Fractal analysis of bone texture : a screening tool for stress fracture risk?

Background The aim of this study was to identify specific bone characteristics of stress fracture (SF) cases in sportswomen. To date, no tool is able to distinguish individuals who are at risk, limiting preventive measures.

Material and methods We investigated the skeletal system of sportswomen who did sustain SF in the past (n = 19) and compared it with that of female controls (C) with a similar sporting history but without any fracture history (n = 20).

Bone mass and body composition were measured using dual-energy X-ray absorptiometry. Bone micro-architecture was investigated by calcaneal ultrasound and fractal analysis of calcaneus radiographic images. Oestradiol levels were measured by E.I.A, and IGF-1 by R.I.A. Menstrual characteristics, nutrient intake, and training were assessed using questionnaires.

Results The result of the fractal analysis, expressed by the Hmean parameter, was significantly lower in the SF group, reflecting a more complex structure of the trabecular micro-architectural organization (P < 0·005). Body mass index (BMI) at birth was also found to be lower in the SF cases as compared with their C (P < 0·03).

Multivariate analysis revealed that the fractal parameter Hmean, bone mineral content (BMC) at Ward's triangle and the BMI at birth correctly assigned 84·85% of the female athletes into their respective SF or C groups (P = 0·001).

Conclusion These results suggest that the fractal parameter and the BMI at birth may be able to identify female athletes most at risk for this overuse bone injury, as their low indexes might reflect a greater skeletal sensitivity.

Investigating directionality for a media consumption construct : establishing the utility of confirmatory vanishing tetrad analysis

Purpose – When assessing the psychometric properties of measures and estimate relations among latent variables, many studies in the social sciences (including management and marketing) often fail to comprehensively appraise the directionality of indicants. Such failures can lead to model misspecification and inaccurate parameter estimates. The purpose of this paper is to apply a post hoc test called confirmatory vanishing tetrad analysis (CTA hereafter) to a single construct called mass media consumption information exposure, which antecedent studies conceptually posited to be a formative (causative) representation.
Design/methodology/approach – This paper analyses a consumer sample of 585 US respondents and applies the CTA test to a single construct by its inclusion in various matrices within a statistical analysis system-macro that takes into account nonnormal data characteristics. The matrices are derived from Mplus 5 through the estimation of a single-factor congeneric model. The CTA test calculates a test statistic similar to an asymptotic x2 distribution with degrees of freedom equal to the number of nonredundant tetrads tested.
Findings – The preliminary data analyses reveal that the data characteristics are nonnormal which is not uncommon in social research. The CTA results reveal that the reflective (emergent) item orientation cannot be fully ruled out as being the correct model representation. This is in contrast to prior theoretical conceptual work which would strongly support this construct being a formative representation.
Originality/value – Insofar as the authors are aware, there is no paper with a particular focus on how the CTA might not provide sound results with a demonstrated example. The paper makes a valuable contribution by discussing modelling philosophy and a procedure for directionality testing. The authors advocate the implementation of pre and post hoc tests as a key component of standard research practice.

Re-gendering labour: class and gender determinants of New South Wales electoral behaviour 1930-32

Historians have neglected tbe impact of female enfranchisement on Australian electoral outcomes. This papers employs multivariate analysis to explore electoral behaviour in New South Wales during the Great Depression. It argues that women were less prone to support Labor than men, but that women in paid employment constituted a partial exception to this pattern. In 1932 the conservative parties significantly eroded Labor's working-class support. Part of this success was due to the ability of employers to coerce workers with the threat of dismissal. Female wage earners were particularly vulnerable to this coercion. Conservative electoral appeals recast masculinity in terms of family responsibility rather than class assertion. Conflict in the household economy possibly influenced women to vote against Labor due to its identification with the cause of male breadwinners. Overall female voting behaviour was more stable than that of men and this despite the higb profile of issues that would have been expected particularly to influence female voters.

The reliability, validity, discriminant and predictive properties of the social Phobia Inventory (SoPhI)

This paper reports on the psychometric properties of the Social Phobic Inventory (SoPhI) a 21-item scale that was designed to measure social anxiety according to the criteria of DSM-IV (American Psychiatric Association, APA (1994) Diagnostic and Statistical Manual of Mental Disorder , 4th Edn., Washington). Factor analysis of the SoPhI using data from a clinical sample of respondents with social phobia revealed one factor which explained approximately 59% of variance and which demonstrated strong internal reliability ( agr= 0.93). The SoPhI demonstrated concurrent validity with the SPAI ( r = 0.86) and convergent validity with the Fear of Negative Evaluations-Revised ( r = 0.68). The predictive utility of the scale was demonstrated in a sample of university students classified as extroverted, normal, shy/introverted, and phobic/withdrawn ( -2 57%). Multivariate Analysis of Variance (MANOVA) revealed that the combined university sample differed from the clinical sample on the summated scores on the SoPhI and that 43% ( -2 ) of this difference was attributable to group membership. This figure rose to 58% attributable to group membership when these same groups were compared for differences on the 21 individual items. Scores of the SoPhI that are indicative of concern and of possible diagnostic criteria, as well as suggestions for future research, are discussed.

Meiofaunal recruitment to mimic pneumatophores in a cool-temperate mangrove forest: spatial context and biofilm effects

A field experiment was devised to test whether meiofauna that colonised mimic pneumatophores (artificial substrates) resembled the assemblage on adjacent live pneumatophores in three randomly chosen intertidal, estuarine sites. The experiment showed that the close proximity of particular biota on living pneumatophores did not reliably influence subsequent development of assemblages upon mimic pneumatophores within a scale of 10 m during a colonisation period of less than 20 weeks. There was some convergence of the composition of the colonising assemblage of meiofauna on mimic pneumatophores with the local assemblages in sites dominated by barnacles, or where the natural pneumatophores were free from macroscopic epibionts. However, tychopelagic meiofauna from algal epiphytes did not significantly colonise mimic pneumatophores during the 20-week trial, probably due a lack of growing algae. During the conditioning phase suspended in water at a marine site 20 km from the mangroves, mimic pneumatophores acquired an assemblage of meiofauna different from the estuarine assemblage that colonised mimics following implantation in the estuarine mudflat. Enhanced colonisation rates of mimics in suspended bags at the conditioning site may be explained by the absence of benthic macroinvertebrates, and the lack of intertidal exposure. Biofilms aged 2, 7, and 11 weeks had no consistent, different effect on the subsequent colonisation of meiofauna. We conclude that divergence of phytal-based assemblages of meiofauna depends upon the amount of coverage, as well as the type, of fouling macro-epibionts on the pneumatophores. Meiofaunal assemblages on artificial substrates after 20 weeks colonisation displayed less intrinsic patchiness than mature phytal assemblages on natural pneumatophores, and so present a potentially useful way of improving the power of biomonitoring applications using meiofauna.

Rationale and design of the national benchmarking and evidence-based national clinical guidelines for chronic heart failure management programs study

OBJECTIVES: The National Benchmarks and Evidence-Based National Clinical Guidelines for Heart Failure Management Programs Study is a national, multicenter study designed to determine the nature, range, and effect of interventions applied by chronic heart failure management programs (CHF-MPs) throughout Australia on patient outcomes. Its primary objective is to use these data to develop national benchmarks and evidence-based clinical guidelines and optimize their cost-effective application by reducing quality and outcome variability. DATA SOURCES/STUDY SETTING: Primary data will be collected from CHF-MP coordinators and CHF patients enrolled in these programs on a national basis. Secondary outcome data will be collected from a national morbidity record and from patients' medical records. STUDY DESIGN: Stage I of the study involves a prospective clinical audit of all CHF-MPs throughout Australia (n = 45) to determine the extent of variability in programs currently. Stage II is a prospective cross-sectional survey design enrolling 1,500 patients (average of 40 patients per program) to firstly determine the typical profile of patients being managed via a CHF-MP in Australia and, secondly, the subsequent morbidity and mortality during the 6-month follow-up. Outcome data will be subject to multivariate analysis to determine the key components of care in this regard. All study data will be then examined in the final stage of the study (III) to develop national benchmarks for the application and auditing of CHF-MPs in Australia. CONCLUSION: Variability in patient outcomes is a product of heterogeneity among CHF-MPs. The development of national benchmarks will minimize such heterogeneity and will provide a greater level of evidence for their cost-effective application.

Genetic variation in BEACON influences quantitative variation in metabolic syndrome-related phenotypes

The BEACON gene (also known as UBL5) was identified as differentially expressed between lean and obese Psammomys obesus, a polygenic animal model of obesity, type 2 diabetes, and dyslipidemia. The human homologue of BEACON is located on chromosome 19p, a region likely to contain genes affecting metabolic syndrome–related quantitative traits as established by linkage studies. To assess whether the human BEACON gene may be involved in influencing these traits, we exhaustively analyzed the complete gene for genetic variation in 40 unrelated individuals and identified four variants (three novel). The two more common variants were tested for association with a number of quantitative metabolic syndrome–related traits in two large cohorts of unrelated individuals. Significant associations were found between these variants and fat mass (P = 0.026), percentage of fat (P = 0.001), and waist-to-hip ratio (P = 0.031). The same variants were also associated with total cholesterol (P = 0.024), LDL cholesterol (P = 0.019), triglycerides (P = 0.006), and postglucose load insulin levels (P = 0.018). Multivariate analysis of these correlated phenotypes also yielded a highly significant association (P = 0.0004), suggesting that BEACON may influence phenotypic variation in metabolic syndrome–related traits.

Self-perceived quality of life for adolescents with physical disabilities - a preliminary study

The purpose of this study was to explore the effect of physical disabilities (PD) on the quality of life (QoL) of adolescents aged from 10 to 18 years. Sixty-three adolescents with PD (aged 14.9 ± 2.4 years) from primary (5th grade or above) to high schools in Kaohsiung City volunteered to participate in this research; 282 children without disability (aged 13.8 ± 2.3 years) attending schools in the same geographical region were recruited as controls. The Student Version of the Comprehensive Quality of Life Scale was used in this study. This is a multidimensional self-report, global measure of subjective and objective QoL. Multivariate analysis of variance revealed that the two groups were significantly different in objective QoL (F = 11.53, p < 0.001). Material wellbeing was substantially lower in the PD group when compared to the control group. In contrast, domains such as productivity, safety, and emotion were higher in the PD group. Among the subjective scales, the PD group showed higher productivity and better emotion when compared to the control group. No significant correlation was observed between objective and subjective overall QoL scores (r = 0.20, p = 0.12) in the PD group. These findings showed that subjects with PD in regular schools demonstrated different patterns in objective and subjective QoL when compared to those without PD. Both subjective and objective domains are important when measuring QoL of adolescents with PD.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.

Coastal marine habitat mapping using multi-beam acoustics, video data and a decision tree classifier on the temperate south-east Australian continental shelf

In this habitat mapping study, multi-beam acoustic data are integrated with extensive, precisely geo-referenced video validation data in a GIS environment to classify benthic substrates and biota at a 33km2 site in the near shore waters of Victoria, Australia. Using an automated decision-tree classification method, 5 representative biotic groups were identified in the Cape Nelson survey area using a combination of multi-beam bathymetry, backscatter and derivative products. Rigorous error assessment of derived, classified maps produced high overall accuracies (>85%) for all mapping products. In addition, a discrete multivariate analysis technique (kappa analysis) was used to assess classification accuracy. High-resolution (2.5m cell-size) representation of sea floor morphology and textural characteristics provided by multi-beam bathymetry and backscatter datasets, allowed the interpretation of benthic substrates of the Cape Nelson site and the communities of sessile organisms that populate them. Non-parametric multivariate statistical analysis (ANOSIM) revealed a significant difference in biotic composition between depth strata, and between substrate types. Incorporated with other descriptive measures, these results indicate that depth and substrate are important factors in the distributional ecology of the biotic communities at the Cape Nelson study site. BIOENV analysis indicates that derivatives of both multi-beam datasets (bathymetry and backscatter) are correlated with distribution and density of biotic communities. Results from this study provide new tools for research and management of the coastal zone.

Effects of comorbid ADHD with learning disabilities on anxiety, depression, and aggression in adults

Objective: ADHD and learning disabilities (LD) frequently coexist and there are indications that comorbidity may increase the risk of psychopathology.

Method: The current study examined the gender distribution and frequency of comorbidity and its impact on the prevalence of symptoms of anxiety,  depression, and aggression in a clinic sample of 80 adults with ADHD, aged 18 to 58 years. More individuals were diagnosed with ADHD+LD than ADHD only, with no difference in this distribution according to gender.

Results: A factorial multivariate analysis of variance indicated that females with ADHD+LD displayed more cognitive depression than females with ADHD only and than males with ADHD+LD and ADHD only. However,individuals with ADHD only and individuals with ADHD+LD did not differ on overall anxiety, depression or aggression. Likewise, males and females did not differ on measures of psychopathology.

Conclusion: This study lays the foundation for continued research into the characteristics and comorbidities of adults with ADHD.

An empirical model of international student satisfaction

Purpose – Based on the theoretical framework of expectancy-disconfirmation paradigm, the purpose of this paper is to examine the differences in student perceptions of the level of satisfaction related to educational and non-educational services among four groups of international postgraduate business students from China, India, Indonesia and Thailand undertaking study in Australia.

Design/methodology/approach – The data used in this study were derived from a mail survey conducted among international postgraduate business students from Asia studying at five universities in the state of Victoria, Australia. A total of 573 usable responses were received. Analysis using structural equation modelling, multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA) was undertaken.

Findings – This study develops and tests a model of international postgraduate student satisfaction. Findings indicate that the importance of service quality factors related to both educational and non-educational services varies among nationality groups and, therefore, has a differential impact on student satisfaction.

Practical implications – The study provides insights into seven constructs related to educational and non-educational services that are perceived as important by postgraduate business students from Asia in satisfaction formation. Universities should develop a diversified strategic marketing plan that incorporates the differential needs of international postgraduate business students according to the educational and non-educational constructs developed in this paper.

Originality/value – This study makes a contribution by filling a void in academic research in the area of satisfaction in relation to postgraduate international business students from four nationality groups in Asia.

Internationalization and alliance formation : evidence from Turkish SMEs

This study explores the issue of internationalization through forming alliances with foreign capital in the small business sector in Turkey. Using a sample of 257 SMEs from this emerging market economy, collected via a field study, it finds that Turkish SMEs would like to form alliances with foreign capital for expanding their production capacity and accessing to world markets. Multivariate multinomial logit models are employed to analyse the survey data econometrically. Size-specific, sector-specific and management-specific factors are identified in the alliance motivation. The `market' and `finance' aspects of alliances prevail in the multivariate analysis with significant implications. There is also evidence that some conditional relationships offered by multivariate analysis differ from unconditional associations found in the survey, which implies that alliance motivation is partly a product of multidimensional decision-making process on behalf of SMEs.

Are aspects of study design associated with the reported prevalence of female sexual difficulties?

Objective: To investigate associations between the prevalence of sexual  difficulties reported in published studies and design features of those studies to determine if differences in design contribute to variation in prevalence estimates.
Design: Systematic review, multivariate analysis.
Setting: Studies published internationally in English.
Patient(s): Not applicable.
Intervention(s): None.
Main Outcome Measure(s): Prevalence estimates of difficulty with desire, arousal, orgasm, and sexual pain reported in published studies.
Result(s): Our systematic literature search identified 1,380 publications. Fifty-five studies met our inclusion criteria (reporting prevalence, sample size and response rate, sample size greater than 100, not clinic based). Reported prevalence of sexual difficulty varied across studies (up to tenfold). Eleven aspects of research conduct in these studies were included in our multivariate analysis as explanatory variables. Five aspects of study design and conduct (data collection procedures, inclusion criteria, duration of sexual difficulty recorded, sample size, and response rate) were associated with the reported prevalence of at least one type of sexual difficulty independently of likely predictors of true variation in prevalence: study location, study year, and age range of participants.
Conclusion(s): This review provides evidence that study design may influence reported prevalence estimates of female sexual difficulties and contribute to the wide variation in published estimates.