severe cases. Whether minimal stages are associated with infertility is still unclear. The purpose of this systematic review is to present studies regarding the association between pregnancy rates and the presence of early stages of endometriosis. Studies regarding infertility, minimal (stage I, American Society of Reproductive Medicine [ASRM] and mild (stage II, ASRM endometriosis were identified by searching on the MEDLINE database from 1985 to September 2011 using the following MESH terms: endometriosis; infertility; minimal; mild endometriosis; pregnancy rate. 1188 articles published between January of 1985 and November of 2011 were retrieved; based on their titles, 1038 citations were excluded. Finally, after inclusion and exclusion criteria, 16 articles were selected to be part of this systematic review. Several reasons have been discussed in the literature to explain the impact of minimal endometriosis on fertility outcome, such as: ovulatory dysfunction, impaired folliculogenesis, defective implantation, decrease embryo quality, abnormal immunological peritoneal environment, and luteal phase problems. Despite the controversy involving the topic, the largest randomized control trial, published by Marcoux et al. in 1997 found a statistically different pregnancy rate after resection of superficial endometrial lesions. Earlier stages of endometriosis play a critical role in infertility, and most likely negatively impact pregnancy outcomes. Further studies into stage I endometriosis, especially randomized controlled trials, still need to be conducted.RESUMO O objetivo desta revisão sistemática é apresentar estudos sobre a associação entre as taxas de gravidez e a presença de fases iniciais de endometriose. Estudos relacionados com a infertilidade e estágios mínimos e leves (estágios I,II, American Society of Reproductive Medicine [ASRM

  7. Common Factor Mechanisms in Clinical Practice and Their Relationship with Outcome.

    Science.gov (United States)

    Gaitan-Sierra, Carolina; Hyland, Michael E

    2015-01-01

    This study investigates three common factor mechanisms that could affect outcome in clinical practice: response expectancy, the affective expectation model and motivational concordance. Clients attending a gestalt therapy clinic (30 clients), a sophrology (therapeutic technique) clinic (33 clients) and a homeopathy clinic (31 clients) completed measures of expectancy and the Positive Affect and Negative Affect Schedule (PANAS) before their first session. After 1 month, they completed PANAS and measures of intrinsic motivation, perceived effort and empowerment. Expectancy was not associated with better outcome and was no different between treatments. Although some of the 54 clients who endorsed highest expectations showed substantial improvement, others did not: 19 had no change or deteriorated in positive affect, and 18 had the same result for negative affect. Intrinsic motivation independently predicted changes in negative affect (β = -0.23). Intrinsic motivation (β = 0.24), effort (β = 0.23) and empowerment (β = 0.20) independently predicted positive affect change. Expectancy (β = -0.17) negatively affected changes in positive affect. Clients found gestalt and sophrology to be more intrinsically motivating, empowering and effortful compared with homeopathy. Greater improvement in mood was found for sophrology and gestalt than for homeopathy clients. These findings are inconsistent with response expectancy as a common factor mechanism in clinical practice. The results support motivational concordance (outcome influenced by the intrinsic enjoyment of the therapy) and the affective expectation model (high expectations can lead for some clients to worse outcome). When expectancy correlates with outcome in some other studies, this may be due to confound between expectancy and intrinsic enjoyment. Common factors play an important role in outcome. Intrinsic enjoyment of a therapeutic treatment is associated with better outcome. Active engagement with a

  8. The indirect effect of emotion dysregulation in terms of negative affect and smoking-related cognitive processes.

    Science.gov (United States)

    Johnson, Adrienne L; McLeish, Alison C

    2016-02-01

    Although negative affect is associated with a number of smoking-related cognitive processes, the mechanisms underlying these associations have yet to be examined. The current study sought to examine the indirect effect of emotion regulation difficulties in terms of the association between negative affect and smoking-related cognitive processes (internal barriers to cessation, negative affect reduction smoking motives, negative affect reduction smoking outcome expectancies). Participants were 126 daily cigarette smokers (70.4% male, Mage=36.5years, SD=13.0; 69.8% Caucasian) who smoked an average of 18.5 (SD=8.7) cigarettes per day and reported moderate nicotine dependence. Formal mediation analyses were conducted using PROCESS to examine the indirect effect of negative affect on internal barriers to cessation and negative affect reduction smoking motives and outcome expectancies through emotion regulation difficulties. After accounting for the effects of gender, daily smoking rate, and anxiety sensitivity, negative affect was indirectly related to internal barriers to cessation and negative affect reduction smoking motives through emotion regulation difficulties. There was no significant indirect effect for negative affect reduction smoking outcome expectancies. These findings suggest that greater negative affect is associated with a desire to smoke to reduce this negative affect and perceptions that quitting smoking will be difficult due to negative emotions because of greater difficulties managing these negative emotions. Thus, emotion regulation difficulties may be an important target for smoking cessation interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. When negation is not negation

    OpenAIRE

    Milicevic, Nataša

    2008-01-01

    In this paper I will discuss the formation of different types of yes/no questions in Serbian (examples in (1)), focusing on the syntactically and semantically puzzling example (1d), which involves the negative auxiliary inversion. Although there is a negative marker on the fronted auxiliary, the construction does not involve sentential negation. This coincides with the fact that the negative quantifying NPIs cannot be licensed. The question formation and sentential negation have similar synta...

  10. Predicting problem behaviors with multiple expectancies: expanding expectancy-value theory.

    Science.gov (United States)

    Borders, Ashley; Earleywine, Mitchell; Huey, Stanley J

    2004-01-01

    Expectancy-value theory emphasizes the importance of outcome expectancies for behavioral decisions, but most tests of the theory focus on a single behavior and a single expectancy. However, the matching law suggests that individuals consider expected outcomes for both the target behavior and alternative behaviors when making decisions. In this study, we expanded expectancy-value theory to evaluate the contributions of two competing expectancies to adolescent behavior problems. One hundred twenty-one high school students completed measures of behavior problems, expectancies for both acting out and academic effort, and perceived academic competence. Students' self-reported behavior problems covaried mostly with perceived competence and academic expectancies and only nominally with problem behavior expectancies. We suggest that behavior problems may result from students perceiving a lack of valued or feasible alternative behaviors, such as studying. We discuss implications for interventions and suggest that future research continue to investigate the contribution of alternative expectancies to behavioral decisions.

  11. Negative ion sources

    International Nuclear Information System (INIS)

    Ishikawa, Junzo; Takagi, Toshinori

    1983-01-01

    Negative ion sources have been originally developed at the request of tandem electrostatic accelerators, and hundreds of nA to several μA negative ion current has been obtained so far for various elements. Recently, the development of large current hydrogen negative ion sources has been demanded from the standpoint of the heating by neutral particle beam injection in nuclear fusion reactors. On the other hand, the physical properties of negative ions are interesting in the thin film formation using ions. Anyway, it is the present status that the mechanism of negative ion action has not been so fully investigated as positive ions because the history of negative ion sources is short. In this report, the many mechanisms about the generation of negative ions proposed so far are described about negative ion generating mechanism, negative ion source plasma, and negative ion generation on metal surfaces. As a result, negative ion sources are roughly divided into two schemes, plasma extraction and secondary ion extraction, and the former is further classified into the PIG ion source and its variation and Duoplasmatron and its variation; while the latter into reflecting and sputtering types. In the second half of the report, the practical negative ion sources of each scheme are described. If the mechanism of negative ion generation will be investigated more in detail and the development will be continued under the unified know-how as negative ion sources in future, the development of negative ion sources with which large current can be obtained for any element is expected. (Wakatsuki, Y.)

  12. Personal use of countermeasures seen in a coping perspective. Could the development of expedient countermeasures as a repertoire in the population, optimise coping and promote positive outcome expectancies, when exposed to a contamination threat?

    International Nuclear Information System (INIS)

    Toennessen, A.; Skuterud, L.; Strand, P.; Panova, J.; Travnikova, I.G.; Balonov, M.I.

    1996-01-01

    The appraisal and use of countermeasures in a rural district of Russia with quite high deposition after the Chernobyl accident is studied from a coping perspective. The field work was done during the summer of 1994, in the Bryansk region. There are important methodological shortages in the study, the sample of respondents is not a random sample and therefore not necessarily representative for the villages covered, and in some parts of the questionnaire the frequency of 'don't know/missing' responses is too high. With these limitations in mind the current study tries to expand the knowledge about reactions to diffuse environmental threats by studying populations as they continue their daily lives living in a contaminated area. The data from interviews with the final net sample of 163 respondents shows that about one in four were users of countermeasures such as, refraining from consumption of natural foods, or radiometric inspection of the food. Of the different countermeasures that were included in the questionnaire, the renunciation of natural products was most frequently employed. Findings indicate that the respondents who used countermeasures had lower levels of radiocaesium content in their bodies, they felt more able to influence possible health effects of the accident, and at the same time answered that they were more afraid of possible health effects than the non-users of countermeasures. This higher emotional concern is seen in a perspective of 'realistic anxiety', and the use of countermeasures is related to perceived control and outcome expectancies. (author)

  13. Thermodynamics of negative absolute pressures

    International Nuclear Information System (INIS)

    Lukacs, B.; Martinas, K.

    1984-03-01

    The authors show that the possibility of negative absolute pressure can be incorporated into the axiomatic thermodynamics, analogously to the negative absolute temperature. There are examples for such systems (GUT, QCD) processing negative absolute pressure in such domains where it can be expected from thermodynamical considerations. (author)

  14. Negative mass

    International Nuclear Information System (INIS)

    Hammond, Richard T

    2015-01-01

    Some physical aspects of negative mass are examined. Several unusual properties, such as the ability of negative mass to penetrate any armor, are analysed. Other surprising effects include the bizarre system of negative mass chasing positive mass, naked singularities and the violation of cosmic censorship, wormholes, and quantum mechanical results as well. In addition, a brief look into the implications for strings is given. (paper)

  15. Expression of the hypoxia-inducible monocarboxylate transporter MCT4 is increased in triple negative breast cancer and correlates independently with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Doyen, J. [Department of Radiation Oncology, Centre A. Lacassagne, Nice (France); Trastour, C. [Department of Gynecology, Archet II Hospital, 06202 Nice (France); Ettore, F.; Peyrottes, I.; Toussant, N. [Department of Pathology, Centre A. Lacassagne, Nice (France); Gal, J. [Department of Medical Statistics, Centre A. Lacassagne, Nice (France); Ilc, K.; Roux, D. [Institute for Research on Cancer and Aging (IRCAN), University of Nice, Centre A. Lacassagne, 06189 Nice (France); Parks, S.K. [Centre Scientifique de Monaco (CSM) (Monaco); Ferrero, J.M. [Department of Medical Oncology, Centre A. Lacassagne, Nice (France); Pouysségur, J., E-mail: jacques.pouyssegur@unice.fr [Institute for Research on Cancer and Aging (IRCAN), University of Nice, Centre A. Lacassagne, 06189 Nice (France); Centre Scientifique de Monaco (CSM) (Monaco)

    2014-08-15

    Highlights: • Glycolytic markers are highly expressed in triple negative breast cancers. • Lactate/H{sup +} symporter MCT4 demonstrated the strongest deleterious impact on survival. • MCT4 should serve as a new prognostic factor in node-negative breast cancers. - Abstract: Background: {sup 18}Fluor-deoxy-glucose PET-scanning of glycolytic metabolism is being used for staging in many tumors however its impact on prognosis has never been studied in breast cancer. Methods: Glycolytic and hypoxic markers: glucose transporter (GLUT1), carbonic anhydrase IX (CAIX), monocarboxylate transporter 1 and 4 (MCT1, 4), MCT accessory protein basigin and lactate-dehydrogenase A (LDH-A) were assessed by immunohistochemistry in two cohorts of breast cancer comprising 643 node-negative and 127 triple negative breast cancers (TNBC) respectively. Results: In the 643 node-negative breast tumor cohort with a median follow-up of 124 months, TNBC were the most glycolytic (≈70%), followed by Her-2 (≈50%) and RH-positive cancers (≈30%). Tumoral MCT4 staining (without stromal staining) was a strong independent prognostic factor for metastasis-free survival (HR = 0.47, P = 0.02) and overall-survival (HR = 0.38, P = 0.002). These results were confirmed in the independent cohort of 127 cancer patients. Conclusion: Glycolytic markers are expressed in all breast tumors with highest expression occurring in TNBC. MCT4, the hypoxia-inducible lactate/H{sup +} symporter demonstrated the strongest deleterious impact on survival. We propose that MCT4 serves as a new prognostic factor in node-negative breast cancer and can perhaps act soon as a theranostic factor considering the current pharmacological development of MCT4 inhibitors.

  16. Expectations for a scientific collaboratory

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.

    2003-01-01

    In the past decade, a number of scientific collaboratories have emerged, yet adoption of scientific collaboratories remains limited. Meeting expectations is one factor that influences adoption of innovations, including scientific collaboratories. This paper investigates expectations scientists have...... with respect to scientific collaboratories. Interviews were conducted with 17 scientists who work in a variety of settings and have a range of experience conducting and managing scientific research. Results indicate that scientists expect a collaboratory to: support their strategic plans; facilitate management...... of the scientific process; have a positive or neutral impact on scientific outcomes; provide advantages and disadvantages for scientific task execution; and provide personal conveniences when collaborating across distances. These results both confirm existing knowledge and raise new issues for the design...

  17. Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

    Directory of Open Access Journals (Sweden)

    David P. G. van den Berg

    2016-09-01

    Full Text Available Background: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective: This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method: Therapist-rated (n=16 credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results: Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD in patients with psychotic disorders (n=79, pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions: These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment.

  18. Common TNF-α, IL-1β, PAI-1, uPA, CD14 and TLR4 polymorphisms are not associated with disease severity or outcome from Gram negative sepsis

    Directory of Open Access Journals (Sweden)

    Eugen-Olsen Jesper

    2007-09-01

    Full Text Available Abstract Background Several studies have investigated single nucleotide polymorphisms (SNPs in candidate genes associated with sepsis and septic shock with conflicting results. Only few studies have combined the analysis of multiple SNPs in the same population. Methods Clinical data and DNA from consecutive adult patients with culture proven Gram negative bacteremia admitted to a Danish hospital between 2000 and 2002. Analysis for commonly described SNPs of tumor necrosis-α, (TNF-α, interleukin-1β (IL-1β, plasminogen activator-1 (PAI-1, urokinase plasminogen activator (uPA, CD14 and toll-like receptor 4 (TLR4 was done. Results Of 319 adults, 74% had sepsis, 19% had severe sepsis and 7% were in septic shock. No correlation between severity or outcome of sepsis was observed for the analyzed SNPs of TNF-α, IL-1β, PAI-1, uPA, CD14 or TLR-4. In multivariate Cox proportional hazard regression analysis, increasing age, polymicrobial infection and haemoglobin levels were associated with in-hospital mortality. Conclusion We did not find any association between TNF-α, IL-1β, PAI-1, uPA, CD14 and TLR4 polymorphisms and outcome of Gram negative sepsis. Other host factors appear to be more important than the genotypes studied here in determining the severity and outcome of Gram negative sepsis.

  19. Changing expectations: a longitudinal study of community attitudes toward a nuclear power plant

    International Nuclear Information System (INIS)

    Hughey, J.B.; Lounsbury, J.W.; Sundstrom, E.; Mattingly, T.J. Jr.

    1983-01-01

    Initial and 5-year follow-up interviews were conducted with 213 residents of the host community for a nuclear power plant. The purpose was to determine possible changes in attitudes toward the plant and expectations about potential outcomes associated with construction. Large negative changes in attitudes toward the plant were noted and were accompanied most notably by decreased expectations of positive outcomes. The structure of the expectations remained essentially stable over the 5-year period. Perceptions of hazards, community disruption, and economic benefits as measured early in construction and during peak construction were found to be the best predictors of acceptance of the nuclear plant. Initial expectations were found to predict overall attitude toward the plant 5 years later. Results were discussed in terms of implications for social impact assessment, large-scale community change, and the predictability of community attitudes toward nuclear power plant construction

  20. Expecting the unexpected

    DEFF Research Database (Denmark)

    Mcneill, Ilona M.; Dunlop, Patrick D.; Heath, Jonathan B.

    2013-01-01

    People who live in wildfire-prone communities tend to form their own hazard-related expectations, which may influence their willingness to prepare for a fire. Past research has already identified two important expectancy-based factors associated with people's intentions to prepare for a natural......) and measured actual rather than intended preparedness. In addition, we tested the relation between preparedness and two additional threat-related expectations: the expectation that one can rely on an official warning and the expectation of encountering obstacles (e.g., the loss of utilities) during a fire...

  1. Best Practice Life Expectancy

    DEFF Research Database (Denmark)

    Medford, Anthony

    2017-01-01

    been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value theory. Methods: Extreme value distributions are fit to the time series (1900 to 2012) of maximum life......Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has...... expectancies at birth and age 65, for both sexes, using data from the Human Mortality Database and the United Nations. Conclusions: Generalized extreme value distributions offer a theoretically justified way to model best-practice life expectancies. Using this framework one can straightforwardly obtain...

  2. Negative Leadership

    Science.gov (United States)

    2013-03-01

    Negative Leadership by Colonel David M. Oberlander United States Army United States Army War...SUBTITLE Negative Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Colonel David M...Dr. Richard C. Bullis Department of Command Leadership , and Management 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING

  3. Negative liability

    NARCIS (Netherlands)

    Dari-Mattiacci, G.

    2009-01-01

    Negative and positive externalities pose symmetrical problems to social welfare. The law internalizes negative externalities by providing general tort liability rules. According to such rules, those who cause harm to others should pay compensation. In theory, in the presence of positive

  4. Negative ... concord?

    NARCIS (Netherlands)

    Giannakidou, A

    The main claim of this paper is that a general theory of negative concord (NC) should allow for the possibility of NC involving scoping of a universal quantifier above negation. I propose that Greek NC instantiates this option. Greek n-words will be analyzed as polarity sensitive universal

  5. Characteristics of Helicobacter pylori-positive and Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma and their influence on clinical outcome.

    Science.gov (United States)

    Choi, Yoon Jin; Kim, Nayoung; Paik, Jin Ho; Kim, Jung Mogg; Lee, Sang Hyub; Park, Young Soo; Hwang, Jin-Hyeok; Kim, Jin-Wook; Jeong, Sook-Hyang; Lee, Dong Ho; Jung, Hyun Chae

    2013-06-01

    To compare clinicopathologic and molecular characteristics of low-grade gastric mucosa-associated lymphoid tissue lymphoma depending on Helicobacter pylori positivity and to find out a predictive factor for unresponsiveness to Helicobacter pylori eradication therapy in Korea. A total of 53 Helicobacter pylori-positive and 13 negative mucosa-associated lymphoid tissue lymphoma patients were enrolled, and tissues from 21 patients were investigated to examine the presence of t(11;18)(q21;q21) with fluorescence in situ hybridization. Clinicopathologic features such as the endoscopic appearance, dominant site of lesion, depth of invasion, clinical stage, and the existence of MALT1 gene rearrangement were compared between these two groups. Fifty-six patients who underwent H. pylori eradication therapy were divided into responder and nonresponder groups. The two groups were analyzed to calculate odds ratios for resistance to the eradication. Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma patients averaged a more advanced clinical stage than H. pylori-positive (p = .023) patients. The frequency of t(11;18)/API2-MALT1 did not differ between H. pylori-positive (45.5%) and H. pylori-negative cases (55.6%). Thirty-eight of 51 (74.5%) H. pylori-positive patients achieved complete regression after the eradication, while 2 of 5 (40%) H. pylori-negative patients obtained regression. Presence of lesions in both distal and proximal parts of stomach (p = .041) and bearing of t(11;18)(q21;q21) (p = .007) were predictors for nonresponsiveness for H. pylori eradication. Helicobacter pylori eradication could be performed as a primary therapy regardless of H. pylori status, and assessing t(11;18)/API2-MALT1 would be considered after failure to remission by H. pylori eradication. © 2013 John Wiley & Sons Ltd.

  6. Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3-10 years following knee joint injury in youth sport.

    Science.gov (United States)

    Whittaker, J L; Woodhouse, L J; Nettel-Aguirre, A; Emery, C A

    2015-07-01

    Post-traumatic osteoarthritis (PTOA) commonly affects the knee joint. Although the risk of PTOA substantially increases post-joint injury, there is little research examining PTOA outcomes early in the period between joint injury and disease onset. Improved understanding of this interval would inform secondary prevention strategies aimed at preventing and/or delaying PTOA progression. This study examines the association between sport-related knee injury and outcomes related to development of PTOA, 3-10 years post-injury. This preliminary analysis of the first year of a historical cohort study includes 100 (15-26 years) individuals. Fifty with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age, sex and sport matched controls. The primary outcome was the 'Symptoms' sub-scale of the Knee Osteoarthritis and Injury Outcome Score (KOOS). Secondary outcomes included; the remaining KOOS subscales, body mass index (BMI), hip abductor/adductor and knee extensor/flexor strength, estimated aerobic capacity (VO2max) and performance scores on three dynamic balance tests. Descriptive statistics (mean within-pair difference; 95% Confidence interval (CI) and conditional odds ratio (OR, 95% CI; BMI) were used to compare study groups. Injured participants demonstrated poorer KOOS outcomes [symptoms -9.4 (-13.6, -5.2), pain -4.0 (-6.8, -1.2), quality-of-life -8.0 (-11.0, -5.1), daily living -3.0 (-5.0, -1.1) and sport/recreation -6.9 (-9.9, -3.8)], were 3.75 times (95% CI 1.24, 11.3) more likely to be overweight/obese and had lower triple single leg hop scores compared to controls. No significant group differences existed for remaining balance scores, estimated VO2max, hip or knee strength ratios or side-to-side difference in hip abductor/adductor or quadricep/hamstring strength. This study provides preliminary evidence that youth/young adults following sport-related knee injury report more symptoms and poorer function, and are at

  7. Adolescent expectations of early death predict adult risk behaviors.

    Directory of Open Access Journals (Sweden)

    Quynh C Nguyen

    Full Text Available Only a handful of public health studies have investigated expectations of early death among adolescents. Associations have been found between these expectations and risk behaviors in adolescence. However, these beliefs may not only predict worse adolescent outcomes, but worse trajectories in health with ties to negative outcomes that endure into young adulthood. The objectives of this study were to investigate perceived chances of living to age 35 (Perceived Survival Expectations, PSE as a predictor of suicidal ideation, suicide attempt and substance use in young adulthood. We examined the predictive capacity of PSE on future suicidal ideation/attempt after accounting for sociodemographics, depressive symptoms, and history of suicide among family and friends to more fully assess its unique contribution to suicide risk. We investigated the influence of PSE on legal and illegal substance use and varying levels of substance use. We utilized the National Longitudinal Study of Adolescent Health (Add Health initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II, 2001-02 (Wave III and 2008 (Wave IV; ages 24-32. Compared to those who were almost certain of living to age 35, perceiving a 50-50 or less chance of living to age 35 at Waves I or III predicted suicide attempt and ideation as well as regular substance use (i.e., exceeding daily limits for moderate drinking; smoking ≥ a pack/day; and using illicit substances other than marijuana at least weekly at Wave IV. Associations between PSE and detrimental adult outcomes were particularly strong for those reporting persistently low PSE at both Waves I and III. Low PSE at Wave I or Wave III was also related to a doubling and tripling, respectively, of death rates in young adulthood. Long-term and wide-ranging ties between PSE and detrimental outcomes suggest these expectations may contribute to identifying at-risk youth.

  8. Expectation of recovery from low back pain

    DEFF Research Database (Denmark)

    Kongsted, Alice; Vach, Werner; Axø, Marie

    2014-01-01

    Study Design. A prospective cohort study conducted in general practice (GP) and chiropractic practice (CP).Objectives. To explore which patient characteristics were associated with recovery expectations in low back pain (LBP) patients, whether expectations predicted 3-month outcome, and to what...

  9. Presence of subchondral bone marrow edema at the time of treatment represents a negative prognostic factor for early outcome after autologous chondrocyte implantation

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Salzmann, Gian; Steinwachs, Matthias

    2010-01-01

    INTRODUCTION: Since introduction of autologous chondrocyte implantation (ACI), various factors have been described that influence the clinical outcome. The present paper investigates the influence of bone marrow edema at time of treatment on clinical function before and in the early clinical course...... after ACI. METHODS: 67 patients treated with ACI for cartilage defects of the knee joint were included. Presence of subchondral bone marrow edema was graded as absent (1), mild (2), moderate (3) or severe (4) using magnetic resonance (MR) imaging before surgery. All patients were assessed in terms...... of clinical function before surgery and 6 as well as 12 months after ACI using IKDC and Lysholm scores. Presence of subchondral edema was correlated with functional outcome. RESULTS: In 18 patients edema on initial MRI was graded as "absent", while 17 patients had grade 2 edema, 19 patients had grade 3 edema...

  10. Determining health expectancies

    National Research Council Canada - National Science Library

    Robine, Jean-Marie

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jean-Marie Robine 9 1 Increase in Life Expectancy and Concentration of Ages at Death . . . . France Mesle´ and Jacques Vallin 13 2 Compression of Morbidity...

  11. Immunohistochemical subtypes predict the clinical outcome in high-risk node-negative breast cancer patients treated with adjuvant FEC regimen: results of a single-center retrospective study

    International Nuclear Information System (INIS)

    Rahal, S.; Boher, J M; Extra, J M; Tarpin, C.; Charafe-Jauffret, E.; Lambaudie, E.; Sabatier, R.; Thomassin-Piana, J.; Tallet, A.; Resbeut, M.; Houvenaeghel, G.; Laborde, L.; Bertucci, F.; Viens, P.; Gonçalves, A.

    2015-01-01

    Anthracycline-based adjuvant chemotherapy improves survival in patients with high-risk node-negative breast cancer (BC). In this setting, prognostic factors predicting for treatment failure might help selecting among the different available cytotoxic combinations. Between 1998 and 2008, 757 consecutive patients with node-negative BC treated in our institution with adjuvant FEC (5FU, epirubicin, cyclophosphamide) chemotherapy were identified. Data collection included demographic, clinico-pathological characteristics and treatment information. Molecular subtypes were derived from estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Scarff-Bloom-Richardson (SBR) grade. Disease-free survival (DFS), distant disease-free survival (DDFS) and overall survival (OS) were estimated using the Kaplan-Meier Method, and prognostic factors were examined by multivariate Cox analysis. After a median follow-up of 70 months, the 5-year DFS, DDFS and OS were 90.6 % (95 % confidence interval (CI): 88.2–93.1), 92.8 % (95 % CI: 90.7–95) and 95.1 % (95 % CI, 93.3–96.9), respectively. In the multivariate analysis including classical clinico-pathological parameters, only grade 3 maintained a significant and independent adverse prognostic impact. In an alternative multivariate model where ER, PR and grade were replaced by molecular subtypes, only luminal B/HER2-negative and triple-negative subtypes were associated with reduced DFS and DDFS. Node-negative BC patients receiving adjuvant FEC regimen have a favorable outcome. Luminal B/HER2-negative and triple-negative subtypes identify patients with a higher risk of treatment failure, which might warrant more aggressive systemic treatment. The online version of this article (doi:10.1186/s12885-015-1746-3) contains supplementary material, which is available to authorized users

  12. Self-Verification Strivings in Children Holding Negative Self-Views: The Mitigating Effects of a Preceding Success Experience.

    Science.gov (United States)

    Reijntjes, Albert; Thomaes, Sander; Kamphuis, Jan Henk; de Castro, Bram Orobio; Telch, Michael J

    2010-12-01

    Research among adults has consistently shown that people holding negative self-views prefer negative over positive feedback. The present study tested the hypothesis that this preference is less robust among pre-adolescents, such that it will be mitigated by a preceding positive event. Pre-adolescents (n = 75) holding positive or negative global self-esteem were randomized to a favorable or unfavorable peer evaluation outcome. Next, preferences for positive versus negative feedback were assessed using an unobtrusive behavioral viewing time measure. As expected, results showed that after being faced with the success outcome children holding negative self-views were as likely as their peers holding positive self-views to display a significant preference for positive feedback. In contrast, children holding negative self-views displayed a stronger preference for negative feedback after being faced with the unfavorable outcome that matched their pre-existing self-views.

  13. Understanding the relationship between religiousness, spirituality, and underage drinking: the role of positive alcohol expectancies.

    Science.gov (United States)

    Sauer-Zavala, Shannon; Burris, Jessica L; Carlson, Charles R

    2014-02-01

    Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18-20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality's protective influence on underage drinking is partly due to their influence on expectations about alcohol's positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.

  14. Performance appraisal of expectations

    Directory of Open Access Journals (Sweden)

    Russkikh G.A.

    2016-11-01

    Full Text Available this article provides basic concepts for teachers to estimate and reach planned students’ expectations, describes functions and elements of expectations; nature of external and internal estimate, technology to estimate the results, gives recommendations how to create diagnostic assignments.

  15. Spiking the expectancy profiles

    DEFF Research Database (Denmark)

    Hansen, Niels Chr.; Loui, Psyche; Vuust, Peter

    Melodic expectations are generated with different degrees of certainty. Given distributions of expectedness ratings for multiple continuations of each context, as obtained with the probe-tone paradigm, this certainty can be quantified in terms of Shannon entropy. Because expectations arise from s...

  16. Negative effect of DNA hypermethylation on the outcome of intensive chemotherapy in older patients with high-risk myelodysplastic syndromes and acute myeloid leukemia following myelodysplastic syndrome

    DEFF Research Database (Denmark)

    Grövdal, Michael; Khan, Rasheed; Aggerholm, Anni

    2007-01-01

    was designed to assess the effect of methylation status on the outcome of conventional induction chemotherapy. EXPERIMENTAL DESIGN: Sixty patients with high-risk MDS or acute myeloid leukemia following MDS were treated with standard doses of daunorubicin and 1-beta-d-arabinofuranosylcytosine. Standard.......008), and CDH methylation retained its prognostic value also in the multivariate analysis. Hypermethylation was associated with increased CD34 expression, but not with other known predictive factors for response, such as cytogenetic profile. CONCLUSIONS: We show for the first time a significant effect...

  17. Sub-Saharan African Students’ Experiences, Perceptions, and Expectations with American Health Services: An Intercultural Challenge

    Directory of Open Access Journals (Sweden)

    Claudia L. McCalman

    2009-12-01

    Full Text Available Understanding patients‟ cultural expectations could contribute to better health outcomes and decrease cultural health disparities. This qualitative pilot study objective was to explore experiences, perceptions, and expectations of males and females Angolan students as patients in America. Eighteen face-to-face interviews were conducted at a Midwestern university. Burgoon‟s expectancy violation theory (1991 was the theoretical background. Results revealed as positive expectation violations an advanced technology, quality of services, medicine availability, and emphasis on preventive care. Negative expectation violations included high service costs, complicated insurance system, short medical encounters, and difficulty in building relational history with providers. The study also revealed that culturally related communication barriers as well as negative violations of expectations hinder the quality of intercultural clinical encounters and can affect health outcomes. Participants emphasized the importance of these interpersonal relations and their connection with perceptions of caregivers‟ professional competence. International patients/students revealed that they believe friendliness on the part of the caregiver is a signal that they are dealing with a “good” doctor or nurse. Intercultural competence is an important asset of caregivers who work in multicultural clinics and in college health. Practical implications emerged in international advising and clinician‟s education.

  18. Expectancies as core features of mental disorders.

    Science.gov (United States)

    Rief, Winfried; Glombiewski, Julia A; Gollwitzer, Mario; Schubö, Anna; Schwarting, Rainer; Thorwart, Anna

    2015-09-01

    Expectancies are core features of mental disorders, and change in expectations is therefore one of the core mechanisms of treatment in psychiatry. We aim to improve our understanding of expectancies by summarizing factors that contribute to their development, persistence, and modification. We pay particular attention to the issue of persistence of expectancies despite experiences that contradict them. Based on recent research findings, we propose a new model for expectation persistence and expectation change. When expectations are established, effects are evident in neural and other biological systems, for example, via anticipatory reactions, different biological reactions to expected versus unexpected stimuli, etc. Psychological 'immunization' and 'assimilation', implicit self-confirming processes, and stability of biological processes help us to better understand why expectancies persist even in the presence of expectation violations. Learning theory, attentional processes, social influences, and biological determinants contribute to the development, persistence, and modification of expectancies. Psychological interventions should focus on optimizing expectation violation to achieve optimal treatment outcome and to avoid treatment failures.

  19. Negative CO

    NARCIS (Netherlands)

    Meysman, F.J.R.; Montserrat, F.

    2017-01-01

    Negative emission technologies (NETs) target the removal of carbon dioxide (CO2) from the atmosphere, and are being actively investigated as a strategy to limit global warming to within the 1.5–2°C targets of the 2015 UN climate agreement. Enhanced silicate weathering (ESW) proposes to

  20. Negative Certainty

    Science.gov (United States)

    Ariso, José María

    2017-01-01

    The definitions of "negative knowledge" and the studies in this regard published to date have not considered the categorial distinction Wittgenstein established between knowledge and certainty. Hence, the important role that certainty, despite its omission, should have in these definitions and studies has not yet been shown. In this…

  1. The role of emotion expectancies in adolescents' moral decision making.

    Science.gov (United States)

    Krettenauer, Tobias; Jia, Fanli; Mosleh, Maureen

    2011-02-01

    This study investigated the impact of emotion expectancies on adolescents' moral decision making in hypothetical situations. The sample consisted of 160 participants from three different grade levels (mean age=15.79 years, SD=2.96). Participants were confronted with a set of scenarios that described various emotional outcomes of (im)moral actions and needed to decide what they would do if they were in the protagonist's shoes. Findings demonstrate that emotion expectancies differentially influenced adolescents' hypothetical decision making in antisocial versus prosocial behavioral contexts. Whereas negatively charged self-evaluative emotions over failing to act morally (e.g., guilt) were the strongest predictor for moral choice in antisocial behavioral contexts, positively charged self-evaluative emotions over acting morally (e.g., pride) most strongly predicted moral choice in prosocial contexts. Older adolescents paid greater attention to outcome-oriented emotions that make the decision to act morally less attractive (e.g., regret). Overall, the study suggests that emotion expectancies influence moral decision making in unique and meaningful ways. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Life expectancy and education

    DEFF Research Database (Denmark)

    Hansen, Casper Worm; Strulik, Holger

    2017-01-01

    , we find that US states with higher mortality rates from cardiovascular disease prior to the 1970s experienced greater increases in adult life expectancy and higher education enrollment. Our estimates suggest that a one-standard deviation higher treatment intensity is associated with an increase...... in adult life expectancy of 0.37 years and 0.07–0.15 more years of higher education....

  3. Expected Classification Accuracy

    Directory of Open Access Journals (Sweden)

    Lawrence M. Rudner

    2005-08-01

    Full Text Available Every time we make a classification based on a test score, we should expect some number..of misclassifications. Some examinees whose true ability is within a score range will have..observed scores outside of that range. A procedure for providing a classification table of..true and expected scores is developed for polytomously scored items under item response..theory and applied to state assessment data. A simplified procedure for estimating the..table entries is also presented.

  4. Expected utility without utility

    OpenAIRE

    Castagnoli, E.; Licalzi, M.

    1996-01-01

    This paper advances an interpretation of Von Neumann–Morgenstern’s expected utility model for preferences over lotteries which does not require the notion of a cardinal utility over prizes and can be phrased entirely in the language of probability. According to it, the expected utility of a lottery can be read as the probability that this lottery outperforms another given independent lottery. The implications of this interpretation for some topics and models in decision theory are considered....

  5. Plasma thymidine kinase-1 activity predicts outcome in patients with hormone receptor positive and HER2 negative metastatic breast cancer treated with endocrine therapy.

    Science.gov (United States)

    Bonechi, Martina; Galardi, Francesca; Biagioni, Chiara; De Luca, Francesca; Bergqvist, Mattias; Neumüller, Magnus; Guarducci, Cristina; Boccalini, Giulia; Gabellini, Stefano; Migliaccio, Ilenia; Di Leo, Angelo; Pestrin, Marta; Malorni, Luca

    2018-03-27

    The aim of this study was to investigate if thymidine kinase-1 (TK1), a well-known proliferation marker, could represent a valid circulating biomarker to identify hormone receptor positive (HR+)/HER2 negative (HER2neg) metastatic breast cancer (MBC) patients most likely to benefit from endocrine therapy (ET). We used the DiviTum™ assay to analyze TK1 activity in cell lysates of three HR+/HER2neg BC cell lines and in plasma of 31 HR+/HER2neg MBC patients receiving ET. Blood samples were collected at treatment initiation, after one month and at disease progression. CTCs count and ESR1 / PIK3CA mutations in circulating tumor DNA were performed and correlated with TK1 activity. TK1 activity was reduced in the two endocrine-sensitive cell lines after 2 days of treatment. In patients, high baseline TK1 activity correlated with CTCs positivity (p-value=0.014). Patients with low baseline levels of TK1 activity had a significantly better PFS compared to those with high baseline TK1 activity (p-value=0.012). Patients with an early drop of TK1 activity after one month of treatment had a significantly better PFS compared to those who experienced an increase (p-value=0.0026). Our study suggests that TK1 could be a potential prognostic, predictive and monitoring marker of early ET response in HR+/HER2neg MBC patients.

  6. Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion.

    Science.gov (United States)

    Mel-Hennawi, D; Ahmed, M R

    2015-11-01

    To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion. The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole). In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent). H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.

  7. No negative impact of serum IgG4 levels on clinical outcome in 435 patients with primary sclerosing cholangitis from Japan.

    Science.gov (United States)

    Tanaka, Atsushi; Tazuma, Susumu; Nakazawa, Takahiro; Isayama, Hiroyuki; Tsuyuguchi, Toshio; Inui, Kazuo; Takikawa, Hajime

    2017-04-01

    Several studies have demonstrated that elevated serum IgG4 levels are associated with poor outcomes of primary sclerosing cholangitis (PSC), but the impact of serum IgG4 levels on PSC remains controversial. In this study, we aimed to determine prognostic factors of patients with PSC and to investigate the association between serum IgG4 levels and the clinical features and prognosis of PSC in a Japanese cohort. We retrospectively analyzed follow-up data for 435 patients with PSC (UMIN000018438). Patients with distinct etiologies of sclerosing cholangitis including IgG4-related sclerosing cholangitis (IgG4-SC) were excluded from this study. Serum IgG4 levels were tested at the time of diagnosis in 216 of 435 patients with PSC, and were elevated in 27 patients (>134 mg/dl, 12.5%). Clinical features at diagnosis were comparable between patients with normal and elevated serum IgG4 levels, with the exception of serum albumin. The overall and liver-transplantation free survival rate was comparable between the groups. Multivariate analysis indicated that age, albumin, and bilirubin, but not IgG4, at the time of diagnosis affected PSC prognosis. The current study showed that serum IgG4 levels at diagnosis do not affect PSC prognosis in a Japanese cohort that excluded patients with IgG4-SC. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  8. Impact of HIV exposure on health outcomes in HIV-negative infants born to HIV-positive mothers in Sub-Saharan Africa.

    Science.gov (United States)

    Moraleda, Cinta; de Deus, Nilsa; Serna-Bolea, Celia; Renom, Montse; Quintó, Llorenç; Macete, Eusebio; Menéndez, Clara; Naniche, Denise

    2014-02-01

    Up to 30% of infants may be HIV-exposed noninfected (ENI) in countries with high HIV prevalence, but the impact of maternal HIV on the child's health remains unclear. One hundred fifty-eight HIV ENI and 160 unexposed (UE) Mozambican infants were evaluated at 1, 3, 9, and 12 months postdelivery. At each visit, a questionnaire was administered, and HIV DNA polymerase chain reaction and hematologic and CD4/CD8 determinations were measured. Linear mixed models were used to evaluate differences in hematologic parameters and T-cell counts between the study groups. All outpatient visits and admissions were registered. ENI infants received cotrimoxazol prophylaxis (CTXP). Negative binomial regression models were estimated to compare incidence rates of outpatient visits and admissions. Hematocrit was lower in ENI than in UE infants at 1, 3, and 9 months of age (P = 0.024, 0.025, and 0.012, respectively). Percentage of CD4 T cells was 3% lower (95% confidence interval: 0.86 to 5.15; P = 0.006) and percentage of CD8 T cells 1.15 times higher (95% confidence interval: 1.06 to 1.25; P = 0.001) in ENI vs. UE infants. ENI infants had a lower weight-for-age Z score (P = 0.049) but reduced incidence of outpatient visits, overall (P = 0.042), diarrhea (P = 0.001), and respiratory conditions (P = 0.042). ENI children were more frequently anemic, had poorer nutritional status, and alterations in some immunologic profiles compared with UE children. CTXP may explain their reduced mild morbidity. These findings may reinforce continuation of CTXP and the need to understand the consequences of maternal HIV exposure in this vulnerable group of children.

  9. The lack of negative outcome of Chernobyl accident in infants born between 26 April and 5 May 1986 in central Poland

    International Nuclear Information System (INIS)

    Lenartowska, I.; Oltarzewski, M.; Lisewska, I.; Staroszczyk, B.

    1991-01-01

    The Institute of Mother and Child was invited in 1988 by professor J.Nauman to his Chernobyl program, so as to inspect children born after Chernobyl accident, particularly these born in first days following the accident dated 26 April 1986. The central part of Poland is covered with screening for congenital PKU and hypothyroidism therefore all children had estimated TSH-spot levels between 3rd and 5th day of life. So as to control the present state of general health and thyroid state in the study group a questionnaire with a letter to parents explaining the aim of the inquiry was sent. About 14000 letters were send from which around 12000 responses were returned to the Institute. From information received this way we draw the preliminary conclusion that no significant damage in health of these children or their siblings can be found. About 20% of the mothers admitted taking the Lugol solution in a last day of pregnancy. However it should be taken into account that these data were collected 2 years after the accident and are not fully reliable. In the period 1989-1990 a group of 1912 children (938 boys and 974 girls) was called to the Department of Endocrinology of the Institute and inspected. The age was from 2.9 to 4.2 years. All children had screening TSH-spot test result negative (below 30 μIU/ml). In the study group of 1912 children inspected no significant changes in thyroid state or general health state was found which could be connected with the Chernobyl accident. (author). 5 tabs

  10. Major depressive disorder and suicidality in early HIV infection and its association with risk factors and negative outcomes as seen in semi-urban and rural Uganda.

    Science.gov (United States)

    Kinyanda, Eugene; Nakasujja, Noeline; Levin, Jonathan; Birabwa, Harriet; Mpango, Richard; Grosskurth, Heiner; Seedat, Soraya; Patel, Vikram

    2017-04-01

    There is a paucity of research into the psychiatric problems associated with early stage HIV clinical disease in sub-Saharan Africa. A cross sectional study was undertaken among 899 adult ART naïve persons in early stage HIV clinical disease (participants with CD4≥250 and who were at WHO clinical Stage I or II) attending a semi-urban and a rural clinic in Uganda. The prevalence of major depressive disorder in this study was 14.0% [95% CI 11.7-6.3%] while that of 'moderate to high risk for suicidality' was 2.8% [95% CI 1.7%; 3.9%]. Multivariable analyses found that factors in the socio-demographic, vulnerability/protective and stress (only for major depressive disorder) domains were significantly associated with both major depressive disorder and 'moderate to high risk for suicidality'. Major depressive disorder but not 'moderate to high risk for suicidality' was significantly associated with impaired psychosocial functioning, greater utilisation of health services and non-adherence to septrin/dasone. Neither major depressive disorder nor 'moderate to high risk for suicidality' was associated with CD4 counts, risky sexual behaviour nor with non-utilisation of condoms. The bidirectional nature of some of the relationships between the investigated psychiatric problems, risk factors and outcomes in this cross sectional study makes it difficult to elucidate the actual direction of causality. Early stage HIV clinical disease is associated with considerable major depressive disorder and 'moderate to high risk for suicidality'. Therefore there is a need to integrate mental health into HIV interventions that target early stage HIV disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Sex and life expectancy.

    Science.gov (United States)

    Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J

    2012-12-01

    A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the

  12. Anomalous vacuum expectation values

    International Nuclear Information System (INIS)

    Suzuki, H.

    1986-01-01

    The anomalous vacuum expectation value is defined as the expectation value of a quantity that vanishes by means of the field equations. Although this value is expected to vanish in quantum systems, regularization in general produces a finite value of this quantity. Calculation of this anomalous vacuum expectation value can be carried out in the general framework of field theory. The result is derived by subtraction of divergences and by zeta-function regularization. Various anomalies are included in these anomalous vacuum expectation values. This method is useful for deriving not only the conformal, chiral, and gravitational anomalies but also the supercurrent anomaly. The supercurrent anomaly is obtained in the case of N = 1 supersymmetric Yang-Mills theory in four, six, and ten dimensions. The original form of the energy-momentum tensor and the supercurrent have anomalies in their conservation laws. But the modification of these quantities to be equivalent to the original one on-shell causes no anomaly in their conservation laws and gives rise to anomalous traces

  13. Social cognitive determinants of nutrition and physical activity among web-health users enrolling in an online intervention: the influence of social support, self-efficacy, outcome expectations, and self-regulation.

    Science.gov (United States)

    Anderson-Bill, Eileen Smith; Winett, Richard A; Wojcik, Janet R

    2011-03-17

    had good self-efficacy and outcome expectations for health behavior change; however, they perceived little social support for making these changes and engaged in few self-regulatory behaviors. Consistent with SCT, theoretical models provided good fit to Web-users' data (root mean square error of the approximation [RMSEA] social support and use of self-regulatory behaviors were strong predictors of physical activity and nutrition behavior. Web users' self-efficacy was also a good predictor of healthier levels of physical activity and dietary fat but not of fiber, fruits, and vegetables. Social support and self-efficacy indirectly predicted behavior through self-regulation, and social support had indirect effects through self-efficacy. Results suggest Web-health users visiting and ultimately participating in online health interventions may likely be middle-aged, well-educated, upper middle class women whose detrimental health behaviors put them at risk of obesity, heart disease, some cancers, and diabetes. The success of Internet physical activity and nutrition interventions may depend on the extent to which they lead users to develop self-efficacy for behavior change, but perhaps as important, the extent to which these interventions help them garner social-support for making changes. Success of these interventions may also depend on the extent to which they provide a platform for setting goals, planning, tracking, and providing feedback on targeted behaviors.

  14. Expectations in patients with total knee arthroplasty.

    Science.gov (United States)

    Tekin, Burcu; Unver, Bayram; Karatosun, Vasfi

    2012-01-01

    The primary objective of total knee arthroplasty (TKA) is to decrease pain and restore functional knee joint. Current hypotheses indicate higher knee flexion is required in terms of life style, culture and expectations in Eastern communities. Therefore, society-specific features related to life style and cultural habits are needed. The objective of this study was to investigate the expectations of patients undergoing TKA. The study included 131 patients (18 male, 113 female; mean age: 66.2 ± 8.3 years) who underwent cemented TKA due to knee osteoarthritis. All patients were operated by the same surgeon using the same implant and surgical technique. Patients were evaluated using the Hospital for Special Surgery (HSS) knee score, a 15-item clinical knee assessment questionnaire and the HSS knee arthroplasty expectation questionnaire. Mean HSS score for the right knee was 89.2 ± 10.5 and for the left knee was 89.6 ± 9.4. The two most expected outcomes were improvements in pain (99.2%) and gait (96.2%) and the two least expected outcomes were improvements in psychological well-being (22.9%) and communicative skills (35.1%). Expectations were not affected by education and working conditions. Patients' most expected outcomes were improvement in pain and restoration of function (gait, climbing stairs and no need of assistive devices), similar to Western and American communities.

  15. Price expectations and petroleum development

    International Nuclear Information System (INIS)

    Pollio, G.; Marian, W.S.

    1991-01-01

    In the first section of this paper, the authors present a highly stylized model of the world oil market that explicitly incorporates both expectative and financial effects. The model generates the extremely interesting result that actual future price outcomes are inversely related to prevailing price expectations, owing to fluctuation in the level and timing of industry investment expenditure. Given the importance of price expectations, it is surprising that the topic has received such scant attention. The authors therefore present in the second section of selective survey of the various measures that have been proposed and used in the literature, as well as an assessment of the value of potentially new indices and market prices for existing hydrocarbon reserves, for example. In the final section of the paper, we discuss the extent to which financial innovation, in the form of commodity-linked products-such as swaps, caps, collars, and so forth-are transforming the oil market, enabling all market segments to manage price uncertainty far more effectively than was ever possible in the past

  16. Performance expectation plan

    Energy Technology Data Exchange (ETDEWEB)

    Ray, P.E.

    1998-09-04

    This document outlines the significant accomplishments of fiscal year 1998 for the Tank Waste Remediation System (TWRS) Project Hanford Management Contract (PHMC) team. Opportunities for improvement to better meet some performance expectations have been identified. The PHMC has performed at an excellent level in administration of leadership, planning, and technical direction. The contractor has met and made notable improvement of attaining customer satisfaction in mission execution. This document includes the team`s recommendation that the PHMC TWRS Performance Expectation Plan evaluation rating for fiscal year 1998 be an Excellent.

  17. Behavior, Expectations and Status

    Science.gov (United States)

    Webster, Jr, Murray; Rashotte, Lisa Slattery

    2010-01-01

    We predict effects of behavior patterns and status on performance expectations and group inequality using an integrated theory developed by Fisek, Berger and Norman (1991). We next test those predictions using new experimental techniques we developed to control behavior patterns as independent variables. In a 10-condition experiment, predictions…

  18. Life Expectancy in 2040

    DEFF Research Database (Denmark)

    Canudas-Romo, Vladimir; DuGoff, Eva H; Wu, Albert W.

    2016-01-01

    We use expert clinical and public health opinion to estimate likely changes in the prevention and treatment of important disease conditions and how they will affect future life expectancy. Focus groups were held including clinical and public health faculty with expertise in the six leading causes...

  19. Telaah Kritis Expectancy Theory Victor Harold Vroom

    OpenAIRE

    Anatan, Lina

    2010-01-01

    Expectancy theory has emerge as the dominant process theory of motivation, originally developed by Vroom is a theory explaining the process individual use to make decision on a various behavioral alternatives. The motivational force for a behavior, action, or task is a function of three distinctive perceptions: expectancy, instrumentality, and valance. The theory contains of two models: for the precition of valance of an outcome, and the other for the prediction of force toward behavior. It p...

  20. Converting customer expectations into achievable results.

    Science.gov (United States)

    Landis, G A

    1999-11-01

    It is not enough in today's environment to just meet customers' expectations--we must exceed them. Therefore, one must learn what constitutes expectations. These needs have expanded during the past few years from just manufacturing the product and looking at the outcome from a provincial standpoint. Now we must understand and satisfy the entire supply chain. To manage this process and satisfy the customer, the process now involves the supplier, the manufacturer, and the entire distribution system.

  1. Cannabis expectancies in substance misusers: French validation of the Marijuana Effect Expectancy Questionnaire.

    Science.gov (United States)

    Guillem, Eric; Notides, Christine; Vorspan, Florence; Debray, Marcel; Nieto, Isabel; Leroux, Mayliss; Lépine, Jean-Pierre

    2011-01-01

    The aim of this study was to evaluate the psychometric properties of the French version of the Marijuana Effect Expectancy Questionnaire (48 items) and study the cannabis expectancies according to the patterns of substance use and psychiatric disorders (DSM-IV). A sample of 263 subjects (average age 33.1 years [SD = 8.7], 56% men) consisting of cannabis users (n = 64), psychiatric inpatients (n = 175, most of whom were hospitalized for withdrawal), and a control group (n = 24) completed the questionnaire. Internal reliability was good (α= .87) and temporal reliability was satisfactory, with 24 of 48 items having a significant κ ≥ .41. Factor analysis showed four main factors that explained 42.1% of the total variance. The women feared Cognitive Impairment and Negative Effects, and Negative Behavioral Effects more than the men. The onset age of cannabis use, onset age of abuse, abuse and dependence were associated with fewer negative expectancies. Cannabis dependents differed from abusers by more Relaxation and Social Facilitation expectancies. Patients with major depressive episodes, panic disorder, social anxiety disorder, or posttraumatic stress disorder feared negative effects the most. Schizophrenic patients expected more Perceptual Enhancement and Craving. The French version of the Marijuana Effect Expectancy Questionnaire has good psychometric properties and is valid to assess cannabis expectancies in adolescents and adults with substance use disorders. Copyright © American Academy of Addiction Psychiatry.

  2. Wages, Amenities and Negative Attitudes

    DEFF Research Database (Denmark)

    Waisman, Gisela; Larsen, Birthe

    We exploit the regional variation in negative attitudes towards immigrants to Sweden in order to analyse the consequences of the attitudes on immigrants welfare. We find that attitudes towards immigrants are of importance: they both affect their labour market outcomes and their quality of life. We...... interpret the negative effect on wages as evidence of labour market discrimination. We estimate the welfare effects of negative attitudes, through their wage and local amenities, for immigrants with different levels of skills, origin, gender and age....

  3. Treatment Outcomes from 68Ga-PSMA PET/CT-Informed Salvage Radiation Treatment in Men with Rising PSA After Radical Prostatectomy: Prognostic Value of a Negative PSMA PET.

    Science.gov (United States)

    Emmett, Louise; van Leeuwen, Pim J; Nandurkar, Rohan; Scheltema, Matthijs J; Cusick, Thomas; Hruby, George; Kneebone, Andrew; Eade, Thomas; Fogarty, Gerald; Jagavkar, Raj; Nguyen, Quoc; Ho, Bao; Joshua, Anthony M; Stricker, Phillip

    2017-12-01

    68 Ga-PSMA (prostate-specific membrane antigen) PET/CT is increasingly used in men with prostate-specific antigen (PSA) failure after radical prostatectomy (RP) to triage those who will benefit from salvage radiation treatment (SRT). This study examines the value of PSMA-informed SRT in improving treatment outcomes in the context of biochemical failure after RP. Methods: We analyzed men with rising PSA after RP with PSA readings between 0.05 and 1.0 ng/mL, considered eligible for SRT at the time of PSMA. For each patient, clinical and pathologic features as well as scan results, including site of PSMA-positive disease, number of lesions, and a certainty score, were documented. Subsequent management, including SRT, and most recent PSA were recorded using medical records. Treatment response was defined as both PSA ≤ 0.1 ng/mL and >50% reduction in PSA. Multivariate logistic regression analysis was performed for association of clinical variables and treatment response to SRT. Results: One hundred sixty-four men were included. PSMA was positive in 62% ( n = 102/164): 38 of 102 in the prostatic fossa, 41 of 102 in pelvic nodes, and 23 of 102 distantly. Twenty-four patients received androgen-deprivation therapy (ADT) and were excluded for outcomes analysis. In total, 99 of 146 received SRT with a median follow-up after radiation treatment of 10.5 mo (interquartile range, 6-14 mo). Overall treatment response after SRT was 72% ( n = 71/99). Forty-five percent ( n = 27/60) of patients with a negative PSMA underwent SRT whereas 55% (33/60) did not. In men with a negative PSMA who received SRT, 85% ( n = 23/27) demonstrated a treatment response, compared with a further PSA increase in 65% (22/34) in those not treated. In 36 of 99 patients with disease confined to the prostate fossa on PSMA, 81% ( n = 29/36) responded to SRT. In total, 26 of 99 men had nodal disease on PSMA, of whom 61% ( n = 16/26) had treatment response after SRT. On multivariate logistic regression

  4. Spiking the expectancy profiles

    DEFF Research Database (Denmark)

    Hansen, Niels Chr.; Loui, Psyche; Vuust, Peter

    Melodic expectations have long been quantified using expectedness ratings. Motivated by statistical learning and sharper key profiles in musicians, we model musical learning as a process of reducing the relative entropy between listeners' prior expectancy profiles and probability distributions...... of a given musical style or of stimuli used in short-term experiments. Five previous probe-tone experiments with musicians and non-musicians are revisited. Exp. 1-2 used jazz, classical and hymn melodies. Exp. 3-5 collected ratings before and after exposure to 5, 15 or 400 novel melodies generated from...... a finite-state grammar using the Bohlen-Pierce scale. We find group differences in entropy corresponding to degree and relevance of musical training and within-participant decreases after short-term exposure. Thus, whereas inexperienced listeners make high-entropy predictions by default, statistical...

  5. Chinese students' great expectations

    DEFF Research Database (Denmark)

    Thøgersen, Stig

    2013-01-01

    The article focuses on Chinese students' hopes and expectations before leaving to study abroad. The national political environment for their decision to go abroad is shaped by an official narrative of China's transition to a more creative and innovative economy. Students draw on this narrative to...... system, they think of themselves as having a role in the transformation of Chinese attitudes to education and parent-child relations....

  6. Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers.

    Science.gov (United States)

    Garey, Lorra; Taha, Samar A; Kauffman, Brooke Y; Manning, Kara F; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

    2017-10-01

    Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N=182; 53.3% female; M age =40.67; SD=13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR=0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR=1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Maternal expectations and postpartum emotional adjustment in first-time mothers: results of a questionnaire survey.

    Science.gov (United States)

    Henshaw, Erin J; Fried, Rachel; Teeters, Jenni Beth; Siskind, Emily E

    2014-09-01

    Several predictors of postpartum mood have been identified in the literature, but the role of maternal expectations in postpartum mental health remains unclear. The aim of this study was to identify whether maternal expectations during the postpartum hospital stay predict adjustment and depressive symptoms at 6 weeks postpartum. The sample included 233 first-time mothers recruited from the postpartum unit of a Midwestern hospital. Participants completed measures of maternal expectations and depressive symptoms (EPDS) at Time 1 (2 d postpartum) and completed EPDS and an Emotional Adjustment Scale (BaM-13) at Time 2 (6 weeks postpartum). A conditional relationship between the expectation that an infant's behavior will reflect maternal skill and Time 2 outcomes (BaM-13 and EPDS) was found, such that endorsing this belief predicted increased depression and poorer adjustment in those with higher (but not lower) Time 1 EPDS scores. Time 2 BaM-13 scores were also negatively predicted by expectations of self-sacrifice and positively predicted by expectations that parenthood would be naturally fulfilling. The expectations that new mothers hold about parenting soon after delivery are predictive of emotional adjustment in the early postpartum period, suggesting a role for discussion of expectations in future preventive strategies.

  8. Selfie Expectancies Among Adolescents: Construction and Validation of an Instrument to Assess Expectancies Toward Selfies Among Boys and Girls

    Directory of Open Access Journals (Sweden)

    Valentina Boursier

    2018-05-01

    Full Text Available Selfie-taking and posting is one of the most popular activities among teenagers, an important part of online self-presentation that is related to identity issues and peer relations. The scholarly literature emphasizes different yet conflicting motivations for selfie-behavior, stressing deeper analysis of psychological factors and the influence of gender and age. Expectancies are “explanatory device[s]” that can help us study adolescent behavior. However, no instruments have been devised that specifically explore the expectations teenagers have about selfies and their influence on selfie-frequency. The current study proposes a short and reliable instrument to identify teen expectancies about selfie-behavior. This instrument was validated using a sample of 646 Italian adolescents (14 to 19 years old by means of Exploratory Factor Analysis (EFA and Confirmatory Factor Analysis (CFA. We also explore the relationship between selfie expectancies and selfie-frequency, as well as the role of gender in shaping selfies. Our results point toward a 7-factor model that characterizes expectations toward selfies as a multi-dimensional construct linked to both positive and negative perceptions of the nature and consequences of selfies. The overall model fitted the data sufficiently (χ2 = 5067.051, p 0.0000; CFI = 0.962; TLI = 0.954; RMSEA ≤ 0.05: 0.035; SRMR = 0.046, showing an adequate reliability of the scale (α = 0.830. Bivariate correlations between selfie expectancies and selfie-frequency (r = 0.338, p < 0.001 confirmed the convergent validity of the tool. Selfie-sharing is a common practice that is widespread among the participants in this study. Self-promotion represents a positive function of selfies. Selfies promote self-presentation and self-confidence, both in boys and girls. Moreover, selfie expectancies address sexual self-attractiveness, especially among boys. Despite the positive aspects of selfies, our results stress adolescent awareness

  9. Patch test study of 90 patients with tattoo reactions: negative outcome of allergy patch test to baseline batteries and culprit inks suggests allergen(s) are generated in the skin through haptenization.

    Science.gov (United States)

    Serup, Jørgen; Hutton Carlsen, Katrina

    2014-11-01

    Tattoo reactions, especially in red tattoos, are often suggested as allergic in nature, however, systematic evaluation by patch testing has not performed in the past. To report the results of patch testing in 90 patients with non-infectious chronic tattoo reactions. From 2009 to 2013 at the 'Tattoo Clinic', Department of Dermatology, Bispebjerg University Hospital, 90 patients were patch tested with batteries of baseline allergens, disperse dyes/textile allergens, and a selection of tattoo ink stock products, which, according to case observations, were problematic, supplemented with individual culprit inks when accessible. Patients with reactions to the tattoo colour red, the most predominant colour associated with skin reactions, showed negative patch test results with common allergens. Outcomes were also negative in patients who had experienced concomitant reactions in another hitherto tolerated tattoo of the same colour as the problematic tattoo. The allergen or allergens responsible for tattoo reactions are not present directly in tattoo ink stock products. This is despite the fact that clinical histories suggest that the vast majority of clinical reactions, especially reactions to red and red nuances, are likely to be allergic events caused by the injected inks. We suggest that the responsible allergen results from a complicated and slow process of haptenization, which may even include photochemical cleavage of red azo pigment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Expected Term Structures

    DEFF Research Database (Denmark)

    Buraschi, Andrea; Piatti, Ilaria; Whelan, Paul

    We construct and study the cross-sectional properties of survey-based bond risk premia and compare them to their traditional statistical counterparts. We document large heterogeneity in skill, identify top forecasters, and learn about the importance of subjective risk premia in long-term bonds...... dynamics. The consensus is not a sufficient statistics of the cross-section of expectations and we propose an alternative real-time aggregate measure of risk premia consistent with Friedmans market selection hypothesis. We then use this measure to evaluate structural models and find support...

  11. Referral expectations of radiology

    International Nuclear Information System (INIS)

    Smith, W.L.; Altmaier, E.; Berberoglu, L.; Morris, K.

    1989-01-01

    The expectation of the referring physician are key to developing a successful practice in radiology. Structured interviews with 17 clinicians in both community care and academic practice documented that accuracy of the radiologic report was the single most important factor in clinician satisfaction. Data intercorrelation showed that accuracy of report correlated with frequency of referral (r = .49). Overall satisfaction of the referring physician with radiology correlated with accuracy (r = .69), patient satisfaction (r = .36), and efficiency in archiving (r = .42). These data may be weighted by departmental managers to allocate resources for improving referring physician satisfaction

  12. Outcomes of critically ill intensive care unit patients treated with fosfomycin for infections due to pandrug-resistant and extensively drug-resistant carbapenemase-producing Gram-negative bacteria.

    Science.gov (United States)

    Pontikis, Konstantinos; Karaiskos, Ilias; Bastani, Styliani; Dimopoulos, George; Kalogirou, Michalis; Katsiari, Maria; Oikonomou, Angelos; Poulakou, Garyphallia; Roilides, Emmanuel; Giamarellou, Helen

    2014-01-01

    Fosfomycin is active in vitro against extensively drug-resistant (XDR) and pandrug-resistant (PDR) Pseudomonas aeruginosa and Klebsiella pneumoniae carbapenemase-producing strains; however, the in vivo effectiveness against such pathogens is almost unknown. A multicentre, observational, prospective case-series study was performed in 11 ICUs. All consecutive fosfomycin-treated patients suffering from XDR or PDR fosfomycin-susceptible, microbiologically documented infections were recorded. Clinical and microbiological outcomes were assessed. A safety analysis was performed. In total, 68 patients received fosfomycin during the study period, 48 of whom were considered suitable for effectiveness analysis based on predefined criteria. Bacteraemia and ventilator-associated pneumonia were the main infections. Carbapenemase-producing K. pneumoniae and P. aeruginosa were isolated in 41 and 17 cases, respectively. All isolates exhibited an XDR or PDR profile, being fosfomycin-susceptible by definition. Fosfomycin was administered intravenously at a median dose of 24g/day for a median of 14 days, mainly in combination with colistin or tigecycline. Clinical outcome at Day 14 was successful in 54.2% of patients, whilst failure, indeterminate outcome and superinfection were documented in 33.3%, 6.3% and 6.3%, respectively. All-cause mortality at Day 28 was 37.5%. Bacterial eradication was observed in 56.3% of cases. Fosfomycin resistance developed in three cases. The main adverse event was reversible hypokalaemia. In conclusion, fosfomycin could have a place in the armamentarium against XDR and PDR Gram-negative infections in the critically ill. Resistance development during therapy, which has been a matter of concern in previous studies, did not occur frequently. The necessity of combination with other antibiotics requires further investigation. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  13. Probability via expectation

    CERN Document Server

    Whittle, Peter

    1992-01-01

    This book is a complete revision of the earlier work Probability which ap­ peared in 1970. While revised so radically and incorporating so much new material as to amount to a new text, it preserves both the aim and the approach of the original. That aim was stated as the provision of a 'first text in probability, de­ manding a reasonable but not extensive knowledge of mathematics, and taking the reader to what one might describe as a good intermediate level'. In doing so it attempted to break away from stereotyped applications, and consider applications of a more novel and significant character. The particular novelty of the approach was that expectation was taken as the prime concept, and the concept of expectation axiomatized rather than that of a probability measure. In the preface to the original text of 1970 (reproduced below, together with that to the Russian edition of 1982) I listed what I saw as the advantages of the approach in as unlaboured a fashion as I could. I also took the view that the text...

  14. Gender Roles and Expectations

    Directory of Open Access Journals (Sweden)

    Susana A. Eisenchlas

    2013-09-01

    Full Text Available One consequence of the advent of cyber communication is that increasing numbers of people go online to ask for, obtain, and presumably act upon advice dispensed by unknown peers. Just as advice seekers may not have access to information about the identities, ideologies, and other personal characteristics of advice givers, advice givers are equally ignorant about their interlocutors except for the bits of demographic information that the latter may offer freely. In the present study, that information concerns sex. As the sex of the advice seeker may be the only, or the predominant, contextual variable at hand, it is expected that that identifier will guide advice givers in formulating their advice. The aim of this project is to investigate whether and how the sex of advice givers and receivers affects the type of advice, through the empirical analysis of a corpus of web-based Spanish language forums on personal relationship difficulties. The data revealed that, in the absence of individuating information beyond that implicit in the advice request, internalized gender expectations along the lines of agency and communality are the sources from which advice givers draw to guide their counsel. This is despite the trend in discursive practices used in formulating advice, suggesting greater language convergence across sexes.

  15. ATLAS: Exceeding all expectations

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    “One year ago it would have been impossible for us to guess that the machine and the experiments could achieve so much so quickly”, says Fabiola Gianotti, ATLAS spokesperson. The whole chain – from collision to data analysis – has worked remarkably well in ATLAS.   The first LHC proton run undoubtedly exceeded expectations for the ATLAS experiment. “ATLAS has worked very well since the beginning. Its overall data-taking efficiency is greater than 90%”, says Fabiola Gianotti. “The quality and maturity of the reconstruction and simulation software turned out to be better than we expected for this initial stage of the experiment. The Grid is a great success, and right from the beginning it has allowed members of the collaboration all over the world to participate in the data analysis in an effective and timely manner, and to deliver physics results very quickly”. In just a few months of data taking, ATLAS has observed t...

  16. Satisfactory functional and radiological outcomes can be expected in young patients under 45 years old after open wedge high tibial osteotomy in a long-term follow-up.

    Science.gov (United States)

    Hantes, Michael E; Natsaridis, Prodromos; Koutalos, Antonios A; Ono, Yohei; Doxariotis, Nikolaos; Malizos, Konstantinos N

    2017-11-30

    To report the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis in patients younger than 45 years old. It was hypothesized that the correction of knee alignment would result in preservation of knee function in a long-term follow-up. Patients under 45 years old, who underwent MOWHTO for symptomatic medial compartment knee osteoarthritis between 2001 and 2005 were retrospectively reviewed after a minimum of 10 years. The osteotomy was performed utilizing a locking plate without the use of bone graft. Patients were evaluated pre- and postoperatively using the International Knee Documentation Committee Score, the Oxford Knee Score, the Knee injury Osteoarthritis Outcome Score and the Short Form-12 Score. Standardized standing whole-limb radiographs were also obtained to assess mechanical tibiofemoral angle (mTFA) and the grade of osteoarthritis. A total of 20 patients (18 males, 2 females, mean age 35.4 years) with a mean follow-up of 12.3 years were included in the study. During the follow-up period, one patient required conversion to total knee replacement (95% survival rate). All clinical outcome scores (IKDC, KOOS, OKS, and SF-12) significantly improved postoperatively (p satisfactory and the survival rate is 95%, 12 years after the procedure. Level IV therapeutic, retrospective, cohort study.

  17. Training Therapists about Client Expectations of Psychotherapy.

    Science.gov (United States)

    Soley, Georgia; Marshall, Renee; Chambliss, Catherine

    Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…

  18. Harnessing placebo effects by targeting expectancies

    NARCIS (Netherlands)

    Peerdeman, K.J.

    2018-01-01

    Placebo effects are health improvements, for example pain reduction, due to an inert treatment. These effects are typically ascribed to a person’s expectations about the beneficial outcomes of the placebo. The literature and experimental research in the current dissertation shows that

  19. Positive expectations encourage generalization from a positive intergroup interaction to outgroup attitudes.

    Science.gov (United States)

    Deegan, Matthew P; Hehman, Eric; Gaertner, Samuel L; Dovidio, John F

    2015-01-01

    The current research reveals that while positive expectations about an anticipated intergroup interaction encourage generalization of positive contact to outgroup attitudes, negative expectations restrict the effects of contact on outgroup attitudes. In Study 1, when Blacks and Whites interacted with positive expectations, interaction quality predicted outgroup attitudes to a greater degree than when groups interacted with negative expectations. When expectations (Studies 2 and 3) and the actual interaction quality (Study 4) were manipulated orthogonally, negative expectations about the interaction predicted negative outgroup attitudes, regardless of actual interaction quality. By contrast, participants holding positive expectations who experienced a positive interaction expressed positive outgroup attitudes, whereas when they experienced a negative interaction, they expressed outgroup attitudes as negative as those with negative expectations. Across all four studies, positive expectations encouraged developing outgroup attitudes consistent with interaction quality. © 2014 by the Society for Personality and Social Psychology, Inc.

  20. The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

    Science.gov (United States)

    Levy, Becca R.; Leifheit-Limson, Erica

    2009-01-01

    Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

  1. Energy providers: customer expectations

    International Nuclear Information System (INIS)

    Pridham, N.F.

    1997-01-01

    The deregulation of the gas and electric power industries, and how it will impact on customer service and pricing rates was discussed. This paper described the present situation, reviewed core competencies, and outlined future expectations. The bottom line is that major energy consumers are very conscious of energy costs and go to great lengths to keep them under control. At the same time, solutions proposed to reduce energy costs must benefit all classes of consumers, be they industrial, commercial, institutional or residential. Deregulation and competition at an accelerated pace is the most likely answer. This may be forced by external forces such as foreign energy providers who are eager to enter the Canadian energy market. It is also likely that the competition and convergence between gas and electricity is just the beginning, and may well be overshadowed by other deregulated industries as they determine their core competencies

  2. Customer experiences and expectations

    International Nuclear Information System (INIS)

    Morton, C. R.

    1997-01-01

    Customer experiences and expectations from competition and cogeneration in the power industry were reviewed by Charles Morton, Director of Energy at CPC International, by describing Casco's decision to get into cogeneration in the early 1990s in three small corn milling plants in Cardinal, London and Port Colborne, Ontario, mainly as result of the threat of a 40 per cent increase in power prices. He stressed that cost competitiveness of cogeneration is entirely site-specific, but it is generally more attractive in larger facilities that operate 24 hours a day, where grid power is expensive or unreliable. Because it is reliable, cogeneration holds out the prospect of increased production-up time, as well as offering a hedge against higher energy costs, reducing the company's variable costs when incoming revenues fall short of costs, and providing an additional tool in head-to-head competition

  3. Macro Expectations, Aggregate Uncertainty, and Expected Term Premia

    DEFF Research Database (Denmark)

    Dick, Christian D.; Schmeling, Maik; Schrimpf, Andreas

    Based on individual expectations from the Survey of Professional Forecasters, we construct a realtime proxy for expected term premium changes on long-term bonds. We empirically investigate the relation of these bond term premium expectations with expectations about key macroeconomic variables as ...

  4. A comparative study of expectant parents ' childbirth expectations.

    Science.gov (United States)

    Kao, Bi-Chin; Gau, Meei-Ling; Wu, Shian-Feng; Kuo, Bih-Jaw; Lee, Tsorng-Yeh

    2004-09-01

    The purpose of this study was to understand childbirth expectations and differences in childbirth expectations among expectant parents. For convenience sampling, 200 couples willing to participate in this study were chosen from two hospitals in central Taiwan. Inclusion criteria were at least 36 weeks of gestation, aged 18 and above, no prenatal complications, and willing to consent to participate in this study. Instruments used to collect data included basic demographic data and the Childbirth Expectations Questionnaire. Findings of the study revealed that (1) five factors were identified by expectant parents regarding childbirth expectations including the caregiving environment, expectation of labor pain, spousal support, control and participation, and medical and nursing support; (2) no general differences were identified in the childbirth expectations between expectant fathers and expectant mothers; and (3) expectant fathers with a higher socioeconomic status and who had received prenatal (childbirth) education had higher childbirth expectations, whereas mothers displayed no differences in demographic characteristics. The study results may help clinical healthcare providers better understand differences in expectations during labor and birth and childbirth expectations by expectant parents in order to improve the medical and nursing system and promote positive childbirth experiences and satisfaction for expectant parents.

  5. Self-Discrepancies and Involvement Moderate the Effects of Positive and Negative Message Framing in Persuasive Communication

    NARCIS (Netherlands)

    Dijkstra, Arie; Schakenraad, Roos; Menninga, Karin; Buunk, Abraham P.; Siero, Frans

    2009-01-01

    One individual difference that is conceptually closely related to the positive and negative framing of outcomes in persuasive communications is the person's self-discrepancy. It was expected that a match between a person's self-discrepancy and framing will lead to more persuasion, under the

  6. Alcohol expectancies pre-and post-alcohol use disorder treatment: Clinical implications.

    Science.gov (United States)

    Coates, Jason M; Gullo, Matthew J; Feeney, Gerald F X; Young, Ross McD; Dingle, Genevieve A; Connor, Jason P

    2018-05-01

    Modification of elevated positive expectations of alcohol consumption (alcohol outcome expectancies; AOEs) is a key feature of Cognitive Behaviour Therapy (CBT) approaches to Alcohol Use Disorders (AUDs). Despite extensive research supporting the efficacy of CBT for AUD, few studies have examined AOE change. This study aimed to assess AOE change following completion of CBT for AUD and its association with drinking behaviour. One-hundred and seventy-five patients who completed a 12-week CBT program for AUD were administered the Drinking Expectancy Questionnaire (DEQ) at pre-treatment assessment and upon completion of treatment. Abstinence was achieved by 108 (61.7%) of completing patients. For patients who lapsed, the mean proportion of abstinent days was 93%. DEQ scales assessing expectations of positive alcohol effects on tension reduction, assertiveness, and cognitive enhancement were significantly lower post-treatment (pscale. Greater percentage of abstinent days over treatment was associated with lower pre-and post-treatment tension reduction expectancy scores (p<0.05). Drinking during treatment was associated with smaller changes in expectations of negative effects of alcohol on mood (p<0.05). Individuals who completed CBT treatment for AUD showed significant AOE change. Tension reduction and affective change expectancies may be particularly important for abstinence and useful markers of lapse risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys

    NARCIS (Netherlands)

    van den Akker-Scheek, Inge; van Raay, Jos J. A. M.; Reininga, Inge H. F.; Bulstra, Sjoerd K.; Zijlstra, Wiebren; Stevens, Martin

    2010-01-01

    Background: Preoperative expectations of outcome of total hip and knee arthroplasty are important determinants of patients' satisfaction and functional outcome. Aims of the study were (1) to translate the Hospital for Special Surgery Hip Replacement Expectations Survey and Knee Replacement

  8. Expectations from ethics

    International Nuclear Information System (INIS)

    Fleming, P.

    2008-01-01

    Prof. Patricia Fleming, centred her presentation on ethical expectations in regulating safety for future generations. The challenge is to find a just solution, one that provides for a defensible approach to inter-generational equity. The question on equity is about whether we are permitted to treat generations differently and to still meet the demands of justice. And the question must be asked regarding these differences: 'in what ways do they make a moral difference?' She asked the question regarding the exact meaning of the ethical principle 'Radioactive waste shall be managed in such a way that predicted impacts on the health of future generations will not be greater than relevant levels of impact that are acceptable today'. Some countries have proposed different standards for different time periods, either implicitly or explicitly. In doing so, have they preserved our standards of justice or have they abandoned them? Prof. Fleming identified six points to provide with some moral maps which might be used to negotiate our way to a just solution to the disposal of nuclear waste. (author)

  9. Framing sound: Using expectations to reduce environmental noise annoyance.

    Science.gov (United States)

    Crichton, Fiona; Dodd, George; Schmid, Gian; Petrie, Keith J

    2015-10-01

    Annoyance reactions to environmental noise, such as wind turbine sound, have public health implications given associations between annoyance and symptoms related to psychological distress. In the case of wind farms, factors contributing to noise annoyance have been theorised to include wind turbine sound characteristics, the noise sensitivity of residents, and contextual aspects, such as receiving information creating negative expectations about sound exposure. The experimental aim was to assess whether receiving positive or negative expectations about wind farm sound would differentially influence annoyance reactions during exposure to wind farm sound, and also influence associations between perceived noise sensitivity and noise annoyance. Sixty volunteers were randomly assigned to receive either negative or positive expectations about wind farm sound. Participants in the negative expectation group viewed a presentation which incorporated internet material indicating that exposure to wind turbine sound, particularly infrasound, might present a health risk. Positive expectation participants viewed a DVD which framed wind farm sound positively and included internet information about the health benefits of infrasound exposure. Participants were then simultaneously exposed to sub-audible infrasound and audible wind farm sound during two 7 min exposure sessions, during which they assessed their experience of annoyance. Positive expectation participants were significantly less annoyed than negative expectation participants, while noise sensitivity only predicted annoyance in the negative group. Findings suggest accessing negative information about sound is likely to trigger annoyance, particularly in noise sensitive people and, importantly, portraying sound positively may reduce annoyance reactions, even in noise sensitive individuals. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. School transitions, peer influence, and educational expectation formation: Girls and boys.

    Science.gov (United States)

    Andrew, Megan; Flashman, Jennifer

    2017-01-01

    School transitions are a regular feature of the educational career. While they are of general interest as instances of academic change, they also represent instances of peer environment and influence change. Previous theoretical and empirical work suggests peer influence is important for students' academic and educational outcomes, especially for the complex decision-making processes leading up to those outcomes. In this manuscript, we study the impact of peers on educational expectation formation at the 8th-to-9th-grade school transition. In doing so, we test a theoretical model that links institutional settings, social influence, and individual decision-making. We find the 9th grade transition likely represents a negative shock for students' college attendance expectations. Independent of this transition, however, stable peer environments further depress expectations. A more equal mixture of new and old peers in the 9th grade likely increases students' educational expectations in contrast. These effects of peer perturbations and the re-organization of social ties they imply mainly apply to female students. But, both male and female students revise their educational expectations in light of changing peer intelligence comparisons, albeit in countervailing ways. Copyright © 2016. Published by Elsevier Inc.

  11. Expectations from Society

    International Nuclear Information System (INIS)

    Blowers, A.

    2008-01-01

    Prof. A. Blowers observed that the social context within which radioactive waste management is considered has evolved over time. The early period where radioactive waste was a non-issue was succeeded by a period of intense conflict over solutions. The contemporary context is more consensual, in which solutions are sought that are both technically sound and socially acceptable. Among the major issues is that of inter-generational equity embraced in the question: how long can or should our responsibility to the future extend? He pointed out the differences in timescales. On the one hand, geo-scientific timescales are very long term, emphasizing the issue of how far into the future it is possible to make predictions about repository safety. By contrast, socio cultural timescales are much shorter, focusing on the foreseeable future of one or two generations and raising the issue of how far into the future we should be concerned. He listed. the primary expectations from society which are: safety and security to alleviate undue burdens to future generations and flexibility in order to enable the future generations to have a stake in decision making. The need to reconcile the two had led to a contemporary emphasis on phased geological disposal incorporating retrievability. However, the long timescales for implementation of disposal provided for sufficient flexibility without the need for retrievability. Future generations would inevitably have sold stake in decision making. Prof. A.. Blowers pointed out that society is also concerned with participation in decision making for implementation. The key elements for success are: openness and transparency, staged process, participation, partnership, benefits to enhance the well being of communities and a democratic framework for decision making, including the ratification of key decisions and the right for communities to withdraw from the process up to a predetermined point. This approach for decision making may also have

  12. Expected years ever married

    Directory of Open Access Journals (Sweden)

    Ryohei Mogi

    2018-04-01

    Full Text Available Background: In the second half of the 20th century, remarkable marriage changes were seen: a great proportion of never married population, high average age at first marriage, and large variance in first marriage timing. Although it is theoretically possible to separate these three elements, disentangling them analytically remains a challenge. Objective: This study's goal is to answer the following questions: Which of the three effects, nonmarriage, delayed marriage, or expansion, has the most impact on nuptiality changes? How does the most influential factor differ by time periods, birth cohorts, and countries? Methods: To quantify nuptiality changes over time, we define the measure 'expected years ever married' (EYEM. We illustrate the use of EYEM, looking at time trends in 15 countries (six countries for cohort analysis and decompose these trends into three components: scale (the changes in the proportion of never married - nonmarriage, location (the changes in timing of first marriage - delayed marriage, and variance (the changes in the standard deviation of first marriage age - expansion. We used population counts by sex, age, and marital status from national statistical offices and the United Nations database. Results: Results show that delayed marriage is the most influential factor on period EYEM's changes, while nonmarriage has recently begun to contribute to the change in North and West Europe and Canada. Period and cohort analysis complement each other. Conclusions: This study introduces a new index of nuptiality and decomposes its change into the contribution of three components: scale, location, and variance. The decomposition steps presented here offer an open possibility for more elaborate parametric marriage models.

  13. Expectations from implementers

    International Nuclear Information System (INIS)

    Biurrun, E.; Zuidema, P.

    2008-01-01

    Enrique Biurrun (DBE) presented the expectations from the implementer. He explained that the implementer needs a framework to successfully develop a repository which means the definition of requirements and guidance (for repository system development, analysis, licences, etc.) as well as the decision-making process (stepwise approach, roles of different players, etc.). He also needs a reasonable stability of the regulatory system. The regulatory framework should be developed in a clear, reasonable and consistent manner. In the context of the long duration of the project (100 years) there will be technological progress. In that context E. Biurrun asked what is the meaning of best practice. How can one deal with judgmental issues in a step-wise approach? Regulatory criteria and guidance must deal with the repository system for which an iterative process is necessary where dialogue is needed with the regulator despite the need to maintain his independence. The safety case, which is a periodic documentation of the status of the project, must provide a synthesis of the underlying scientific understanding and evidence and becomes part of the design process through feedback. E. Biurrun pointed out that safety is not calculated or assessed, but designed and built into the repository system (by geological and engineered barriers). He stressed the importance of the operational aspects since the implementer has to build and operate the repository safely. He asked the question: is it 'Ethical' to buy 'peace of mind' of some stakeholders with casualties of the implementer's staff because of mining accidents if the repository is left open during a phase of reversibility. The implementer needs dependable criteria, legal security and investment security. He interpreted the 'Precautionary principle' as meaning 'do it now'. Long-lasting solutions are very uncertain. Will we heave the money and the technology to do it later? He made some reflections regarding the ethical need to

  14. Prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis Fatores prognósticos de letalidade da neurotuberculose em crianças HIV-negativas

    Directory of Open Access Journals (Sweden)

    Murilo Gimenes Rodrigues

    2010-10-01

    Full Text Available OBJECTIVE: To identify prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis based on clinical, epidemiological, and laboratory findings. METHOD: The clinical records of all in-patients diagnosed with neurotuberculosis from 1982 to 2005 were evaluated retrospectively. The following prognostic parameters were examined: gender, age, close contact with a tuberculosis-infected individual, vaccination for bacillus Calmette-Guérin, purified protein derivative (PPD of tuberculin results, concomitant miliary tuberculosis, seizures, CSF results, and hydrocephalus. RESULTS: One hundred forty-one patients diagnosed with neurotuberculosis were included. Seventeen percent of the cases resulted in death. The factors that were correlated with a negative outcome included lack of contact with a tuberculosis-infected individual, negative PPD reaction, coma, and longer hospitalisation time. A multiple logistic regression analysis was performed to identify which of these factors most often resulted in death. CONCLUSION: Coma at diagnosis, lack of tuberculosis contact, and a non-reactive PPD were the most important predictors of fatality in patients with neurotuberculosisOBJETIVO: Identificar elementos prognósticos para a letalidade da neurotuberculose na criança, a partir das manifestações clínicas, dados epidemiológicos e laboratoriais. MÉTODO: Registros de pacientes internados durante o período de 1982 a 2005 foram retrospectivamente avaliados. Os elementos prognósticos considerados foram: sexo, idade, história de contato íntimo com indivíduo com tuberculose, vacinação com o bacilo de Calmette-Guérin (BCG, teste tuberculínico (PPD, concomitância de tuberculose miliar, convulsões, resultados da análise do LCR e presença de hidrocefalia. RESULTADOS: 141 pacientes com diagnóstico de neurotuberculose foram incluídos. Dezessete por cento dos pacientes foram a óbito. Os fatores associados ao óbito foram

  15. Social gradient in life expectancy and health expectancy in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Andersen, Otto; Kjøller, Mette

    2004-01-01

    Health status of a population can be evaluated by health expectancy expressed as average lifetime in various states of health. The purpose of the study was to compare health expectancy in population groups at high, medium and low educational levels.......Health status of a population can be evaluated by health expectancy expressed as average lifetime in various states of health. The purpose of the study was to compare health expectancy in population groups at high, medium and low educational levels....

  16. Expectancies mediate the relationship between perceived injustice and return to work following whiplash injury: A 1-year prospective study.

    Science.gov (United States)

    Carriere, J S; Thibault, P; Adams, H; Milioto, M; Ditto, B; Sullivan, M J L

    2017-08-01

    Emerging evidence suggests that perceived injustice is a risk factor for work disability in individuals with whiplash injury. At present, however, little is known about the processes by which perceived injustice impacts on return to work. The purpose of this study was to examine whether expectancies mediated the relationship between perceived injustice and return to work in patients with whiplash injury. One hundred and fifty-two individuals (81 men, 71 women) with a primary diagnosis of whiplash injury completed self-report measures of pain intensity, perceived injustice and return-to-work expectancies following admission to a rehabilitation programme. Work status was assessed 1 year after discharge. Consistent with previous research, high scores on a measure of perceived injustice were associated with prolonged work disability. Results indicated that high perceptions of injustice were associated with low return-to-work expectancies. Causal mediation analyses revealed that expectancies fully mediated the relationship between perceived injustice and return to work. The findings suggest that intervention techniques designed to target expectancies could improve return-to-work outcomes in patients with whiplash injury. Discussion addresses the processes by which expectancies might impact on return-to-work outcomes and the manner in which negative return-to-work expectancies might be modified through intervention. The study confirms that expectancies are the mechanism through which perceived injustice impacts return to work following whiplash injury. The findings suggest that interventions designed to specifically target return-to-work expectancies might improve rehabilitation outcomes in patients with whiplash injury. © 2017 European Pain Federation - EFIC®.

  17. Auctioning access to networks: evidence and expectations

    International Nuclear Information System (INIS)

    McDaniel, T.

    2003-01-01

    Under very strict assumptions the outcomes that make common auction designs theoretically attractive can be expected to emerge: goods will go to those who value them most and the allocation will maximize revenue for the auctioneer. In network industries such as electricity, gas, telecommunications, rail, and airlines where agents are of different sizes and incumbency these assumptions do not always apply for a number of reasons. For example, the auctioned product may be an intermediate good, bidders are not symmetric with respect to values and information, markets are mixed, and property rights are hard to define. We discuss why it is not straightforward to make theoretical predictions about expected outcomes for these industries and use the British gas industry to discuss the importance of competition and scarcity for auctions of network capacity. (Author)

  18. Safety Behavior After Extinction Triggers a Return of Threat Expectancy

    NARCIS (Netherlands)

    van Uijen, S.L.; Leer, A.; Engelhard, I.M.

    2018-01-01

    Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear

  19. Multiple chronic conditions and life expectancy

    DEFF Research Database (Denmark)

    DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine

    2014-01-01

    BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. RESEARCH DESIGN: A retrospective cohort...... study using single-decrement period life tables. SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer...... and increasing numbers of comorbid conditions. CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency....

  20. Patient (customer) expectations in hospitals.

    Science.gov (United States)

    Bostan, Sedat; Acuner, Taner; Yilmaz, Gökhan

    2007-06-01

    The expectations of patient are one of the determining factors of healthcare service. The purpose of this study is to measure the Patients' Expectations, based on Patient's Rights. This study was done with Likert-Survey in Trabzon population. The analyses showed that the level of the expectations of the patient was high on the factor of receiving information and at an acceptable level on the other factors. Statistical meaningfulness was determined between age, sex, education, health insurance, and the income of the family and the expectations of the patients (pstudy, the current legal regulations have higher standards than the expectations of the patients. The reason that the satisfaction of the patients high level is interpreted due to the fact that the level of the expectation is low. It is suggested that the educational and public awareness studies on the patients' rights must be done in order to increase the expectations of the patients.

  1. Expectations and Experiences of Information Literacy Instruction

    Directory of Open Access Journals (Sweden)

    Saga Pohjola-Ahlin

    2016-11-01

    Full Text Available In May 2016, 48 third semester undergraduate students enrolled in the physiotherapy program at Karolinska Institutet in Sweden were given three sets of questionnaires; before the information literacy instruction (ILI started, at the end of the first session, and a week after, at the end of the second and last session. The aim of this small-scale pilot study was to shed some light on students’ motivation to attend ILI, how they value the sessions afterwards and how they assess their learning outcome. Furthermore, it was an attempt to do a "students’ user experience study” in a pedagogical setting, with the intention to evaluate and improve teaching in ILI to meet student expectations. The average response rate for the three questionnaires was 92%. The results show that students’ expectations were similar to the actual content of ILI, and that the students were satisfied with their own learning outcome. Both motivation and the sense of relevance got higher scores after students attended ILI. Motivation rose from 7,4 to 8,12 out of 10. This is positive because a high level of motivation often improves the learning outcome (Schunk, 2012. When asked which areas most needed improvement in order to further enhance their learning outcome, the most common responses were “the pedagogy” and “my own achievement”. It would be interesting to start collaborating with a group of students in order to explore new methods and learning activities.

  2. Macro Expectations, Aggregate Uncertainty, and Expected Term Premia

    DEFF Research Database (Denmark)

    Dick, Christian D.; Schmeling, Maik; Schrimpf, Andreas

    2013-01-01

    as well as aggregate macroeconomic uncertainty at the level of individual forecasters. We find that expected term premia are (i) time-varying and reasonably persistent, (ii) strongly related to expectations about future output growth, and (iii) positively affected by uncertainty about future output growth...... and in ation rates. Expectations about real macroeconomic variables seem to matter more than expectations about nominal factors. Additional findings on term structure factors suggest that the level and slope factor capture information related to uncertainty about real and nominal macroeconomic prospects...

  3. Economic Loan Loss Provision and Expected Loss

    Directory of Open Access Journals (Sweden)

    Stefan Hlawatsch

    2010-10-01

    Full Text Available The intention of a loan loss provision is the anticipation of the loan's expected losses by adjusting the book value of the loan. Furthermore, this loan loss provision has to be compared to the expected loss according to Basel II and, in the case of a difference, liable equity has to be adjusted. This however assumes that the loan loss provision and the expected loss are based on a similar economic rationale, which is only valid conditionally in current loan loss provisioning methods according to IFRS. Therefore, differences between loan loss provisions and expected losses should only result from different approaches regarding the parameter estimation within each model and not due to different assumptions regarding the outcome of the model. The provisioning and accounting model developed in this paper overcomes the before-mentioned shortcomings and is consistent with an economic rationale of expected losses. Additionally, this model is based on a close-to-market valuation of the loan that is in favor of the basic idea of IFRS. Suggestions for changes in current accounting and capital requirement rules are provided.

  4. Expectancies, socioeconomic status, and self-rated health: use of the simplified TOMCATS Questionnaire.