Assessment of nutritional status of patients on hemodilaysis: a single center study from Jeddah, Saudi Arabia.

Malnutrition (MN) is prevalent worldwide in hemodialysis patients (HDP); however it has not been assessed in HDP living in Jeddah, Saudi Arabia. The purpose of this study was to estimate the prevalence of MN in HDP at the Jeddah Kidney Center as well as to determine if the 7-point subjective global assessment (SGA) correlates with anthropometric [Body Mass Index (BMI), Tricep Skinfold Thickness (TSF), Mid-Arm Muscle Circumference (MAMC)], or biochemical (albumin) measurements. In a cross sectional, descriptive study, 270 HDP were assessed for MN. Over half of the HDP were malnourished, with 47.8% moderately and 6.3% severely malnourished. Fifty-eight percent of HDP did not adhere to their diet prescription. As albumin, BMI, TSF, and MAMC decreased, malnutrition became more severe (p < .01). Patients who were female (OR=.43, p=.001), older (OR=.45, p=.001), with no education (OR=3.10, p=.001), underweight (OR=3.56, p<.001), small TSF (OR=1.12, p=.001), and small MAMC (OR=1.15, p=.001) were more likely to be malnourished. The prevalence of MN is high in these HDP. A consistent nutritional assessment protocol is warranted and should be implemented to decrease MN in Saudi HDP.

Rigid and non-rigid point-based medical image registration

The primary goal of this dissertation is to develop point-based rigid and non-rigid image registration methods that have better accuracy than existing methods. We first present point-based PoIRe, which provides the framework for point-based global rigid registrations. It allows a choice of different search strategies including (a) branch-and-bound, (b) probabilistic hill-climbing, and (c) a novel hybrid method that takes advantage of the best characteristics of the other two methods. We use a robust similarity measure that is insensitive to noise, which is often introduced during feature extraction. We show the robustness of PoIRe using it to register images obtained with an electronic portal imaging device (EPID), which have large amounts of scatter and low contrast. To evaluate PoIRe we used (a) simulated images and (b) images with fiducial markers; PoIRe was extensively tested with 2D EPID images and images generated by 3D Computer Tomography (CT) and Magnetic Resonance (MR) images. PoIRe was also evaluated using benchmark data sets from the blind retrospective evaluation project (RIRE). We show that PoIRe is better than existing methods such as Iterative Closest Point (ICP) and methods based on mutual information. We also present a novel point-based local non-rigid shape registration algorithm. We extend the robust similarity measure used in PoIRe to non-rigid registrations adapting it to a free form deformation (FFD) model and making it robust to local minima, which is a drawback common to existing non-rigid point-based methods. For non-rigid registrations we show that it performs better than existing methods and that is less sensitive to starting conditions. We test our non-rigid registration method using available benchmark data sets for shape registration. Finally, we also explore the extraction of features invariant to changes in perspective and illumination, and explore how they can help improve the accuracy of multi-modal registration. For multimodal registration of EPID-DRR images we present a method based on a local descriptor defined by a vector of complex responses to a circular Gabor filter.

Rigid and Non-rigid Point-based Medical Image Registration

The primary goal of this dissertation is to develop point-based rigid and non-rigid image registration methods that have better accuracy than existing methods. We first present point-based PoIRe, which provides the framework for point-based global rigid registrations. It allows a choice of different search strategies including (a) branch-and-bound, (b) probabilistic hill-climbing, and (c) a novel hybrid method that takes advantage of the best characteristics of the other two methods. We use a robust similarity measure that is insensitive to noise, which is often introduced during feature extraction. We show the robustness of PoIRe using it to register images obtained with an electronic portal imaging device (EPID), which have large amounts of scatter and low contrast. To evaluate PoIRe we used (a) simulated images and (b) images with fiducial markers; PoIRe was extensively tested with 2D EPID images and images generated by 3D Computer Tomography (CT) and Magnetic Resonance (MR) images. PoIRe was also evaluated using benchmark data sets from the blind retrospective evaluation project (RIRE). We show that PoIRe is better than existing methods such as Iterative Closest Point (ICP) and methods based on mutual information. We also present a novel point-based local non-rigid shape registration algorithm. We extend the robust similarity measure used in PoIRe to non-rigid registrations adapting it to a free form deformation (FFD) model and making it robust to local minima, which is a drawback common to existing non-rigid point-based methods. For non-rigid registrations we show that it performs better than existing methods and that is less sensitive to starting conditions. We test our non-rigid registration method using available benchmark data sets for shape registration. Finally, we also explore the extraction of features invariant to changes in perspective and illumination, and explore how they can help improve the accuracy of multi-modal registration. For multimodal registration of EPID-DRR images we present a method based on a local descriptor defined by a vector of complex responses to a circular Gabor filter.

Gender differences in principal motivations

Women have traditionally not attained the position of secondary school principal as frequently as their male counterparts. Research in the field of motivation theory suggests the significance and impact of gender on career paths. Theorists and researchers believe that women face an orientation to life that is different than men. Some see the principalship as satisfying different values and working toward some psychological needs. ^ In this study, two hypotheses were used to explore whether substantive differences existed between men and women with regard to factors that motivate secondary school administrators to become principals in Miami-Dade County Public Schools. The administrators were surveyed during meetings held with them at Region meetings. Participants were asked to rate the motivation factors on a 7-point Likert Scale (1-strongly disagree to 7-strongly agree) and to rank the motivation factors (1-most important to 10-least important) that might discourage one from becoming a principal as well as those that might encourage one to retire from the principalship; and to identify motivation factors that most influenced their decision to become a school administrator. Two hundred twenty-six surveys were returned.^ Quantitative data were collected to measure differences between men and women with respect to their motivation to seek the principalship in terms of their ratings on the Motivation Factors Survey. Based upon a Factor Analysis, four factors (intrinsic satisfiers, extrinsic satisfiers, principalship challenges and job values) were identified. A MANOVA using the factors as dependent variables revealed that, as predicted by research and theory, women were significantly more likely than men to be motivated by intrinsic satisfiers and job values. In support of this finding, open-ended responses to the survey revealed that men found extrinsic satisfiers to be of greater importance than intrinsic satisfiers. ^

Examination of the impact of personality, social, and cognitive factors on the co-occurrence of health risk behaviors among multi-problem youth: The utility of an integrative framework

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use.^ The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used.^ Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. ^ This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.^

An evaluation of functional impairment among children with anxiety disorders

Despite a considerable progress in developing and testing psychosocial treatments to reduce youth anxiety disorders, much remains to learn about the relation between anxiety symptom reduction and change in youth functional impairment. The specific aims of this dissertation thus were to examine: (1) the relation between different levels of anxiety and youth functional impairment ratings; (2) incremental validity of the Children Global Assessment Scale (CGAS); (3) the mediating role of anxiety symptom reduction on youth functional impairment ratings; (4) the directionality of change between anxiety symptom reduction and youth functional impairment; (5) the moderating effects of youth age, sex, and ethnicity on the mediated relation between youth anxiety symptom reduction and change in functional impairment; and (6) an agreement (or lack thereof) between youths and their parents in their views of change in youth functional impairment vis-à-vis anxiety symptom reduction. ^ The results were analyzed using archival data set acquired from 183 youths and their mothers. Research questions were tested using SPSS and structural equation modeling techniques in Mplus. ^ The results supported the efficacy of psychosocial treatments to reduce the severity of youth anxiety symptoms and its associated functional impairment. Moreover, the results revealed that at posttreatment, youths who scored either low or medium on anxiety levels scored significantly lower on impairment, than youths who scored high on anxiety levels. Incremental validity of the CGAS was also revealed across all assessment points and informants in my sample. In addition, the results indicated the mediating role of anxiety symptom reduction with respect to change in youth functional impairment at posttest, regardless of the youth’s age, sex, and ethnicity. No significant findings were observed with regard to the bidirectionality and an informant disagreement vis-à-vis the relation between anxiety symptom reduction and change in functional impairment. ^ The study’s main contributions and potential implications on theoretical, empirical, and clinical levels are further discussed. The emphasis is on the need to enhance existing evidence-based treatments and develop innovative treatment models that will not only reduce youth’s symptoms (such anxiety) but also evoke genuine and palpable improvements in lives of youths and their families.^

Examination of Personality, Social and Cognitive Factors on the Co-Occurrence of Health Risk Behaviors among Multi-Problem Youth: The Utility of An Integrative Framework

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.

Content Analysis of Outcome Assessment of Global Learning Foundations Courses: A Case Study

This study used content analysis to interpret and evaluate outcome evaluation matrices of undergraduate Global Learning foundations courses. The findings revealed a lack of uniformity in the faculty members’ interpretation and implementation of global learning components in the coursework. Successful teaching practices and challenges were identified and classified.

Integrated Performance Assessment of Engineering Projects at the Interface of Emergent Properties and Uncertainty

Investigation of the performance of engineering project organizations is critical for understanding and eliminating inefficiencies in today’s dynamic global markets. The existing theoretical frameworks consider project organizations as monolithic systems and attribute the performance of project organizations to the characteristics of the constituents. However, project organizations consist of complex interdependent networks of agents, information, and resources whose interactions give rise to emergent properties that affect the overall performance of project organizations. Yet, our understanding of the emergent properties in project organizations and their impact on project performance is rather limited. This limitation is one of the major barriers towards creation of integrated theories of performance assessment in project organizations. The objective of this paper is to investigate the emergent properties that affect the ability of project organization to cope with uncertainty. Based on the theories of complex systems, we propose and test a novel framework in which the likelihood of performance variations in project organizations could be investigated based on the environment of uncertainty (i.e., static complexity, dynamic complexity, and external source of disruption) as well as the emergent properties (i.e., absorptive capacity, adaptive capacity, and restorative capacity) of project organizations. The existence and significance of different dimensions of the environment of uncertainty and emergent properties in the proposed framework are tested based on the analysis of the information collected from interviews with senior project managers in the construction industry. The outcomes of this study provide a novel theoretical lens for proactive bottom-up investigation of performance in project organizations at the interface of emergent properties and uncertainty

Use of Homeostatic Model Assessment Indexes for the Identification of Metabolic Syndrome and Insulin Resistance among Cuban-Americans: A Cross Sectional Study

Aim: to determine cut off points for The Homeostatic Model Assessment Index 1 and 2 (HOMA-1 and HOMA-2) for identifying insulin resistance and metabolic syndrome among a Cuban-American population. Study Design: Cross sectional. Place and Duration of Study: Florida International University, Robert Stempel School of Public Health and Social Work, Department of Dietetics and Nutrition, Miami, FL from July 2010 to December 2011. Methodology: Subjects without diabetes residing in South Florida were enrolled (N=146, aged 37 to 83 years). The HOMA1-IR and HOMA2-IR 90th percentile in the healthy group (n=75) was used as the cut-off point for insulin resistance. A ROC curve was constructed to determine the cut-off point for metabolic syndrome. Results: HOMA1-IR was associated with BMI, central obesity, and triglycerides (P3.95 and >2.20 and for metabolic syndrome were >2.98 (63.4% sensitivity and 73.3% specificity) and >1.55 (60.6% sensitivity and 66.7% specificity), respectively. Conclusion: HOMA cut-off points may be used as a screening tool to identify insulin resistance and metabolic syndrome among Cuban-Americans living in South Florida.

Initial placement methods for Haitian adult ESOL students : the NYS place test plus profile data compared to subjective assessment

Few valid and reliable placement procedures are available to assess the English language proficiency of adults who enroll in English for Speakers of Other Languages (ESOL) programs. Whereas placement material exists for children and university ESOL students, the needs of students in adult community education programs have not been adequately addressed. Furthermore, the research suggests that a number of variables, such as, native language, age, prior schooling, length of residence, and employment are related to second language acquisition. Numerous studies contribute to our understanding of the relationship of these factors to second language acquisition of Spanish-speaking students. Again, there is a void in the research investigating the factors affecting second language acquisition and consequently, appropriate placement of Haitian Creole-speaking students. This study compared a standardized instrument, the NYS Place Test, used alone and in combination with a writing sample in English, to subjective judgement of a department coordinator for initial placement of Haitian adult ESOL students in a community education program. The study also investigated whether or not consideration of student profile data improved the accuracy of the test. Finally, the study sought to determine if a relationship existed between student profile data and those who withdrew from the program or did not enter a class after registering. Analysis of the data by crosstabulation and chi-square revealed that the standardized NYS Place Test was at least as accurate as subjective department coordinator placement and that one procedure could be substituted for li other. Although the writing sample in English improved accuracy of placement by the NYS test, the results were not significant. Of the profile variables, only length of residence was found to be significantly related to accuracy of placement using the NYS Place Test. The number of incorrect placements was higher for those students who lived in the host country from twenty-five to one hundred ten months. A post hoc analysis of NYS test scores according to level showed that those learners who placed in level three also had a significantly higher incidence of incorrect placements. No significant relationship was observed between the profile variables and those who withdrew from the program or registered but did not enter a class.