Influence of gender and life stressors on longitudinal depression treatment outcomes among older primary care patients

Purpose: Depression in older females is a significant and growing problem. Females who experience life stressors across the life span are at higher risk for developing problems with depression than their male counterparts. The primary aim of this study was (a) to examine gender-specific differences in the correlates of depression in older primary care patients based on baseline and longitudinal analyses; and (b) to examine the longitudinal effect of biopsychosocial risk factors on depression treatment outcomes in different models of behavioral healthcare (i.e., integrated care and enhanced referral). Method: This study used a quantitative secondary data analysis with longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study. A linear mixed model approach to hierarchical linear modeling was used for analysis using baseline assessment, and follow-up from three-month and six-month. Results: For participants diagnosed with major depressive disorder female gender was associated with increased depression severity at six-month compared to males at six-month. Further, the interaction between gender and life stressors found that females who reported loss of family and friends, family issues, money issues, medical illness was related to higher depression severity compared to males whereas lack of activities was related to lower depression severity among females compared to males. Conclusion: These findings suggest that gender moderated the relationship between specific life stressors and depression severity similar to how a protective factor can impact a person's response to a problem and reduce the negative impact of a risk factor on a problem outcome. Therefore, life stressors may be a reliable predictor of depression for both females and males in either behavioral health treatment model. This study concluded that life stressors influence males basic comfort, stability, and survival whereas life stressors influence females' development, personal growth, and happiness; therefore, life stressors may be a useful component to include in gender-based screening and assessment tools for depression. ^

Development of operational performance models for truck-lane restrictions on freeway corridors

Highways are generally designed to serve a mixed traffic flow that consists of passenger cars, trucks, buses, recreational vehicles, etc. The fact that the impacts of these different vehicle types are not uniform creates problems in highway operations and safety. A common approach to reducing the impacts of truck traffic on freeways has been to restrict trucks to certain lane(s) to minimize the interaction between trucks and other vehicles and to compensate for their differences in operational characteristics. ^ The performance of different truck lane restriction alternatives differs under different traffic and geometric conditions. Thus, a good estimate of the operational performance of different truck lane restriction alternatives under prevailing conditions is needed to help make informed decisions on truck lane restriction alternatives. This study develops operational performance models that can be applied to help identify the most operationally efficient truck lane restriction alternative on a freeway under prevailing conditions. The operational performance measures examined in this study include average speed, throughput, speed difference, and lane changes. Prevailing conditions include number of lanes, interchange density, free-flow speeds, volumes, truck percentages, and ramp volumes. ^ Recognizing the difficulty of collecting sufficient data for an empirical modeling procedure that involves a high number of variables, the simulation approach was used to estimate the performance values for various truck lane restriction alternatives under various scenarios. Both the CORSIM and VISSIM simulation models were examined for their ability to model truck lane restrictions. Due to a major problem found in the CORSIM model for truck lane modeling, the VISSIM model was adopted as the simulator for this study. ^ The VISSIM model was calibrated mainly to replicate the capacity given in the 2000 Highway Capacity Manual (HCM) for various free-flow speeds under the ideal basic freeway section conditions. Non-linear regression models for average speed, throughput, average number of lane changes, and speed difference between the lane groups were developed. Based on the performance models developed, a simple decision procedure was recommended to select the desired truck lane restriction alternative for prevailing conditions. ^

Effect of blood flow patterns on localized platelet adhesion under physiologic flow conditions using two-dimensional and three-dimensional stent models: An experimental and computational approach

This dissertation presents dynamic flow experiments with fluorescently labeled platelets to allow for spatial observation of wall attachment in inter-strut spacings, to investigate their relationship to flow patterns. Human blood with fluorescently labeled platelets was circulated through an in vitro system that produced physiologic pulsatile flow in (1) a parallel plate blow chamber that contained two-dimensional (2D) stents that feature completely recirculating flow, partially recirculating flow, and completely reattached flow, and (2) a three-dimensional (3D) cylindrical tube that contained stents of various geometric designs. ^ Flow detachment and reattachment points exhibited very low platelet deposition. Platelet deposition was very low in the recirculation regions in the 3D stents unlike the 2D stents. Deposition distal to a strut was always high in 2D and 3D stents. Spirally recirculating regions were found in 3D unlike in 2D stents, where the deposition was higher than at well-separated regions of recirculation. ^

An investigation of location effect on trip production using artificial neural networks

As traffic congestion exuberates and new roadway construction is severely constrained because of limited availability of land, high cost of land acquisition, and communities' opposition to the building of major roads, new solutions have to be sought to either make roadway use more efficient or reduce travel demand. There is a general agreement that travel demand is affected by land use patterns. However, traditional aggregate four-step models, which are the prevailing modeling approach presently, assume that traffic condition will not affect people's decision on whether to make a trip or not when trip generation is estimated. Existing survey data indicate, however, that differences exist in trip rates for different geographic areas. The reasons for such differences have not been carefully studied, and the success of quantifying the influence of land use on travel demand beyond employment, households, and their characteristics has been limited to be useful to the traditional four-step models. There may be a number of reasons, such as that the representation of influence of land use on travel demand is aggregated and is not explicit and that land use variables such as density and mix and accessibility as measured by travel time and congestion have not been adequately considered. This research employs the artificial neural network technique to investigate the potential effects of land use and accessibility on trip productions. Sixty two variables that may potentially influence trip production are studied. These variables include demographic, socioeconomic, land use and accessibility variables. Different architectures of ANN models are tested. Sensitivity analysis of the models shows that land use does have an effect on trip production, so does traffic condition. The ANN models are compared with linear regression models and cross-classification models using the same data. The results show that ANN models are better than the linear regression models and cross-classification models in terms of RMSE. Future work may focus on finding a representation of traffic condition with existing network data and population data which might be available when the variables are needed to in prediction.

A precise measurement of the two -photon exchange effect

The two-photon exchange phenomenon is believed to be responsible for the discrepancy observed between the ratio of proton electric and magnetic form factors, measured by the Rosenbluth and polarization transfer methods. This disagreement is about a factor of three at Q 2 of 5.6 GeV2. The precise knowledge of the proton form factors is of critical importance in understanding the structure of this nucleon. The theoretical models that estimate the size of the two-photon exchange (TPE) radiative correction are poorly constrained. This factor was found to be directly measurable by taking the ratio of the electron-proton and positron-proton elastic scattering cross sections, as the TPE effect changes sign with respect to the charge of the incident particle. A test run of a modified beamline has been conducted with the CEBAF Large Acceptance Spectrometer (CLAS) at Thomas Jefferson National Accelerator Facility. This test run demonstrated the feasibility of producing a mixed electron/positron beam of good quality. Extensive simulations performed prior to the run were used to reduce the background rate that limits the production luminosity. A 3.3 GeV primary electron beam was used that resulted in an average secondary lepton beam of 1 GeV. As a result, the elastic scattering data of both lepton types were obtained at scattering angles up to 40 degrees for Q2 up to 1.5 GeV2. The cross section ratio displayed an &epsis; dependence that was Q2 dependent at smaller Q2 limits. The magnitude of the average ratio as a function of &epsis; was consistent with the previous measurements, and the elastic (Blunden) model to within the experimental uncertainties. Ultimately, higher luminosity is needed to extend the data range to lower &epsis; where the TPE effect is predicted to be largest.