WorldWideScience

Sample records for spousal atv concordance

  1. Consanguinity and spousal concordance in Kuwait.

    Science.gov (United States)

    al-Kandari, Y; Crews, D E; Poirier, F E

    2002-12-01

    Consanguineous marriage is favored in Kuwait. This research focuses on the relationship of physical and cultural traits to marriage types in Kuwait and examines concordance as a function of consanguinity and marriage duration. In a nonrandom opportunistic sample of 242 couples anthropometric and blood pressure data have been collected as well as data on acculturation, religiosity, Farsi proficiency, level of education, occupation, and attitudes regarding fertility. Significant concordances occur in cultural characteristics among couples in all three types of marriages with respect to the degree of religiosity, acculturation, language similarity, education, and occupation. Non-consanguineous spouses have the highest concordance in educational level, occupation, and degree of acculturation, but the lowest for religiosity and Farsi proficiency. Nonkin marriages seem to be based on personal preferences. In the wider potential nonkin marriage pool spouses show more concordance in stature and education indicating the positive assortative mating for those traits. Non-consanguineous spouses show a significant association for triceps and subscapular skinfold thicknesses hip and waist circumferences, and body fat distribution. Unrelated spouses exhibit more concordance for physical traits than do related spouses. There is a significant correlation between spouses in first and double cousin marriages as well as in spouses in second and less than second cousin unions for systolic and diastolic blood pressure, while non-consanguineous spouses show a significant association in diastolic blood pressure only.

  2. Spousal concordance for overall health risk status and preventive service compliance.

    Science.gov (United States)

    Pai, Chih-Wen; Godboldo-Brooks, Ambyr; Edington, Dee W

    2010-07-01

    In this study we examined spousal concordance for two aggregate measures of health risk status and compliance with preventive service recommendations among 9620 pairs of cohabitating, opposite-sex married couples. Health risk appraisals were the primary data source to measure two outcome variables. Health risk status was compiled from 12 health risks and categorized into three levels (low-, medium-, and high-risk status). Overall preventive service compliance status was estimated by seven age-sex specific preventive service recommendations and dichotomized into lower and higher compliance status. For each of the husband and wife populations, we conducted proportional odds models and logistic regression models to assess spousal concordance for the two aggregate measures respectively. All models were adjusted for household income, one's characteristics (age, race, education, disease burden), and the same set of characteristics and the corresponding outcome variable from the spouse. A positive correlation within spousal pairs was statistically significant for both health risk status and compliance status (p education. 2010 Elsevier Inc. All rights reserved.

  3. Concorde

    CERN Multimedia

    Bernard

    1971-01-01

    Concorde -volera, volera pas et comment volera-t-il? Film: les Concordes de vol Le Commandant Bernard présente le Concorde, "né" en 1962, et commente l'appareil qui est d'actualité- commentaires techniques à l'aide d'une maquette et présentation des dias

  4. ATV: Image display tool

    Science.gov (United States)

    Barth, Aaron J.; Schlegel, David; Finkbeiner, Doug; Colley, Wesley; Liu, Mike; Brauher, Jim; Cunningham, Nathaniel; Perrin, Marshall; Roe, Henry; Weaver, Hal

    2014-05-01

    ATV displays and analyses astronomical images using the IDL image-processing language. It allows interactive control of the image scaling, color table, color stretch, and zoom, with support for world coordinate systems. It also does point-and-click aperture photometry, simple spectral extractions, and can produce publication-quality postscript output images.

  5. Modal concord

    NARCIS (Netherlands)

    Zeijlstra, H.; Gibson, M.; Friedman, T.

    2008-01-01

    Sentences containing two (or more) modal elements of the same modal type and quantificational force often yield a concord reading, where the semantics of the sentence seems to contain only one modal operator, rather than a cumulative reading. In this paper I have argued that Modal Concord is a

  6. Trends of ATV use and associated injury on Saskatchewan farms.

    Science.gov (United States)

    Clay, Lynne; Milosavljevic, Stephan; Koehncke, Niels; Dosman, James; Trask, Catherine

    2017-11-01

    All-terrain vehicles (ATV's) are a hazardous source of injury in many contexts and geographical regions, but to date have not been investigated in Saskatchewan. Baseline surveys from the Saskatchewan Farm Injury Project were examined at two time points in terms of: (1) rates and correlated characteristics of reported ATV use; and (2) qualitative content analysis of injury events involving ATVs. The sample of eligible farmers was 2,972 in 2007 and 1,702 in 2013. Self-reported ATV use increased on Saskatchewan farms over the five-year period, both in terms of the number of individuals using ATV's on the farm and the days per year of operation. ATV use is significantly more common on farms with livestock, among male farmers, and among younger farmers. Farmers with low back pain were also more likely to report ATV use. Qualitative content analysis of farmers' reported "most serious injury" on the farm revealed themes related to: (1) tasks undertaken with ATV's at the time of the incident (e.g., stock work and personal transport); (2) contributing factors (vehicle, environmental and driver); and (3) safety reflections. The apparent trends of increasing ATV use on Saskatchewan farms and serious nature of the injury incidents reported indicate that this is an issue worthy of further investigation.

  7. 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

  8. Spousal Adjustment to Myocardial Infarction.

    Science.gov (United States)

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  9. A Comparison of ATV-Related Behaviors, Exposures, and Injuries Between Farm Youth and Nonfarm Youth

    Science.gov (United States)

    Jones, Chester S.; Bleeker, Jeanne

    2005-01-01

    All terrain vehicles (ATVs) are a popular form of transportation and recreation for youth. ATVs are also convenient for farm-related activities. However, the impact of the farming environment on ATV-related injuries is not clear. To determine differences in ATV-related behaviors, exposures, risk factors, and injuries between farm youth and their…

  10. Spousal violence and pregnancy termination among married ...

    African Journals Online (AJOL)

    Methods: Data on spousal violence among ever married women was extracted from the 2013 Nigeria Demographic and Health Survey. The outcome variable is pregnancy termination. The explanatory variables were the type of spousal violence experienced by the women in the last 12 months preceding the survey.

  11. 'Killing the beloved': psychosocial factors precipitating spousal ...

    African Journals Online (AJOL)

    The prevalence of spousal homicide in Nigeria appears to have been on the increase in recent years, sparking criminological and public health concerns. Meanwhile, research on family violence has vigorously focused on spousal abuse, trends and prevalence of domestic violence, and risk factors, while the most severe of ...

  12. 5 CFR 1620.23 - Spousal rights.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Spousal rights. 1620.23 Section 1620.23... and Judges § 1620.23 Spousal rights. (a) The current spouse of a justice or judge of the United States (as defined in 28 U.S.C. 451), or of a Court of Veterans Appeals judge, possesses the rights described...

  13. 5 CFR 1655.18 - Spousal rights.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Spousal rights. 1655.18 Section 1655.18 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD LOAN PROGRAM § 1655.18 Spousal rights. (a) Spouse of CSRS participant. (1) Before a loan is disbursed to a CSRS participant, the TSP record keeper...

  14. The Stable Concordance Genus

    OpenAIRE

    Kearney, M. Kate

    2013-01-01

    The concordance genus of a knot is the least genus of any knot in its concordance class. Although difficult to compute, it is a useful invariant that highlights the distinction between the three-genus and four-genus. In this paper we define and discuss the stable concordance genus of a knot, which describes the behavior of the concordance genus under connected sum.

  15. 16 CFR 1420.4 - Restrictions on three-wheel ATVs.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Restrictions on three-wheel ATVs. 1420.4... REGULATIONS REQUIREMENTS FOR ALL TERRAIN VEHICLES § 1420.4 Restrictions on three-wheel ATVs. Until a mandatory consumer product safety standard applicable to three-wheel ATVs promulgated pursuant to the Consumer...

  16. 16 CFR 1420.3 - Requirements for four-wheel ATVs.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Requirements for four-wheel ATVs. 1420.3... REGULATIONS REQUIREMENTS FOR ALL TERRAIN VEHICLES § 1420.3 Requirements for four-wheel ATVs. (a) Each ATV shall comply with all applicable provisions of the American National Standard for Four Wheel All-Terrain...

  17. Quantitative and qualitative analysis of the ATV data base

    International Nuclear Information System (INIS)

    Bento, J.-P.; Wendler, E.

    1981-01-01

    The Swedish ATV data base has been analyzed with respect to the coverage of component failures in Swedish BWRs, and the correctness and quality of the ATV failure information. The main findings regarding the years 1974-1978 are: the coverage of occurred component failures is not greater than about 50 %, although the trend is upward; the correctness of the failure coding and the quality of the plain-language remarks should be enhanced; as the system is now, the coverage and description of common cause failures and human error is insufficient as far as the needs in probabilistic risk analyses are concerned. (Auth.)

  18. Spousal Caregiver Narratives and Credible Authority: Uncertainty in Illness of Spousal Caregivers

    Science.gov (United States)

    Sodowsky, Karen

    2012-01-01

    This article is taken from a larger longitudinal study that used caregiver interviews, caregiver surveys, and caregiver statistical information of one community. The interviews were conducted with six spousal caregivers to examine the narratives produced by spouses actively caring for their partners with dementia. The spousal caregivers were…

  19. Pediatric ATV Injuries in a Statewide Sample: 2004 to 2014.

    Science.gov (United States)

    Garay, Mariano; Hess, Joseph; Armstrong, Douglas; Hennrikus, William

    2017-08-01

    To establish the incidence, mortality rate, and fracture location of pediatric patients injured while using an all-terrain vehicle (ATV) over an 11-year period. A retrospective study using a state trauma database for patients ages 0 to 17 years who sustained injuries while using an ATV. Thirty-two pediatric and adult trauma centers within the state were evaluated from January 1, 2004, to December 31, 2014. The inclusion criteria were met by 1912 patients. The estimated mean annual incidence during the period of the study was 6.2 patients per 100 000 children in the pediatric population children and remained relatively constant. The majority of patients (55.4%) sustained at least 1 bone fracture at or below the cervical spine. The femur and tibia were more commonly fractured (21.6% and 17.7% of the patients, respectively). Despite current guidelines by the American Academy of Pediatrics, patients younger than 16 years of age remain victims of ATV injuries. Although there was a 13.4% reduction in the incidence of ATV-related injuries in recent years, continued preventive guidelines are still necessary to avert these injuries in children and adolescents. Copyright © 2017 by the American Academy of Pediatrics.

  20. Spousal communication about HIV prevention in Kenya.

    Science.gov (United States)

    Chiao, Chi; Mishra, Vinod; Ksobiech, Kate

    2011-11-01

    High HIV rates among cohabiting couples in many African countries have led to greater programmatic emphasis on spousal communication in HIV prevention. This study examines how demographic and socioeconomic characteristics of cohabiting adults influence their dyadic communication about HIV. A central focus of this research is on how the position of women relative to their male partners influences spousal communication about HIV prevention. The authors analyze gaps in spousal age and education and females' participation in household decision making as key factors influencing spousal communication about HIV, while controlling for sexual behaviors of both partners as well as other individual and contextual factors. Data were obtained from the 2003 Kenya Demographic and Health Survey for 1,388 cohabiting couples. Information regarding spousal communication was self-reported, assessing whether both, either, or neither partner ever discussed HIV prevention with the other. Analyses showed higher levels of education for the female partner and participation in household decision making are positively associated with spousal communication about HIV prevention. With females' education and other factors controlled, couples with more educated male partners were more likely to have discussed HIV prevention than couples in which both partners have the same level of education. Spousal communication was also positively associated with household wealth status and exposure to the mass media, but couples in which male partners reported having nonspousal sex in the past year were less likely to have discussed HIV prevention with their spouses. Findings suggest HIV prevention programs should promote female empowerment and encourage male participation in sexual health discussion.

  1. Spousal Religiosity, Religious Bonding, and Pornography Consumption.

    Science.gov (United States)

    Perry, Samuel L

    2017-02-01

    Religiosity and pornography use are often closely connected. Relatively few studies, however, have examined how this religion-pornography connection plays out within the context of committed romantic relationships. Moreover, virtually all studies of religion and pornography use conceptualize religiosity as a quality intrinsic to the person that typically reduces pornography viewing. Focusing on married Americans, this study shifted the focus to consider whether the religiosity of one's spouse relates to one's own pornography viewing and under what circumstances. Analyses of the nationally representative Portraits of American Life Study (N = 1026) revealed that spousal religiosity was strongly and negatively related to participants viewing pornography, controlling for participants' own religious or sociodemographic characteristics or sexual satisfaction. This relationship held whether spousal religiosity was measured with participants' evaluations of their spouses' religiosity or spouses' self-reported religiosity. The association between spousal religiosity and pornography use was also moderated by participants' religious service attendance, gender, and age. Considering mechanisms, the association between spousal religiosity and pornography use was mediated by frequent participation in religious bonding activities as a couple, suggesting that spousal religiosity may decrease pornography viewing among married Americans by promoting greater religious intimacy and unity between the couple, consequently decreasing one's interest or opportunities to view pornography.

  2. Simulation of the ATV Re-Entry Obsrvations

    Science.gov (United States)

    Bastida Virgili, B.; Krag, H.; Lips, T.; De Pasquale, E.

    2010-09-01

    The first ATV was launched on 9th March 2008 and, after a successful mission, the last phase was a controlled destructive re-entry on 29th September 2008, shortly after 13:30 UTC, in which the remains of the ATV and its load fell into the South Pacific Ocean. In order to better understand the re-entry processes, an insitu optical observation campaign was launched to record and analyze the ATV controlled re-entry with several instruments on board of two airplanes and also from the ISS. This observation campaign was successful and triggered several different still-ongoing studies on the extraction and analysis of data to draw conclusions on the adequacy of the re-entry break-up and explosion models used for the safety analysis of the ATV re-entry. This paper addresses the validation process for ESA’s model for re-entry survivability and on-ground risk assessment for explosive re-entry events using the observation data. The underlying rationale is to improve the models for the benefit of planning and execution of future controlled re-entries and in risk calculation in case of uncontrolled ones. The re-entry trajectory of the ATV, the explosive event and the trajectories of the fragments are simulated with the existing ESA tools and the EVOLVE explosion model. Additional software has been developed to simulate airborne sensor field of view(FOV) crossings based on the aircraft trajectories, attitude profile, sensor mounts and FOVs. Sensor performance and object radiation are modeled in order to generate synthetic images for the different sensors in the ISS and the two airplanes. These synthetic images and synthetic videos are compared with the available reentry observations of the ATV. This paper will present the software and techniques to generate synthetic imagery. It will give results of the comparison between the simulated and the real trajectories and fragmentation and explain the subsequent validation process of the ESA re-entry tools and the potential

  3. Impact risk assessment for the ATV using ESABASE/DEBRIS

    Science.gov (United States)

    Beltrami Karlezi, P.; Drolshagen, G.; Lambert, M.

    2001-10-01

    The European Space Agency ESA participates in the International Space Station with various programs, one of them being the Automated Transfer Vehicle (ATV). The ATV is an unmanned servicing and logistics vehicle launched on Ariane 5 and designed to fulfil different roles like cargo transport, re-supply of fuel and consumables and orbit re-boost of the International Space Station (ISS). For this reason it is important that the risks imposed on these modules by meteoroids and orbital debris are calculated accurately. Following such calculations the Meteoroid and Orbital Debris Protection System (M/ODPS) can be optimised. This paper presents the results of the risk assessment of meteoroids and space debris for the ATV spacecraft attached to the ISS using different shield configurations. The results are presented as the probability of no penetration (PNP) for each component and each configuration. They are compared to a target PNP requirement of 0.999 for 135 days and the weight penalty produced by the extra shielding is given.

  4. Visualizing Concordance of Sets

    National Research Council Canada - National Science Library

    Kim, Bohyoung; Lee, Bongshin; Seo, Jinwook

    2006-01-01

    .... For example, several clustering algorithms generate different results for the same input. To get useful insights, users need to combine different perspectives by checking concordance between those results...

  5. Spousal veto over family planning services.

    Science.gov (United States)

    Cook, R J; Maine, D

    1987-01-01

    In many countries a spouse, usually the husband, can veto a partner's use of family planning services. Where spousal veto acts as a barrier to family planning services it represents a serious threat to the lives and health of women and children. Removal of spousal authorization requirements has been shown to increase the use of family planning services. The Family Guidance Association of Ethiopia, for example, removed their requirement in 1982 and clinic utilization increased by 26 per cent within a few months. Courts of several countries have held that spousal veto practices violate principles of personal privacy and autonomy and the right to health care. The effect of such judgements has been to reinforce rights to sexual nondiscrimination found, for example, in national constitutions and the Convention on the Elimination of All Forms of Discrimination against Women. This article discusses the nature and application of spousal veto practices, explains how such requirements can violate certain human rights, and explores possible remedies to this problem, including ministerial, legislative, and judicial initiatives. PMID:3812842

  6. Spousal rape: A challenge for pastoral counsellors

    Directory of Open Access Journals (Sweden)

    James A. Glanville

    2013-06-01

    Full Text Available This article reflects on the criticism regarding the pastoral counsellor’s dealings with spousal rape victims. It argues that counsellors should be sensitive not to be biased, either personally or theologically, and should have an understanding of the biopsychosocial (biological, psychological and social impact of spousal rape, such as rape-related post-traumatic stress and other related illnesses such as depression, victimisation and stigmatisation. The pastoral counsellors should be aware of the legal and medical ramifications of spousal rape and have knowledge of the correct referral resources and procedures (trusted professionals, shelters and support structures. They should be self-aware and understand the effect that gender or previous traumatic personal experiences may have on their reactions. The article consists of the following sections: the phenomenon ‘rape’; acquaintance rape; spousal rape; post-traumatic stress; post-traumatic stress disorder; rape trauma syndrome; cognitive behavioural therapy; spirituality; doctrinal matters; social system of patriarchy; a pastoral counselling model; self-care.

  7. Spousal rape: A challenge for pastoral counsellors

    Directory of Open Access Journals (Sweden)

    James A. Glanville

    2013-01-01

    Full Text Available This article reflects on the criticism regarding the pastoral counsellor’s dealings with spousal rape victims. It argues that counsellors should be sensitive not to be biased, either personally or theologically, and should have an understanding of the biopsychosocial (biological, psychological and social impact of spousal rape, such as rape-related post-traumatic stress and other related illnesses such as depression, victimisation and stigmatisation. The pastoral counsellors should be aware of the legal and medical ramifications of spousal rape and have knowledge of the correct referral resources and procedures (trusted professionals, shelters and support structures. They should be self-aware and understand the effect that gender or previous traumatic personal experiences may have on their reactions. The article consists of the following sections: the phenomenon ‘rape’; acquaintance rape; spousal rape; post-traumatic stress; post-traumatic stress disorder; rape trauma syndrome; cognitive behavioural therapy; spirituality; doctrinal matters; social system of patriarchy; a pastoral counselling model; self-care.

  8. Spousal violence and pregnancy termination among married ...

    African Journals Online (AJOL)

    Descriptive statistical analysis and binary logistic regression were ap- plied using stata version 12. Results: Results show that 13.8% of women had ever terminated pregnancy; 19.9% had ever experienced at least one type of spousal violence; and women who had ever terminated pregnancy had higher prevalence of all ...

  9. influence of spousal communication on marital stability

    African Journals Online (AJOL)

    Engr E. Egbochukwu

    become a slave to it. The assumption for its social necessity is rested on the premise that through it, families are established and the family is the fundamental unit .... problems. This research deems it necessary to investigate the Influence of spousal communication on marital stability. This is because divorce is becoming a ...

  10. Impacts of all terrain vehicles (ATV) on National Forest lands and grasslands [Abstract

    Science.gov (United States)

    Randy B. Foltz; Kristina A. Yanosek

    2005-01-01

    The US Forest Service has identified unmanaged all terrain vehicle (ATV) use as a threat to forested lands and grasslands. Some undesirable impacts include severely eroded soils, usercreated unplanned roads, disrupted wetland ecosystems, as well as general habitat destruction and degraded water quality throughout forested lands. More insight on how ATV use affects...

  11. ATV Engineering Support Team Safety Console Preparation for the Johannes Kepler Mission

    Science.gov (United States)

    Chase, R.; Oliefka, L.

    2010-09-01

    This paper describes the improvements to be implemented in the Safety console position of the Engineering Support Team(EST) at the Automated Transfer Vehicle(ATV) Control Centre(ATV-CC) for the upcoming ATV Johannes Kepler mission. The ATV missions to the International Space Station are monitored and controlled from the ATV-CC in Toulouse, France. The commanding of ATV is performed by the Vehicle Engineering Team(VET) in the main control room under authority of the Flight Director. The EST performs a monitoring function in a room beside the main control room. One of the EST positions is the Safety console, which is staffed by safety engineers from ESA and the industrial prime contractor, Astrium. The function of the Safety console is to check whether the hazard controls are available throughout the mission as required by the Hazard Reports approved by the ISS Safety Review Panel. Safety console preparation activities were limited prior to the first ATV mission due to schedule constraints, and the safety engineers involved have been working to improve the readiness for ATV 2. The following steps have been taken or are in process, and will be described in this paper: • review of the implementation of Operations Control Agreement Documents(OCADs) that record the way operational hazard controls are performed to meet the needs of the Hazard Reports(typically in Flight Rules and Crew Procedures), • crosscheck of operational control needs and implementations with respect to ATV's first flight observations and post flight evaluations, with a view to identifying additional, obsolete or revised operational hazard controls, • participation in the Flight Rule review and update process carried out between missions, • participation in the assessment of anomalies observed during the first ATV mission, to ensure that any impacts are addressed in the ATV 2 safety documentation, • preparation of a Safety console handbook to provide lists of important safety aspects to be

  12. TERRAIN, Concord, Massachusetts

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Concord AOI consists of one area. Ground Control is collected throughout the AOI for use in the processing of LiDAR data to ensure data accurately represents the...

  13. Concordant Chemical Reaction Networks

    Science.gov (United States)

    Shinar, Guy; Feinberg, Martin

    2015-01-01

    We describe a large class of chemical reaction networks, those endowed with a subtle structural property called concordance. We show that the class of concordant networks coincides precisely with the class of networks which, when taken with any weakly monotonic kinetics, invariably give rise to kinetic systems that are injective — a quality that, among other things, precludes the possibility of switch-like transitions between distinct positive steady states. We also provide persistence characteristics of concordant networks, instability implications of discordance, and consequences of stronger variants of concordance. Some of our results are in the spirit of recent ones by Banaji and Craciun, but here we do not require that every species suffer a degradation reaction. This is especially important in studying biochemical networks, for which it is rare to have all species degrade. PMID:22659063

  14. Spousal Caregiver Burden and Its Relation with Disability in Schizophrenia.

    Science.gov (United States)

    Arun, R; Inbakamal, S; Tharyan, Anna; Premkumar, Prasanna S

    2018-01-01

    Schizophrenia, a chronic psychiatric disorder, can affect one's productivity and psychosocial functioning. In Indian context, the responsibility of caring persons with schizophrenia is increasingly on their spouses. Spousal caregiver experience and its relation with disability in schizophrenia need to be studied. We conducted a cross-sectional study among 52 outpatients with schizophrenia and their spouses attending a tertiary psychiatric center. The objectives were: (a) to explore spousal caregiver burden in schizophrenia and (b) to assess the relation between disability and spousal caregiver burden. The study adopted recommended ethical principles. Scales such as Burden Assessment Schedule, Indian Disability Evaluation and Assessment Scale (IDEAS), and Positive and Negative Syndrome Scale were used to collect appropriate data. Descriptive analysis, bivariate analysis, and multivariate analysis were done in SPSS software version 16.0. The mean spousal caregiver burden score was 73.5 (standard deviation: 14.0). In bivariate analysis, disability, duration of schizophrenia, severity of schizophrenia, place of residence, and socioeconomic status had statistically significant relation with spousal caregiver burden. Adjusted for spouses' age, gender, and other significant factors in bivariate analysis, the IDEAS global disability score (2.6, [confidence interval 0.5-3.8, P = 0.013]) retained statistically significant association with spousal caregiver burden. Spouses of persons with schizophrenia experience significant caregiver burden. Disability was found to be the most powerful determinant of spousal caregiver burden in the sample. Focus on disability alleviation in the management of schizophrenia may help reduce spousal caregiver burden.

  15. Spousal Capital as a Resource for Couples Starting a Business

    Science.gov (United States)

    Matzek, Amanda E.; Gudmunson, Clinton G.; Danes, Sharon M.

    2010-01-01

    This longitudinal study finds that spousal capital is an important resource for entrepreneurs starting a business because it has implications for business sustainability and couple relationship quality. Structural equation modeling supported a process whereby gender had an impact on spousal involvement in the business, which was positively…

  16. Extremity Fractures Associated With ATVs and Dirt Bikes: A 6 Year National Epidemiological Study

    OpenAIRE

    Gambone, Andrew; Lombardo, Daniel Joseph; Jelsema, Timothy; Sabesan, Vani

    2015-01-01

    Objectives: All-terrain vehicle (ATV) and dirt bike use is increasing in the US and is associated with risk of traumatic injury. Extremity fractures are common injures associated with these vehicles. The purpose of this study is to compare and contrast the patterns extremity fractures associated with ATVs and dirt bikes. Our hypothesis is that these different vehicles will result in similar rates of high impact injuries, but differences in vehicle stability will result in greater proportions ...

  17. SPOUSAL VIOLENCE IN THE CONTEXT OF WOMEN’S VICTIMIZATION

    Directory of Open Access Journals (Sweden)

    T. V. Shipunova

    2016-01-01

    Full Text Available The article deals with spousal violence against women. Criminal and everyday aspects of conjugal violence highlighted. Criminal violence is reflected in the crime statistics. Everyday aspect includes impostored and indifference violence. The author distinguishes four contexts in which spousal violence is unfolding: sociocultural (class structure of society, settings and attitudes towards violence, etc.; family (the modern family structure, family relationships and their dynamics, and others; individual (prescribed cultural understanding of the strengths and weaknesses, self-esteem and self-control, etc.; crisis (means and opportunities to establish and maintain non-conflict situation in the family, reduced resistance to the couple in crisis situations, etc.. The article presents the results of empirical research of problem of spousal violence youth too. The study found gender differences in the perception and evaluation of the problem of conjugal violence, the differences in the assessment methods of spousal violence, etc. 

  18. Barriers to spousal contribution to childbirth pain relief in Nigeria.

    Science.gov (United States)

    Emelonye, A U; Pitkäaho, T; Aregbesola, A; Vehviläinen-Julkunen, K

    2017-12-01

    The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. A cross-sectional survey conducted in four hospitals in Nigeria involving midwives (n = 100), women (n = 142) and their spouses (n = 142) from June to December 2014 using pretested questionnaires. Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. © 2016 International Council of Nurses.

  19. Sex differences in depressive effects of experiencing spousal bereavement.

    Science.gov (United States)

    Lee, Hyo Jung; Lee, Sang Gyu; Chun, Sung-Youn; Park, Eun-Cheol

    2017-02-01

    Spousal death is a significant event that becomes a turning point in an individual's life. Widowed persons experience new circumstances, which might induce depression. However, the effects of spousal death on depression can differ by sex and culture. Thus, the present study examined the association between depressive levels and experience of spousal death in Korean adults aged older than 45 years. The data were from the Korean Longitudinal Study of Aging from 2010 to 2012. The analysis used frequency analysis to compare the distribution of demographic variables between men and women, and anova to compare 10-item short-form Center for Epidemiological Studies Depression Scale scores as the dependent variable among comparison groups. We also carried out linear mixed model analysis on the association between the 10-item short-form Center for Epidemiological Studies Depression Scale and experience of spousal death. Among 5481 respondents, 2735 were men and 2741 were women. The number of men and women who experienced spousal death were 43 (1.6%) and 181 (6.6%), respectively. Men had lower depressive levels than women when they had been married (men 2.99, women 3.64). Both men and women experiencing spousal death had significantly higher 10-item short-form Center for Epidemiological Studies Depression Scale scores than married men and women (men β = 0.911, P = 0.003; women β = 0.512, P = 0.001; ref: no experience of spousal death). There was a significant association between experience of spousal death and depressive level for both men and women. We suggest that policy practitioners promote community programs that provide bereaved adults with easy access to meaningful social participation and support the minimum cost of living of the widowed. Geriatr Gerontol Int 2017; 17: 322-329. © 2016 Japan Geriatrics Society.

  20. Extremity fractures associated with ATVs and dirt bikes: a 10-year national epidemiologic study.

    Science.gov (United States)

    Lombardo, D J; Jelsema, T; Gambone, A; Weisman, M; Petersen-Fitts, G; Whaley, J D; Sabesan, V J

    2017-08-01

    Morbidity and mortality of all-terrain vehicles and dirt bikes have been studied, as well as the association of helmet use and head injury. The purpose of this study is to compare and contrast the patterns of extremity fractures associated with ATVs and dirt bikes. We believe there will be unique and potentially preventable injury patterns associated with dirt bikes and three-wheeled ATVs due to the poor stability of these vehicles. Descriptive epidemiology study. The National Electronic Injury Surveillance System (NEISS) was used to acquire data for extremity fractures related to ATV (three wheels, four wheels, and number of wheels undefined) and dirt bike use from 2007 to 2012. Nationwide estimation of injury incidence was determined using NEISS weight calculations. The database yielded an estimate of 229,362 extremity fractures from 2007 to 2012. The incidence rates of extremity fractures associated with ATV and dirt bike use were 3.87 and 6.85 per 1000 participant-years. The largest proportion of all fractures occurred in the shoulder (27.2%), followed by the wrist and lower leg (13.8 and 12.4%, respectively). There were no differences in the distribution of the location of fractures among four-wheeled or unspecified ATVs. However, three-wheeled ATVs and dirt bikes had much larger proportion of lower leg, foot, and ankle fractures compared to the other vehicle types. While upper extremity fractures were the most commonly observed in this database, three-wheeled ATVs and dirt bikes showed increased proportions of lower extremity fractures. Several organizations have previously advocated for better regulation of the sale and use of these specific vehicles due to increased risks. These findings help illustrate some of the specific risks associated with these commonly used vehicles.

  1. Does the Relationship of the Proxy to the Target Person Affect the Concordance between Survey Reports and Medicare Claims Measures of Health Services Use?

    Science.gov (United States)

    Wehby, George L; Jones, Michael P; Ullrich, Fred; Lou, Yiyue; Wolinsky, Fredric D

    2016-02-01

    To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies. 1995-2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993-2010 Medicare claims for 3,229 individuals (13,488 person-years). Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under- and over-reported physician visits. Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters-in-law and sons/sons-in-law, had less discordance, mainly due to reduced under-reporting. Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents. © Health Research and Educational Trust.

  2. Extremity Fractures Associated With ATVs and Dirt Bikes: A 6 Year National Epidemiological Study

    Science.gov (United States)

    Gambone, Andrew; Lombardo, Daniel Joseph; Jelsema, Timothy; Sabesan, Vani

    2015-01-01

    Objectives: All-terrain vehicle (ATV) and dirt bike use is increasing in the US and is associated with risk of traumatic injury. Extremity fractures are common injures associated with these vehicles. The purpose of this study is to compare and contrast the patterns extremity fractures associated with ATVs and dirt bikes. Our hypothesis is that these different vehicles will result in similar rates of high impact injuries, but differences in vehicle stability will result in greater proportions of upper extremity fractures associated with ATV use. Methods: The National Electronic Injury Surveillance System (NEISS) was used to acquire data for extremity fractures related to ATV (3-wheels, 4-wheels, and number of wheels undefined) and dirt bike use from 2007-2012. Locations were coded as shoulder, upper arm, elbow, lower arm, wrist, hand, upper leg, knee, lower leg, ankle, foot, and toe. The data were stratified according to age and gender for each year. Incidence rates were calculated on a per vehicle basis using previous estimates of the number of ATVs and dirt bikes in the country. Results: The database yielded an estimate of 229,362.52 extremity fractures from 2007-2012. An estimated total of 130,319.20 fractures were associated with ATVs, while 99,043.37 were associated with dirt bikes. The incidence rates of extremity fractures associated with ATV and dirt bike use were 3.87 and 6.85 per 1000 vehicle-years. Most fractures were in patients 10-19 years of age, after which the number of fractures decreased with age. The largest proportion of all fractures occurred in the shoulder (27.19%), followed by the wrist and lower leg (13.77% and 12.36%, respectively). This distribution of fractures was consistent among ATV use for all age groups except in the 0-9 year olds, where the lower arm and wrist were the most commonly fractured locations. Fracture distribution associated with dirt bike use also followed this general pattern, with the exception of 0-9 and 10-19 year

  3. Physical spousal violence against women in India: some risk factors.

    Science.gov (United States)

    Jeyaseelan, L; Kumar, Shuba; Neelakantan, Nithya; Peedicayil, Abraham; Pillai, Rajamohanam; Duvvury, Nata

    2007-09-01

    Domestic spousal violence against women in developing countries like India, is now beginning to be recognized as a widespread health problem impeding development. This study aimed to explore the risk and protective factors for lifetime spousal physical violence. A cross-sectional household survey was carried out in rural, urban and urban-slum areas across seven sites in India, among women aged 15-49 years, living with a child less than 18 years of age. The sample was selected using the probability proportionate to size method. Trained field workers administered a structured questionnaire to elicit information on spousal physical violence. The main hypothesized variables were social support, witnessed father beating mother and experience of harsh physical violence during childhood, alcohol abuse by spouse and socioeconomic variables. The outcome variables included three physical violence behaviours of hit, kick and beat. Odds ratios were calculated for risk and protective factors of violence using logistic regression. Of 9938 women surveyed, 26% reported experiencing spousal physical violence during the lifetime of their marriage. Adjusted odds ratios calculated using multiple logistic regression analysis suggest that women whose husbands regularly consumed alcohol (OR 5.6; 95% CI 4.7-6.6); who experienced dowry harassment (OR 3.2; 95% CI 2.7-3.8); had reported experiencing harsh physical punishment during childhood (OR 1.6; 95% CI 1.4-1.8) and had witnessed their fathers beat their mothers (OR 1.9; 95% CI 1.6-2.1), were at increased risk of spousal physical violence (beat, hit and kick). Higher socioeconomic status and good social support acted as protective buffers against spousal physical violence. The findings provide compelling evidence of the potential risk factors for spousal physical violence, which in turn could help in planning interventions.

  4. Spousal resemblance in psychopathology: A comparison of parents of children with and without psychopathology

    NARCIS (Netherlands)

    Wesseldijk, L. W.; Dieleman, G. C.; Lindauer, R. J. L.; Bartels, M.; Willemsen, G.; Hudziak, J. J.; Boomsma, D. I.; Middeldorp, C. M.

    2016-01-01

    Spouses resemble each other for psychopathology, but data regarding spousal resemblance in externalizing psychopathology, and data regarding spousal resemblance across different syndromes (e.g. anxiety in wives and attention deficit/hyperactivity disorder [ADHD] in husbands) are limited. Moreover,

  5. Fabrication of a Textured Non-Magnetic Ni-12at.%V Alloy Substrate for Coated Conductors

    DEFF Research Database (Denmark)

    Gao, M. M.; Grivel, Jean-Claude; Suo, H. L.

    2011-01-01

    Ni-12at.%V alloy is a promising candidate for non-magnetic cube textured metallic substrates used for high temperature coated conductors. In this work, a textured Ni-12at.%V substrate has been fabricated by powder metallurgy route. After cold rolling and recrystallization annealing, a cube texture...

  6. Gender Differences in Dementia Spousal Caregiving

    Directory of Open Access Journals (Sweden)

    Minna Maria Pöysti

    2012-01-01

    Full Text Available The proportion of male caregivers is rapidly increasing. However, there are few large scale studies exploring gender differences in the burden or coping with caregiving. We investigated this among caregivers of patients with dementia. The study cohort consisted of 335 dyads of wife-husband couples from two studies including dementia patients and their spousal caregivers. Baseline mini-mental state examination (MMSE, clinical dementia rating scale (CDR, neuropsychiatric inventory (NPI, cornell depression scale and charlson comorbidity index (CCI were used to describe patients with dementia, Zarit burden scale and geriatric depression scale were used to measure experienced burden and depression of caregivers. Mean age of caregivers was 78 years. There were no differences in depression, satisfaction with life, or loneliness according to caregivers' gender. Male caregivers had more comorbidities than females (CCI 1.9 versus 1.1, P<0.001, and the wives of male caregivers had a more severe stage of dementia than husbands of female caregivers (CDR, P=0.048; MMSE14.0 versus 17.7, P<0.001. However, the mean Zarit burden scale was significantly lower among male than female caregivers (31.5 versus 37.5; P<0.001. Lower education of male caregivers tended to be associated with less experienced burden. In conclusion, male caregivers of dementia experienced lower burden than female caregivers despite care recipients' more severe disease.

  7. Modeling the Distress of Spousal Caregivers of People with Dementia.

    Science.gov (United States)

    Wawrziczny, Emilie; Berna, Guillaume; Ducharme, Francine; Kergoat, Marie-Jeanne; Pasquier, Florence; Antoine, Pascal

    2017-01-01

    The progressive mobilization of spouse caregivers who take care of a person with dementia (PWD) can lead to situations of distress. The current study sought to investigate the influence of the characteristics of the caregiving context on spousal caregiver distress. 125 spousal caregivers participated in this study. The characteristics of the caregiving context were assessed using questionnaires. We examined a moderated-mediator model (Step 1) in which we hypothesized that PWD and caregiver characteristics and dyadic determinants contribute to spousal caregiver distress. This model was compared based on the age at onset of the disease and the gender of the caregiver (Step 2). The model revealed that poor self-rated health and a lack of family support accentuated spousal caregiver distress, whereas the feeling of being prepared and level of confidence decreased spousal caregiver distress. Moreover, the quality of couple adjustment affected spousal caregiver distress, and this effect was mediated by the severity of the PWD's symptoms. Regarding the age at onset of the disease, the path between Couple Adjustment and the Care recipient's impairments was more important for caregivers of person with early-onset dementia (PEOD). Female caregivers who reported poor self-rated health experienced greater distress. It would be interesting to create a support program that would incorporate these three areas of intervention regarding the progression of the disease: first, "preparedness modules"; second, "dyadic modules" (especially for caregivers of PEOD); and third, "family modules". Specific attention should be given to female caregivers who report poor self-rated health.

  8. Spousal Recollections of Early Signs of Primary Progressive Aphasia

    Science.gov (United States)

    Pozzebon, Margaret; Douglas, Jacinta; Ames, David

    2018-01-01

    Background: Although primary progressive aphasia (PPA) is characterized by progressive loss of language and communication skills, knowledge about the earliest emerging signs announcing the onset of this condition is limited. Aims: To explore spousal recollections regarding the earliest signs of PPA and to compare the nature of the earliest…

  9. Does spousal participation in Gamblers Anonymous benefit compulsive gamblers?

    Science.gov (United States)

    Johnson, E E; Nora, R M

    1992-12-01

    Extent of gambling-free periods was compared for 90 compulsive gamblers, 44 with spouses who participated in Gamblers Anonymous and 46 with spouses who did not. Although the results were in the direction of a beneficial effect of spousal participation, the relationship was statistically nonsignificant.

  10. Influence of Spousal Communication on Marital Stability: Implication ...

    African Journals Online (AJOL)

    It is often said that the home is the basic unit of the larger society. Thus when the home is settled, the society is at peace. The main focus of this study was to find out the influence of spousal communication on marital stability: Implications for Conducive Home Environment. A researcher-designed questionnaire titled ...

  11. Owners' Dynamic Capabilities and Spousal Resources in Small ...

    African Journals Online (AJOL)

    The study explores the relationship between spousal resources and franchisees' dynamic capabilities using both in-depth interviews and questionnaires from the convenience store franchisees in Taiwan. Franchising is recognized as one of the fastest paths to success for a small business, and many owners of the franchise ...

  12. Effect of male partner's support on spousal modern contraception in ...

    African Journals Online (AJOL)

    Background: As efforts continue to increase contraceptive uptake, male partner support remains important in spousal modern contraceptive use. Methods: A prospective cross-sectional survey involving women on modern contraception was conducted at the family planning clinic of the University of Ilorin Teaching Hospital, ...

  13. Concordância associativa

    Directory of Open Access Journals (Sweden)

    Ingedore Grunfeld Villaça Koch

    2000-10-01

    Full Text Available Este estudo objetiva discutir o alcance que se vem dando à noção deanáfora associativa, com o objetivo de explicar os casos de concordância ad sensum ou silepses de gênero e número. Recorre-se, também,para justificar tais tipos de concordância, às noções de microssintaxe ede macrossintaxe.

  14. Engaging Agribusinesses: Feasibility and Cost of an ATV Safety Poster Project.

    Science.gov (United States)

    Jennissen, Charles A; Sweat, Shane; Wetjen, Kristel; Hoogerwerf, Pam; Denning, Gerene M

    2017-01-01

    All-terrain vehicle (ATV)-related deaths and injuries continue to be a significant problem. Influential change agents such as agribusinesses could be important partners for improving safety behaviors among rural ATV users. Our objective was to determine how effectively an injury prevention project could engage agribusinesses through the postal service and to assess their willingness to display a safety poster. One thousand two hundred forty-four agribusinesses received an ATV safety poster and a postcard survey by mail. A randomized sampling of these businesses was surveyed by telephone 4-7 weeks later. Telephone survey questions included whether they recalled receiving the poster, and if so, whether, where and how long the poster was displayed. One hundred six postcards were returned. Of the 192 eligible business persons contacted by telephone, 89% agreed to participate. Approximately one-third of telephone survey participants recalled receiving the poster. Among these, 81% with walk-in customers posted it, and 74% still had it displayed 1 month later. Of participants who did not recall receiving the poster, 83% stated they would have displayed the poster. The cost of displaying each poster in a business was 16.6 cents/day during the first month. Final costs/day would be much less because of continued display. A high percentage of agribusinesses displayed or would have displayed an ATV safety poster, and most displayed it beyond 1 month. Unfortunately, participant recruitment via postal delivery alone was challenging. Nevertheless, mass mailing of injury prevention materials to be displayed in the retail setting may be a low cost method for raising safety awareness.

  15. The nature and scope of stressful spousal caregiving relationships.

    Science.gov (United States)

    Davis, Linda Lindsey; Gilliss, Catherine L; Deshefy-Longhi, Tess; Chestnutt, Deborah H; Molloy, Margory

    2011-05-01

    The caregiving literature provides compelling evidence that caregiving burden and depressive symptoms are linked with stressful care relationships, however, relational difficulties around caregiving are seldom described in the literature. This article presents findings from content analysis of baseline interviews with 40 Alzheimer's disease (AD) and Parkinson's disease (PD) spousal caregivers enrolled in a home care skill-training trial who identified their care relationship as a source of care burden. Disappointment and sadness about the loss of the relationship; tension within the relationship; and care decision conflicts within the relationship were recurrent themes of relational stress in caregiving. These spousal caregivers had relationship quality scores below the mean and burden and depressive symptom scores above the means of other caregivers in the study. These findings provide support for developing dyadic interventions that help spouses manage relational losses, care-related tensions, and care decision-making conflicts.

  16. Living with loss: middle-aged men face spousal bereavement.

    Science.gov (United States)

    Daggett, Luann M

    2002-05-01

    Spousal bereavement is one of the most profoundly disturbing events encountered in the human life span. Research has shown that conjugal bereavement has significant physical and psychological consequences for the surviving spouse. In American culture, men and women experience bereavement in different ways. The author used in-depth interviews in the tradition of phenomenology to collect data from 8 men aged 41 to 54 years who had experienced the death of their spouse within the previous 8 months to 6 years. The research revealed the lived experience of spousal bereavement to be a journey from the realization of irreconcilable loss through themes of responding to the loss and living through the loss toward reclamation and reconstruction of a life.

  17. Effect of Marriage and Spousal Criminality on Recidivism

    DEFF Research Database (Denmark)

    Andersen, Signe Hald; Andersen, Lars Højsgaard; Skov, Peer Ebbesen

    2015-01-01

    The authors analyzed whether the effect of marriage on recidivism varied by spousal criminality. For this purpose, they used propensity score matching and full population data from Statistics Denmark on all unmarried and previously convicted men from birth cohorts 1965–1985 (N = 102,839). The res......The authors analyzed whether the effect of marriage on recidivism varied by spousal criminality. For this purpose, they used propensity score matching and full population data from Statistics Denmark on all unmarried and previously convicted men from birth cohorts 1965–1985 (N = 102......,839). The results showed that marriage reduced recidivism compared to nonmarriage only when the spouse had no criminal record. Similarly, marriage to a nonconvicted spouse reduced recidivism significantly more than marriage to a convicted spouse. These findings not only underline how important marriage...... is for social integration but also stress the heterogeneous nature of the protective effects of marriage....

  18. Effect of Marriage and Spousal Criminality on Recidivism

    OpenAIRE

    Andersen, Signe Hald; Andersen, Lars H?jsgaard; Skov, Peer Ebbesen

    2015-01-01

    The authors analyzed whether the effect of marriage on recidivism varied by spousal criminality. For this purpose, they used propensity score matching and full population data from Statistics Denmark on all unmarried and previously convicted men from birth cohorts 1965?1985 (N?=?102,839). The results showed that marriage reduced recidivism compared to nonmarriage only when the spouse had no criminal record. Similarly, marriage to a nonconvicted spouse reduced recidivism significantly more tha...

  19. Relationships between soldiers' PTSD symptoms and spousal communication during deployment.

    Science.gov (United States)

    Carter, Sarah; Loew, Benjamin; Allen, Elizabeth; Stanley, Scott; Rhoades, Galena; Markman, Howard

    2011-06-01

    Social support, including support from spouses, may buffer against posttraumatic stress disorder (PTSD) symptoms. The current study assessed whether the frequency of spousal communication during a recent deployment, a potentially important source of support for soldiers, was related to postdeployment PTSD symptoms. Data came from 193 married male Army soldiers who returned from military deployment within the past year. For communication modalities conceptualized as delayed (i.e., letters, care packages, and e-mails), greater spousal communication frequency during deployment was associated with lower postdeployment PTSD symptom scores, but only at higher levels of marital satisfaction (p = .009). At lower marital satisfaction, more delayed spousal communication during deployment was associated with more PTSD symptoms (p = .042). For communication modalities conceptualized as interactive (i.e., phone calls, instant messaging, instant messaging with video), the same general direction of effects was seen, but the interaction between communication frequency and marital satisfaction predicting PTSD symptoms did not reach significance. Copyright © 2011 International Society for Traumatic Stress Studies.

  20. Emotional Expression and Spousal Support as Predictors of Marital Satisfaction: The Case of Turkey

    Science.gov (United States)

    Yedirir, Sabiha; Hamarta, Erdal

    2015-01-01

    This study examines the relationship between spousal support and the ability to express feelings of marital satisfaction, and the extent to which spousal support and the ability to express feelings can predict marital satisfaction. Research was conducted in accordance with general survey models. The study group comprised 195 married couples (N =…

  1. U.S. spousal homicide rates by racial composition of marriage.

    Science.gov (United States)

    Roberts, John M

    2015-09-01

    American spousal homicide rates persistently and substantially vary by racial composition of the married couple. Analyses examined different racial couple types' spousal homicide rates in light of nonspousal homicide victimization and offending rates and couple types' average social, demographic, and economic characteristics. Analyses used 2003 to 2007 spousal homicide data from Supplementary Homicide Reports for which missing data have been multiply imputed. Current Population Survey data provided estimates of the number and average characteristics of different couple types. Log-linear models related couple types' differing spousal homicide rates to different race-sex groups' general rates of homicide victimization and offending and couple types' average characteristics. Among couple types with at least 50,000 couples, annual rates of male-on-female spousal homicide ranged from 0.95 to 8.76 per 100,000 couples; for female-on-male spousal homicide, this range was 0.13 to 2.29. Rates somewhat reflect different race-sex groups' nonspousal homicide activity, but with greater gender disparity and an excess of spousal homicide in some couple types. The association between victim's and offender's race is parsimoniously described by models using couple types' average characteristics (proportion with female's education exceeding the male's, proportion in central cities, and relative frequency). General homicidal-violence reduction strategies may partly apply to spousal homicide, but specifically targeted efforts are required too. Interventions must address different couple types' particular social, economic, and cultural experiences. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Effect of Marriage and Spousal Criminality on Recidivism.

    Science.gov (United States)

    Andersen, Signe Hald; Andersen, Lars Højsgaard; Skov, Peer Ebbesen

    2015-04-01

    The authors analyzed whether the effect of marriage on recidivism varied by spousal criminality. For this purpose, they used propensity score matching and full population data from Statistics Denmark on all unmarried and previously convicted men from birth cohorts 1965-1985 (N = 102,839). The results showed that marriage reduced recidivism compared to nonmarriage only when the spouse had no criminal record. Similarly, marriage to a nonconvicted spouse reduced recidivism significantly more than marriage to a convicted spouse. These findings not only underline how important marriage is for social integration but also stress the heterogeneous nature of the protective effects of marriage.

  3. Characteristics of spousal homicide perpetrators: a study of all cases of spousal homicide in Sweden 1990-1999.

    Science.gov (United States)

    Belfrage, Henrik; Rying, Mikael

    2004-01-01

    In Sweden 20 000 cases of assault against women are reported to the police every year. All data on the perpetrators of spousal homicide in Sweden between 1990 and 1999 were investigated (n = 164). A control group of all other perpetrators of homicide in Sweden during the same period, i.e. cases of homicide not committed in the context of spouse violence (n = 690) was used. All verdicts, as well as all material in the police investigations, including interviews with all of the police investigators, were analysed. Copies of police examinations of the suspects, and forensic reports from the autopsies, were also examined. Data on all registered criminality were collected from the National Police Register, and in cases where the perpetrators had been subject to forensic psychiatric examinations, those reports were obtained from the Swedish National Board of Forensic Medicine. In addition, the Psychopathy Checklist: Screening Version scores were rated from the forensic psychiatric examinations. There was a four times higher suicide rate among the spousal homicide perpetrators (24%, n = 40) compared with the perpetrators in the control-group (6%, n = 39, chi-squared = 55,42 df = 1, p suicidal ideation must be considered as an important risk factor for spousal homicide. In 79% of the cases the spousal homicide perpetrators were subject to forensic psychiatric examinations. All except 5% were diagnosed with at least one psychiatric diagnosis, and 34% were sentenced to forensic psychiatric treatment. If it is assumed that the psychiatric morbidity was high in the 24% of the perpetrators who committed suicide, then 80% of all perpetrators of spouse homicide during the study period can be characterized as mentally disordered. 'Psychopathic' perpetrators, who generally are over-represented in most violent criminality, were comparatively uncommon. Only seven (4%) in the study group met the diagnostic criteria for psychopathy as measured with the PCL:SV. The group of spouse

  4. ATV manual: Industrial effluents of the chemical industry, food processing industry, consumer goods industries and public services. 4. ed.; ATV-Handbuch: Industrieabwasser - Dienstleistungs- und Veredelungsindustrie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The book describes liquid effluents of the following industries: Animal and plant production; flesh meal production; sausage casings processing; leather, glue and gelatine production; fish meal production; paper and cellulose production; textile industry; motor car repair shops; railway industry; carwash facilities; military services; tank cleaning; laundries and cleaners'; waste management systems; hospitals. Each chapter contains information on the industry concerned, its capacity and products, including all process stages, technologies, and flowcharts. Effluent-relevant process stages are analyzed, and their environmental relevance is assessed. In each case, the available options for waste treatment are pointed out. Practical example, technical data and cost figures supplement the text. [German] Das vorliegende ATV-Handbuch behandelt die wichtigsten Industriebranchen der Dienstleistungs- und Veredelungsindustrie: Betriebe der Tier- und Pflanzenproduktion - Fleischmehlindustrie - Naturdarmbearbeitungsbetriebe - Lederherstellung, Hautleim- und Gelatineindustrie - Fischmehlfabriken - Papier- und Zellstoffindustrie - Textilindustrie - Kfz-Werkstaetten - Eisenbahn - Kfz-Waesche - Militaer, Entkonservierung - Transportbehaelterinnenreinigung - Gewerbliche Waescherei und Textilreinigung - Sickerwasser aus Abfallanlagen - Krankenhausabwasser. Jedes Kapitel beginnt mit einer Uebersicht ueber die Bedeutung der Branche, ihre Kapazitaet sowie deren Fertigerzeugnisse. Die Produktionsschritte und -techniken werden erlaeutert, wobei in Fliessschemata auch alle beteiligten Stoffstroeme dargestellt sind. Abwasserrelevante Teilstroeme werden analysiert und der immer mehr an Bedeutung zunehmende produktionsintegrierte Umweltschutz entsprechend gewichtet. Die verfahrenstechnischen Moeglichkeiten der Abwasserbehandlung - Vorbehandlung, Indirekt- und Direkteinleitung - werden aufgezeigt. Anwendungsbeispiele aus der Praxis, die neben der Verfahrenstechnik auch Anlagen zu

  5. Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Runeson, Bo; Bolton, James M.

    2017-01-01

    Importance: Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. Objective: To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health...... outcomes when compared with the general population and spouses bereaved by other manners. Design, Setting, and Participants: This nationwide, register-based cohort study conducted in Denmark of 6.7 million individuals aged 18 years and older from 1980 to 2014 covered more than 136 million person......-years and compared people bereaved by spousal suicide with the general population and people bereaved by other manners of death. Incidence rate ratios were calculated using Poisson regressions while adjusting for sociodemographic characteristics and the presence of mental and physical disorders. Main Outcomes...

  6. Smoking within the Household: Spousal Peer Effects and Children's Health Implications

    OpenAIRE

    Canta, Chiara; Dubois, Pierre

    2011-01-01

    This paper studies spousal peer effects on the smoking behaviour and their implication for the health of children through passive smoking. Smoking decisions are modeled as equilibrium strategies of an incomplete information game within the couple. Using data from the French Health Survey 2002-2003, we identify two distinct effects linked to spousal behaviour: a smoking enhancing effect of smoking partners and a smoking deterring effect of non smoking partners. On the one hand, ...

  7. Notes on the knot concordance invariant Upsilon

    OpenAIRE

    Livingston, Charles

    2014-01-01

    The knot concordance invariant Upsilon, recently defined by Ozsvath, Stipsicz, and Szabo, takes values in the group of piecewise linear functions on the closed interval [0,2]. This paper presents a description of one approach to defining Upsilon and of proving its basic properties related to the knot 3-genus, 4-genus, and concordance genus.

  8. Motivational interviewing and concordance with antiretroviral therapy.

    Science.gov (United States)

    Brown, Michelle; Bennett, Clare

    Concordance with therapy is essential in maintaining quality of life for individuals who have human immunodeficiency virus. This article examines the use of motivational interviewing in assisting people to increase their concordance with antiretroviral therapy. It investigates the evidence base for motivational interviewing and discusses its principles and techniques. The article highlights the benefits of adopting a holistic approach to the intervention.

  9. A Semantic Analysis of Negative Concord

    NARCIS (Netherlands)

    Wouden van der, Ton; Zwarts, Frans

    1993-01-01

    It is not uncommon in natural languages that negation seems to behave in an illogical manner. The general term for the many cases where multiple occurrences of morphologically negative constituents express a single semantic negation is negative concord (Labov 1979). Negative concord may take either

  10. Integrated cosmological probes: concordance quantified

    Energy Technology Data Exchange (ETDEWEB)

    Nicola, Andrina; Amara, Adam; Refregier, Alexandre, E-mail: andrina.nicola@phys.ethz.ch, E-mail: adam.amara@phys.ethz.ch, E-mail: alexandre.refregier@phys.ethz.ch [Department of Physics, ETH Zürich, Wolfgang-Pauli-Strasse 27, CH-8093 Zürich (Switzerland)

    2017-10-01

    Assessing the consistency of parameter constraints derived from different cosmological probes is an important way to test the validity of the underlying cosmological model. In an earlier work [1], we computed constraints on cosmological parameters for ΛCDM from an integrated analysis of CMB temperature anisotropies and CMB lensing from Planck, galaxy clustering and weak lensing from SDSS, weak lensing from DES SV as well as Type Ia supernovae and Hubble parameter measurements. In this work, we extend this analysis and quantify the concordance between the derived constraints and those derived by the Planck Collaboration as well as WMAP9, SPT and ACT. As a measure for consistency, we use the Surprise statistic [2], which is based on the relative entropy. In the framework of a flat ΛCDM cosmological model, we find all data sets to be consistent with one another at a level of less than 1σ. We highlight that the relative entropy is sensitive to inconsistencies in the models that are used in different parts of the analysis. In particular, inconsistent assumptions for the neutrino mass break its invariance on the parameter choice. When consistent model assumptions are used, the data sets considered in this work all agree with each other and ΛCDM, without evidence for tensions.

  11. Sociodemographic Correlates of HIV Discordant and Concordant ...

    African Journals Online (AJOL)

    AIDS is significant. An understanding of the characteristics of HIV- affected couples will help modify preventive strategies. The aim of this study was to compare the HIV discordant and concordant partnerships for sociodemographic ...

  12. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...... of the working model. We further illustrate the methods by computing the concordance probability for a prognostic model of coronary heart disease (CHD) events in the presence of the competing risk of non-CHD death.......The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate...... it to recently proposed time-dependent area under the receiver operating characteristic curve measures. For right-censored data, we investigate inverse probability of censoring weighted (IPCW) estimates of a truncated concordance index based on a working model for the censoring distribution. We demonstrate...

  13. Spousal violence and paternal disinvestment among Tsimane' forager-horticulturalists.

    Science.gov (United States)

    Stieglitz, Jonathan; Kaplan, Hillard; Gurven, Michael; Winking, Jeffrey; Tayo, Basilio Vie

    2011-01-01

    We develop and test a conceptual model of factors influencing the likelihood of physical wife abuse. The paternal disinvestment model emphasizes that spousal conflict over resource use results from men's attempts to increase individual fitness at a cost to the family (e.g., through pursuit of extramarital affairs). We propose that men use violence to control women's responses to the diversion of resources away from the family: to quell women's objections to male disinvestment, maintain women's parental investment, and to dissuade women from pursuing relationships with other men. Interviews were conducted among men and women to determine rates of violence and demographic and behavioral covariates. Structural equation modeling and generalized estimating equations analyses were used to test predictions derived from the model. We also collected data on frequent complaints in marriage and women's perceptions of arguments precipitating violence. Over 85% of women experienced physical wife abuse (n = 49). Indicators of paternal disinvestment positively covary with indicators of marital strife and with rates of wife abuse. The wife's age, matrilocal residence, and presence of joint dependent offspring decrease the likelihood of violence through direct and indirect routes. Wife abuse is linked to the importance of paternal investment in human families, and is a means by which men control women's responses to a dual reproductive strategy of familial investment and pursuit of extramarital sexual relationships. This framework is more general than traditional sociological and evolutionary perspectives emphasizing patriarchy and men's sexual jealousy, respectively. Copyright © 2011 Wiley-Liss, Inc.

  14. [The influence of attitude of inhibiting spousal disclosure about stress on the mental health of firefighters].

    Science.gov (United States)

    Yoo, Seonyoung; Matsui, Yutaka

    2012-12-01

    The present study focused on attitudes related to inhibiting spousal disclosure about stress as an influential factor for the mental health of firefighters. In a pilot study using semi-structured interviews (N = 14), we found that some firefighters usually did not talk about their stresses with their spouses. Some reasons were that they were hiding their weakness, were feeling sure of controlling their stress, out of consideration for their spouse, were giving up on the possibility for improving the situation after spousal disclosure, or hoped to distract themselves. In a subsequent questionnaire survey (N = 554), the results showed that attitudes about inhibiting spousal disclosure of stress have an effect on spousal disclosure about stress and the mental health of firefighters. The findings of the present study imply that spousal disclosure about interpersonal stress can be regarded as an effective factor, along with the disclosure to colleagues, for relieving stress. It is necessary to consider the importance of attitudes about inhibiting disclosure for stress as part of stress management for firefighters.

  15. Feasibility of a pocket-PC based cognitive control intervention in dementia spousal caregivers.

    Science.gov (United States)

    Callan, Judith A; Siegle, Greg J; Abebe, Kaleab; Black, Beverly; Martire, Lynn; Schulz, Richard; Reynolds, Charles; Hall, Martica H

    2016-01-01

    Spousal caregivers of patients with dementia are in need of interventions to bolster their quality of life. Computer-based, self-administered cognitive training is an innovative approach to target spousal caregiver distress and coping. We tested the feasibility of administering one such intervention with minimal clinician intervention. Twenty-seven elderly adults (>64 years old), who each were the primary caregiver for a spouse with dementia, were recruited through the Memory Disorders Clinic of the Alzheimer Disease Research Center in Pittsburgh, PA. Spousal caregivers were instructed to use a handheld computer version of the Adaptive Paced Visual Serial Attention Task (APVSAT) at least three times per week for four weeks as part of a larger caregiver intervention trial (P01 AG020677). Feasibility was explored by examining the frequency of APVSAT usage. Results suggest that self-directed cognitive training is feasible for spousal caregivers of dementia patients. The mean usage of the APVSAT was 42 (SD = 28.58). Performance increased from the beginning to the end of the trial, and usage was not affected by stress, worry, or poor sleep quality. Findings suggest the potential utility of cognitive training via handheld computer for spousal caregivers of dementia patients to improve problem solving, coping and adaptation, planning, and persevering with goal-directed tasks.

  16. Spousal caregiving and financial strain among middle-aged and older adults.

    Science.gov (United States)

    Lee, Yeonjung; Zurlo, Karen A

    2014-01-01

    We examine whether spousal caregivers face difficulties in meeting their basic household expenses compared to nonspousal caregivers and whether social support mechanisms ameliorate any financial strain from caregiving responsibilities. We use data for caregivers aged 45 and over drawn from a nationally representative, cross-sectional Canadian Community Health Survey--Healthy Aging (N = 5,067). Spousal caregiving is associated with a 35% increase in the likelihood of experiencing difficulties in meeting basic expenses compared to other types of caregiving. Each of social support mechanisms (affectionate, emotional/informational, and positive social interaction), singularly and combined, lessens financial strain from caregiving. Our findings suggest that spousal caregivers are particularly vulnerable because they have fewer resources to draw on for support and perform much more intensive care. Our results highlight the importance of developing appropriate policies and programs to support caregivers. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Spousal communication and contraceptive use in rural Nepal: an event history analysis.

    Science.gov (United States)

    Link, Cynthia F

    2011-06-01

    This study analyzes longitudinal data from couples in rural Nepal to investigate the influence of spousal communication about family planning on their subsequent contraceptive use. The study expands current understanding of the communication-contraception link by (a) exploiting monthly panel data to conduct an event history analysis, (b) incorporating both wives' and husbands' perceptions of communication, and (c) distinguishing effects of spousal communication on the use of four contraceptive methods. The findings provide new evidence of a strong positive impact of spousal communication on contraceptive use, even when controlling for confounding variables. Wives' reports of communication are substantial explanatory factors in couples' initiation of all contraceptive methods examined. Husbands' reports of communication predict couples'subsequent use of male-controlled methods. This analysis advances our understanding of how marital dynamics--as well as husbands' perceptions of these dynamics--influence fertility behavior, and should encourage policies to promote greater integration of men into family planning programs.

  18. “Correcting an Erring Wife Is Normal”: Moral Discourses of Spousal Violence in Ghana

    DEFF Research Database (Denmark)

    Adjei, Stephen Baffour

    2015-01-01

    and other infractions against male authority in marriage. Both perpetrators and victims build their talk around familiar normative discourses and practices that provide tacit support for spousal violence in Ghana. While perpetrators mobilize culturally resonant and normative repertoires to justify abuse......This study draws insights from discursive psychology to explore moral discourses of spousal violence in Ghana. In particular, it investigates how sociocultural norms and practices are invoked in talk of perpetrators and victims as moral warrants for husband-to-wife abuse in Ghana. Semi......, blame their victims, and manage their moral accountability; victims position husband-to-wife abuse as normal, legitimate, disciplinary, and corrective. These moral discourses of spousal violence apparently serve to relieve perpetrators of moral agency; prime battered women to accept abuse; and devastate...

  19. The ESA/NASA Multi-Aircraft ATV-1 Re-Entry Campaign: Analysis of Airborne Intensified Video Observations from the NASA/JSC Experiment

    Science.gov (United States)

    Barker, Ed; Maley, Paul; Mulrooney, Mark; Beaulieu, Kevin

    2009-01-01

    In September 2008, a joint ESA/NASA multi-instrument airborne observing campaign was conducted over the Southern Pacific ocean. The objective was the acquisition of data to support detailed atmospheric re-entry analysis for the first flight of the European Automated Transfer Vehicle (ATV)-1. Skilled observers were deployed aboard two aircraft which were flown at 12.8 km altitude within visible range of the ATV-1 re-entry zone. The observers operated a suite of instruments with low-light-level detection sensitivity including still cameras, high speed and 30 fps video cameras, and spectrographs. The collected data has provided valuable information regarding the dynamic time evolution of the ATV-1 re-entry fragmentation. Specifically, the data has satisfied the primary mission objective of recording the explosion of ATV-1's primary fuel tank and thereby validating predictions regarding the tanks demise and the altitude of its occurrence. Furthermore, the data contains the brightness and trajectories of several hundred ATV-1 fragments. It is the analysis of these properties, as recorded by the particular instrument set sponsored by NASA/Johnson Space Center, which we present here.

  20. On the concordance genus of topologically slice knots

    OpenAIRE

    Hom, Jennifer

    2012-01-01

    The concordance genus of a knot K is the minimum Seifert genus of all knots smoothly concordant to K. Concordance genus is bounded below by the 4-ball genus and above by the Seifert genus. We give a lower bound for the concordance genus of K coming from the knot Floer complex of K. As an application, we prove that there are topologically slice knots with 4-ball genus equal to one and arbitrarily large concordance genus.

  1. SPOUSAL INTRUSION AS A PREDICTOR OF WIVES' MARITAL SATISFACTION IN THEIR SPOUSES' RETIREMENT.

    Science.gov (United States)

    Bozoglan, Bahadir

    2015-06-01

    Retirement of men changes their roles and participation and affects their spouses' daily routines, roles, and participation. This study assessed the effects of spousal intrusion on marital satisfaction in retirement. Questionnaires assessing demographics, spousal intrusion, shared couple activities, feelings, and marital satisfaction were administered to a group of 151 volunteer women whose husbands were retired in two cities in Turkey. The women were recruited among those who were willing to share their feelings and thoughts about their husbands' retirement process as a result of one-on-one interviews. Hierarchical regression analysis indicated that the perception of spousal intrusion, education status, frequency of shared activities, and dyadic adjustment predicted women's marital satisfaction in retirement. However, spousal intrusion did not significantly predict women's marital satisfaction when dyadic adjustment was entered in the second model. In the third model, final variables together predicted 19% of women's marital satisfaction in their spouse's retirement. These findings are important as they underline the factors affecting women's marital satisfaction in their spouses' retirement period.

  2. Spousal Caregivers of Persons with Alzheimer's and Parkinson's Disease Dementia: A Preliminary Comparison.

    Science.gov (United States)

    Dura, Jason R.; And Others

    1990-01-01

    Compared self- and other-rated depression in spousal caregivers for 23 Alzheimer's patients, 23 Parkinsons' Disease patients, and 23 control subjects. Two caregiver groups were similar in length of time they had been giving care and in caregiver distress and both caregiver groups were more depressed than control subjects. (Author/NB)

  3. Relationship satisfaction in couples confronted with colorectal cancer : the interplay of past and current spousal support

    NARCIS (Netherlands)

    Hagedoorn, Mariet; Dagan, Meirav; Puterman, Eli; Hoff, Christiaan; Meijerink, W. J. H. Jeroen; DeLongis, Anita; Sanderman, Robbert

    Based on attribution theory, this study hypthesized that past spousal supportiveness may act as a moderator of the link between one partner's current support behavior and the other partner's relationship satisfaction. A sample of 88 patients with colorectal cancer and their partners completed

  4. Individual and spousal unemployment as predictors of smoking and drinking behavior.

    Science.gov (United States)

    Arcaya, Mariana; Glymour, M Maria; Christakis, Nicholas A; Kawachi, Ichiro; Subramanian, S V

    2014-06-01

    The effects of unemployment on health behaviors, and substance use in particular, is still unclear despite substantial existing research. This study aimed to assess the effects of individual and spousal unemployment on smoking and alcohol consumption. The study was based on eight waves of geocoded Framingham Heart Study Offspring Cohort data (US) from 1971 to 2008 that contained social network information. We fit three series of models to assess whether lagged 1) unemployment, and 2) spousal unemployment predicted odds of being a current smoker or drinks consumed per week, adjusting for a range of socioeconomic and demographic covariates. Compared with employment, unemployment was associated with nearly twice the subsequent odds of smoking, and with increased cigarette consumption among male, but not female, smokers. In contrast, unemployment predicted a one drink reduction in weekly alcohol consumption, though effects varied according to intensity of consumption, and appeared stronger among women. While spousal unemployment had no effect on substance use behaviors among men, wives responded to husbands' unemployment by reducing their alcohol consumption. We conclude that individual, and among women, spousal unemployment predicted changes in substance use behaviors, and that the direction of the change was substance-dependent. Complex interactions among employment status, sex, and intensity and type of consumption appear to be at play and should be investigated further. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Spousal Support and Work--Family Balance in Launching a Family Business

    Science.gov (United States)

    Gudmunson, Clinton G.; Danes, Sharon M.; Werbel, James D.; Loy, Johnben Teik-Cheok

    2009-01-01

    This study examines whether emotional spousal support contributes to business owners' perceived work-family balance while launching a family business. Hobfoll's Conservation of Resources theory of stress is applied to 109 family business owners and their spouses. Results from structural equation models support several hypotheses. First, reports of…

  6. Voices of Strength and Struggle: Women's Coping Strategies against Spousal Violence in Pakistan

    Science.gov (United States)

    Zakar, Rubeena; Zakar, Muhammad Zakria; Kramer, Alexander

    2012-01-01

    This article documents the coping strategies adopted by women victims of spousal violence in Pakistan. By drawing on 21 in-depth interviews conducted in Lahore and Sialkot (Pakistan), we found that the women tried to cope with violence by using various strategies, both emotion focused (e.g., use of religion, placating the husband, etc.) and…

  7. Alcohol Involvement and Family Violence in a High Risk Sample: I. Spousal Violence.

    Science.gov (United States)

    Reider, Eve E.; And Others

    This report presents cross-sectional data on the relationships of alcohol difficulties, antisocial behavior, family conflict, family violence, and, particularly, spousal violence. The data were derived from a large-scale, longitudinal study of causes of alcohol abuse and the development of patterns of family violence. Subjects in the part of the…

  8. May I Recruit through Your Agency? Considerations for Researchers of Spousal Caregivers

    Science.gov (United States)

    Pote, Steven

    2016-01-01

    Few resources within social science literature provide helpful information related to participant recruitment for research on spousal caregivers of individuals with dementia. Independent researchers with limited resources may not have access to large databases or centers in which access to caregivers is readily available. As a result, these…

  9. Constitutional Law: Abortion, Parental and Spousal Consent Requirements, Right to Privacy

    Science.gov (United States)

    Long, Sharon L.; Ravenscraft, Patricia

    1976-01-01

    The constitutionality of the Missouri abortion statute was challenged by two physicians and Planned Parenthood of Central Missouri in the Danforth case. The Supreme Court reversed a district court decision in part, ruling that parental and spousal consent requirements are unconstitutional. For journal availability see HE 508 875. (LBH)

  10. Spousal Perceptions of Marital Stress and Support among Grandparent Caregivers: Variations by Life Stage

    Science.gov (United States)

    Matzek, Amanda E.; Cooney, Teresa M.

    2009-01-01

    Few studies have examined how raising grandchildren influences the marital relationship of grandparent caregivers although half of such caregivers are married. This study used national survey data from Midlife Development in the United States (MIDUS) to contrast perceptions of spousal support and strain for grandparents who had recently provided…

  11. A study of spousal domestic violence in an urban slum of Mumbai

    Directory of Open Access Journals (Sweden)

    Prateek S Shrivastava

    2013-01-01

    Results: The proportion of domestic violence was 36.9%. The most common form of violence was verbal in 87 (86.1% followed by physical in 64 (63.4%. Conclusion: A significant association was found between domestic violence and age, education, spousal alcoholism, and duration of marriage.

  12. "Correcting an Erring Wife Is Normal": Moral Discourses of Spousal Violence in Ghana.

    Science.gov (United States)

    Adjei, Stephen Baffour

    2015-12-16

    This study draws insights from discursive psychology to explore moral discourses of spousal violence in Ghana. In particular, it investigates how sociocultural norms and practices are invoked in talk of perpetrators and victims as moral warrants for husband-to-wife abuse in Ghana. Semi-structured focus group and personal interviews were conducted with a total of 40 participants: 16 victims, 16 perpetrators, and eight key informants from rural and urban Ghana. Participants' discursive accounts suggest that husbands have implicit moral right and obligation to punish their wives for disobedience and other infractions against male authority in marriage. Both perpetrators and victims build their talk around familiar normative discourses and practices that provide tacit support for spousal violence in Ghana. While perpetrators mobilize culturally resonant and normative repertoires to justify abuse, blame their victims, and manage their moral accountability; victims position husband-to-wife abuse as normal, legitimate, disciplinary, and corrective. These moral discourses of spousal violence apparently serve to relieve perpetrators of moral agency; prime battered women to accept abuse; and devastate their agency to leave abusive marital relationships. The findings contribute to our understanding of how cultural and social norms of spousal violence are morally constituted, reproduced, and sustained in talk of perpetrators, victims, and other key members of society. © The Author(s) 2015.

  13. Morbidities, concordance, and predictors of preterm premature ...

    African Journals Online (AJOL)

    2015-12-05

    Dec 5, 2015 ... accompany PPROM include prematurity, umbilical cord prolapse and compression, neonatal sepsis, respiratory. Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital. (UNTH), Enugu, Nigeria. TC Okeke ...

  14. Systematic Literature Review and Meta-Analysis of Renal Function in Human Immunodeficiency Virus (HIV-Infected Patients Treated with Atazanavir (ATV-Based Regimens.

    Directory of Open Access Journals (Sweden)

    Sandrine Cure

    Full Text Available Some HIV antiretroviral therapies (ART have been associated with renal toxicities, which become of increasing concern as HIV-infected patients age and develop comorbidities. The objective of this study was to evaluate the relative impact of atazanavir (ATV-based regimens on the renal function of adult patients with HIV. We conducted a systematic literature review by searching PubMed, EMBASE, Cochrane library, and the CRD from 2000 until March 2013. Major HIV-related conferences occurring in the past two years were also searched. All randomized clinical trials and large cohort studies assessing renal function in treatment-naïve and/or treatment-experienced HIV patients on ATV-based regimens were included. Fixed-effect mixed-treatment network analyses were carried out on the most frequently reported renal outcomes. 23 studies met the inclusion criteria, and change in estimated glomerular filtration rate (eGFR from baseline to 48 weeks was identified as the main outcome. Two networks including, respectively, six studies (using the Cockcroft-Gault method and four studies (using MDRD and CKD-EPI were analysed. With CG network, ATV/r + TDF/FTC was associated with lower impact on the decline of eGFR than ATV/cobicistat + TDF/FTC but with higher decrease in eGFR than ATV/r + ABC/3TC (difference in mean change from baseline in eGFR respectively +3.67 and -3.89. The use of ATV/cobicistat + TDF/FTC led to a similar decline in eGFR as EVG/cobicistat/TDF/FTC. With respect to third agents combined with TDF/FTC, ATV/r had a lower increase in eGFR in comparison to EFV, and no difference was shown when compared to SQV/r and DRV/r. The effect of ATV-based regimens on renal function at 48 weeks appears similar to other ART regimens and appears to be modest regardless of boosting agent or backbone, although TDF containing backbones consistently leads to greater decline in eGFR.

  15. Spousal violence and receipt of skilled maternity care during and after pregnancy in Nepal.

    Science.gov (United States)

    Furuta, Marie; Bick, Debra; Matsufuji, Hiromi; Coxon, Kirstie

    2016-12-01

    a substantial number of Nepali women experience spousal violence, which affects their health in many ways, including during and after pregnancy. This study aimed to examine associations between women's experiences of spousal violence and their receipt of skilled maternity care, using two indicators: (1) receiving skilled maternity care across a continuum from pregnancy to the early postnatal period and (2) receiving any skilled maternity care in pregnancy, childbirth, or postpartum. data were analysed for married women aged 15-49 from the 2011 Nepal Demographic and Health Survey. Data were included on women who completed an interview on spousal violence as part of the survey and had given birth within the five years preceding the survey (weighted n=1375). Logistic regression models were developed for analyses. the proportion of women who received skilled maternity care across the pregnancy continuum and those who received any skilled maternity care was 24.1% and 53.7%, respectively. Logistic regression analyses showed that spousal violence was statistically significantly associated with receiving low levels of skilled maternity care, after adjusting for accessibility of health care. However, after controlling for women's sociodemographic backgrounds (age, number of children born, educational level, husband's education level, husband's occupation, region of residence, urban/rural residence, wealth index), these significant associations disappeared. Better-educated women, women whose husbands were professionals or skilled workers and women from well-off households were more likely to receive skilled maternity care either across the pregnancy continuum or at recommended points during or after pregnancy. spousal violence and low uptake of skilled maternity care are deeply embedded in a society in which gender inequality prevails. Factors affecting the receipt of skilled maternity care are multidimensional; simply expanding geographical access to maternity services may

  16. Couple's concordance and discordance in household decision-making and married women's use of modern contraceptives in Bangladesh.

    Science.gov (United States)

    Uddin, Jalal; Hossin, Muhammad Zakir; Pulok, Mohammad Habibullah

    2017-11-09

    Although a large body of studies documents that women's autonomy in the household is associated with better reproductive health outcomes, these studies typically examined autonomy only from women's point of view. The current study employs husband's and wife's perspectives together to examine the relationship between the decision-making arrangements in the household and the women's use of modern contraceptives in Bangladesh. The study used the couple dataset of 2007 Bangladesh Demographic and Health Survey. The sample was comprised of 3336 married couples. Binary logistic regression models were used to examine the associations between the selected items on household decision-making and the use of modern contraceptives. Our results indicate that the couples disagree considerably as to who in the household exercises the decision-making power. The pattern of decision-making regarding visiting family and relatives emerged as an important predictor of use of modern contraceptives in the multivariate regression analysis. The results suggest that compared to the couple's concordant joint decision-making, the husband-only decision-making is associated with lower odds of contraceptives use (OR 0.49; 95% CI 0.28-0.85). Only a small part of this association is explained by spousal communication about family planning issues while the socio-demographic correlates hardly affected the association. On the contrary, the wife-only decision-making did not result in increased contraceptives use (OR 0.71; 95% CI 0.45-1.13). The study findings imply that women's greater autonomy may not necessarily result in improved reproductive health behavior, and therefore, a balance of power in the spousal relationship is warranted.

  17. The Origin of Spousal Resemblance for Alcohol Use Disorder.

    Science.gov (United States)

    Kendler, Kenneth S; Lönn, Sara Larsson; Salvatore, Jessica; Sundquist, Jan; Sundquist, Kristina

    2018-03-01

    Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear. To examine longitudinally, in first marriages, the association of a first registration for AUD in one spouse with risk of registration in his or her partner and to explore changes in the risk for AUD registration in individuals with multiple marriages as they transition from a spouse with AUD to one without or vice versa. Population-wide Swedish registries were used to identify individuals born in Sweden between 1960 and 1990 who were married before the end of study follow-up on December 31, 2013. The study included 8562 marital pairs with no history of AUD registration prior to their first marriage and an AUD registration in 1 spouse during marriage and 4891 individuals with multiple marriages whose first spouse had no AUD registration and second spouse did or vice versa. Final statistical analyses were conducted from August 15 to September 1, 2017. A spousal onset or history of AUD registration. Alcohol use disorder registration in national medical, criminal, or pharmacy registries. Among the 8562 marital pairs (5883 female probands and 2679 male probands; mean [SD] age at marriage, 29.2 [5.7] years) in first marriages, the hazard ratio of AUD registration in wives immediately after the first AUD registration in their husbands was 13.82, which decreased 2 years later to 3.75. The hazard ratio of AUD registration in husbands after the first AUD registration in their wives was 9.21, which decreased 2 years later to 3.09. Among the 4891 individuals with multiple marriages (1439 women and 3452 men; mean [SD] age at first marriage, 25.5 [4.2] years), when individuals transitioned from a first marriage to a spouse with AUD to a second marriage to a spouse without AUD, the hazard ratio for AUD registration was 0.50 (95% CI, 0.42-0.59) in women and 0.51 (95% CI, 0.44-0.59) in men. After a first marriage to a spouse without AUD, the

  18. Concordant DNA Methylation in Synchronous Colorectal Carcinomas

    Science.gov (United States)

    Konishi, Kazuo; Shen, Lanlan; Jelinek, Jaroslav; Watanabe, Yoshiyuki; Ahmed, Saira; Kaneko, Kazuhiro; Kogo, Mari; Takano, Toshihumi; Imawari, Michio; Hamilton, Stanley R.; Issa, Jean-Pierre J.

    2012-01-01

    Epigenetic changes have been proposed as mediators of the field defect in colorectal carcinogenesis, which has implications for risk assessment and cancer prevention. As a test of this hypothesis, we evaluated the methylation status of eight genes (MINT1, 2, 31, MLH1, p16, p14, MGMT, and ESR1), as well as BRAF and KRAS mutations, in 57 multiple colorectal neoplasias (M-CRN) and compared these to 69 solitary colorectal cancers (S-CRC). There were no significant differences in methylation between M-CRNs and S-CRCs except for p14 and MGMT that was significantly higher in M-CRNs than S-CRCs (16.1% versus 9.3%; 26.5% versus 17.3%, respectively; P < 0.05). We found significant (P < 0.05) correlations for MINT1 (r = 0.8), p16 (r = 0.8), MLH1 (r = 0.9), and MGMT (r = 0.6) methylation between tumors pairs of the same site (proximal/proximal and distal/distal). KRAS showed no concordance in mutations. BRAF mutation showed concordance in proximal site pairs but was discordant in different site pairs. Histologically, eight of 10 paired cancers with similar locations were concordant for a cribriform glandular configuration. We conclude that synchronous colorectal tumors of the same site are highly concordant for methylation of multiple genes, BRAF mutations, and a cribriform glandular configuration, all consistent with a patient-specific predisposition to particular subtypes of colorectal cancers. Screening for and secondary prevention of colon cancer should take this fact into account. PMID:19737982

  19. Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors.

    Science.gov (United States)

    Ismayilova, Leyla

    2015-11-01

    I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries. I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months. Partner's problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands. My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions.

  20. Association between spousal emotional abuse and reproductive outcomes of women in India: findings from cross-sectional analysis of the 2005-2006 National Family Health Survey.

    Science.gov (United States)

    Tiwari, Sucheta; Gray, Ron; Jenkinson, Crispin; Carson, Claire

    2018-03-09

    Spousal violence against women is a global public health problem. In India, approximately 40% of women report spousal violence. Like physical and sexual violence, emotional violence may be a determinant of women's health. This study explores the association between exposure to spousal emotional abuse and poor reproductive outcomes in Indian women. Data on 60,350 women, collected in the Third Indian National Family Health Survey were analysed to assess the impact of spousal emotional abuse on seven reproductive outcomes: age at first birth, number of children, terminated pregnancies, unwanted pregnancies, access to prenatal and skilled delivery care, and breastfeeding. Spousal emotional abuse was assessed using two overlapping constructs: emotional violence and controlling behaviour. Multivariable logistic regression was used for analysis. Spousal emotional violence and controlling behaviour was reported by 16 and 38% of the women, respectively. In unadjusted analyses, spousal emotional violence was associated with all adverse reproductive outcomes, except breastfeeding. Controlling for socio-demographic risk factors attenuated the association, and further adjustment for other forms of violence removed all significant associations. Spousal controlling behaviour was significantly associated with all outcomes, except breastfeeding. The effects remained statistically significant in multivariable regression. Women's experience of violence may be under-reported. When other forms of violence were adjusted for, emotional violence was not associated with adverse reproductive outcomes, whereas controlling behaviour remained associated with all but one adverse reproductive outcome. Therefore, spousal controlling behaviour requires further investigation as a determinant of reproductive health.

  1. Why Does Spousal Education Matter for Earnings? Assortative Mating or Cross-productivity

    OpenAIRE

    Chong Huang; Hongbin Li; Pak Wai Liu; Junsen Zhang

    2006-01-01

    In interpreting the positive relationship between spousal education and one's earnings, economists have two major hypotheses: cross-productivity between couples and assortative mating. However, no prior empirical study has been able to separate the two effects. This paper empirically disentangles the two effects by using twins data that we collected from urban China. We have two major innovations: we use twins data to control for the unobserved mating effect in our estimations, and we estimat...

  2. Spousal Effects in Smoking Cessation: Matching, Learning, or Bargaining?

    OpenAIRE

    Kerry Anne McGeary

    2015-01-01

    Previous research studying the correlation in smoking behavior between spouses has discounted the role of bargaining or learning. Using the Health and Retirement Study, which contains information on smoking cessation and spouse’s preferences, this paper presents an essential investigation of the impact of spousal bargaining or learning on the decision to cease smoking. We find that, regardless of gender, when one member of a couple ceases smoking this induces the other member to cease smoking...

  3. The link among self-esteem, differentiation, and spousal intimacy in deaf and hearing adults.

    Science.gov (United States)

    Levinger, Miriam; Ronen, Tammie

    2010-01-01

    Family, as the most important human support system, is the major component that clinicians can use to help people in their struggle to cope, adjust, and adapt to society. The ability to form a family and intimate relations with a spouse comprises a central measure of normative adult functioning and a critical stage of adult development. This study examined a personal component (self-esteem), an original family component (differentiation), and the capacity for spousal intimacy among 101 deaf adults (comprising about one fourth of the Israeli deaf population) and 57 normally hearing adults matched to the deaf sample according to age, gender, place of birth, and marital status. As expected, correlations emerged between higher levels of self-esteem, greater emotional differentiation from parents, and higher spousal intimacy within each group. Also, intergroup differences emerged, with deaf participants lower than their hearing peers both in self-esteem and ability for spousal intimacy. Contrary to expectations, differentiation from original family was similar in both groups. Results emphasized the significant contribution of self-esteem to adult functioning. Outcomes pinpoint the need for social workers and other clinicians to increase these clients' self-esteem to improve functioning.

  4. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    Science.gov (United States)

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Immigration policy and economic cycle effects on spousal reunification in Spain

    Directory of Open Access Journals (Sweden)

    Francisco Javier Mato Díaz

    2017-09-01

    Full Text Available This paper analyzes the influence of immigration policy and the Great Recession on spousal reunification in Spain. After a significant immigration boom (2000-2008, family-related migration has contributed to the significant flows that continued to arrive in Spain during the economic crisis. But this type of migration was subject to both the crisis and immigration policy changes, such as visa conditions, which may not have been specifically addressed to influence these flows. Using data from the Spanish Labor Force Survey (LFS, the research considers married primary immigrants who came to Spain from the four main countries of origin (Ecuador, Colombia, Romania and Morocco and concludes, first, that tighter conditions to visit the country—particularly tourist border controls—discourage spousal reunification. The reason could be that during the immigration boom, illicit immigration abounded and secondary immigrants were arriving as tourists. Secondly, reunification was slowed down by the Great Recession for the majority of the countries considered, except Ecuador. Unsurprisingly, given the job losses in typical male jobs, the negative influence of the crisis is greater for female primary immigrants. Third, contrary to the expectations that placed secondary immigrants as people with relatively low ties to the labor market, the research shows that because spousal reunification coincided with a deep economic and job crisis, female secondary immigrants increased the family labor supply in order to maintain consumption and/or remittance in what looks like an added-worker effect.

  6. To Love is to Suffer: Older Adults' Daily Emotional Contagion to Perceived Spousal Suffering.

    Science.gov (United States)

    Monin, Joan K; Levy, Becca R; Kane, Heidi S

    2017-05-01

    For older adults coping with a spouse's chronic condition, greater marital satisfaction may not be entirely protective for psychological health. We examined marital satisfaction and gender as moderators of the association between perceived spousal suffering and daily emotional contagion. Based on empathy-altruism and interdependent self-construal theories, we hypothesized that high marital satisfaction and being female would heighten daily emotional contagion, or within-person associations between perceived spouse suffering and distress to spouse suffering. Forty-five older adults who had a spouse with a musculoskeletal condition completed daily interviews. Participants reported their marital satisfaction once in the laboratory and then daily perceptions of their spouse's physical suffering and their own distress to spouse suffering via phone at home for 7 days. Consistent with hypotheses, there were significant within-person effects such that highly satisfied wives experienced heightened emotional contagion on days when they perceived higher than average spouse suffering. Unexpectedly, men who were high in marital satisfaction experienced heightened daily distress irrespective of their perceptions of level of spousal suffering. Marital satisfaction can increase daily emotional contagion to spousal suffering among older couples dealing with chronic conditions. Wives' distress may be more dependent on perceiving high levels of partner suffering compared with husbands' distress.

  7. Spousal recovery support, recovery experiences, and life satisfaction crossover among dual-earner couples.

    Science.gov (United States)

    Park, YoungAh; Fritz, Charlotte

    2015-03-01

    Research has indicated the importance of recovery from work stress for employee well-being and work engagement. However, very little is known about the specific factors that may support or hinder recovery in the context of dual-earner couples. This study proposes spousal recovery support as a potential resource that dual-earner couples can draw on to enhance their recovery experiences and well-being. It was hypothesized that spousal recovery support would be related to the recipient spouse's life satisfaction via his or her own recovery experiences (i.e., psychological detachment, relaxation, and mastery experiences). The study further investigated the crossover of life satisfaction between working spouses as a potential outcome of recovery processes. Data from 318 full-time employed married couples in South Korea were analyzed using structural equation modeling. Results showed that spousal recovery support was positively related to all 3 recovery experiences of the recipient spouse. Moreover, this recovery support was related to the recipient spouse's life satisfaction via relaxation and mastery experiences. Unexpectedly, psychological detachment was negatively related to life satisfaction, possibly indicating a suppression effect. Life satisfaction crossed over between working spouses. No gender differences were found in the hypothesized paths. Based on these findings, theoretical and practical implications are discussed, and future research directions are presented. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  8. Spousal violence against pregnant women from a Bedouin community in Jordan.

    Science.gov (United States)

    Okour, Abdelhakeem M; Badarneh, Raja

    2011-12-01

    The objective of this study was to estimate the prevalence of spousal violence against pregnant women during their current pregnancy and investigate factors related to violence. A cross-sectional survey was performed with 303 pregnant women who attended antenatal clinics in Al-Mafraq, northern desert of Jordan. The prevalence of violence (any type) during pregnancy was 40.9%. Physical violence was the highest (34.7 %), followed by psychologic violence (28.1%) and sexual violence (15.5%). Women who resided in the city (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.05-2.79), had six or more pregnancies including the current one (OR 5.4, 95% CI 1.45-20.0), had four or more female children (OR 4.03, 95% CI 1.3- 11.9) and were under pressure to have a male child (OR 1.82, 95% CI 1.07- 3.08) were more likely to be exposed to violence during pregnancy. This study attempted to shed light on some of the cultural dimensions behind spousal violence, especially preference for male children. This study is important to the Jordanian and Arab communities in their efforts to protect women's rights and in designing interventions against domestic and spousal violence.

  9. Child marriage and its associations with controlling behaviors and spousal violence against adolescent and young women in Pakistan.

    Science.gov (United States)

    Nasrullah, Muazzam; Zakar, Rubeena; Zakar, Muhammad Zakria

    2014-12-01

    Child marriage (before 18 years) is widely prevalent in Pakistan, and disproportionately affects young girls in rural, low-income, and poorly educated households. Our study aims to determine the associations between child marriage and controlling behaviors (CB) and spousal violence by husbands against adolescent and young women in Pakistan beyond those attributed to social vulnerabilities. We analyzed data from the Pakistan Demographic and Health Survey, 2012-2013, of currently married women aged 15-24 years who had participated in the domestic violence module (n = 589, 22.5% [589/2,615] of the subsample aged 15-24 years) to identify differences in CB and spousal violence experiences between early (marriage. Associations between child marriage and CB and spousal violence by husband were assessed by calculating adjusted odds ratios (AOR) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, and rural residence), spousal age gap, and husband's education. Overall, 47.8% of currently married women aged 15-24 years in Pakistan were married before the age of 18 years. About one third of women aged 15-24 years in Pakistan reported experiencing CB (31.8%) and spousal violence (31.1%) by their husbands. Compared with adult marriage, child marriage was significantly associated with CB (AOR = 1.50; 95% confidence interval [CI], 1.042-2.157), any form of spousal violence (physical or emotional) (AOR = 2.03; 95% CI, 1.392-2.969), emotional violence (AOR = 1.86; 95% CI, 1.254-2.767), and physical violence (AOR = 2.44; 95% CI, 1.582-3.760), including severe physical violence (AOR = 2.57; 95% CI, 1.122-5.872). Effective interventions are needed to prevent child marriages and raise awareness about their negative consequences, with special reference to spousal violence. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Sleep Concordance in Couples is Associated with Relationship Characteristics.

    Science.gov (United States)

    Gunn, Heather E; Buysse, Daniel J; Hasler, Brant P; Begley, Amy; Troxel, Wendy M

    2015-06-01

    Coregulation of biological systems is a defining feature of normative attachment in close adult relationships. Sleep is a shared, intimate biological process between couples; however, sleep is usually examined at the individual level. We examined minute-by-minute concordance in couples' actigraphy-defined sleep-wake patterns, and how attachment style and marital satisfaction relate to concordance. Couples completed measures of avoidant and anxious attachment styles and relationship functioning and wore wrist actigraphs for 10 days. Minute-by-minute concordance of sleep and wake (i.e., the percentage of epochs in which both partners were asleep, or both were awake) was calculated for each sleep period. Mixed modeling was used to account for measurement occasions across time. Percent concordance ranged from 53-88% and was not associated with couples' sleep quality or circadian preference. For wives, neither anxious nor avoidant attachment was associated with sleep-wake concordance. For husbands, anxious attachment style was associated with higher concordance, but was moderated by wives' marital satisfaction. High marital satisfaction in wives was associated with higher concordance, regardless of husbands' attachment style. In couples in which wives reported low satisfaction, concordance was higher when husbands had an anxious attachment style. Avoidant attachment style in husbands was not related to concordance. Sleep concordance provides a unique measure of couples' cosleep and varies depending on attachment style and relationship satisfaction. © 2015 Associated Professional Sleep Societies, LLC.

  11. Crystal structure of ATVORF273, a new fold for a thermo- and acido-stable protein from the Acidianus two-tailed virus

    DEFF Research Database (Denmark)

    Felisberto-Rodrigues, Catarina; Blangy, Stéphanie; Goulet, Adeline

    2012-01-01

    in the viral world. To understand this intriguing phenomenon, we have undertaken structural studies of ATV virion proteins and here we present the crystal structure of one of these proteins, ATV[Formula: see text]. ATV[Formula: see text] forms tetramers in solution and a molecular envelope is provided...... for the tetramer, computed from small-angle X-ray scattering (SAXS) data. The crystal structure has properties typical of hyperthermostable proteins, including a relatively high number of salt bridges. However, the protein also exhibits flexible loops and surface pockets. Remarkably, ATV[Formula: see text......] displays a new [Formula: see text] protein fold, consistent with the absence of homologues of this protein in public sequence databases....

  12. Is Spousal Violence Being "Vertically Transmitted" through Victims? Findings from the Pakistan Demographic and Health Survey 2012-13.

    Directory of Open Access Journals (Sweden)

    Syeda Kanwal Aslam

    Full Text Available Violence against women is regarded as a major violation of human rights, and several socio-behavioral aspects among victims have been identified as important determinants of spousal violence experience. Pakistani nationally representative contextual evidence is scarce in this regard. We aimed to estimate prevalence of spousal violence, and explore its association with intergenerational transfer, and attitudinal acceptance of violence, among Pakistani ever-married women.Data of 3,687 ever-married women from Pakistan Demographic and Health Survey, 2012-13 was used to perform secondary analysis. Logistic regression analyses were conducted. Association between the different forms of spousal violence and the independent variables: intergenerational transfer of spousal violence (mother also beaten up by father; and attitudinal acceptance of spousal violence (beating is justifies if wife argues with husband were reported as Odds ratios with 95% confidence intervals (CI.Overall, more than a third (n=1344, 37.9%of ever-married women reported that they experienced spousal violence. Almost 68% (n=539 of the women who reported that their mothers were also beaten up by their fathers, were victims of spousal violence; and almost 47% (n=603 of the women who agreed that beating was justified if the wife argues with her husband, also suffered spousal violence. Intergenerational transfer (OR =5.71, 95%CI 4.40-7.41, p-value <0.01, and attitudinal acceptance (OR =1.66, 95%CI 1.27-2.15, p-value <0.01 were significantly associated with experience of physical violence even after adjusting for respondents' age at marriage, education level, wealth index, parity, employment status, and empowerment status.Spousal violence continues to haunt the lives of women in Pakistan, and is being transmitted as a learned behavior from mothers to daughters who tend to accept such violation of human rights. Girl children from such unfortunate homes may continue to transmit such

  13. Disease-Concordant Twins Empower Genetic Association Studies

    DEFF Research Database (Denmark)

    Tan, Qihua; Li, Weilong; Vandin, Fabio

    2017-01-01

    concordant for a disease, should confer increased power in genetic association analysis because of their genetic relatedness. We conducted a computer simulation study to explore the power advantage of the disease-concordant twin design, which uses singletons from disease-concordant twin pairs as cases...... of an ordinary case-control design, with variations depending on genetic mode. Importantly, the enriched power for dizygotic twins also applies to disease-concordant sibling pairs, which largely extends the application of the concordant twin design. Overall, our simulation revealed a high value of disease......-concordant twins in genetic association studies and encourages the use of genetically related individuals for highly efficiently identifying both common and rare genetic variants underlying human complex diseases without increasing laboratory cost....

  14. Concorde sonic booms as an atmospheric probe.

    Science.gov (United States)

    Balachandran, N K; Donn, W L; Rind, D H

    1977-07-01

    Infrasound generated by the sonic boom from the inbound Concorde supersonic transport is recorded at Palisades, New York (Lamont-Doherty Geological Observatory), as a series of impulses from distances varying from 165 to about 1000 kilometers. Refraction effects determined by temperature and wind conditions return the signal to the surface from both stratospheric (40 to 50 kilometers) and thermospheric (100 to 130 kilometers) levels. The frequency of the recorded signal is a function of the level of reflection; the frequency decreases from impulse stretching as the atmosphere becomes more rarified relative to the sound pressure. The horizontal trace velocity of the signal across the array of instruments is equal to the acoustic velocity at the reflection level. The sonic boom can thus be used to provide temperature-wind parameters at reflection levels estimated from the signal frequency. Daily observed signal variations have indicated significant variations in these parameters.

  15. Practically delineating bacterial species with genealogical concordance.

    Science.gov (United States)

    Venter, Stephanus N; Palmer, Marike; Beukes, Chrizelle W; Chan, Wai-Yin; Shin, Giyoon; van Zyl, Elritha; Seale, Tarren; Coutinho, Teresa A; Steenkamp, Emma T

    2017-10-01

    Bacterial species are commonly defined by applying a set of predetermined criteria, including DNA-DNA hybridization values, 16S rRNA gene sequence similarity, phenotypic data as well as genome-based criteria such as average nucleotide identity or digital DNA-DNA hybridization. These criteria mostly allow for the delimitation of taxa that resemble typical bacterial species. Their application is often complicated when the objective is to delineate new species that are characterized by significant population-level diversity or recent speciation. However, we believe that these complexities and limitations can be easily circumvented by recognizing that bacterial species represent unique and exclusive assemblages of diversity. Within such a framework, methods that account for the population processes involved in species evolution are used to infer species boundaries. A method such as genealogical concordance analysis is well suited to delineate a putative species. The existence of the new taxon is then interrogated using an array of traditional and genome-based characters. By making use of taxa in the genera Pantoea, Paraburkholderia and Escherichia we demonstrate in a step-wise process how genealogical concordance can be used to delimit a bacterial species. Genetic, phenotypic and biological criteria were used to provide independent lines of evidence for the existence of that taxon. Our six-step approach to species recognition is straightforward and applicable to bacterial species especially in the post-genomic era, with increased availability of whole genome sequences. In fact, our results indicated that a combined genome-based comparative and evolutionary approach would be the preferred alternative for delineating coherent bacterial taxa.

  16. Seasonal concordance of recurrence in mood disorder patients.

    Science.gov (United States)

    Barbini, B; Di Molfetta, D; Gasperini, M; Manfredonia, M; Smeraldi, E

    1995-01-01

    The aim of the present study is to evaluate the seasonal pattern of recurrences and the concordance among first episode (index episode) versus the subsequent recurrences in a sample of 210 patients affected by mood disorders, referred to the Mood Disorder Unit of San Raffaele Hospital. The most depressive recurrences are in spring for unipolar subjects and in fall for bipolars. Manic episodes are more frequent in summer. Patients presented a high concordance rate between the first and the second episode, female patients were more concordant than male subjects, and patients with low cycle of illness (one episode every six or more years) were the most concordant ones.

  17. Concordance and discordance of couples living in a rural Pakistani village: perspectives on contraception and abortion--a qualitative study.

    Science.gov (United States)

    Kamran, Iram; Arif, M Shafique; Vassos, Katherine

    2011-01-01

    In Pakistan, fertility rates and intended family size have fallen, but contraceptive use remains low. This has led to a high prevalence of unintended pregnancies, a large proportion of which result from disagreement between spouses about how to confront them. This study aims to understand how Pakistani couples view family planning, and how they communicate and make decisions surrounding fertility regulation. In-depth interviews were conducted with five couples and an additional five women and two men. Two focus groups--one for males and one for females--were also conducted. Family planning methods were more favoured by women than their husbands. Women reported the largest barrier to contraceptive use to be men's opposition to family planning or reproductive choices more generally, as well as fear of side effects of contraception. Abortion was viewed unfavourably except in situations of economic difficulty, having several young children or women's health problems. Couples reported rarely communicating about fertility intentions until later in childbearing after an unintended pregnancy. Discussions about family planning were largely initiated by women, although some felt unable to approach their husbands regarding this topic. Concordant intentions and communication between spouses led to desired pregnancy outcomes. In cases of discordance, women's intentions tended to determine actions and outcomes. Spousal communication, or the lack thereof, is an obstacle to effective contraceptive use, and strategies to improve couples' communication would undoubtedly enable them to achieve their reproductive intentions.

  18. "Concordance" Revisited: A Multispecialty Appraisal of "Concordant" Preliminary Abdominopelvic CT Reports.

    Science.gov (United States)

    Brown, Jordan M; Dickerson, Elliot C; Rabinowitz, Lee C; Cohan, Richard H; Ellis, James H; Litell, John M; Kaza, Ravi K; Lopez, Alexis N; Theyyunni, Nikhil R; Weber, Joseph T; Kocher, Keith E; Davenport, Matthew S

    2016-09-01

    To determine whether resident abdominopelvic CT reports considered prospectively concordant with the final interpretation are also considered concordant by other blinded specialists and abdominal radiologists. In this institutional review board-approved retrospective cohort study, 119 randomly selected urgent abdominopelvic CT examinations with a resident preliminary report deemed prospectively "concordant" by the signing faculty were identified. Nine blinded specialists from Emergency Medicine, Internal Medicine, and Abdominal Radiology reviewed the preliminary and final reports and scored the preliminary report with respect to urgent findings as follows: 1.) concordant; 2.) discordant with minor differences; 3.) discordant with major differences that do not alter patient management; or 4.) discordant with major differences that do alter patient management. Predicted management resulting from scores of 4 was recorded. Consensus was defined as majority agreement within a specialty. Consensus major discrepancy rates (ie, scores 3 or 4) were compared to the original major discrepancy rate of 0% (0/119) using the McNemar test. Consensus scores of 4 were assigned in 18% (21/119, P Medicine), 5% (6/119, P = .03, Internal Medicine), and 13% (16/119, P Medicine), 14% (17/119, P Internal Medicine), and 18% (22/119, P medical therapy (1%-4%), imaging (1%-10%), subspecialty consultation (3%-13%), nonsurgical procedure (3%), operation (1%-3%), and other (0-3%). The historical low major discrepancy rate for urgent findings between resident and faculty radiologists is likely underreported. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Influence of alcohol on condom use pattern during non-spousal sexual encounter in male migrant workers in north India.

    Science.gov (United States)

    Rizwan, S A; Kant, S; Goswami, K; Rai, S K; Misra, P

    2014-01-01

    Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India. A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out. A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders. Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.

  20. Prevalence and Attitude of Women to Spousal Physical Abuse in Pregnancy in a Niger Delta Community of Nigeria

    Directory of Open Access Journals (Sweden)

    Augustine Vincent Umoh

    2012-12-01

    Full Text Available ABSTRACT Introduction: Spousal physical violence in pregnancy is a major public health and human rights concern. Identifying its prevalence and understanding the women’s attitude towards this phenomenon in our environment is key to developing strategies for effective intervention. Methods: This was a cross sectional study of pregnant women attending antenatal clinics of the University of Uyo Teaching Hospital (UUTH, Uyo in the Niger Delta region of Nigeria. Information was collected using a pre-tested self-administered questionnaire instrument. Results: The mean age of respondents was 28.72 ± 4.47 years with a range of 16 – 48 years. The prevalence of spousal physical violence in the current pregnancy was 10.3%. 45.2% of those who experienced violence in the current pregnancy also experienced violence in other pregnancies while 73.7% of those who reported spousal violence in previous pregnancies also experienced violence in the current pregnancy. There was a significant relationship between spousal physical violence and the woman’s number of deliveries/parity (x2 = 16.145, p=0.025, marital status (x2=11.105, p=0.025 and husband’s occupation (x2=12.786, p=0.047. About half of the respondents expressed the view that spousal violence was not excusable under any circumstance while 22.7% believed that it could be excused under certain circumstances. Also 50.0% of those who experienced physical violence in the current pregnancy expressed the view that physical violence can be excusable. Most of the women (65.8% either kept the incidence of abuse secret or just did nothing. None reported to the police. Conclusion: Spousal physical abuse is still prevalent in our society. There is need to enlighten the women on this phenomenon in order to get their cooperation towards its eradication. [TAF Prev Med Bull 2012; 11(6.000: 731-736

  1. Medical Care Tasks among Spousal Dementia Caregivers: Links to Care-Related Sleep Disturbances.

    Science.gov (United States)

    Polenick, Courtney A; Leggett, Amanda N; Maust, Donovan T; Kales, Helen C

    2018-02-01

    Medical care tasks are commonly provided by spouses caring for persons living with dementia (PLWDs). These tasks reflect complex care demands that may interfere with sleep, yet their implications for caregivers' sleep outcomes are unknown. The authors evaluated the association between caregivers' medical/nursing tasks (keeping track of medications; managing tasks such as ostomy care, intravenous lines, or blood testing; giving shots/injections; and caring for skin wounds/sores) and care-related sleep disturbances. A retrospective analysis of cross-sectional data from the 2011 National Health and Aging Trends Study and National Study of Caregiving was conducted. Spousal caregivers and PLWDs/proxies were interviewed by telephone at home. The U.S. sample included 104 community-dwelling spousal caregivers and PLWDs. Caregivers reported on their sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and sleep disturbances. PLWDs (or proxies) reported on their health conditions and sleep problems. Caregivers who performed a higher number of medical/nursing tasks reported significantly more frequent care-related sleep disturbances, controlling for sociodemographic and health characteristics, caregiving stressors, negative caregiving relationship quality, and PLWDs' sleep problems and health conditions. Post hoc tests showed that wound care was independently associated with more frequent care-related sleep disturbances after accounting for the other medical/nursing tasks and covariates. Spousal caregivers of PLWDs who perform medical/nursing tasks may be at heightened risk for sleep disturbances and associated adverse health consequences. Interventions to promote the well-being of both care partners may benefit from directly addressing caregivers' needs and concerns about their provision of medical/nursing care. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

  2. Talking about Sexuality and Intimacy with Women Spousal Caregivers: Perspectives of Service Providers.

    Science.gov (United States)

    Brotman, Shari; Drummond, Jennifer; Silverman, Marjorie; Sussman, Tamara; Orzeck, Pam; Barylak, Lucy; Wallach, Isabelle; Billette, Veronique

    2016-11-20

    This article reports the findings of an exploratory study examining service provider perceptions and experiences of addressing sexuality and intimacy with women spousal caregivers. The caregiver-provider encounter is examined, and challenges faced by service providers in addressing sexuality are considered. Themes identified include ambivalence and discomfort, personal and institutional barriers, meanings attributed to sexuality and intimacy, and lack of opportunities to discuss experiences. Strategies to overcome silence and invisibility on the part of service providers in the health and social services system are considered. © 2016 National Association of Social Workers.

  3. Sexual Scripts and Criminal Statutes: Gender Restrictions, Spousal Allowances, and Victim Accountability After Rape Law Reform.

    Science.gov (United States)

    Levine, Ethan Czuy

    2018-03-01

    The author provides a mixed-methods assessment of U.S. rape statutes to assess progress in reform. Contemporary statutes offer restrictive frameworks for distinguishing criminal from noncriminal sexual violence, many of which are grounded in gendered and heterosexist assumptions. Fourteen states retain gender restrictions in rape statutes. Twenty maintain marital distinctions that limit accountability for spousal rape. Furthermore, whereas explicit resistance requirements have been eliminated nationwide, implicit resistance expectations manifest through emphasis on physical force and involuntary intoxication. Analyses conclude with recommendations for further legal reform and a discussion of the potential for legislation to affect broader social perceptions of rape.

  4. Mohs surgery histopathology concordance in Australia.

    Science.gov (United States)

    Tan, Ernest; Elliott, Tim; Yu, Lawrence; Litterick, Kelly

    2011-11-01

    Mohs micrographic surgery is an important technique for dealing with difficult non-melanoma skin cancers. The ability of the Mohs surgeon to correctly interpret the histopathology is crucial to the practice of this surgery. This study sought to assess the concordance between a Mohs surgeon and a dermatopathologist in the reading of Mohs section histopathology slides. This study was a retrospective study of Mohs frozen section histopathology slides of patients from a private Mohs practice. The slides were provided for assessment by a dermatopathologist who had to interpret the histopathology and mark on a Mohs map the location of the tumour. We demonstrate a 95% agreement between the Mohs surgeon and the dermatopathologist in the interpretation of Mohs frozen section histopathology slides. An Australian Mohs surgeon is capable of correctly identifying and interpreting histopathology in non-melanoma skin cancers, and this compares favourably to an overseas study. © 2011 The Authors. Australasian Journal of Dermatology © 2011 The Australasian College of Dermatologists.

  5. The impact of dementia and mild memory impairment (MMI) on intimacy and sexuality in spousal relationships.

    Science.gov (United States)

    Davies, Helen D; Newkirk, Lori A; Pitts, Christiane B; Coughlin, Christine A; Sridhar, Sneha B; Zeiss, L McKenzie; Zeiss, Antonette M

    2010-06-01

    Sexuality and intimacy in couples in which one partner is affected by dementia has been widely researched. Few studies have explored these issues in couples where one partner is affected by mild memory impairment (MMI) or mild cognitive impairment (MCI). The objectives of this study were to (1) identify and contrast issues of intimacy and sexuality that spousal caregivers of persons with MMI and dementia may experience, and (2) identify future lines of research in this population. Fourteen dementia and nine MMI spousal caregivers participated in focus groups conducted between 2008 and 2009 at the Stanford/VA Alzheimer's Research Center. Content analyses were conducted to identify themes. Five themes emerged: communication, marital cohesion, affectional expression, caregiver burden, and ambiguity concerning the future of the relationship. Dementia caregivers reported more difficulties with communication, cohesion, and perceptions of increased burden than their MMI counterparts. Both groups indicated reduced sexual expression due to physical limitations; substitute activities including hand-holding, massaging, and hugging were noted. Both groups reported difficulty anticipating the future of the relationship due to present stressors. While dementia caregivers could consider future romantic relationships with others, MMI caregivers were primarily able to consider future relationships only for companionship and emotional intimacy. Early therapeutic interventions may assist couples in modifying activities, behaviors, and expectations about the future of the relationship. Such modifications may help maintain relationship satisfaction, decrease burden, preserve quality of life, and delay time-to-placement. Extending time-to-placement could have cost savings implications for families and the healthcare system.

  6. Is Women's Empowerment Associated With Help-Seeking for Spousal Violence in India?

    Science.gov (United States)

    Rowan, Kathleen; Mumford, Elizabeth; Clark, Cari Jo

    2018-05-01

    Violence against women by their husbands is a problem for women worldwide. However, the majority of women do not seek help. This article presents findings from a national survey in India on empowerment-related correlates of help-seeking behaviors for currently married women who experienced spousal violence. We examined individual-, relationship-, and state-level measures of empowerment on help-seeking from informal and formal sources. Findings indicate that help-seeking is largely not associated with typical measures of empowerment or socio-economic development, whereas state-level indicators of empowerment may influence help-seeking. Although not a target of this study, we also note that injury from violence and the severity of the violence were among the strongest factors related to seeking help. Taken together, the low prevalence of help-seeking and lack of strong individual-level correlates, apart from severe harm, suggests widespread barriers to seeking help. Interventions that affect social norms and reach women and men across social classes in society are needed in addition to any individual-level efforts to promote seeking help for spousal violence.

  7. Do Afterlife Beliefs Affect Psychological Adjustment to Late-Life Spousal Loss?

    Science.gov (United States)

    2014-01-01

    Objectives. We explore whether beliefs about the existence and nature of an afterlife affect 5 psychological symptoms (anxiety, anger, depression, intrusive thoughts, and yearning) among recently bereaved older spouses. Method. We conduct multivariate regression analyses using data from the Changing Lives of Older Couples (CLOC), a prospective study of spousal loss. The CLOC obtained data from bereaved persons prior to loss and both 6 and 18 months postloss. All analyses are adjusted for health, sociodemographic characteristics, and preloss marital quality. Results. Bleak or uncertain views about the afterlife are associated with multiple aspects of distress postloss. Uncertainty about the existence of an afterlife is associated with elevated intrusive thoughts, a symptom similar to posttraumatic distress. Widowed persons who do not expect to be reunited with loved ones in the afterlife report significantly more depressive symptoms, anger, and intrusive thoughts at both 6 and 18 months postloss. Discussion. Beliefs in an afterlife may be maladaptive for coping with late-life spousal loss, particularly if one is uncertain about its existence or holds a pessimistic view of what the afterlife entails. Our findings are broadly consistent with recent work suggesting that “continuing bonds” with the decedent may not be adaptive for older bereaved spouses. PMID:23811692

  8. Compassionate Love in Individuals With Alzheimer's Disease and Their Spousal Caregivers: Associations With Caregivers' Psychological Health.

    Science.gov (United States)

    Monin, Joan K; Schulz, Richard; Feeney, Brooke C

    2015-12-01

    To examine whether compassionate love in both individuals with Alzheimer's disease (AD) and their spousal caregivers related to less caregiving burden, more positive caregiving appraisals, and less depressive symptoms for caregivers. Fifty-eight individuals with AD and their spousal caregivers participated in interviews in which both partners reported their compassionate love for their partner, and caregivers self-reported burden, positive appraisals of caregiving, and depressive symptoms. As hypothesized, both AD individuals' and caregivers' compassionate love were associated with less burden and more positive appraisals of caregiving. Also, care givers' compassionate love mediated the association between AD individuals' compassionate love and caregivers' burden as well as the association between AD individuals' compassionate love and caregivers' positive appraisals of caregiving. Finally, there was a marginally significant association between caregivers' compassionate love and less caregiver depressive symptoms. Results suggest that AD individuals' compassionate love is related to compassionate love in caregivers, which in turn relates to reduced burden but not significantly less depressive symptoms for caregivers. Assessing caregivers' and AD individuals' feelings of compassionate love may be useful in identifying caregivers who are resilient and those who are at a heightened risk for caregiving burden. Also, interventions that enhance both partners' compassionate love may benefit caregivers. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. The Effects of Forgiveness Therapy on Depression, Anxiety, and Posttraumatic Stress for Women after Spousal Emotional Abuse

    Science.gov (United States)

    Reed, Gayle L.; Enright, Robert D.

    2006-01-01

    Emotionally abused women experience negative psychological outcomes long after the abusive spousal relationship has ended. This study compares forgiveness therapy (FT) with an alternative treatment (AT; anger validation, assertiveness, interpersonal skill building) for emotionally abused women who had been permanently separated for 2 or more years…

  10. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder

    Science.gov (United States)

    Curtin, C.; Hubbard, K.; Anderson, S. E.; Mick, E.; Must, A.; Bandini, L. G.

    2015-01-01

    Mealtime behavior problems and family stress occur frequently among families of children with autism spectrum disorder (ASD). However, it is unknown whether food selectivity is an associated factor. The associations of high food selectivity with mealtime behavior problems, spousal stress, and influence on family members were assessed among 53…

  11. Marital satisfaction of advanced prostate cancer survivors and their spousal caregivers: the dyadic effects of physical and mental health.

    Science.gov (United States)

    Zhou, Eric S; Kim, Youngmee; Rasheed, Mikal; Benedict, Catherine; Bustillo, Natalie E; Soloway, Mark; Kava, Bruce R; Penedo, Frank J

    2011-12-01

    Coping with the physical and mental side effects of diagnosis and treatment for advanced prostate cancer (APC) is a challenge for both survivors and their spousal caregivers. There is a gap in our current understanding of the dyadic adjustment process on marital satisfaction in this population. The current study sought to: (1) document levels of physical and mental health, and marital satisfaction, and (2) evaluate the relationship between physical and mental health with marital satisfaction in this understudied population. APC survivors who had undergone androgen deprivation therapy within the past year and their spousal caregiver participated in the study (N = 29 dyads). Physical and mental health was assessed using the MOS SF-36 Health Survey and marital satisfaction was evaluated using the Dyadic Adjustment Scale. The Actor-Partner Interdependence Model revealed strong relations between physical and mental health with marital satisfaction for both survivor and caregiver (actor effects). Furthermore, caregiver physical and mental health was related with the survivor's marital satisfaction (partner effect). Levels of mental health and marital satisfaction were comparable to community-based and prostate cancer samples, while physical health was higher. Marital satisfaction between APC survivors and their spousal caregivers may be influenced by both physical and mental health functioning. In particular, APC survivor functioning may affect his marital satisfaction as well as his spousal caregiver's. This has implications for psychosocial interventions for APC dyads. Further evaluation of the complex nature of survivor/caregiver dyadic adjustment in dealing with APC is necessary. Copyright © 2010 John Wiley & Sons, Ltd.

  12. Spousal Interrelations in Happiness in the Seattle Longitudinal Study: Considerable Similarities in Levels and Change over Time

    Science.gov (United States)

    Hoppmann, Christiane A.; Gerstorf, Denis; Willis, Sherry L.; Schaie, K. Warner

    2011-01-01

    Development does not take place in isolation and is often interrelated with close others such as marital partners. To examine interrelations in spousal happiness across midlife and old age, we used 35-year longitudinal data from both members of 178 married couples in the Seattle Longitudinal Study. Latent growth curve models revealed sizeable…

  13. Caregiver Burden in Alzheimer's Disease: Differential Associations in Adult-Child and Spousal Caregivers in the GERAS Observational Study

    Directory of Open Access Journals (Sweden)

    Catherine Reed

    2014-02-01

    Full Text Available Background/Aims: To examine factors influencing the caregiver burden in adult-child and spousal caregivers of community-dwelling patients with Alzheimer's disease (AD. Methods: Baseline data from the 18-month, prospective, observational GERAS study of 1,497 patients with AD in France, Germany, and the UK were used. Analyses were performed on two groups of caregivers: spouses (n = 985 and adult children (n = 405. General linear models estimated patient and caregiver factors associated with subjective caregiver burden assessed using the Zarit Burden Interview. Results: The caregiver burden increased with AD severity. Adult-child caregivers experienced a higher burden than spousal caregivers despite spending less time caring. Worse patient functional ability and more caregiver distress were independently associated with a greater burden in both adult-child and spousal caregivers. Additional factors were differentially associated with a greater caregiver burden in both groups. In adult-child caregivers these were: living with the patient, patient living in an urban location, and patient with a fall in the past 3 months; in spouses the factors were: caregiver gender (female and age (younger, and more years of patient education. Conclusion: The perceived burden differed between adult-child and spousal caregivers, and specific patient and caregiver factors were differentially associated with this burden.

  14. Caregiver Burden in Alzheimer's Disease: Differential Associations in Adult-Child and Spousal Caregivers in the GERAS Observational Study

    Science.gov (United States)

    Reed, Catherine; Belger, Mark; Dell'Agnello, Grazia; Wimo, Anders; Argimon, Josep Maria; Bruno, Giuseppe; Dodel, Richard; Haro, Josep Maria; Jones, Roy W.; Vellas, Bruno

    2014-01-01

    Background/Aims To examine factors influencing the caregiver burden in adult-child and spousal caregivers of community-dwelling patients with Alzheimer's disease (AD). Methods Baseline data from the 18-month, prospective, observational GERAS study of 1,497 patients with AD in France, Germany, and the UK were used. Analyses were performed on two groups of caregivers: spouses (n = 985) and adult children (n = 405). General linear models estimated patient and caregiver factors associated with subjective caregiver burden assessed using the Zarit Burden Interview. Results The caregiver burden increased with AD severity. Adult-child caregivers experienced a higher burden than spousal caregivers despite spending less time caring. Worse patient functional ability and more caregiver distress were independently associated with a greater burden in both adult-child and spousal caregivers. Additional factors were differentially associated with a greater caregiver burden in both groups. In adult-child caregivers these were: living with the patient, patient living in an urban location, and patient with a fall in the past 3 months; in spouses the factors were: caregiver gender (female) and age (younger), and more years of patient education. Conclusion The perceived burden differed between adult-child and spousal caregivers, and specific patient and caregiver factors were differentially associated with this burden. PMID:24711814

  15. The influence of stressors, appraisal and personal conditions on the burden of spousal caregivers of persons with dementia

    NARCIS (Netherlands)

    Wijngaart, M.A.G. van den; Vernooij-Dassen, M.J.F.J.; Felling, A.J.A.

    2007-01-01

    Objectives: The aim of this study was to explore the main and mediating influences of stressors, a caregiver's appraisal, coping, personal conditions and social resources on the burden of dementia caregivers. Method: The study sample consisted of 95 spousal caregivers of non-institutionalized

  16. The effect of spousal violence on women′s health: Findings from the Stree Arogya Shodh in Goa, India

    Directory of Open Access Journals (Sweden)

    Chowdhary N

    2008-01-01

    Full Text Available Background: Spousal violence has wide-ranging effects on the physical, reproductive, sexual and psychological health of women. There are few longitudinal studies that describe this association in developing countries. Aim: To test the hypothesis that spousal violence is an independent risk factor for a broad range of adverse health outcomes in women. Setting and Design: A population-based cohort study of women living in the catchment area of a primary health center in north Goa. Two thousand four hundred and ninety-four of 3000 randomly selected women were recruited of whom 1750 married women were included for this paper. Materials and Methods: Each participant was assessed at baseline with a structured interview for the assessment of exposure to spousal violence (verbal, physical, sexual over two time periods (lifetime; recent in the past three months. The interview collected data on gynecological complaints and the Revised Clinical Interview Schedule was used for the diagnosis of depressive disorder. Laboratory tests for anemia and sexually transmitted infections (STI were carried out. Longitudinal data was collected after six and 12 months on these outcomes. In addition, baseline measures for nutritional status and menstrual health were also obtained. Statistical Analysis: Univariate analyses were carried out on the cross-sectional and longitudinal data to assess the association between each type of spousal violence and each health outcome. Multivariate analyses adjusted for age, literacy, household per capita income. Logistic regression was used for all analyses in Stata (Version 10. Results: Lifetime spousal violence was reported by 290 (16.6%, 95%CI=14.9-18.4 women; recent violence was reported by 230 (13.0%, 95%CI=11.6-14.8. The cross-sectional data showed an association between violence and a range of self-reported gynecological complaints, low Body Mass Index, depressive disorder and attempted suicide. The longitudinal analyses

  17. Estimating twin concordance for bivariate competing risks twin data

    DEFF Research Database (Denmark)

    Scheike, Thomas; Holst, Klaus K.; Hjelmborg, Jacob B.

    2014-01-01

    For twin time-to-event data, we consider different concordance probabilities, such as the casewise concordance that are routinely computed as a measure of the lifetime dependence/correlation for specific diseases. The concordance probability here is the probability that both twins have experienced...... over time, and covariates may be further influential on the marginal risk and dependence structure. We establish the estimators large sample properties and suggest various tests, for example, for inferring familial influence. The method is demonstrated and motivated by specific twin data on cancer...

  18. Spousal violence in sub-Saharan Africa: does household poverty-wealth matter?

    Science.gov (United States)

    Bamiwuye, Samson Olusina; Odimegwu, Clifford

    2014-06-17

    Despite the threat of violence to the health and rights of women yet, for many years, there has been a dearth of nationally comparable data on domestic violence in sub-Saharan Africa. This paper examines whether women from poor households are more likely to experience violence from husband/partner than other women who are from middle or rich households. Data for the study are derived from most recent DHS surveys of ever-married women age 15-49 in Cameroun(3,691), Kenya(4,336), Mozambique(5610), Nigeria (16,763), Zambia(3,010) and Zimbabwe(5,016) who participated in the questions on Domestic Violence Module. Bivariate analysis and Binary Logistic Regression Analysis are used to explore the linkage between household poverty-wealth and spousal violence while simultaneously controlling for confounding variables. The overall prevalence of any form of violence (physical, sexual or emotional) ranges from 30.5% in Nigeria to 43.4% in Zimbabwe; 45.3% in Kenya; 45.5% in Mozambique; 53.9% in Zambia and 57.6% in Cameroun. Both bivariate and multivariate analyses show that in two of the six countries -Zambia and Mozambique, experience of violence is significantly higher among women from non-poor (rich) households than those from other households (poor and middle). For Zimbabwe and Kenya, women from poor households are more likely to have ever experienced spousal violence than those from non-poor households. In the remaining two countries- Nigeria and Cameroun, women from the middle class are more likely to have ever suffered abuse from husband/partner than those from the poor and rich households. Our results thus show that similar measurements of household poverty-wealth have produced varying relationships with respect to experience of spousal violence in six sub-Saharan African countries. In other words, experience of violence cuts across all household poverty-wealth statuses and therefore may not provide enough explanations on whether household-poverty necessarily serves to

  19. Confronting the concordance model of cosmology with Planck data

    International Nuclear Information System (INIS)

    Hazra, Dhiraj Kumar; Shafieloo, Arman

    2014-01-01

    We confront the concordance (standard) model of cosmology, the spatially flat ΛCDM Universe with power-law form of the primordial spectrum with Planck CMB angular power spectrum data searching for possible smooth deviations beyond the flexibility of the standard model. The departure from the concordance cosmology is modeled in the context of Crossing statistic and statistical significance of this deviation is used as a measure to test the consistency of the standard model to the Planck data. Derived Crossing functions suggest the presence of some broad features in angular spectrum beyond the expectations of the concordance model. Our results indicate that the concordance model of cosmology is consistent to the Planck data only at 2 to 3σ confidence level if we allow smooth deviations from the angular power spectrum given by the concordance model. This might be due to random fluctuations or may hint towards smooth features in the primordial spectrum or departure from another aspect of the standard model. Best fit Crossing functions indicate that there are lack of power in the data at both low-ℓ and high-ℓ with respect to the concordance model. This hints that we may need some modifications in the foreground modeling to resolve the significant inconsistency at high-ℓ. However, presence of some systematics at high-ℓ might be another reason for the deviation we found in our analysis

  20. Daily concordance between parent and adolescent sleep habits.

    Science.gov (United States)

    Fuligni, Andrew J; Tsai, Kim M; Krull, Jennifer L; Gonzales, Nancy A

    2015-02-01

    To assess the daily concordance between parent and adolescent daily sleep habits, how that concordance compares to other predictors of sleep, and whether the degree of concordance varies across families. A total of 421 adolescents (Mage = 15.03 years) and their primary caregivers (Mage = 41.93 years) reported their sleep, bed, and wake times on a daily basis for a 2-week period. Approximately 80% of the sample repeated the same protocol 1 year later. Multilevel modeling indicated a significant concordance between parent and adolescent sleep, bed, and wake times on a daily basis. Concordance existed independent of other predictors of sleep such as day of the week and adolescent study time. Larger families and those with higher levels of parent-adolescent support exhibited greater concordance. Adolescent sleep is connected to the sleep habits of their parents, above and beyond commonly known structural and experiential factors that can shape teenage sleep. Efforts to improve teenage sleep should pay greater attention to the sleep patterns of parents and potentially other family members. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Examining the relationship between spousal involvement in Gam-Anon and relapse behaviors in pathological gamblers.

    Science.gov (United States)

    Zion, M M; Tracy, E; Abell, N

    1991-06-01

    The present investigation focused on Gamblers Anonymous (GA) members in Ohio to ascertain whether or not spousal participation in Gam-Anon, the companion support group, decreased the gambler's relapse into gambling behavior. A cross-sectional survey of 43 GA members was conducted using a self-administered questionnaire. While no significant difference was found in the relapse of those gamblers with or without a spouse in Gam-Anon, the degree to which the gambler had engaged in other addictive-like behaviors in the past did appear to be related to relapse. Those gamblers who had not relapsed reported significantly more engagement in past addictive-like behaviors (excessive overeating, drinking, and using drugs) than those who had relapsed. Additionally, their spouses had also engaged in addictive-like behaviors in the past. Discussion suggests possible explanations for the findings. Implications are drawn for both outcome measures and research with self-help groups.

  2. Positive affect and sleep in spousal Alzheimer caregivers: a longitudinal study.

    Science.gov (United States)

    von Känel, Roland; Mausbach, Brent T; Ancoli-Israel, Sonia; Mills, Paul J; Dimsdale, Joel E; Patterson, Thomas L; Grant, Igor

    2014-09-03

    This article examines the longitudinal relation between positive affect (PA) and sleep in 126 spousal Alzheimer's disease caregivers. Caregivers underwent 4 yearly assessments for the Positive and Negative Affect Schedule, the self-rated Pittsburgh Sleep Quality Index, and actigraphy to objectify nighttime total sleep time, wake after sleep onset, and percentage of sleep. Increased levels of PA and a greater positivity (i.e., positive-to-negative affect) ratio were significantly associated with better subjective sleep over the entire study period. Yearly increases in PA-even when controlling for negative affect (NA)-and in the positivity ratio were also associated with better subjective sleep. PA and actigraphy measures showed no significant relations. Increased PA is longitudinally associated with better sleep in dementia caregivers largely independent of NA.

  3. Relationship satisfaction and emotional language in frontotemporal dementia and Alzheimer disease patients and spousal caregivers.

    Science.gov (United States)

    Ascher, Elizabeth A; Sturm, Virginia E; Seider, Benjamin H; Holley, Sarah R; Miller, Bruce L; Levenson, Robert W

    2010-01-01

    We studied the impact of 2 types of dementia on marital satisfaction and on the emotional language that spouses use during conflictive marital interactions. Fifteen frontotemporal dementia (FTD) and 16 Alzheimer disease (AD) patient-caregiver couples, and 21 control couples, discussed a relationship problem in a laboratory setting. Marital satisfaction was assessed through questionnaire, and emotion language was quantified using text analysis. FTD couples reported lower marital satisfaction than AD and control couples. During the interactions, FTD and AD caregivers used significantly more negative emotion words than their patient spouses (no spousal differences were found in control couples). FTD caregivers also used more negative words than AD caregivers and controls. We interpret these findings as reflecting challenges that the behavioral changes in FTD create for maintaining a healthy marital bond.

  4. Early father–daughter relationship and demographic determinants of spousal marital satisfaction

    Directory of Open Access Journals (Sweden)

    Alsheikh Ali A

    2016-04-01

    Full Text Available Ahmad Alsheikh Ali,1 Fawzi Shaker Daoud2 1Counseling Psychology Program, Faculty of Educational Sciences, Hashemite University, 2Department of Psychology, Faculty of Arts and Sciences, Al-Ahliyya Amman University, Amman, Jordan Abstract: This study examined several dimensions of early father–daughter relationship as predictors of marital satisfaction among 494 respondents. Descriptive comparative approach was used in result analysis. The Father Presence Questionnaire and Marital Satisfaction Questionnaire were used, in addition to a number of demographic variables. Results showed that only physical relationship with the father, and perceptions of father’s influence, had a positive significant impact on wives’ marital satisfaction. Of all domains, only positive feelings about the father had a negative impact on the husband's marital satisfaction. Most demographic variables had statistically significant effect on marital satisfaction. Sociocultural implications for marital satisfaction for wives and husbands are discussed. Keywords: early father–daughter relationship, demographic, spousal marital satisfaction

  5. Spousal Breadwinning Across 30 Years of Marriage and Husbands' Health: A Gendered Life Course Stress Approach.

    Science.gov (United States)

    Springer, Kristen W; Lee, Chioun; Carr, Deborah

    2017-08-01

    Wives increasingly outearn their husbands, and gender relations theory suggests this arrangement may undermine men's well-being. We explore how long-term histories of spousal breadwinning may be associated with older men's self-rated mental and physical health, and risk of nine health diagnoses. Using 30 years of couple-level income data from the Health and Retirement Study ( n = 1,095 couples), we use latent class analyses to identify six classes that differ with respect to the timing and level of wife breadwinning. We link these classes to older husbands' later-life health. Classes that transitioned from husband breadwinning to wife breadwinning in early or later adulthood were associated with husbands' poorer overall physical health and risk of cardiometabolic and stress-related diseases. Patterns persist net of sociodemographics, depressive symptoms, health behaviors, and adolescent health. Violating cultural expectations, such as the masculinity ideal of male breadwinning, is associated with older men's poorer health.

  6. Risk Factors for Spousal Physical Violence Against Women in Saudi Arabia.

    Science.gov (United States)

    Eldoseri, Halah M; Sharps, Phyllis

    2017-03-01

    This study aimed to explore selected risk factors for spousal physical violence (SPV) in women frequenting primary health care clinics (PHCs) in Saudi Arabia. A cross-sectional study design was conducted in six PHCs, where one-on-one, private interviews with 200 women were conducted using a standardized World Health Organization (WHO) violence against women questionnaire (v.10.0). SPV was reported by 45.5% of women. Husband-specific risk factors including alcohol or drug addiction, unemployment, control of wealth in the family, and physical aggression toward other men were significant predictors for SPV. A multisectoral approach should be implemented with focus on providers' training, women's safety, and involvement of men in violence prevention and intervention programs.

  7. Alpha-1 couples: interpersonal and intrapersonal predictors of spousal communication and stress.

    Science.gov (United States)

    Smith, Rachel A; Wienke, Sara; Coffman, Donna L

    2014-04-01

    Couples often discuss genetic test results, and then manage their implications together. This interdependence can lead to common, shared experiences, similar intrapersonal processes to manage shared stressors, or interpersonal influences between spouses, leading to different outcomes. This study sought to reveal the intracouple, intrapersonal, and interpersonal influences of genetic stigma and negative feelings on spousal communication and perceived stress with 50 couples in which one spouse is a member of a genetic disease registry. The results were analyzed with dyadic analysis, including multilevel modeling. The findings showed that registered members and their spouses were not statistically different in their mean levels of perceived genetic stigma, negative feelings about alpha-1 antitrypsin deficiency (AATD), conversations with each other about the AATD test results, and their perceived stress. The findings also showed that their intracouple consistencies were not high, and their intrapersonal and interpersonal influences on communication and stress differed. The social implications of genetic research at the interpersonal level are discussed.

  8. Association Between Spousal Caregiver Well-Being and Care Recipient Healthcare Expenditures.

    Science.gov (United States)

    Ankuda, Claire K; Maust, Donovan T; Kabeto, Mohammed U; McCammon, Ryan J; Langa, Kenneth M; Levine, Deborah A

    2017-10-01

    To measure the association between spousal depression, general health, fatigue and sleep, and future care recipient healthcare expenditures and emergency department (ED) use. Prospective cohort study. Health and Retirement Study. Home-dwelling spousal dyads in which one individual (care recipient) was aged 65 and older and had one or more activity of daily living or instrumental activity of daily living disabilities and was enrolled in Medicare Part B (N = 3,101). Caregiver sleep (Jenkins Sleep Scale), depressive symptoms (Center for Epidemiologic Studies Depression-8 Scale), and self-reported general health measures. Primary outcome was care recipient Medicare expenditures. Secondary outcome was care recipient ED use. Follow-up was 6 months. Caregiver depressive symptoms score and six of 17 caregiver well-being measures were prospectively associated with higher care recipient expenditures after minimal adjustment (P care recipient expenditures remained significantly associated with caregiver fatigue (cost increase, $1,937, 95% confidence interval (CI) = $770-3,105) and caregiver sadness (cost increase, $1,323, 95% CI = $228-2,419) after full adjustment. Four of 17 caregiver well-being measures, including severe fatigue, were significantly associated with care recipient ED use after minimal adjustment (P care recipient ED use remained significantly associated with caregiver fatigue (odds ratio (OR) = 1.24, 95% CI = 1.01-1.52) and caregiver fair to poor health (OR = 1.23, 95% CI = 1.04-1.45) after full adjustment. Caregiver total sleep score was not associated with care recipient outcomes. Poor caregiver well-being, particularly severe fatigue, is independently and prospectively associated with higher care recipient Medicare expenditures and ED use. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  9. Effects of Individual, Spousal, and Offspring Socioeconomic Status on Mortality Among Elderly People in China.

    Science.gov (United States)

    Yang, Lei; Martikainen, Pekka; Silventoinen, Karri

    2016-11-05

    The relationship between socio-economic status and health among elderly people has been well studied, but less is known about how spousal or offspring's education affects mortality, especially in non-Western countries. We investigated these associations using a large sample of Chinese elderly. The data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from the years 2005 to 2011 (n = 15 355, aged 65-105 years at baseline; 5046 died in 2008, and 2224 died in 2011). Educational attainment, occupational status, and household income per capita were used as indicators of socio-economic status. Spousal and offspring's education were added into the final models. The Cox proportional hazards model was used to study mortality risk by gender. Adjusted for age, highly educated males and females had, on average, 29% and 37% lower mortality risk, respectively, than those with a lower education. Particularly among men, this effect was observed among those whose children had intermediate education only. A higher household income was also associated with lower mortality risk among the elderly. Male elderly living with a well-educated spouse (HR 0.79; 95% CI, 0.64-0.99) had a lower mortality risk than those living with a low-educated spouse. Both the socio-economic status of the individual and the educational level of a co-resident spouse or child are associated with mortality risk in elderly people. The socio-economic position of family members plays an important role in producing health inequality among elderly people.

  10. The self-management balancing act of spousal care partners in the case of Parkinson's disease.

    Science.gov (United States)

    Berger, Sue; Chen, Tiffany; Eldridge, Jenna; Thomas, Cathi A; Habermann, Barbara; Tickle-Degnen, Linda

    2017-12-12

    Living with and caring for someone with chronic illness can lead to limitations in activity and social participation for the care partner. Past research emphasizes the importance of care partners taking care of themselves physically and emotionally so they can stay healthy to support the care recipient. There is little information regarding how the care partner takes care of their own social lives. The purpose of this study was to explore the concept of social self-management from the perspective of spousal care partners of people with Parkinson's disease. Twenty spousal care partners of people with Parkinson's disease were interviewed three times. A grounded theory approach informed data analysis. Findings that emerged from the data focused on balance in activities, support, and emotions and were summarized into three main themes: (1) Activities: Caregiving and beyond; (2) Strategies to support self and spouse; and (3) Emotional impact: Burden and compassion. This research shows that care partners want to retain social participation and provides support for the importance of addressing the socio-emotional needs of care partners of people with a chronic disease. Interventions that guide care partners to take care of their spectrum of needs may lead to healthier, positive relationships. Implications for rehabilitation The focus of rehabilitation is often on the person diagnosed with the chronic condition. Living with and caring for someone with a chronic illness, such as Parkinson's disease, can lead to limitations in activity and social participation for the care partner. Including care partners in the rehabilitation process is key to helping maintain their health and well-being. Learning caregiving and self-management strategies may help care partners support their loved ones while staying socially engaged.

  11. Women’s opinion on the justification of physical spousal violence: A quantitative approach to model the most vulnerable households in Bangladesh

    OpenAIRE

    Biswas, Raaj Kishore; Rahman, Nusma; Kabir, Enamul; Raihan, Farabi

    2017-01-01

    Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV) and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014) were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31....

  12. Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes: A Longitudinal and Nationwide Register-Based Study.

    Science.gov (United States)

    Erlangsen, Annette; Runeson, Bo; Bolton, James M; Wilcox, Holly C; Forman, Julie L; Krogh, Jesper; Shear, M Katherine; Nordentoft, Merete; Conwell, Yeates

    2017-05-01

    Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health outcomes when compared with the general population and spouses bereaved by other manners. This nationwide, register-based cohort study conducted in Denmark of 6.7 million individuals aged 18 years and older from 1980 to 2014 covered more than 136 million person-years and compared people bereaved by spousal suicide with the general population and people bereaved by other manners of death. Incidence rate ratios were calculated using Poisson regressions while adjusting for sociodemographic characteristics and the presence of mental and physical disorders. Mental disorders (any disorder, mood, posttraumatic stress disorder, anxiety, alcohol use disorders, drug use disorders, and self-harm); physical disorders (cancers, diabetes, sleep disorder, cardiovascular diseases, chronic lower respiratory tract diseases, liver cirrhosis, and spinal disc herniation); causes of mortality (all-cause, natural, unintentional, suicide, and homicide); social health outcomes; and health care use. The total study population included 3 491 939 men, 4814 of whom were bereaved by spousal suicide, and 3 514 959 women, 10 793 of whom were bereaved by spousal suicide. Spouses bereaved by a partner's suicide had higher risks of developing mental disorders within 5 years of the loss (men: incidence rate ratio, 1.8; 95% CI, 1.6-2.0; women: incidence rate ratio, 1.7; 95% CI, 1.6-1.8) than the general population. Elevated risks for developing physical disorders, such as cirrhosis and sleep disorders, were also noted as well as the use of more municipal support, sick leave benefits, and disability pension funds than the general population. Compared with spouses bereaved by other manners of death, those bereaved by

  13. Concordant Chemical Reaction Networks and the Species-Reaction Graph

    Science.gov (United States)

    Shinar, Guy; Feinberg, Martin

    2015-01-01

    In a recent paper it was shown that, for chemical reaction networks possessing a subtle structural property called concordance, dynamical behavior of a very circumscribed (and largely stable) kind is enforced, so long as the kinetics lies within the very broad and natural weakly monotonic class. In particular, multiple equilibria are precluded, as are degenerate positive equilibria. Moreover, under certain circumstances, also related to concordance, all real eigenvalues associated with a positive equilibrium are negative. Although concordance of a reaction network can be decided by readily available computational means, we show here that, when a nondegenerate network’s Species-Reaction Graph satisfies certain mild conditions, concordance and its dynamical consequences are ensured. These conditions are weaker than earlier ones invoked to establish kinetic system injectivity, which, in turn, is just one ramification of network concordance. Because the Species-Reaction Graph resembles pathway depictions often drawn by biochemists, results here expand the possibility of inferring significant dynamical information directly from standard biochemical reaction diagrams. PMID:22940368

  14. Women's opinion on the justification of physical spousal violence: A quantitative approach to model the most vulnerable households in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Raaj Kishore Biswas

    Full Text Available Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014 were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31.9% and 28.7% women in the surveys found justification for physical violence in household in 2007, 2011 and 2014 respectively. The binary logistic model showed wealth index, education of both women and their partner, religion, geographical division, decision making freedom and marital age as significant household contributors for women's perspective in all the three years. Women in rich households and the highly educated were found to be 40% and 50% less likely to accept domestic physical violence compared to the poorest and illiterate women. Similarly, women who got married before 18 years were 20% more likely accept physical violence in the family as a norm. Apart from these particular groups (richest, highly educated and married after 18 years, other groups had around 30% acceptance rate of household violence. For any successful attempt to reduce spousal physical violence in the traditional patriarchal society of Bangladesh, interventions must target the most vulnerable households and the geographical areas where women experience spousal violence. Although this paper focuses on women's attitudes, it is important that any intervention scheme should be devised to target both men and women.

  15. Women's opinion on the justification of physical spousal violence: A quantitative approach to model the most vulnerable households in Bangladesh.

    Science.gov (United States)

    Biswas, Raaj Kishore; Rahman, Nusma; Kabir, Enamul; Raihan, Farabi

    2017-01-01

    Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV) and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014) were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31.9% and 28.7% women in the surveys found justification for physical violence in household in 2007, 2011 and 2014 respectively. The binary logistic model showed wealth index, education of both women and their partner, religion, geographical division, decision making freedom and marital age as significant household contributors for women's perspective in all the three years. Women in rich households and the highly educated were found to be 40% and 50% less likely to accept domestic physical violence compared to the poorest and illiterate women. Similarly, women who got married before 18 years were 20% more likely accept physical violence in the family as a norm. Apart from these particular groups (richest, highly educated and married after 18 years), other groups had around 30% acceptance rate of household violence. For any successful attempt to reduce spousal physical violence in the traditional patriarchal society of Bangladesh, interventions must target the most vulnerable households and the geographical areas where women experience spousal violence. Although this paper focuses on women's attitudes, it is important that any intervention scheme should be devised to target both men and women.

  16. Role of spousal involvement in continuous positive airway pressure (CPAP adherence in patients with obstructive sleep apnea (OSA

    Directory of Open Access Journals (Sweden)

    Batool-Anwar S

    2017-05-01

    Full Text Available Introduction: Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP adherence. The aim of this study was to determine whether spouse involvement affects adherence with CPAP therapy, and how this association varies with gender. Methods: 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES completed the Dyadic Adjustment Scale (DAS. The majority of participants were Caucasian (83%, and males (73%, with mean age of 56 years, mean BMI of 31 kg/m2. & 62% had severe OSA. The DAS is a validated 32-item self-report instrument measuring dyadic consensus, satisfaction, cohesion, and affectional expression. A high score in the DAS is indicative of a person’s adjustment to the marriage. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP use was downloaded from the device and self-report, and compliance was defined as usage > 4 h per night. Results: There were no significant differences in overall marital quality between the compliant and noncompliant subjects. However, level of spousal involvement was associated with increased CPAP adherence at 6 months (p=0.01. After stratifying for gender these results were significant only among males (p=0.03. Three years after completing APPLES, level of spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion: Spousal involvement is important in determining CPAP compliance in males in the 1st 6 months after initiation of therapy but is not predictive of longer-term adherence. Involvement of the spouse should be considered an integral part of CPAP initiation procedures.

  17. Prevalence and predictors of help-seeking for women exposed to spousal violence in India - a cross-sectional study.

    Science.gov (United States)

    Leonardsson, Malin; San Sebastian, Miguel

    2017-11-03

    Spousal violence against women is prevalent in India (29%). Studies from various countries have shown that few women exposed to intimate partner violence or spousal violence seek help, especially in low-income countries. The objective of this study was to estimate the prevalence and predictors of help-seeking among women in India who have experienced various types of spousal violence. Cross-sectional data on 19,125 married, separated, divorced or widowed women in India who had experienced physical or sexual violence at the hands of their husbands were obtained from the India National Family Health Survey III 2005-2006. Bivariate and multivariate logistic regression analyses were carried out. Less than one fourth (23.7%) of married, separated, divorced or widowed women in India who had experienced some form of physical or sexual spousal violence had sought help, but only 1% had sought help from formal institutions. Help-seeking was most prevalent in women who had been exposed to a combination of physical, sexual and emotional abuse (48.8%) and the least prevalent in women who had experienced sexual violence only (1.5%). Experience of severe violence and violence resulting in injury were the strongest predictors of help-seeking. Having education, being Christian or an acknowledged adherent of another minority religion - mainly Buddhism and Sikhism (Islam not included), getting married after the age of 21 and living in the South region were also associated with seeking help. Women in the North and Northeast regions were less likely to seek help, as were women with children and women who thought that a husband could be justified in hitting his wife. Very few Indian women who experience spousal violence seek help. The characteristics of the violence are the strongest predictors of help-seeking, but sociodemographic factors are also influential. We recommend efforts to ensure educational attainment for girls, prevention of child marriages, and that police officers and

  18. Concordance between Stages of Behavior Change Questionnaire and IPAQ

    Directory of Open Access Journals (Sweden)

    Priscila Missaki Nakamura

    2013-12-01

    Full Text Available A low rate of physical activity (PA participation is observed worldwide. The identification of feasible and reliable instruments able to accurately measuring PA and help in the development of interventions to promote PA are necessary. This study aimed to analyze the concordance between the Stages of Behavior Change Questionnaire (SBCQ and the International Physical Activity Questionnaire (IPAQ long-version in assessing adult leisure-time physical activity (LTPA. A total of 1.588 adults completed the IPAQ to assess LTPA and the participants who performed more than 10 min/week were classified in active individuals. Using the SBCQ, active individuals were those classified in the action or maintenance stage and inactive individuals were those classified in the precontemplation, contemplation or preparation stage. The concordance between SBCQ and IPAQ was found to be 0.80. Separated by gender, it was observed a concordance between the two instruments of 0.82 for women, and 0.77 for men. Regarding age group, it was found to be 0.81 for young and middle-aged adults, and 0.77 for older people. The SBCQ presented a very good concordance with IPAQ to assess LTPA.

  19. Common Ground? The Concordance of Sarcopenia and Frailty Definitions

    NARCIS (Netherlands)

    Reijnierse, Esmee M.; Trappenburg, Marijke C.; Blauw, Gerard Jan; Verlaan, Sjors; de van der Schueren, Marian A.E.; Meskers, Carel G.M.; Maier, Andrea B.

    2016-01-01

    Objectives: This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients. Design: Data were retrieved from a cross-sectional study. Setting: The study was performed in a geriatric outpatient clinic of a

  20. The Concordance of Multilingual Legal Texts at the WTO

    Science.gov (United States)

    Condon, Bradly J.

    2012-01-01

    Multilingualism is a sensitive and complex subject in a global organisation such as the World Trade Organization (WTO). In the WTO legal texts, there is a need for full concordance, not simply translation. This article begins with an overview of the issues raised by multilingual processes at the WTO in the negotiation, drafting, translation,…

  1. Populating Subentries with Multiword Units from Concordance Lines

    African Journals Online (AJOL)

    Riette Ruthven

    Populating Sub-entries in Dictionaries with Multi-word Units from Concordance Lines 447. What constitutes words is critical in corpus linguistics, since it translates into the problem of what gets counted by the computer. Lexicographically, those ones considered as words are listed in the dictionary. 2. The word problem.

  2. Negative Concord in Afrikaans: Filling the typological gap

    NARCIS (Netherlands)

    Biberauer, T.; Zeijlstra, H.

    2012-01-01

    Many languages exhibit Negative Concord (NC), with multiple morphosyntactic instances of negation corresponding to one semantic negation. Traditionally, NC languages are distinguished as Strict and Non-strict (cf. Giannakidou 2000). In the former (e.g. Czech), multiple negative elements may or even

  3. Inexact proximal Newton methods for self-concordant functions

    DEFF Research Database (Denmark)

    Li, Jinchao; Andersen, Martin Skovgaard; Vandenberghe, Lieven

    2016-01-01

    We analyze the proximal Newton method for minimizing a sum of a self-concordant function and a convex function with an inexpensive proximal operator. We present new results on the global and local convergence of the method when inexact search directions are used. The method is illustrated...

  4. Perceptions of Purpose in Life Within Spousal Care Dyads: Associations With Emotional and Physical Caregiving Difficulties.

    Science.gov (United States)

    Polenick, Courtney A; Kales, Helen C; Birditt, Kira S

    2018-01-05

    Greater feelings of purpose in life are associated with better health and may reduce the negative impact of chronic stress. Yet little is known about how purpose in life may buffer the negative effects of caregiving, a common chronic stressor in middle and later life. This cross-sectional study utilized a U.S. sample of 315 spousal caregivers and their partners with functional disability drawn from the 2011 National Health and Aging Trends Study and National Study of Caregiving to examine how both parties' perceptions of purpose in life are associated with caregivers' emotional and physical caregiving difficulties. We also evaluated whether care recipients' purpose in life moderates the association between caregivers' purpose in life and care-related difficulties. Finally, we considered whether these links differed by caregiver gender. Models controlled for caregivers' sociodemographics, care tasks, support resources, valued activity participation, and each care partner's health conditions. Caregivers' greater purpose in life was significantly linked to fewer physical caregiving difficulties. Caregivers' greater purpose in life was significantly associated with fewer emotional care-related difficulties among caregiving wives and when care recipients' purpose in life was low. Although the associations between purpose in life and care-related difficulties are likely bidirectional, purpose in life may represent an important resource for combating the adverse consequences of caregiving. This study highlights the value of considering personal resources and their implications for caregivers' well-being within a dyadic context.

  5. Protective buffering and emotional desynchrony among spousal caregivers of cancer patients.

    Science.gov (United States)

    Langer, Shelby L; Rudd, Michael E; Syrjala, Karen L

    2007-09-01

    To examine protective buffering and emotional desynchrony among spousal caregivers of cancer survivors. Repeated measures; 42 caregivers engaged in 2 videotaped, oral emotional expression exercises: 1 in the presence of their patient and 1 in the absence of their patient. Felt emotion (self-report) and expressed emotion (lexical expression or words uttered and coder-derived facial expression). Other measures assessed mental and physical health, dyadic satisfaction, and dispositional emotional inhibition. Protective buffering differed by communicative channel (lexical vs. facial). Caregivers' facial expressions were more positive when the patient was present versus absent. In contrast, the valence of caregivers' words did not differ per patient presence. Facial protective buffering was unrelated to health and dyadic outcomes. Lexical protective buffering was inversely related to both caregiver and patient marital satisfaction. Dispositional emotional inhibition was inversely related to caregiver mental health and marital satisfaction. Desynchrony occurred when the patient was present but was counter to prediction; felt emotion was more positive than expressed emotion. Results provide behavioral evidence of facial protective buffering. To the extent that lexical buffering occurs, it poses a dyadic risk, and chronic inhibition poses both psychological and dyadic risks. Future research is needed to refine the operational definition of desynchrony and to examine the biopsychosocial sequelae of buffering. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

  6. Correlates of spousal empathic accuracy for pain-related thoughts and feelings.

    Science.gov (United States)

    Leonard, Michelle T; Issner, Jaclyn Heller; Cano, Annmarie; Williams, Amy M

    2013-04-01

    This study explored correlates of spousal ability to infer the thoughts and feelings of individuals with chronic pain (ICPs). Participant couples (N=57), who consisted of at least 1 couple member with chronic pain, engaged in a videotaped discussion about pain, after which they completed an empathic accuracy procedure where spouses of ICP were asked to infer thoughts/feelings of ICPs. Overall levels of partner empathic accuracy were similar to other studies of couples. Several characteristics of the pain experience and the marital relationship correlated with empathic accuracy for thoughts and feelings. Specifically, partner catastrophizing about the ICP's pain was associated with less empathic accuracy for thoughts, whereas ICP pain severity was related to a greater empathic accuracy for feelings. Several significant interactions were also found, with marital satisfaction and partner's own pain experience acting as moderators. These findings provide support for models of empathy that argue that characteristics of the pain condition and characteristics of the observer are important contributors to observers' understanding of pain. In addition, the findings support previous research that suggests there are different processes for understanding the emotional versus the cognitive experience of others.

  7. Predictive Factors for the Uptake of Coping Strategies by Spousal Dementia Caregivers: A Systematic Review.

    Science.gov (United States)

    Roche, Lauren; MacCann, Carolyn; Croot, Karen

    2016-01-01

    An understanding of spousal dementia caregivers' coping strategies and their predictive factors is imperative for caregivers' well-being. Although several reviews have explored the relationship between coping strategies and outcomes, no review has investigated factors that predict caregivers' use of one type of coping strategy over another. The current review aimed to identify factors that predict caregivers' coping strategies. Within this, we attempted to identify caregivers who are more likely to adopt dysfunctional coping strategies and be at risk of adverse outcomes. Several electronic databases were systematically searched. Twenty-one studies were eligible for review, describing 18 caregiver and care-recipient factors related to the 3 coping strategies. No factors were classified "predictive," however, 16 factors were "potentially predictive." Younger, more highly educated caregivers with greater emotional supports and knowledge of dementia were associated with solution-focused coping. Younger, less educated caregivers were associated with emotional support/acceptance-based coping strategies. Whereas nonwhite caregivers with less emotional supports caregiving for persons with more behavioral problems were associated with dysfunctional coping strategies. Enhancing caregiver self-efficacy, knowledge of dementia, improving social supports, linking to support groups, managing behavioral problems, as well as coaching adaptive coping strategies while flagging caregivers at risk for dysfunctional coping may improve outcomes for caregivers.

  8. Exposure to Spousal Violence in the Family, Attitudes and Dating Violence Perpetration Among High School Students in Port-au-Prince.

    Science.gov (United States)

    Gage, Anastasia J

    2016-09-01

    This study examined the associations of exposure to spousal violence in the family and personal and peer attitudes with dating violence (DV) perpetration among high school students in Port-au-Prince, Haiti. Participants were 342 high school students in Grades 10 to 12 who stated that they had ever been on a date. Multiple linear regression methods were used to examine correlates of the scale of DV perpetration. Findings showed that personal acceptance of DV mediated the association between exposure to wife-perpetrated and husband-perpetrated spousal violence in the family and DV perpetration for girls. Boys who were exposed to husband-perpetrated spousal violence in the family had significantly higher levels of psychological DV perpetration than those who were not. Contrary to expectations, exposure to wife-perpetrated spousal violence in the family was negatively associated with psychological and physical/sexual DV perpetration by boys, after controlling for other factors. Overall, perceived peer tolerance of DV was more strongly associated with DV perpetration than personal tolerance of DV, and was the only significant correlate of psychological DV perpetration for girls. Perceived peer attitudes also moderated the association between boys' exposure to spousal violence in the family and DV perpetration. Implications for future research and policy are discussed. © The Author(s) 2015.

  9. Gender vulnerabilities, spousal abuse and the incidence of HIV in Lesotho:a case for an integrative rights-based approach.

    Science.gov (United States)

    Olowu, 'Dejo

    2011-09-01

    The article posits that imbalances in gender relations are influencing two distinctive yet connected crises for women in Lesotho: the HIV epidemic and spousal abuse. The overarching premise is that as spousal abuse is increasingly recognised and as HIV infections spread, responses to the phenomenon do not reflect the related risks and consequences in married women's lives. This article underscores the nexus of connections between HIV and spousal abuse in Lesotho, identifying potential areas for pragmatic state-led responses. Applying a rights-based approach, it assesses women's vulnerability to each problem at the individual, societal and programmatic levels, noting that there are both direct and underlying factors heightening risks for women. The article asks, what is the value added by a rights-based approach to the subject under discourse? And, how can a rights-based approach be translated into practical tools for planning, monitoring and evaluating projects and programmes aimed at tackling the multifaceted risks and challenges of HIV and spousal abuse confronting women in Lesotho? In response to these questions, the author identifies three trajectories of opportunities for an integrated, comprehensive response. The unmistakable anchor of the article's propositions is the rights-based approach. Although the discussion focuses on Lesotho, the implications for the broader African region cannot be overemphasised in light of commonly shared experiences pertaining to the severe difficulties posed by spousal abuse and HIV.

  10. Sleep in Spousal Alzheimer Caregivers: A Longitudinal Study with a Focus on the Effects of Major Patient Transitions on Sleep

    Science.gov (United States)

    von Känel, Roland; Mausbach, Brent T.; Ancoli-Israel, Sonia; Dimsdale, Joel E.; Mills, Paul J.; Patterson, Thomas L.; Ziegler, Michael G.; Roepke, Susan K.; Chattillion, Elizabeth A.; Allison, Matthew; Grant, Igor

    2012-01-01

    Study Objectives: Findings on sleep disturbances in family dementia caregivers are conflicting. We studied the longitudinal effects of dementia caregiving and major transitions in the caregiving situation on caregivers' sleep and the effect of moderating variables. Design and Setting: Community-based longitudinal study with assessments about once a year for up to three years. Participants: A sample of 109 elderly spousal Alzheimer caregivers and 48 non-caregiving age- and gender-matched controls. Measurements and Results: Random regression models with fixed and time-variant effects for covariates known to affect sleep were used to evaluate changes in the Pittsburgh Sleep Quality Index (PSQI) and in four actigraphy measures over time in relation to caregiving status and transitions (i.e., nursing home placement or death of the Alzheimer disease spouse). Multivariate-adjusted sleep characteristics did not significantly differ between caregivers and non-caregivers over time. Spousal death increased caregivers' nighttime wake after sleep onset (WASO) by 23 min (P = 0.002) and daytime total sleep time (TST) by 29 min (P = 0.003), while nighttime sleep percent decreased by 3.2% (P = 0.009) and nighttime TST did not change. Placement of the spouse had no significant effect on caregivers' sleep. Older age, male gender, role overload, depressive symptoms, and proinflammatory cytokines variously emerged as significant moderators of the relationships between caregiving and transitions with poor subjective and objective sleep. Conclusions: Alzheimer caregivers and non-caregiving controls had similar trajectories of sleep. However, there may be subgroups of caregivers who are vulnerable to develop sleep disturbances, including those whose spouses have died. Citation: von Känel R; Mausbach BT; Ancoli-Israel S; Dimsdale JE; Mills PJ; Patterson TL; Ziegler MG; Roepke SK; Chattillion EA; Allison M; Grant I. Sleep in spousal alzheimer caregivers: a longitudinal study with a focus

  11. Price squeezes in electric power: The new Battle of Concord

    International Nuclear Information System (INIS)

    Kwoka, J.E. Jr.

    1992-01-01

    The US Court of Appeals opinion in Town of Concord v. Boston Edison offers a vigorous statement of the position that in a regulated market, what may appear to be a price squeeze almost certainly cannot harm the competitive process and therefore should not be held to violate the antitrust laws. While not disputing the possibility of self-serving claims of price squeezes, this article shows that truly anticompetitive price squeezes may indeed occur in the electric power industry and cannot be so readily dismissed. This analysis begins with a brief factual and economic background on price squeezes, then addresses arguments made in Concord and elsewhere seeking to disprove their possibility, and demonstrate that sound economics and good policy require a more balanced approach

  12. Spousal separation, selectivity and contextual effects: exploring the relationship between international labour migration and fertility in post-Soviet Tajikistan

    Directory of Open Access Journals (Sweden)

    David Clifford

    2009-12-01

    Full Text Available This paper contributes to the sparse literature on the impact of temporary migration on fertility in origin areas. It examines the case of male labour migration from post-Soviet Tajikistan, a significant and relatively recent phenomenon. Fertility and migration models are solved simultaneously to account for cross-process correlation. There is clear evidence for a short-term disruptive effect of spousal separation, but it is too early to assess the implications for completed fertility. While there is no evidence for unobserved selectivity at the couple level, there is a significant positive correlation between the migration and fertility processes at the community level.

  13. The temporal relationship between change in symptoms of prolonged grief and posttraumatic stress following old age spousal bereavement

    DEFF Research Database (Denmark)

    O Connor, Maja; Nickerson, Angela; Aderka, Idan M.

    2015-01-01

    following the death of a loved one. The purpose of this study was to examine the temporal relationship between change in high levels of PGS and PTSS during the first four years following old age spousal loss. Methods: Participants were 237 Danes (40% male; mean age = 73 years, SD = 4.4; range 65-81) who...... bereavement to a greater extent than vice versa. Conclusions: The findings in the present study indicate that changes in PGS may precede and potentially directly impact changes in PTSS following bereavement. This tentative conclusion points to the potential value of targeting PGS in psychological...

  14. Effect of Male Partner's Support on Spousal Modern Contraception in a Low Resource Setting.

    Science.gov (United States)

    Balogun, Olayinka; Adeniran, Abiodun; Fawole, Adegboyega; Adesina, Kikelomo; Aboyeji, Abiodun; Adeniran, Peace

    2016-09-01

    As efforts continue to increase contraceptive uptake, male partner support remains important in spousal modern contraceptive use. A prospective cross-sectional survey involving women on modern contraception was conducted at the family planning clinic of the University of Ilorin Teaching Hospital, Nigeria, between December 2013 and April 2014. All consenting participants completed a self-administered questionnaire designed for the study, and statistical analysis was done with SPSS version 20.0 using with chi square test and logistic regression; p value contraceptives used were IUD and injectables while male partner was responsible for discontinuation in 30(23.3%) of previous users. Covert contraceptive use was 22(7.2%), male partner support was 209(68.5%) as payment for the contraceptives (203; 66.6%) or transportation to the clinic (198; 64.9%). Also, 55(18.0%) women failed to comply with contraception recently due to male partner hindrance (25; 45.5%) or inability to pay for contraceptive (11; 20%) or transportation to the clinic (8; 14.5%). Male partners hindered contraception by reporting the woman to relatives/friends (8; 32%) or denying her money for feeding allowance (6; 24%); 277(90.8%) women want contraception to be couple decision while 261(85.6%) want contraception administered only if both partners consented. The significant predictors of male partner support were awareness about the contraceptive use (pMale partner hindrances and costs of contraceptive or transportation to clinic are important in noncompliance. Male partner education, subsidized/free contraceptives and mobile/community services will improve compliance.

  15. Relationships among spousal communication, self-efficacy, and motivation among expectant Latino fathers who smoke.

    Science.gov (United States)

    Khaddouma, Alexander; Gordon, Kristina Coop; Fish, Laura J; Bilheimer, Alicia; Gonzalez, Alicia; Pollak, Kathryn I

    2015-10-01

    Cigarette smoking is a prevalent problem among Latinos, yet little is known about what factors motivate them to quit smoking or make them feel more confident that they can. Given cultural emphases on familial bonds among Latinos (e.g., familismo), it is possible that communication processes among Latino spouses play an important role. The present study tested a mechanistic model in which perceived spousal constructive communication patterns predicted changes in level of motivation for smoking cessation through changes in self-efficacy among Latino expectant fathers. Latino males (n = 173) and their pregnant partners participated in a couple-based intervention targeting males' smoking. Couples completed self-report measures of constructive communication, self-efficacy (male partners only), and motivation to quit (male partners only) at 4 time points throughout the intervention. Higher levels of perceived constructive communication among Latino male partners predicted subsequent increases in male partners' self-efficacy and, to a lesser degree, motivation to quit smoking; however, self-efficacy did not mediate associations between constructive communication and motivation to quit smoking. Furthermore, positive relationships with communication were only significant at measurements taken after completion of the intervention. Female partners' level of perceived constructive communication did not predict male partners' outcomes. These results provide preliminary evidence to support the utility of couple-based interventions for Latino men who smoke. Findings also suggest that perceptions of communication processes among Latino partners (particularly male partners) may be an important target for interventions aimed at increasing desire and perceived ability to quit smoking among Latino men. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  16. Does Spousal Support Can Increase the Women’s Physical Activity?

    Directory of Open Access Journals (Sweden)

    Hajar Rezaee

    2017-04-01

    Full Text Available Background: Numerous benefits of physical activity are well-known for the prevention and treatment of various diseases such as diabetes, cardiovascular disease, obesity, and cancers. However, the status of physical activities among women remains noticeably less than the recommended level. Considering the importance of the spouses’ participation in the promotion of women’s health, this study examined the impact of spousal support on women’s physical activity. Methods: This semi--experimental study was done in February 2015 on 100 couples in reproductive age referred to health centers of Falavarjan city. The participants were randomly divided into intervention and control groups. The information related to women’s physical activity in both groups was collected by aquestionnaire in two steps, before and three months after the intervention. The spouses of women in the intervention group were trained in the field of the importance of physical activity in women’s health in two sessions. The data were analyzed by the software SPSS21 and suitable statistical tests (Independent t, paired t, and Chi-square. Results: The mean and standard deviation of women’s age in the both groups were 28.76±5.51 and 30.38±5.31, respectively. The prevalence of obesity and overweight in the women under the study was generally estimated 44%. Physical activities of women in the intervention group were significantly increased after the intervention (P<0.0001. Also, the Body Mass Index in the intervention group was significantly decreased compared to before the intervention and control group (P<0.001. Conclusion: Spouses could encourage women to perform physical activities. It is recommended that the health care system should implement educational sessions for men to encourage women to exercise.

  17. [Low concordance between primary care and hospital clinical information].

    Science.gov (United States)

    Revilla-López, Concha; Calderón-Larrañaga, Amaia; Enríquez-Martín, Natalia; Prados-Torres, Alexandra

    2016-04-01

    To measure the diagnostic agreement between Primary Care (PC) and hospital information systems, in order to assess the usefulness of health care records for research purposes. Cross-sectional retrospective study integrating PC and hospital diagnostic information for the Aragon population admitted to hospital in 2010. 75.176 patients were analysed. Similarities, differences and the kappa index were calculated for each of the diagnoses recorded in both information systems. The studied diseases included COPD, diabetes, hypertension, cerebrovascular disease, ischaemic heart disease, asthma, epilepsy, and heart failure. Diagnostic concordance was higher in men and between 45 and 64 years. Diabetes was the condition showing the highest concordance (kappa index: 0.75), while asthma had the lowest values (kappa index: 0.34). The low concordance between the diagnostic information recorded in PC and in the hospital setting calls for urgent measures to ensure that healthcare professionals have a comprehensive picture of patient's health problems. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Do changes in spousal employment status lead to domestic violence? Insights from a prospective study in Bangalore, India.

    Science.gov (United States)

    Krishnan, Suneeta; Rocca, Corinne H; Hubbard, Alan E; Subbiah, Kalyani; Edmeades, Jeffrey; Padian, Nancy S

    2010-01-01

    The prevalence of physical domestic violence--violence against women perpetrated by husbands--is staggeringly high across the Indian subcontinent. Although gender-based power dynamics are thought to underlie women's vulnerability, relatively little is known about risk and protective factors. This prospective study in southern India examined the association between key economic aspects of gender-based power, namely spousal employment status, and physical domestic violence. In 2005-2006, 744 married women, aged 16-25, residing in low-income communities in Bangalore, India were enrolled in the study. Data were collected at enrollment, 12 and 24 months. Multivariable logistic regression models were used to examine the prospective association between women's employment status, their perceptions of their husband's employment stability, and domestic violence. Women who were unemployed at one visit and began employment by the next visit had an 80% higher odds of violence, as compared to women who maintained their unemployed status. Similarly, women whose husbands had stable employment at one visit and newly had difficulty with employment had 1.7 times the odds of violence, as compared to women whose husbands maintained their stable employment. To our knowledge, this study is the first from a developing country to confirm that changes in spousal employment status are associated with subsequent changes in violence risk. It points to the complex challenges of violence prevention, including the need for interventions among men and gender-transformative approaches to promote gender-equitable attitudes, practices and norms among men and women.

  19. Changing spousal roles and their effect on recovery in gamblers anonymous: GamAnon, social support, wives and husbands.

    Science.gov (United States)

    Ferentzy, Peter; Skinner, Wayne; Antze, Paul

    2010-09-01

    This paper examines changing spousal roles and their effects upon recovery in Gamblers Anonymous (GA). It is based upon a qualitative study designed to gage uniformity as well as variations in approaches to recovery in GA. Interviews were conducted with 39 GA members (26 men, 13 women; mean age 56.5 years). Though the study was based in the Toronto area, only 13 interviews involved participants from that region. Phone interviews were conducted with GA members from various regions of both Canada and the US. GamAnon, GA's sister fellowship, has been designed for anyone affected seriously by someone's gambling problem. In practice, GamAnon comprises mostly women--spouses of male GA members--who traditionally have taken a keen interest in the ways in which their husbands achieve and maintain abstinence from gambling. Changing spousal roles have led to fewer women joining GamAnon, as many opt instead to part with troubled spouses. As well, more women are attending GA than in the past, typically with husbands who are disinclined to join GamAnon. All of this has drastically altered how GA members pursue recovery. These changes and their implications are discussed.

  20. The longitudinal and dyadic effects of mutuality on perceived stress for stroke survivors and their spousal caregivers.

    Science.gov (United States)

    Godwin, Kyler M; Swank, Paul R; Vaeth, Patrice; Ostwald, Sharon K

    2013-01-01

    Functional impairment resulting from a stroke frequently requires the care of a family caregiver, often the spouse. This change in the relationship can be stressful for the couple. Thus, this study examined the longitudinal, dyadic relationship between caregivers' and stroke survivors' mutuality and caregivers' and stroke survivors' perceived stress. This secondary data analysis of 159 stroke survivors and their spousal caregivers utilized a cross-lagged, mixed models analysis with the actor-partner interdependence model to examine the dyadic relationship between mutuality and perceived stress over the first year post-discharge from inpatient rehabilitation. Caregivers' mutuality showed an actor effect (β = -3.82, p perceived stress but not the stroke survivors' perceived stress. Stroke survivors' perceived stress showed a partner effect and affected caregivers' perceived stress (β = 0.13, p = 0.047). Caregivers' perceived stress did not show a partner effect and did not significantly affect stroke survivors' perceived stress. These findings highlight the interpersonal nature of stress in the context of caregiving for a spouse. Caregivers are especially influenced by perceived stress in the spousal relationship. Couples should be encouraged to focus on positive aspects of the caregiving relationship to mitigate stress.

  1. Compassionate Love in Individuals With Alzheimer’s Disease and Their Spousal Caregivers: Associations With Caregivers’ Psychological Health

    Science.gov (United States)

    Monin, Joan K.; Schulz, Richard; Feeney, Brooke C.

    2015-01-01

    Purpose of the Study: To examine whether compassionate love in both individuals with Alzheimer’s disease (AD) and their spousal caregivers related to less caregiving burden, more positive caregiving appraisals, and less depressive symptoms for caregivers. Design and Methods: Fifty-eight individuals with AD and their spousal caregivers participated in interviews in which both partners reported their compassionate love for their partner, and caregivers self-reported burden, positive appraisals of caregiving, and depressive symptoms. Results: As hypothesized, both AD individuals’ and caregivers’ compassionate love were associated with less burden and more positive appraisals of caregiving. Also, care givers’ compassionate love mediated the association between AD individuals’ compassionate love and caregivers’ burden as well as the association between AD individuals’ compassionate love and caregivers’ positive appraisals of caregiving. Finally, there was a marginally significant association between caregivers’ compassionate love and less caregiver depressive symptoms. Implications: Results suggest that AD individuals’ compassionate love is related to compassionate love in caregivers, which in turn relates to reduced burden but not significantly less depressive symptoms for caregivers. Assessing caregivers’ and AD individuals’ feelings of compassionate love may be useful in identifying caregivers who are resilient and those who are at a heightened risk for caregiving burden. Also, interventions that enhance both partners’ compassionate love may benefit caregivers. PMID:24534607

  2. Parent-child and spousal relationships in families with a young child with end-stage renal disease.

    Science.gov (United States)

    Laakkonen, Hanne; Taskinen, Sara; Rönnholm, Kai; Holmberg, Christer; Sandberg, Seija

    2014-02-01

    End-stage renal disease (ESRD) leads to the need for dialysis and renal transplantation (Tx). Peritoneal dialysis (PD) of young children is normally performed at home by the parents and affects the whole family. We studied the coping of families with a young child with ESRD by interviewing the parents of 19 children. The spousal and parent-child relationships were assessed by using the Psychosocial Assessment of Childhood Experiences (PACE) and the Brief Measure of Expressed Emotion, respectively. A control group of 22 families with a healthy child was used for the parent-child relationship evaluation. The spousal relationship at the start of PD was good or fairly good in most of the families and remained good in half of the families following renal Tx. Lack of support from close relatives and renal Tx were associated with a poorer relationship quality. Almost all parents expressed much or fairly much emotional warmth towards the child throughout the study, but there was a trend towards increased criticism over time. No differences in the degree of expressed warmth or criticism were noted between the index parents and controls. Overall, the study families appeared to cope well despite the serious illness of their child and the demands of the treatments.

  3. Concordance: Design Ideal for Facilitating Situated Negotiations in Out-of-clinic Healthcare

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.; Gronvall, Erik; Sokoler, Tomas

    2014-01-01

    Healthcare HCI research has explored various designs that encourage people to follow prescribed treatments, mostly adopting compliance and adherence as design ideals. However, within the medical sciences the notion of concordance also exists. Concordance promotes negotiation between the patient...... and healthcare professional for forging a therapeutic alliance. However, the HCI community has still not adopted concordance as a design ideal. This paper revisits four old design-cases to explore the role of concordance in out-of-clinic healthcare. We argue that concordance, as a design ideal, can guide new...

  4. Need and value of case management in multidisciplinary ALS care: A qualitative study on the perspectives of patients, spousal caregivers and professionals

    NARCIS (Netherlands)

    Bakker, Minne; Creemers, Huub; Schipper, Karen; Beelen, Anita; Grupstra, Hepke; Nollet, Frans; Abma, Tineke

    2015-01-01

    Our objective was to explore the needs and value of case management according to patients with amyotrophic lateral sclerosis (ALS), their spousal caregivers, and health care professionals in the context of multidisciplinary ALS care. We undertook semi-structured interviews with 10 patients with ALS,

  5. Common Ground? The Concordance of Sarcopenia and Frailty Definitions.

    Science.gov (United States)

    Reijnierse, Esmee M; Trappenburg, Marijke C; Blauw, Gerard Jan; Verlaan, Sjors; de van der Schueren, Marian A E; Meskers, Carel G M; Maier, Andrea B

    2016-04-01

    This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients. Data were retrieved from a cross-sectional study. The study was performed in a geriatric outpatient clinic of a middle-sized teaching hospital. The study included 299 geriatric outpatients (mean age 82.4, SD 7.1) who were consecutively referred to the outpatient clinic. Prevalence rates and subsequent concordance evolving from 3 definitions of sarcopenia and 2 definitions of frailty were compared. Definitions of sarcopenia included the European Working Group on Sarcopenia in Older People (gait speed, handgrip strength, muscle mass), International Working Group on Sarcopenia (gait speed, muscle mass) and the definition by Janssen (muscle mass). Definitions of frailty included the Fried frailty phenotype (weight loss, exhaustion, physical inactivity, handgrip strength, walk time) and the definition of Rockwood (use of walking aid, activities of daily living, incontinence, and cognitive impairment). Prevalence rates for sarcopenia varied between 17% and 22% and between 29% and 33% for frailty. There was little concordance in intraindividual prevalence rates of sarcopenia and frailty using different definitions. None of the outpatients was classified as having sarcopenia and frailty according to all applied definitions. Outpatients with sarcopenia were more likely to be frail than frail outpatients to be sarcopenic. This study clearly indicates that sarcopenia and frailty are 2 separate conditions based on the current definitions. It is important to diagnose sarcopenia and frailty as separate entities, as each may require specific treatment. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Parent/Adolescent Weight Status Concordance and Parent Feeding Practices

    Science.gov (United States)

    Berge, Jerica M.; Meyer, Craig S.; Loth, Katie; MacLehose, Richard; Neumark-Sztainer, Dianne

    2017-01-01

    Background Prior studies have examined the independent influence of mothers’ weight status or childs’ weight status on parents’ use of specific feeding practices (i.e., restriction, pressure-to-eat). However, studies have not examined the mutual influence of parents' and adolescents' weight status on parents' feeding practices. This study examines the relationship between parent/adolescent weight status concordance and discordance and parent feeding practices. Methods Data from two linked population-based studies, EAT 2010 and F-EAT, were used for cross-sectional analysis. Mothers and fathers (n = 3,252; 63% females; mean age = 42.6 years) and adolescents (n = 2,153; 54% females; mean age = 14.4 years) were socio-economically and racially/ethnically diverse. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parents used the highest levels of pressure-to-eat feeding practices when parents and adolescents were both nonoverweight compared to all other combinations of concordant and discordant parent/adolescent weight status categories. Additionally, parents used the highest levels of food restriction when parents and adolescents were both overweight/obese compared to all other combinations of concordant and discordant parent/adolescent weight status categories. Sensitivity analyses with two parent households revealed similar patterns. Conclusions Results suggest that parents used parent feeding practices in response to both their adolescent’s and their own weight status. Results may inform health care providers and public health interventionists which parent/adolescent dyads are at highest risk for experiencing food restriction or pressure-to-eat parent feeding practices in the home environment and who to target in interventions. PMID:26304822

  7. Concordance of commercial data sources for neighborhood-effects studies.

    Science.gov (United States)

    Hoehner, Christine M; Schootman, Mario

    2010-07-01

    Growing evidence supports a relationship between neighborhood-level characteristics and important health outcomes. One source of neighborhood data includes commercial databases integrated with geographic information systems to measure availability of certain types of businesses or destinations that may have either favorable or adverse effects on health outcomes; however, the quality of these data sources is generally unknown. This study assessed the concordance of two commercial databases for ascertaining the presence, locations, and characteristics of businesses. Businesses in the St. Louis, Missouri area were selected based on their four-digit Standard Industrial Classification (SIC) codes and classified into 14 business categories. Business listings in the two commercial databases were matched by standardized business name within specified distances. Concordance and coverage measures were calculated using capture-recapture methods for all businesses and by business type, with further stratification by census-tract-level population density, percent below poverty, and racial composition. For matched listings, distance between listings and agreement in four-digit SIC code, sales volume, and employee size were calculated. Overall, the percent agreement was 32% between the databases. Concordance and coverage estimates were lowest for health-care facilities and leisure/entertainment businesses; highest for popular walking destinations, eating places, and alcohol/tobacco establishments; and varied somewhat by population density. The mean distance (SD) between matched listings was 108.2 (179.0) m with varying levels of agreement in four-digit SIC (percent agreement = 84.6%), employee size (weighted kappa = 0.63), and sales volume (weighted kappa = 0.04). Researchers should cautiously interpret findings when using these commercial databases to yield measures of the neighborhood environment.

  8. Weak Concordance between Fish and Macroinvertebrates in Mediterranean Streams

    Science.gov (United States)

    Larsen, Stefano; Mancini, Laura; Pace, Giorgio; Scalici, Massimiliano; Tancioni, Lorenzo

    2012-01-01

    Although anthropogenic degradation of riverine systems stimulated a multi-taxon bioassessment of their ecological integrity in EU countries, specific responses of different taxonomic groups to human pressure are poorly investigated in Mediterranean rivers. Here, we assess if richness and composition of macroinvertebrate and fish assemblages show concordant variation along a gradient of anthropogenic pressure in 31 reaches across 13 wadeable streams in central Italy. Fish and invertebrate taxonomic richness was not correlated across sites. However, Mantel test showed that the two groups were significantly, albeit weakly, correlated even after statistically controlling for the effect of environmental variables and site proximity. Variance partitioning with partial Canonical Correspondence Analysis showed that the assemblages of the two groups were influenced by different set of environmental drivers: invertebrates were influenced by water organic content, channel and substratum features, while fish were related to stream temperature (mirroring elevation) and local land-use. Variance partitioning revealed the importance of biotic interactions between the two groups as a possible mechanisms determining concordance. Although significant, the congruence between the groups was weak, indicating that they should not be used as surrogate of each other for environmental assessments in these Mediterranean catchments. Indeed, both richness and patterns in nestedness (i.e. where depauperate locations host only a subset of taxa found in richer locations) appeared influenced by different environmental drivers suggesting that the observed concordance did not result from a co-loss of taxa along similar environmental gradients. As fish and macroinvertebrates appeared sensitive to different environmental factors, we argue that monitoring programmes should consider a multi-assemblage assessment, as also required by the Water Framework Directive. PMID:23251432

  9. Association between gap in spousal education and domestic violence in India and Bangladesh

    Directory of Open Access Journals (Sweden)

    Rapp Daniel

    2012-06-01

    Full Text Available Abstract Background Domestic violence (DV against women is a serious human rights abuse and well recognised global public health concern. The occurrence of DV is negatively associated with the educational level of spouses but studies dealing with educational discrepancies of spouses show contradicting results: Wives with higher education than their husbands were more likely to ever experience DV as compared to equally educated couples. The purpose of this study was to investigate the association between spousal education gap (SEG and the prevalence and severity of DV in India and Bangladesh. Methods Nationally representative data collected through the 2005/2006 Indian National Family Health Survey (NFHS-3 and 2007 Bangladesh Demographic and Health Survey (BDHS were used. In total, we analysed data of 69,805 women aged 15–49 years (Bangladesh: 4,195 women, India: 65,610 women. In addition to univariate and bivariable analyses, a multinomial logistic regression model was used to quantify the association between education gap and less severe as well as severe domestic violence. Adjustment was made for age, religion, and family structure. Results Wives with higher education than their husbands were less likely to experience less severe (OR = 0.83, 95% CI: 0.77–0.89 and severe (OR = 0.79, 95% CI: 0.72–0.87 DV as compared to equally low-educated spouses (reference group. Equally high-educated couples revealed the lowest likelihood of experiencing DV (severe violence: OR 0.43, CI 0.39–0.48; less severe violence: OR 0.59, CI 0.55–0.63. The model’s goodness of fit was low (Nagelkerke’s R2 = 0.152. Conclusions Our analysis revealed no increased DV among wives with a higher educational level than their husbands. Moreover, the results point towards a decrease of severe violence with an increase in education levels among spouses. However, the model did not explain a satisfying amount of DV. Therefore, further research should be

  10. Association between gap in spousal education and domestic violence in India and Bangladesh.

    Science.gov (United States)

    Rapp, Daniel; Zoch, Beate; Khan, M Mobarak H; Pollmann, Thorsten; Krämer, Alexander

    2012-06-21

    Domestic violence (DV) against women is a serious human rights abuse and well recognised global public health concern. The occurrence of DV is negatively associated with the educational level of spouses but studies dealing with educational discrepancies of spouses show contradicting results: Wives with higher education than their husbands were more likely to ever experience DV as compared to equally educated couples. The purpose of this study was to investigate the association between spousal education gap (SEG) and the prevalence and severity of DV in India and Bangladesh. Nationally representative data collected through the 2005/2006 Indian National Family Health Survey (NFHS-3) and 2007 Bangladesh Demographic and Health Survey (BDHS) were used. In total, we analysed data of 69,805 women aged 15-49 years (Bangladesh: 4,195 women, India: 65,610 women). In addition to univariate and bivariable analyses, a multinomial logistic regression model was used to quantify the association between education gap and less severe as well as severe domestic violence. Adjustment was made for age, religion, and family structure. Wives with higher education than their husbands were less likely to experience less severe (OR = 0.83, 95% CI: 0.77-0.89) and severe (OR = 0.79, 95% CI: 0.72-0.87) DV as compared to equally low-educated spouses (reference group). Equally high-educated couples revealed the lowest likelihood of experiencing DV (severe violence: OR 0.43, CI 0.39-0.48; less severe violence: OR 0.59, CI 0.55-0.63). The model's goodness of fit was low (Nagelkerke's R2 = 0.152). Our analysis revealed no increased DV among wives with a higher educational level than their husbands. Moreover, the results point towards a decrease of severe violence with an increase in education levels among spouses. However, the model did not explain a satisfying amount of DV. Therefore, further research should be done to reveal unknown determinants so that suitable interventions to reduce DV can be

  11. Interpreter Services, Language Concordance, and Health Care Quality

    Science.gov (United States)

    Green, Alexander R; Ngo-Metzger, Quyen; Legedza, Anna TR; Massagli, Michael P; Phillips, Russell S; Iezzoni, Lisa I

    2005-01-01

    BACKGROUND Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter- and language-concordant clinicians may help overcome these problems but few studies have compared these approaches. OBJECTIVE To compare self-reported communication and visit ratings for LEP Asian immigrants whose visits involve either a clinic interpreter or a clinician speaking their native language. DESIGN Cross-sectional survey—response rate 74%. PATIENTS Two thousand seven hundred and fifteen LEP Chinese and Vietnamese immigrant adults who received care at 11 community-based health centers across the U.S. MEASUREMENTS Five self-reported communication measures and overall rating of care. RESULTS Patients who used interpreters were more likely than language-concordant patients to report having questions about their care (30.1% vs 20.9%, Pinterpreters highly (“excellent” or “very good”) were more likely to rate the health care they received highly (adjusted odds ratio 4.8, 95% confidence interval, 2.3 to 10.1). CONCLUSIONS Assessments of communication and health care quality for outpatient visits are similar for LEP Asian immigrants who use interpreters and those whose clinicians speak their language. However, interpreter use may compromise certain aspects of communication. The perceived quality of the interpreter is strongly associated with patients' assessments of quality of care overall. PMID:16307633

  12. No new cosmological concordance with massive sterile neutrinos.

    Science.gov (United States)

    Leistedt, Boris; Peiris, Hiranya V; Verde, Licia

    2014-07-25

    It has been claimed recently that massive sterile neutrinos could bring about a new concordance between observations of the cosmic microwave background, the large-scale structure of the Universe, and local measurements of the Hubble constant, H(0). We demonstrate that this apparent concordance results from combining data sets which are in significant tension, even within this extended model, possibly indicating remaining systematic biases in the measurements. We further show that this tension remains when the cosmological model is further extended to include significant tensor modes, as suggested by the recent BICEP2 results. Using the Bayesian evidence, we show that the cold dark matter model with a cosmological constant is strongly favored over its neutrino extensions by various combinations of data sets. Robust data combinations yield stringent limits of ∑m(ν) ≲ 0.3 eV and m(ν,sterile)(eff) ≲ 0.3 eV at 95% C.L. for the sum of active and sterile neutrinos, respectively.

  13. Monozygotic male twins concordant for Beckwith-Wiedemann syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Clemens, M.; McPherson, E.; Sherer, C. [West Penn Hospital, Pittsburgh, PA (United States)]|[Ludwig Institute for Cancer Reseach, LaJolla, CA (United States)] [and others

    1994-09-01

    The Beckwith-Wiedemann syndrome (BWS) is a multiple congenital anomaly syndrome characterized by macrosomia, macro glossia, visceromegaly, characteristic facies, and in some cases omphalocele, hypoglycemia, hemihypertrophy, and risk of embryonal tumors. Most cases occur sporadically in chromosomally normal individuals, but a few BWS patients have anomalies of 11p and others have evidence of microduplications or paternal isodisomy in this region. In some families with autosomal dominant transmission, BWS maps to 11p15.5, but the mechanism of transmission is not fully understood. BWS has been reported in 11 sets of MZ twins, including 10 female pairs (9 discordant and 1 partially concordant) and one male pair concordant for both BWS & dup 15q11.2-q13. We report a pair of premature male MZ twins with macroglossia, postnatal overgrowth, characteristic BWS facies, and mild developmental delay. One twin had hypoglycemia, but neither had omphalocele or hemihypertrophy and serial abdominal ultrasounds have been normal. DNA fingerprinting confirmed monozygosity. Chromosome studies showed a marker 11p14.2 in one twin only, and molecular genetic studies of the 11p15.5 region showed no evidence of duplication or isodisomy in either twin.

  14. Spousal cardiometabolic risk factors and incidence of type 2 diabetes: a prospective analysis from the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Nielsen, Jannie; Hulman, Adam; Witte, Daniel R

    2018-03-08

    In the UK, more than one million people have undiagnosed diabetes and an additional five million are at high risk of developing the disease. Given that early identification of these people is key for both primary and secondary prevention, new screening approaches are needed. Since spouses resemble each other in cardiometabolic risk factors related to type 2 diabetes, we aimed to investigate whether diabetes and cardiometabolic risk factors in one spouse can be used as an indicator of incident type 2 diabetes in the other spouse. We analysed data from 3649 men and 3478 women from the English Longitudinal Study of Ageing with information on their own and their spouse's diabetes status and cardiometabolic risk factors. We modelled incidence rates and incidence rate ratios with Poisson regression, using spousal diabetes status or cardiometabolic risk factors (i.e. BMI, waist circumference, systolic and diastolic BP, HDL- and LDL-cholesterol and triacylglycerols) as exposures and type 2 diabetes incidence in the index individual as the outcome. Models were adjusted for two nested sets of covariates. Spousal BMI and waist circumference were associated with incident type 2 diabetes, but with different patterns for men and women. A man's risk of type 2 diabetes increased more steeply with his wife's obesity level, and the association remained statistically significant even after adjustment for the man's own obesity level. Having a wife with a 5 kg/m 2 higher BMI (30 kg/m 2 vs 25 kg/m 2 ) was associated with a 21% (95% CI 11%, 33%) increased risk of type 2 diabetes. In contrast, the association between incident type 2 diabetes in a woman and her husband's BMI was attenuated after adjusting for the woman's own obesity level. Findings for waist circumference were similar to those for BMI. Regarding other risk factors, we found a statistically significant association only between the risk of type 2 diabetes in women and their husbands' triacylglycerol levels. The main

  15. The Relationship between Spousal Age Difference and Violence against Wife in Nigeria: A Generalized Linear Modelling Approach

    Directory of Open Access Journals (Sweden)

    Anthony C. Akpanta

    2017-11-01

    Full Text Available The act of violence against wife is condemnable and attracts various legal penalties, globally. This article attempts to find a link between spousal age difference and violence (Emotional, Physical and Sexual against wives in Nigeria. The result show that wives who are older than their partners are more likely to experience sexual and emotional violence; also, wives who are same age as their husbands are more likely to experience sexual violence; whereas wives who are 1-4 years younger than their husbands are more likely to experience physical violence; while wives 5 years or more younger than their husbands are generally less likely to experience any form of violence.

  16. Managing End-of-Life Uncertainty: Applying Problematic Integration Theory to Spousal Communication About Death and Dying.

    Science.gov (United States)

    Rafferty, Katherine A; Cramer, Emily M; Priddis, DeAnne

    2016-02-01

    A significant number of Americans die in ways that do not reflect their preferences for end-of-life (EOL) care. For married individuals, the spouse often has the legal authority to make decisions at EOL. Many factors, most notably open preemptive communication about care preferences and dying wishes, determine whether such communication is viable and a partner's wishes are respected. We used a mixed method approach, involving a content analysis of spouses' reasons for seeking and avoiding conversations regarding their partners' EOL care preferences, and examined whether certain demographic factors (eg, income, gender, age) more likely contributed to the initiation of EOL conversations. We situate our findings within the broader cultural discourse about death and dying and highlight the influence of uncertainty in spousal EOL communication. © The Author(s) 2014.

  17. MHC-Dependent Mate Selection within 872 Spousal Pairs of European Ancestry from the Health and Retirement Study.

    Science.gov (United States)

    Qiao, Zhen; Powell, Joseph E; Evans, David M

    2018-01-22

    Disassortative mating refers to the phenomenon in which individuals with dissimilar genotypes and/or phenotypes mate with one another more frequently than would be expected by chance. Although the existence of disassortative mating is well established in plant and animal species, the only documented example of negative assortment in humans involves dissimilarity at the major histocompatibility complex (MHC) locus. Previous studies investigating mating patterns at the MHC have been hampered by limited sample size and contradictory findings. Inspired by the sparse and conflicting evidence, we investigated the role that the MHC region played in human mate selection using genome-wide association data from 872 European American spouses from the Health and Retirement Study (HRS). First, we treated the MHC region as a whole, and investigated genomic similarity between spouses using three levels of genomic variation: single-nucleotide polymorphisms (SNPs), classical human leukocyte antigen (HLA) alleles (both four-digit and two-digit classifications), and amino acid polymorphisms. The extent of MHC dissimilarity between spouses was assessed using a permutation approach. Second, we investigated fine scale mating patterns by testing for deviations from random mating at individual SNPs, HLA genes, and amino acids in HLA molecules. Third, we assessed how extreme the spousal relatedness at the MHC region was compared to the rest of the genome, to distinguish the MHC-specific effects from genome-wide effects. We show that neither the MHC region, nor any single SNPs, classic HLA alleles, or amino acid polymorphisms within the MHC region, were significantly dissimilar between spouses relative to non-spouse pairs. However, dissimilarity in the MHC region was extreme relative to the rest of genome for both spousal and non-spouse pairs. Despite the long-standing controversy, our analyses did not support a significant role of MHC dissimilarity in human mate choice.

  18. Socioeconomic and Demographic Factors for Spousal Resemblance in Obesity Status and Habitual Physical Activity in the United States

    Directory of Open Access Journals (Sweden)

    Hsin-Jen Chen

    2014-01-01

    Full Text Available Studies suggested that the married population has an increased risk of obesity and assimilation between spouses’ body weight. We examined what factors may affect married spouses’ resemblance in weight status and habitual physical activity (HPA and the association of obesity/HPA with spouses’ sociodemoeconomic characteristics and lifestyles. Medical Expenditure Panel Survey data of 11,403 adult married couples in the US during years 2006–2008 were used. Absolute-scale difference and relative-scale resemblance indices (correlation and kappa coefficients in body mass index (BMI and HPA were estimated by couples’ socioeconomic and demographic characteristics. We found that spousal difference in BMI was smaller for couples with a lower household income, for who were both unemployed, and for older spouses. Correlation coefficient between spouses’ BMI was 0.24, differing by race/ethnicity and family size. Kappa coefficient for weight status (obesity: BMI ≥ 30, overweight: 30 > BMI ≥ 25 was 0.11 and 0.35 for HPA. Never-working women’s husbands had lower odds of obesity than employed women’s husbands (OR = 0.69 (95% CI = 0.53–0.89. Men’s unemployment status was associated with wives’ greater odds of obesity (OR = 1.31 (95% CI = 1.01–1.71. HPA was associated with men’s employment status and income level, but not with women’s. The population representative survey showed that spousal resemblance in weight status and HPA varied with socioeconomic and demographic factors.

  19. Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep.

    Science.gov (United States)

    von Känel, Roland; Mausbach, Brent T; Ancoli-Israel, Sonia; Dimsdale, Joel E; Mills, Paul J; Patterson, Thomas L; Ziegler, Michael G; Roepke, Susan K; Chattillion, Elizabeth A; Allison, Matthew; Grant, Igor

    2012-02-01

    Findings on sleep disturbances in family dementia caregivers are conflicting. We studied the longitudinal effects of dementia caregiving and major transitions in the caregiving situation on caregivers' sleep and the effect of moderating variables. Community-based longitudinal study with assessments about once a year for up to three years. A sample of 109 elderly spousal Alzheimer caregivers and 48 non-caregiving age- and gender-matched controls. Random regression models with fixed and time-variant effects for covariates known to affect sleep were used to evaluate changes in the Pittsburgh Sleep Quality Index (PSQI) and in four actigraphy measures over time in relation to caregiving status and transitions (i.e., nursing home placement or death of the Alzheimer disease spouse). Multivariate-adjusted sleep characteristics did not significantly differ between caregivers and non-caregivers over time. Spousal death increased caregivers' nighttime wake after sleep onset (WASO) by 23 min (P = 0.002) and daytime total sleep time (TST) by 29 min (P = 0.003), while nighttime sleep percent decreased by 3.2% (P = 0.009) and nighttime TST did not change. Placement of the spouse had no significant effect on caregivers' sleep. Older age, male gender, role overload, depressive symptoms, and proinflammatory cytokines variously emerged as significant moderators of the relationships between caregiving and transitions with poor subjective and objective sleep. Alzheimer caregivers and non-caregiving controls had similar trajectories of sleep. However, there may be subgroups of caregivers who are vulnerable to develop sleep disturbances, including those whose spouses have died.

  20. MHC-Dependent Mate Selection within 872 Spousal Pairs of European Ancestry from the Health and Retirement Study

    Directory of Open Access Journals (Sweden)

    Zhen Qiao

    2018-01-01

    Full Text Available Disassortative mating refers to the phenomenon in which individuals with dissimilar genotypes and/or phenotypes mate with one another more frequently than would be expected by chance. Although the existence of disassortative mating is well established in plant and animal species, the only documented example of negative assortment in humans involves dissimilarity at the major histocompatibility complex (MHC locus. Previous studies investigating mating patterns at the MHC have been hampered by limited sample size and contradictory findings. Inspired by the sparse and conflicting evidence, we investigated the role that the MHC region played in human mate selection using genome-wide association data from 872 European American spouses from the Health and Retirement Study (HRS. First, we treated the MHC region as a whole, and investigated genomic similarity between spouses using three levels of genomic variation: single-nucleotide polymorphisms (SNPs, classical human leukocyte antigen (HLA alleles (both four-digit and two-digit classifications, and amino acid polymorphisms. The extent of MHC dissimilarity between spouses was assessed using a permutation approach. Second, we investigated fine scale mating patterns by testing for deviations from random mating at individual SNPs, HLA genes, and amino acids in HLA molecules. Third, we assessed how extreme the spousal relatedness at the MHC region was compared to the rest of the genome, to distinguish the MHC-specific effects from genome-wide effects. We show that neither the MHC region, nor any single SNPs, classic HLA alleles, or amino acid polymorphisms within the MHC region, were significantly dissimilar between spouses relative to non-spouse pairs. However, dissimilarity in the MHC region was extreme relative to the rest of genome for both spousal and non-spouse pairs. Despite the long-standing controversy, our analyses did not support a significant role of MHC dissimilarity in human mate choice.

  1. Clinical, mammographic, and pathologic concordance in breast cancer

    International Nuclear Information System (INIS)

    Rodriguez Cascaret, Argenis; Martin Rodriguez, Andres; Hernandez Castellanos, Kirenia

    2011-01-01

    An observational descriptive and cross-sectional study was carried out in 100 patients with breast cancer, who attended the Breast Care Department at 'Conrado Benitez' Teaching Oncology Hospital in Santiago de Cuba from August 2009 to July 2010, to characterize them according to imaging, pathological, clinical, and general variables. Percentage as summary measure to statically validate the results and Kappa index to determine diagnostic concordance were used. Women between 40-49 years with history of fibrocystic breast disease and palpable lesions, as well as lump in the right breast, upper outer quadrant and periphery of the breast, tumor greater than one centimeter in diameter and infiltrating ductal carcinoma in the stages III-b and IV prevailed in the case material.(author)

  2. Numerical modelling of the Concorde wake during ZEBRE

    Energy Technology Data Exchange (ETDEWEB)

    Gierens, K. [Deutsche Forschungsanstalt fuer Luft- und Raumfahrt e.V. (DLR), Oberpfaffenhofen (Germany). Inst. fuer Physik der Atmosphaere

    1997-12-31

    Numerical simulations of the Concorde contrail during the ZEBRE experiment have been performed. The main goal of the simulations is to reproduce the fast vanishing of the contrail which disappeared 20-30 s after exhaust. It is difficult to evaporate ice crystals during the jet and vortex phase of the aircraft wake, when the exhaust products are trapped in the vortex cores. The trapping also excludes spatial dispersion of the ice crystals as an explanation of the short contrail lifetime. The disappearance of the contrail within 20-30 s requires that a substantial part of the exhaust gases escapes from the region that is later on trapped in the vortex cores. (author) 10 refs.

  3. Molecular Concordance Between Primary Breast Cancer and Matched Metastases

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Thomassen, Mads

    2016-01-01

    , transcriptomics, and genome aberrations in primary tumors and metastases. In conclusion, biopsy of metastatic lesions at recurrence of breast cancer is encouraged to provide optimal treatment of the disease. Furthermore, molecular profiling of metastatic tissue provides invaluable mechanistic insight......Clinical management of breast cancer is increasingly personalized and based on molecular profiling. Often, primary tumors are used as proxies for systemic disease at the time of recurrence. However, recent studies have revealed substantial discordances between primary tumors and metastases, both....... The purpose of this review is to illuminate the extent of cancer genome evolution through disease progression and the degree of molecular concordance between primary breast cancers and matched metastases. We present an overview of the most prominent studies investigating the expression of endocrine receptors...

  4. The brain atlas concordance problem: quantitative comparison of anatomical parcellations.

    Directory of Open Access Journals (Sweden)

    Jason W Bohland

    2009-09-01

    Full Text Available Many neuroscientific reports reference discrete macro-anatomical regions of the brain which were delineated according to a brain atlas or parcellation protocol. Currently, however, no widely accepted standards exist for partitioning the cortex and subcortical structures, or for assigning labels to the resulting regions, and many procedures are being actively used. Previous attempts to reconcile neuroanatomical nomenclatures have been largely qualitative, focusing on the development of thesauri or simple semantic mappings between terms. Here we take a fundamentally different approach, discounting the names of regions and instead comparing their definitions as spatial entities in an effort to provide more precise quantitative mappings between anatomical entities as defined by different atlases. We develop an analytical framework for studying this brain atlas concordance problem, and apply these methods in a comparison of eight diverse labeling methods used by the neuroimaging community. These analyses result in conditional probabilities that enable mapping between regions across atlases, which also form the input to graph-based methods for extracting higher-order relationships between sets of regions and to procedures for assessing the global similarity between different parcellations of the same brain. At a global scale, the overall results demonstrate a considerable lack of concordance between available parcellation schemes, falling within chance levels for some atlas pairs. At a finer level, this study reveals spatial relationships between sets of defined regions that are not obviously apparent; these are of high potential interest to researchers faced with the challenge of comparing results that were based on these different anatomical models, particularly when coordinate-based data are not available. The complexity of the spatial overlap patterns revealed points to problems for attempts to reconcile anatomical parcellations and nomenclatures

  5. Perceptions and receptivity of non-spousal family support: A mixed methods study of psychological distress among older, church-going African American men.

    Science.gov (United States)

    Watkins, Daphne C; Wharton, Tracy; Mitchell, Jamie A; Matusko, Niki; Kales, Helen

    2017-10-01

    The purpose of this study was to explore the role of non-spousal family support on mental health among older, church-going African American men. The mixed methods objective was to employ a design that used existing qualitative and quantitative data to explore the interpretive context within which social and cultural experiences occur. Qualitative data (n=21) were used to build a conceptual model that was tested using quantitative data (n= 401). Confirmatory factor analysis indicated an inverse association between non-spousal family support and distress. The comparative fit index, Tucker-Lewis fit index, and root mean square error of approximation indicated good model fit. This study offers unique methodological approaches to using existing, complementary data sources to understand the health of African American men.

  6. Women’s opinion on the justification of physical spousal violence: A quantitative approach to model the most vulnerable households in Bangladesh

    Science.gov (United States)

    2017-01-01

    Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV) and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014) were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31.9% and 28.7% women in the surveys found justification for physical violence in household in 2007, 2011 and 2014 respectively. The binary logistic model showed wealth index, education of both women and their partner, religion, geographical division, decision making freedom and marital age as significant household contributors for women’s perspective in all the three years. Women in rich households and the highly educated were found to be 40% and 50% less likely to accept domestic physical violence compared to the poorest and illiterate women. Similarly, women who got married before 18 years were 20% more likely accept physical violence in the family as a norm. Apart from these particular groups (richest, highly educated and married after 18 years), other groups had around 30% acceptance rate of household violence. For any successful attempt to reduce spousal physical violence in the traditional patriarchal society of Bangladesh, interventions must target the most vulnerable households and the geographical areas where women experience spousal violence. Although this paper focuses on women’s attitudes, it is important that any intervention scheme should be devised to target both men and women. PMID:29161277

  7. Spousal overprotection is indirectly associated with poorer dietary adherence for patients with type 2 diabetes via diabetes distress when active engagement is low.

    Science.gov (United States)

    Johnson, Matthew D; Anderson, Jared R; Walker, Ann; Wilcox, Allison; Lewis, Virginia L; Robbins, David C

    2015-05-01

    The current study sought to explore the indirect association of spousal overprotection on patient dietary adherence through the mechanism of diabetes distress and whether the link between overprotection and diabetes distress was moderated by spouse active engagement. Participants were 117 married couples in which one member had been diagnosed with type 2 diabetes and were recruited from a patient registry at a Midwestern (USA) medical centre. Data were gathered from spouses and patients through a self-report survey instrument. The research questions were answered with structural equation modelling using the latent moderated structural equations (LMS) approach and dyadic data analytic procedures. Overprotection was associated with reduced dietary adherence indirectly via increased diabetes distress only at low levels of active engagement. The proposed model also proved superior when compared to two plausible alternatives. These findings highlight the importance of understanding the nuanced associations among the different ways spouses cope with illness to achieve better diabetes outcomes and the mechanisms responsible for linking coping and dietary adherence. Statement of contribution What is already known on this subject? Spousal coping behaviour can influence dietary adherence among patients diagnosed with type 2 diabetes, positively and negatively. Spouses simultaneously engage in different ways of coping with partner illness, but little is known about the interactive nature of coping styles or possible mechanisms that might link coping with illness outcomes. What does this study add? Spousal overprotection is only associated with reduced patient dietary adherence when spouses are also engaging in low levels of active engagement. Diabetes distress is an important mechanism linking spousal coping with patient dietary adherence. © 2014 The British Psychological Society.

  8. La responsabilidad social en las empresas de comunicación peruanas: La mirada de los stakeholders. Casos: ATV Televisión, Radio Capital y diario Perú 21

    OpenAIRE

    Ramírez-Lozano, Julianna Paola; Universidad de Lima (Perú); Villacorta-Calderón, Mario Edwin; Universidad de Lima (Perú)

    2012-01-01

    En el presente documento se hace una revisión conceptual del tema de la responsabilidad social, desde una mirada a diversos autores. Asimismo, se presenta un análisis acerca de la importancia e implicancia del significado de la responsabilidad social en las empresas de comunicación desde el conocimiento, la percepción y la opinión de sus stakeholders o grupos de interés. Para esto se ha tomado como referencia el caso de tres empresas peruanas de comunicación: ATV Televisión, Radio Capital y d...

  9. La responsabilidad social en las empresas de comunicación peruanas: La mirada de los stakeholders. Casos: ATV Televisión, Radio Capital y diario Perú 21

    Directory of Open Access Journals (Sweden)

    Julianna Paola Ramírez-Lozano

    2012-03-01

    Full Text Available En el presente documento se hace una revisión conceptual del tema de la responsabilidad social, desde una mirada a diversos autores. Asimismo, se presenta un análisis acerca de la importancia e implicancia del significado de la responsabilidad social en las empresas de comunicación desde el conocimiento, la percepción y la opinión de sus stakeholders o grupos de interés. Para esto se ha tomado como referencia el caso de tres empresas peruanas de comunicación: ATV Televisión, Radio Capital y diario Perú 21.

  10. Phenotypic concordance in familial inflammatory bowel disease (IBD). Results of a nationwide IBD Spanish database.

    Science.gov (United States)

    Cabré, Eduard; Mañosa, Míriam; García-Sánchez, Valle; Gutiérrez, Ana; Ricart, Elena; Esteve, Maria; Guardiola, Jordi; Aguas, Mariam; Merino, Olga; Ponferrada, Angel; Gisbert, Javier P; Garcia-Planella, Esther; Ceña, Gloria; Cabriada, José L; Montoro, Miguel; Domènech, Eugeni

    2014-07-01

    Disease outcome has been found to be poorer in familial inflammatory bowel disease (IBD) than in sporadic forms, but assessment of phenotypic concordance in familial IBD provided controversial results. We assessed the concordance for disease type and phenotypic features in IBD families. Patients with familial IBD were identified from the IBD Spanish database ENEIDA. Families in whom at least two members were in the database were selected for concordance analysis (κ index). Concordance for type of IBD [Crohn's disease (CD) vs. ulcerative colitis (UC)], as well as for disease extent, localization and behaviour, perianal disease, extraintestinal manifestations, and indicators of severe disease (i.e., need for immunosuppressors, biological agents, and surgery) for those pairs concordant for IBD type, were analyzed. 798 out of 11,905 IBD patients (7%) in ENEIDA had familial history of IBD. Complete data of 107 families (231 patients and 144 consanguineous pairs) were available for concordance analyses. The youngest members of the pairs were diagnosed with IBD at a significantly younger age (p<0.001) than the oldest ones. Seventy-six percent of pairs matched up for the IBD type (κ=0.58; 95%CI: 0.42-0.73, moderate concordance). There was no relevant concordance for any of the phenotypic items assessed in both diseases. Familial IBD is associated with diagnostic anticipation in younger individuals. Familial history does not allow predicting any phenotypic feature other than IBD type. Copyright © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  11. Is There Concordance in Attitudes and Beliefs between Parents and Scientists about Autism Spectrum Disorder?

    Science.gov (United States)

    Fischbach, Ruth L.; Harris, Mark J.; Ballan, Michelle S.; Fischbach, Gerald D.; Link, Bruce G.

    2016-01-01

    There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma,…

  12. The chameleonic nature of French ni : negative coordination in a negative concord language

    NARCIS (Netherlands)

    Doetjes, Jenny

    2005-01-01

    The main goal of this paper is to defend the claim that ni, the French counterpart of neither and nor is always a negative conjunction which takes part in the negative concord system of French. The interpretation one seems to get for this negative concord ni varies depending on the environment where

  13. Depressed Spousal Caregivers Have Psychological Stress Unrelated to the Progression of Alzheimer Disease: A 3-Year Follow-Up Report, Kuopio ALSOVA Study.

    Science.gov (United States)

    Välimäki, Tarja H; Martikainen, Janne A; Hallikainen, Ilona T; Väätäinen, Saku T; Koivisto, Anne M

    2015-12-01

    To explore family caregiver (FC) long-term psychological distress after Alzheimer disease (AD) diagnosis in a family member. FC (n = 236) and patients with AD were prospectively followed up to 36 months after AD diagnosis. FC psychological distress was evaluated using the General Health Questionnaire (GHQ). Furthermore, caregiver depressive symptoms and sense of coherence, along with AD patient measurements, were measured at baseline and annually. Generalized estimating equation models were applied to study associations of these baseline factors to caregiver GHQ. After 36 months of follow-up, spousal caregivers (SCs) GHQ was significantly higher (P caregivers (NSCs). The difference in GHQ scores was associated by depressive symptoms (P caregiving, spousal and depressed caregivers of patients with AD report higher and increasing psychological stress than nonspousal and nondepressed caregivers. Spousal relationship, caregivers' depressive symptoms, and the severity of patients' neuropsychological symptoms at the time of AD diagnosis predict the trajectory of psychological distress. The current study highlights the need for evaluating AD caregiver mental health and level of coping. © The Author(s) 2015.

  14. The script concordance test as a tool to evaluate clinical reasoning in neonatology.

    Science.gov (United States)

    Ben Hamida, Emira; Ayadi, Imen; Marrakchi, Zahra; Quinton, André

    2017-05-01

    Script concordance test aims to evaluate knowledge organization, which represents an essential component of the clinical competence. To build a script concordance test and demonstrate its relevance in the evaluation of Neonatology skills. A script concordance test including 20 vignettes and 20 items, was provided to 52 fourth year medical students and 11 family medicine interns. Script concordance test scores obtained by experts were higher then those obtained by students and family medicine interns. The scores (out of 100) were 82.52 ± 7.35 CI95% [77.26-87.78] for the experts, 58.52 ± 9.72 CI95% [55.82-61.23] for the students, and 63.17±11.36 IC95%  [55.53-70.81] (p<0.0001) for the interns. Our data suggest that script concordance tests could be used to assess the acquisition of clinical reasoning among fourth year medical students in neonatolgy.

  15. Estimating Twin Pair Concordance for Age of Onset

    DEFF Research Database (Denmark)

    Scheike, Thomas H.; Hjelmborg, Jacob B.; Holst, Klaus K.

    2015-01-01

    given that the co-twin has the disease. Most diseases have a varying age-of-onset that will lead to age-specific prevalence. Typically, this aspect is not considered, and this may lead to severe bias as well as make it very unclear exactly what population quantities that we are estimating. In addition...... that they will develop the disease. The aim of this contribution is to show that the standard casewise concordance and standard prevalence estimators do not work in general for age-of-onset data. We show how one can in fact do something easy and simple even with censored data. The key is to take age into account when......, one will typically need to deal with censoring in the data, that is the fact that we for some subjects only know that they are alive at a specific age without having the disease. These subjects needs to be considered age specifically, and clearly if they are young there is still a risk...

  16. Concordance in the radiological diagnosis of thoracolumbar spine fractures.

    Science.gov (United States)

    Hirschfeld, M; Rodriguez, M; Cerván, A M; Ortega, J A; Rivas-Ruiz, F; Guerado, E

    2015-01-01

    Thoracolumbar spine fractures are frequent and severe. Early diagnosis and appropriate treatment to obtain good clinical results is essential, with many classifications being proposed for this purpose. To determine the external validity of radiographic and computed tomography (CT) measurements for the most used classifications, and decide on the type of treatment required. The working hypothesis is the existence of external validity of radiographic measurements. A sample of patients with thoracolumbar fracture was selected. Three spine specialists and a resident performed measurements on anteroposterior and lateral radiographic images as well as coronal, sagittal and axial CT slices. Fractures were classified as stable or unstable, evaluating the degree of intra-and interobserver agreement based on a standard observer. Sagittal index of Farcy, lateral wedging, Beck Index, traumatic regional angulation and channel occupancy were studied. All indicators studied, except the lateral wedging, showed a high degree of concordance. Instability determinants studied with radiographs and CT, which had obtained statistical significance, are reliable and accurate for the classification of thoracolumbar fractures and, therefore, to indicate an appropriate treatment. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  17. Racing the Moon’s shadow with Concorde 001

    CERN Document Server

    Léna, Pierre

    2015-01-01

    This is the unique story of  observing a total solar exlipse for no less than 74 consecutive minutes. On the summer morning of June 30, 1973, the Sun rises on the Canary Islands. But it is strangely indented by the Moon. The eclipse of the century has just begun. From the west, the lunar shadow rushes to the African coast at a velocity of over 2000 kilometers per hour. Astronomers on the ground will enjoy seven short minutes of total eclipse to study the solar corona - too short for Pierre Lena and seven scientists who board the Concorde 001 prototype, an extraordinary plane to become the first commercial supersonic aircraft. With André Turcat as chief pilot and a crew of five, at 17000 m altitude, the aircraft remains in the lunar shadow for 74 minutes, a record time of scientific observations not yet beaten and allowing for exceptional measurements. Science, technology, aviation and history combine in the story of a unique human adventure aboard a legendary aircraft, illustrated with a rich and original ...

  18. Behavioral and neural concordance in parent-child dyadic sleep patterns

    Directory of Open Access Journals (Sweden)

    Tae-Ho Lee

    2017-08-01

    Full Text Available Sleep habits developed in adolescence shape long-term trajectories of psychological, educational, and physiological well-being. Adolescents’ sleep behaviors are shaped by their parents’ sleep at both the behavioral and biological levels. In the current study, we sought to examine how neural concordance in resting-state functional connectivity between parent-child dyads is associated with dyadic concordance in sleep duration and adolescents’ sleep quality. To this end, we scanned both parents and their child (N = 28 parent-child dyads; parent Mage = 42.8 years; adolescent Mage = 14.9 years; 14.3% father; 46.4% female adolescent as they each underwent a resting-state scan. Using daily diaries, we also assessed dyadic concordance in sleep duration across two weeks. Our results show that greater daily concordance in sleep behavior is associated with greater neural concordance in default-mode network connectivity between parents and children. Moreover, greater neural and behavioral concordances in sleep is associated with more optimal sleep quality in adolescents. The current findings expand our understanding of dyadic concordance by providing a neurobiological mechanism by which parents and children share daily sleep behaviors.

  19. Behavioral and neural concordance in parent-child dyadic sleep patterns.

    Science.gov (United States)

    Lee, Tae-Ho; Miernicki, Michelle E; Telzer, Eva H

    2017-08-01

    Sleep habits developed in adolescence shape long-term trajectories of psychological, educational, and physiological well-being. Adolescents' sleep behaviors are shaped by their parents' sleep at both the behavioral and biological levels. In the current study, we sought to examine how neural concordance in resting-state functional connectivity between parent-child dyads is associated with dyadic concordance in sleep duration and adolescents' sleep quality. To this end, we scanned both parents and their child (N=28 parent-child dyads; parent M age =42.8years; adolescent M age =14.9years; 14.3% father; 46.4% female adolescent) as they each underwent a resting-state scan. Using daily diaries, we also assessed dyadic concordance in sleep duration across two weeks. Our results show that greater daily concordance in sleep behavior is associated with greater neural concordance in default-mode network connectivity between parents and children. Moreover, greater neural and behavioral concordances in sleep is associated with more optimal sleep quality in adolescents. The current findings expand our understanding of dyadic concordance by providing a neurobiological mechanism by which parents and children share daily sleep behaviors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Work happiness among teachers: a day reconstruction study on the role of self-concordance.

    Science.gov (United States)

    Tadić, Maja; Bakker, Arnold B; Oerlemans, Wido G M

    2013-12-01

    Self-concordant work motivation arises from one's authentic choices, personal values, and interests. In the present study, we investigated whether self-concordant motivation may fluctuate from one work-related task to the next. On the basis of self-determination theory, we hypothesized that momentary self-concordance buffers the negative impact of momentary work demands on momentary happiness. We developed a modified version of the day reconstruction method to investigate self-concordance, work demands, and happiness during specific work-related tasks on a within-person and within-day level. In total, 132 teachers completed a daily diary on three consecutive work days as well as a background questionnaire. The daily diary resulted in 792 reported work activities and activity-related work demands, self-concordance, and happiness scores. Multilevel analysis showed that-for most work activities-state self-concordant motivation buffered the negative association of work demands with happiness. These findings add to the literature on motivation and well-being by showing that the levels of self-concordance and happiness experienced by employees vary significantly on a within-day level and show a predictable pattern. We discuss theoretical and practical implications of the findings to increase employees' well-being. © 2013.

  1. Smoking concordance during pregnancy: Are there relationship benefits?

    Science.gov (United States)

    Cornelius, Talea; Desrosiers, Alethea; Kershaw, Trace

    2017-11-01

    Couples often engage in similar patterns of behavior, including substance use, and similarity may benefit relationship quality. Such relationship benefits may be especially salient for adolescent and young couples, whose relationships are often unstable and prone to breakups. This study examined the effect of mutual smoking during pregnancy on relationship quality in pregnant adolescent and young adult couples. Couples (N = 228; M AgeFemale  = 18.69; M AgeMale  = 21.12) were recruited from obstetrics/gynecology clinics in Connecticut from July 2007 to February 2011. Couples completed measures of recent smoking and relationship quality (i.e. satisfaction, affectional expression, cohesion, and consensus) during pregnancy and at six months postpartum. Data were analyzed using multilevel models to account for interdependence within dyads. Discrepant smoking patterns were associated with a reduction in satisfaction and cohesion over time (B = -1.14, p = 0.03, and, B = -2.74, p = 0.03, respectively), and a reduction in consensus over time for female participants, B = -1.98, p = 0.07, but not for male participants, p = 0.51. Discrepant smoking was not related to affectional expression, p = 0.11. Results suggest relationship benefits concordant smoking patterns during pregnancy. Interventions should consider potential unintended relationship consequences of changing individual health behavior and instead work to develop couple-level health interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Patient–Physician Gender Concordance and Weight-Related Counseling of Obese Patients

    Science.gov (United States)

    Pickett-Blakely, Octavia; Bleich, Sara N.; Cooper, Lisa A

    2013-01-01

    Background Obesity affects approximately one third of Americans. Patient and provider characteristics such as gender may influence obesity care. Gender concordance has been associated with clinical practice patterns in chronic conditions such as hypertension and diabetes, but its role in obesity care is unknown. Purpose The purpose of this study was to investigate the association of patient–physician gender concordance with weight-related counseling among obese adults. Methods A cross-sectional study using the 2005–2007 National Ambulatory Medical Care Survey was conducted in 2010. Postvisit data from the clinical encounters of 5667 obese individuals and their physicians were analyzed to determine the association between patient– physician gender concordance (categorized using patient gender as the reference point as female gender-concordant, male gender-concordant, male gender-discordant and female gender-discordant) and three types of weight-related counseling (diet/nutrition, exercise, and weight reduction). Results Diet/nutrition, exercise, and weight reduction counseling was provided to 30%, 23%, and 20% of obese patients, respectively. Patients in male gender-concordant patient–physician pairs had significantly higher adjusted odds of receiving diet/nutrition (OR 1.58; 95% CI: 1.05, 2.40) and exercise counseling (1.76; 95% CI: 1.13, 2.74) than female gender-concordant pairs. There were no significant differences in any form of weight-related counseling between female gender-concordant and gender-discordant pairs. Conclusions The findings of this study suggest that male patient–physician gender concordance is positively associated with diet/nutrition and exercise counseling. PMID:21565652

  3. Concordance of BI-RADS Assessments and Management Recommendations for Breast MRI in Community Practice.

    Science.gov (United States)

    Lee, Amie Y; Ichikawa, Laura; Lee, Janie M; Lee, Christoph I; DeMartini, Wendy B; Joe, Bonnie N; Wernli, Karen J; Sprague, Brian L; Herschorn, Sally D; Lehman, Constance D

    2016-01-01

    The purpose of this study was to evaluate concordance between BI-RADS assessments and management recommendations for breast MRI in community practice. Breast MRI data were collected from four regional Breast Cancer Surveillance Consortium registries from 2005 to 2011 for women who were 18-79 years old. Assessments and recommendations were compared to determine concordance according to BI-RADS guidelines. Concordance was compared by assessment category as well as by year of examination and clinical indication. In all, 8283 MRI examinations were included in the analysis. Concordance was highest (93% [2475/2657]) in examinations with a BI-RADS category 2 (benign) assessment. Concordance was also high in examinations with category 1 (negative) (87% [1669/1909]), category 0 (incomplete) (83% [348/417]), category 5 (highly suggestive of malignancy) (83% [208/252]), and category 4 (suspicious) (74% [734/993]) assessments. Examinations with categories 3 (probably benign) and 6 (known biopsy-proven malignancy) assessments had the lowest concordance rates (36% [302/837] and 56% [676/1218], respectively). The most frequent discordant recommendation for a category 3 assessment was routine follow-up. The most frequent discordant recommendation for a category 6 assessment was biopsy. Concordance of assessments and management recommendations differed across clinical indications (p BI-RADS management recommendations were most concordant for assessments of negative, incomplete, suspicious, and highly suggestive of malignancy. Lower concordance for assessments of probably benign and known biopsy-proven malignancy and for examinations performed to assess disease extent highlight areas for interventions to improve breast MRI reporting.

  4. Concordance between preoperative and postoperative assessments of primary caries lesion depth: results from the Dental PBRN

    DEFF Research Database (Denmark)

    Nascimento, Marcelle M; Bader, James D; Qvist, Vibeke

    2010-01-01

    This study investigated the concordance between pre- and postoperative assessments of primary caries lesion depths by dentists from The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org). A total of 229 DPBRN dentists collected data on 8,351 consecutive restorations inserted due...... was at an advanced stage: 88% concordance at the D3 depth, compared to 54% concordance at the E1 depth. DPBRN dentists can discriminate caries lesions at different depths, but the accuracy of their depth assessments was higher for dentin than for enamel lesions. In general, DPBRN dentists were more likely...

  5. Concordance of attachment representations in preschool siblings assessed by the attachment story completion task

    OpenAIRE

    Werner, Helene; Zahn, Salome; Titze, Karl; Walitza, Susanne; Zulauf Logoz, Marina

    2015-01-01

    Several studies have indicated only a modest concordance of attachment security in siblings in infancy. Until now, very little was known about the concordance of siblings’ attachment security beyond infancy, as assessed by the attachment story completion task. This cross-sectional study aims to examine the concordance of attachment representations of 38 first-born (4–7 years) and 38 second-born (3–5 years) siblings living in middle-class two-parent families. Personality factors and the level ...

  6. Let's talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners

    NARCIS (Netherlands)

    Ose, D.; Mahler, C.; Vogel, I.; Ludt, S.; Szecsenyi, J.; Freund, T.

    2012-01-01

    BACKGROUND: Medication adherence can be essential for improving health outcomes. Patients with multiple chronic conditions, often receiving multiple medications, are at higher risk for medication nonadherence. Previous research has focused on concordance between patients and providers about which

  7. 2010 Federal Emergency Management Agency (FEMA) Topographic Lidar: Concord River Watershed, Massachusetts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Concord AOI consists of one area. Ground Control is collected throughout the AOI for use in the processing of LiDAR data to ensure data accurately represents the...

  8. Concordance measures and second order stochastic dominance-portfolio efficiency analysis

    Czech Academy of Sciences Publication Activity Database

    Kopa, Miloš; Tichý, T.

    2012-01-01

    Roč. 15, č. 4 (2012), s. 110-120 ISSN 1212-3609 R&D Projects: GA ČR(CZ) GBP402/12/G097 Institutional support: RVO:67985556 Keywords : dependency * concordance * portfolio selection * second order stochastic dominance Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.633, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kopa-concordance measures and second order stochastic dominance- portfolio efficiency analysis.pdf

  9. Concordance of visual and manipulative responses to novel and familiar stimuli: a reply to Rubenstein (1974).

    Science.gov (United States)

    Schaffer, H R

    1975-03-01

    Rubenstein's failure to find evidence for the previously suggested lack of concordance between visual and manipulative responses to novel and familiar stimuli in 6-month-old infants is discussed. It is shown that a lack of concordance is not specific to the use of 1 measure of manipulative behavior, and other possible explanations for the discrepancy in findings are examined. A 2-stage development of responsiveness to familiarity-novelty in infancy remains the most plausible account.

  10. The concordance of directly and indirectly measured built environment attributes and physical activity adoption

    Directory of Open Access Journals (Sweden)

    O'Connor Daniel P

    2011-07-01

    Full Text Available Background Physical activity (PA adoption is essential for obesity prevention and control, yet ethnic minority women report lower levels of PA and are at higher risk for obesity and its comorbidities compared to Caucasians. Epidemiological studies and ecologic models of health behavior suggest that built environmental factors are associated with health behaviors like PA, but few studies have examined the association between built environment attribute concordance and PA, and no known studies have examined attribute concordance and PA adoption. Purpose The purpose of this study was to associate the degree of concordance between directly and indirectly measured built environment attributes with changes in PA over time among African American and Hispanic Latina women participating in a PA intervention. Method Women (N = 410 completed measures of PA at Time 1 (T1 and Time 2 (T2; environmental data collected at T1 were used to compute concordance between directly and indirectly measured built environment attributes. The association between changes in PA and the degree of concordance between each directly and indirectly measured environmental attribute was assessed using repeated measures analyses. Results There were no significant associations between built environment attribute concordance values and change in self-reported or objectively measured PA. Self-reported PA significantly increased over time (F(1,184 = 7.82, p = .006, but this increase did not vary by ethnicity or any built environment attribute concordance variable. Conclusions Built environment attribute concordance may not be associated with PA changes over time among minority women. In an effort to promote PA, investigators should clarify specific built environment attributes that are important for PA adoption and whether accurate perceptions of these attributes are necessary, particularly among the vulnerable population of minority women.

  11. Transitions from hospital to community care: the role of patient-provider language concordance.

    Science.gov (United States)

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

    2014-01-01

    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  12. Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

    International Nuclear Information System (INIS)

    Chen, Ronald C.; Carpenter, William R.; Hendrix, Laura H.; Bainbridge, John; Wang, Andrew Z.; Nielsen, Matthew E.

    2014-01-01

    Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those aged 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ≤76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease

  13. A concordance-based study to assess doctors' and nurses' mental models in Internal Medicine.

    Directory of Open Access Journals (Sweden)

    Katherine S Blondon

    Full Text Available Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional's roles. Our objective was to identify factors influencing concordance on the expectations of doctors' and nurses' roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196, we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario. In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender. Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73, for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62, and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65. Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions.

  14. A valoração de traços de concordância dentro do DP Concord features valuing within DP

    Directory of Open Access Journals (Sweden)

    Telma M.V. Magalhães

    2004-06-01

    Full Text Available Este trabalho argumenta em favor da valoração dos traços de concordância dentro do DP em termos da operação Agree (Chomsky, 1999 sem a necessidade de estipular nenhum outro mecanismo para tanto. Mostro que Agree dá conta da valoração de traços tanto no nível da sentença quanto no nível do DP, contra a sugestão de Chomsky (1999 de que concordância no DP envolveria algum outro mecanismo de checagem.This paper argues in favor of a concord features valuing within the DP in terms of the Agree operation (Chomsky, 1999, with no recourse to any other mechanism. I show that Agree accounts for feature valuing both in the sentence level as well as in the DP, contrary to Chomsky's (1999 suggestion that concord in DP should involve some other checking mechanism.

  15. Long-term effects of the Family Bereavement Program on spousally bereaved parents: Grief, mental health problems, alcohol problems, and coping efficacy.

    Science.gov (United States)

    Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim

    2016-08-01

    This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping

  16. Sex Differences in Medication and Primary Healthcare Use before and after Spousal Bereavement at Older Ages in Denmark: Nationwide Register Study of over 6000 Bereavements

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Jacobsen, Rune; Glaser, Karen

    2011-01-01

    Background. The study aimed to examine sex differences in healthcare use before and after widowhood to investigate whether reduced healthcare use among widowers compared with widows may partially explain excess mortality and more adverse health outcomes among men than women after spousal loss...... use and the average annual number of visits to general physicians (GPs). Results. The average daily use of all-cause and major system-specific medications, as well as the number of GP visits increased over the period from 1 year before and up to 5 years after a spouse's death, but there were no sex...

  17. Brief Report: Relationships Among Spousal Communication, Self-Efficacy, and Motivation Among Expectant Latino Fathers Who Smoke

    Science.gov (United States)

    Khaddouma, Alexander; Gordon, Kristina Coop; Fish, Laura J.; Bilheimer, Alecia; Gonzalez, Alecia; Pollak, Kathryn I.

    2015-01-01

    Objective Cigarette smoking is a prevalent problem among Latinos, yet little is known about what factors motivate them to quit smoking or make them feel more confident that they can. Given cultural emphases on familial bonds among Latinos (e.g., familismo), it is possible that communication processes among Latino spouses play an important role. The present study tested a mechanistic model in which perceived spousal constructive communication patterns predicted changes in level of motivation for smoking cessation through changes in self-efficacy among Latino expectant fathers. Methods Latino males (n = 173) and their pregnant partners participated in a couple-based intervention targeting males’ smoking. Couples completed self-report measures of constructive communication, self-efficacy (male partners only), and motivation to quit (male partners only) at four time points throughout the intervention. Results Higher levels of perceived constructive communication among Latino male partners predicted subsequent increases in male’s partners’ self-efficacy and, to a lesser degree, motivation to quit smoking; however, self-efficacy did not mediate associations between constructive communication and motivation to quit smoking. Furthermore, positive relationships with communication were only significant at measurements taken after completion of the intervention. Female partners’ level of perceived constructive communication did not predict male partners’ outcomes. Conclusion These results provide preliminary evidence to support the utility of couple-based interventions for Latino men who smoke. Findings also suggest that perceptions of communication processes among Latino partners (particularly male partners) may be an important target for interventions aimed increasing desire and perceived ability to quit smoking among Latino men. PMID:25844907

  18. Power Estimation for Gene-Longevity Association Analysis Using Concordant Twins

    Directory of Open Access Journals (Sweden)

    Qihua Tan

    2014-01-01

    Full Text Available Statistical power is one of the major concerns in genetic association studies. Related individuals such as twins are valuable samples for genetic studies because of their genetic relatedness. Phenotype similarity in twin pairs provides evidence of genetic control over the phenotype variation in a population. The genetic association study on human longevity, a complex trait that is under control of both genetic and environmental factors, has been confronted by the small sample sizes of longevity subjects which limit statistical power. Twin pairs concordant for longevity have increased probability for carrying beneficial genes and thus are useful samples for gene-longevity association analysis. We conducted a computer simulation to estimate the power of association study using longevity concordant twin pairs. We observed remarkable power increases in using singletons from longevity concordant twin pairs as cases in comparison with cases of sporadic proband. A similar power would require doubled sample sizes for fraternal twins than for identical twins who are concordant for longevity suggesting that longevity concordant identical twins are more efficient samples than fraternal twins. We also observed an approximate of 2- to 3-fold increase in sample sizes needed for longevity cutoff at age 90 as compared with that at age 95. Overall, our results showed high value of twins in genetic association studies on human longevity.

  19. Is intraoperative parathyroid hormone monitoring necessary in symptomatic primary hyperparathyroidism with concordant imaging?

    Directory of Open Access Journals (Sweden)

    C Gopalakrishnan Nair

    2016-01-01

    Full Text Available Introduction: Symptomatic primary hyperparathyroidism (PHPT is still seen frequently in referral centers all over India. These patients require parathyroidectomy and this study aimed to assess the roll of intraoperative parathyroid hormone (PTH assay when concordant results of two localization studies were available. Study Design: We analyzed the case records of patients who underwent parathyroidectomy for PHPT from January 2005 to June 2015. Results: Of 143 patients included in the study, technetium 99m methoxyisobutylisonitrate dual phase scintigraphy showed true positive images in 93.7% and high definition ultrasonography in 84.6% of patients. Concordance in localization studies was observed in 121 (84.6% patients, successful parathyroidectomy was done in 117 (96.7% patients with concordant localization studies. Intraoperative PTH monitoring showed 97.84% sensitivity and 75% specificity and predicted failure in 2 patients with concordant imaging. However, re-exploration was not successful in these patients. Conclusion: When concordant result is available between parathyroid scintigraphy and anatomical imaging surgical cure rate is high in trained hands. Re-exploration is unlikely to be successful since these patients require higher imaging.

  20. Evaluation of genome-wide genotyping concordance between tumor tissues and peripheral blood.

    Science.gov (United States)

    Shao, Wei; Ge, Yuqiu; Ma, Gaoxiang; Du, Mulong; Chu, Haiyan; Qiang, Fulin; Zhang, Zhengdong; Wang, Meilin

    2017-03-01

    Tumor tissues were potential resources in cancer susceptibility studies. To assess the genotyping concordance between tumor tissues and peripheral blood, we conducted this study in a large sample size and genome-wide scale. Genome-wide genotypes of human colon adenocarcinoma (COAD) retrieved from The Cancer Genome Atlas (TCGA) was analyzed. A total of 387 pairs of matched fresh frozen tumor tissues and peripheral blood samples passed the quality control processes. High concordant rate (94.85% with no-calls and 97.89% without no-calls) was found between tumor tissues and peripheral blood. The discordant rate raised with the increase of heterozygote rate, and the tendency was statistically significant. The total missing rate was 3.10%. We also verified 14 susceptibility SNPs and the average genotyping concordant rate was 97.42%. These findings suggest that majority of SNPs could be accurately genotyped using DNA isolated from tumor tissues. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Evaluation of the concordance of sialometry and salivary glands scintigraphy in dry mouth patients.

    Science.gov (United States)

    Liquidato, Bianca Maria; Soler, Rita de Cássia; Bussoloti Filho, Ivo

    2006-01-01

    Many diagnostic tests are used to evaluate dry mouth patients, especially the ones with Sjögren's Syndrome, to whom these tests are part of classification criteria for scientific studies. Thus, the concordance between results of sialometry and salivary glands scintigraphy was evaluated; if positive, it would enable the choice of one or the other for diagnosis. Seventy-two dry mouth patients were divided into non-Sjögren's Syndrome group, primary Sjögren's Syndrome group and secondary Sjögren's Syndrome group. The concordance among sialometry and scintigraphy results was evaluated by Kappa test. It was observed that their concordance was equal or near to zero. It is not possible to make a choice between these tests and both should be performed.

  2. On the heritability of psoriatic arthritis. Disease concordance among monozygotic and dizygotic twins

    DEFF Research Database (Denmark)

    Pedersen, Ole Birger; Svendsen, Anders Jørgen; Ejstrup, Leif

    2008-01-01

    : This first twin study on PsA confirms that genes are important in the causation of psoriatic skin disease. Despite the limited statistical power, the almost identical concordance rates for PsA in MZ and DZ twins stresses the importance of continued search for non genetic effectors in PsA.......OBJECTIVE: In a nationwide unselected twin population to estimate the relative importance of genetic and environmental effectors in the etiopathogenesis of psoriatic arthritis (PsA). METHODS: The study comprised three Danish nationwide twin cohorts. In 1994 and 2002 a total of 37,388 and 46......, resulting in 36 complete pairs. A total of 1/10 MZ pairs and 1/26 DZ pairs were concordant for PsA, yielding a 6.2% difference in proportions (95% CI: -11%, 37%). 5/10 MZ pairs and 4/26 DZ pairs were concordant for psoriatic skin disease implying a 35% difference (95% CI: 2%, 60%, p

  3. Concorde noise-induced building vibrations: International Airport Dulles. [studies by Langley Research Center

    Science.gov (United States)

    Mayes, W. H.; Scholl, H. F.; Stephens, D. G.; Holliday, B. G.; Deloach, R.; Finley, T. D.; Holmes, H. K.; Lewis, R. B.; Lynch, J. W.

    1977-01-01

    A series of studies were conducted to assess the noise-induced building vibrations associated with Concorde operations. The vibration levels of windows, walls, and floors were measured along with the associated noise levels of Concorde, subsonic aircraft and some nonaircraft events. Test sites included Sully Plantation which is adjacent to Dulles International Airport and three residential homes located in Montgomery County, Maryland. The measured vibration response levels due to Concorde operations were found to be: (1) higher than the levels due to other aircraft, (2) less than the levels due to certain household events which involve direct impulsive loading such as door and window closing, (3) less than criteria levels for building damage, and (4) comparable to levels which are perceptible to people.

  4. Power Estimation for Gene-Longevity Association Analysis Using Concordant Twins

    DEFF Research Database (Denmark)

    Tan, Qihua; Zhao, Jing Hua; Kruse, Torben A

    2014-01-01

    Statistical power is one of the major concerns in genetic association studies. Related individuals such as twins are valuable samples for genetic studies because of their genetic relatedness. Phenotype similarity in twin pairs provides evidence of genetic control over the phenotype variation...... in a population. The genetic association study on human longevity, a complex trait that is under control of both genetic and environmental factors, has been confronted by the small sample sizes of longevity subjects which limit statistical power. Twin pairs concordant for longevity have increased probability...... for carrying beneficial genes and thus are useful samples for gene-longevity association analysis. We conducted a computer simulation to estimate the power of association study using longevity concordant twin pairs. We observed remarkable power increases in using singletons from longevity concordant twin pairs...

  5. Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity.

    Science.gov (United States)

    Street, Richard L; O'Malley, Kimberly J; Cooper, Lisa A; Haidet, Paul

    2008-01-01

    Although concordance by race and sex in physician-patient relationships has been associated with patient ratings of better care, mechanisms through which concordance leads to better outcomes remains unknown. This investigation examined (1) whether patients' perceptions of similarity to their physicians predicted their ratings of quality of care and (2) whether perceived similarity was influenced by racial and sexual concordance and the physician's communication. The research design was a cross-sectional study with 214 patients and 29 primary care physicians from 10 private and public outpatient clinics. Measures included postvisit patient ratings of similarity to the physician; satisfaction, trust, and intent to adhere; and audiotape analysis of patient involvement and physicians' patient-centered communication. Factor analysis revealed 2 dimensions of similarity, personal (in beliefs, values) and ethnic (in race, community). Black and white patients in racially concordant interactions reported more personal and ethnic similarity (mean score, 87.6 and 78.8, respectively, on a 100-point scale) to their physicians than did minority patients (mean score, 81.4 and 41.2, respectively) and white patients (mean score, 84.4 and 41.9, respectively) in racially discordant encounters. In multivariable models, perceived personal similarity was predicted by the patient's age, education, and physicians' patient-centered communication, but not by racial or sexual concordance. Perceived personal similarity and physicians' patient-centered communication predicted patients' trust, satisfaction, and intent to adhere. The physician-patient relationship is strengthened when patients see themselves as similar to their physicians in personal beliefs, values, and communication. Perceived personal similarity is associated with higher ratings of trust, satisfaction, and intention to adhere. Race concordance is the primary predictor of perceived ethnic similarity, but several factors affect

  6. Implications of community concordance for assessing stream health at three nested spatial scales in Minnesota, USA

    Science.gov (United States)

    Dolph, Christine L.; Huff, David D.; Chizinski, Christopher J.; Vondracek, Bruce C.

    2011-01-01

    1. Fish and invertebrate assemblage data collected from 670 stream sites in Minnesota (U.S.A.) were used to calculate concordance across three nested spatial scales (statewide, ecoregion and catchment). Predictive taxa richness models, calibrated using the same data, were used to evaluate whether concordant communities exhibited similar trends in human-induced taxa loss across all three scales. Finally, we evaluated the strength of the relationship between selected environmental variables and the composition of both assemblages at all three spatial scales.

  7. Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

    Science.gov (United States)

    2018-01-01

    Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies. PMID:29169231

  8. Concordance between Reticulocyte Hemoglobin Equivalent and Reticulocyte Hemoglobin Content in CKD Patients Undergoing Hemodialysis

    Directory of Open Access Journals (Sweden)

    Riadi Wirawan

    2017-04-01

    Full Text Available Aim: to evaluate the correlation and the concordance between reticulocyte hemoglobin equivalent (RET-He and reticulocyte hemoglobin content (CHr as well as to obtain the cut-off value of RET-He as the target of iron supplementation in chronic kidney disease (CKD patients undergoing hemodialysis. Methods: a cross-sectional study was performed using K3EDTA-anticoagulated peripheral blood samples collected from 106 CKD patients undergoing routine hemodialysis. The samples were then analyzed using both Sysmex XN-2000 and Siemens ADVIA 2120i for RET-He and CHr analysis. Results: a very strong correlation (r=0.91; p<0.0001 and a good concordance were found between RET-He and CHr with mean bias of 0.5 pg. The diagnostic concordance was 96.23%. The cut-off value of RET-He 29.2 pg was obtained from the receiver operating characteristic (ROC curve with CHr as the gold standard. At this cut-off point, the sensitivity and specificity to assess the target of iron supplementation in CKD patients undergoing hemodialysis were 95.5% and 94%, respectively. Conclusion: the study shows a good correlation and concordance between RET-He and CHr in CKD patients undergoing hemodialysis.

  9. Concordance analysis for QTL detection in dairy cattle: a case study of leg morphology

    DEFF Research Database (Denmark)

    van den Berg, Irene; Rodrigue; Fritz, Sebastien

    2014-01-01

    be performed, we were able to reduce the number of candidate mutations. For part of the QTL, the concordant analyses narrowed QTL regions down to a limited number of genes, of which some are known for their role in limb or skeletal development in humans and mice. Mutations in these genes are good candidates...

  10. Motor Impairment in Sibling Pairs Concordant and Discordant for Autism Spectrum Disorders

    Science.gov (United States)

    Hilton, Claudia List; Zhang, Yi; Whilte, Megan R.; Klohr, Cheryl L.; Constantino, John

    2012-01-01

    Aim: Although motor impairment is frequently observed in children with autism spectrum disorders (ASD), the manner in which these impairments aggregate in families affected by autism is unknown. We used a standardized measure of motor proficiency to objectively examine quantitative variation in motor proficiency in sibling pairs concordant and…

  11. English Collocation Learning through Corpus Data: On-Line Concordance and Statistical Information

    Science.gov (United States)

    Ohtake, Hiroshi; Fujita, Nobuyuki; Kawamoto, Takeshi; Morren, Brian; Ugawa, Yoshihiro; Kaneko, Shuji

    2012-01-01

    We developed an English Collocations On Demand system offering on-line corpus and concordance information to help Japanese researchers acquire a better command of English collocation patterns. The Life Science Dictionary Corpus consists of approximately 90,000,000 words collected from life science related research papers published in academic…

  12. [Evaluation of the concordance between biological markers and clinical activity in inflammatory bowel disease].

    Science.gov (United States)

    Miranda García, Pablo; Chaparro, María; Gisbert, Javier P

    2015-01-06

    Endoscopy is the gold standard to assess disease severity in inflammatory bowel disease, although it is an invasive procedure. Clinical activity and biological markers have been routinely used to determine disease activity in a non-invasive manner. The aim of this study was to determine concordance between common biological markers (C reactive protein, orosomucoid, erythrocyte sedimentation rate, fibrinogen, platelets, leukocytes, neutrophils and haemoglobin) and clinical activity in inflammatory bowel disease. Consecutive patients with inflammatory bowel disease were included. Clinical activity was evaluated according to the Harvey-Bradshaw index in Crohn's disease and to the partial Mayo score in ulcerative colitis. Serum concentrations of the different biomarkers were analysed. Concordance between clinical activity and elevation of the serological biomarkers was determined using the kappa statistic. In total, 350 patients were included (median age 46 years, Crohn's disease 59%). Eleven percent of patients had clinical activity. Crohn's disease patients had mild clinical activity in 44% of cases, moderate disease in 44% and only 12% of patients had severe clinical activity. In ulcerative colitis, patients had mild, moderate and severe clinical activity in 50, 42 and 8% of cases, respectively. None of the biomarkers included had an acceptable concordance with clinical activity (kappa statistic ≤ 0.30). Concordance between serological biomarkers and clinical activity in inflammatory bowel disease is remarkably low. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. Concordance between prenatal ultrasound and autopsy findings in a tertiary center.

    Science.gov (United States)

    Rodriguez, M Angeles; Prats, Pilar; Rodríguez, Ignacio; Cusí, Victoria; Comas, Carmina

    2014-08-01

    The aim of this study was to evaluate the ultrasound (US)/autopsy concordance in elective termination of pregnancies (TOP) due to fetal causes. We performed a retrospective evaluation of elective TOP from 2004 to 2012. Inclusion criteria were gestational age at termination autopsy data. Based on the US-autopsy concordance, cases were divided into four groups: Group 1: agreement; Group 2: autopsy confirmed all US findings but provided additional information; Group 3: autopsy didn't confirm all US findings; Group 4: disagreement. One hundred and fifty-one patients fulfilled the inclusion criteria during the study period. Central nervous system malformations (91.5%), cardiovascular anomalies (90.2%) and renal system malformations (91.3%) were confirmed by autopsy. We found less concordance in the abdominal and musculoskeletal anomalies (61.5% and 66.7%, respectively). There were 130 (86%) fetuses in group 1, 7 in group 2 (4.6%), 3 in group 3 (1.9%) and 11 in group 4 (7.2%). In 5.29% of cases, the autopsy added relevant information to the diagnosis and counselling. Diagnosis concordance between US and necropsy is achieved in almost 90% of cases. An autopsy may help to adjust the diagnosis and help in counselling the parents for a future pregnancy. © 2014 John Wiley & Sons, Ltd.

  14. Young Girls' and Caretakers' Reports of Problem Behavior: Comprehension and Concordance across Age, Race, and Behavior

    Science.gov (United States)

    Slocum, Lee Ann; Simpson, Sally S.; Hipwell, Alison E.; Loeber, Rolf

    2011-01-01

    The article discusses a research instrument developed and utilized by the Pittsburgh Girls Study that asked young girls (ages 7 and 8) and their caretakers to report on the girls' involvement in a variety of problem behaviors. In this article, the authors evaluate whether comprehension, prevalence, and caretaker-child concordance of problem…

  15. Parent/Child Concordance about Bullying Involvement and Family Characteristics Related to Bullying and Peer Victimization

    Science.gov (United States)

    Holt, Melissa K.; Kaufman Kantor, Glenda; Finkelhor, David

    2009-01-01

    This study examined parent perspectives on bullying, parent/child concordance about bullying involvement, and family characteristics associated with bullying perpetration and peer victimization. Participants were 205 fifth-grade students and their parents. Students attended an urban, ethnically diverse school district in the Northeast. Youth…

  16. [Concordance and usefulness of a stratification system for clinical decision making].

    Science.gov (United States)

    González González, Ana Isabel; Miquel Gómez, Ana María; Rodríguez Morales, David; Hernández Pascual, Montserrat; Sánchez Perruca, Luis; Mediavilla Herrera, Inmaculada

    2017-04-01

    1) To analyse concordance between the level of risk classification using the Adjusted Groups Morbidity (GMA) tool and the assigned level of intervention by general practitioners (GP). 2) To study the usefulness of the GMA tool as an aid in electronic medical records (EMR) for decision making. Cross-sectional observational study of concordance. Primary Care. Madrid Health Service. Twenty eight GPs. A sample of 840 patients assigned to participating GPs was selected by disproportionate stratified random sampling (0.65 kappa, 0.125 precision, 5% positive rate, 95% confidence level). Weighted Cohen Kappa index for the degree of concordance between the GMA tool and the GPs. The usefulness of the tool was assessed using an ad hoc developed questionnaire. Kappa weighted index obtained was 0.60 (95%CI: 0.55-0.65). In 3% of cases the disagreement was maximum. The GPs found that the grouping tool had been useful in 76% of cases. Moderate strength/good concordance; incorporating a grouping tool in the EMR helps as a reminder for taking more proactive/integrated decisions based on social and health needs of people with chronic diseases. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. Concordance of Parent- and Child-Reported Physical Abuse Following Child Protective Services Investigation.

    Science.gov (United States)

    Kobulsky, Julia M; Kepple, Nancy Jo; Holmes, Megan R; Hussey, David L

    2017-02-01

    Knowledge about the concordance of parent- and child-reported child physical abuse is scarce, leaving researchers and practitioners with little guidance on the implications of selecting either informant. Drawing from a 2008-2009 sample of 11- to 17-year-olds ( N = 636) from Wave 1 of the second National Survey of Child and Adolescent Well-Being, this study first examined parent-child concordance in physical abuse reporting (Parent-Child Conflict Tactic Scale). Second, it applied multivariate regression analysis to relate parent-child agreement in physical abuse to parent-reported (Child Behavior Checklist) and child-reported (Youth Self Report) child behavioral problems. Results indicate low parent-child concordance of physical abuse (κ = .145). Coreporting of physical abuse was related to clinical-level parent-reported externalizing problems ([Formula: see text] = 64.57), whereas child-only reports of physical abuse were the only agreement category related to child-reported internalizing problems ( B = 4.17, p < .001). Attribution bias theory may further understanding of reporting concordance and its implications.

  18. Concordance Between Administrator and Clinician Ratings of Organizational Culture and Climate.

    Science.gov (United States)

    Beidas, Rinad S; Williams, Nathaniel J; Green, Philip D; Aarons, Gregory A; Becker-Haimes, Emily M; Evans, Arthur C; Rubin, Ronnie; Adams, Danielle R; Marcus, Steven C

    2018-01-01

    Organizational culture and climate are important determinants of behavioral health service delivery for youth. The Organizational Social Context measure is a well validated assessment of organizational culture and climate that has been developed and extensively used in public sector behavioral health service settings. The degree of concordance between administrators and clinicians in their reports of organizational culture and climate may have implications for research design, inferences, and organizational intervention. However, the extent to which administrators' and clinicians' reports demonstrate concordance is just beginning to garner attention in public behavioral health settings in the United States. We investigated the concordance between 73 administrators (i.e., supervisors, clinical directors, and executive directors) and 247 clinicians in 28 child-serving programs in a public behavioral health system. Findings suggest that administrators, compared to clinicians, reported more positive cultures and climates. Organizational size moderated this relationship such that administrators in small programs (climate in contrast to administrators in large programs (≥466 youth clients served annually) who reported more positive cultures and climates than clinicians. We propose a research agenda that examines the effect of concordance between administrators and clinicians on organizational outcomes in public behavioral health service settings.

  19. Ethnic minorities and prescription medication; concordance between self-reports and medical records

    NARCIS (Netherlands)

    Uiters, Ellen; Dijk, Liset van; Devillé, Walter; Foets, Marleen; Spreeuwenberg, Peter; Groenewegen, Peter P.

    2006-01-01

    Background: Ethnic differences in health care utilisation are frequently reported in research. Little is known about the concordance between different methods of data collection among ethnic minorities. The aim of this study was to examine to which extent ethnic differences between selfreported data

  20. Ethnic minorities and prescription medication: concordance between self-reports and medical records.

    NARCIS (Netherlands)

    Uiters, E.; Dijk, L. van; Devillé, W.; Foets, M.; Spreeuwenberg, P.; Groenewegen, P.P.

    2006-01-01

    Background: Ethnic differences in health care utilisation are frequently reported in research. Little is known about the concordance between different methods of data collection among ethnic minorities. The aim of this study was to examine to which extent ethnic differences between selfreported data

  1. Assessing clinical reasoning in pediatric emergency medicine: validity evidence for a Script Concordance Test.

    Science.gov (United States)

    Carrière, Benoit; Gagnon, Robert; Charlin, Bernard; Downing, Steven; Bordage, Georges

    2009-05-01

    Clinical reasoning is a crucial skill for all residents to acquire during their training. During most patient encounters in pediatric emergency medicine, physicians and trainees are challenged by diagnostic, investigative, and treatment uncertainties. The Script Concordance Test may provide a means to assess reasoning skills in the context of uncertainty in the practice of pediatric emergency medicine. We gathered validity evidence for the use of a pediatric emergency medicine Script Concordance Test to evaluate residents' reasoning skills. A 1-hour test containing 60 questions nested in 38 cases was administered to 53 residents at the end of their pediatric emergency medicine rotation at 1 academic institution. Twelve experienced pediatricians were part of a reference panel to establish the basis for the scoring process. An optimized version of the test, based on positive item discrimination data, contained 30 cases and 50 questions. Scores ranged from 48% to 82%, with a mean score of 69.9 (SD=11.5). The reliability of the optimized test (Cronbach's alpha) was 0.77. Performance on the test increased as the level of experience of the residents increased. The residents considered the Script Concordance Test true to real-life clinical problems and had enough time to complete the test. This pediatric emergency medicine Script Concordance Test was reliable and useful to assess the progression of clinical reasoning during residency training.

  2. Patient-clinician ethnic concordance and communication in mental health intake visits.

    Science.gov (United States)

    Alegría, Margarita; Roter, Debra L; Valentine, Anne; Chen, Chih-nan; Li, Xinliang; Lin, Julia; Rosen, Daniel; Lapatin, Sheri; Normand, Sharon-Lise; Larson, Susan; Shrout, Patrick E

    2013-11-01

    This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment. Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews. Latino concordant dyad patients were more verbally dominant (pcommunication (pmodels that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients. Communication patterns seem to explain the role of ethnic concordance for continuance in care. Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

    Science.gov (United States)

    Dickson, Kelsey S.; Suhrheinrich, Jessica; Rieth, Sarah R.; Stahmer, Aubyn C.

    2018-01-01

    Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent-teacher concordance of ratings of adaptive functioning and…

  4. Study of concord in the examination scripts of students of Ghana ...

    African Journals Online (AJOL)

    In conclusion, as a recommendation, the paper posits that more exciting pedagogical methods such as teaching grammar in context, using substitution tables, constant practice, amongst others, should be employed by teachers to whet students' appetite in the discipline. Key Words: Grammar, concord, antecedent, critical ...

  5. A Descriptive Enquiry into Subject-Verb Concord in English Existential Constructions

    Science.gov (United States)

    Tsuchida, Takehiro

    2011-01-01

    Subject-verb concord in English existential constructions is often viewed as problematic from both prescriptive and descriptive approaches to grammar and causes considerable confusion among teachers and learners of English as a second language (ESL). This paper aims to disentangle debates over the curious usage of the "there" + plural noun phrase…

  6. [Inter-rater concordance of the "Nursing Activities Score" in intensive care].

    Science.gov (United States)

    Valls-Matarín, Josefa; Salamero-Amorós, Maria; Roldán-Gil, Carmen; Quintana-Riera, Salvador

    2015-01-01

    To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  7. Concordance between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

    Science.gov (United States)

    Bacow, Terri Landon; May, Jill Ehrenreich; Choate-Summers, Molly; Pincus, Donna B.; Mattis, Sara G.

    2010-01-01

    This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment…

  8. Young Learners and Lexical Awareness: Children's Engagement with Wordlists and Concordances

    Science.gov (United States)

    MacGregor, Alex

    2014-01-01

    Sinclair (1991) found that lexical analysis can be overcomplicated, yet Johns (1994) called for investigation into whether corpus analysis can motivate beginners and near-beginners. The findings of this research suggest that young EFL learners can enjoy using corpus analysis tools (wordlists and concordances) to identify, classify, and generalize…

  9. Concordance among Physical Educators', Teachers', and Parents' Perceptions of Attention Problems in Children

    Science.gov (United States)

    Efstratopoulou, Maria; Simons, Johan; Janssen, Rianne

    2013-01-01

    Objective: The study examined the concordance among rating sources on attention problems of elementary school-aged children. Method: A randomly selected sample ("N" = 841) of children was rated by the physical educators, the teachers, and the parents, using the Attention Scales of the Motor Behavior Checklist (MBC), the Teacher Report…

  10. 15 CFR Appendix E to Part 30 - FTSR to FTR Concordance

    Science.gov (United States)

    2010-01-01

    ... the United States to another point in the United States by routes passing through Canada or Mexico. 30... 30.37(d) Shipments from one point in Canada or Mexico to another point in the same country by routes... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false FTSR to FTR Concordance E Appendix E...

  11. 15 CFR Appendix F to Part 30 - FTR to FTSR Concordance

    Science.gov (United States)

    2010-01-01

    ... Canada or Mexico 30.55(c) Shipments from one point in the United States to another thereof by routes... Canada or Mexico to another point in the same country by routes through the United States. 30.58(a... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false FTR to FTSR Concordance F Appendix F...

  12. Concordance of Interests in Dynamic Models of Social Partnership in the System of Continuing Professional Education

    Science.gov (United States)

    Tarasenko, Larissa V.; Ougolnitsky, Guennady A.; Usov, Anatoly B.; Vaskov, Maksim A.; Kirik, Vladimir A.; Astoyanz, Margarita S.; Angel, Olga Y.

    2016-01-01

    A dynamic game theoretic model of concordance of interests in the process of social partnership in the system of continuing professional education is proposed. Non-cooperative, cooperative, and hierarchical setups are examined. Analytical solution for a linear state version of the model is provided. Nash equilibrium algorithms (for non-cooperative…

  13. A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia.

    Science.gov (United States)

    Bridges, John F P; Slawik, Lara; Schmeding, Annette; Reimer, Jens; Naber, Dieter; Kuhnigk, Olaf

    2013-06-01

    While much discussion has been placed on the problem of poor compliance in the treatment of schizophrenia, there has been little discussion on the concordance between patients and psychiatrists, an important contributing factor to patient-centred care. To estimate the concordance between patients' and psychiatrists' (ordinal and cardinal) valuations of multiple goals for schizophrenia treatment and to illustrate the utility of the self-explicated method in valuing a large number of treatment goals. Twenty treatment goals were identified during focus groups and literature review and were presented to patients and psychiatrists during structured interviews. Respondents were asked to rank the multiple treatment goals and rate them on a 5-point Likert scale. Three scores were calculated based on the ranking (1-20), rating (Likert scale) (1-5) and a self-explicated method estimated as the product of rating and ranking score (1-100). Concordance was tested using Spearman's rho for overall ordinal rankings and via anova and F-test for the cardinal values assigned to a specific treatment goal. A total of 105 outpatients diagnosed with schizophrenia and 160 psychiatrists in Germany. Patient and psychiatrist values were concordant when the ordinal properties of their valuations were assessed by rating (ρ = 0.63; P = 0.002), ranking (ρ = 0.51; P = 0.02) and self-explicated methods (ρ = 0.54; P = 0.01). Significant discordances were found when comparing the cardinal value placed on any given treatment goal using all three approaches, but the self-explicated method produced a more discerning statistic. Relative to patients, psychiatrists significantly (P sexual pleasure and improved communication while undervaluing reuptake of activities of daily living, improved satisfaction and recovered capacity for work. While there is an overall concordance between patients' and psychiatrists' valuation, significantly different valuations on specific goals can be identified. Here

  14. CNS safety at 48-week of switching to ATV/r plus 3TC or two nucleos(t)ides in HIV-suppressed patients on stable ART: the SALT neurocognitive sub-study.

    Science.gov (United States)

    Valero, Ignacio Pérez; Pasquau, Juan; Rubio, Rafael; Ribero, Antonio; Santos, Jose; Sanz, Jesus; Mariño, Ana; Crespo, Manel; Hernandez, Jose; Iribarren, Jose Antonio; Gutierrez, Felix; Terron, Alberto; Esteban, Herminia; Pérez-Molina, Jose Antonio

    2014-01-01

    Due to their low CNS penetrance, there are concerns about the capacity of non-conventional PI-based ART (monotherapy and dual therapies) to preserve neurocognitive performance (NP). We evaluated the NP change of aviremic participants of the SALT clinical trial (1) switching therapy to dual therapy (DT: ATV/r+3TC) or triple therapy (TT: ATV/r+2NRTI) who agreed to perform an NP assessment (NPZ-5) at baseline and W48. Neurocognitive impairment and NP were assessed using AAN-2007 criteria (2) and global deficit scores (GDS) (3). Neurocognitive change (GDS change: W48 - baseline) and the effect of DT on NP evolution crude and adjusted by significant confounders were determined using ANCOVA. A total of 158 patients were included (Table 1). They had shorter times because HIV diagnosis, ART initiation and HIV-suppression and their virologic outcome at W48 by snapshot was higher (79.1% vs 72.7%; p=0.04) compared to the 128 patients not included in the sub-study. By AAN-2007 criteria, 51 patients in each ART group (68% vs 63%) were neurocognitively impaired at baseline (p=0.61). Forty-seven patients were not reassessed at W48: 30 lost of follow-up (16 DT-14 TT) and 17 had non-evaluable data (6 DT-11 TT). Patients retested were more likely to be men (78.9% vs 61.4%) and had neurological cofounders (9.6% vs 0%) than patients non-retested. At W48, 3 out of 16 (5.7%) patients on DT and 6 out of 21 (10.5%) on TT who were non-impaired at baseline became impaired (p=0.49) while 10 out of 37 (18.9%) on DT and 7 out of 36 (12.3%) on TT who were neurocognitively impaired at baseline became non-impaired (p=0.44). Mean GDS changes (95% CI) were: Overall -0.2 (-0.3 to -0.04): DT -0.26 (-0.4 to -0.07) and TT -0.08 (-0.2 to 0.07). NP was similar between DT and TT (0.15). This absence of differences was also observed in all cognitive tests. Effect of DT: -0.16 [-0.38 to 0.06]) (r(2)=0.16) on NP evolution was similar to TT (reference), even after adjusting (DT: -0.11 [-0.33 to 0.1], TT

  15. An efficient concordant integrative analysis of multiple large-scale two-sample expression data sets.

    Science.gov (United States)

    Lai, Yinglei; Zhang, Fanni; Nayak, Tapan K; Modarres, Reza; Lee, Norman H; McCaffrey, Timothy A

    2017-12-01

    We have proposed a mixture model based approach to the concordant integrative analysis of multiple large-scale two-sample expression datasets. Since the mixture model is based on the transformed differential expression test P-values (z-scores), it is generally applicable to the expression data generated by either microarray or RNA-seq platforms. The mixture model is simple with three normal distribution components for each dataset to represent down-regulation, up-regulation and no differential expression. However, when the number of datasets increases, the model parameter space increases exponentially due to the component combination from different datasets. In this study, motivated by the well-known generalized estimating equations (GEEs) for longitudinal data analysis, we focus on the concordant components and assume that the proportions of non-concordant components follow a special structure. We discuss the exchangeable, multiset coefficient and autoregressive structures for model reduction, and their related expectation-maximization (EM) algorithms. Then, the parameter space is linear with the number of datasets. In our previous study, we have applied the general mixture model to three microarray datasets for lung cancer studies. We show that more gene sets (or pathways) can be detected by the reduced mixture model with the exchangeable structure. Furthermore, we show that more genes can also be detected by the reduced model. The Cancer Genome Atlas (TCGA) data have been increasingly collected. The advantage of incorporating the concordance feature has also been clearly demonstrated based on TCGA RNA sequencing data for studying two closely related types of cancer. Additional results are included in a supplemental file. Computer program R-functions are freely available at http://home.gwu.edu/∼ylai/research/Concordance. ylai@gwu.edu. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press. All rights

  16. Concordance of sleep and pain outcomes of diverse interventions: an umbrella review.

    Directory of Open Access Journals (Sweden)

    Anthony G Doufas

    Full Text Available BACKGROUND/OBJECTIVE: Pain influences sleep and vice versa. We performed an umbrella review of meta-analyses on treatments for diverse conditions in order to examine whether diverse medical treatments for different conditions have similar or divergent effects on pain and sleep. METHODS: We searched published systematic reviews with meta-analyses in the Cochrane Database of Systematic Reviews until October 20, 2011. We identified randomized trials (or meta-analyses thereof, when >1 trial was available where both pain and sleep outcomes were examined. Pain outcomes were categorized as headache, musculoskeletal, abdominal, pelvic, generic or other pain. Sleep outcomes included insomnia, sleep disruption, and sleep disturbance. We estimated odds ratios for all outcomes and evaluated the concordance in the direction of effects between sleep and various types of pain and the correlation of treatment effects between sleep and pain outcomes. RESULTS: 151 comparisons with 385 different trials met our eligibility criteria. 96 comparisons had concordant direction of effects between each pain outcome and sleep, while in 55 the effect estimates were in opposite directions (P<0.0001. In the 20 comparisons with largest amount of evidence, the experimental drug always had worse sleep outcomes and tended to have worse pain outcomes in 17/20 cases. For headache and musculoskeletal pain, 69 comparisons showed concordant direction of effects with sleep outcomes and 36 showed discordant direction (P<0.0001. For the other 4 pain types there were overall 27 vs. 19 pairs with concordant vs. discordant direction of effects (P = 0.095. There was a weak correlation of the treatment effect sizes for sleep vs. headache/musculoskeletal pain (r = 0.17, P = 0.092. CONCLUSIONS: Medical interventions tend to have effects in the same direction for pain and sleep outcomes, but exceptions occur. Concordance is primarily seen for sleep and headache or musculoskeletal

  17. Liver Steatosis: Concordance of MR Imaging and MR Spectroscopic Data with Histologic Grade

    Science.gov (United States)

    Lam, Maggie M.; Merriman, Raphael B.; Ferrell, Linda; Qayyum, Aliya

    2012-01-01

    Purpose: To determine if the concordance of magnetic resonance (MR) imaging and MR spectroscopic data with histologic measures of steatosis is affected by histologic magnification level, tissue heterogeneity, or assessment of tissue area versus that of hepatocytes. Materials and Methods: This study was institutional review board approved and HIPAA compliant. Written informed consent was obtained. In- and out-of-phase MR imaging and MR spectroscopic measures of steatosis were compared in 33 patients with nonalcoholic fatty liver disease and in 15 healthy volunteers. Concordance of MR imaging and MR spectroscopic data with histologic findings was assessed for (a) histologic examination at standard (×40 and ×100) versus high magnification (×200 and ×400), (b) heterogeneity and homogeneity of livers, and (c) percentage of tissue and hepatocytes that contained lipids. Evaluations included linear regression and Fisher exact tests. Results: In- and out-of-phase MR imaging and MR spectroscopic data were well correlated (R2 = 0.93) and generally concordant with histologic measures. Patients in whom MR fat fractions were higher than expected compared with steatosis grades at standard magnification histologic examination were upgraded significantly more often when high magnification was used than were the remaining patients (100% [10 of 10] vs 47% [7 of 15], P spectroscopic data of homogeneous livers were significantly more likely than those of heterogeneous livers to be concordant with steatosis grades when high magnification was used (81% [13 of 16] vs 47% [8 of 17], P spectroscopic data were generally concordant with histologic measures of steatosis. Discordance between them may reflect differences in magnification at histologic examination and in liver heterogeneity. © RSNA, 2012 PMID:22723561

  18. Parent-Youth Rating Concordance for Hair Pulling Variables, Functional Impairment, and Anxiety Scale Scores in Trichotillomania

    Science.gov (United States)

    Keuthen, Nancy J.; Flessner, Christopher A.; Woods, Douglas W.; Franklin, Martin E.; Piacentini, John A.; Khanna, Muniya; Moore, Phoebe; Cashin, Susan

    2008-01-01

    Knowledge of cross-informant rating concordance is critical for the assessment of child and adolescent problems in clinical and research settings. We explored parent-youth rating concordance for hair pulling variables, functional impairment, and anxiety symptoms in a sample of child and adolescent hair pullers (n = 133) satisfying conservative…

  19. Intimate Partner Aggression Reporting Concordance and Correlates of Agreement among Men with Alcohol Use Disorders and Their Female Partners

    Science.gov (United States)

    Panuzio, Jillian; O'Farrell, Timothy J.; Marshall, Amy D.; Murphy, Christopher M.; Murphy, Marie; Taft, Casey T.

    2006-01-01

    This study examined relationship aggression reporting concordance among 303 men with alcohol use disorders and their female partners enrolled in couples-based alcohol abuse treatment. Agreement for physical and psychological aggression was generally consistent with, or higher than, concordance rates reported among other populations. Men's…

  20. Dyadic analysis of self-efficacy and perceived support: the relationship of individual and spousal characteristics with physical activity among middle-aged and young-older adults.

    Science.gov (United States)

    Ayotte, Brian J; Margrett, Jennifer A; Patrick, Julie Hicks

    2013-06-01

    The purpose of this study was to examine the associations among self-efficacy, perceived support, and physical activity in middle-aged and older married couples. A total of 116 middle-aged and older couples (M = 58.86 years, SD = 7.16, range 50-74) participated in the study. A dyadic approach to path modeling was taken. The final model indicated that for both husbands and wives, one's own self-efficacy was directly related to physical activity. In addition, husband self-efficacy was positively related to wive physical activity and indirectly related to wife physical activity through wife self-efficacy. Wife self-efficacy was indirectly related to husband physical activity via the level of husband perceived support. These results provide evidence for the importance of incorporating spousal characteristics in addition to individual characteristics when investigating physical activity during middle and later married life. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  1. High concordance between two companion diagnostics tests: a concordance study between the HercepTest and the HER2 FISH pharmDx kit

    DEFF Research Database (Denmark)

    Jørgensen, Jan Trøst; Møller, Susanne; Rasmussen, Birgitte

    2011-01-01

    The present study was done to investigate the concordance between the HER2 status measured by immunohistochemical analysis (HercepTest, DAKO, Carpinteria, CA) and fluorescence in situ hybridization (FISH; HER2 FISH pharmDx, DAKO) in a large study cohort (n = 681) of patients with high-risk breast...... cancer. A high agreement between immunohistochemical and FISH results was demonstrated. For the whole study population, the agreement between the 2 assays was 93.1% with a corresponding κ coefficient of 0.85. When the equivocal immunohistochemical 2+ cases were excluded from the analysis (n = 79...

  2. Facing Spousal Cancer During Child-Rearing Years: Do Social Support and Hardiness Moderate the Impact of Psychological Distress on Quality of Life?

    Science.gov (United States)

    Senneseth, Mette; Hauken, May A; Matthiesen, Stig B; Gjestad, Rolf; Laberg, Jon C

    Partners of cancer patients report psychological distress and reduced quality of life. However, partners' mental health status and quality of life during child-rearing years and the influence of social support and hardiness on their well-being have not yet been studied. The aim of this study was to describe psychological distress, quality of life, social support, and hardiness of the partners facing spousal cancer during child-rearing years and investigate whether social support or hardiness moderated the relationship between psychological distress and quality of life. Cross-sectional data were collected in Norway from December 2013 to July 2015 as part of the Cancer-PEPSONE study. Five questionnaires were administered to 14 females and 21 males (n = 35). Participants reported more psychological distress and lower quality-of-life scores than other healthy Norwegian populations. Psychological distress seemed to be associated with their not being in control of their futures. Received social support moderated the effect of psychological distress on quality of life. Facing spousal cancer during child-rearing years seemed to have a substantial impact on partners' mental health and an adverse impact on their quality of life. Accordingly, these partners' self-care abilities may be reduced. Received social support may reduce the multiple burdens and consequently allow for enhancement of self-care. Interventions should aim to improve the social support provided to child-rearing partners, which may improve their quality of life. Providing adequate information about their partner's cancer illness and treatment may enhance their feelings of control, which may be beneficial for their mental health status.

  3. Genotype-specific concordance of oral and genital human papillomavirus infections among marital couples is low.

    Science.gov (United States)

    Kero, K; Rautava, J; Louvanto, K; Syrjänen, K; Grenman, S; Syrjänen, S

    2016-04-01

    Data on genotype-specific concordance of oral-oral and genital-oral HPV infections among marital couples are key to understand HPV transmission between spouses. Genotype-specific concordance of HPV infections (oral/genital) and their co-variates among 131 marital couples were determined during 6-year follow-up (FU). Seven oral scrapings were taken from both spouses, accompanied by six genital samplings from the women and one (at baseline) from the male partners. HPV-genotyping was performed by nested PCR and a Luminex®-based Multimetrix Assay. Demographic data were collected with questionnaires at baseline and study conclusion. Prevalence of oral HPV varied from 10.3 to 27.0 % and 15.8 to 31.3 % in women and men, respectively. At baseline, 37.6 % of the male genital samples were HPV-positive while in female genital samples, HPV prevalence varied from 13.3 to 59.4 %. Only 15 couples had HPV genotype-specific concordance (oral-oral n = 7; male oral-female genital n = 9; female oral-male genital n = 2). In the nested case-control setting, higher number of deliveries (OR 0.145, 95%CI 0.030-0.706, p = 0.017) and higher number of intercourse (OR 0.488, 95%CI 0.243-0.978, p = 0.043) decreased the likelihood of concordant HPV infections while practicing oral sex increased the risk (OR 0.299, 95%CI 0.120-0.748, p = 0.010). In multivariate analysis, the likelihood of concordance was decreased by higher number of pregnancies of the female partner (p = 0.020) and by higher frequency of intercourse reported by the male spouse (p = 0.027). To conclude, asymptomatic HPV infections were common in both spouses while genotype-specific concordance was low. This supports the view that HPV profile of the spouses has been established before the current marital relationship.

  4. Is there concordance in attitudes and beliefs between parents and scientists about autism spectrum disorder?

    Science.gov (United States)

    Fischbach, Ruth L; Harris, Mark J; Ballan, Michelle S; Fischbach, Gerald D; Link, Bruce G

    2016-04-01

    There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma, and disclosure of genetic test results, telephone interviews were conducted. Parents (n = 502) were recruited from the Simons Simplex Collection, and research scientists (n = 60) were recruited from investigators funded by the Simons Foundation. Response rates were notable (parents 91%, scientists 80%). Parents and scientists differed significantly regarding beliefs of the likely major cause of autism (p = 0.007) and priorities for further research (p causes while many parents believed in vaccines as the cause of autism. Parents (37%) were more likely to hesitate vaccinating their child (p autism spectrum disorder and their families. © The Author(s) 2015.

  5. Concordance Between Anal and Oral Human Papillomavirus Infections Among Young Men Who have Sex With Men.

    Science.gov (United States)

    Steinau, Martin; Gorbach, Pamina; Gratzer, Beau; Braxton, Jim; Kerndt, Peter R; Crosby, Richard A; Unger, Elizabeth R; Markowitz, Lauri E; Meites, Elissa

    2017-06-15

    Prevalence of human papillomavirus (HPV) infections was assessed among 1033 young men who have sex with men (MSM) aged 18-26 years. HPV (any type) was detected in 742 (71.8%) anal specimens and 101 (9.8%) oral specimens. Although HPV was detected in specimens from both anatomical sites in 83 (8.0%) participants, type-specific concordance for at least 1 HPV type was found in only 35 (3.4%) participants. HIV and smoking were associated with higher prevalence at both sites and frequency of concordant types. Coinfections of identical HPV types were rare, suggesting independent infection events and/or different modes of clearance. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  6. Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy

    DEFF Research Database (Denmark)

    Yao, Zhilei; Deng, Lijuan; Xu-Monette, Z Y

    2018-01-01

    with positive BM. Intensive immunochemotherapy seemingly rendered survival benefit for patients with concordant BM, as did rituximab maintenance for the discordant BM group. Frequently revealing adverse clinical and molecular characteristics, patients with concordant BM demonstrated gene expression signatures...

  7. The two sides of goal intentions: Intention self-concordance and intention strength as predictors of physical activity.

    Science.gov (United States)

    Fuchs, Reinhard; Seelig, Harald; Göhner, Wiebke; Schlatterer, Martina; Ntoumanis, Nikos

    2017-01-01

    The present research introduces an extended conceptualisation of self-concordance, which is considered an attribute not only of goals, but also of goal intentions. Based on a corresponding operationalisation, we investigate the interplay of both intention strength and intention self-concordance in the prediction of physical activity. Data were taken from a longitudinal study of 134 obese people who were asked to fill out a questionnaire three times every six months. Physical activity and intention self-concordance were measured by validated scales. Intentions strength was assessed by an item typically employed in the extant literature. Logistic regression analyses and path analyses showed both intention strength and self-concordance to be significant predictors of changes in physical activity over time. Additional analyses found self-efficacy to be a significant predictor of intention strength and self-concordance; for outcome expectations this was not the case. Findings support the idea that intention strength and self-concordance are two critical facets of a goal intention that need to be considered in the prediction of physical activity participation. Whereas intention strength refers to the degree of determination with which a goal intention is adopted, self-concordance rather captures the quality of this intention.

  8. Learning-by-Concordance (LbC): introducing undergraduate students to the complexity and uncertainty of clinical practice.

    Science.gov (United States)

    Fernandez, Nicolas; Foucault, Amélie; Dubé, Serge; Robert, Diane; Lafond, Chantal; Vincent, Anne-Marie; Kassis, Jeannine; Kazitani, Driss; Charlin, Bernard

    2016-10-01

    A current challenge in medical education is the steep exposure to the complexity and uncertainty of clinical practice in early clerkship. The gap between pre-clinical courses and the reality of clinical decision-making can be overwhelming for undergraduate students. The Learning-by-Concordance (LbC) approach aims to bridge this gap by embedding complexity and uncertainty by relying on real-life situations and exposure to expert reasoning processes to support learning. LbC provides three forms of support: 1) expert responses that students compare with their own, 2) expert explanations and 3) recognized scholars' key-messages. Three different LbC inspired learning tools were used by 900 undergraduate medical students in three courses: Concordance-of-Reasoning in a 1 st -year hematology course; Concordance-of-Perception in a 2nd-year pulmonary physio-pathology course, and; Concordance-of-Professional-Judgment with 3rd-year clerkship students. Thematic analysis was conducted on freely volunteered qualitative comments provided by 404 students. Absence of a right answer was challenging for 1 st year concordance-of-reasoning group; the 2 nd year visual concordance group found radiology images initially difficult and unnerving and the 3 rd year concordance-of-judgment group recognized the importance of divergent expert opinion. Expert panel answers and explanations constitute an example of "cognitive apprenticeship" that could contribute to the development of appropriate professional reasoning processes.

  9. Which factors influence MRI-pathology concordance of tumour size measurements in breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Rominger, M.; Frauenfelder, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Berg, D. [Urbankrankenhaus Berlin, Anesthesiology, Berlin (Germany); Ramaswamy, A. [University Hospital Marburg, Pathology, Marburg (Germany); Timmesfeld, N. [Philipps University Marburg, Institute for Medical Biometry and Epidemiology, Marburg (Germany)

    2016-05-15

    To assess MRI-pathology concordance and factors influencing tumour size measurement in breast cancer. MRI tumour size (greatest diameter in anatomical planes (MRI-In-Plane) and greatest diameter along main tumour axis (MRI-MPR)) of 115 consecutive breast lesions (59 invasive lobular carcinoma, 46 invasive ductal carcinoma, and 10 ductal carcinoma in situ) was retrospectively compared to size measured at histopathology (pT size (Path-TNM) and greatest tumour diameter as relevant for excision (Path-Diameter; reference standard)). Histopathological tumour types, preoperative palpability, surgical management, additional high-risk lesions, and BI-RADS lesion type (mass versus non-mass enhancements) were assessed as possible influencing factors. Systematic errors were most pronounced between MRI-MPR and Path-TNM (7.1 mm, limits of agreement (LoA) [-21.7; 35.9]), and were lowest between MRI-In-Plane and Path-Diameter (0.2 mm, LoA [-19.7; 20.1]). Concordance rate of MRI-In-Plane with Path-Diameter was 86 % (97/113), overestimation 9 % (10/113) and underestimation 5 % (6/113); BI-RADS mass lesions were overestimated in 7 % (6/81) versus 41 % (13/32) for non-mass enhancements. On multivariate analysis only BI-RADS lesion type significantly influenced MRI-pathology concordance (p < 0.001). 2/59 (3 %) ILC did not enhance. Concordance rate varies according to the execution of MRI and histopathological measurements. Beyond this only non-mass enhancement significantly predicted discordance. (orig.)

  10. Correction of technical bias in clinical microarray data improves concordance with known biological information

    DEFF Research Database (Denmark)

    Eklund, Aron Charles; Szallasi, Zoltan Imre

    2008-01-01

    The performance of gene expression microarrays has been well characterized using controlled reference samples, but the performance on clinical samples remains less clear. We identified sources of technical bias affecting many genes in concert, thus causing spurious correlations in clinical data...... sets and false associations between genes and clinical variables. We developed a method to correct for technical bias in clinical microarray data, which increased concordance with known biological relationships in multiple data sets....

  11. Concordance between cerebrospinal fluid biomarkers and [11C]PIB PET in a memory clinic cohort.

    Science.gov (United States)

    Zwan, Marissa; van Harten, Argonde; Ossenkoppele, Rik; Bouwman, Femke; Teunissen, Charlotte; Adriaanse, Sofie; Lammertsma, Adriaan; Scheltens, Philip; van Berckel, Bart; van der Flier, Wiesje

    2014-01-01

    Two approaches are available for measuring Alzheimer's disease (AD) pathology in vivo. Biomarkers in cerebrospinal fluid (CSF) include amyloid-β1-42 (Aβ42) and tau. Furthermore, amyloid deposition can be visualized using positron emission tomography (PET) and [11C]Pittsburgh compound-B ([11C]PIB). We investigated concordance between CSF biomarkers and [11C]PIB PET as markers for AD pathology in a memory clinic cohort. We included 64 AD patients, 34 non-AD dementia patients, 22 patients with mild cognitive impairment (MCI), and 16 controls. [11C]PIB scans were visually rated as positive or negative. CSF biomarkers were considered abnormal based on Aβ42 alone ( 1). Concordance between CSF biomarkers and [11C]PIB PET was determined. Overall, concordance between [11C]PIB PET and CSF Aβ42 (PIB PET was more often AD-positive than Aβ42. When a more lenient Aβ42 cut-point (PIB PET appeared to be even higher (90% and 89%). This difference is explained by a subgroup of mostly MCI and AD patients with Aβ42 levels just above cut-off. Now, in discordant cases, CSF was more often AD-positive than [11C]PIB PET. Concordance between CSF Aβ42 and [11C]PIB PET was good in all diagnostic groups. Discordance was mostly seen in MCI and AD patients close to the cut-point. These results provide convergent validity for the use of both types of biomarkers as measures of AD pathology.

  12. Patient-physician language concordance and use of preventive care services among limited English proficient Latinos and Asians.

    Science.gov (United States)

    Jih, Jane; Vittinghoff, Eric; Fernandez, Alicia

    2015-01-01

    Patient-physician language concordance among limited English proficient (LEP) patients is associated with better outcomes for specific clinical conditions. Whether or not language concordance contributes to use of specific preventive care services is unclear. We pooled data from the 2007 and 2009 California Health Interview Surveys to examine mammography, colorectal cancer (CRC) screening, and influenza vaccination use among self-identified LEP Latino and Asian (i.e., Chinese, Korean, and Vietnamese) immigrants. We defined language concordance by respondents reporting that their physician spoke their non-English language. Analyses were completed in 2013-2014. Language concordance did not appear to facilitate mammography use among Latinas (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] 0.72, 1.45). Among Asian women, we could not definitively exclude a negative association of language concordance with mammography (AOR=0.55, 95% CI 0.27, 1.09). Patient-physician language concordance was associated with lower odds of CRC screening among Asians but not Latinos (Asian AOR=0.50, 95% CI 0.29, 0.86; Latino AOR=0.85, 95% CI 0.56, 1.28). Influenza vaccination did not differ by physician language use among either Latinos or Asians. Patient-physician language concordance was not associated with higher use of mammography, CRC screening, or influenza vaccination. Language concordance was negatively associated with CRC screening among Asians for reasons that require further research. Future research should isolate the impact of language concordance on the use of preventive care services from health system factors.

  13. Grading of Cerebral Glioma with Multiparametric MR Imaging and {sup 18}F-FDG-PET: Concordance and Accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jeong Hee; Kim, Ji-hoon; Sohn, Chul-Ho; Choi, Seung Hong; Yun, Tae Jin; Song, Yong Sub [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kang, Won Jun [Seoul National University Hospital, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Eun, Yong [Seoul National University, College of Medicine, Seoul (Korea, Republic of); Chang, Kee-Hyun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon (Korea, Republic of)

    2014-02-15

    To retrospectively evaluate concordance rates and predictive values in concordant cases among multiparametric MR techniques and FDG-PET to grade cerebral gliomas. Multiparametric MR imaging and FDG-PET were performed in 60 consecutive patients with cerebral gliomas (12 low-grade and 48 high-grade gliomas). As the dichotomic variables, conventional MRI, minimum apparent diffusion coefficient in diffusion-weighted imaging, maximum relative cerebral blood volume ratio in perfusion-weighted imaging, choline/creatine ratio and (lipid and lactate)/creatine ratio in MR spectroscopy, and maximum standardised uptake value ratio in FDG-PET in low- and high-grade gliomas were compared. Their concordance rates and positive/negative predictive values (PPV/NPV) in concordant cases were obtained for the various combinations of multiparametric MR techniques and FDG-PET. There were significant differences between low- and high-grade gliomas in all techniques. Combinations of two, three, four, and five out of the five techniques showed concordance rates of 77.0 ± 4.8 %, 65.5 ± 4.0 %, 58.3 ± 2.6 % and 53.3 %, PPV in high-grade concordant cases of 97.3 ± 1.7 %, 99.1 ± 1.4 %, 100.0 ± 0 % and 100.0 % and NPV in low-grade concordant cases of 70.2 ± 7.5 %, 78.0 ± 6.0 %, 80.3 ± 3.4 % and 80.0 %, respectively. Multiparametric MR techniques and FDG-PET have a concordant tendency in a two-tiered classification for the grading of cerebral glioma. If at least two examinations concordantly indicated high-grade gliomas, the PPV was about 95 %. (orig.)

  14. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Lin, Chunqing; Ji, Guoping; Xiao, Yongkang

    2016-01-01

    HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV− female couples, 98 HIV− male/HIV+ female couples, and 38 HIV-positive concordant couples, were included in the analyses. We collected data using the computer-assisted personal interview method. We used a linear mixed-effects regression model to assess whether gender differences in depressive symptoms varied across couple types. HIV-positive women reported a significantly higher level of depressive symptoms than their partners/spouses. HIV-positive women with HIV-positive partners had higher depressive symptoms than those with HIV-negative partners, whereas HIV-positive men reported similar levels of depressive symptoms regardless of their partners’ serostatus. Among the concordant couples, those with the highest annual family income showed the greatest gender differences in depressive symptoms. We suggest that family interventions should be gender- and couple-type specific and that mental health counseling is warranted not only for HIV-positive women but also for HIV-negative women in an HIV-affected relationship. PMID:28490832

  15. Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

    Science.gov (United States)

    Elledge, Julie

    2017-12-01

    As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

  16. [Concordance between preoperatory diagnosis and arthroscopy findings of meniscal lesions associated to anterior cruciate ligament injury].

    Science.gov (United States)

    Montiel-Jarquín, A; Barragán-Hervella, R; López-Cázares, G; Lima-Ramírez, P; Lázaro-Michaca, G; Vallecillo-Velázquez, H; Sánchez-Durán, M; Medina-Escobedo, C; Villatoro-Martínez, A

    2015-01-01

    Ligament injuries of the knee joint are common during the second and third decades of life, clinical and radiological diagnosis presents difficulties since the surgical findings may differ significantly. The objective is to determine correlation between clinical-radiologic and arthroscopic diagnosis in patients with injury of the anterior cruciate ligament (ACL) and meniscal lesions. Cross-sectional study held in 29 patients with ACL injury associated to meniscal lesions treated arthroscopically. Variables were age, gender, affected side, preoperative and postoperative diagnosis, type and location of meniscal injury; descriptive statistics and Cohen Kappa for concordance were used. There were 29 patients, 23 (79.3%) men and 6 (20.7%) women, mean age 39.04 (15-50) ± 13.19 years; right side was affected in 69% and left in 31%; 19% had not meniscal lesion, 17.2% had injury in anterior horn, 10.3% in posterior horn and 6.9% in the body. The concordance between preoperative and artroscopic diagnosis was: Kappa 0.2; intraboservador was Kappa 1.0; between suspected meniscal injury and arthroscopic findings was: Kappa 0.2. The concordance between the clinical-radiological and arthroscopic diagnosis in patients with ACL injuries and meniscal injury associated is low, which has to be considered in the initial review and the arthroscopic treatment of patients.

  17. Familial concordance for age at natural menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Morris, Danielle H; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J

    2011-09-01

    Existing estimates of the heritability of menopause age have a wide range. Furthermore, few studies have analyzed to what extent familial similarities might reflect shared environment, rather than shared genes. We therefore analyzed familial concordance for age at natural menopause and the effects of shared genetic and environmental factors on this concordance. Participants were 2,060 individuals comprising first-degree relatives, aged 31 to 90 years, and participating in the UK Breakthrough Generations Study. Menopause data were collected using a self-administered questionnaire and analyzed using logistic regression and variance-components models. Women were at an increased risk of early menopause (≤45 y) if their mother (odds ratio, 6.2; P menopause. Likewise, women had an increased risk of late menopause (≥54 y) if their relative had had a late menopause (mother: odds ratio, 6.1; P menopause age attributed to environmental factors shared by sisters. We confirm that early menopause aggregates within families and show, for the first time, that there is also strong familial concordance for late menopause. Both genes and shared environment were the source of variation in menopause age. Past heritability estimates have not accounted for shared environment, and thus, the effect of genetic variants on menopause age may previously have been overestimated.

  18. How doctors' communication style and race concordance influence African-Caribbean patients when disclosing depression.

    Science.gov (United States)

    Adams, A; Realpe, A; Vail, L; Buckingham, C D; Erby, L H; Roter, D

    2015-10-01

    To determine the impact of doctors' communication style and doctor-patient race concordance on UK African-Caribbeans' comfort in disclosing depression. 160 African-Caribbean and 160 white British subjects, stratified by gender and history of depression, participated in simulated depression consultations with video-recorded doctors. Doctors were stratified by black or white race, gender and a high (HPC) or low patient-centred (LPC) communication style, giving a full 2×2×2 factorial design. Afterwards, participants rated aspects of doctors' communication style, their comfort in disclosing depression and treatment preferences Race concordance had no impact on African-Caribbeans' comfort in disclosing depression. However a HPC versus LPC communication style made them significantly more positive about their interactions with doctors (p=0.000), their overall comfort (p=0.003), their comfort in disclosing their emotional state (p=0.001), and about considering talking therapy (p=0.01); but less positive about considering antidepressant medication (p=0.01). Doctors' communication style was shown to be more important than patient race or race concordance in influencing African Caribbeans' depression consultation experiences. Changing doctors' communication style may help reduce disparities in depression care. Practitioners should cultivate a HPC style to make African-Caribbeans more comfortable when disclosing depression, so that it is less likely to be missed. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  19. Learning medical professionalism with the online concordance-of-judgment learning tool (CJLT): A pilot study.

    Science.gov (United States)

    Foucault, Amélie; Dubé, Serge; Fernandez, Nicolas; Gagnon, Robert; Charlin, Bernard

    2015-01-01

    Professionalism development entails learning to make judgments in ambiguous situations. A Concordance of Judgment Learning Tool (CJLT), comprised of 20 vignettes involving professionalism issues, was developed. Students obtained a measure of how concordant their judgments were with a panel of experts and learned from given explanations. Twenty clinical vignettes implying professionalism issues were written including, for each, four possible courses of action. Expert panel, nominated by all clerkship students, was made up of attending physicians that best represented professionalism role models. Experts completed CJLT and gave explanations for their answers. All clerks were invited to answer each vignette, and then received automated expert feedback including explanations. Seventy-nine students sat for the activity. The optimized test included 20 cases and 54 questions (Cronbach's alpha coefficient of 0.64). Student - expert concordance scores ranged from 54 to 77 with a mean at 64.6 (standard deviation 5.1). Satisfaction survey results indicated high satisfaction and relevance of tool despite some pitfalls. Post-test focus group data revealed relevant experiential learning on professionalism issues. Students' scores and perceptions suggest pedagogic relevance of the CJLT in fostering professionalism development in clerkship. CJLT is user-friendly and shows promise as a situation experiential learning activity.

  20. Concordance between macrophytes and macroinvertebrates in a Mediterranean river of central Apennine region.

    Science.gov (United States)

    Traversetti, Lorenzo; Scalici, Massimiliano; Ginepri, Valeria; Manfrin, Alessandro; Ceschin, Simona

    2014-05-01

    The main aim of this study was to improve the knowledge about the concordance among macrophytes and macroinvertebrates to provide complementary information and facilitate the procedures for quality assessment of river ecosystems. Macrophytes and macroinvertebrates were collected in 11 sampling sites along a central Apennine calcareous river in October 2008 and June 2009. The concordance between the two biomonitoring groups was tested according to several environmental parameters. The comparison of data matrix similarities by Mantel test showed differences in the assemblage of macrophytes and macroinvertebrates along the river since correlation values were 0.04, p > 0.05 in October 2008 and 0.39, p > 0.05 in June 2009. The study revealed lack of concordance between the two groups, emphasizing that the information provided by macrophytes and macroinvertebrates does not overlap in terms of response to environmental parameters. Indeed, the two different biological groups resulted useful descriptors of different parameters. Together, they could represent a complementary tool to reflect the river environmental quality.

  1. Concordance of visual and manipulative responsiveness to novel and familiar stimuli: a function of test procedures or of prior experience?

    Science.gov (United States)

    Rubenstein, J

    1976-12-01

    Concordance of differential visual and manipulative responsiveness to novel stimuli at 6 months of age was found when differential attractiveness and familiarity of the stimuli were controlled. This finding corroborates the findings of an earlier study in which the same object was used as the familiarization object for all subjects. The data indicate that concordance at 6 months of age is not an artifact of the test procedure. A hypothesis suggested by the comparison of these findings with others in the literature is that the opportunity to manipulate a wide variety of objects in the natural environment may contribute to the concordance of visual and manipulative responsiveness to novel stimuli at this age.

  2. Correlates of non-concordance between perceived and objective measures of walkability.

    Science.gov (United States)

    Gebel, Klaus; Bauman, Adrian; Owen, Neville

    2009-04-01

    Objective and self-reported physical environmental attributes have been related to physical activity. We examined the characteristics of adults who are resident in objectively identified high walkable neighborhoods but whose perceptions of neighborhood attributes are not concordant with objective attributes relating to high walkability. Neighborhood built-environment attributes relating to walkability (dwelling density, intersection density, land use mix, and net retail area) were determined objectively, using Geographic Information System databases; data on corresponding perceptions of local environment attributes (from the Neighborhood Environment Walkability Scale) were derived from a self-completion survey of a socially diverse sample of 2,650 adults aged 19 to 65. Objective and perceived walkability attributes were categorized using median splits, and correlates of non-concordance were determined using multiple logistic regression models. There was a fair overall agreement between objectively determined walkability and perceived walkability (Kappa = 0.35, 95% CI = 0.31-0.39). Among those resident in objectively assessed high walkable areas (n = 1,063), 32.1% perceived them to be low walkable; conversely, 32.7% (n = 1,021) resident in objectively determined low walkability areas perceived them to be high. For residents of objectively determined high walkable areas, the characteristics that differentiated those with perceptions of low walkability (non-concordant perceptions) from those with concordant perceptions of high walkability were: not being university-educated (OR = 1.47, 95% CI = 1.06-2.04); having lower household incomes (OR = 1.54, 95% CI = 1.09-2.17); being overweight (OR = 1.46, 95% CI = 1.03-2.07); and walking fewer days per week for transport (OR = 1.75, 95% CI = 1.11-2.70). Higher walking times and more positive cognitive variables were noted among participants who lived in a neighborhood with low walkability that was perceived as high compared

  3. Concordance between myocardial perfusion scan assessed by SPECT and fractional flow reserve findings for detection of significant ischemia

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2016-09-01

    Conclusion: FFR and MPI with SPECT techniques showed significant concordance for detection of myocardial ischemia, regardless of the type of diseased coronary arteries. In this context, SPECT has high sensitivity and NPV for detection of ischemia compared with FFR.

  4. Fine Needle Aspiration Using Improved Agar Microbiopsy is Highly Concordant With Renal Mass Final Diagnosis and Subclassification

    NARCIS (Netherlands)

    Schieven, Louise W.; Smedts, Frank; Hopman, Anton H.; van der Wijk, Jan; Nijman, Rien J.; de Jong, Igle J.

    2009-01-01

    Purpose: Computerized tomography and ultrasound are usually sufficient for preoperative evaluation of renal masses greater than 5 cm. For renal masses less than 5 cm additional histological evaluation could improve diagnosis and treatment decisions. We investigated the concordance between an

  5. Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact.

    Science.gov (United States)

    Sanders, Justin J; Curtis, J Randall; Tulsky, James A

    2018-03-01

    High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve "goal-concordant" care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both.

  6. Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

    OpenAIRE

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin; Trivedi, Madhukar H.

    2010-01-01

    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician (“concordant patients”) were defined as having a standardiz...

  7. Brief report: parent-adolescent child concordance in social norms related to gender equity in marriage - findings from rural India.

    Science.gov (United States)

    Raj, Anita; Ghule, Mohan; Battala, Madhusudana; Dasgupta, Anindita; Ritter, Julie; Nair, Saritha; Saggurti, Niranjan; Silverman, Jay G; Balaiah, Donta

    2014-10-01

    The purpose of this exploratory study was to assess parent-adolescent child concordance on social norms related to gender equity in marriage in rural Maharashtra, India. Survey data on marital norms related to girl's marital age and choice, contraception, and marital violence (MV) were collected from unmarried adolescents (n = 113 girls, 116 boys) and their parents (n = 227 mothers, 203 fathers). Concordance was assessed using a Cohen's unweighted Kappa statistic, with analyses stratified by sex of parent and child. Analyses revealed fair (K = .25-.27) mother-daughter concordance on girls' right to choose when to marry, contraception use, and acceptability of MV. Father-son concordance was seen on girls' right to choose when (K = .22, slight) and who (K = .20, fair) to marry and MV acceptability (K = .53, moderate). No opposite sex parent-child concordance was revealed. Results indicate same but not opposite sex parent-child concordance on gender equity social norms related to marriage, suggesting same sex transfer of these norms. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  8. Parent-Adolescent Child Concordance in Social Norms related to Gender Equity in Marriage- Findings from Rural India

    Science.gov (United States)

    Raj, Anita; Ghule, Mohan; Battala, Madhusudana; Dasgupta, Anindita; Ritter, Julie; Nair, Saritha; Saggurti, Niranjan; Silverman, Jay; Balaiah, Donta

    2014-01-01

    The purpose of this exploratory study was to assess parent-adolescent child concordance on social norms related to gender equity in marriage in rural Maharashtra, India. Survey data on marital norms related to girl’s marital age and choice, contraception, and marital violence (MV) were collected from unmarried adolescents (n=113 girls, 116 boys) and their parents (n=227 mothers, 203 fathers). Concordance was assessed using a Cohen’s unweighted Kappa statistic, with analyses stratified by sex of parent and child. Analyses revealed fair (K=.25-.27) mother-daughter concordance on girls’ right to choose when to marry, contraception use, and acceptability of MV. Father-son concordance was seen on girls’ right to choose when (K=.22, slight) and who (K=.20, fair) to marry and MV acceptability (K=.53, moderate). No opposite sex parent-child concordance was revealed. Results indicate same but not opposite sex parent-child concordance on gender equity social norms related to marriage, suggesting same sex transfer of these norms. PMID:25173179

  9. Implications of community concordance for assessing stream integrity at three nested spatial scales in Minnesota, U.S.A.

    Science.gov (United States)

    Dolph, C.L.; Huff, D.D.; Chizinski, C.J.; Vondracek, B.

    2011-01-01

    Fish and invertebrate assemblage data collected from 670 stream sites in Minnesota (U.S.A.) were used to calculate concordance across three nested spatial scales (statewide, ecoregion and catchment). Predictive taxa richness models, calibrated using the same data, were used to evaluate whether concordant communities exhibited similar trends in human-induced taxa loss across all three scales. Finally, we evaluated the strength of the relationship between selected environmental variables and the composition of both assemblages at all three spatial scales. Significant concordance between fish and invertebrate communities occurred at the statewide scale as well as in six of seven ecoregions and 17 of the 21 major catchments. However, concordance was not consistently indicative of significant relationships between rates of fish and invertebrate taxa loss at those same scales. Fish and invertebrate communities were largely associated with different environmental variables, although the composition of both communities was strongly correlated with stream size across all three scales. Predictive taxa-loss models for fish assemblages were less sensitive and precise than models for invertebrate assemblages, likely because of the relatively low number of common fish taxa in our data set. Both models, however, distinguished reference from non-reference sites. The importance of concordance, geographic context and scale are discussed in relation to the design and interpretation of stream integrity indicators. In particular, our findings suggest that community concordance should not be viewed as a substitute for an evaluation of how assemblages respond to environmental stressors. ?? 2011 Blackwell Publishing Ltd.

  10. [Diabetic retinopathy screening programme in primary health care. Diagnostic concordance between family and eye care practitioners].

    Science.gov (United States)

    Alonso Porcel, C; Martínez Ibán, M; Arboleya Álvarez, L; Suárez Gil, P; Sánchez Rodríguez, L M

    2016-09-01

    To evaluate the diagnostic concordance in retinography interpretation between primary care and eye care practitioners and assess the soundness index of a diabetic retinography screening programme during its implementation stage. Descriptive, observational study was conducted on a sample of 243 patients with diabetes mellitus (type 1 and 2) over age 14, in 2 urban health care centers, gathered in an opportunistic manner between the dates of 21/07/2011 and 26/01/2012. A 45° digital bilateral retinography, intraocular pressure and visual acuity were obtained from each patient. The primary care practitioners prepared a report for each patient, which was telematically sent to the eye care doctor within the corresponding retinographies. A new diagnostic report was prepared then by the eye care doctor after revising the images. The lack of retinographies and/or reports were considered both as losses. The diagnostic concordance between the observers and the validity and reliability from the screening programme were estimated. The kappa value obtained was 0.62 (95% CI 0.42-0.82) and 0.89 PABAK. The following validity indexes were obtained: Sensitivity 68.8%, specificity 96.5%, positive and negative predictive values: 61.1 and 97.5%, respectively. A percentage of 57.2 of the patients were not observed any pathology requiring referral to a eye care doctor. The concordance value obtained varied between considerable and almost perfect, depending on the index used for the analysis (kappa/PABAK, respectively). It's worth highlighting that carrying out retinographies in the primary care centers enhances patient-treatment capacity of the primary care doctors and the patients accessibility to screening. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Concordance of In-Home "Smart" Scale Measurement with Body Weight Measured In-Person.

    Science.gov (United States)

    Ross, Kathryn M; Wing, Rena R

    2016-06-01

    Newer "smart" scales that transmit participants' body weights directly to data collection centers offer the opportunity to simplify weight assessment in weight management research; however, little data exist on the concordance of these data compared to weights measured at in-person assessments. We compared the weights of 58 participants (mean±SD BMI = 31.6±4.8, age = 52.1±9.7 years, 86.2% White, 65.5% Female) measured by study staff at an in-person assessment visit to weights measured on the same day at home using BodyTrace "smart" scales. These measures occurred after 3 months of an internet-based weight management intervention. Weight (mean±SD) measured at the 3-month in-person assessment visit was 81.5±14.7kg compared to 80.4±14.5kg measured on the same day using in-home body weight scales; mean bias =1.1±0.8kg, 95% limits of agreement = -0.5 to 2.6. Two outliers in the data suggest that there may be greater variability between measurements for participants weighing above 110 kg. Results suggest good concordance between the measurements and support the use of the BodyTrace smart scale in weight management research. Future trials using BodyTrace scales for outcome assessment should clearly define protocols for measurement and associated instructions to participants (e.g., instruct individuals to weigh at the same time of day, similarly clothed). Finally, measure concordance should be investigated in a group of individuals weighing more than 110kg.

  12. Prostate cancer: concordance between 18F-choline PET and CT in biochemical relapse

    International Nuclear Information System (INIS)

    Herández Pinzón, J.; Ferrarotti, C.; Ferrari, L.; Larrañaga, N.; Gallo, J.C.; Mena, D.; Bastianello, M.

    2016-01-01

    Objective: To establish the concordance between 18-fluor choline positron emission tomography (PET) and computed tomography (CT) for re-staging patients with biochemical relapse of prostate cancer according to the TNM system. Materials and methods: The medical records of the Molecular Imaging Section were retrospectively reviewed. The TNM classification was established by us for each method, and the Kappa concordance statistic was used to classify the results according to the Landis and Koch proposal. Results: The PET-choline reported 19 (59.4%) patients N0 and 13 (40.6%) N1, while CT reported 28 (87.5%) N0 and 4 (12.5%) N1. In metastasis classification PET-choline established M0 in 17 (53.1%) patients, M1a in 1 (3.1%), M1b in 5 (15.6%), M1c in 1 (3.1%), M1a + M1b in 7 (21.9%), and M1b + M1c in 1 (3.1%). On the other hand, CT was M0 in 23 (71.9%) patients, M1a in 2 (6.25%), M1a + M1b in 2 (6.25%), and M1b + M1c in 5 (15.6%). The correlation between PET-choline and CT in the TNM lymph node and metastasis classifications was 71.88%, with a Kappa of 0.3455 (standard error 0.1336; P=.0049) and 62.5% with Kappa 0.3725 (standard error 0.0847; P=.0001), respectively. Discussion: Several studies have shown a high diagnostic accuracy of PET-choline detecting the spread of the disease compared to conventional methods. Conclusion: There is poor concordance for metastatic and lymph node classifications according to the TNM system between choline-PET and CT. (authors) [es

  13. Mismatch repair deficiency concordance between primary colorectal cancer and corresponding metastasis.

    Science.gov (United States)

    Haraldsdottir, Sigurdis; Roth, Rachel; Pearlman, Rachel; Hampel, Heather; Arnold, Christina A; Frankel, Wendy L

    2016-04-01

    Universal screening for mismatch repair deficiency (dMMR) in cancer is increasingly being implemented to detect Lynch syndrome and aid in treatment decisions. The mismatch repair (MMR) immunohistochemistry (IHC) concordance rate between primary colorectal cancer (CRC) and metastasis is unknown. At times, only metastatic tumor is available for screening (lymph node, liver, lung etc.) rather than the primary tumor. Therefore, it is important to confirm that tissue from metastases can be used for screening for dMMR. We tested dMMR primary and metastatic tumor to assess concordance between the two. We identified dMMR CRC resected at Ohio State University from 1999 to 2013 and stained a corresponding metastasis for all four MMR proteins (MLH1, MSH2, MSH6, PMS2) with IHC. A total of 50 primary CRC with dMMR and available regional lymph nodes (LN; 26 cases) or other metastatic tissue (24 cases) were identified. Thirteen cases were explained by MLH1 hypermethylation and 10 cases had Lynch syndrome. Two cases had somatic MMR mutations and the etiology for dMMR was unknown in 25 cases. All cases showed concordance in IHC staining between the primary tumor and corresponding metastatic tissue. In 36 cases, metastatic LN/other site was resected at the same time as the primary tumor. In 14 cases, time lapsed [median 16.5 months; quartile (Q)1 8.0; Q3 25; range 3-69] from the primary resection until metastatic resection. Metastatic tissue can be used to screen for Lynch syndrome and dMMR.

  14. [Concordance in the registry of dementia among the main sources of clinical information].

    Science.gov (United States)

    Marta-Moreno, Javier; Obón-Azuara, Blanca; Gimeno-Felíu, Luis; Achkar-Tuglaman, Nesib Nicolás; Poblador-Plou, Beatriz; Calderón-Larrañaga, Amaia; Prados-Torres, Alexandra

    2016-01-01

    The objective of this work was to analyse the concordance in the registry of dementia among the main sources of clinical information, with the aim of determining their usefulness for epidemiological and clinical research. Descriptive study of patients assigned to the Aragon Health Service in 2010 (n=1,344,891). (i)the pharmacy billing database (n=9,392); (ii)Primary Care electronic health records (EHR) (n=9,471), and (iii)the hospital minimum basic data set (n=3,289). When studying the concordance of the databases, the group of patients with a specific treatment for dementia (i.e., acetylcholinesterase inhibitors and/or memantine) was taken as the reference. The diagnosis in Primary Care was missing for 47.3% of patients taking anti-dementia drugs. The same occurred with 38.3% of dementia patients admitted to hospital during the study year. Among patients with a diagnosis of dementia in the EHR, only half (52.3%) was under treatment for this condition. This percentage decreased to 34.4% in patients with the diagnosis registered in the hospital database. The weak concordance in the registry of the dementia diagnosis between the main health information systems makes their use and analysis more complex, and supports the need to include all available health data sources in order to gain a global picture of the epidemiological and clinical reality of this health condition. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Concordance between brain 18F-FDG PET and cerebrospinal fluid biomarkers in diagnosing Alzheimer's disease.

    Science.gov (United States)

    Rubí, S; Noguera, A; Tarongí, S; Oporto, M; García, A; Vico, H; Espino, A; Picado, M J; Mas, A; Peña, C; Amer, G

    Cortical posterior hypometabolism on PET imaging with 18 F-FDG (FDG-PET), and altered levels of Aß 1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß 1-42 , tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß 1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive of AD from one non-suggestive of AD, with a 91% sensitivity and 93% specificity at the cut-off line Aß 1-42 =44+1.3×tTau. The level of concordance between FDG-PET and CSF biomarkers was moderate, indicating their complementary value in diagnosing AD. The Aß 1-42 and tTau levels in CSF help to predict the patient FDG-PET cortical metabolic status. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  16. Lack of Patient-Clinician Concordance in Cancer Patients: Its Relation With Patient Variables.

    Science.gov (United States)

    Chandwani, Kavita D; Zhao, Fengmin; Morrow, Gary R; Deshields, Teresa L; Minasian, Lori M; Manola, Judith; Fisch, Michael J

    2017-06-01

    Patients with cancer are bothered by its diagnosis, treatment, and associated uncertainty. Lack of concordance (LOC) of patients' reporting of their symptoms and quality of life (QOL) with that of their clinicians has been observed in cancer care. However, information regarding the reporting of patients' bother due to aspects of cancer experience and their clinicians' assessment is lacking. The objective was to describe cancer patients' bother due to aspects of their disease experience and explore the concordance (LOC) or a lack thereof between patients' and clinicians' reporting of patients' bother and factors associated with it. Data from a prospective study of cancer patients' symptoms were analyzed. LOC was defined as any discrepancy between patient-clinician pairs in reporting patients' bother due to disease, cancer treatment, comorbidity, and side effects of symptom management. The relation of LOC to patients' QOL and distress was also explored. Of the 2597 patients analyzed, a perfect concordance was observed in 37%-42%. Clinicians underestimated the severity of bother in 62%-76% of discordant cases. LOC was significantly associated with patient-reported distress and poor QOL. Referral for symptom management was associated with the clinician's rating of patients' bother, and LOC was associated with likelihood of poor compliance with recommendations for symptom management. Majority of clinicians tended to underestimate cancer patients' bother, and this was associated with poor QOL of cancer patients and their distress. Future studies should examine the LOC and its correlates to confirm the results of this study. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. Single nucleotide polymorphisms concordant with the horned/polled trait in Holsteins

    Directory of Open Access Journals (Sweden)

    Nissing Nick J

    2008-12-01

    Full Text Available Abstract Background Cattle that naturally do not grow horns are referred to as polled, a trait inherited in a dominant Mendelian fashion. Previous studies have localized the polled mutation (which is unknown to the proximal end of bovine chromosome 1 in a region approximately 3 Mb in size. While a polled genetic test, Tru-Polled™, is commercially available from MetaMorphix Inc., Holsteins are not a validated breed for this test. Findings Approximately 160 kb were sequenced within the known polled region from 12 polled and 12 horned Holsteins. Analysis of the polymorphisms identified 13 novel single nucleotide polymorphisms (SNPs that are concordant with the horned/polled trait. Three of the 13 SNPs are located in gene coding or regulatory regions (e.g., the untranslated region, or UTR where one is located in the 3'UTR of a gene and the other two are located in the 5'UTR and coding region (synonymous SNP of another gene. The 3'UTR of genes have been shown to be targets of microRNAs regulating gene expression. In silico analysis indicates the 3'UTR SNP may disrupt a microRNA target site. Conclusion These 13 novel SNPs concordant with the horned/polled trait in Holsteins represent a test panel for the breed and this is the first report to the authors' knowledge of SNPs within gene coding or regulatory regions concordant with the horned/polled trait in cattle. These SNPs will require further testing for verification and further study to determine if the 3'UTR SNP may have a functional effect on the polled trait in Holsteins.

  18. Candidate region linkage analysis in twins discordant or concordant for depression symptomatology

    DEFF Research Database (Denmark)

    Christiansen, Lene; Tan, Q; Kruse, T A

    2009-01-01

    from 4,731 participants of the Longitudinal Study of Ageing Danish Twins. Our results showed suggestive evidence of linkage to this region with a peak LOD score of 1.91 for marker D12S1634 located at 148 cM, and thus indicates that the previously identified disease locus at 12q24 is also a general...... for a common susceptibility locus in affective disorders on chromosome 12q24. In this study we investigated the chromosome 12 candidate region for linkage to the mean level of depression symptomatology, over a 10-year follow-up, using a highly informative sample of concordant and discordant twin pairs selected...

  19. Beyond concordance cosmology with magnification of gravitational-wave standard sirens.

    Science.gov (United States)

    Camera, Stefano; Nishizawa, Atsushi

    2013-04-12

    We show how future gravitational-wave detectors would be able to discriminate between the concordance Λ cold dark matter cosmological model and up-to-date competing alternatives, e.g., dynamical dark energy (DE) models or modified gravity (MG) theories. Our method consists of using the weak-lensing magnification effect that affects a standard-siren signal because of its traveling through the Universe's large scale structure. As a demonstration, we present constraints on DE and MG from proposed gravitational-wave detectors, namely Einstein Telescope and DECI-Hertz Interferometer Gravitational-Wave Observatory and Big-Bang Observer.

  20. Exploring the Circulation Dynamics of Mississippi Sound and Bight Using the CONCORDE Synthesis Model

    Science.gov (United States)

    Pan, C.; Dinniman, M. S.; Fitzpatrick, P. J.; Lau, Y.; Cambazoglu, M. K.; Parra, S. M.; Hofmann, E. E.; Dzwonkowski, B.; Warner, S. J.; O'Brien, S. J.; Dykstra, S. L.; Wiggert, J. D.

    2017-12-01

    As part of the modeling effort of the GOMRI (Gulf of Mexico Research Initiative)-funded CONCORDE consortium, a high resolution ( 400 m) regional ocean model is implemented for the Mississippi (MS) Sound and Bight. The model is based on the Coupled Ocean Atmosphere Wave Sediment Transport Modeling System (COAWST), with initial and lateral boundary conditions drawn from data assimilative 3-day forecasts of the 1km-resolution Gulf of Mexico Navy Coastal Ocean Model (GOM-NCOM). The model initiates on 01/01/2014 and runs for 3 years. The model results are validated with available remote sensing data and with CONCORDE's moored and ship-based in-situ observations. Results from a three-year simulation (2014-2016) show that ocean circulation and water properties of the MS Sound and Bight are sensitive to meteorological forcing. A low resolution surface forcing, drawn from the North America Regional Reanalysis (NARR), and a high resolution forcing, called CONCORDE Meteorological Analysis (CMA) ) that resolves the diurnal sea breeze, are used to drive the model to examine the sensitivity of the circulation to surface forcing. The model responses to the low resolution NARR forcing and to the high resolution CMA are compared in detail for the CONCORDE Fall and Spring field campaigns when contemporaneous in situ data are available, with a focus on how simulated exchanges between MS Sound and MS Bight are impacted. In most cases, the model shows higher simulation skill when it is driven by CMA. Freshwater plumes of the MS River, MS Sound and Mobile Bay influence the shelf waters of the MS Bight in terms of material budget and dynamics. Drifters and dye experiments near Mobile Bay demonstrate that material exchanges between Mobile Bay and the Sound, and between the Sound and Bight, are sensitive to the wind strength and direction. A model - data comparison targeting the Mobile Bay plume suggests that under both northerly and southerly wind conditions the model is capable of

  1. Enhancing shared decision making through assessment of patient-clinician concordance on decision quality

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Selby, Warwick; Salkeld, Glenn

    ) of the 8 MDQ criteria (options, effects, importance, chances; trust, support, control, commitment) were elicited and fed back in decomposed formats, along with concordance measures (Mean Squared Difference (MSD), Mean Absolute Difference (MAD)). The Incremental Values of Perfect Ratings were calculated...... on both W and R for options and control, but otherwise a discordant W distribution. The other dyad showed more discordant W and R. The MSDs of W and R were .0275 and .0175 for the former patient and .0150 and .0025 for the latter. The MADs of W and R were .1250 and .1000 for the former and .1000 and .0250...

  2. Concordance between preoperative and postoperative assessments of primary caries lesion depth: results from the Dental PBRN

    DEFF Research Database (Denmark)

    Nascimento, Marcelle M; Bader, James D; Qvist, Vibeke

    2010-01-01

    This study investigated the concordance between pre- and postoperative assessments of primary caries lesion depths by dentists from The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org). A total of 229 DPBRN dentists collected data on 8,351 consecutive restorations inserted due...... to primary caries in 5,810 patients. Dentists estimated the preoperative depth of caries lesions based on the diagnostic methods they typically used. The preoperative depth was then compared to the postoperative depth, which dentists determined using actual clinical observation. Both estimated and observed...

  3. A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members.

    Science.gov (United States)

    Dam, Alieske E H; Boots, Lizzy M M; van Boxtel, Martin P J; Verhey, Frans R J; de Vugt, Marjolein E

    2017-06-13

    Access to social support contributes to feelings of independence and better social health. This qualitative study aims to investigate multi-informant perspectives on informal social support in dementia care networks. Ten spousal caregivers of people with dementia (PwD) completed an ecogram, a social network card and a semi-structured interview. The ecogram aimed to trigger subjective experiences regarding social support. Subsequently, 17 network members were interviewed. The qualitative analyses identified codes, categories, and themes. Sixth themes emerged: (1) barriers to ask for support; (2) facilitators to ask for support; (3) barriers to offer support; (4) facilitators to offer support; (5) a mismatch between supply and demand of social support; and (6) openness in communication to repair the imbalance. Integrating social network perspectives resulted in a novel model identifying a mismatch between the supply and demand of social support, strengthened by a cognitive bias: caregivers reported to think for other social network members and vice versa. Openness in communication in formal and informal care systems might repair this mismatch.

  4. Gender differences in caregiver strain, needs for support, social support, and quality of life among spousal caregivers of persons with multiple sclerosis.

    Science.gov (United States)

    Lee, Eun-Jeong; Pieczynski, Jessica; DeDios-Stern, Samantha; Simonetti, Camille; Lee, Gloria K

    2015-01-01

    Caregivers of individuals with MS may experience unique caregiver strain due to the age at onset and progressive nature of the disease. Additionally, because MS is more prevalent in women, men often become spousal caregivers. However, gender differences in psychosocial adjustment among caregivers have not been fully explored. The purpose of this study was to explore gender differences in the need for various supports and type of social support needed, caregiver strain, and quality of life among caregivers for individuals with MS. 106 caregivers participated in this study. Independent sample t-tests and multiple regression analyses were conducted to examine gender differences in strain, need for supports, social support, and quality of life. Analyses revealed gender difference among important psychosocial variables. Specifically, women reported higher levels of caregiver strain, higher needs for emotional support, and higher perceived social support. Additionally, multiple regression analyses revealed an inverse relationship between expressed emotional needs and quality of life for men, but not for women. MS caregivers experience significant strain that diminishes quality of life. Social support and needs fulfillment can act to buffer this stress; however, results indicate that this varies by gender, with gender differences observed in strain, perceived support, and expressed needs among MS caregivers. The study implications for rehabilitation research are discussed.

  5. Dealing with daily challenges in dementia (deal-id study): process evaluation of the experience sampling method intervention 'Partner in Sight' for spousal caregivers of people with dementia.

    Science.gov (United States)

    van Knippenberg, Rosalia J M; de Vugt, Marjolein E; Smeets, Claudia M J; Myin-Germeys, Inez; Verhey, Frans R J; Ponds, Rudolf W

    2017-07-17

    This study describes the process evaluation of the experience sampling method (ESM) intervention 'Partner in Sight' for spousal caregivers of people with dementia. The aim was to determine internal and external validity of the intervention and provide information for future implementation in clinical practice. Qualitative and quantitative data on sampling quality (recruitment and randomization, reach) and intervention quality (relevance and feasibility, adherence to protocol) were evaluated using descriptive statistics and conventional content analysis. The participation rate included 31.4%. Due to recruitment difficulties and time constraints the original goal to include 90 caregivers was not met. The intervention was largely performed according to protocol and well received by the participants. Overall, the ESM-derived feedback was considered supportive and increased participants' awareness of their feelings and behavior. A large variance was found in the extent to which caregivers applied the feedback into their daily lives. The importance of the personal coach to provide face-to-face feedback and stimulate caregivers to implement new insights into their daily lives was emphasized. Suggestions for improvement were to reduce the time intensity of the program, to better tailor the program content to one's personal situation, and to improve the ESM device. Although recruitment barriers were encountered, results indicate that future implementation of the ESM intervention 'Partner in Sight' is likely to be feasible in regular health care. If the intervention turns out to be (cost-) effective, a fine-tuned version of the program could be a valuable addition to the current health care system.

  6. Cognitive reserve and self-efficacy as moderators of the relationship between stress exposure and executive functioning among spousal dementia caregivers.

    Science.gov (United States)

    Pertl, M M; Hannigan, C; Brennan, S; Robertson, I H; Lawlor, B A

    2017-04-01

    A substantial literature has reported that stress negatively impacts on cognitive processes. As dementia caregiving can be stressful, it has been hypothesized that the challenges of dementia care may increase caregivers' own vulnerability to cognitive decline. Prefrontal processes are thought to be most vulnerable to stress; however, few studies have examined whether greater caregiver stress predicts poorer executive dysfunction, and no previous research has considered potential moderators of this relationship. We examined (1) whether greater psychological stress mediated a relationship between caregiver stress exposure and executive functioning and (2) whether greater self-efficacy and cognitive reserve (CR) moderated this relationship. Spousal dementia caregivers (n = 253) completed the Neuropsychiatric Inventory Questionnaire (stress exposure), the Perceived Stress Scale, the National Adult Reading Test (CR), the Fortinsky dementia-specific caregiver self-efficacy scale, and the Color Trails Test (executive functioning). Moderated mediation was tested using the PROCESS macro. Age, gender, and dementia risk factors were included as covariates. Greater stress exposure indirectly predicted executive functioning through psychological stress. Stronger relationships between greater psychological stress and poorer executive functioning were observed among caregivers with lower CR; there was no evidence that self-efficacy moderated the relationship between stress exposure and psychological stress. Our findings are in line with the idea that greater psychological stress in response to challenges associated with dementia care predicts poorer caregiver executive functioning, particularly among caregivers with low CR. However, these findings are cross sectional; it is also possible that poorer executive functioning contributes to greater caregiver stress.

  7. He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status

    Science.gov (United States)

    Berge, Jerica M.; MacLehose, Richard F; Meyer, Craig; Didericksen, Katharine; Loth, Katie A.; Neumark-Sztainer, Dianne

    2015-01-01

    Introduction Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. Objective The main objective of the study is to examine whether and how parental concordance/discordance on factors in the home environment (e.g., importance of family meals, parent feeding practices, encouraging child physical activity, limit setting on child screen time) are associated with adolescent health behaviors and weight status. Design Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents’ health behaviors and weight status. Participant/Settings Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age = 14.3 years) and their parents (n=2,104; 52% female; mean age = 41.0 years) from Minneapolis and St. Paul, Minnesota participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parental concordance on home environment factors was high for some factors (e.g., 68% concordance on not pressuring adolescent to eat) and low for other factors (e.g., 2% concordance on parent engaging in physically activity with child 4+ hours/week). Parental concordance on positive home environment factors (e.g., frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (p adolescents had higher consumption of fast food and more unhealthy weight control behaviors (p adolescent health behaviors and weight status. PMID

  8. Concordance between otic cytology and culture in diagnosis of external otitis canine by Malassezia spp

    Directory of Open Access Journals (Sweden)

    Adriana Pulido-Villamarín

    2015-09-01

    Full Text Available Objective. To determine the correlation between microbiological culture and otic cytology for diagnoses of external otitis by Malassezia in dogs. Materials and methods. 158 ear swabs of dogs with clinical diagnosis of external otitis were analyzed by cytology, mycological culture and metabolic tests. Results. Were obtained a positive results by cytology of 62% and 75.3% by culture. The 31.1% of isolates were identified as M. pachydermatis, 12.6% as M. furfur and 56.3% were classified as Malassezia spp., because was not possible to define the species. We found a positive concordance between cytology and culture for Malassezia spp., of 0.76 with a kappa index of 0.448 (95% CI 0.30 to 0.60 which represents a moderate strength of concordance between the two techniques, without regard the identified species. Conclusions. The use of a diagnostic test is not enough to establish the participation of Malassezia spp., as a causal disease agent.

  9. Hair analysis and its concordance with self-report for drug users presenting in emergency department.

    Science.gov (United States)

    Sharma, Gaurav; Oden, Neal; VanVeldhuisen, Paul C; Bogenschutz, Michael P

    2016-10-01

    Secondary analysis using data from the National Drug Abuse Treatment Clinical Trials Network randomized trial (NCT # 01207791), in which 1285 adult ED patients endorsing moderate to severe problems related to drug use were recruited from 6 US academic hospitals. To investigate the utility of hair analysis in drug use disorder trials with infrequent visits, and its concordance with Timeline Follow Back (TLFB). This study compared the self-reported drug use on the TLFB instrument with the biological measure of drug use from hair analysis for four major drug classes (Cannabis, Cocaine, Prescribed Opioids and Street Opioids). Both hair analysis and TLFB were conducted at 3, 6 and 12 month follow-up visit and each covered a 90-day recall period prior to the visit. The concordance between the hair sample results and the TLFB was high for cannabis and street opioids, but was low to moderate for cocaine and prescribed opioids. Under-reporting of drug use given the positive hair sample was always significantly lower for the drug the study participant noted as their primary drug of choice compared with other drugs the participant reported taking, irrespective of whether the drug of choice was cannabis, cocaine, street opioids and prescribed opioids. Over-reporting of drug use given the negative hair sample was always significantly higher for the drug of choice, except for cocaine. This study extends the literature on hair analysis supporting its use as a secondary outcome measure in clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships

    Science.gov (United States)

    Blumberg, Jeffrey B.; Vita, Joseph A.; Chen, C. -Y. Oliver

    2015-01-01

    Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages. PMID:26633488

  11. Concordance of Attachment Representations in Mother-/Father-Child Dyads and between Siblings

    Directory of Open Access Journals (Sweden)

    Marie Stievenart

    2013-07-01

    Full Text Available This study focuses on the concordance of attachment representations in two-parent, two-child families as an original contribution to the current attachment literature. It uses both categorical attachment patterns and continuous scores. Data was collected on 92 native French-speaking Belgian families. In order to disentangle conceptual and methodological interpretations, each hypothesis was tested in two complementary ways: first in a sample where the parent completed the 'Cartes pour les Modèles Internes de Relation' (CaMir and their young children (four- to seven-year-olds the French version of the 'Attachment Story Completion Task'(Fr-ASCT and second, in a sample where both parents and their teenage to young-adult children (15- to 34-year-olds completed the CaMir. Our results indicated very little if any concordance of attachment representations, either when using categorical scores or when using continuous scores. The implications of these results for both theoretical and research purposes are discussed.

  12. Monozygotic twins with Neurofibromatosis type 1, concordant phenotype and synchronous development of MPNST and metastasis

    Directory of Open Access Journals (Sweden)

    Melean German

    2010-08-01

    Full Text Available Abstract Background Neurofibromatosis type 1 is a common autosomal dominant disorder with full penetrance and variable expression. The condition predisposes individuals to the development of malignant nervous system tumours, most frequently Malignant Peripheral Nerve Sheath Tumours (MPNSTs. Previous studies indicate that genetic factors other than mutations in NF1 may be responsible for the condition's variable expression. Case report Here we present data from a pair of monozygotic twins affected by Neurofibromatosis type 1 resulting from a de novo mutation. Both twins developed a left sciatic plexiform neurofibroma that evolved into MPNST at a similar age and they also developed pulmonary metastasis at the same age. Other concordant traits between the twins were: macrocephaly, psychomotor delay, café-au-lait spots, cutaneous neurofibromas, retroperitoneal, pleural and paraspinal neurofibromas. The main discordant features observed were tibial pseudoarthrosis, pectus carinatum, osteoporosis and thymus hyperplasia. Conclusions This is the first report of monozygotic twins with Neurofibromatosis type 1 that develop MPNSTs, the localization and chronological evolution of which, and its metastasis, is concordant in both twins. These cases suggest that the events involved in the transformation of benign plexiform neurofibromas to MPNSTs in Neurofibromatosis type 1, follow a spatiotemporally programme that is influenced by heritable factors other than NF1 mutations.

  13. Concordance between Self and Standardized Patient Ratings of Medical Students' Communication Skills.

    Science.gov (United States)

    Je, Min Ji; Lee, Su Hyun; Lee, Chang Hyung; Kim, Sung Soo

    2013-03-01

    The purpose of this study was to examine the concordance between self and standardized patient (SP) ratings of medical students' communication skills. Forty-three students interviewed SPs. The students were asked to complete a communication skills questionnaire that comprised 2 measures (empathy and interpersonal communication) before the interview. After each student's interview with the SP, the latter completed the same questionnaire as the students. Based on Lin's concordance coefficient, there was strong disconcordance between students' self-ratings and the SPs' ratings. With regard to empathic communication, more than 50% of students who considered themselves higher than middle level were regarded by SP as low level. On interpersonal communication, 39% of students who assessed themselves as higher than middle level were scored low level by SPs. There was strong disconcordance between students' self-ratings and the SPs' ratings-students tended to overevaluate themselves regarding their communication skills. These differences might result in patient dissatisfaction and noncompliance. Further, it could become a serious hindrance to the development of a good doctor-patient relationship. Medical educators should make sincere efforts to reduce this gap by teaching medical students the importance of the patients' perception of his doctors' communication skills.

  14. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.

    Science.gov (United States)

    Mueller, Stephanie K; Schnipper, Jeffrey L; Giannelli, Kyla; Roy, Christopher L; Boxer, Robert

    2016-09-01

    Dispersion of inpatient care teams across different medical units impedes effective team communication, potentially leading to adverse events (AEs). To regionalize 3 inpatient general medical teams to nursing units and examine the association with communication and preventable AEs. Pre-post cohort analysis. A 700-bed academic medical center. General medicine patients on any of the participating nursing units before and after implementation of regionalized care. Regionalizing 3 general medical physician teams to 3 corresponding nursing units. Concordance of patient care plan between nurse and intern, and adjusted odds of preventable AEs. Of the 414 included nurse and intern paired surveys, there were no significant differences pre- versus postregionalization in total mean concordance scores (0.65 vs 0.67, P = 0.26), but there was significant improvement in agreement on expected discharge date (0.56 vs 0.68, P = 0.003), knowledge of the other provider's name (0.56 vs 0.86,P communication and lead to patient safety improvements. Journal of Hospital Medicine 2016;11:620-627. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  15. Concordance between physiological arousal and emotion expression during fear in young children with autism spectrum disorders.

    Science.gov (United States)

    Zantinge, Gemma; van Rijn, Sophie; Stockmann, Lex; Swaab, Hanna

    2018-03-01

    This study aimed to measure emotional expression and physiological arousal in response to fear in 21 children with autism spectrum disorders (43-75 months) and 45 typically developing children (41-81 months). Expressions of facial and bodily fear and heart rate arousal were simultaneously measured in response to a remote controlled robot (Laboratory Temperament Assessment Battery). Heart rate analyses revealed a main effect of task from baseline to fear ( p autism spectrum disorder showed intact facial and bodily expressions of fearful affect compared to typically developing children. With regard to the relationship between expression and arousal, the results provided evidence for concordance between expression and arousal in typically developing children ( r = 0.45, n = 45, p autism spectrum disorder, no significant correlation was found ( r = 0.20, n = 21, p = 0.38). A moderation analysis revealed no significant interaction between expression and arousal for children with and without autism spectrum disorder ( F(1, 62) = 1.23, p = 0.27, [Formula: see text]), which might be the result of limited power. The current results give reason to further study concordance between expression and arousal in early autism spectrum disorder. Discordance might significantly impact social functioning and is an important topic in light of both early identification and treatment.

  16. Social network concordance in food choice among spouses, friends, and siblings.

    Science.gov (United States)

    Pachucki, Mark A; Jacques, Paul F; Christakis, Nicholas A

    2011-11-01

    We investigated whether eating behaviors were concordant among diverse sets of social ties. We analyzed the socioeconomic and demographic distribution of eating among 3418 members of the Framingham Heart Study observed from 1991 to 2001. We used a data-classification procedure to simplify choices into 7 nonoverlapping patterns that we matched with information on social network ties. We used correlation analysis to examine eating associations among 4 types of peers (spouses, friends, brothers, and sisters). Longitudinal multiple logistic regression was used to evaluate evidence for peer influences on eating. Of all peer types, spouses showed the strongest concordances in eating patterns over time after adjustment for social contextual factors. Across all peers, the eating pattern most likely to be shared by socially connected individuals was "alcohol and snacks." Models estimating one's current eating pattern on the basis of a peer's prior eating provided supportive evidence of a social influence process. Certain eating patterns appeared to be socially transmissible across different kinds of relationships. These findings represent an important step in specifying the relevant social environment in the study of health behaviors to include eating.

  17. Aligning conservation goals: are patterns of species richness and endemism concordant at regional scales?

    Directory of Open Access Journals (Sweden)

    Ricketts, T. H.

    2001-01-01

    Full Text Available Biodiversity conservation strategies commonly target areas of high species richness and/or high endemism. However, the correlation between richness and endemism at scales relevant to conservation is unclear; these two common goals of conservation plans may therefore be in conflict. Here the spatial concordance between richness and endemism is tested using five taxa in North America: butterflies, birds, mammals, amphibians, and reptiles. This concordance is also tested using overall indices of richness and endemism (incorporating all five taxa. For all taxa except birds, richness and endemism were significantly correlated, with amphibians, reptiles, and the overall indices showing the highest correlations (rs = 0.527-0.676. However, 'priority sets' of ecoregions (i.e., the top 10% of ecoregions based on richness generally overlapped poorly with those based on endemism (< 50% overlap for all but reptiles. These results offer only limited support for the idea that richness and endemism are correlated at broad scales and indicate that land managers will need to balance these dual, and often conflicting, goals of biodiversity conservation.

  18. [Concordance of nasal swabs and nasopharyngeal swabs in the detection of respiratory viruses by direct immunofluorescence].

    Science.gov (United States)

    Del Pozo, Paulina; Abarca, Katia; Concha, Ida; Cerda, Jaime

    2014-04-01

    The most used test for the diagnosis of viral respiratory infection is the detection of viral antigens by direct immunofluorescence (DFA), in samples taken by nasopharyngeal swab (NPS) or aspirate (NPA). It would be desirable to have a less uncomfortable technique to obtain a sample from the patient, but of equal performance. To evaluate the diagnostic agreement between nasal swab (NS) and nasopharyngeal swab (NPS) in the detection of respiratory viruses by DFA and compare the degree of discomfort of both techniques in pediatric patients. Cross-sectional study in children who consulted to a pediatric emergency service with respiratory symptoms. Two samples (NPS and NS) per child were collected. The concordance between the two was determined by Kappa (K) coefficient and the degree of discomfort by a visual pain scale. We obtained 112 samples from 56 children, one by each technique. 82.1% were concordant, K = 0.61 (CI 95%, 0.39-0.83) for the detection of any virus, and K = 0.69 (CI 95%, 0.46-0.92) and K = 0.76 (CI 95%, 0.51-1) for syncytial respiratory virus and influenza A detection, respectively. The degree of discomfort was significantly lower for the NS. There is considerable agreement in the detection of respiratory viruses by DFA between samples obtained by NS and NPS, but not enough to recommend a change in the sampling method in this population.

  19. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates.

    Science.gov (United States)

    Chowdhry, R; Dangman, B; Pinheiro, J M B

    2015-07-01

    Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not. Prospective observational clinical trial. After obtaining informed consent, patients with an ETT who required X-ray for clinical reasons underwent sonographic evaluation of the ETT by an ultrasound technologist or pediatric radiologist, usually within the hour. A total of 56 image pairs were obtained from 29 patients. Ninety-eight percent of the ultrasound/X-ray image pairs were suitable for analysis. The concordance of ultrasound with X-ray to identify deeply and not deeply positioned ETTs was 95% (53/56). The sensitivity of ultrasound to detect deeply positioned ETTs on X-ray was 86% (6/7). The specificity of ultrasound to detect ETTs that were not deeply positioned on X-ray was 96% (47/49). As the largest clinical trial of its kind to date, with the greatest number of ultrasound operators, we have further established US as a feasible imaging modality to determine whether an ETT is deeply positioned or not.

  20. Concordance of Penile and Oral Human Papillomavirus Infections Among Men in the United States.

    Science.gov (United States)

    Patel, Eshan U; Rositch, Anne F; Gravitt, Patti E; Tobian, Aaron A R

    2017-04-15

    This study examined the concordance of penile and oral human papillomavirus (HPV) infections in the United States. A total of 1683 men aged 18-59 years who participated in the 2013-2014 National Health and Nutrition Examination Survey and had results of oral and penile HPV DNA testing were examined. The prevalence of any HPV genotype was 45.3% on the penis, 11.2% in the oral cavity, and 8.8% at both sites. The prevalence of HPV in the oral cavity was higher among those with than among those without penile HPV infection (19.3% vs 4.4%; prevalence ratio, 4.37 [95% confidence interval, 2.66-7.16]). The prevalence of ≥1 genotype-concordant HPV infection was 3.2% and was associated with sexual behavior, independent of demographic characteristics and smoking status. Sexual behavior may partly explain the observed association between penile and oral HPV infections. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  1. Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships.

    Science.gov (United States)

    Blumberg, Jeffrey B; Vita, Joseph A; Chen, C-Y Oliver

    2015-12-02

    Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages.

  2. Equivalent dose measurements on board an Armenian Airline flight and Concord (9-17 km)

    International Nuclear Information System (INIS)

    Akopova, A.B.; Melkonyan, A.A.; Tatikyan, S.Sh.; Capdevielle, J-N.

    2002-01-01

    The results of investigations of the neutron component (E=1-10 MeV) of cosmic radiation on board the 'Armenian Airlines' aircrafts using nuclear photoemulsion are presented. The emulsions were exposed on the flights from Yerevan to Moscow, St.-Petersburg, Beirut, Athens, Frankfurt, Amsterdam, Paris and Sofia, and on Concord supersonic flights from Paris to New York. The dependence of the neutron fluxes, and on absorbed and equivalent doses on the flight parameters were investigated. On the flights of the supersonic Concord, with an altitude of 17 km, the neutron fluxes were essentially higher in comparison to those measured on Armenian airliners. It is interesting to note, that the neutron flux and equivalent dose rate decrease with altitude up to 470 km in space, for example, on board the STS-57. The shape of the differential energy spectrum for fast neutrons is the same on all Armenian airlines flights, but significantly different at 17 km altitude, where the flux in the energy region above 3 MeV is increasing

  3. Equivalent dose measurements on board an Armenian Airline flight and Concord (9-17 km)

    Energy Technology Data Exchange (ETDEWEB)

    Akopova, A.B. E-mail: akopova@lx2.yerphi.am; Melkonyan, A.A.; Tatikyan, S.Sh.; Capdevielle, J-N

    2002-12-01

    The results of investigations of the neutron component (E=1-10 MeV) of cosmic radiation on board the 'Armenian Airlines' aircrafts using nuclear photoemulsion are presented. The emulsions were exposed on the flights from Yerevan to Moscow, St.-Petersburg, Beirut, Athens, Frankfurt, Amsterdam, Paris and Sofia, and on Concord supersonic flights from Paris to New York. The dependence of the neutron fluxes, and on absorbed and equivalent doses on the flight parameters were investigated. On the flights of the supersonic Concord, with an altitude of 17 km, the neutron fluxes were essentially higher in comparison to those measured on Armenian airliners. It is interesting to note, that the neutron flux and equivalent dose rate decrease with altitude up to 470 km in space, for example, on board the STS-57. The shape of the differential energy spectrum for fast neutrons is the same on all Armenian airlines flights, but significantly different at 17 km altitude, where the flux in the energy region above 3 MeV is increasing.

  4. Concordance between nucleic acid amplification technique and culture for the diagnosis of gonorrhoea.

    Science.gov (United States)

    Creighton, S; Revell, B; Barrow, A

    2009-05-01

    The objective of the study was to evaluate the concordance between nucleic acid amplification technique (NAAT) and culture for the diagnosis of Neisseria gonorrhoeae among attendees at a genitourinary medicine clinic in East London. All patients testing positive for N. gonorrhoeae on NAAT and/or culture between 1 April 2007 and 31 August 2008 at the Department of Sexual Health at Homerton University Hospital were included. Male patients had a first void urine sample for NAAT and urethral culture; female patients had a self-taken vulval swab or endocervical sample sent for NAAT and an endocervical culture sample. After interim analysis, discrepant results had both NAAT and culture repeated prior to treatment. Of 159 male patients with a positive NAAT, 22 (13%) had a negative culture. Among 135 female patients with a positive NAAT, 36 (27%) had a negative culture. Three men had a positive culture and negative NAAT. Nineteen of the discrepant samples were retested prior to treatment and 12 (63%) had spontaneously revered to negative. In conclusion, there was concordance in 84% of male and 67% of female samples. In two-thirds of the discrepant cases, the previously positive NAAT had become negative prior to treatment. This study highlights the importance of consideration of the clinical picture when assessing results.

  5. He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status.

    Science.gov (United States)

    Berge, Jerica M; MacLehose, Richard F; Meyer, Craig; Didericksen, Katharine; Loth, Katie A; Neumark-Sztainer, Dianne

    2016-01-01

    Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. The main objective of the study was to examine whether and how parental concordance/discordance on factors in the home environment (eg, importance of family meals, parent feeding practices, encouraging child physical activity, and limit setting on child screen time) are associated with adolescent health behaviors and weight status. Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents' health behaviors and weight status. Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age=14.3 years) and their parents (n=2,104; 52% women; mean age=41.0 years) from Minneapolis and St Paul, MN, participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Parental concordance on home environment factors was high for some factors (eg, 68% concordance on not pressuring adolescent to eat) and low for other factors (eg, 2% concordance on parent engaging in physically activity with child 4+ hours per week). Parental concordance on positive home environment factors (eg, frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (Pconsumption of fast food and more unhealthy weight control behaviors (P<0.05), but not consistently. Results suggest there is some degree of parental concordance on home environment factors; however, the results were

  6. A Comparison of Total Antioxidant Capacities of Concord, Purple, Red, and Green Grapes Using the CUPRAC Assay

    Directory of Open Access Journals (Sweden)

    Connor M. Callaghan

    2013-10-01

    Full Text Available Considering how popular grapes are in terms of their antioxidant benefits, we compared concord, purple, red, and green grapes for total antioxidant capacity (TAC and carbohydrate concentration. All grapes were acquired from commercial sources and samples of each were separated into skinned and not skinned groups. Each whole grape and the skins were individually homogenized and then separated into pulp and supernatant fractions. Each fraction was analyzed for total TAC and carbohydrates. The concord grapes and purple grapes had significantly higher TAC in the homogenates than did the red or green grapes. The concord grapes and green grapes had significantly higher TAC in the pulp than in the cytosol whereas the red and purple grapes had approximately the same amount. The majority of the TAC of the purple and red grapes was in the skin whereas the concord and green grapes had approximately the same TAC in the skin and pulp. The concord and purple grapes had the highest TAC when compared to the red and green grapes, whereas the red and green grapes had approximately the same total TAC.

  7. Influence knowledge and behavior of TB medical personnels’ concordance principle based communications skill at primary healthcare, Medan, Indonesia

    Science.gov (United States)

    Wahyuni, A. S.; Soeroso, N. N.; Alona, I.; Yunanda, Y.; Siregar, I.

    2018-03-01

    Concordance behavior of TB management is a form of collaboration among doctors, personnel, and patients in treating TB. Approvalamong them could be achieved if credibility and policy occur. This study is aimed to analyze the influence of TB medical personnel’s concordance behaviour principle to patient obedience at primary health care in Medan.The design of this study was quasi experimental, focusing on interventional primary health care, which is those who applied concordance behaviour principle to non-interventionalprimary health care. The population is TB patients, starting from 18 years old, TB category I with positive Acid Fast Bacilli Smear Test (AFBST), and taking TB regimens at Medan. Seventy- four patients were selected to be samples. They had undergone interview based on validated concordance principle, knowledge, behavior, and treatment. Data were analyzed using chi- square. The percentage of knowledge, behavior of TB patient to the treatment is higher on interventional primary health care than noninterventional ones. Treatment awareness based on concordance principle is expected to planish DOTS-based TB programs.

  8. Concordance and robustness of quality indicator sets for hospitals: an analysis of routine data

    Directory of Open Access Journals (Sweden)

    Färber Robert

    2011-05-01

    Full Text Available Abstract Background Hospitals are increasingly being evaluated with respect to the quality of provided care. In this setting, several indicator sets compete with one another for the assessment of effectiveness and safety. However, there have been few comparative investigations covering different sets. The objective of this study was to answer three questions: How concordant are different indicator sets on a hospital level? What is the effect of applying different reference values? How stable are the positions of a hospital ranking? Methods Routine data were made available to three companies offering the Patient Safety Indicators, an indicator set from the HELIOS Hospital Group, and measurements based on Disease Staging™. Ten hospitals from North Rhine-Westphalia, comprising a total of 151,960 inpatients in 2006, volunteered to participate in this study. The companies provided standard quality reports for the ten hospitals. Composite measures were defined for strengths and weaknesses. In addition to the different indicator sets, different reference values for one set allowed the construction of several comparison groups. Concordance and robustness were analyzed using the non-parametric correlation coefficient and Kendall's W. Results Indicator sets differing only in the reference values of the indicators showed significant correlations in most of the pairs with respect to weaknesses (maximum r = 0.927, CI 0.714-0.983, p Conclusions Our results reveal an unsettling lack of concordance in estimates of hospital performance when different quality indicator sets are used. These findings underline the lack of consensus regarding optimal validated measures for judging hospital quality. The indicator sets shared a common definition of quality, independent of their focus on patient safety, mortality, or length of stay. However, for most of the hospitals, changing the indicator set or the reference value resulted in a shift from the superior to the

  9. Hydrodynamics of concordant and discordant fixed bed open-channel confluences

    Science.gov (United States)

    Birjukova Canelas, Olga; Lage Ferreira, Rui Miguel; Heleno Cardoso, António

    2017-04-01

    The detailed characterization of the flow field in river confluences constitutes a relevant step towards the understanding of the hydro-morpho-dynamics of these key zones of the fluvial system. With a few exceptions, existing works on this topic covered concordant bed scenarios, meaning that both confluent channels had the same elevation. This laboratory study aims to contribute to a detailed three-dimensional characterization of the flow field at a fixed bed confluence, as well as to shed light on how bed elevation discordance modifies the flow patterns of the converging flows. While the junction angle and the discharge ratio were kept fixed, two scenarios were studied on the basis of detailed water level and 3D ADV measurements at the denser mesh ever. The internal flow structure of the concordant bed scenario mostly complied with the classical conceptual models. A relevant difference concerns the size of the stagnation zone, much smaller close to the bed of the discordant bed confluence. A more significant difference is a horizontal flow structure, not previously identified in the literature, characterized by strong streamwise mean vorticity and strong secondary motion. It is observed for the discordant bed case, occurring along the inner wall of the main channel and downstream the junction corner. This structure is spatially well-correlated to a pronounced imbalance of cross-stream and vertical normal Reynolds stresses. This highlights the role of Reynolds stress anisotropy (RSA) that is generated in the shear layers than accompany the entrance of the tributary flow. Since this structure is not present in the concordant case, where RSA is also evident, it is argued that convective effects should also play a role in its formation, presumably due to deflection of the flow in the main channel by the tributary. The newly identified secondary motion should, thus, be a combination of Prandtĺs second kind and Prandtĺs first kind of secondary flow. The relative

  10. Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.

    Science.gov (United States)

    Kahn, Ben; Freeland, Zachary; Gopal, Purva; Agrawal, Deepak; Mayorga, Christian A; Mithani, Rozina; Skinner, Celette Sugg; Halm, Ethan A; Singal, Amit G

    2015-11-01

    Appropriate surveillance intervals for colorectal cancer (CRC) screening is one of the Centers for Medicare and Medicaid Services 2014 physician quality reporting system measures. Appropriateness of surveillance intervals will continue to be monitored closely, particularly as reimbursements become tied to quality measures. Quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. We conducted a retrospective cohort study of patients who had colonoscopy with polypectomy at a safety-net health system between June 2011 and December 2013. Surveillance recommendations shorter and longer than guideline recommendations were defined as potential overuse and underuse. We used multivariate logistic regression to identify correlates of guideline-concordant surveillance recommendations, overuse, and underuse. Among 1,822 patients with polypectomy, 1,329 had ≥1 adenoma. Surveillance interval recommendations were guideline-concordant in 1,410 (77.4%) patients, potential overuse in 263 (14.4%), potential underuse in 85 (4.7%), and missing in 64 (3.5%) patients. Predictors of guideline-concordant recommendations in multivariate analyses included age >65 years (OR 1.36, 95% CI 1.02-1.80), incomplete resection (OR 3.58, 95% CI 1.41-9.09), and good/excellent prep quality (OR 2.22, 95% CI 1.72-2.86). Underuse recommendations were more likely in patients with ≥3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, ≥3 adenomas, age >65, or Hispanic ethnicity. Surveillance recommendations are not concordant with guidelines in one of four cases. Interventions to improve prep quality and guideline concordance of surveillance recommendations can improve cost-effectiveness of CRC screening.

  11. Are the classic signs of infection in concordance with results from percutaneous aspiration to diagnose infection in pressure injuries?

    Science.gov (United States)

    Blanco-Blanco, Joan; Gea-Sánchez, Montserrat; Valenzuela-Pascual, Francesc; Barallat-Gimeno, Eva; Espart, Anna; Escobar-Bravo, Miguel Ángel

    2017-06-01

    To explore the concordance between the presence of classic signs of infection and the positive diagnosis identified by the microbiological culture of fluid collected by percutaneous aspiration. The classic signs of infection are commonly applied in some contexts to confirm infection in pressure injuries, but its accuracy has been questioned in chronic wounds. Little is known about the concordance of this method with others, such as the deep fluid culture from pressure injuries collected by percutaneous aspiration. Multicentre, cross-sectional observational study. Pressure injuries of patients from four health centres were analysed. Three types of data were recorded between February 2011 and March 2012: i) socio-demographic and clinical data, ii) number and type of infection signs and iii) microbiological results of deep fluid culture from injuries. The concordance was calculated with the kappa index to find a possible concordance between both methods. On 40·2% (n = 47) of injuries, two or more classic signs of infection or purulent exudate as unique sign were present, while the total positive results in the microbiological cultures were 50·4% (n = 59). The disparity of positive results, depending on the location and the stage of the pressure injury and the method applied, suggested a poor concordance between methods. The -0·092 kappa index confirmed the non-concordance of the analysed methods. The tandem strategy is not useful to indicate an infection in pressure injuries. We advocate exploring other signs of infection and the adoption of other more reliable signs together with the classic signs of infection. © 2016 John Wiley & Sons Ltd.

  12. Concordance with DASH diet and blood pressure change: results from the Framingham Offspring Study (1991-2008).

    Science.gov (United States)

    Jiang, Jieying; Liu, Mengling; Troy, Lisa M; Bangalore, Sripal; Hayes, Richard B; Parekh, Niyati

    2015-11-01

    Concordance with the Dietary Approaches to Stop Hypertension (DASH) diet has been shown to reduce blood pressure (BP) in short-term intervention studies, but long-term effects are unclear. We evaluated the association of DASH diet concordance with BP trajectories and incidence of hypertension, in 2187 men and women (mean age 52.5 years at baseline) participating in the Framingham Offspring cohort. Diet and BP were assessed from 1991 to 2008, with a median follow-up time of 13.4 years. DASH scores (ranging from 0 for worst to 10 for best concordance with DASH diet) were calculated by summing 10 food components that comprise the DASH diet pattern, including fruits and vegetables, low-fat dairy products, lean meat, and plant-based protein. Mixed-effect and Cox regression models were applied, to assess the association of DASH diet concordance with BP longitudinal change and with incidence of hypertension, respectively. All analyses were adjusted for age, sex, smoking status, history of diabetes, BMI, and physical activity. Overall, SBP increased by 0.34 mmHg and DBP by 0.10 mmHg annually, in the Framingham Offspring cohort. Every unit increase in the DASH score resulted in a modest increase in SBP of 0.054 mmHg/year (P = 0.028). No associations were observed between DASH diet concordance and DBP or incidence of hypertension. Long-term concordance with the DASH diet was not associated with a decreasing BP trajectory over time, or with decreased incidence of hypertension, in this population of middle-aged adults.

  13. Comparison between spousal donor transplantation treated with anti-thymocyte globulin induction therapy and, living related donor transplantation treated with standard immunosuppression

    Directory of Open Access Journals (Sweden)

    Erkan Demir

    2014-01-01

    Full Text Available The worldwide shortage of organs available for transplantation has led to the use of living-unrelated kidney donors. In this context, spouses represent an important source of organ donors. We compared the allograft outcomes of spousal donor transplantation (SDT with anti-thymocyte globulin (ATG induction therapy and living related donor transplantation (LRDT with triple immonosuppression and basiliximab, in addition. Among the 335 living and deceased donor kidney transplantations performed between April 2001 and June 2010, there were 274 living donor kidney transplantations including 34 SDT and 240 LRDT. The minimum follow-up period was 36 months. All recipients of SDT received ATG (1.5 mg/kg induction therapy, which was stopped five to seven days after surgery. Maintenance immunosuppression included tacrolimus (TAC, mycophenolate mofetil (MMF and prednisolone. LRDT recipients received triple immunosuppressive protocol consisting of cyclosporine or TAC, MMF and prednisolone, in addition to basiliximab. There was a significant difference between the two groups in recipient age, while pre-operative duration on dialysis, recipient sex and donor age and sex were not significantly different. There was also a significant difference between the two groups in the number of human leukocyte antigen (HLA mismatches. The 1-, 3- and 5-year graft survival rates of SDT were 94.1%, 88.2% and 79.4%, respectively, and the frequency of acute rejection episodes was 5.8% (two cases. The 1-, 3- and 5-year graft survival rates of LRDT were 95.8%, 91.6% and 83.3%, respectively, with the frequency of acute rejection being 16.2%. The graft survival rates of SDT were as good as LRDT, while the acute rejection rates in SDT were lower than in LRDT, although the difference was not statistically different (P = 0.13.

  14. The Effect of Emotional Focused Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Married Couples: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Maryam Hazrati

    2017-10-01

    Full Text Available Background: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples. Methods: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples (114 participants who were eligible for study were assigned in two groups by block randomization (29 in the experimental and 28 in the control group(.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn’t receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire (MMEAQ and Marital Satisfaction Questionnaire for Older People (MSQFOP. Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P≤0.05 was measured as significant. Results: The mean duration of marriage was 39.56±9.64 years. In the experimental group, the abusive behaviors decreased significantly (P<0.001 at times 2 and 3 compared with time 1, and marital satisfaction improved significantly only at time 3 (P<0.001. These differences were not significant in the control group. Conclusion: Emotion-focused couple-based interventions are helpful in reducing the spousal emotional abuse and improving marital satisfaction in among the elderly couples. Trial Registration Number: 2013111715426N1

  15. An astronomical age for the Bishop Tuff and concordance with radioisotopic dates

    DEFF Research Database (Denmark)

    Rivera, Tiffany; Zeeden, Christian; Storey, Michael

    2014-01-01

    and global correlation of records. The Quaternary time scale is anchored by 40Ar/39Ar ages on lava flows and ash layers where available, with stage boundaries and geomagnetic reversals including astronomically tuned records. However, astronomical dating has not yet validated the high-precision 238U/206Pb...... zircon and 40Ar/39Ar sanidine ages of the Bishop Tuff. We have identified the Bishop Tuff within the marine sedimentary record and derived an astronomical age of 0.765 ± 0.008 Ma by correlation to the LR04 δ18O global benthic stack and its age model. This age is consistent with Bishop Tuff radioisotopic...... ages, including new single crystal 40Ar/39Ar sanidine fusion analyses presented here, which demonstrates that concordance through multiple dating techniques is achievable within the Quaternary...

  16. Concordance Rates of Adolescent Idiopathic Scoliosis in a Danish Twin Population

    DEFF Research Database (Denmark)

    Simony, Ane; Carreon, Leah Y; Højmark, Karen

    2016-01-01

    STUDY DESIGN: Clinical, radiological and genetic determination of zygosity of twin pairs from the Danish Twin Registry who self-reported having Adolescent Idiopathic Scoliosis (AIS). OBJECTIVE: To establish concordance rates of AIS. SUMMARY OF BACKGROUND DATA: The aetiology of and the true mode...... reported. METHODS: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a survey, which included questions about scoliosis. The survey was returned by 34,944 individuals (75.3%) representing 23,204 pairs. From this study, 548 individuals representing 274 complete twin...... pairs where at least one twin self-reported having scoliosis were invited to a clinical and radiological examination. Zygosity was established by genetic testing. RESULTS: 182 individuals (33.2%) of the original cohort agreed to participate, 128 of whom had scoliosis by self-report. There were 91 twin...

  17. Lesion concordance, image quality and artefacts in PET/CT. Results of a multicenter study

    International Nuclear Information System (INIS)

    Stergar, H.; Bockisch, A.; Krause, B.J.; Eschmann, S.M.; Juergens, K.U.; Kuehl, H.; Pfannenberg, A.C.; Stollfuss, J.; Weckesser, M.

    2010-01-01

    This study had three major objectives: (1.) to record the number of concordant (both in PET and CT) pathological lesions in different body regions/organs, (2.) to evaluate the image quality and (3.) to determine both, the quantity and the quality of artefacts in whole body FDG PET/CT scans. Routine whole body scans of 353 patients referred to FDG-PET/CT exams at 4 university hospitals were employed. All potentially malignant lesions in 13 different body regions/organs were classified as either concordant or suspicious in FDG-PET or CT only. In the latter case the diagnostic relevance of this disparity was judged. The image quality in PET and CT was rated as a whole and separately in 5 different body regions. Furthermore we investigated the frequency and site of artefacts caused by metal implants and oral or intravenous contrast media as well as the subjective co-registration quality (in 4 body regions) and the diagnostic impact of such artefacts or misalignment. In addition, the readers rated the diagnostic gain of adding the information from the other tomographic method. In total 1941 lesions (5.5 per patient) were identified, 1094 (56%) out of which were concordant. 602 (71%) out of the 847 remaining lesions were detected only with CT, 245 (29%) were only PET-positive. As expected, CT particularly depicted the majority of lesions in the lungs and abdominal organs. However, the diagnostic relevance was greater with PET-only positive lesions. Most of the PET/CT scans were performed with full diagnostic CT including administration of oral and intravenous contast media (> 80%). The image quality in PET and CT was rated excellent. Artefacts occurred in more than 60% of the scans and were mainly due to (dental) metal implants and contrast agent. Nevertheless there was almost no impact on diagnostic confidence if reading of the non attenuation corrected PET was included. The co-registration quality in general was also rated as excellent. Misalignment mostly occurred due

  18. Concordance between continuity of care reported by patients and measured from administrative data.

    Science.gov (United States)

    Nyweide, David J

    2014-04-01

    Continuity of care can be measured using patient survey or administrative data, though the degree of concordance between continuity of care reported by patients and measured from their actual utilization is not well understood. A cross-sectional analysis of the 2010 Medicare Current Beneficiary Survey and linked 2009-2010 Medicare Carrier and outpatient claims data measured the concentration of ambulatory care visit patterns according to two commonly used metrics of continuity of care. Continuity of care measured from claims data did not align with patient reports of having a usual care provider. However, high levels of continuity for patients with a usual care provider were associated with a longer patient-provider relationship, greater patient-perceived provider knowledge of the patient's medical condition and history, and more confidence in the provider. Inferences about a patient's continuity of care must be placed in the context of the data source with which continuity is measured.

  19. Concordance of self-report and measured height and weight of college students.

    Science.gov (United States)

    Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Kattelmann, Kendra; Phillips, Beatrice; Hoerr, Sharon L; Greene, Geoffrey

    2015-01-01

    This study examined associations between college students' self-report and measured height and weight. Participants (N = 1,686) were 77% white, 62% female, aged 18-24 years (mean ± SD, 19.1 ± 1.1 years), and enrolled at 8 US universities. Body mass index (BMI) was calculated for self-report (via online survey); trained researchers measured height and weight and categorized them as normal (18.5 to obese (30 to obese (≥ 35). Concordance of self-report vs objectively measured BMI groups using chi-square revealed that 93% were accurate, 4% were underestimated, and 2.7% were overestimated. Pearson correlations and adjusted linear regression revealed significant associations between self-report and measured BMI (r = .97; P college students. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  20. Radioimmunoassay determination of antigenic concordance among hemagglutinins of vaccine and epidemic influenza virus strains

    Energy Technology Data Exchange (ETDEWEB)

    Blokha, V.V.; Yamnikova, S.S.; Karpovich, L.G.; Yakhno, M.A.; Zakstel' skaya, L.Ya.

    Radioimmunoassay studies were conducted on the antigenic concordance of hemagglutinin of influenza A H3N2 viruses, to determine the suitability of vaccine strains in engendering immunity against viruses circulating in nature. Specifically, the inhibition studies involved the hemagglutinins of the A/Victoria/35/72 vaccine strain, the proposed vaccine strain A/Khabarovsk/15/76, and the RK-5 recombinant strains, containing antigenic determinants of viruses isolated in the 1972-1976 epidemic period (A/Victoria/3/75, A/Leningrad/173/75, A/Victoria/112/76). The results showed that A/Victoria/35/72 is becoming less important as a vaccine, but that RK-5 and A/Khabarovsk/15/76 can provide significant immunity with respect to influenza viruses circulating in 1975-1976. These observations point to the usefulness of radioimmunoassay in assessing the suitability of influenza A viruses for vaccine production. 12 references, 2 figures.

  1. Concordance between inflammation at physical examination and on MRI in patients with early arthritis.

    Science.gov (United States)

    Krabben, A; Stomp, W; Huizinga, T W J; van der Heijde, D; Bloem, J L; Reijnierse, M; van der Helm-van Mil, A H M

    2015-03-01

    MRI is increasingly used to measure inflammation in rheumatoid arthritis (RA) research, but the correlation to clinical assessment is unexplored. This study determined the association and concordance between inflammation of small joints measured with MRI and physical examination. 179 patients with early arthritis underwent a 68 tender joint count and 66 swollen joint count and 1.5T MRI of MCP (2-5), wrist and MTP (1-5) joints at the most painful side. Two readers scored synovitis and bone marrow oedema (BME) according to the OMERACT RA MRI scoring method and assessed tenosynovitis. The MRI data were first analysed continuously and then dichotomised to analyse the concordance with inflammation at joint examination. 1790 joints of 179 patients were studied. Synovitis and tenosynovitis on MRI were independently associated with clinical swelling, in contrast to BME. In 86% of the swollen MCP joints and in 92% of the swollen wrist joints any inflammation on MRI was present. In 27% of the non-swollen MCP joints and in 66% of the non-swollen wrist joints any MRI inflammation was present. Vice versa, of all MCP, wrist and MTP joints with inflammation on MRI 64%, 61% and 77%, respectively, were not swollen. BME, also in case of severe lesions, occurred frequently in clinically non-swollen joints. Similar results were observed for joint tenderness. Inflammation on MRI is not only present in clinically swollen but also in non-swollen joints. In particular BME occurred in clinically non-inflamed joints. The relevance of subclinical inflammation for the disease course is a subject for further studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. A community study of language concordance in Russian patients with diabetes.

    Science.gov (United States)

    Mehler, Philip S; Lundgren, Rita A; Pines, Irina; Doll, Katherine

    2004-01-01

    Unique challenges exist in the provision of culturally and linguistically appropriate health care to ethnically diverse populations. The purpose of this study was to improve the metabolic control of Russian patients with diabetes through increased attention to language and cultural concordance between the provider and patient. This is a retrospective cohort study of 55 Russian immigrant type 2 patients with diabetes to assess levels of glycemic, lipid, and blood pressure control before and after the arrival of a bilingual Russian internist trained in both the United States and Russia. Paired t test was used to compare these parameters before and after the bilingual Russian provider joined our practice. Overall, the mean low density lipoprotein (LDL) level decreased by 20% from 126 mg/dL to 102 mg/dL (P=.0002) respectively before and after the Russian provider began treating these patients. Mean hemoglobin A1c decreased from 8.4% to 8.0% (P=.007), and diastolic blood pressure was reduced from 82.7 mm Hg to 76.3 mm Hg (P=.0002). Systolic blood pressure also improved from 143.2 mm Hg to 140.6 mm Hg (P=.3). At the end of the study period more than 90% of the patients with diabetes were appropriately taking lipid-lowering medications and an angiotensin converting enzyme (ACE) inhibitor. Our findings suggest that it is important to facilitate the health care of ethnically diverse minority populations in a manner that attempts to maximize language and cultural concordance. These potential benefits will assume an even greater importance with the expansive growth of ethnic minorities in the United States and their unique healthcare needs.

  3. Diagnostic mammography and sonography: Concordance of the breast imaging reporting assessments and final clinical outcome

    International Nuclear Information System (INIS)

    Lorenzen, J.; Wedel, A.K.; Adam, G.; Lisboa, B.W.; Loening, T.

    2005-01-01

    Purpose: The purpose of the study was to assess the final clinical outcome of BI-RADS categories for diagnostic mammography and sonography. Material and methods: We analysed 632 mammography and sonography examinations from women with diagnostic indications (age: 23 - 100, mean 58) performed during 2001 and 2003. All patients received mammography and sonography examinations at different outside facilities and all patients received an additional sonography examination at the university radiology department and if necessary supplemental mammographic views. Final clinical outcome (Histology: 554; follow-up: 78) was ascertained in each case and concordance of BI-RADS-categories for mammography and sonography and final diagnosis were analysed. Results: Final diagnosis yielded 230 benign lesions (36%) and 402 cancers (64%). Concordance of BI-RADS assessment and final outcome was documented in 542 cases (86%). There were 11 correct category 1 and 2 assessments (2%). 142 lesions were classified with BI-RADS 3 (22%) with 5 false negative ratings. There were 264 category 4 lesions (42%) with a PPV for a malignant lesion of 71% (187/264) and finally 215 BI-RADS 5 lesions with a PPV of 98% (210/215). Overall sensitivity of mammography was 92% with specificity of 75% and for sonography 86% and 76%. Mammography had a significantly higher detection rate for malignant lesions than sonography. The highest correlation between BI-RADS category and final outcome was documented for the diagnostic combination of mammography and sonography with a kappa-value of 0.817 (p<0.001), followed by mammography (kappa: 0.684) and sonography (kappa: 0.631). The overall correlation was 0.681 (p<0.001). Conclusion: BI-RADS assessments of diagnostic mammography and sonography yields in a high cancer detection rate with a justifiable part of false positive ratings. (orig.)

  4. A SNP panel and online tool for checking genotype concordance through comparing QR codes.

    Science.gov (United States)

    Du, Yonghong; Martin, Joshua S; McGee, John; Yang, Yuchen; Liu, Eric Yi; Sun, Yingrui; Geihs, Matthias; Kong, Xuejun; Zhou, Eric Lingfeng; Li, Yun; Huang, Jie

    2017-01-01

    In the current precision medicine era, more and more samples get genotyped and sequenced. Both researchers and commercial companies expend significant time and resources to reduce the error rate. However, it has been reported that there is a sample mix-up rate of between 0.1% and 1%, not to mention the possibly higher mix-up rate during the down-stream genetic reporting processes. Even on the low end of this estimate, this translates to a significant number of mislabeled samples, especially over the projected one billion people that will be sequenced within the next decade. Here, we first describe a method to identify a small set of Single nucleotide polymorphisms (SNPs) that can uniquely identify a personal genome, which utilizes allele frequencies of five major continental populations reported in the 1000 genomes project and the ExAC Consortium. To make this panel more informative, we added four SNPs that are commonly used to predict ABO blood type, and another two SNPs that are capable of predicting sex. We then implement a web interface (http://qrcme.tech), nicknamed QRC (for QR code based Concordance check), which is capable of extracting the relevant ID SNPs from a raw genetic data, coding its genotype as a quick response (QR) code, and comparing QR codes to report the concordance of underlying genetic datasets. The resulting 80 fingerprinting SNPs represent a significant decrease in complexity and the number of markers used for genetic data labelling and tracking. Our method and web tool is easily accessible to both researchers and the general public who consider the accuracy of complex genetic data as a prerequisite towards precision medicine.

  5. A SNP panel and online tool for checking genotype concordance through comparing QR codes.

    Directory of Open Access Journals (Sweden)

    Yonghong Du

    Full Text Available In the current precision medicine era, more and more samples get genotyped and sequenced. Both researchers and commercial companies expend significant time and resources to reduce the error rate. However, it has been reported that there is a sample mix-up rate of between 0.1% and 1%, not to mention the possibly higher mix-up rate during the down-stream genetic reporting processes. Even on the low end of this estimate, this translates to a significant number of mislabeled samples, especially over the projected one billion people that will be sequenced within the next decade. Here, we first describe a method to identify a small set of Single nucleotide polymorphisms (SNPs that can uniquely identify a personal genome, which utilizes allele frequencies of five major continental populations reported in the 1000 genomes project and the ExAC Consortium. To make this panel more informative, we added four SNPs that are commonly used to predict ABO blood type, and another two SNPs that are capable of predicting sex. We then implement a web interface (http://qrcme.tech, nicknamed QRC (for QR code based Concordance check, which is capable of extracting the relevant ID SNPs from a raw genetic data, coding its genotype as a quick response (QR code, and comparing QR codes to report the concordance of underlying genetic datasets. The resulting 80 fingerprinting SNPs represent a significant decrease in complexity and the number of markers used for genetic data labelling and tracking. Our method and web tool is easily accessible to both researchers and the general public who consider the accuracy of complex genetic data as a prerequisite towards precision medicine.

  6. Concordance and robustness of quality indicator sets for hospitals: an analysis of routine data.

    Science.gov (United States)

    Stausberg, Jürgen; Halim, Axel; Färber, Robert

    2011-05-18

    Hospitals are increasingly being evaluated with respect to the quality of provided care. In this setting, several indicator sets compete with one another for the assessment of effectiveness and safety. However, there have been few comparative investigations covering different sets. The objective of this study was to answer three questions: How concordant are different indicator sets on a hospital level? What is the effect of applying different reference values? How stable are the positions of a hospital ranking? Routine data were made available to three companies offering the Patient Safety Indicators, an indicator set from the HELIOS Hospital Group, and measurements based on Disease Staging™. Ten hospitals from North Rhine-Westphalia, comprising a total of 151,960 inpatients in 2006, volunteered to participate in this study. The companies provided standard quality reports for the ten hospitals. Composite measures were defined for strengths and weaknesses. In addition to the different indicator sets, different reference values for one set allowed the construction of several comparison groups. Concordance and robustness were analyzed using the non-parametric correlation coefficient and Kendall's W. Indicator sets differing only in the reference values of the indicators showed significant correlations in most of the pairs with respect to weaknesses (maximum r = 0.927, CI 0.714-0.983, p definition of quality, independent of their focus on patient safety, mortality, or length of stay. However, for most of the hospitals, changing the indicator set or the reference value resulted in a shift from the superior to the inferior half of the group or vice versa. Thus, while taken together the indicator sets offer the hospitals complementary pictures of their quality, on an individual basis they do not establish a reliable ranking.

  7. Concordance in the Health Behaviors of Couples by Age: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Seungmin Jeong

    2018-01-01

    Full Text Available Objectives To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners. Methods We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners’ corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ≥ 65 years and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife. Results Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49 was highest when the participant’s partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66, eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62; and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98. In comparison to non-housewives, housewives had higher odds of eating salty food. Conclusions The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.

  8. Merger of Multiple Accreting Black Holes Concordant with Gravitational-wave Events

    Science.gov (United States)

    Tagawa, Hiromichi; Umemura, Masayuki

    2018-03-01

    Recently, the advanced Laser Interferometer Gravitational-Wave Observatory (aLIGO) has detected black hole (BH) merger events, most of which are sourced by BHs more massive than 30 M ⊙. Especially, the observation of GW170104 suggests dynamically assembled binaries favoring a distribution of misaligned spins. It has been argued that mergers of unassociated BHs can be engendered through a chance meeting in a multiple BH system under gas-rich environments. In this paper, we consider the merger of unassociated BHs, concordant with the massive BH merger events. To that end, we simulate a multiple BH system with a post-Newtonian N-body code incorporating gas accretion and general relativistic effects. As a result, we find that gas dynamical friction effectively promotes a three-body interaction of BHs in dense gas of n gas ≳ 106 cm‑3, so that BH mergers can take place within 30 Myr. This scenario predicts an isotropic distribution of spin tilts. In the concordant models with GW150914, the masses of seed BHs are required to be ≳25 M ⊙. The potential sites of such chance meeting BH mergers are active galactic nucleus (AGN) disks and dense interstellar clouds. Assuming the LIGO O1, we roughly estimate the event rates for PopI BHs and PopIII BHs in AGN disks to be ≃1–2 yr‑1 and ≃1 yr‑1, respectively. Multiple episodes of AGNs may enhance the rates by roughly an order of magnitude. For massive PopI BHs in dense interstellar clouds the rate is ≃0.02 yr‑1. Hence, high-density AGN disks are a more plausible site for mergers of chance meeting BHs.

  9. The Relationship Between Ants and Lycaeides melissa samuelis (Lepidoptera: Lycaenidae) at Concord Pine Barrens, NH, USA.

    Science.gov (United States)

    Pascale, Elizabeth G; Thiet, Rachel K

    2016-04-22

    The Karner blue butterfly (Lycaeides melissa samuelis Nabokov) (Lepidoptera: Lycaenidae) is a federally listed, endangered species that has experienced dramatic decline over its historic range. In surviving populations, Karner blue butterflies have a facultative mutualism with ants that could be critically important to their survival where their populations are threatened by habitat loss or disturbance. In this study, we investigated the effects of ants, wild blue lupine population status (native or restored), and fire on adult Karner blue butterfly abundance at the Concord Pine Barrens, NH, USA. Ant frequency (the number of times we collected each ant species in our pitfall traps) was higher in restored than native lupine treatments regardless of burn status during both Karner blue butterfly broods, and the trend was statistically significant during the second brood. We observed a positive relationship between adult Karner blue butterfly abundance and ant frequency during the first brood, particularly on native lupine, regardless of burn treatment. During the second brood, adult Karner blue butterfly abundance and ant frequency were not significantly correlated in any treatments or their combinations. Our findings suggest that a combination of native and restored lupine is important for supporting both Karner blue butterflies and ants at the Concord Pine Barrens, and that burning does not affect the mutualism. Thus, scientists and managers at the site may wish to target their habitat management activities to best support both Karner blue butterflies and the particular ant species that provide the greatest benefit to their survival. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Avaliação da concordância da sialometria e cintilografia de glândulas salivares em pacientes com boca seca Evaluation of the concordance of sialometry and salivary glands scintigraphy in dry mouth patients

    Directory of Open Access Journals (Sweden)

    Bianca Maria Liquidato

    2006-02-01

    Full Text Available INTRODUÇÃO: São utilizados vários exames para avaliar os pacientes com queixa de boca seca e, especialmente, os pacientes com Síndrome de Sjögren, em que estes exames fazem parte de critérios de classificação para estudos científicos. OBJETIVO: Desta maneira, procurou-se avaliar se haveria concordância entre os resultados da sialometria e da cintilografia de glândulas salivares para, se esta concordância estiver presente, optar por apenas um dos dois exames. CASUÍSTICA E MÉTODO: Foram avaliados 72 pacientes com boca seca, divididos em grupos não-Síndrome de Sjögren, com Síndrome de Sjögren primária e com Síndrome de Sjögren secundária. Os resultados de sialometria e cintilografia de glândulas salivares foram estudados, procurando-se dimensionar a concordância existente entre eles, através do teste de Kappa. RESULTADOS: Observou-se concordância igual ou próxima de zero entre os dois testes. CONCLUSÃO: Pelos resultados observados, não é possível fazer a opção por um ou outro exame, devendo ambos serem realizados.INTRODUCTION: Many diagnostic tests are used to evaluate dry mouth patients, especially the ones with Sjögren’s Syndrome, to whom these tests are part of classification criteria for scientific studies. AIM: Thus, the concordance between results of sialometry and salivary glands scintigraphy was evaluated; if positive, it would enable the choice of one or the other for diagnosis. PATIENTS AND METHOD: Seventy-two dry mouth patients were divided into non-Sjögren’s Syndrome group, primary Sjögren’s Syndrome group and secondary Sjögren’s Syndrome group. The concordance among sialometry and scintigraphy results was evaluated by Kappa test. RESULTS: It was observed that their concordance was equal or near to zero. CONCLUSION: It is not possible to make a choice between these tests and both should be performed.

  11. Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes.

    Science.gov (United States)

    Pourat, Nadereh; Charles, Shana A; Snyder, Sophie

    2016-03-01

    Care delivery redesign in the form of patient-centered medical home (PCMH) is considered as a potential solution to improve patient outcomes and reduce costs, particularly for patients with chronic conditions. But studies of prevalence or impact at the population level are rare. We aimed to assess whether desired outcomes indicating better care delivery and patient-centeredness were associated with receipt of care according to 3 important PCMH principles. We analyzed data from a representative population survey in California in 2009, focusing on a population with chronic condition who had a usual source of care. We used bivariate, logistic, and negative-binomial regressions. The indicators of PCMH concordant care included continuity of care (personal doctor), care coordination, and care management (individual treatment plan). Outcomes included flu shots, count of outpatient visits, any emergency department visit, timely provider communication, and confidence in self-care. We found that patients whose care was concordant with all 3 PCMH principles were more likely to receive flu shots, more outpatient care, and timely response from providers. Concordance with 2 principles led to some desired outcomes. Concordance with only 1 principle was not associated with desired outcomes. Patients who received care that met 3 key aspects of PCMH: coordination, continuity, and management, had better quality of care and more efficient use of the health care system.

  12. An Explication of Concordance between Man's Mental Structure and the Narrative Structure in the Light of Vygotsky's SCT

    Science.gov (United States)

    Azabdaftari, Behrooz

    2013-01-01

    This paper seeks to throw light on the concordance between man's mental structure and the structure of narrative with regard to Vygotsky's sociocultural theory. In so doing, the author first provides the backdrop of the literature on the topic by first explaining Vygotsky's approach to the genesis of mind, and then gives a synoptic account of the…

  13. Genetic determinants of LDL, lipoprotein(a), triglyceride-rich lipoproteins and HDL: concordance and discordance with cardiovascular disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2011-01-01

    To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance...

  14. Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

    NARCIS (Netherlands)

    Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2016-01-01

    Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive

  15. National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

    Science.gov (United States)

    Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

    2009-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

  16. Differences in parent-provider concordance regarding prognosis and goals of care among children with advanced cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Orellana, Liliana; Kang, Tammy I; Geyer, J Russell; Feudtner, Chris; Dussel, Veronica; Wolfe, Joanne

    2014-09-20

    Concordance between parents of children with advanced cancer and health care providers has not been described. We aimed to describe parent-provider concordance regarding prognosis and goals of care, including differences by cancer type. A total of 104 pediatric patients with recurrent or refractory cancer were enrolled at three large children’s hospitals. On enrollment, their parents and providers were invited to complete a survey assessing perceived prognosis and goals of care. Patients’ survival status was retrospectively abstracted from medical records. Concordance was assessed via discrepancies in perceived prognosis, statistics, and McNemar’s test. Distribution of categorical variables and survival rates across cancer type were compared with Fisher’s exact and log-rank tests, respectively. Data were available from 77 dyads (74% of enrolled). Parent-provider agreement regarding prognosis and goals of care was poor (kappa, 0.12 to 0.30). Parents were more likely to report cure was likely (P < .001). The frequency of perceived likelihood of cure and the goal of cure varied by cancer type for both parents and providers (P < .001 to .004). Relatively optimistic responses were more common among parents and providers of patients with hematologic malignancies, although there were no differences in survival. Parent-provider concordance regarding prognosis and goals in advanced pediatric cancer is generally poor. Perceptions of prognosis and goals of care vary by cancer type. Understanding these differences may inform parent-provider communication and decision making.

  17. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

    Science.gov (United States)

    Mazurek, Micah O.; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M.; Hundley, Rachel J.; Poulsen, Marie; Kanne, Stephen M.; Macklin, Eric A.; Handen, Benjamin L.

    2017-01-01

    The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children…

  18. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: evaluating concordance across psychophysiological and observational measures.

    Science.gov (United States)

    Crowell, Sheila E; Baucom, Brian R; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P

    2014-04-01

    Many depressed adolescents experience difficulty in regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings

    Science.gov (United States)

    Stadnick, Nicole; Chlebowski, Colby; Brookman-Frazee, Lauren

    2017-01-01

    Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the…

  20. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme.

    Science.gov (United States)

    Allemani, Claudia; Coleman, Michel P

    2017-12-15

    CONCORD is a programme for the global surveillance of cancer survival. In 2015, the second cycle of the program (CONCORD-2) established long-term surveillance of cancer survival worldwide, for the first time, in the largest cancer survival study published to date. CONCORD-2 provided cancer survival trends for 25,676,887 patients diagnosed during the 15-year period between 1995 and 2009 with 1 of 10 common cancers that collectively represented 63% of the global cancer burden in 2009. Herein, the authors summarize the past, describe the present, and outline the future of the CONCORD programme. They discuss the difference between population-based studies and clinical trials, and review the importance of international comparisons of population-based cancer survival. This study will focus on the United States. The authors explain why population-based survival estimates are crucial for driving effective cancer control strategies to reduce the wide and persistent disparities in cancer survival between white and black patients, which are likely to be attributable to differences in access to early diagnosis and optimal treatment. Cancer 2017;123:4977-81. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  1. Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

    NARCIS (Netherlands)

    D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )

    2016-01-01

    textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between

  2. Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

    NARCIS (Netherlands)

    Dewi Stalpers; Prof. Dr. Marieke J. Schuurmans; Marian J. Kaljouw; Renate A.M.M. Kieft; Dimitri van der Linden

    2016-01-01

    Background: Nurse-sensitive indicators and nurses’ satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive

  3. Concordance Between Different Amyloid Immunoassays and Visual Amyloid Positron Emission Tomographic Assessment.

    Science.gov (United States)

    Janelidze, Shorena; Pannee, Josef; Mikulskis, Alvydas; Chiao, Ping; Zetterberg, Henrik; Blennow, Kaj; Hansson, Oskar

    2017-12-01

    Visual assessment of amyloid positron emission tomographic (PET) images has been approved by regulatory authorities for clinical use. Several immunoassays have been developed to measure β-amyloid (Aβ) 42 in cerebrospinal fluid (CSF). The agreement between CSF Aβ42 measures from different immunoassays and visual PET readings may influence the use of CSF biomarkers and/or amyloid PET assessment in clinical practice and trials. To determine the concordance between CSF Aβ42 levels measured using 5 different immunoassays and visual amyloid PET analysis. The study included 262 patients with mild cognitive impairment or subjective cognitive decline from the Swedish BioFINDER (Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably) cohort (recruited from September 1, 2010, through December 31, 2014) who had undergone flutemetamol F 18 ([18F]flutemetamol)-labeled PET. Levels of CSF Aβ42 were analyzed using the classic INNOTEST and the newer modified INNOTEST, fully automated Lumipulse (FL), EUROIMMUN (EI), and Meso Scale Discovery (MSD) assays. Concentrations of CSF Aβ were assessed using an antibody-independent mass spectrometry-based reference measurement procedure. The concordance of CSF Aβ42 levels and Aβ42:Aβ40 and Aβ42:tau ratios with visual [18F]flutemetamol PET status. Of 262 participants (mean [SD] age, 70.9 [5.5] years), 108 were women (41.2%) and 154 were men (58.8%). The mass spectrometry-derived Aβ42 values showed higher correlations with the modified Aβ42-INNOTEST (r = 0.97), Aβ42-FL (r = 0.93), Aβ42-EI (r = 0.93), and Aβ42-MSD (r = 0.95) assays compared with the classic Aβ42-INNOTEST assay (r = 0.88; P ≤ .01). The signal in the classic Aβ42-INNOTEST assay was partly quenched by recombinant Aβ1-40 peptide. However, the classic Aβ42-INNOTEST assay showed better concordance with visual [18F]flutemetamol PET status (area under the receiver operating characteristic curve [AUC], 0.92) compared with the

  4. Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

    Science.gov (United States)

    Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

    2017-12-01

    The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  5. Analysis of Canis mitochondrial DNA demonstrates high concordance between the control region and ATPase genes

    Directory of Open Access Journals (Sweden)

    White Bradley N

    2010-07-01

    Full Text Available Abstract Background Phylogenetic studies of wild Canis species have relied heavily on the mitochondrial DNA control region (mtDNA CR to infer species relationships and evolutionary lineages. Previous analyses of the CR provided evidence for a North American evolved eastern wolf (C. lycaon, that is more closely related to red wolves (C. rufus and coyotes (C. latrans than grey wolves (C. lupus. Eastern wolf origins, however, continue to be questioned. Therefore, we analyzed mtDNA from 89 wolves and coyotes across North America and Eurasia at 347 base pairs (bp of the CR and 1067 bp that included the ATPase6 and ATPase8 genes. Phylogenies and divergence estimates were used to clarify the evolutionary history of eastern wolves, and regional comparisons of nonsynonomous to synonomous substitutions (dN/dS at the ATPase6 and ATPase8 genes were used to elucidate the potential role of selection in shaping mtDNA geographic distribution. Results We found high concordance across analyses between the mtDNA regions studied. Both had a high percentage of variable sites (CR = 14.6%; ATP = 9.7% and both phylogenies clustered eastern wolf haplotypes monophyletically within a North American evolved lineage apart from coyotes. Divergence estimates suggest the putative red wolf sequence is more closely related to coyotes (DxyCR = 0.01982 ± 0.00494 SD; DxyATP = 0.00332 ± 0.00097 SD than the eastern wolf sequences (DxyCR = 0.03047 ± 0.00664 SD; DxyATP = 0.00931 ± 0.00205 SD. Neutrality tests on both genes were indicative of the population expansion of coyotes across eastern North America, and dN/dS ratios suggest a possible role for purifying selection in the evolution of North American lineages. dN/dS ratios were higher in European evolved lineages from northern climates compared to North American evolved lineages from temperate regions, but these differences were not statistically significant. Conclusions These results demonstrate high concordance between coding

  6. Concordance and predictive value of two adverse drug event data sets.

    Science.gov (United States)

    Cami, Aurel; Reis, Ben Y

    2014-08-22

    Accurate prediction of adverse drug events (ADEs) is an important means of controlling and reducing drug-related morbidity and mortality. Since no single "gold standard" ADE data set exists, a range of different drug safety data sets are currently used for developing ADE prediction models. There is a critical need to assess the degree of concordance between these various ADE data sets and to validate ADE prediction models against multiple reference standards. We systematically evaluated the concordance of two widely used ADE data sets - Lexi-comp from 2010 and SIDER from 2012. The strength of the association between ADE (drug) counts in Lexi-comp and SIDER was assessed using Spearman rank correlation, while the differences between the two data sets were characterized in terms of drug categories, ADE categories and ADE frequencies. We also performed a comparative validation of the Predictive Pharmacosafety Networks (PPN) model using both ADE data sets. The predictive power of PPN using each of the two validation sets was assessed using the area under Receiver Operating Characteristic curve (AUROC). The correlations between the counts of ADEs and drugs in the two data sets were 0.84 (95% CI: 0.82-0.86) and 0.92 (95% CI: 0.91-0.93), respectively. Relative to an earlier snapshot of Lexi-comp from 2005, Lexi-comp 2010 and SIDER 2012 introduced a mean of 1,973 and 4,810 new drug-ADE associations per year, respectively. The difference between these two data sets was most pronounced for Nervous System and Anti-infective drugs, Gastrointestinal and Nervous System ADEs, and postmarketing ADEs. A minor difference of 1.1% was found in the AUROC of PPN when SIDER 2012 was used for validation instead of Lexi-comp 2010. In conclusion, the ADE and drug counts in Lexi-comp and SIDER data sets were highly correlated and the choice of validation set did not greatly affect the overall prediction performance of PPN. Our results also suggest that it is important to be aware of the

  7. Memories of falling in elderly patients with dementia: response concordance rate and reproducibility.

    Science.gov (United States)

    Otaki, Masayo; Moriguchi, Kyoko; Lebowitz, Adam; Asada, Takashi

    2014-12-23

    Although demented elderly patients have impaired memory, memories of falling are not uncommon. We aim to clarify reliability of memories of falling in such patients. Subjects included 62 patients (18 men, 44 women) diagnosed with dementia who resided in long-term care facilities. Mean age was 82.9 ± 7.8 years, mean Mini-Mental State Examination score was 16.4 ± 4.7 points, and mean Functional Independence Measure score was 67.9 ± 18.4 points. Subjects were asked a closed question about whether they were aware of having fallen (i.e. memories of falling) over the past year. Fear of falling was quantified using the visual analogue scale and FACES Pain Rating Scale. Scores were re-measured during retest approximately 10 days later to examine reproducibility of memories and fear of falling. Subjects whom staff had witnessed suffering a fall between baseline and retest session were excluded. Fall memory concordance rate was 0.84, visual analogue scale reproducibility (correlation coefficient) was 0.98, and FACES Pain Rating Scale was 0.86. No differences in Mini-Mental State Examination scores were noted between groups for whom memories of falling were or were not reproducible. No correlation was observed among Mini-Mental State Examination, Functional Independence Measure scores, and intensity of fear of falling. There was a high concordance rate for patients' memories of falling, which suggests that falls were retained as memories. No relationship was observed between memories of falling and degree of cognitive impairment, and severe dementia did not necessarily imply memories of falling were unreliable. The reproducibility of fear of falling suggested the intensity of fear of falling was not easily altered. It was possible memories of falling and fear of falling mutually interacted to reinforce and fixate with each other, leading to the observed phenomenon. Therefore, it appeared memories of falling were retained by patients; this fact can be used in fall

  8. Concordance among remission and admission diagnoses at intensive care unit, Hospital Universitario San José, Popayán, 2011

    Directory of Open Access Journals (Sweden)

    Victor Daniel Montenegro

    2012-03-01

    Full Text Available There are few published studies about diagnostic concordance in hospital services. The objective of this study was to calculate the concordance among remission and admission diagnoses from Hospital Universitario San José adult intensive care unit (I.C.U. of Popayán, 2011. Methods: Descriptive and retrospective study about concordance between the main remission and admission diagnoses from patients admitted in the Hospital adult intensive care unit; 914 patients were studied from the intensive care unit database, months January to December 2011. Statistical analysis about sociodemographic variables was performed, and Kappa index according to Landis and Koch scale among remission and admission diagnoses defined as priority was calculated. Results: It was found al almost perfect level of concordance in the diagnoses pancreatitis and intoxication, a substantial level of concordance in the diagnoses acute coronary syndrome, convulsive status, gastric cancer and eclampsia, a moderate level of concordance in the diagnoses stroke, head trauma, politraumatism and cardiac failure, and a fair level of concordance in the diagnoses sepsis, pneumonia, chronic obstructive pulmonary disease (COPD, gastrointestinal bleeding, acute respiratory infection and acute respiratory distress syndrome. Conclusion: Six of the seventeen studied diagnoses presented an outstanding concordance level; this can be related to factors such as: physicians’, diagnostic ability, provenance of the patients remitted to the I.C.U. and diagnostic coding made by health staff.

  9. Environmental assessment proposed license renewal of Nuclear Metals, Inc. Concord, Massachusetts

    International Nuclear Information System (INIS)

    Miller, R.L.; Easterly, C.E.; Lombardi, C.E.; Treitler, I.E.; Winbow, R.T.; Zimmerman, G.P.

    1997-02-01

    The US Nuclear Regulatory Commission (NRC) has prepared this Environmental Assessment (EA) to evaluate environmental issues associated with the renewal of licenses issued by NRC for facilities operated by Nuclear Metals, Inc. (NMI) in Concord, Massachusetts. By renewing the licenses, NRC proposes to allow the continuation of ongoing operations involving radioactive materials at NMI's facilities. This EA focuses on the potential impacts related to air emissions at NMI during normal (incident-free) operations and accidental releases. Findings indicate that there are only two areas of potential concern. First, modeling results for sulfur dioxide (SO 2 ) emissions from the boilers during normal operations indicate that the potential exists for exceeding the short-term National Ambient Air Quality Standards (NAAQS). NMI is prepared to undertake mitigative action to prevent potential exceedances of the short-term SO 2 NAAQS, and the Massachusetts Department of Environmental Protection is prepared to resolve the issue via a permit/approval change or through a Consent Order. Second, in the unlikely event of a severe fire, predicted sulfuric acid (H 2 SO 4 ) concentrations based on conservative (upper bound) modeling exceed the Emergency Response Planning Guideline (ERPG) levels. NMI has committed to NRC to give a briefing for local emergency response officials regarding the potential for an accidental H 2 SO 4 release

  10. Environmental assessment proposed license renewal of Nuclear Metals, Inc. Concord, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.L.; Easterly, C.E.; Lombardi, C.E.; Treitler, I.E.; Winbow, R.T.; Zimmerman, G.P. [Oak Ridge National Lab., TN (United States)

    1997-02-01

    The US Nuclear Regulatory Commission (NRC) has prepared this Environmental Assessment (EA) to evaluate environmental issues associated with the renewal of licenses issued by NRC for facilities operated by Nuclear Metals, Inc. (NMI) in Concord, Massachusetts. By renewing the licenses, NRC proposes to allow the continuation of ongoing operations involving radioactive materials at NMI`s facilities. This EA focuses on the potential impacts related to air emissions at NMI during normal (incident-free) operations and accidental releases. Findings indicate that there are only two areas of potential concern. First, modeling results for sulfur dioxide (SO{sub 2}) emissions from the boilers during normal operations indicate that the potential exists for exceeding the short-term National Ambient Air Quality Standards (NAAQS). NMI is prepared to undertake mitigative action to prevent potential exceedances of the short-term SO{sub 2} NAAQS, and the Massachusetts Department of Environmental Protection is prepared to resolve the issue via a permit/approval change or through a Consent Order. Second, in the unlikely event of a severe fire, predicted sulfuric acid (H{sub 2}SO{sub 4}) concentrations based on conservative (upper bound) modeling exceed the Emergency Response Planning Guideline (ERPG) levels. NMI has committed to NRC to give a briefing for local emergency response officials regarding the potential for an accidental H{sub 2}SO{sub 4} release.

  11. Concord grape pomace polyphenols complexed to soy protein isolate are stable and hypoglycemic in diabetic mice.

    Science.gov (United States)

    Roopchand, Diana E; Kuhn, Peter; Krueger, Christian G; Moskal, Kristin; Lila, Mary Ann; Raskin, Ilya

    2013-11-27

    Polyphenols extracted from Concord grape pomace were stabilized by complexation to soy protein isolate (SPI) to produce grape polyphenol-SPI complex (GP-SPI) containing 5% or 10% grape polyphenols. LC-MS and MALDI-TOF analysis showed that a broad range of phytochemicals were present in the grape pomace extract. Anthocyanins and total polyphenols in the GP-SPI complex were stable after a 16-week incubation at 37 °C but were reduced by up 60% in dried grape pomace extract. Compared to vehicle (236 ± 34 mg/dL), a single dose of 300 mg/kg GP-SPI (184 ± 32 mg/dL) or 500 mg/kg GP-SPI (177 ± 28 mg/dL) having 5% grape polyphenols significantly lowered blood glucose in obese and hyperglycemic C57BL/6 mice 6 h after administration. GP-SPI allows the capture of grape pomace polyphenols in a protein-rich food matrix and may be useful as a functional food ingredient for the management of blood glucose levels.

  12. Concordant posterior urethral valves in male monochorionic twins with secondary prune belly syndrome.

    Science.gov (United States)

    Nouaili, Emira Ben Hamida; Chaouachi, Sihem; Nouira, Faouzi; Benmassoud, Ines; Laabidi, Kamel; Chaouachi, Beji; Marrakchi, Zahra

    2008-12-01

    Posterior urethral valves (PUVs), the most common congenital cause of lower urinary tract obstruction, have been described to occur in identical and nonidentical twins. Until now, reports have been published on 15 cases of PUVs. We report a new case of concordant PUVs in one set of male monochorionic twins with secondary Prune Belly Syndrome. The twins were born by elective cesarean section at 38 weeks of gestation to a 36-year-old mother, gravida 6, para 6. On ultrasound perfomed at 18 weeks's gestation, both fetuses showed signs of PUVs. At birth, physical examination of both revealed a secondary Prune Belly Syndrome (PBS). Postnatal renal ultrasound confirmed the diagnosis of PUV. The two infants underwent transurethral resection of the valves after a cystoscopic evaluation of the urethra. Since this procedure, their voiding has been unremarkable with stable renal function and sterile urine until their discharge. We have documented a rare association between VUP and PBS in two monochiorionic twins. More studies are needed to throw light on the significance of the present associated anomalies.

  13. Using the Script Concordance Test to Evaluate Clinical Reasoning Skills in Psychiatry.

    Science.gov (United States)

    Kazour, François; Richa, Sami; Zoghbi, Marouan; El-Hage, Wissam; Haddad, Fady G

    2017-02-01

    Although clinical reasoning is a major component of psychiatric training, most evaluating tools do not assess this skill properly. Clinicians mobilize networks of organized knowledge (scripts) to assess ambiguous or uncertain situations. The Script Concordance Test (SCT) was developed to assess clinical reasoning in an uncertainty context. The objective of this study was to test the usefulness of the SCT to assess the reasoning capacities of interns (7th year medical students) during the psychiatry training. The authors designed a SCT for psychiatry teaching, adapted to interns. The test contained 20 vignettes of five questions each. A reference panel of senior psychiatrists underwent the test, and we used their scoring as a reference for the student group. The SCT assessed the competence of students at the beginning and the end of their training in psychiatry. A panel of 10 psychiatrists and 47 interns participated to this study. As expected, the reference panel performed significantly (ppsychiatry rotation. The students improved significantly (ppsychiatry. This study shows the feasibility of this procedure and its utility in the field of psychiatry for evaluating medical students in their clinical reasoning competence. It can provide a valid alternative to classical evaluation methods.

  14. Independent estimates of marine population connectivity are more concordant when accounting for uncertainties in larval origins.

    Science.gov (United States)

    Nolasco, R; Gomes, I; Peteiro, L; Albuquerque, R; Luna, T; Dubert, J; Swearer, S E; Queiroga, H

    2018-02-08

    Marine larval dispersal is a complex biophysical process that depends on the effects of species biology and oceanography, leading to logistical difficulties in estimating connectivity among populations of marine animals with biphasic life cycles. To address this challenge, the application of multiple methodological approaches has been advocated, in order to increase confidence in estimates of population connectivity. However, studies seldom account for sources of uncertainty associated with each method, which undermines a direct comparative approach. In the present study we explicitly account for the statistical uncertainty in observed connectivity matrices derived from elemental chemistry of larval mussel shells, and compare these to predictions from a biophysical model of dispersal. To do this we manipulate the observed connectivity matrix by applying different confidence levels to the assignment of recruits to source populations, while concurrently modelling the intrinsic misclassification rate of larvae to known sources. We demonstrate that the correlation between the observed and modelled matrices increases as the number of observed recruits classified as unknowns approximates the observed larval misclassification rate. Using this approach, we show that unprecedented levels of concordance in connectivity estimates (r = 0.96) can be achieved, and at spatial scales (20-40 km) that are ecologically relevant.

  15. Integrated genomics and proteomics of the Torpedo californica electric organ: concordance with the mammalian neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Mate Suzanne E

    2011-05-01

    Full Text Available Abstract Background During development, the branchial mesoderm of Torpedo californica transdifferentiates into an electric organ capable of generating high voltage discharges to stun fish. The organ contains a high density of cholinergic synapses and has served as a biochemical model for the membrane specialization of myofibers, the neuromuscular junction (NMJ. We studied the genome and proteome of the electric organ to gain insight into its composition, to determine if there is concordance with skeletal muscle and the NMJ, and to identify novel synaptic proteins. Results Of 435 proteins identified, 300 mapped to Torpedo cDNA sequences with ≥2 peptides. We identified 14 uncharacterized proteins in the electric organ that are known to play a role in acetylcholine receptor clustering or signal transduction. In addition, two human open reading frames, C1orf123 and C6orf130, showed high sequence similarity to electric organ proteins. Our profile lists several proteins that are highly expressed in skeletal muscle or are muscle specific. Synaptic proteins such as acetylcholinesterase, acetylcholine receptor subunits, and rapsyn were present in the electric organ proteome but absent in the skeletal muscle proteome. Conclusions Our integrated genomic and proteomic analysis supports research describing a muscle-like profile of the organ. We show that it is a repository of NMJ proteins but we present limitations on its use as a comprehensive model of the NMJ. Finally, we identified several proteins that may become candidates for signaling proteins not previously characterized as components of the NMJ.

  16. Integrated genomics and proteomics of the Torpedo californica electric organ: concordance with the mammalian neuromuscular junction

    Science.gov (United States)

    2011-01-01

    Background During development, the branchial mesoderm of Torpedo californica transdifferentiates into an electric organ capable of generating high voltage discharges to stun fish. The organ contains a high density of cholinergic synapses and has served as a biochemical model for the membrane specialization of myofibers, the neuromuscular junction (NMJ). We studied the genome and proteome of the electric organ to gain insight into its composition, to determine if there is concordance with skeletal muscle and the NMJ, and to identify novel synaptic proteins. Results Of 435 proteins identified, 300 mapped to Torpedo cDNA sequences with ≥2 peptides. We identified 14 uncharacterized proteins in the electric organ that are known to play a role in acetylcholine receptor clustering or signal transduction. In addition, two human open reading frames, C1orf123 and C6orf130, showed high sequence similarity to electric organ proteins. Our profile lists several proteins that are highly expressed in skeletal muscle or are muscle specific. Synaptic proteins such as acetylcholinesterase, acetylcholine receptor subunits, and rapsyn were present in the electric organ proteome but absent in the skeletal muscle proteome. Conclusions Our integrated genomic and proteomic analysis supports research describing a muscle-like profile of the organ. We show that it is a repository of NMJ proteins but we present limitations on its use as a comprehensive model of the NMJ. Finally, we identified several proteins that may become candidates for signaling proteins not previously characterized as components of the NMJ. PMID:21798097

  17. Neuropsychological Profiles of Written Expression Learning Disabilities Determined by Concordance-Discordance Model Criteria.

    Science.gov (United States)

    Fenwick, Melanie E; Kubas, Hanna A; Witzke, Justin W; Fitzer, Kim R; Miller, Daniel C; Maricle, Denise E; Harrison, Gina L; Macoun, Sarah J; Hale, James B

    2016-01-01

    Children with specific learning disabilities (SLD) have disparate neuropsychological processing deficits that interfere with academic achievement in spelling, writing fluency, and/or written expression (WE). Although there are multiple potential causes of WE SLD, there is a paucity of research exploring this critical academic skill from a neuropsychological perspective. This study examined the neuropsychological profiles of WE SLD subtypes defined using the concordance-discordance model (C-DM) of SLD identification. Participants were drawn from a sample of 283 children (194 boys, 89 girls) aged 6 years to 16 years old (M(age) = 9.58 years, SD = 2.29 years) referred for comprehensive neuropsychological evaluations in school settings and subsequently selected based on C-DM determined spelling, writing fluency, and WE SLD. WE SLD subtypes differed on several psychomotor, memory, and executive function measures (F range = 2.48-5.07, p range = .049 to <.001), suggesting that these children exhibit distinct patterns of neuropsychological processing strengths and weaknesses. Findings have relevance for differential diagnosis of WE subtypes, discriminating WE SLD subtypes from low WE achievement, and developing differentiated evidence-based instruction and intervention for children with WE SLD. Limitations and future research will be addressed.

  18. Does mindfulness prepare adolescents for value-behavior concordance? Examining the role of value content.

    Science.gov (United States)

    Warren, Michael T; Wray-Lake, Laura

    2017-07-01

    Great thinkers throughout history advocated living one's values, yet little research has examined factors that contribute to adolescents' value-behavior concordance (VBC). Mindfulness may foster VBC via heightened awareness of values, but VBC for intrinsic values may be more adaptive than VBC for extrinsic values. To situate mindfulness in developmental context, we examined age and attachment security as predictors of mindfulness. We collected self- and parent-report data from 299 families (M age-adolescents  = 14.45, SD = 1.68; 51% female) from 42 US states to test these ideas. Results indicated that mindfulness was positively associated with intrinsic VBC but was negatively linked with extrinsic VBC, and both kinds of VBC partially mediated the link from mindfulness to meaning (but not life satisfaction). Attachment security was associated with higher mindfulness. Overall, mindfulness may deliver its benefits by helping young people avoid behaviors that align with extrinsic values. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  19. A novel attractant for Anastrepha ludens (Diptera: Tephritidae) from a Concord grape product.

    Science.gov (United States)

    Robacker, David C; Massa, Michelle J; Sacchetti, Patrizia; Bartelt, Robert J

    2011-08-01

    An attractant for Mexican fruit fly, Anastrepha ludens (Loew) (Diptera: Tephritidae), was developed from a commercial product called Sabor Uva containing processed Concord grape juice. The principal volatile components of Sabor Uva aroma were identified and an aqueous mixture of 15 components that was gas chromatographically similar to Sabor Uva was prepared. This mixture was equivalent to Sabor Uva in attractiveness by using wind-tunnel bioassays. After deleting chemicals that did not contribute to attractiveness, and increasing the concentrations of the remaining chemicals, the final attractant contained propylene glycol (90,000 ppm, vol/vol), acetic acid (4500), methyl anthranilate (1800), ethyl 2-methylpropionate (670), and one or both of the esters ethyl 3-methylbutyrate (44) and 2-methylbutyl propionate (44), in aqueous solution. This mixture was approximately 1.8X as attractive as Sabor Uva by indirect comparison. Deletion of propylene glycol, acetic acid, methyl anthranilate, or ethyl 2-methylpropionate from the mixture significantly decreased attractiveness. Deletion of either of the other two esters seemed to diminish attractiveness although effects were not statistically significant. Deletion of water from the mixture significantly decreased attractiveness. We conclude that propylene glycol, acetic acid, methyl anthranilate, water, and at least one or as many as all three of the methyl-branched esters are essential for complete attractiveness.

  20. Contextual Influences on Concordance between Maternal Report and Laboratory Observation of Toddler Fear

    Science.gov (United States)

    Kiel, Elizabeth J.; Hummel, Alexandra C.

    2016-01-01

    Emotion and temperament researchers have faced an enduring issue of how to best measure children’s tendencies to express specific emotions. Inconsistencies between laboratory observation and parental report have made it challenging for researchers to determine the utility of these different forms of measurement. The current study examined the effect of laboratory episode characteristics (i.e., threat-level of the episode, maternal involvement) on concordance between maternal report and laboratory observation of toddler fear. The sample included 111 mother-toddler dyads who participated in a laboratory assessment when toddlers were approximately 24-months-old. Toddler fear was assessed both via maternal report and observation from a number of laboratory episodes that varied in their level of threat and whether mothers were free or constrained in their involvement in the task. Results indicated that maternal report related to the observed fear composites for low-threat, but not high-threat episodes. On the other hand, maternal involvement in the laboratory episodes did not moderate the relation between maternal report and laboratory observation of fear. These results suggest that the threat-level of laboratory episodes designed to elicit fear, but not maternal involvement in these episodes, may be important to take into consideration when assessing their relation to maternal report of fear and fearful temperament. PMID:27606826

  1. Concordant Biogeographic Patterns among Multiple Taxonomic Groups in the Mexican Freshwater Biota

    Science.gov (United States)

    Quiroz-Martínez, Benjamín; Álvarez, Fernando; Espinosa, Héctor; Salgado-Maldonado, Guillermo

    2014-01-01

    In this paper we analyse the degree of concordance in species richness and taxonomic distinctness (diversity) patterns among different freshwater taxonomic groups in order to test three long held patterns described in Mexican freshwater biogeography: 1. The aquatic biota of Mexico includes two distinct faunas, a rich Neotropical component in the south and a south-eastern region and a less rich Nearctic component towards central and northern latitudes of the country. 2. A hotspot of species richness and diversity has been recorded in the Usumacinta, including the Yucatan Peninsula. 3. The presence of two distinct biotas in Mexico, an eastern one distributed along the Gulf of Mexico slope, and a western one associated to the Pacific versant. We use species richness and taxonomic distinctness to explore patterns of diversity and how these patterns change between zoogeographical regions. This paper points out a clear separation between Neotropical and Nearctic drainage basins but also between eastern (Gulf of Mexico) and western (Pacific) drainage basins. Present data gives additional empirical support from freshwater biota for three long held beliefs regarding distributional patterns of the Mexican biota. The neotropical basins of Mexico are generally host to a richest and more diversified fauna, that includes more families, genera and species, compared to the less rich and less diverse fauna in the nearctic basins. PMID:25136979

  2. Assessment of intimate partner violence among high-risk postpartum mothers: concordance of clinical measures.

    Science.gov (United States)

    Connelly, C D; Newton, R R; Landsverk, J; Aarons, G A

    2000-01-01

    Intimate partner violence (IPV) may be a more common problem than some conditions for which pregnant women are routinely screened and evaluated. Screening for IPV necessitates competence in assessment using reliable and valid instruments. The present study examines the concordance in the prevalence of abuse reported by 436 high-risk postpartum mothers using (1) a single item hospital screen, (2) trained paraprofessional interviewer-interview format, and (3) the Conflict Tactics Scale (CTS), a standardized research instrument. The hospital screen identified 4% of the sample as scared, threatened or hurt, the Family Stress Checklist (FSC) identified 16.9% of the fathers as having severe potential for violence, and the CTS identified 18.6% of the sample as victims of physical abuse at the hands of the baby's father. There was minimal overlap between the ratings of severe potential for violence and the occurrence of violence as assessed by the CTS. Study findings illustrate the inadequacy of current procedures for detecting IPV with high-risk populations and highlight the need to develop reliable and valid assessments that can be easily utilized in the hospital setting.

  3. NDRC: A Disease-Causing Genes Prioritized Method Based on Network Diffusion and Rank Concordance.

    Science.gov (United States)

    Fang, Minghong; Hu, Xiaohua; Wang, Yan; Zhao, Junmin; Shen, Xianjun; He, Tingting

    2015-07-01

    Disease-causing genes prioritization is very important to understand disease mechanisms and biomedical applications, such as design of drugs. Previous studies have shown that promising candidate genes are mostly ranked according to their relatedness to known disease genes or closely related disease genes. Therefore, a dangling gene (isolated gene) with no edges in the network can not be effectively prioritized. These approaches tend to prioritize those genes that are highly connected in the PPI network while perform poorly when they are applied to loosely connected disease genes. To address these problems, we propose a new disease-causing genes prioritization method that based on network diffusion and rank concordance (NDRC). The method is evaluated by leave-one-out cross validation on 1931 diseases in which at least one gene is known to be involved, and it is able to rank the true causal gene first in 849 of all 2542 cases. The experimental results suggest that NDRC significantly outperforms other existing methods such as RWR, VAVIEN, DADA and PRINCE on identifying loosely connected disease genes and successfully put dangling genes as potential candidate disease genes. Furthermore, we apply NDRC method to study three representative diseases, Meckel syndrome 1, Protein C deficiency and Peroxisome biogenesis disorder 1A (Zellweger). Our study has also found that certain complex disease-causing genes can be divided into several modules that are closely associated with different disease phenotype.

  4. The association of soda sales tax and school nutrition laws: a concordance of policies.

    Science.gov (United States)

    Greathouse, K Leigh; Chriqui, Jamie; Moser, Richard P; Agurs-Collins, Tanya; Perna, Frank M

    2014-10-01

    The current research examined the association between state disfavoured tax on soda (i.e. the difference between soda sales tax and the tax on food products generally) and a summary score representing the strength of state laws governing competitive beverages (beverages that compete with the beverages in the federally funded school lunch programme) in US schools. The Classification of Laws Associated with School Students (CLASS) summary score reflected the strength of a state's laws restricting competitive beverages sold in school stores, vending machines, school fundraisers and à la carte cafeteria items. Bridging the Gap (BTG) is a nationally recognized research initiative that provided state-level soda tax data. The main study outcome was the states' competitive beverage summary scores for elementary, middle and high school grade levels, as predicted by the states' disfavoured soda tax. Univariate and multivariate analyses were conducted, adjusting for year and state. Data from BTG and CLASS were used. BTG and CLASS data from all fifty states and the District of Columbia from 2003 to 2010 were used. A higher disfavoured soda sales tax was generally associated with an increased likelihood of having strong school beverage laws across grade levels, and especially when disfavoured soda sales tax was >5 %. These data suggest a concordance between states' soda taxes and laws governing beverages sold in schools. States with high disfavoured sales tax on soda had stronger competitive beverage laws, indicating that the state sales tax environment may be associated with laws governing beverage policy in schools.

  5. Testing concordance of instrumental variable effects in generalized linear models with application to Mendelian randomization

    Science.gov (United States)

    Dai, James Y.; Chan, Kwun Chuen Gary; Hsu, Li

    2014-01-01

    Instrumental variable regression is one way to overcome unmeasured confounding and estimate causal effect in observational studies. Built on structural mean models, there has been considerale work recently developed for consistent estimation of causal relative risk and causal odds ratio. Such models can sometimes suffer from identification issues for weak instruments. This hampered the applicability of Mendelian randomization analysis in genetic epidemiology. When there are multiple genetic variants available as instrumental variables, and causal effect is defined in a generalized linear model in the presence of unmeasured confounders, we propose to test concordance between instrumental variable effects on the intermediate exposure and instrumental variable effects on the disease outcome, as a means to test the causal effect. We show that a class of generalized least squares estimators provide valid and consistent tests of causality. For causal effect of a continuous exposure on a dichotomous outcome in logistic models, the proposed estimators are shown to be asymptotically conservative. When the disease outcome is rare, such estimators are consistent due to the log-linear approximation of the logistic function. Optimality of such estimators relative to the well-known two-stage least squares estimator and the double-logistic structural mean model is further discussed. PMID:24863158

  6. Interindividual concordance of methylation profiles in human genes for tumor necrosis factors α and β

    International Nuclear Information System (INIS)

    Kochanek, S.; Toth, M.; Dehmel, A.; Renz, D.; Doerfler, W.

    1990-01-01

    The DNA in mammalian genomes is characterized by complex patterns of DNA methylation that reflect the states of all genetic activities of that genome. The modified nucleotide 5-methyldeoxycytidine ( 5 mdC) can affect the interactions of specific proteins with DNA sequence motifs. The most extensively studied effect of sequence-specific methylations is that of the long-term silencing of eukaryotic (mammalian) promoters. The authors have initiated studies on the methylation status of parts of the human genome to view patterns of DNA methylation as indicators for genetic activities. In this report, analyses using both restriction enzyme-Southern blotting and the very precise genomic sequencing technique have been done. The results are characterized by a remarkable interindividual concordance of DNA methylation in specific human cell types. The patterns are identical in the DNA from one cell type for different individuals even of different genetic origins but different in the DNA from different cell types. The TNF-β promoter is methylated in granulocytes from 9 different individuals, and TNF-β is not expressed. In human lymphocytes, the main source of TNF-β, the TNF-β promoter is free of 5 mdC residues

  7. Average and dispersion of the luminosity-redshift relation in the concordance model

    CERN Document Server

    Ben-Dayan, I.; Marozzi, G.; Nugier, F.; Veneziano, G.

    2013-01-01

    Starting from the luminosity-redshift relation recently given up to second order in the Poisson gauge, we calculate the effects of the realistic stochastic background of perturbations of the so-called concordance model on the combined light-cone and ensemble average of various functions of the luminosity distance, and on their variance, as functions of redshift. We apply a gauge-invariant light-cone averaging prescription which is free from infrared and ultraviolet divergences, making our results robust with respect to changes of the corresponding cutoffs. Our main conclusions, in part already anticipated in a recent letter for the case of a perturbation spectrum computed in the linear regime, are that such inhomogeneities not only cannot avoid the need for dark energy, but also cannot prevent, in principle, the determination of its parameters down to an accuracy of order $10^{-3}-10^{-5}$, depending on the averaged observable and on the regime considered for the power spectrum. However, taking into account t...

  8. Concordance of outcomes of pairs of kidneys transplanted into different recipients.

    LENUS (Irish Health Repository)

    Traynor, Carol

    2012-09-01

    Kidney transplant outcomes are influenced by donor characteristics, including age and gender. Additional donor factors, both genetic and environmental, also influence graft outcome. We aim to assess the strength of donor factors in determining kidney transplant outcomes by comparing paired kidneys from a single donor transplanted into different recipients. We conducted a retrospective cohort study of outcomes of pairs of deceased donor kidneys transplanted in our centre between 1992 and 2008. We examined the relationship within pairs for eGFR at 1 year and at 5 years post-transplant using Spearman\\'s Correlation and the concordance of pairs of transplant kidneys with respect to the occurrence of acute rejection and delayed graft function (DGF). A total of 652 recipient pairs were analysed. Spearman\\'s correlation for eGFR was 0.36 at 1 year and 0.36 at 5 years post-transplant. The incidence of DGF was 11%. The odds ratio of DGF occurring if the contralateral kidney had DGF was 5.99 (95% CI, 3.19-11.25). There is a significant degree of relationship within pairs of kidneys transplanted from the same donor for serum creatinine at 1 year and 5 years post-transplant and also for the occurrence of delayed graft function.

  9. Concordance of programmatic and laboratory-based multidrug-resistant tuberculosis treatment outcomes in Peru.

    Science.gov (United States)

    Alexy, E R; Podewils, L J; Mitnick, C D; Becerra, M C; Laserson, K F; Bonilla, C

    2012-01-01

    Confirmation of cure for multidrug-resistant tuberculosis (MDR-TB) patients requires laboratory tests for Mycobacterium tuberculosis growth on culture media. Outcome decisions dictate patient management, and inaccuracies place patients at an increased risk of morbidity and mortality, and may contribute to continued transmission of MDR-TB. To examine concordance between programmatic and laboratory-based MDR-TB treatment outcomes. The study population included 1658 MDR-TB patients in Peru treated between 1996 and 2002 with both program and laboratory-based outcomes. Laboratory-based outcomes were assigned according to international standards requiring at least five consecutive negative cultures in the last 12 months of treatment to confirm cure. Compared to the global culture-defined standard classification, only 1.1% of treatment successes, but 54.3% of failures, were misclassified programmatically. Overall, 10.4% of patients identified by a clinician as having a successful treatment outcome still had cultures positive for MDR-TB. Most patients with successful treatment outcomes by strict culture definitions were also classified by clinicians as having successful outcomes. However, many culture-confirmed failures were missed. In light of delays and incomplete access to culture in MDR-TB programs, efforts should be made to improve the accuracy of programmatically determined treatment outcomes.

  10. Concordance of mutation detection in circulating tumor DNA in early clinical trials using different blood collection protocols

    DEFF Research Database (Denmark)

    Ahlborn, Lise B.; Madsen, Mette; Jonson, Lars

    2017-01-01

    in a clinical setting. Here we investigate the concordance between standard blood collection for molecular analysis using immediate separation of plasma, compared to the use of collection tubes allowing for delayed processing. Methods: In this study, we measured the fractional abundance of tumor specific...... patients with advanced solid cancers enrolled in early clinical trials. Results: Concordance in the fractional abundance of mutations in ctDNA isolated from blood collected in either K3EDTA or BCT tubes from patients with different solid cancers was observed. Conclusions: This study indicates that BCT...... mutations (BRAF p.V600E and PIK3CA p.H1047R) in ctDNA isolated from blood samples collected in either cell-stabilizing Cell-Free DNA BCT tubes (delayed processing within 72 hours) or standard K3EDTA tubes (immediate processing within 15 minutes). Twenty-five blood sample pairs (EDTA/BCT) were collected from...

  11. Goal striving, goal attainment, and well-being: adapting and testing the self-concordance model in sport.

    Science.gov (United States)

    Smith, Alison; Ntoumanis, Nikos; Duda, Joan

    2007-12-01

    Grounded in self-determination theory (Deci & Ryan, 1985) and the self-concordance model (Sheldon & Elliot, 1999), this study examined the motivational processes underlying goal striving in sport as well as the role of perceived coach autonomy support in the goal process. Structural equation modeling with a sample of 210 British athletes showed that autonomous goal motives positively predicted effort, which, in turn, predicted goal attainment. Goal attainment was positively linked to need satisfaction, which, in turn, predicted psychological well-being. Effort and need satisfaction were found to mediate the associations between autonomous motives and goal attainment and between attainment and well-being, respectively. Controlled motives negatively predicted well-being, and coach autonomy support positively predicted both autonomous motives and need satisfaction. Associations of autonomous motives with effort were not reducible to goal difficulty, goal specificity, or goal efficacy. These findings support the self-concordance model as a framework for further research on goal setting in sport.

  12. Fault Severity Evaluation and Improvement Design for Mechanical Systems Using the Fault Injection Technique and Gini Concordance Measure

    Directory of Open Access Journals (Sweden)

    Jianing Wu

    2014-01-01

    Full Text Available A new fault injection and Gini concordance based method has been developed for fault severity analysis for multibody mechanical systems concerning their dynamic properties. The fault tree analysis (FTA is employed to roughly identify the faults needed to be considered. According to constitution of the mechanical system, the dynamic properties can be achieved by solving the equations that include many types of faults which are injected by using the fault injection technique. Then, the Gini concordance is used to measure the correspondence between the performance with faults and under normal operation thereby providing useful hints of severity ranking in subsystems for reliability design. One numerical example and a series of experiments are provided to illustrate the application of the new method. The results indicate that the proposed method can accurately model the faults and receive the correct information of fault severity. Some strategies are also proposed for reliability improvement of the spacecraft solar array.

  13. Concordance between current job and usual job in occupational and industry groupings: assessment of the 2010 national health interview survey.

    Science.gov (United States)

    Luckhaupt, Sara E; Cohen, Martha A; Calvert, Geoffrey M

    2013-09-01

    To determine whether current job is a reasonable surrogate for usual job. Data from the 2010 National Health Interview Survey were utilized to determine concordance between current and usual jobs for workers employed within the past year. Concordance was quantitated by kappa values for both simple and detailed industry and occupational groups. Good agreement is considered to be present when kappa values exceed 60. Overall kappa values ± standard errors were 74.5 ± 0.5 for simple industry, 72.4 ± 0.5 for detailed industry, 76.3 ± 0.4 for simple occupation, 73.7 ± 0.5 for detailed occupation, and 80.4 ± 0.6 for very broad occupational class. Sixty-five of 73 detailed industry groups and 78 of 81 detailed occupation groups evaluated had good agreement between current and usual jobs. Current job can often serve as a reliable surrogate for usual job in epidemiologic studies.

  14. Script concordance testing: assessing residents' clinical decision-making skills for infant lumbar punctures.

    Science.gov (United States)

    Chang, Todd P; Kessler, David; McAninch, Brett; Fein, Daniel M; Scherzer, D J; Seelbach, Elizabeth; Zaveri, Pavan; Jackson, Jennifer M; Auerbach, Marc; Mehta, Renuka; Van Ittersum, Wendy; Pusic, Martin V

    2014-01-01

    Residents must learn which infants require a lumbar puncture (LP), a clinical decision-making skill (CDMS) difficult to evaluate because of considerable practice variation. The authors created an assessment model of the CDMS to determine when an LP is indicated, taking practice variation into account. The objective was to detect whether script concordance testing (SCT) could measure CDMS competency among residents for performing infant LPs. In 2011, using a modified Delphi technique, an expert panel of 14 attending physicians constructed 15 case vignettes (each with 2 to 4 SCT questions) that represented various infant LP scenarios. The authors distributed the vignettes to residents at 10 academic pediatric centers within the International Simulation in Pediatric Innovation, Research, and Education Network. They compared SCT scores among residents of different postgraduate years (PGYs), specialties, training in adult medicine, LP experience, and practice within an endemic Lyme disease area. Of 730 eligible residents, 102 completed 47 SCT questions. They could earn a maximum score of 47. Median SCT scores were significantly higher in PGY-3s compared with PGY-1s (difference: 3.0; 95% confidence interval [CI] 1.0-4.9; effect size d = 0.87). Scores also increased with increasing LP experience (difference: 3.3; 95% CI 1.1-5.5) and with adult medicine training (difference: 2.9; 95% CI 0.6-5.0). Residents in Lyme-endemic areas tended to perform more LPs than those in nonendemic areas. SCT questions may be useful as an assessment tool to determine CDMS competency among residents for performing infant LPs.

  15. Postmortem CT compared to autopsy in children; concordance in a forensic setting.

    Science.gov (United States)

    Sieswerda-Hoogendoorn, Tessa; Soerdjbalie-Maikoe, Vidija; de Bakker, Henri; van Rijn, Rick R

    2014-11-01

    The aim of this study is to assess the accuracy of postmortem CT (PMCT) in determining the cause of death in children who underwent a forensic autopsy because of a suspected nonnatural death. We selected forensic pediatric autopsies at the Netherlands Forensic Institute, whereby the subject underwent PMCT between 1-1-2008 and 31-12-2012. Cause of death was independently scored by a radiologist and a pathologist. Cause of death was classified (1) in categories being natural, unnatural, and unknown; (2) according to the ICD-10; and (3) according to institutional classification. In the study period, 189 pediatric forensic autopsies were performed. Fifteen were excluded because of putrefaction. Of the remaining 174 autopsies, 98 (56%) underwent PMCT. PMCT and autopsy identified the same category in 69/98 cases (70%, kappa 0.49). They identified the same cause of death in 66/98 cases (67%, kappa 0.5) using ICD-10; in 71/98 (72%, kappa 0.62) using a forensic classification. PMCT performed better in unnatural deaths (59-67 % agreement) than in natural deaths (0 % agreement). If no cause of death was detected with autopsy, PMCT failed to identify a cause of death in 98% (39/40). Pediatric PMCT does identify the majority of unnatural causes of death, but does not identify new diagnoses (true positives) if no cause of death is found during autopsy. Diagnostic accuracy in natural deaths is low. • The case mix is an important predictor for the concordance between PMCT and autopsy. • In case of an unnatural death, 72--81% of PMCT results matches autopsy results. • In case of a natural death, 0% of PMCT results matches autopsy results. • If no cause of death is identified with autopsy, 98% of PMCT results concurs.

  16. Association Rules Analysis of Comorbidity and Multimorbidity: The Concord Health and Aging in Men Project.

    Science.gov (United States)

    Held, Fabian P; Blyth, Fiona; Gnjidic, Danijela; Hirani, Vasant; Naganathan, Vasikaran; Waite, Louise M; Seibel, Markus J; Rollo, Jennifer; Handelsman, David J; Cumming, Robert G; Le Couteur, David G

    2016-05-01

    Comorbidity and multimorbidity are common in older people. Here we used a novel analytic approach called Association Rules together with network analysis to evaluate multimorbidity (two or more disorders) and comorbidity in old age. A population-based cross-sectional study was undertaken where 17 morbidities were analyzed using network analysis, cluster analysis, and Association Rules methodology. A comorbidity interestingness score was developed to quantify the richness and variability of comorbidities associated with an index condition. The participants were community-dwelling men aged 70 years or older from the Concord Health and Ageing in Men Project, Sydney, Australia, with complete data (n = 1,464). The vast majority (75%) of participants had multimorbidity. Several morbidity clusters were apparent (vascular cluster, metabolic cluster, neurodegenerative cluster, mental health and other cluster, and a musculoskeletal and other cluster). Association Rules revealed unexpected comorbidities with high lift and confidence linked to index diseases. Anxiety and heart failure had the highest comorbidity interestingness scores while obesity, hearing impairment, and arthritis had the lowest (zero) scores. We also performed Association Rules analysis for the geriatric syndromes of frailty and falls to determine their association with multimorbidity. Frailty had a very complex and rich set of frequent and interesting comorbidities, while there were no frequent and interesting sets associated with falls. Old age is characterized by a complex pattern of multimorbidity and comorbidity. Single disease definitions do not account for the prevalence and complexity of multimorbidity in older people and a new lexicon may be needed to underpin research and health care interventions for older people. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Adrenal incidentalomas showing unilateral concordant visualization by adrenocortical scintigraphy. Comparison with adenomas in Cushing's syndrome

    International Nuclear Information System (INIS)

    Tani, Atsushi; Nakajo, Masayuki; Tsuchimochi, Shinsaku; Nakabeppu, Yoshiaki; Umanodan, Tomokazu

    2000-01-01

    An adrenocortical adenoma causing Cushing's syndrome (Cushing's adenoma) produces a unilateral concordant visualization (UCV) imaging pattern in which the adenoma is only visualized on radioiodocholesterol adrenocortical scintigraphy. But because this imaging pattern is also noted in some patients with adrenal incidentalomas, we examined whether the UCV-incidentaloma was essentially identical with Cushing's adenoma and would develop Cushing's syndrome. The subjects were 9 patients with UCV-incidentalomas (mean size, 30 mm; range, 20-45 mm) and 6 patients with Cushing's adenomas (mean size, 28 mm; range, 25-35 mm). Endocrinological evaluations showed several abnormalities including blunted diurnal rhythm of plasma cortisol within the normal range, low plasma ACTH and/or high 24-hr urinary 17-OHCS levels in 8 of 9 patients with UCV-incidentalomas, but these abnormalities did not meet the diagnostic criteria of Cushing's syndrome. Adrenal uptake of the tracer in the patients with UCV-incidentalomas was not statistically different from that in the patients with Cushing's adenomas and had no relationship with hormonal values in either patient group. Tumor size on CT correlated with the levels of 24-hr urinary 17-OHCS (r=0.75, p=0.02) and plasma cortisol at 7:00 (r=0.82, p=0.007) in the patients with UCV-incidentalomas, but not in the patients with Cushing's adenomas. Although 3 UCV-incidentalomas increased slightly in size, none of 9 patients with UCV-incidentalomas has developed Cushing's syndrome for 4 to 52 months. These results suggest that the UCV-incidentaloma may be essentially different from the Cushing's adenoma and unlikely to develop Cushing's syndrome. (author)

  18. Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder.

    Science.gov (United States)

    Ohashi, Kei; Mizuno, Yoshifumi; Miyachi, Taishi; Asai, Tomoko; Imaeda, Masayuki; Saitoh, Shinji

    2015-12-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age. © 2015 Japan Pediatric Society.

  19. Effects of Concord grape juice on ambulatory blood pressure in prehypertension and stage 1 hypertension123

    Science.gov (United States)

    Dohadwala, Mustali M; Hamburg, Naomi M; Holbrook, Monika; Kim, Brian H; Duess, Mai-Ann; Levit, Aaron; Titas, Megan; Chung, William B; Vincent, Felix B; Caiano, Tara L; Frame, Alissa A; Keaney, John F

    2010-01-01

    Background: Consumption of flavonoid-containing foods may be useful for the management of hypertension. Objective: We investigated whether 100% Concord grape juice lowers blood pressure in patients with prehypertension and stage 1 hypertension. Design: We conducted a double-blind crossover study to compare the effects of grape juice (7 mL · kg−1 · d−1) and matched placebo beverage on 24-h ambulatory blood pressure, stress-induced changes in blood pressure, and biochemical profile. Participants consumed each beverage for 8 wk with a 4-wk rest period between beverages. They ceased consumption of grapes and other flavonoid-containing beverages throughout the study. Results: We enrolled 64 otherwise healthy patients taking no antihypertensive medications (31% women, 42% black, age 43 ± 12 y). Baseline mean (±SD) cuff blood pressure was 138 ± 7 (systolic)/82 ± 7 (diastolic) mm Hg. No effects on the primary endpoint of 24-h mean systolic blood pressure, diastolic blood pressure, or stress-induced changes in blood pressure were observed. A secondary endpoint was nocturnal dip in systolic pressure. At baseline, nocturnal pressure was 8.3 ± 7.1% lower at night than during daytime. The mean nocturnal dip increased 1.4 percentage points after grape juice and decreased 2.3 percentage points after placebo (P = 0.005). Fasting blood glucose was 91 ± 10 mg/dL at baseline for the entire cohort. Glucose decreased 2 mg/dL after consumption of grape juice and increased 1 mg/dL after consuming the placebo (P = 0.03). Conclusions: We observed no effect of grape juice on ambulatory blood pressure in this cohort of relatively healthy individuals with modestly elevated blood pressure. Secondary analyses suggested favorable effects on nocturnal dip and glucose homeostasis that may merit further investigation. This trial was registered at clinicaltrials.gov as NCT00302809. PMID:20844075

  20. Know your tools - concordance of different methods for measuring brain volume change after ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [The University of Melbourne, Departments of Medicine and Neurology, Melbourne Brain Centre rate at The Royal Melbourne Hospital, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid [The University of Melbourne, The Florey Institute of Neurosciences and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2015-07-15

    Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions. (orig.)

  1. Effect of Experience and Training on the Concordance and Precision of Strain Measurements.

    Science.gov (United States)

    Negishi, Tomoko; Negishi, Kazuaki; Thavendiranathan, Paaladinesh; Cho, Goo-Yeong; Popescu, Bogdan A; Vinereanu, Dragos; Kurosawa, Koji; Penicka, Martin; Marwick, Thomas H

    2017-05-01

    This study sought to show the degree to which experience and training affect the precision and validity of global longitudinal strain (GLS) measurement and to evaluate the variability of strain measurement after feedback. The application of GLS for the detection of subclinical dysfunction has been recommended in an expert consensus document and is being used with increasing frequency. The role of experience in the precision and validity of GLS measurement is unknown, as is the efficacy of training. Fifty-eight readers, divided into 4 groups on the basis of their experience with GLS, calculated GLS from speckle strain analysis of 9 cases with various degrees of image quality. Intraclass correlation coefficients (ICCs), mean difference, SD, and coefficient of variation (CV) were compared against the measurements of a reference group that had experience with >1,000 cases of strain measurement. Individualized feedback was distributed, and repeat measurements were performed by 40 readers. Comparisons with the baseline variation provided information about whether feedback was effective. The ICC for GLS was significantly greater than that for ejection fraction regardless of image quality. Experience with strain measurement affected the concordance in strain values among the readers; the group with the highest level of experience showed significantly better ICC than those with no experience, although the ICC of the inexperienced readers was still very good (0.996 vs. 0.975; p = 0.0002). As experience increased, the mean difference, SD, and CV became significantly smaller. The CV of segmental strain analysis showed significant improvement after training, regardless of experience. The favorable interobserver agreement of GLS makes it more attractive than ejection fraction for follow-up of left ventricular function by multiple observers. Although experience is important, the precision of GLS was high for all groups. Training appears to be of most value for the assessment of

  2. Concordance and discrepancy in sexual identity, attraction, and behavior among adolescents.

    Science.gov (United States)

    Igartua, Karine; Thombs, Brett D; Burgos, Giovani; Montoro, Richard

    2009-12-01

    Nonheterosexual youth are at greater risk for mental and physical health problems than heterosexual youth. Definitions of nonheterosexual youth, however, are not consistent between studies, variably including sexual identity, attraction, and/or behavior. This study's objective was to describe the concordance and discrepancy between sexual identification, attraction, and behavior in adolescents. A total of 1,951 students aged 14 and older from 14 high schools in Montreal, Quebec, were surveyed anonymously using the Quebec Youth Risk Behaviour Survey. The survey included three items assessing sexual orientation (sexual identity, sexual attraction, sexual behavior). Twelve percent of adolescents (n=237) endorsed at least one measure of nonexclusive heterosexuality. A total of 3.4% reported gay/lesbian or bisexual (GLB) identity (another 3.4% were unsure), 9.0% reported same-gender attraction, and 4.0% same-gender behavior. There was no consistent pattern of overlap between the three measures, and no single dimension effectively captured this population. The question about attraction identified 71%; identity identified 52%; and behavior only 31%. In raw numbers, more heterosexually identified students reported same-gender attraction (n=95) or same-gender behavior (n=33) than GLB-identified students (n=44 and 29, respectively). "Nonheterosexual" youth are a heterogeneous group that cannot be identified accurately using a single question. In both research and clinical settings, the best way to assess sexual orientation, consistent with American Academy of Pediatrics, is to ask multiple questions that address the dimensions of identity, attraction, and behavior. All youth who endorse any combination of nonexclusively heterosexual identity, behavior, or attraction are potentially at risk for the ill effects of direct and indirect discrimination.

  3. Concordant and discordant regulation of target genes by miR-31 and its isoforms.

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    Yu-Tzu Chan

    Full Text Available It has been shown that imprecise cleavage of a primary or precursor RNA by Drosha or Dicer, respectively, may yield a group of microRNA (miRNA variants designated as "isomiR". Variations in the relative abundance of isoforms for a given miRNA among different species and different cell types beg the question whether these isomiRs might regulate target genes differentially. We compared the capacity of three miR-31 isoforms (miR-31-H, miR-31-P, and miR-31-M, which differ only slightly in their 5'- and/or 3'-end sequences, to regulate several known targets and a predicted target, Dicer. Notably, we found isomiR-31s displayed concordant and discordant regulation of 6 known target genes. Furthermore, we validated a predicted target gene, Dicer, to be a novel target of miR-31 but only miR-31-P could directly repress Dicer expression in both MCF-7 breast cancer cells and A549 lung cancer cells, resulting in their enhanced sensitivity to cisplatin, a known attribute of Dicer knockdown. This was further supported by reporter assay using full length 3'-untranslated region (UTR of Dicer. Our findings not only revealed Dicer to be a direct target of miR-31, but also demonstrated that isomiRs displayed similar and disparate regulation of target genes in cell-based systems. Coupled with the variations in the distribution of isomiRs among different cells or conditions, our findings support the possibility of fine-tuning gene expression by miRNAs.

  4. Concordance of oral HPV prevalence between patients with oropharyngeal cancer and their partners.

    Science.gov (United States)

    Tsao, Anne S; Papadimitrakopoulou, Vassiliki; Lin, Heather; Guo, Ming; Lee, J Jack; Holsinger, F Christopher; Hong, Waun Ki; Sturgis, Erich M

    2016-01-01

    Human papilloma virus (HPV) is a known causative factor in oropharyngeal squamous cell cancer (OPC). In this prospective study, we sought to define the risk of HPV transmission between OPC patients and their sexual partners by performing HPV genotyping on oral cytology brushings. Newly diagnosed OPC patients and their sexual partners underwent oral mouth swabs and answered a risk factor questionnaire. Patient tumor samples and oral swabs from both the patient and partner were assessed for HPV status and genotyped using Easy-Chip HPV Blot PCR. We enrolled 227 patient-partner pairs and obtained sufficient analyzable DNA from both members in 198 pairs. Of 144 patients with available OPC tumor tissue, 128 (89 %) had HPV-positive tumors by either in situ hybridization or p16 immunohistochemical analysis (104 or 121, respectively). In total, there were 28 patients and 30 partners who were HPV positive by oral swab. The prevalence rate of oral HPV in partners was 15 %. There were 39 patient-partner pairs who had one or both members returning positive for HPV in the oral swab, and 49 % of these pairs were concordant for their HPV-genotype. Female partners had a higher oral HPV prevalence (16 %) than did male partners (11 %). Patients who were non-white were also found to have a higher oral prevalence of HPV (p = 0.032) by mouth swab. Partners of OPC patients may have a higher prevalence of oral HPV and should be studied prospectively to understand their OPC risk. Additional future research is needed to identify oral HPV persistence in partners to OPC patients and to determine the optimal sampling methods and technologies to screen patients at high risk for HPV-related disease.

  5. Dermatoglyphics in relation to brain volumes in twins concordant and discordant for bipolar disorder.

    Science.gov (United States)

    Vonk, R; van der Schot, A C; van Baal, G C M; van Oel, C J; Nolen, W A; Kahn, R S

    2014-12-01

    Palmar and finger dermatoglyphics are formed between the 10th and the 17th weeks of gestation and their morphology can be influenced by genetic or environmental factors, interfering with normal intrauterine development. As both the skin and the brain develop from the same embryonal ectoderm, dermatoglyphic alterations may be informative for early abnormal neurodevelopmental processes in the brain. We investigated whether dermatoglyphic alterations are related to structural brain abnormalities in bipolar disorder and to what extent they are of a genetic and of an environmental origin. Dermatoglyphics and volumetric data from structural MRI were obtained in 53 twin pairs concordant or discordant for bipolar disorder and 51 healthy matched control twin pairs. Structural equation modeling was used. Bipolar disorder was significantly positively associated with palmar a-b ridge count (ABRC), indicating higher ABRC in bipolar patients (rph=.17 (CI .04-.30)). Common genes appear to be involved because the genetic correlation with ABRC was significant (rph-A=.21 (CI .05-.36). Irrespective of disease, ABRC showed a genetically mediated association with brain volume, indicated by a significant genetic correlation rph-A of respectively -.36 (CI -.52 to -.22) for total brain, -.34 (CI -.51 to -.16) total cortical volume, -.27 (CI -.43 to -.08) cortical gray matter and -.23 (CI -.41 to -.04) cortical white matter. In conclusion, a genetically determined abnormal development of the foetal ectoderm between the 10th and 15th week of gestation appears related to smaller brain volumes in (subjects at risk for) bipolar disorder. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  6. Concordance of HOMIM and HOMINGS technologies in the microbiome analysis of clinical samples

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    Jean-Luc C. Mougeot

    2016-04-01

    Full Text Available Background: Over 700 bacterial species reside in human oral cavity, many of which are associated with local or distant site infections. Extensive characterization of the oral microbiome depends on the technologies used to determine the presence and proportions of specific bacterial species in various oral sites. Objective: The objective of this study was to compare the microbial composition of dental plaque at baseline using Human Oral Microbe Identification Microarray (HOMIM and Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS technologies, which are based on 16S rRNA. Methods: Dental plaque samples were collected from 96 patients at baseline prior to a dental procedure involving manipulation of gingival tissues. The samples were surveyed for 293 and 597 oral bacterial species via HOMIM and HOMINGS, respectively, based on 16S rRNA gene sequences. We determined the concordance between the two technologies for common species. Genus level analysis was performed using HOMINGS-specific genus identification capabilities. Results: HOMINGS detected twice the number of species in the same dental plaque samples compared to HOMIM. For the species detected by both HOMIM and HOMINGS, there was no difference in relative proportions of overall bacterial composition at the species, genus or phylum levels. Additionally, there was no difference in relative proportion for total species per patient between the two technologies. Conclusion: HOMINGS significantly expanded oral bacterial species identification compared to HOMIM. The genus and species probes, combined in HOMINGS, provided a more comprehensive representation of oral bacterial community, critical for future characterization of oral microbes in distant site infections.

  7. The Script Concordance Test: a new tool assessing clinical judgement in neurology.

    Science.gov (United States)

    Lubarsky, Stuart; Chalk, Colin; Kazitani, Driss; Gagnon, Robert; Charlin, Bernard

    2009-05-01

    Clinical judgment, the ability to make appropriate decisions in uncertain situations, is central to neurological practice, but objective measures of clinical judgment in neurology trainees are lacking. The Script Concordance Test (SCT), based on script theory from cognitive psychology, uses authentic clinical scenarios to compare a trainee's judgment skills with those of experts. The SCT has been validated in several medical disciplines, but has not been investigated in neurology. We developed an Internet-based neurology SCT (NSCT) comprising 24 clinical scenarios with three to four questions each. The scenarios were designed to reflect the uncertainty of real-life clinical encounters in adult neurology. The questions explored aspects of the scenario in which several responses might be acceptable; trainees were asked to judge which response they considered to be best. Forty-one PGY1-PGY5 neurology residents and eight medical students from three North American neurology programs (McGill, Calgary, and Mayo Clinic) completed the NSCT. The responses of trainees to each question were compared with the aggregate responses of an expert panel of 16 attending neurologists. The NSCT demonstrated good reliability (Cronbach alpha = 0.79). Neurology residents scored higher than medical students and lower than attending neurologists, supporting the test's construct validity. Furthermore, NSCT scores discriminated between senior (PGY3-5) and junior residents (PGY1-2). Our NSCT is a practical and reliable instrument, and our findings support its construct validity for assessing judgment in neurology trainees. The NSCT has potentially widespread applications as an evaluation tool, both in neurology training and for licensing examinations.

  8. Interobserver concordance of Ki67 labeling index in breast cancer: Japan Breast Cancer Research Group Ki67 ring study.

    Science.gov (United States)

    Mikami, Yoshiki; Ueno, Takayuki; Yoshimura, Kenichi; Tsuda, Hitoshi; Kurosumi, Masafumi; Masuda, Shinobu; Horii, Rie; Toi, Masakazu; Sasano, Hironobu

    2013-11-01

    The standardized assessment of Ki67 labeling index (LI) is of clinical importance to identify patients with primary breast cancer who could benefit from chemotherapy. In this study, we evaluated the interobserver concordance of Ki67 LI assessment. Six surgical pathologists participated and all the slides were prepared from archival breast cancer tissues fixed in 10% buffered formalin for 24 h and stained with MIB-1. Three independent studies were conducted. In the first study, 30 stained slides were assessed using two different methods: the scoring system, with a positive rate scored from 1 (0-9%) to 10 (90-100%) by visual estimate; and the counting method, with approximately 1000 cells counted in hot spots. In the second study, 20 tumors with Ki67 LI 5-25% were assessed, and in the third study, 15 printed photographs of stained slides were assessed to avoid variations by selecting different fields. In study 1, the counting system (intraclass correlation coefficient [ICC], 0.66 [95% confidence interval 0.52-0.78]) demonstrated a better correlation than the scoring system (ICC, 0.57 [0.42-0.72]). In study 2, the assessment for Ki67 LI of 5-25% demonstrated a correlation (ICC, 0.68 [0.50-0.81]) similar to that of study 1 (unrestricted range of Ki67 LI). In study 3, the assessment of Ki67 LI by counting yielded a good concordance (ICC, 0.94 [0.88-0.97]). In conclusion, there was better concordance with the counting system, and concordance was high when the assessed field was predetermined, indicating that the selection of the evaluation area is critical for obtaining reproducible Ki67 LI in breast cancer. © 2013 Japanese Cancer Association.

  9. Goal striving, coping, and well-being: a prospective investigation of the self-concordance model in sport

    OpenAIRE

    Smith, Alison L; Ntoumanis, Nikos; Duda, Joan L; Vansteenkiste, Maarten

    2011-01-01

    Developing upon cross-sectional research (Smith, Ntoumanis, & Duda, 2007) supporting the self-concordance model (Sheldon & Elliot, 1999) as a framework for contextual goal striving, the current study investigated the assumptions of the model in relation to season-long goal striving in sport. The study additionally examined the role of coping strategies in the persistence of goal-directed effort. Structural equation modeling analysis with a sample of 97 British athletes indicated that ...

  10. Concordance between phylogeographical and biogeographical patterns in the Brazilian Cerrado: diversification of the endemic tree Dalbergia miscolobium (Fabaceae).

    Science.gov (United States)

    Novaes, Renan Milagres Lage; Ribeiro, Renata Acácio; Lemos-Filho, José Pires; Lovato, Maria Bernadete

    2013-01-01

    Few studies have addressed the phylogeography of species of the Cerrado, the largest savanna biome of South America. Here we aimed to investigate the phylogeographical structure of Dalbergia miscolobium, a widespread tree from the Cerrado, and to verify its concordance with plant phylogeographical and biogeographical patterns so far described. A total of 287 individuals from 32 populations were analyzed by sequencing the trnL intron of the chloroplast DNA and the internal transcribed spacer of the nuclear ribosomal DNA. Analysis of population structure and tests of population expansion were performed and the time of divergence of haplotypes was estimated. Twelve and 27 haplotypes were identified in the cpDNA and nrDNA data, respectively. The star-like network configuration and the mismatch distributions indicated a recent spatial and demographic expansion of the species. Consistent with previous tree phylogeographical studies of Cerrado trees, the cpDNA also suggested a recent expansion towards the southern Cerrado. The diversity of D. miscolobium was widespread but high levels of genetic diversity were found in the Central Eastern and in the southern portion of Central Western Cerrado. The combined analysis of cpDNA and nrDNA supported a phylogeographic structure into seven groups. The phylogeographical pattern showed many concordances with biogeographical and phylogeographical studies in the Cerrado, mainly with the Cerrado phytogeographic provinces superimposed to our sampling area. The data reinforced the uniqueness of Northeastern and Southeastern Cerrados and the differentiation between Eastern and Western Central Cerrados. The recent diversification of the species (estimated between the Pliocene and the Pleistocene) and the 'genealogical concordances' suggest that a shared and persistent pattern of species diversification might have been present in the Cerrado over time. This is the first time that an extensive 'genealogical concordance' between

  11. Prevalence, concordance and determinants of human papillomavirus infection among heterosexual partners in a rural region in central Mexico

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    Parada Rocio

    2010-07-01

    Full Text Available Abstract Background Although human papillomavirus (HPV infection in heterosexual couples has been sparsely studied, it is relevant to understand disease burden and transmission mechanisms. The present study determined the prevalence and concordance of type-specific HPV infection as well as the determinants of infection in heterosexual couples in a rural area of Mexico. Methods A cross-sectional study was conducted in 504 clinically healthy heterosexual couples from four municipalities in the State of Mexico, Mexico. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot in cervical samples from women and in genital samples from men. Thirty-seven HPV types were detected, including high-risk oncogenic types and low-risk types. Multivariate logistic regression models were utilized to evaluate factors associated with HPV. Results The prevalence of HPV infection was 20.5% in external male genitals and 13.7% in cervical samples. In 504 sexual couples participating in the study, concordance of HPV status was 79%; 34 partners (6.7% were concurrently infected, and 21 out of 34 partners where both were HPV positive (61.8% showed concordance for one or more HPV types. The principal risk factor associated with HPV DNA detection in men as well as women was the presence of HPV DNA in the respective regular sexual partner (OR = 5.15, 95%CI 3.01-8.82. In men, having a history of 10 or more sexual partners over their lifetime (OR 2.5, 95%CI 1.3 - 4.8 and having had sexual relations with prostitutes (OR 1.7, 95%CI 1.01 - 2.8 increased the likelihood of detecting HPV DNA. Conclusions In heterosexual couples in rural regions in Mexico, the prevalence of HPV infection and type-specific concordance is high. High-risk sexual behaviors are strong determinants of HPV infection in men.

  12. [Concordance of glomerular filtration rate with creatinine clearance in 24-hour urine and Schwartz and Schwartz updated].

    Science.gov (United States)

    Salazar-Gutiérrez, María Luisa; Ochoa-Ponce, Cristina; Lona-Reyes, Juan Carlos; Gutiérrez-Íñiguez, Sara Ivonne

    Reference methods for the quantification of the glomerular filtration rate (GFR) are difficult to use in clinical practice; formulas for evaluating GFR based on serum creatinine (SCr) and/or creatinine clearance are used. The aim of this study was to quantify the correlation and concordance of GFR with creatinine clearance in 24-hour urine (GFR24) and Schwartz and Schwartz updated formulas. Cross-sectional study involving healthy pediatric patients and with chronic kidney disease (CKD) from 5 to 16.9 years. Linear correlation between GFR 24 and two formulas was evaluated with the Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC). We studied 134 patients, of which 59.7% were male. Mean age was 10.8 years. The average GFR24 was 140.34ml/min/1.73m 2 ; 34.3% (n=46) had GFR Schwartz (r= 0.63) and Schwartz updated (r= 0.65) formulas was observed. There was good concordance between the GFR24 and Schwartz (ICC= 0.77) and updated Schwartz (ICC= 0.77) formulas. Schwartz classical formula in patients with GFR24 ≥ 90ml/min/1.73m 2 estimated higher values, while Schwartz updated underestimated values. There is moderate correlation and good concordance between the GFR24 and Schwartz and Schwartz updated formulas. The concordance was better in patients with obesity and lower in women, patients with hyperfiltration and normal weight. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

    Science.gov (United States)

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin; Trivedi, Madhukar H.

    2013-01-01

    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician (“concordant patients”) were defined as having a standardized patient-rated Inventory of Depressive Symptoms-Self Report (IDS-SR30) score minus standardized clinician-rated Hamilton Rating Scale for Depression (HAM-D17) score SR30 during acute and continuation therapy and time to recurrence during maintenance therapy. During acute treatment female patients were more likely to overrate their depression severity compared to the clinician; older age predicted overrating during continuation treatment. Overrating patients had a slower onset of response on the HAM-D17 during acute treatment (P = 0.004). There were no differences between cohorts for remission or response on the HAM-D17 or CGI-S. Overrating patients at week 10 had lower remission and response rates on the IDS-SR30 during continuation therapy (32% and 50%, respectively; P ≤ 0.001) compared with underrating patients (76%, 77%) or concordant patients (64%, 78%). Patient concordance at the end of continuation therapy did not predict recurrence during maintenance therapy, indicating that patient rating scales may be useful in tracking recurrence during maintenance therapy. Poor agreement between patient- and clinician-ratings of depression severity is primarily a state phenomenon, although it is trait-like for some patients. PMID:20537348

  14. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

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    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  15. Recommendations for Best Communication Practices to Facilitate Goal-concordant Care for Seriously Ill Older Patients With Emergency Surgical Conditions.

    Science.gov (United States)

    Cooper, Zara; Koritsanszky, Luca A; Cauley, Christy E; Frydman, Julia L; Bernacki, Rachelle E; Mosenthal, Anne C; Gawande, Atul A; Block, Susan D

    2016-01-01

    To address the need for improved communication practices to facilitate goal-concordant care in seriously ill, older patients with surgical emergencies. Improved communication is increasingly recognized as a central element in providing goal-concordant care and reducing health care utilization and costs among seriously ill older patients. Given high rates of surgery in the last weeks of life, high risk of poor outcomes after emergency operations in these patients, and barriers to quality communication in the acute setting, we sought to create a framework to support surgeons in communicating with seriously ill, older patients with surgical emergencies. An interdisciplinary panel of 23 national leaders was convened for a 1-day conference at Harvard Medical School to provide input on concept, content, format, and usability of a communication framework. A prototype framework was created. Participants supported the concept of a structured approach to communication in these scenarios, and delineated 9 key elements of a framework: (1) formulating prognosis, (2) creating a personal connection, (3) disclosing information regarding the acute problem in the context of the underlying illness, (4) establishing a shared understanding of the patient's condition, (5) allowing silence and dealing with emotion, (6) describing surgical and palliative treatment options, (7) eliciting patient's goals and priorities, (8) making a treatment recommendation, and (9) affirming ongoing support for the patient and family. Communication with seriously ill patients in the acute setting is difficult. The proposed communication framework may assist surgeons in delivering goal-concordant care for high-risk patients.

  16. Concordance of seven gene genealogies compared to phenotypic data reveals multiple cryptic species in Australian dermocyboid Cortinarius (Agaricales).

    Science.gov (United States)

    Stefani, Franck O P; Jones, Rodney H; May, Tom W

    2014-02-01

    This study aims to delimit species of Australian dermocyboid fungi (Cortinarius, Agaricales) using genealogical concordance on well-characterised phenotypic species and to assess the utility of seven loci for DNA barcoding Australian Cortinarius taxa. Eighty-six collections of dermocyboid Cortinarius were sampled from across southern Australia. Phenotypic species were first recognised by performing clustering analyses on a comprehensive phenotypic dataset including morphological, colour and pigment data. Then phylogenetic species were delimited from the concordance of seven locus genealogies (ITS, nLSU, gpd, mcm7, rpb1, rpb2 and tef1). Seventeen phenotypic species were recognised while the concordance of gene genealogies recovered 35 phylogenetic species. All loci except for LSU recovered most phylogenetic species, although only rpb1 correctly identified all phylogenetic species. The ITS region is confirmed as an effective barcode for Cortinarius and a standard pairwise distance threshold of 2.0% is proposed to DNA barcode Australian Cortinarius taxa. Australian dermocyboid fungi belong in separate clades to the boreal clade Dermocybe, mostly in the clade Splendidi. This study provides a solid foundation for future ecological, taxonomic and systematic research on one of the most diverse genera of mushrooms worldwide. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Science.gov (United States)

    2012-01-01

    Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

  18. Species trees for spiny lizards (genus Sceloporus): identifying points of concordance and conflict between nuclear and mitochondrial data.

    Science.gov (United States)

    Leaché, Adam D

    2010-01-01

    Spiny lizards (genus Sceloporus) represent one of the most diverse and species rich clades of squamate reptiles in continental North America. Sceloporus contains 90+ species, which are partitioned into 21 species groups containing anywhere from one to 15 species. Despite substantial progress towards elucidating the phylogeographic patterns for many species of Sceloporus, efforts to resolve the phylogenetic relationships among the major species groups remain limited. In this study, the phylogenetic relationships of 53 species of Sceloporus, representing all 21 species groups, are estimated based on four nuclear genes (BDNF, PNN, R35, RAG-1; >3.3 kb) and contrasted with a new mitochondrial DNA genealogy based on six genes (12S, ND1, ND4, and the histidine, serine, and leucine tRNA genes; >2.5 kb). Species trees estimated from the nuclear loci using data concatenation or a coalescent-based inference method result in concordant topologies, but the coalescent approach provides lower resolution and support. When comparing nuclear versus mtDNA-based topologies for Sceloporus species groups, conflicting relationships outnumber concordant relationships. Incongruence is not restricted to weak or unresolved nodes as might be expected under a scenario of rapid diversification, but extends to conflicts involving strongly support clades. The points of concordance and conflict between the nuclear and mtDNA data are discussed, and arguments for preferring the species trees estimated from the multilocus nuclear data are presented.

  19. Informed decision making in advance care planning: concordance of patient self-reported diagnosis with physician diagnosis.

    Science.gov (United States)

    Schubart, Jane R; Toran, Lisa; Whitehead, Megan; Levi, Benjamin H; Green, Michael J

    2013-02-01

    This study aimed to determine the extent to which patients with advanced cancer agree with their physicians regarding their cancer diagnoses prior to engaging in advance care planning (ACP) and whether variables such as age and level of education correlate with the degree of patient-physician concordance. One hundred and fifty patients with a diagnosis of cancer and an estimated life expectancy of 18 months or less completed questionnaires about their cancer diagnoses prior to creating an advance directive. A review of the patients' medical records was performed and the physician-designated diagnosis was identified for each patient. Patient-physician agreement on diagnosis was coded based on predetermined study criteria. Concordance rates were expressed in percentages. The majority of patients (62.2 %) were in exact agreement with their physicians; 24.3 % were in partial agreement with the patient missing part of the diagnosis, and 9.5 % were in partial agreement with the physician missing part of the diagnosis; 4.1 % did not agree with their physicians on diagnosis. Age and education level did not correlate with patient-physician concordance rates. The majority of patients with advanced cancer correctly identified their cancer diagnosis. However, almost 40 % were not in full agreement with their physicians regarding diagnosis, a situation that has bearing on efforts to engage in meaningful shared decision making as well as advance care planning.

  20. Concordance-based Kendall's Correlation for Computationally-Light vs. Computationally-Heavy Centrality Metrics: Lower Bound for Correlation

    Directory of Open Access Journals (Sweden)

    Natarajan Meghanathan

    2017-01-01

    Full Text Available We identify three different levels of correlation (pair-wise relative ordering, network-wide ranking and linear regression that could be assessed between a computationally-light centrality metric and a computationally-heavy centrality metric for real-world networks. The Kendall's concordance-based correlation measure could be used to quantitatively assess how well we could consider the relative ordering of two vertices vi and vj with respect to a computationally-light centrality metric as the relative ordering of the same two vertices with respect to a computationally-heavy centrality metric. We hypothesize that the pair-wise relative ordering (concordance-based assessment of the correlation between centrality metrics is the most strictest of all the three levels of correlation and claim that the Kendall's concordance-based correlation coefficient will be lower than the correlation coefficient observed with the more relaxed levels of correlation measures (linear regression-based Pearson's product-moment correlation coefficient and the network wide ranking-based Spearman's correlation coefficient. We validate our hypothesis by evaluating the three correlation coefficients between two sets of centrality metrics: the computationally-light degree and local clustering coefficient complement-based degree centrality metrics and the computationally-heavy eigenvector centrality, betweenness centrality and closeness centrality metrics for a diverse collection of 50 real-world networks.

  1. Breast Intraductal Papillomas without Atypia in Radiologic-Pathologic Concordant Core Needle Biopsies: Predictors of Upgrade to Carcinoma at Excision

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana; Brennan, Sandra; Murray, Melissa P.; Bowser, Zenica; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth; Brogi, Edi

    2016-01-01

    Background The surgical management of breast intraductal papilloma without atypia (IDP) identified at core needle biopsy (CNB) is controversial. We assessed the rate of upgrade to carcinoma at surgical excision, and identified parameters predictive of upgrade. Methods We identified women with CNB diagnosis of intraductal papilloma without atypia or carcinoma at our center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. We correlated the radiologic and clinicopathologic features of patients with CNB diagnosis of IDP with upgrade to carcinoma at surgical excision. Results Our study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent excision. The upgrade rate was 2.3% (4/171). The upgrade lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥8 mm away. Twenty-four women (25 IDPs) did not undergo excision, and had stable imaging at follow-up (median of 23.5 months). Conclusions The upgrade rate at excision of IDP diagnosed at CNB with radiologic-pathologic concordance is 2.3%. Our findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. PMID:27315013

  2. Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging.

    Science.gov (United States)

    Bermejo, C; Martínez Ten, P; Cantarero, R; Diaz, D; Pérez Pedregosa, J; Barrón, E; Labrador, E; Ruiz López, L

    2010-05-01

    To demonstrate the value of three-dimensional (3D) ultrasound in the diagnosis of uterine malformations and its concordance with magnetic resonance imaging (MRI). This study included 286 women diagnosed with uterine malformation by 3D ultrasound, having been referred to our clinics on suspicion of uterine malformation following clinical and/or conventional two-dimensional ultrasound examination. With the exception of three with intact hymen, patients underwent both bimanual examination and speculoscopy before and/or after sonography. MRI was performed in 65 cases. We analyzed the diagnostic concordance between the techniques in the study of uterine malformations. Using 3D ultrasound we diagnosed: one case with uterine agenesis; 10 with unicornuate uterus, four of which also underwent MRI; six with didelphic uterus, one of which had MRI; 45 with bicornuate uterus, 12 of which had MRI; 125 with septate uterus (18 with two cervices), 42 of which had MRI (six with two cervices); 96 with arcuate uterus, three of which had MRI; and three with diethylstilbestrol (DES) iatrogenic uterine malformations, all of which had MRI. Among the 65 which underwent MRI, the diagnosis was: four cases with unicornuate uterus, 10 with bicornuate uterus (two with two cervices), 45 with septate uterus (five with two cervices), three with arcuate uterus and three with DES-related uterine malformations. The concordance between 3D ultrasound and MRI was very good (kappa index, 0.880 (95% CI, 0.769-0.993)). Discrepancies in diagnosis between the two techniques occurred in four cases. There was very good concordance in the diagnosis of associated findings (kappa index, 0.878 (95% CI, 0.775-0.980)), this analysis identifying differences in two cases. There is a high degree of concordance between 3D ultrasound and MRI in the diagnosis of uterine malformations, the relationship between cavity and fundus being visualized equally well with both techniques. 3D ultrasound should be complemented by

  3. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

    Science.gov (United States)

    Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

    2018-04-01

    In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

  4. Concordance of chart and billing data with direct observation in dental practice.

    Science.gov (United States)

    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

    2008-10-01

    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  5. The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?

    Science.gov (United States)

    Prieto-Velasco, Mario; Quiros, Pedro; Remon, Cesar

    2015-01-01

    It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs. An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT. Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)]. Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.

  6. Concordance of Epileptic Networks Associated with Epileptic Spikes Measured by High-Density EEG and Fast fMRI.

    Directory of Open Access Journals (Sweden)

    Vera Jäger

    Full Text Available The present study aims to investigate whether a newly developed fast fMRI called MREG (magnetic resonance encephalography measures metabolic changes related to interictal epileptic discharges (IED. For this purpose BOLD changes are correlated with the IED distribution and variability.Patients with focal epilepsy underwent EEG-MREG using a 64 channel cap. IED voltage maps were generated using 32 and 64 channels and compared regarding their correspondence to the BOLD response. The extents of IEDs (defined as number of channels with >50% of maximum IED negativity were correlated with the extents of positive and negative BOLD responses. Differences in inter-spike variability were investigated between interictal epileptic discharges (IED sets with and without concordant positive or negative BOLD responses.17 patients showed 32 separate IED types. In 50% of IED types the BOLD changes could be confirmed by another independent imaging method. The IED extent significantly correlated with the positive BOLD extent (p = 0.04. In 6 patients the 64-channel EEG voltage maps better reflected the positive or negative BOLD response than the 32-channel EEG; in all others no difference was seen. Inter-spike variability was significantly lower in IED sets with than without concordant positive or negative BOLD responses (with p = 0.04.Higher density EEG and fast fMRI seem to improve the value of EEG-fMRI in epilepsy. The correlation of positive BOLD and IED extent could suggest that widespread BOLD responses reflect the IED network. Inter-spike variability influences the likelihood to find IED concordant positive or negative BOLD responses, which is why single IED analysis may be promising.

  7. Concordance analysis of methylation biomarkers detection in self-collected and physician-collected samples in cervical neoplasm

    International Nuclear Information System (INIS)

    Chang, Cheng-Chang; Huang, Rui-Lan; Liao, Yu-Ping; Su, Po-Hsuan; Hsu, Yaw-Wen; Wang, Hui-Chen; Tien, Chau-Yang; Yu, Mu-Hsien; Lin, Ya-Wen; Lai, Hung-Cheng

    2015-01-01

    Non-attendance at gynecological clinics is a major limitation of cervical cancer screening and self-collection of samples may improve this situation. Although HPV testing of self-collected vaginal samples is acceptable, the specificity is inadequate. The current focus is increasing self-collection of vaginal samples to minimize clinic visits. In this study, we analyzed the concordance and clinical performance of DNA methylation biomarker (PAX1, SOX1, and ZNF582) detection in self-collected vaginal samples and physician-collected cervical samples for the identification of cervical neoplasm. We enrolled 136 cases with paired methylation data identified from abnormal Pap smears (n = 126) and normal controls (n = 10) regardless of HPV status at gynecological clinics. The study group comprised 37 cervical intraepithelial neoplasm I (CIN1), 23 cervical intraepithelial neoplasm II (CIN2), 16 cervical intraepithelial neoplasm III (CIN3), 30 carcinoma in situ (CIS), 13 squamous cell carcinomas (SCCs) and seven adenocarcinomas (ACs)/adenosquamous carcinomas (ASCs). PAX1, SOX1 and ZNF582 methylation in study samples was assessed by real-time quantitative methylation-specific polymerase chain reaction analysis. We generated methylation index cutoff values for the detection of CIN3+ in physician-collected cervical samples for analysis of the self-collected group. Concordance between the physician-collected and self-collected groups was evaluated by Cohen’s Kappa. Sensitivity, specificity and area under curve (AUC) were calculated for detection of CIN3+ lesions. Finally, we produced an optimal cutoff value with the best sensitivity from the self-collected groups. We generated a methylation index cutoff value from physician-collected samples for detection of CIN3+. There were no significant differences in sensitivity, specificity of PAX1, SOX1 and ZNF582 between the self-collected and physician-collected groups. The methylation status of all three genes in the normal control

  8. [Clinical usefulness of IDEA and CARS: concordance with DSM-IV-TR in children and adolescents with suspicion of PDD].

    Science.gov (United States)

    García-López, C; Narbona, J

    2014-02-01

    Observational scales are useful to estimate the severity of symptoms in PDD as well as to monitor their evolution. a) To analyze the concordance between diagnoses based on the Autism Spectrum Inventory (Inventario del Espectro Autista, IDEA)) and the Childhood Autism Rating Scale (CARS), compared to DSM-IV-TR criteria, in subjects with a suspicion of pervasive developmental disorders (PDD), and b) to study the discrimination power of both scales to differentiate between a clinical diagnosis situated in the autism spectrum. Fifty-six children and adolescents, between 2 and 20 years-old, who attended our Neuropediatric Unit due to suspicion of PDD. Independently, two clinicians evaluated the presence of PDD symptoms; one of them according to DSM-IV-TR criteria and the other one based on the application of IDEA and CARS. The concordance of IDEA and CARS when compared to DSM-IV-TR classification was 73 and 82%, respectively, with a sensitivity of 1 and 0,83 and a specificity of 0,61 and 0,82, respectively. Both scales correctly discriminated between autistic disorder and other clinical diagnoses. Both IDEA and CARS are useful instruments to detect and monitor autism symptoms in the context of routine clinical practice. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  9. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use.

    Science.gov (United States)

    Ngo-Metzger, Quyen; Sorkin, Dara H; Phillips, Russell S; Greenfield, Sheldon; Massagli, Michael P; Clarridge, Brian; Kaplan, Sherrie H

    2007-11-01

    Provider-patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak Spanish. However, little is known about language barriers among LEP Asian-American patients. We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic interpreter affected these outcomes. Cross-sectional survey, response rate 74%. A total of 2,746 Chinese and Vietnamese patients receiving care at 11 health centers in 8 cities. Provider-patient language concordance, health education received, quality of interpersonal care, patient ratings of providers, and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding. Patients with language-discordant providers reported receiving less health education (beta = 0.17, p interpreter. Patients with language-discordant providers also reported worse interpersonal care (beta = 0.28, p interpreter did not mitigate these effects and in fact exacerbated disparities in patients' perceptions of their providers. Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients' ratings of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for language concordance between patient and provider.

  10. Molecular cloning and biochemical characterization of the UDP-glucose: flavonoid 3-O-glucosyltransferase from Concord grape (Vitis labrusca).

    Science.gov (United States)

    Hall, Dawn; Yuan, Xiao Xin; Murata, Jun; De Luca, Vincenzo

    2012-02-01

    Glucosylation of anthocyanidin substrates at the 3-O-position is crucial for the red pigmentation of grape berries and wine. The gene that encodes the enzyme involved in this reaction has been cloned from Vitis labrusca cv. Concord, heterologously expressed, and the recombinant enzyme (rVL3GT) was characterized. VL3GT has 96% amino acid sequence identity with Vitis vinifera VV3GT and groups phylogenetically with several other flavonoid 3-O-glycosyltransferases. In vitro substrate specificity studies and kinetic analyses of rVL3GT indicate that this enzyme preferentially glucosylates cyanidin as compared with quercetin. Crude protein extracts from several Concord grape tissues were assayed for glucosyltransferase activity with cyanidin and quercetin as acceptor substrates. A comparison of the VL3GT activities toward with these substrates showed that the 3GT enzyme activity is consistent with the expression of VL3GT in these tissues and is coincident with the biosynthesis of anthocyanins in both location and developmental stages. Enzyme activities in grape mesocarp, pre-veraison exocarp, leaf, flower bud, and flower tissues glucosylated quercetin but not cyanidin at high rates, suggesting the presence of additional enzymes which are able to glucosylate the 3-O-position of flavonols with higher specificity than anthocyanidins. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Goal striving, coping, and well-being: a prospective investigation of the self-concordance model in sport.

    Science.gov (United States)

    Smith, Alison L; Ntoumanis, Nikos; Duda, Joan L; Vansteenkiste, Maarten

    2011-02-01

    Developing upon cross-sectional research (Smith, Ntoumanis, & Duda, 2007) supporting the self-concordance model (Sheldon & Elliot, 1999) as a framework for contextual goal striving, the current study investigated the assumptions of the model in relation to season-long goal striving in sport. The study additionally examined the role of coping strategies in the persistence of goal-directed effort. Structural equation modeling analysis with a sample of 97 British athletes indicated that start-of-season autonomous goal motives were linked to midseason effort, which subsequently predicted end-of-season goal attainment. Attainment was positively related to changes in psychological need satisfaction, which, in turn, predicted changes in emotional well-being. In a second model, autonomous and controlled motives positively predicted task- and disengagement-oriented coping strategies, respectively. In turn, these strategies were differentially associated with effort. The findings provide support for contextual adaptations of the self-concordance model and demonstrate the role of coping strategies in the goal striving process.

  12. Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile?

    Energy Technology Data Exchange (ETDEWEB)

    Shaylor, Sara D.; Melsaether, Amy N.; Gupta, Avani; Babb, James; Moy, Linda [NYU School of Medicine, Department of Radiology, New York, NY (United States); Heller, Samantha L. [St. George' s Healthcare Trust, Department of Radiology, London (United Kingdom); Gupta, Dipti [Northwestern Memorial Hospital, Breast and Women' s Imaging Center, Chicago, IL (United States)

    2014-06-15

    To determine the utility of short-interval follow-up after benign concordant MRI-guided breast biopsy. Institutional review board approved, retrospective review of consecutive biopsies performed over 3 years (2007-10) yielded 170 women with 188 lesions that were considered benign concordant. Indication for original study, biopsy results, follow-up recommendations, compliance and outcomes of subsequent MRI and mammography examinations were reviewed. The most common indication for breast MRI was high-risk screening 119/170 (70 %). Overall, 59 % of lesions (113/188) had follow-up MRI. Of those lesions (n = 113), 43 % (49/113) presented within 7 months, 26 % (29/113) presented within 8-13 months, 11.5 % (13/113) presented within 14-22 months, and 19 % (22/113) presented after 23 months. At initial follow-up, 37 % of lesions were stable and 61 % were decreased in size. Three lesions were recommended for excision based on follow-up imaging with one malignancy diagnosed 2 years following biopsy. One additional patient had MRI-detected bilateral cancers remote from the biopsy site 3 years after biopsy. Overall cancer yield of lesions with follow-up MRI was 0.9 % (1/113); no cancers were detected at 6 months. Our data suggests that 6-month follow-up may not be required and that annual screening MRI would be acceptable to maintain a reasonable cancer detection rate. (orig.)

  13. [Cerebral vasoreactivity: Concordance of breath holding test and acetazolamide injection in current practice: 20 cases of asymptomatic carotid artery stenosis].

    Science.gov (United States)

    De Bortoli, M; Maillet, A; Skopinski, S; Sassoust, G; Constans, J; Boulon, C

    2017-10-01

    Cerebral vasoreactivity (CVR) is the ability of the brain's vascular system to keep cerebral blood inflow stable. Impaired CVR is a risk marker of stroke in patients with asymptomatic carotid stenosis. The gold standard to assess CVR with transcranial ultrasound is acetazolamide (ACTZ) injection. The breath holding test (BHT) might be easier to perform. CVR proved to be efficient in laboratory conditions but not in routine practice. To study the validity of BHT versus ACTZ in routine practice in a vascular exploration unit in patients with asymptomatic carotid stenosis. Study of concordance of BHT and ACTZ, to assess CVR in patients consecutively explored on the same day. Eighteen patients with 20 carotid stenosis were included. The temporal window was missing in 20% of cases. Only 11 out of the 20 procedures were analyzed. Concordance was low between BHT and ACTZ to assess CVR (k=0.3714). BHT cannot replace ACTZ injection. It might be a first-step test so that ACTZ injection might be avoided if CVR is normal. Our present results must be confirmed by further study enrolling many more patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. A comprehensive study design reveals treatment- and transcript abundance–dependent concordance between RNA-seq and microarray data

    Science.gov (United States)

    Wang, Charles; Gong, Binsheng; Bushel, Pierre R.; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Xu, Joshua; Fang, Hong; Hong, Huixiao; Shen, Jie; Su, Zhenqiang; Meehan, Joe; Li, Xiaojin; Yang, Lu; Li, Haiqing; Łabaj, Paweł P.; Kreil, David P.; Megherbi, Dalila; Florian, Caiment; Gaj, Stan; van Delft, Joost; Kleinjans, Jos; Scherer, Andreas; Viswanath, Devanarayan; Wang, Jian; Yang, Yong; Qian, Hui-Rong; Lancashire, Lee J.; Bessarabova, Marina; Nikolsky, Yuri; Furlanello, Cesare; Chierici, Marco; Albanese, Davide; Jurman, Giuseppe; Riccadonna, Samantha; Filosi, Michele; Visintainer, Roberto; Zhang, Ke K.; Li, Jianying; Hsieh, Jui-Hua; Svoboda, Daniel L.; Fuscoe, James C.; Deng, Youping; Shi, Leming; Paules, Richard S.; Auerbach, Scott S.; Tong, Weida

    2014-01-01

    RNA-seq facilitates unbiased genome-wide gene-expression profiling. However, its concordance with the well-established microarray platform must be rigorously assessed for confident uses in clinical and regulatory application. Here we use a comprehensive study design to generate Illumina RNA-seq and Affymetrix microarray data from the same set of liver samples of rats under varying degrees of perturbation by 27 chemicals representing multiple modes of action (MOA). The cross-platform concordance in terms of differentially expressed genes (DEGs) or enriched pathways is highly correlated with treatment effect size, gene-expression abundance and the biological complexity of the MOA. RNA-seq outperforms microarray (90% versus 76%) in DEG verification by quantitative PCR and the main gain is its improved accuracy for low expressed genes. Nonetheless, predictive classifiers derived from both platforms performed similarly. Therefore, the endpoint studied and its biological complexity, transcript abundance, and intended application are important factors in transcriptomic research and for decision-making. PMID:25150839

  15. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)

    2014-01-15

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  16. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    International Nuclear Information System (INIS)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu; Bullier, Eric; Riviere, Annalisa; Dromer, Claire; Picard, Francois; Billes, Marc-Alain; Corneloup, Olivier

    2014-01-01

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  17. [Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly].

    Science.gov (United States)

    Coronado, R; Macaya Ruíz, A; Giraldo Arjonilla, J; Roig-Quilis, M

    2015-08-01

    Our aim was to investigate the correlations between patterns of head growth and intellectual disability among distinct aetiological presentations of microcephaly. 3,269 head circumference (HC) charts of patients from a tertiary neuropediatric unit were reviewed and 136 microcephalic participants selected. Using the Z-scores of registered HC measurements we defined the variables: HC Minimum, HC Drop and HC Catch-up. We classified patients according to the presence or absence of intellectual disability (IQ below 71) and according to the cause of microcephaly (idiopathic, familial, syndromic, symptomatic and mixed). Using Discriminant Analysis a C-function was defined as C=HC Minimum + HC Drop with a cut-off level of C=-4.32 Z-score. In our sample 95% of patients scoring below this level, severe microcephaly, were classified in the disabled group while the overall concordance was 66%. In the symptomatic-mixed group the concordance between HC function and outcome reached 82% in contrast to only 54% in the idiopathic-syndromic group (P-value=0.0002). We defined a HC growth function which discriminates intellectual disability of microcephalic patients better than isolated HC measurements, especially for those with secondary and mixed aetiologies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  18. [Concordance between central venous and arterial blood gases in post-surgical myocardial revascularization patients in stable condition].

    Science.gov (United States)

    Santos-Martínez, Luis Efren; Guevara-Carrasco, Marlene; Naranjo-Ricoy, Guillermo; Baranda-Tovar, Francisco Martín; Moreno-Ruíz, Luis Antonio; Herrera-Velázquez, Marco Antonio; Magaña-Serrano, José Antonio; Valencia-Sánchez, Jesús Salvador; Calderón-Abbo, Moisés Cutiel

    2014-01-01

    The concordance between the parameters of arterial and central venous blood gases has not been defined yet. We studied the concordance between both parameters in post-surgical myocardial revascularization patients in stable condition. Consecutive subjects were studied in a cross-sectional design. The position of the central venous catheter was performed and simultaneously we obtained arterial and central venous blood samples prior to discharge from the intensive care unit. Data are expressed according to Bland-Altman statistical method and the intraclass correlation coefficient. Statistical result was accepted at P<.05. Two hundred and six samples were studied of 103 post-surgical patients, pH and lactate had a mean difference (limits of agreement) 0.029±0.048 (-0018, 0.077) and -0.12±0.22 (-0.57, 0.33) respectively. The magnitude of the intraclass correlation coefficient was 0.904 and 0.943 respectively. The values related to oxygen pressure were 27.86±6.08 (15.9, 39.8) and oxygen saturation 33.02±6.13 (21, 45), with magnitude of 0.258 and 0.418 respectively. The best matching parameters between arterial and central venous blood samples were pH and lactate. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  19. Concordance of KRAS/BRAF Mutation Status in Metastatic Colorectal Cancer before and after Anti-EGFR Therapy

    Directory of Open Access Journals (Sweden)

    S. Gattenlöhner

    2009-01-01

    Full Text Available Anti-EGFR targeted therapy is a potent strategy in the treatment of metastatic colorectal cancer (mCRC but activating mutations in the KRAS gene are associated with poor response to this treatment. Therefore, KRAS mutation analysis is employed in the selection of patients for EGFR-targeted therapy and various studies have shown a high concordance between the mutation status in primary CRC and corresponding metastases. However, although development of therapy related resistance occurs also in the context of novel drugs such as tyrosine kinase-inhibitors the effect of the anti-EGFR treatment on the KRAS/BRAF mutation status itself in recurrent mCRC has not yet been clarified. Therefore, we analyzed 21 mCRCs before/after anti-EGFR therapy and found a pre-/posttherapeutic concordance of the KRAS/BRAF mutation status in 20 of the 21 cases examined. In the one discordant case, further analyses revealed that a tumor mosaicism or multiple primary tumors were present, indicating that anti-EGFR therapy has no influence on KRAS/BRAF mutation status in mCRC. Moreover, as the preselection of patients with a KRASwt genotype for anti-EGFR therapy has become a standard procedure, sample sets such ours might be the basis for future studies addressing the identification of potential anti-EGFR therapy induced genetic alterations apart from KRAS/BRAF mutations.

  20. Concordância entre citologia, colposcopia e histopatologia cervical Agreement between cytology, colposcopy and cervical histopathology

    Directory of Open Access Journals (Sweden)

    Letícia Maria Correia Katz

    2010-08-01

    Full Text Available OBJETIVO: avaliar a concordância da citologia convencional por Papanicolaou repetida no momento da colposcopia com os achados colposcópicos e a histopatologia. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN, de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia em meio convencional, pesquisando-se os achados colposcópicos anormais. A nomenclatura citológica utilizada foi a de Bethesda e a histopatológica, da Organização Mundial de Saúde. A citologia no momento da colposcopia e a colposcopia foram comparadas entre si e com o resultado do histopatológico obtido por biópsia dirigida. A concordância entre os métodos foi avaliada pelo coeficiente Kappa (K, além do teste χ2 a um nível de significância de 5%. RESULTADOS: foi encontrada uma concordância fraca entre a citologia realizada no momento da colposcopia e a colposcopia, K=0,33 (IC95%=0,21-0,45 e entre a colposcopia e a histopatologia, K=0,35 (IC95%=0,39-0,51. Para a concordância entre citologia no momento da colposcopia e histopatologia, o Kappa foi de 0,41 (IC95%=0,29-0,530, considerado moderado. CONCLUSÕES: houve melhor concordância entre citologia e histopatologia do que entre colposcopia e citologia ou colposcopia e histopatologia.PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings

  1. Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance

    Science.gov (United States)

    King, Eleanor M; Gilson, Richard; Beddows, Simon; Soldan, Kate; Panwar, Kavita; Young, Carmel; Jit, Mark; Edmunds, W John; Sonnenberg, Pam

    2015-01-01

    Objectives To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers. Methods Paired oral rinse samples and anogenital samples were available from 151 HIV-negative MSM within a larger cross-sectional survey. All samples were tested in parallel for 21 types of HPV DNA using an in-house assay. Results The median age of participants was 30 (IQR 25–35). The prevalence of any oral HPV and of high-risk HPV (HR-HPV) was 13.7% (n=21; 95% CI 8.7 to 20.2) and 5.9% (n=9; 95% CI 2.7 to 10.9) compared with 64.9% (n=98; 95% CI 56.7 to 72.5) and 34.4% (n=52; 95% CI 26.9 to 42.6) in any anogenital sample, respectively. The prevalence of types prevented by the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccines was 1.3% (95% CI 0.2 to 4.7), 2.6% (95% CI 0.7 to 6.6) and 4.6% (95% CI 1.9 to 9.3), respectively. There was no concordance between HPV genotypes detected in oral and anogenital sites. Conclusions HR-HPV DNA, including HPV 16/18, was detected in oral specimens from HIV-negative MSM attending sexual health clinics, suggesting a potential role for vaccination, but is far less common than anogenital infection. How this relates to the risk and natural history of HPV-related head and neck cancers warrants further study. Lack of concordance with anogenital infection also suggests that oral HPV infection should be considered separately when estimating potential vaccine impact. PMID:25887283

  2. Lung cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.

    Science.gov (United States)

    Richards, Thomas B; Henley, S Jane; Puckett, Mary C; Weir, Hannah K; Huang, Bin; Tucker, Thomas C; Allemani, Claudia

    2017-12-15

    Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%-20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15-99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. Five-year net survival increased from 16.4% (95% confidence interval, 16.3%-16.5%) for patients diagnosed 2001-2003 to 19.0% (18.8%-19.1%) for those diagnosed 2004-2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. Lung cancer survival improved slightly between the periods 2001-2003 and 2004-2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state. Cancer 2017;123:5079-99. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. Record completeness and data concordance in an anesthesia information management system using context-sensitive mandatory data-entry fields.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles

    2012-03-01

    Use of an anesthesia information management system (AIMS) does not insure record completeness and data accuracy. Mandatory data-entry fields can be used to assure data completeness. However, they are not suited for data that is mandatory depending on the clinical situation (context sensitive). For example, information on equal breath sounds should be mandatory with tracheal intubation, but not with mask ventilation. It was hypothesized that employing context-sensitive mandatory data-entry fields can insure high data-completeness and accuracy while maintaining usability. A commercial off-the-shelf AIMS was enhanced using its built-in VBScript programming tool to build event-driven forms with context-sensitive mandatory data-entry fields. One year after introduction of the system, all anesthesia records were reviewed for data completeness. Data concordance, used as a proxy for accuracy, was evaluated using verifiable age-related data. Additionally, an anonymous satisfaction survey on general acceptance and usability of the AIMS was performed. During the initial 12 months of AIMS use, 12,241 (99.6%) of 12,290 anesthesia records had complete data. Concordances of entered data (weight, size of tracheal tubes, laryngoscopy blades and intravenous catheters) with patients' ages were 98.7-99.9%. The AIMS implementation was deemed successful by 98% of the anesthesiologists. Users rated the AIMS usability in general as very good and the data-entry forms in particular as comfortable. Due to the complexity and the high costs of implementation of an anesthesia information management system it was not possible to compare various system designs (for example with or without context-sensitive mandatory data entry-fields). Therefore, it is possible that a different or simpler design would have yielded the same or even better results. This refers also to the evaluation of usability, since users did not have the opportunity to work with different design approaches or even different

  4. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  5. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    International Nuclear Information System (INIS)

    Yoon, Seok Nam

    2012-01-01

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

  6. Variação na concordância verbal com "a gente" no português europeu

    Directory of Open Access Journals (Sweden)

    Cássio Florêncio Rubio

    2014-02-01

    Full Text Available Este trabalho tem como objetivo atestar que a concordância verbal com a forma pronominal a gente constitui fenômeno variável no português europeu. As amostras, estratificadas de forma equânime em relação às variáveis sociais escolaridade, faixa etária e gênero, provém do Corpus de Referência do Português Contemporâneo. Para a análise, recorremos à Teoria da Variação Linguística (LABOV, 1972, 1994. Os resultados apontam, no fenômeno variável, o predomínio do uso da terceira pessoa do singular condicionado pelos fatores linguísticos explicitude do sujeito e tempo e modo verbal e pelos fatores sociais escolaridade, faixa etária e gênero.

  7. Concordância inter-observador em testes de avaliação proprioceptiva do joelho por goniometria

    OpenAIRE

    Carvalho,Alberito Rodrigo de; Rahn,Márcio Edyr; Diedrichs,Maiara; Lopes,Andréia Coleto; Gregol,Franciele; Grochoski,Renata; Pozzer,Leonardo Mascarello; Machado,Maurício Antônio

    2010-01-01

    O propósito deste foi determinar o grau de concordância inter-avaliador de dois testes que mensuram a propriocepção do joelho por meio da goniometria, em uma amostra de universitárias (n=13; 23,8±6,4 anos). Mensurou-se a acurácia proprioceptiva pelos testes de percepção do limiar de movimento passivo lento (T1), movendo-se passivamente a perna até o ângulo alvo; e pelo teste de senso de posição articular (T2), solicitando-se movimento ativo até o ângulo alvo, previamente atingido passivamente...

  8. Sexual identity in the American Deep South: the concordance and discordance of sexual activity, relationships, and identities.

    Science.gov (United States)

    Baunach, Dawn Michelle; Burgess, Elisabeth O

    2013-01-01

    This research explores the association between sexual identity and sexual behavior and how that association varies across gender and race in the American Deep South. Multinomial logistic regression analysis is used to determine the likelihood of each sexual identity given past sexual behavior, sexual relationships, and other social characteristics. The more traditional cultural climate of the South appears to suppress identification as a sexual minority. Sexual identification in the Deep South is primarily a product of sexual activity and sexual relationships, although attitudes toward and contact with the lesbian, gay, bisexual, and transgender (LGBT) community play a minor role. Although most participants' sexual behaviors and identities were in concordance, sexual discordance was highest for White women and lowest for White men. Discordance was also associated with traditional men's roles attitudes, negative homosexuality attitudes, and contact with the LGBT community. It is hoped that these results encourage scholarship that deconstructs the sexual behavior and identity of all groups, not just oppressed groups.

  9. Whole-Genome Sequencing and Concordance Between Antimicrobial Susceptibility Genotypes and Phenotypes of Bacterial Isolates Associated with Bovine Respiratory Disease

    Directory of Open Access Journals (Sweden)

    Joseph R. Owen

    2017-09-01

    Full Text Available Extended laboratory culture and antimicrobial susceptibility testing timelines hinder rapid species identification and susceptibility profiling of bacterial pathogens associated with bovine respiratory disease, the most prevalent cause of cattle mortality in the United States. Whole-genome sequencing offers a culture-independent alternative to current bacterial identification methods, but requires a library of bacterial reference genomes for comparison. To contribute new bacterial genome assemblies and evaluate genetic diversity and variation in antimicrobial resistance genotypes, whole-genome sequencing was performed on bovine respiratory disease–associated bacterial isolates (Histophilus somni, Mycoplasma bovis, Mannheimia haemolytica, and Pasteurella multocida from dairy and beef cattle. One hundred genomically distinct assemblies were added to the NCBI database, doubling the available genomic sequences for these four species. Computer-based methods identified 11 predicted antimicrobial resistance genes in three species, with none being detected in M. bovis. While computer-based analysis can identify antibiotic resistance genes within whole-genome sequences (genotype, it may not predict the actual antimicrobial resistance observed in a living organism (phenotype. Antimicrobial susceptibility testing on 64 H. somni, M. haemolytica, and P. multocida isolates had an overall concordance rate between genotype and phenotypic resistance to the associated class of antimicrobials of 72.7% (P < 0.001, showing substantial discordance. Concordance rates varied greatly among different antimicrobial, antibiotic resistance gene, and bacterial species combinations. This suggests that antimicrobial susceptibility phenotypes are needed to complement genomically predicted antibiotic resistance gene genotypes to better understand how the presence of antibiotic resistance genes within a given bacterial species could potentially impact optimal bovine respiratory

  10. HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.

    Science.gov (United States)

    Li, Min Hua; Hou, Chuan Ling; Wang, Cheng; Sun, Ai Jing

    2016-04-01

    To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient. In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH). In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640). This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions. Copyright © 2015 Elsevier GmbH. All rights reserved.

  11. Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study

    Directory of Open Access Journals (Sweden)

    Mathie Robert T

    2012-04-01

    Full Text Available Abstract Background A method for assessing the model validity of randomised controlled trials of homeopathy is needed. To date, only conventional standards for assessing intrinsic bias (internal validity of trials have been invoked, with little recognition of the special characteristics of homeopathy. We aimed to identify relevant judgmental domains to use in assessing the model validity of homeopathic treatment (MVHT. We define MVHT as the extent to which a homeopathic intervention and the main measure of its outcome, as implemented in a randomised controlled trial (RCT, reflect 'state-of-the-art' homeopathic practice. Methods Using an iterative process, an international group of experts developed a set of six judgmental domains, with associated descriptive criteria. The domains address: (I the rationale for the choice of the particular homeopathic intervention; (II the homeopathic principles reflected in the intervention; (III the extent of homeopathic practitioner input; (IV the nature of the main outcome measure; (V the capability of the main outcome measure to detect change; (VI the length of follow-up to the endpoint of the study. Six papers reporting RCTs of homeopathy of varying design were randomly selected from the literature. A standard form was used to record each assessor's independent response per domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among the eight verdicts per domain, across all six papers, was evaluated using the kappa (κ statistic. Results The six judgmental domains enabled MVHT to be assessed with 'fair' to 'almost perfect' concordance in each case. For the six RCTs examined, the method allowed MVHT to be classified overall as 'acceptable' in three, 'unclear' in two, and 'inadequate' in one. Conclusion Future systematic reviews of RCTs in homeopathy should adopt the MVHT method as part of a complete appraisal of trial validity.

  12. Measurement Methods for Humeral Retroversion Using Two-Dimensional Computed Tomography Scans: Which Is Most Concordant with the Standard Method?

    Science.gov (United States)

    Oh, Joo Han; Kim, Woo; Cayetano, Angel A

    2017-06-01

    Humeral retroversion is variable among individuals, and there are several measurement methods. This study was conducted to compare the concordance and reliability between the standard method and 5 other measurement methods on two-dimensional (2D) computed tomography (CT) scans. CT scans from 21 patients who underwent shoulder arthroplasty (19 women and 2 men; mean age, 70.1 years [range, 42 to 81 years]) were analyzed. The elbow transepicondylar axis was used as a distal reference. Proximal reference points included the central humeral head axis (standard method), the axis of the humeral center to 9 mm posterior to the posterior margin of the bicipital groove (method 1), the central axis of the bicipital groove -30° (method 2), the base axis of the triangular shaped metaphysis +2.5° (method 3), the distal humeral head central axis +2.4° (method 4), and contralateral humeral head retroversion (method 5). Measurements were conducted independently by two orthopedic surgeons. The mean humeral retroversion was 31.42° ± 12.10° using the standard method, and 29.70° ± 11.66° (method 1), 30.64° ± 11.24° (method 2), 30.41° ± 11.17° (method 3), 32.14° ± 11.70° (method 4), and 34.15° ± 11.47° (method 5) for the other methods. Interobserver reliability and intraobserver reliability exceeded 0.75 for all methods. On the test to evaluate the equality of the standard method to the other methods, the intraclass correlation coefficients (ICCs) of method 2 and method 4 were different from the ICC of the standard method in surgeon A ( p method 2 and method 3 were different form the ICC of the standard method in surgeon B ( p method 1) would be most concordant with the standard method even though all 5 methods showed excellent agreements.

  13. Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial.

    Science.gov (United States)

    Bernstein, Steven L; Rosner, June; Toll, Benjamin

    2016-01-01

    Smoking cessation clinical trials assess tobacco abstinence using self-report and biomarkers. Optimum methods for each are unclear; a common question assesses smoking in the prior 7 days. In contrast, timeline follow-back (TLFB) is another technique often used to assess use of alcohol in treatment trials; it is used less frequently in studies of smoking cessation. The goal of this study was to assess concordance between the 7-day smoking question and a 7-day TLFB. Secondary analysis of data from a randomized clinical trial of smoking cessation was conducted at a busy, urban hospital emergency department (ED) from October 2010 to December 2012. At 1, 3, and 12 months, subjects were contacted by phone to assess smoking status. Those reporting abstinence at 3 months were asked to return for an in-person measurement of exhaled carbon monoxide. For this analysis, smoking status at 1 month was compared for subjects in response to 2 questions asked concurrently, addressing 7-day point prevalence tobacco use and a 7-day TLFB. Of 780 subjects, 666 (85.4%) were available for 1-month follow-up. Of these, 99 (14.9%) reported no smoking in response to the 7-day question, and 96 (14.4%) reported no smoking in response to the 7-day TLFB. The overall proportionate agreement between the 2 methods was 98.6%, with a kappa of 0.95 (95% confidence interval [CI]: 0.91-0.98). A single question that assesses smoking at 7 days provides excellent concordance with the more detailed TLFB. The single question appears adequate to assess self-reported tobacco use in clinical trials of smoking cessation.

  14. Five omic technologies are concordant in differentiating the biochemical characteristics of the berries of five grapevine (Vitis vinifera L.) cultivars.

    Science.gov (United States)

    Ghan, Ryan; Van Sluyter, Steven C; Hochberg, Uri; Degu, Asfaw; Hopper, Daniel W; Tillet, Richard L; Schlauch, Karen A; Haynes, Paul A; Fait, Aaron; Cramer, Grant R

    2015-11-16

    Grape cultivars and wines are distinguishable by their color, flavor and aroma profiles. Omic analyses (transcripts, proteins and metabolites) are powerful tools for assessing biochemical differences in biological systems. Berry skins of red- (Cabernet Sauvignon, Merlot, Pinot Noir) and white-skinned (Chardonnay, Semillon) wine grapes were harvested near optimum maturity (°Brix-to-titratable acidity ratio) from the same experimental vineyard. The cultivars were exposed to a mild, seasonal water-deficit treatment from fruit set until harvest in 2011. Identical sample aliquots were analyzed for transcripts by grapevine whole-genome oligonucleotide microarray and RNAseq technologies, proteins by nano-liquid chromatography-mass spectroscopy, and metabolites by gas chromatography-mass spectroscopy and liquid chromatography-mass spectroscopy. Principal components analysis of each of five Omic technologies showed similar results across cultivars in all Omic datasets. Comparison of the processed data of genes mapped in RNAseq and microarray data revealed a strong Pearson's correlation (0.80). The exclusion of probesets associated with genes with potential for cross-hybridization on the microarray improved the correlation to 0.93. The overall concordance of protein with transcript data was low with a Pearson's correlation of 0.27 and 0.24 for the RNAseq and microarray data, respectively. Integration of metabolite with protein and transcript data produced an expected model of phenylpropanoid biosynthesis, which distinguished red from white grapes, yet provided detail of individual cultivar differences. The mild water deficit treatment did not significantly alter the abundance of proteins or metabolites measured in the five cultivars, but did have a small effect on gene expression. The five Omic technologies were consistent in distinguishing cultivar variation. There was high concordance between transcriptomic technologies, but generally protein abundance did not correlate

  15. Diagnostic concordance of breast pathologists: lessons from the National Health Service Breast Screening Programme Pathology External Quality Assurance Scheme.

    Science.gov (United States)

    Rakha, Emad A; Ahmed, Mohamed A; Aleskandarany, Mohammed A; Hodi, Zsolt; Lee, Andrew H S; Pinder, Sarah E; Ellis, Ian O

    2017-03-01

    Previous concordance studies examining accuracy of breast diagnosis by pathologists, typically targeting difficult, histologically challenging breast lesions using artificial and restrictive environments, have reported aberrantly high levels of diagnostic discordance. The results of these studies may be misinterpreted by non-pathologists and raise concerns relating to routine practice. This study aims to assess the diagnostic agreement among UK breast pathologists. Two hundred and forty consecutive breast lesions, submitted by participants from their routine practice, included in the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology EQA scheme during the last 10 years were reviewed. An average of approximately 600 participants viewed each case. Data on diagnostic categories (benign, atypical, in-situ malignant and invasive malignant) were collected. In this study, benign and atypical diagnoses were grouped together. The overall diagnostic agreement level was in the almost perfect range. Thirty-five cases (14.6%) showed diagnostic concordance of ≤95%. Reasons for discordance included one or more of: (1) scheme methodology limitations such as: (i) miscoding of certain lesions (e.g. phyllodes tumours and lobular neoplasia) (n = 7) and (ii) variable representation of the index lesion on glass slides (n = 18); and (2) diagnostically challenging cases that may be interpreted more easily using immunohistochemistry (n = 28). These latter included benign and malignant papillary lesions (n = 12), complex sclerosing lesions (n = 7), intraductal epithelial proliferative lesions (n = 6) and an unusual special tumour type (n = 1). Further review identified pathologists' misinterpretation in 13 cases (5.4%), with an average discordance rate of only 4.2%. The performance of breast pathologists is high. Exclusion of the effect of the scheme methodology limitations highlights further the high performance rate and identifies true diagnostically

  16. Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study

    Science.gov (United States)

    2012-01-01

    Background A method for assessing the model validity of randomised controlled trials of homeopathy is needed. To date, only conventional standards for assessing intrinsic bias (internal validity) of trials have been invoked, with little recognition of the special characteristics of homeopathy. We aimed to identify relevant judgmental domains to use in assessing the model validity of homeopathic treatment (MVHT). We define MVHT as the extent to which a homeopathic intervention and the main measure of its outcome, as implemented in a randomised controlled trial (RCT), reflect 'state-of-the-art' homeopathic practice. Methods Using an iterative process, an international group of experts developed a set of six judgmental domains, with associated descriptive criteria. The domains address: (I) the rationale for the choice of the particular homeopathic intervention; (II) the homeopathic principles reflected in the intervention; (III) the extent of homeopathic practitioner input; (IV) the nature of the main outcome measure; (V) the capability of the main outcome measure to detect change; (VI) the length of follow-up to the endpoint of the study. Six papers reporting RCTs of homeopathy of varying design were randomly selected from the literature. A standard form was used to record each assessor's independent response per domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among the eight verdicts per domain, across all six papers, was evaluated using the kappa (κ) statistic. Results The six judgmental domains enabled MVHT to be assessed with 'fair' to 'almost perfect' concordance in each case. For the six RCTs examined, the method allowed MVHT to be classified overall as 'acceptable' in three, 'unclear' in two, and 'inadequate' in one. Conclusion Future systematic reviews of RCTs in homeopathy should adopt the MVHT method as part of a complete appraisal of trial validity. PMID:22510227

  17. Insomnia From Drug Treatments: Evidence From Meta-analyses of Randomized Trials and Concordance With Prescribing Information.

    Science.gov (United States)

    Doufas, Anthony G; Panagiotou, Orestis A; Panousis, Periklis; Wong, Shane Shucheng; Ioannidis, John P A

    2017-01-01

    To determine whether drugs used to treat diverse conditions cause insomnia symptoms and whether their prescription information is concordant with this evidence. We conducted a survey of meta-analyses (Cochrane Database of Systematic Reviews) and comparisons with package inserts compiled in the Physicians' Desk Reference (PDR). We identified randomized controlled trials (RCTs) in which any drug had been evaluated vs placebo and sleep had been assessed. We collectively referred to insomnia-related outcomes as sleep disturbance. We also searched the PDR to identify any insomnia symptoms listed for drugs with RCT evidence available. Seventy-four Cochrane systematic reviews corresponding to 274 RCTs assessed 88 drugs in 27 different conditions, providing evidence on 109 drug-condition pairs. Of these 88 drugs, 5 decreased sleep problems and 19 increased sleep problems; 64 drugs had no nominally statistically significant effect on sleep. Acetylcholinesterase inhibitors, dopamine agonists, and selective serotonin reuptake inhibitors were the drug classes most importantly associated with sleep disturbance. Of 35 drugs that included disturbed sleep as an adverse effect in the PDR, only 14 had RCT evidence supporting such effect, and 2 had evidence of increasing and decreasing sleep problems in RCTs, although this was not shown in the PDR. We identified weak concordance between the PDR and RCTs (weighted κ=0.31; P<.001). The RCTs offer substantial evidence about the common effects of drugs on the risk of sleep disturbance; currently, prescription information only partially agrees with the available randomized evidence. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. [Standardization of the Test Your Memory and evaluation of their concordance with the outcome of the psychometric examination].

    Science.gov (United States)

    Ferrero-Arias, J; Turrión-Rojo, M A

    2016-05-01

    To explore the relationship between scores on the Test Your Memory (TYM) battery and findings from a more exhaustive neurocognitive assessment. The TYM and fourteen psychometric tests were administered to 84 subjects aged 50 or older who attended an outpatient neurology clinic due to cognitive symptoms. Each patient's cognitive state was determined independently from his/her score on the TYM (CDR 0, n=25; CDR 0.5, n=45; CDR 1, n=14). We analysed concurrent validity of TYM scores and results from the psychometric tests, as well as the degree of concordance between the two types of measurement, by contrasting normalised data from each instrument. Although the intraclass correlation coefficient was 0.67 (confidence interval 95%, 0.53-0.77), analysis of the Bland-Altman plot and the curve on the survival-agreement plot (Luiz et al. method) demonstrates that the individual distances between the two methods exhibit excessive dispersion from a clinical viewpoint. TYM-based predictions of the mean z-score on psychometric tests differed substantially from real results in 30% of the subjects. Concordance of 95% can only be achieved by accepting absolute inter-instrument differences of up to 0.87 as identical values. Furthermore, the TYM underestimates cognitive performance for low values and overestimates it for high values. The TYM is a cognitive screening test which should not be used to predict results on psychometric tests or to detect cognitive changes in clinical trials. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Limited concordance between teachers, parents and healthcare professionals on the presence of chronic diseases in ID-adolescents.

    Science.gov (United States)

    Oeseburg, B; Jansen, D E M C; Reijneveld, S A; Dijkstra, G J; Groothoff, J W

    2010-01-01

    Evidence on teachers' knowledge about somatic and mental chronic diseases among ID-adolescent compared to the knowledge parents and healthcare professionals have, is limited. The aim of this study is: (1) to assess the knowledge of teachers on the presence of chronic diseases in ID-adolescents; (2) to compare teachers with parents and healthcare professionals and parents with healthcare professionals regarding the knowledge on the presence of chronic diseases in ID-adolescents. We obtained data on 1044 ID-adolescents attending secondary schools, fully covering one region of the Netherlands. Teachers, parents and general practitioners (GPs) of the adolescents completed a questionnaire about the occurrence of chronic diseases in their child during the previous 12 months. The questionnaire was derived from the Dutch National Permanent Survey on Living Conditions questionnaire periodically administered in a representative population sample (n ≈ 10,000). Concordance between teachers, parents and healthcare professionals on the presence of chronic diseases in ID-adolescents was relatively low. In about half of all 66 dyads the concordance was for the most part fair and just in 10 dyads good to very good; nine of these latter cases concerned somatic chronic diseases. In addition, teachers reported mostly lower prevalence rates of chronic diseases in ID-adolescents compared to the parents, in particular on mental chronic diseases. Although prevalence rates of chronic diseases among ID-adolescents are very high, knowledge on this among teachers is limited. While information on chronic diseases in ID-adolescents is available among different informants, the disagreement between them reflects different points of view between the informants and probably indicates a lack of communication. The communication among teachers, parents and GPs should be improved to combine the knowledge and information on the presence of chronic diseases in ID-adolescents. This may provide

  20. Just Say “I Don’t”: Lack of Concordance Between Teen Report and Biological Measures of Drug Use

    Science.gov (United States)

    Delaney-Black, Virginia; Chiodo, Lisa M.; Hannigan, John H.; Greenwald, Mark K.; Janisse, James; Patterson, Grace; Huestis, Marilyn A.; Ager, Joel; Sokol, Robert J.

    2012-01-01

    BACKGROUND Prevalence estimates of illicit drug use by teens are typically generated from confidential or anonymous self-report. While data comparing teen self-report with biological measures are limited, adult studies identify varying degrees of under-reporting. METHODS Hair analyses for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in a longitudinal cohort of >400 high-risk urban teens and parents. RESULTS Both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny biomarker-verified cocaine use. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report. The lack of concordance between self-report and bioassay occurred despite participant’s knowledge that a “certificate of confidentiality” protected both teen and adult participants, and that the biological specimens would be tested for drugs. CONCLUSIONS These findings confirm prior reports of adult under-reporting of their own drug use while extending our understanding of teen’s self-admitted drug use. The lack of concordance between teen self- or parent-reported teen drug use and biomarkers confirm our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings. Methods of ascertainment other than self- or parent-report must be considered when health care providers, researchers and public health agencies attempt to estimate teen drug-use prevalence. PMID:20974792

  1. Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer Análise das taxas de concordância entre a biópsia com agulha grossa e a excisão cirúrgica em pacientes com câncer de mama

    Directory of Open Access Journals (Sweden)

    Marcos Desidério Ricci

    2012-10-01

    Full Text Available OBJECTIVE: To evaluate whether immunohistochemical marker studies performed on core needle biopsy (CNB specimens accurately reflect the marker status of the tumor obtained from final surgical specimen. METHODS: This was a retrospective study that used the database of the Division of Mastology of the Hospital das Clínicas, São Paulo, Brazil. Sixty-nine patients submitted to ultrasound-guided CNB diagnosed with breast cancer were retrospectively analyzed. Immunohistochemistry (IHC on core biopsy specimens was compared to that of excisional biopsy regarding estrogen receptor (ER, progesterone receptor (PR, human epidermal gowth factor receptor 2 gene (HER2, p53, and Ki67. The analysis of the concordance between CNB and surgical biopsy was performed using the kappa (k coefficient (95% CI. RESULTS: A perfect concordance between the labeling in the surgical specimens and the preoperative biopsies in p53 (k = 1.0; 95% CI: 0.76-1.0 was identified. There was an almost perfect concordance for ER (k = 0.89; 95% CI: 0.65-1.0 and a substantial concordance for PR (k = 0.70; 95% CI: 0.46-0.93. HER2 (k = 0.61; 95% CI: 0.38-0.84 and Ki-67 (k = 0.74; 95% CI: 0.58-0.98 obtained a substantial concordance this analysis. CONCLUSION: The results of this study indicate that the immunohistochemical analysis of ER, PR, Ki-67, and p53 from core biopsy specimens provided results that accurately reflect the marker status of the tumor. The concordance rate of HER2 was less consistent; although it produced substantial concordance, values were very close to moderate concordance.OBJETIVO: Avaliar se a análise dos marcadores imunoistoquímicos obtidos por meio de espécimes de core biopsy (CB refletem com precisão o perfil dos marcadores tumorais obtidos por biópsia cirúrgica excisional (BCE. MÉTODOS: Estudo retrospectivo usando dados da Divisão de Mastologia do Hospital das Clínicas de São Paulo. Sessenta e nove pacientes submetidas à CB guiada por ultrassom com

  2. Avaliação da concordância interobservadores na análise da polipose nasossinusal por meio da tomografia computadorizada Evaluation of the concordance between observers in sinunasal polyposis through computed tomographic analysis

    Directory of Open Access Journals (Sweden)

    Elaine A. Mendes

    2004-08-01

    Full Text Available Polipose nasossinusal (PNS é uma entidade de etiologia controversa, caracterizada por uma condição inflamatória da superfície mucosa das fossas nasais e seios paranasais, bilateralmente. A queixa principal do paciente consiste na obstrução nasal e, ao exame físico, observam-se freqüentemente massas polipóides ocupando as cavidades nasais em extensões variáveis. Além da rinoscopia anterior e da endoscopia nasal, o uso da tomografia computadorizada (TC torna-se necessário para avaliação das fossas nasais e da presença ou não do acometimento dos seios paranasais por essas massas, bem como a sua extensão. Este trabalho tem como objetivo avaliar a concordância interobservadores, por meio da análise da tomografia computadorizada, de 32 casos de PNS. FORMA DE ESTUDO: Clínico prospectivo. CASUÍSTICA E MÉTODOS: Foram avaliadas 32 TC de pacientes portadores PNS por dois observadores experientes, separadamente, em relação à presença ou não de 3 sinais tomográficos sugestivos dessa doença: (1 alargamento infundibular do complexo ostiomeatal, (2 abaulamento lateral da lâmina papirácea e (3 apagamento do trabeculado ósseo etmoidal. RESULTADOS: Observou-se Qui-quadrado não significante para o primeiro e segundo sinais (p=0,7055 e p=0,2057 e significante para o terceiro (p=0,0040. Contudo, o coeficiente de correlação de Kendall entre os dois observadores foi significante para os três sinais tomográficos acima citados (pSinonasal polyposis (SNP is a condition with a controversial aethiology, known by bilaterally inflammatory mucous membranes of nasal and paranasal sinuses. The major patient's complaint is nasal obstruction, and polypoid masses in different sizes can be found during nasal cavity examination. Beyond anterior rhinoscophy and nasal endoscopy, screening sinus computed tomography (SSCT is necessary to measure the size and the extent of the polyps into nasal cavities and paranasal sinuses. The purpose of this

  3. Parent-adolescent concordance on the Revised Diagnostic Interview for Borderlines (DIB-R) and the Childhood Interview for Borderline Personality Disorder (CI-BPD).

    Science.gov (United States)

    Wall, K; Sharp, C; Ahmed, Y; Goodman, M; Zanarini, M C

    2017-08-01

    While the degree of concordance between parent and adolescent self-report of internalizing and externalizing pathology is well studied, virtually nothing is known about concordance in borderline pathology and the implication of parent-adolescent discrepancies for outcomes. The present study aimed to (1) examine discrepancies between parents and adolescents on two interview-based measures of borderline personality disorder (BPD)-the Revised Diagnostic Interview for Borderlines (DIB-R 22 ) and the Childhood Interview for Borderline Personality Disorder (CI-BPD 23 ); and (2) investigate the implications of discrepancies for clinical outcomes. Diagnostic concordance on the DIB-R and CI-BPD showed rates of 82% and 94% respectively, with lower concordance demonstrated for dimensionally scored variables. Standardized difference scores between adolescent and parent reports on both borderline measures were significantly correlated with few interview-based axis I diagnoses as reported by parents, but not adolescents themselves. Implications regarding the use of each measure for the assessment and diagnosis of borderline personality disorder are discussed. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Measuring Current Drug Use in Female Sex Workers and Their Noncommercial Male Partners in Mexico: Concordance Between Data Collected From Surveys Versus Semi-Structured Interviews.

    Science.gov (United States)

    Palinkas, Lawrence A; Bazzi, Angela Robertson; Syvertsen, Jennifer L; Ulibarri, Monica D; Hernandez, Daniel; Rangel, M Gudelia; Martinez, Gustavo; Strathdee, Steffanie A

    2016-01-02

    Self-reports are commonly used to assess prevalence and frequency of drug use, but it is unclear whether qualitative methods like semi-structured interviews are as useful at obtaining such information as quantitative surveys. This study compared drug use occurrence and frequency using data collected from quantitative surveys and qualitative interviews. We also examined whether combining data from both sources could result in significant increases in percentages of current users and whether the concordance between the two sets of data was associated with the type of drug use, age, gender and socioeconomic status. Self- reports of recent marijuana, heroin, crack, cocaine, crystal/methamphetamine, inhalant, and tranquilizer use were collected using both methods from a cohort of Mexican female sex workers and their non-commercial male partners (n = 82). Participants were significantly less likely to report marijuana, cocaine and tranquilizer use and frequency of use during the qualitative interviews than during the quantitative surveys. Agreement on frequency of drug use was excellent for crystal/methamphetamine, heroin and inhalant use, and weak for cocaine, tranquilizers and marijuana use. Older participants exhibited significantly higher concordance than younger participants in reports of marijuana and methamphetamine use. Higher monthly income was significantly associated with higher concordance in crack use but lower concordance with marijuana use. Although use of such data can result in an underreporting of drug use, qualitative data can be quantified in certain circumstances to triangulate and confirm the results from quantitative analyses and provide a more comprehensive view of drug use.

  5. Concordance of Race or Ethnicity of Interventionists and Caregivers of Dementia Patients: Relationship to Attrition and Treatment Outcomes in the REACH Study

    Science.gov (United States)

    McGinnis, Kathleen A.; Schulz, Richard; Stone, Roslyn A.; Klinger, Julie; Mercurio, Rocco

    2006-01-01

    Purpose: We assess the effects of racial or ethnic concordance between caregivers and interventionists on caregiver attrition, change in depression, and change in burden in a multisite randomized clinical trial. Design and Methods: Family caregivers of patients with Alzheimer's disease were randomized to intervention or control groups at six sites…

  6. Importance of prostate-specific antigen (PSA) as a predictive factor for concordance between the Gleason scores of prostate biopsies and RADICAL prostatectomy specimens.

    Science.gov (United States)

    Lima, Nelson Gianni de; Soares, Daniel de Freitas Gomes; Rhoden, Ernani Luis

    2013-06-01

    To evaluate the concordance between the Gleason scores of prostate biopsies and radical prostatectomy specimens, thereby highlighting the importance of the prostate-specific antigen (PSA) level as a predictive factor of concordance. We retrospectively analyzed 253 radical prostatectomy cases performed between 2006 and 2011. The patients were divided into 4 groups for the data analysis and dichotomized according to the preoperative PSA, PSA level was 9.3±4.9 ng/mL. The overall concordance between the Gleason scores was 52%. Patients presented preoperative PSA levels PSA levels PSA levels ≥10 ng/dL (61% x 23%, p=0.023), which resulted in 77% upgrading after surgery in those patients with PSA levels ≥10 ng/dl. The Gleason scores of needle prostate biopsies and those of the surgical specimens were concordant in approximately half of the global sample. The preoperative PSA level was a strong predictor of discrepancy and might improve the identification of those patients who tended to be upgraded after surgery, particularly in patients with Gleason scores of 3 + 3 in the prostate biopsy and preoperative PSA levels ≥10 ng/mL.

  7. Glucose effectiveness and insulin sensitivity measurements derived from the non-insulin-assisted minimal model and the clamp techniques are concordant

    DEFF Research Database (Denmark)

    Henriksen, Jan Erik; Alford, Frank; Ward, Glenn

    2010-01-01

    We investigated the concordance between glucose effectiveness (SG) and insulin sensitivity (SI), derived from the unmodified dynamic non-insulin-assisted intravenous glucose tolerance test (IVGTT) implemented by SG(MM) and SI(MM); simulation analysis and modelling/conversational interaction (SAAM....../CONSAM) versus the eu/hyperglycaemic basal insulinaemic and the euglycaemic hyperinsulinaemic clamp (SG(CLAMP) and SI(CLAMP))....

  8. Surgical site infections among high-risk patients in clean-contaminated head and neck reconstructive surgery: concordance with preoperative oral flora.

    Science.gov (United States)

    Yang, Ching-Hsiang; Chew, Khong-Yik; Solomkin, Joseph S; Lin, Pao-Yuan; Chiang, Yuan-Cheng; Kuo, Yur-Ren

    2013-12-01

    Salivary contamination of surgical wounds in clean-contaminated head and neck surgery with free flap reconstruction remains a major cause of infection and leads to significant morbidity. This study investigates the correlation between intraoral flora and surgical site infections (SSIs) among high-risk head and neck cancer patients undergoing resection and free flap reconstruction. One hundred twenty-nine patients were identified as being at high risk for infective complications based on cancer stage, tumor size, comorbid factors, and extent of reconstruction. All patients had intraoral swab cultures before surgery. Patients with culture-confirmed SSI after surgery were chosen for analysis, using the κ index and its 95% confidence interval for concordance analysis. All patients received clindamycin and gentamicin for antibiotic prophylaxis for 5 days. Antibiotic susceptibility testing of all isolates was obtained and analyzed. Thirty-seven patients experienced SSI, or an infection rate of 28.3%, occurring at a mean of 9.3 postoperative days. The overall concordance between oral flora and SSI was fair to moderate (κ index of 0.25), but detailed analysis shows a higher concordance for known and opportunistic pathogens, such as Pseudomonas aeruginosa and Enterococcus faecalis, compared to typical oral commensals. Antibiotic susceptibility tests show rapid and significant increases in resistance to clindamycin, indicating a need for a more effective alternative. Predicting pathogens in SSI using preoperative oral swabs did not demonstrate a good concordance in general for patients undergoing clean-contaminated head and neck surgery, although concordance for certain pathogenic species seem to be higher than for typical intraoral commensals. The rapid development of resistance to clindamycin precludes its use as a prophylactic agent.

  9. Modelação computacional de padrões variáveis de concordância em português

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    Leonel Figueiredo de Alencar

    2014-03-01

    Full Text Available Este trabalho descreve a implementação de um parser para um fragmento do português no XLE, sistema que constitui o estado da arte para o desenvolvimento de gramáticas computacionais baseadas no modelo gerativo da LFG. O fragmento abrange os seguintes aspectos da concordância verbal,sujeitos à variação dialetal: (i concordância sintática do chamado pronome a gente, com formas verbais de terceira pessoa do singular e semântica coma primeira e terceira do plural; (ii concordância do pronome tu, com a segunda e a terceira do singular e do pronome vocês, com a segunda e terceira do plural; (iii concordância semântica de um DP definido no plural, com a primeira pessoa do plural. Para derivar os diferentes padrões de concordância nesse domínio, constatados no português padrão e em alguns dialetos não padrão tanto do português do Brasil quanto do português europeu, são propostas estruturas de traços para os DPs e flexões verbais em que se distingue entre traços sintático-formais e traços semântico-discursivos. Mostra-se que as diferenças entre os dialetos investigados em relação a (i – (iiipodem ser derivadas por meio da ativação ou desativação desses traços.

  10. Giant-cell arteritis. Concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

    Energy Technology Data Exchange (ETDEWEB)

    Boysson, Hubert de; Dumont, Anael; Boutemy, Jonathan; Maigne, Gwenola; Martin Silva, Nicolas; Sultan, Audrey; Bienvenu, Boris; Aouba, Achille [Caen University Hospital, Department of Internal Medicine, Caen (France); Liozon, Eric; Ly, Kim Heang [Limoges University Hospital, Department of Internal Medicine, Limoges (France); Lambert, Marc [Lille University Hospital, Department of Internal Medicine, Lille (France); Aide, Nicolas [Caen University Hospital, Department of Nuclear Medicine, Caen (France); INSERM U1086 ' ' ANTICIPE' ' , Francois Baclesse Cancer Centre, Caen (France); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Caen (France); Normandy University, Caen (France)

    2017-12-15

    The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA). We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index. We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively. CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches. (orig.)

  11. Human metabolic response to systemic inflammation: assessment of the concordance between experimental endotoxemia and clinical cases of sepsis/SIRS.

    Science.gov (United States)

    Kamisoglu, Kubra; Haimovich, Beatrice; Calvano, Steve E; Coyle, Susette M; Corbett, Siobhan A; Langley, Raymond J; Kingsmore, Stephen F; Androulakis, Ioannis P

    2015-03-03

    Two recent, independent, studies conducted novel metabolomics analyses relevant to human sepsis progression; one was a human model of endotoxin (lipopolysaccharide (LPS)) challenge (experimental endotoxemia) and the other was community acquired pneumonia and sepsis outcome diagnostic study (CAPSOD). The purpose of the present study was to assess the concordance of metabolic responses to LPS and community-acquired sepsis. We tested the hypothesis that the patterns of metabolic response elicited by endotoxin would agree with those in clinical sepsis. Alterations in the plasma metabolome of the subjects challenged with LPS were compared with those of sepsis patients who had been stratified into two groups: sepsis patients with confirmed infection and non-infected patients who exhibited systemic inflammatory response syndrome (SIRS) criteria. Common metabolites between endotoxemia and both these groups were individually identified, together with their direction of change and functional classifications. Response to endotoxemia at the metabolome level elicited characteristics that agree well with those observed in sepsis patients despite the high degree of variability in the response of these patients. Moreover, some distinct features of SIRS have been identified. Upon stratification of sepsis patients based on 28-day survival, the direction of change in 21 of 23 metabolites was the same in endotoxemia and sepsis survival groups. The observed concordance in plasma metabolomes of LPS-treated subjects and sepsis survivors strengthens the relevance of endotoxemia to clinical research as a physiological model of community-acquired sepsis, and gives valuable insights into the metabolic changes that constitute a homeostatic response. Furthermore, recapitulation of metabolic differences between sepsis non-survivors and survivors in LPS-treated subjects can enable further research on the development and assessment of rational clinical therapies to prevent sepsis mortality

  12. Concordance of the Indian Mental Healthcare Act 2017 with the World Health Organization's Checklist on Mental Health Legislation.

    Science.gov (United States)

    Duffy, Richard M; Kelly, Brendan D

    2017-01-01

    India is revising its mental health legislation with the Indian Mental Healthcare Act 2017 (IMHA). When implemented, this legislation will apply to over 1.25 billion people. In 2005, the World Health Organization (WHO) published a Resource Book (WHO-RB) on mental health, human rights and legislation, including a checklist of 175 specific items to be addressed in mental health legislation or policy in individual countries. Even following the publication of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (2006), the WHO-RB remains the most comprehensive checklist for mental health legislation available, rooted in UN and WHO documents and providing the most systematic, detailed framework for human rights analysis of mental health legislation. We sought to determine the extent to which the IMHA will bring Indian legislation in line with the WHO-RB. The IMHA and other relevant pieces of Indian legislation are compared to each of the items in the WHO-RB. We classify each item in a binary manner, as either concordant or not, and provide more nuanced detail in the text. The IMHA addresses 96/175 (55.4%) of the WHO-RB standards examined. When other relevant Indian legislation is taken into account, 118/175 (68.0%) of the standards are addressed in Indian law. Important areas of low concordance include the rights of families and carers, competence and guardianship, non-protesting patients and involuntary community treatment. The important legal constructs of advance directives, supported decision-making and nominated representatives are articulated in the Indian legislation and explored in this paper. In theory, the IMHA is a highly progressive piece of legislation, especially when compared to legislation in other jurisdictions subject to similar analysis. Along with the Indian Rights of Persons with Disabilities Act 2016, it will bring Indian law closely in line with the WHO-RB. Vague, opaque language is however, used in certain contentious

  13. Evaluation of Concordance between Hip and Spine T Scores in the Diagnosis of Osteoporosis in Men Over Age of Fifty

    Directory of Open Access Journals (Sweden)

    Oya Özdemir

    2015-12-01

    Full Text Available Objective: The aim of this study was to evaluate the concordance in diagnosis of osteoporosis based on the World Health Organization (WHO classification of bone mineral density (BMD measurements of hip and spine in men aged ≥50 years. Materials and Methods: The BMD measurements, which were measured via dual x-ray energy absorptiometry (DXA, of 10.049 patients admitted to our hospital between January 1, 2012 and August 1, 2013 were retrospectively reviewed and 649 men aged ≥50 years were included in the study. It was defined as minor discordance when the difference between two sites was no more than one WHO diagnostic class. Major discordance was present when one site is osteoporotic and the other is normal. Results: The mean age of the participants was 68.7±9.1 (50-93 years. The mean values of lumbar spine and total hip BMD values were 1.1681±0.231 (0.629-2.267 g/cm2 and 0.933±0.152 (0.414-1.444 g/cm2, respectively. According to L1-L4 vertebra T score, 54.4% of the individuals were classified as normal, 33% were osteopenic, and 12.6% were osteoporotic. Whereas, according to total femur T score 41.7% of participants were normal, 47.5% had osteopenia, and 10.8% had osteoporosis. Concordance of T scores, minor discordance, and major discordance were seen in 59.6%, 37.6%, and 2.8% of the patients, respectively. Conclusion: In this study, it was shown that in 4 of every 10 male patients aged ≥50 years tested by DXA, T score discordance between spine and total hip measurement sites is present. This ratio is similar to the results of previous studies investigating the prevalence of this phenomenon in larger samples including both postmenopausal women and men. Clinicians should keep in their mind that T score discordance is a prevalent finding and can be related to various physiological and pathological patient factors as well as the performance or analysis of DXA itself.

  14. Oral Human Papillomavirus Infection: Differences in Prevalence Between Sexes and Concordance With Genital Human Papillomavirus Infection, NHANES 2011 to 2014.

    Science.gov (United States)

    Sonawane, Kalyani; Suk, Ryan; Chiao, Elizabeth Y; Chhatwal, Jagpreet; Qiu, Peihua; Wilkin, Timothy; Nyitray, Alan G; Sikora, Andrew G; Deshmukh, Ashish A

    2017-11-21

    The burden of human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the difference in prevalence of oral HPV infection between men and women is limited. Concordance of oral and genital HPV infection among men is unknown. To determine the prevalence of oral HPV infection, as well as the concordance of oral and genital HPV infection, among U.S. men and women. Nationally representative survey. Civilian noninstitutionalized population. Adults aged 18 to 69 years from NHANES (National Health and Nutrition Examination Survey), 2011 to 2014. Oral rinse, penile swab, and vaginal swab specimens were evaluated by polymerase chain reaction followed by type-specific hybridization. The overall prevalence of oral HPV infection was 11.5% (95% CI, 9.8% to 13.1%) in men and 3.2% (CI, 2.7% to 3.8%) in women (equating to 11 million men and 3.2 million women nationwide). High-risk oral HPV infection was more prevalent among men (7.3% [CI, 6.0% to 8.6%]) than women (1.4% [CI, 1.0% to 1.8%]). Oral HPV 16 was 6 times more common in men (1.8% [CI, 1.3% to 2.2%]) than women (0.3% [CI, 0.1% to 0.5%]) (1.7 million men vs. 0.27 million women). Among men and women who reported having same-sex partners, the prevalence of high-risk HPV infection was 12.7% (CI, 7.0% to 18.4%) and 3.6% (CI, 1.4% to 5.9%), respectively. Among men who reported having 2 or more same-sex oral sex partners, the prevalence of high-risk HPV infection was 22.2% (CI, 9.6% to 34.8%). Oral HPV prevalence among men with concurrent genital HPV infection was 4-fold greater (19.3%) than among those without it (4.4%). Men had 5.4% (CI, 5.1% to 5.8%) greater predicted probability of high-risk oral HPV infection than women. The predicted probability of high-risk oral HPV infection was greatest among black participants, those who smoked more than 20 cigarettes daily, current marijuana users, and those who reported 16 or more lifetime

  15. Concordance of self-reported hormonal contraceptive use and presence of exogenous hormones in serum among African women.

    Science.gov (United States)

    Pyra, Maria; Lingappa, Jairam R; Heffron, Renee; Erikson, David W; Blue, Steven W; Patel, Rena C; Nanda, Kavita; Rees, Helen; Mugo, Nelly R; Davis, Nicole L; Kourtis, Athena P; Baeten, Jared M

    2018-04-01

    Studies that rely on self-report to investigate the relationship between hormonal contraceptive use and HIV acquisition and transmission, as well as other health outcomes, could have compromised results due to misreporting. We determined the frequency of misreported hormonal contraceptive use among African women with and at risk for HIV. We tested 1102 archived serum samples from 664 African women who had participated in prospective HIV prevention studies. Using a novel high-performance liquid chromatography-mass spectrometry assay, we quantified exogenous hormones for injectables (medroxyprogesterone acetate or norethisterone), oral contraceptives (OC) (levonorgestrel or ethinyl estradiol) and implants (levonorgestrel or etonogestrel) and compared them to self-reported use. Among women reporting hormonal contraceptive use, 258/358 (72%) of samples were fully concordant with self-report, as were 642/744 (86%) of samples from women reporting no hormonal contraceptive use. However, 42/253 (17%) of samples from women reporting injectable use, 41/66 (62%) of samples from self-reported OC users and 3/39 (8%) of samples from self-reported implant users had no quantifiable hormones. Among self-reported nonusers, 102/744 (14%) had ≥1 hormone present. Concordance between self-reported method and exogenous hormones did not differ by HIV status. Among African women with and at risk for HIV, testing of exogenous hormones revealed agreement with self-reported contraceptive use for most women. However, unexpected exogenous hormones were identified among self-reported hormonal contraceptive users and nonusers, and an important fraction of women reporting hormonal contraceptive use had no hormones detected; absence of oral contraceptive hormones could be due, at least in part, to samples taken during the hormone-free interval. Misreporting of hormonal contraceptive use could lead to biased results in observational studies of the relationship between contraceptive use and health

  16. Dealing with daily challenges in dementia (deal-id study): effectiveness of the experience sampling method intervention 'Partner in Sight' for spousal caregivers of people with dementia: design of a randomized controlled trial.

    Science.gov (United States)

    van Knippenberg, Rosalia J M; de Vugt, Marjolein E; Ponds, Rudolf W; Myin-Germeys, Inez; Verhey, Frans R J

    2016-05-11

    There is an urgent need for psychosocial interventions that effectively support dementia caregivers in daily life. The Experience Sampling Methodology (ESM) offers the possibility to provide a more dynamic view of caregiver functioning. ESM-derived feedback may help to redirect caregivers' behavior towards situations that elicit positive emotions and to increase their feelings of competence in the caretaking process. This paper presents the design of a study that evaluates the process characteristics and effects of the ESM-based intervention 'Partner in Sight'. A randomized controlled trial with 90 spousal caregivers of people with dementia will be conducted. Participants will be randomly assigned to the experimental (6-week ESM intervention including feedback), pseudo-experimental (6-week ESM intervention without feedback), or control group (care as usual). Assessments will be performed pre- and post-intervention and at 2-, and 6-month follow-up. Main outcomes will be sense of competence, perceived control, momentary positive affect, and psychological complaints (depressive symptoms, perceived stress, anxiety, momentary negative affect). In addition to the effect evaluation, a process and economic evaluation will be conducted to investigate the credibility and generalizability of the intervention, and its cost-effectiveness. The potential effects of the ESM intervention may help caregivers to endure their care responsibilities and prevent them from becoming overburdened. This is the first ESM intervention for caregivers of people with dementia. The results of this study, therefore, provide a valuable contribution to the growing knowledge on m-health interventions for dementia caregivers. Dutch Trial Register NTR4847 ; date registered Oct 9, 2014.

  17. Improved accuracy of U-Pb zircon ages by the creation of more concordant systems using an air abrasion technique

    International Nuclear Information System (INIS)

    Krogh, T.E.

    1982-01-01

    Abrasion combined with an improved paramagnetic separation technique eliminates 90 to 100 percent of discordance so that ages of unprecedented accuracy (+-1 to 3m.y.) can be achieved for virtually all 2700m.y. old zircon populations from plutonic or volcanic rocks. The procedures work even better for younger zircons. Besides removing outer layers that may have been leached, high-U parts are preferentially removed by abrasion because they are softened by radiation damage. Altered and cracked zircons also tend to be eliminated. In most cases, the new concordant data move up the line established by previously analysed paramagnetic fractions but a number of anomalies have been found where old data give upper intersections that are in error by as much as 25m.y. Reducing or eliminating paramagnetically correlated Pb loss greatly enhances our ability to define mixing lines for igneous or metamorphic rocks when two ages of zircon are present. The abrasion technique allows detection of an inherited component if it exists by enhancing the sample in core material. Abrasion in many cases removes about 80 percent of the common lead, thus allowing a direct evaluation of this component. When the outer parts of grains are removed, the correlation between magnetic susceptibility and uranium content is maintained but the usual correlation of uranium level with lead loss is reduced or eliminated. Therefore, only near surface uranium is involved in the classic discordance versus uranium level correlation of Silver (1963). (author)

  18. Improved accuracy of U-Pb zircon ages by the creation of more concordant systems using an air abrasion technique

    International Nuclear Information System (INIS)

    Krogh, T.E.

    1982-01-01

    Abrasion combined with an improved paramagnetic separation technique eliminates 90 to 100 percent of discordance so that ages of unprecedented accuracy (+- 1 to 3 m.y.) can be achieved for virtually all 2700 m.y. old zircon populations from plutonic or volcanic rocks. The procedures work even better for younger zircons. Besides removing outer layers that may have been leached, high-U parts are preferentially removed by abrasion because they are softened by radiation damage. Altered and cracked zircons also tend to be eliminated. In most cases, the new concordant data move up the line established by previously analysed paramagnetic fractions but a number of anomalies have been found where old data give upper intersections that are in error by as much as 25 m.y. Reducing or eliminating paramagnetically correlated Pb loss greatly enhances our ability to define mixing lines for igneous or metamorphic rocks when two ages of zircon are present. The abrasion technique allows detection of an inherited component if it exists by enhancing the sample in core material. Abrasion in many cases removes about 80 percent of the common lead, thus allowing a direct evaluation of this component. (author)

  19. Phylogeographic concordance factors quantify phylogeographic congruence among co-distributed species in the Sarracenia alata pitcher plant system.

    Science.gov (United States)

    Satler, Jordan D; Carstens, Bryan C

    2016-05-01

    Comparative phylogeographic investigations have identified congruent phylogeographic breaks in co-distributed species in nearly every region of the world. The qualitative assessments of phylogeographic patterns traditionally used to i