Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review

OBJECTIVE How long clinicians should wait before considering an antipsychotic ineffective and changing treatment in schizophrenia is an unresolved clinical question. Guidelines differ substantially in this regard. The authors conducted a diagnostic test meta-analysis using mostly individual patient data to assess whether lack of improvement at week 2 predicts later nonresponse. METHOD The search included EMBASE, MEDLINE, BIOSIS, PsycINFO, Cochrane Library, CINAHL, and reference lists of relevant articles, supplemented by requests to authors of all relevant studies. The main outcome was prediction of nonresponse, defined as <50% reduction in total score on either the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) (corresponding to at least much improved) from baseline to endpoint (4-12 weeks), by <20% PANSS or BPRS improvement (corresponding to less than minimally improved) at week 2. Secondary outcomes were absent cross-sectional symptomatic remission and <20% PANSS or BPRS reduction at endpoint. Potential moderator variables were examined by meta-regression. RESULTS In 34 studies (N=9,460) a <20% PANSS or BPRS reduction at week 2 predicted nonresponse at endpoint with a specificity of 86% and a positive predictive value (PPV) of 90%. Using data for observed cases (specificity=86%, PPV=85%) or lack of remission (specificity=77%, PPV=88%) yielded similar results. Conversely, using the definition of <20% reduction at endpoint yielded worse results (specificity=70%, PPV=55%). The test specificity was significantly moderated by a trial duration of <6 weeks, higher baseline illness severity, and shorter illness duration. CONCLUSIONS Patients not even minimally improved by week 2 of antipsychotic treatment are unlikely to respond later and may benefit from a treatment change.

BLOOD PRESSURE CHANGES IN RELATION TO DEMOGRAPHIC, ANTHROPOMETRIC, AND SEXUAL MATURATION VARIABLES IN U.S. HEALTH EXAMINATION SURVEY OF CHILDREN AND YOUTHS (UNITED STATES)

The determinants of change in blood pressure during childhood and adolescence were studied in a cohort of U.S. national probability sample of 2146 children examined on two occasions during the Health Examination Survey. Significant negative correlations between the initial level and the subsequent changes in blood pressure were observed. The multiple regression analyses showed that the major determinants of systolic blood pressure (SBP) change were change in weight, baseline SBP, and baseline upper arm girth. Race, time interval between examinations, baseline age, and height change were also significant determinants in SBP change. For the change in diastolic blood pressure (DBP), baseline DBP, baseline weight, and weight change were the major determinants. Baseline SBP, time interval and race were also significant determinants. Sexual maturation variables were also considered in the subgroup analysis for girls. Weight change was the most important predictor of the change in SBP for the group of girls who were still in the pre-menarchal or pre-breast maturation status at the time of the follow-up examination, and who had started to menstruate or to develop breast maturation at sometime between the two examinations. Baseline triceps skinfold thickness or initial SBP were more important variables than weight change for the group of girls who had already experienced menarche or breast maturation at the time of the initial survey. For the total group, pubic hair maturation was found to be a significant predictor of SBP change at the 5% significance level. The importance of weight change and baseline weight for the changes in blood pressure warrants further study. ^

Baseline quality of life as a predictor of exercise intervention adherence among endometrial cancer survivors

Background: The objective of this analysis is to test whether baseline quality of life (QOL) measurements, body mass index (BMI) and prior exercise behavior are significantly associated with (1) telephone counseling adherence, and (2) activity at the final assessment, in a physical activity promoting intervention among endometrial cancer survivors.^ Methods: One hundred endometrial cancer survivors not currently meeting physical activity guidelines completed baseline QOL and anthropometric assessments to measure general physical and mental health [Medical Outcomes Survey (SF-36)], sleep patterns and sleep quality [Pittsburgh Sleep Quality Index (PSQI)], perceived stress [Perceived Stress Scale (PSS)], cancer-specific concerns of long-term survivors [Quality of Life in Adult Cancer Survivors (QLACS)], and psychological distress [Brief Symptom Inventory-18 (BSI-18)]. Survivors were counseled by telephone during the 6-month intervention and their completion rate determined their adherence. The primary variables of interest included age, baseline BMI, baseline activity level, time since diagnosis, education, treatment received, and the SF-36 physical and mental component scores.^ Results: Final activity was most closely linked with baseline activity (p<.001) and less invasive surgery, being leaner and older, and experiencing less pain and more vitality. Telephone counseling was also predicted well by baseline activity, working less and having better overall cancer-related functioning.^ Conclusion: Above and beyond the QOL measures, baseline activity was the strongest predictor of both final activity and telephone counseling adherence. While education, surgery treatment type and bodily pain were important predictors for final exercise and employment status and cancer-related quality of life were important predictors for telephone counseling adherence, considering adaptive exercise interventions that focus heavily on engaging inactive participants may be a way to produce better exercise-related outcomes in the endometrial cancer survivor population.^

Estimación de variables dasométricas a partir de datos LiDAR y obtención de modelos de referencia para las distribuciones de alturas y diámetros del arbolado

La Gestión Forestal Sostenible se define como “la administración y uso de los bosques y tierras forestales de forma e intensidad tales que mantengan su biodiversidad, productividad, capacidad de regeneración, vitalidad y su potencial para atender, ahora y en el futuro, las funciones ecológicas, económicas y sociales relevantes a escala local, nacional y global, y que no causan daño a otros ecosistemas” (MCPFE Conference, 1993). Dentro del proceso los procesos de planificación, en cualquier escala, es necesario establecer cuál será la situación a la que se quiere llegar mediante la gestión. Igualmente, será necesario conocer la situación actual, pues marcará la situación de partida y condicionará el tipo de actuaciones a realizar para alcanzar los objetivos fijados. Dado que, los Proyectos de Ordenación de Montes y sus respectivas revisiones son herramientas de planificación, durante la redacción de los mismos, será necesario establecer una serie de objetivos cuya consecución pueda verificarse de forma objetiva y disponer de una caracterización de la masa forestal que permita conocer la situación de partida. Esta tesis se centra en problemas prácticos, propios de una escala de planificación local o de Proyecto de Ordenación de Montes. El primer objetivo de la tesis es determinar distribuciones diamétricas y de alturas de referencia para masas regulares por bosquetes, empleando para ello el modelo conceptual propuesto por García-Abril et al., (1999) y datos procedentes de las Tablas de producción de Rojo y Montero (1996). Las distribuciones de referencia obtenidas permitirán guiar la gestión de masas irregulares y regulares por bosquetes. Ambos tipos de masas aparecen como una alternativa deseable en aquellos casos en los que se quiere potenciar la biodiversidad, la estabilidad, la multifuncionalidad del bosque y/o como alternativa productiva, especialmente indicada para la producción de madera de calidad. El segundo objetivo de la Tesis está relacionado con la necesidad de disponer de una caracterización adecuada de la masa forestal durante la redacción de los Proyectos de Ordenación de Montes y de sus respectivas revisiones. Con el fin de obtener estimaciones de variables forestales en distintas unidades territoriales de potencial interés para la Ordenación de Montes, así como medidas de la incertidumbre en asociada dichas estimaciones, se extienden ciertos resultados de la literatura de Estimación en Áreas Pequeñas. Mediante un caso de estudio, se demuestra el potencial de aplicación de estas técnicas en inventario forestales asistidos con información auxiliar procedente de sensores láser aerotransportados (ALS). Los casos de estudio se realizan empleando datos ALS similares a los recopilados en el marco del Plan Nacional de Ortofotografía Aérea (PNOA). Los resultados obtenidos muestran que es posible aumentar la eficiencia de los inventarios forestales tradicionales a escala de proyecto de Ordenación de Montes, mediante la aplicación de estimadores EBLUP (Empirical Best Linear Unbiased Predictor) con modelos a nivel de elemento poblacional e información auxiliar ALS similar a la recopilada por el PNOA. ABSTRACT According to MCPFE (1993) Sustainable Forest Management is “the stewardship and use of forests and forest lands in a way, and at a rate, that maintains their biodiversity, productivity, regeneration capacity, vitality and their potential to fulfill, now and in the future, relevant ecological, economic and social functions, at local, national, and global levels, and that does not cause damage to other ecosystems”. For forest management planning, at any scale, we must determine what situation is hoped to be achieved through management. It is also necessary to know the current situation, as this will mark the starting point and condition the type of actions to be performed in order to meet the desired objectives. Forest management at a local scale is no exception. This Thesis focuses on typical problems of forest management planning at a local scale. The first objective of this Thesis is to determine management objectives for group shelterwood management systems in terms of tree height and tree diameter reference distributions. For this purpose, the conceptual model proposed by García-Abril et al., (1999) is applied to the yield tables for Pinus sylvestris in Sierra de Guadrrama (Rojo y Montero, 1996). The resulting reference distributions will act as a guide in the management of forests treated under the group shelterwood management systems or as an approximated reference for the management of uneven aged forests. Both types of management systems are desirable in those cases where forest biodiversity, stability and multifunctionality are pursued goals. These management systems are also recommended as alternatives for the production of high quality wood. The second objective focuses on the need to adequately characterize the forest during the decision process that leads to local management. In order to obtain estimates of forest variables for different management units of potential interest for forest planning, as well as the associated measures of uncertainty in these estimates, certain results from Small Area Estimation Literature are extended to accommodate for the need of estimates and reliability measures in very small subpopulations containing a reduced number of pixels. A case study shows the potential of Small Area Estimation (SAE) techniques in forest inventories assisted with remotely sensed auxiliary information. The influence of the laser pulse density in the quality of estimates in different aggregation levels is analyzed. This study considers low laser pulse densities (0.5 returns/m2) similar to, those provided by large-scale Airborne Laser Scanner (ALS) surveys, such as the one conducted by the Spanish National Geographic Institute for about 80% of the Spanish territory. The results obtained show that it is possible to improve the efficiency of traditional forest inventories at local scale using EBLUP (Empirical Best Linear Unbiased Predictor) estimators based on unit level models and low density ALS auxiliary information.

Perfeccionismo socialmente prescrito como predictor del alto rechazo a la escuela

El creciente interés en el estudio del comportamiento de rechazo a la escuela se debe a las consecuencias negativas asociadas a esta problemática. Conocer aquellas variables psicoeducativas que predicen esta conducta resulta de interés para la comunidad científica en la actualidad. El objetivo de esta investigación fue analizar la capacidad predictiva el Perfeccionismo Socialmente Prescrito sobre las altas puntuaciones en rechazo escolar. En este estudio participaron 537 estudiantes españoles entre 8 y 12 años. Los instrumentos utilizados fueron la School Refusal Assessment Scale Revised for Children (SRAS-R-C), para medir los cuatro factores que subyacen al comportamiento de rechazo a la escuela (I. Evitar la Afectividad Negativa; II. Escapar de la Aversión Social o Evaluación; III. Búsqueda de la Atención de otras Personas Significativas; IV. Búsqueda de Refuerzos Tangibles Fuera del Ámbito Escolar), y la Child and Adolescent Perfectionism Scale (CAPS), para evaluar la subescala de Perfeccionismo Socialmente Prescrito. A partir de los resultados obtenidos se confirma que la subescala de perfeccionismo evaluada actúa como un predictor positivo de altas puntuaciones en rechazo escolar para los factores II y III de la SRAS-R-C. Estos resultados deben ser valorados por psicólogos escolares y especialistas al evaluar la problemática del rechazo escolar siendo necesario proponer estrategias de prevención e intervención.

Assessing Temperament as a Predictor of Distress at Anesthesia Induction Using the Children’s Behavior Questionnaire Short Form

Thesis (Master's)--University of Washington, 2016-06

Relationship between laboratory-measured variables and heart rate during an ultra-endurance triathlon

The aim of the present study was to examine the relationship between the performance heart rate during an ultra-endurance triathlon and the heart rate corresponding to several demarcation points measured during laboratory-based progressive cycle ergometry and treadmill running. Less than one month before an ultra-endurance triathlon, 21 well-trained ultra-endurance triathletes (mean +/- s: age 35 +/- 6 years, height 1.77 +/- 0.05 in, mass 74.0 +/- 6.9 kg, (V) over dot O-2peak = 4.75 +/- 0.42 1 center dot min(-1)) performed progressive exercise tests of cycle ergometry and treadmill running for the determination of peak oxygen uptake ((V) over do O-2peak), heart rate corresponding to the first and second ventilatory thresholds, as well as the heart rate deflection point. Portable telemetry units recorded heart rate at 60 s increments throughout the ultra-endurance triathlon. Heart rate during the cycle and run phases of the ultra-endurance triathlon (148 +/- 9 and 143 +/- 13 beats center dot min(-1) respectively) were significantly (P < 0.05) less than the second ventilatory thresholds (160 +/- 13 and 165 +/- 14 beats center dot min(-1) respectively) and heart rate deflection points (170 +/- 13 and 179 +/- 9 beats center dot min(-1) respectively). However, mean heart rate during the cycle and run phases of the ultra-endurance triathlon were significantly related to (r = 0.76 and 0.66; P < 0.01), and not significantly different from, the first ventilatory thresholds (146 +/- 12 and 148 +/- 15 beats center dot min(-1) respectively). Furthermore, the difference between heart rate during the cycle phase of the ultra-endurance triathlon and heart rate at the first ventilatory threshold was related to marathon run time (r = 0.61; P < 0.01) and overall ultra-endurance triathlon time (r = 0.45; P < 0.05). The results suggest that triathletes perform the cycle and run phases of the ultra-endurance triathlon at an exercise intensity near their first ventilatory threshold

Adolescents' intentions to smoke as a predictor of smoking

Background. Adolescents' intentions to smoke are generally regarded as a valid and reliable predictor of subsequent smoking. This association is largely based on research with adults and needs a more detailed analysis for adolescents. Methods. Data on intentions and smoking status were collected as part of a longitudinal, birth-cohort study when the study members were 9, 11, 13, 15, 18, and 21 years of age. Results. The results showed that intention to smoke only had an important predictive power in the subgroup of previous nonsmokers. Among those already smoking (on a monthly basis or greater), previous level of smoking was a more important predictor of future behavior than intention to smoke. In addition, the effect of positive intention to smoke was nonlinear over age and had the greatest effect at age 15. Conclusion. The results indicated that in adolescence, measurement of intentions to smoke or not smoke cannot be assumed to be a general predictor of behavior at a later age for all groups of adolescents. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.

Designs for generalized linear models with several variables and model uncertainty

Standard factorial designs sometimes may be inadequate for experiments that aim to estimate a generalized linear model, for example, for describing a binary response in terms of several variables. A method is proposed for finding exact designs for such experiments that uses a criterion allowing for uncertainty in the link function, the linear predictor, or the model parameters, together with a design search. Designs are assessed and compared by simulation of the distribution of efficiencies relative to locally optimal designs over a space of possible models. Exact designs are investigated for two applications, and their advantages over factorial and central composite designs are demonstrated.

An examination of attitude toward change as a predictor of policy/program implementation

Policy/program implementation, e.g., the process of fulfilling policy/program directives, is fundamentally tied to change. Implementation studies have examined the process, identifying many critical organizational variables although individuals perform the activities.^ Many of the studies are predicated on the rational, goal oriented model of organizations and examine implementation, presenting only the goal-oriented view. Organizational change and its resistance, however, are not fully explained by the rational model of organizations. There are other schools of thought providing different views of organizations from which explanation may emerge. Bolman and Deal (1984, 1991a, 1994) provide a different perspective for examining organizations Bolman and Deal argue organizations should be viewed through four different frames or lenses. Framing and reframing organizational action captures the complexity of action and provides better understanding of organizational processes. Understanding of implementation of policies/programs also will benefit from the use of the four-frame approach.^ The goal of this research is to provide a better understanding of the implementation process by examining individual attitudes toward change, the dependent variable of this research, and studying the relationship between the dependent variable and frame. The research was conducted in two phases. In Phase One, a survey was sent to 306 school administrators and teachers in magnet programs in Dade County, Florida. The survey instrument was composed of 55 questions including six from Bolman and Deal's Leadership Orientation Survey (1988) and 38 questions about organizational change. In Phase Two, more in-depth analysis of four school was conducted, to further explore the relationship between frame and attitude toward change.^ The results revealed that frame was a factor in explaining differences in personal Attitude Toward Change and Comfort Level with Change. Individuals using the symbolic frame had more positive attitudes toward change and were also more comfortable with change. The results of Phase Two of the research partially supported this finding in that the most fully implemented program was the product of an administrator who had chosen the symbolic frame. ^

The theory of margin as a predictor of success on the National Council Licensure Examination for Registered Nurses

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the examination that all graduates of nursing education programs must pass to attain the title of registered nurse. Currently the NCLEX-RN passing rate is at an all-time low (81%) for first-time test takers (NCSBN, 2004); amidst a nationwide shortage of registered nurses (Glabman, 2001). Because of the critical need to supply greater numbers of professional nurses, and the potential accreditation ramifications that low NCLEX-RN passing rates can have on schools of nursing and graduates, this research study tests the effectiveness of a predictor model. This model is based upon the theoretical framework of McClusky's (1959) theory of margin (ToM), with the hope that students found to be at-risk for NCLEX-RN failure can be identified and remediated prior to taking the actual licensure examination. To date no theory based predictor model has been identified that predicts success on the NCLEX-RN. ^ The model was tested using prerequisite course grades, nursing course grades and scores on standardized examinations for the 2003 associate degree nursing graduates at a urban community college (N = 235). Success was determined through the reporting of pass on the NCLEX-RN examination by the Florida Board of Nursing. Point biserial correlations tested model assumptions regarding variable relationships, while logistic regression was used to test the model's predictive power. ^ Correlations among variables were significant and the model accounted for 66% of variance in graduates' success on the NCLEX-RN with 98% prediction accuracy. Although certain prerequisite course grades and nursing course grades were found to be significant to NCLEX-RN success, the overall model was found to be most predictive at the conclusion of the academic program of study. The inclusion of the RN Assessment Examination, taken during the final semester of course work, was the most significant predictor of NCLEX-RN success. Success on the NCLEX-RN allows graduates to work as registered nurses, reflects positively on a school's academic performance record, and supports the appropriateness of the educational program's goals and objectives. The study's findings support potential other uses of McClusky's theory of margin as a predictor of program outcome in other venues of adult education. ^

Cognitive and noncognitive variables that predict Florida community college radiography program graduates' success on the Registry

This study examined the predictive merits of selected cognitive and noncognitive variables on the national Registry exam pass rate using 2008 graduates (n = 175) from community college radiography programs in Florida. The independent variables included two GPAs, final grades in five radiography courses, self-efficacy, and social support. The dependent variable was the first-attempt results on the national Registry exam. The design was a retrospective predictive study that relied on academic data collected from participants using the self-report method and on perceptions of students' success on the national Registry exam collected through a questionnaire developed and piloted in the study. All independent variables except self-efficacy and social support correlated with success on the national Registry exam ( p < .01) using the Pearson Product-Moment Correlation analysis. The strongest predictor of the national Registry exam success was the end-of-program GPA, r = .550, p < .001. The GPAs and scores for self-efficacy and social support were entered into a logistic regression analysis to produce a prediction model. The end-of-program GPA (p = .015) emerged as a significant variable. This model predicted 44% of the students who failed the national Registry exam and 97.3% of those who passed, explaining 45.8% of the variance. A second model included the final grades for the radiography courses, self efficacy, and social support. Three courses significantly predicted national Registry exam success; Radiographic Exposures, p < .001; Radiologic Physics, p = .014; and Radiation Safety & Protection, p = .044, explaining 56.8% of the variance. This model predicted 64% of the students who failed the national Registry exam and 96% of those who passed. The findings support the use of in-program data as accurate predictors of success on the national Registry exam.

Class placement and academic and behavioral variables as predictors of graduation for students with disabilities

Dropout rates impacting students with high-incidence disabilities in American schools remain staggering (Bost, 2006; Hehir, 2005). Of this group, students with Emotional Behavioral Disorders (EBD) are at greatest risk. Despite the mandated national propagation of inclusion, students with EBD remain the least included and the least successful when included (Bost). Accordingly, this study investigated the potential significance of inclusive settings and other school-related variables within the context of promoting the graduation potential of students with Specific Learning Disabilities (SLD) or EBD. This mixed-methods study investigated specified school-related variables as likely dropout predictors, as well as the existence of first-order interactions among some of the variables. In addition, it portrayed the perspectives of students with SLD or EBD on the school-related variables that promote graduation. Accordingly, the sample was limited to students with SLD or EBD who had graduated or were close to graduation. For the quantitative component the numerical data were analyzed using linear and logistic regressions. For the qualitative component guided student interviews were conducted. Both strands were subsequently analyzed using Ridenour and Newman’s (2008) model where the quantitative hypotheses are tested and are later built-upon by the related qualitative meta-themes. Results indicated that a successful academic history, or obtaining passing grades was the only significant predictor of graduation potential when statistically controlling all the other variables. While at a marginal significance, results also yielded that students with SLD or EBD in inclusive settings experienced better academic results and behavioral outcomes than those in self-contained settings. Specifically, students with SLD or EBD in inclusive settings were found to be more likely to obtain passing grades and less likely to be suspended from school. Generally, the meta-themes yielded during the student interviews corroborated these findings as well as provided extensive insights on how students with disabilities view school within the context of promoting graduation. Based on the results yielded, provided the necessary academic accommodations and adaptations are in place, along with an effective behavioral program, inclusive settings can be utilized as drop-out prevention tools in special education.

GRE as a predictor of graduate student success at a Hispanic serving institution of higher education

Accurately predicting the success of graduate students is an important aspect of determining which students should be admitted into graduate programs. The GRE is a pivotal factor to examine since it is one of the most widely used criteria for graduate school admission. Even though the GRE is advertised as an accurate tool for predicting first year graduate GPA, there is a lack of research on long term success factors such as time to degree and graduate rate (Luthy, 1996; Powers, 2004). Furthermore, since most studies have low minority sample sizes, the validity of the GRE may not be the same across all groups (ETS, 2008b; Kuncel, Hezlett, & Ones, 2001). Another gap in GRE studies is that few researchers analyze student characteristics, which may alter or moderate the prediction validity of the GRE. Thus, student characteristics such as degree of academic involvement, mentorship interactions, and other academic and social experiences have not been widely examined in this context. These gaps in the analysis of GRE validity are especially relevant given the high attrition rates within of some graduate programs (e.g., an estimated 68% of doctoral student never complete their programs in urban universities; Lovitts, 2001). A sequential mixed methods design was used to answer the research questions in two phases. The quantitative phase used student data files to analyze the relationship of two success variables (graduation rate and graduate GPA) to the GRE scores as well as other academic and demographic graduate student characteristics. The qualitative phase served to complement the first phase by describing a wider range of characteristics from the 11 graduate students who were interviewed. Both proximal and distal moderators influence student behaviors and success in graduate school. In the first phase of the study, the GRE was the distal facilitator under analysis. Findings suggested that both the GRE Quantitative and the GRE Verbal were predictors of success for master’s students, but the GRE Quantitative was not predictive of success for doctoral students. Other student characteristics such as demographic variables and disciplinary area were also predictors of success for the population of students studied. In the second phase of the study, it was inconclusive whether the GRE was predictive of graduate student success; though it did influence access to graduate programs. Furthermore, proximal moderators such as student involvement, faculty/peer interactions, motivational factors, and program structure were perceived to be facilitators and/or detractors for success.

Class Placement and Academic and Behavioral Variables as Predictors of Graduation for Students with Disabilities

This study investigated the impact of specified variables related to academic history, behavioral history, and availability of inclusive systems as potential risk factors for dropouts, impacting students with disabilities. Results indicated that a successful academic history was the only significant predictor of graduation potential when statistically controlling all the other variables.