The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia - an exploratory study

Aims - To develop a method that prospectively assesses adherence rates in paediatric patients with acute lymphoblastic leukaemia (ALL) who are receiving the oral thiopurine treatment 6-mercaptopurine (6-MP). Methods - A total of 19 paediatric patients with ALL who were receiving 6-MP therapy were enrolled in this study. A new objective tool (hierarchical cluster analysis of drug metabolite concentrations) was explored as a novel approach to assess non-adherence to oral thiopurines, in combination with other objective measures (the pattern of variability in 6-thioguanine nucleotide erythrocyte concentrations and 6-thiouric acid plasma levels) and the subjective measure of self-reported adherence questionnaire. Results - Parents of five ALL patients (26.3%) reported at least one aspect of non-adherence, with the majority (80%) citing “carelessness at times about taking medication” as the primary reason for non-adherence followed by “forgetting to take the medication” (60%). Of these patients, three (15.8%) were considered non-adherent to medication according to the self-reported adherence questionnaire (scored ≥ 2). Four ALL patients (21.1%) had metabolite profiles indicative of non-adherence (persistently low levels of metabolites and/or metabolite levels clustered variably with time). Out of these four patients, two (50%) admitted non-adherence to therapy. Overall, when both methods were combined, five patients (26.3%) were considered non-adherent to medication, with higher age representing a risk factor for non-adherence (P < 0.05). Conclusions - The present study explored various ways to assess adherence rates to thiopurine medication in ALL patients and highlighted the importance of combining both objective and subjective measures as a better way to assess adherence to oral thiopurines.

Classification of Chenopodium Genus Populations and Species Based on Continuous and Categorical Variables

2000 Mathematics Subject Classification: 62P10, 62H30

Assessing the construct validity of a measure of learning agility

This study examined the construct validity of the Choices questionnaire that purported to support the theory of Learning Agility. Specifically, Learning Agility attempts to predict an individual's potential performance in new tasks. The construct validity will be measured by examining the convergent/discriminant validity of the Choices Questionnaire against a cognitive ability measure and two personality measures. The Choices Questionnaire did tap a construct that is unique to the cognitive ability and the personality measures, thus suggesting that this measure may have considerable value in personnel selection. This study also examined the relationship of this pew measure to job performance and job promotability. Results of this study found that the Choices Questionnaire predicted job performance and job promotability above and beyond cognitive ability and personality. Data from 107 law enforcement officers, along with two of their co-workers and a supervisor resulted in a correlation of .08 between Learning Agility and cognitive ability. Learning Agility correlated .07 with Learning Goal Orientation and. 17 with Performance Goal Orientation. Correlations with the Big Five Personality factors ranged from −.06 to. 13 with Conscientiousness and Openness to Experience, respectively. Learning Agility correlated .40 with supervisory ratings of job promotability and correlated .3 7 with supervisory ratings of overall job performance. Hierarchical regression analysis found incremental validity for Learning Agility over cognitive ability and the Big Five factors of personality for supervisory ratings of both promotability and overall job performance. A literature review was completed to integrate the Learning Agility construct into a nomological net of personnel selection research. Additionally, practical applications and future research directions are discussed. ^

Examining a proposed job retention model for adult workers with mental retardation in supported employment

This quantitative study investigated the predictive relationships and interaction between factors such as work-related social behaviors (WRSB), self-determination (SD), person-job congruency (PJC), job performance (JP), job satisfaction (JS), and job retention (JR). A convenience sample of 100 working adults with MR were selected from supported employment agencies. Data were collected using a survey test battery of standardized instruments. The hypotheses were analyzed using three multiple regression analyses to identify significant relationships. Beta weights and hierarchical regression analysis determined the percentage of the predictor variables contribution to the total variance of the criterion variables, JR, JP, and JS. ^ The findings highlight the importance of self-determination skills in predicting job retention, satisfaction, and performance for employees with MR. Consistent with the literature and hypothesized model, there was a predictive relationship between SD, JS and JR. Furthermore, SD and PJC were predictors of JP. SD and JR were predictors of JS. Interestingly, the results indicated no significant relationship between JR and JP, or between JP and JS, or between PJC and JS. This suggests that there is a limited fit between the hypothesized model and the study's findings. However, the theoretical contribution made by this study is that self-determination is a particularly relevant predictor of important work outcomes including JR, JP, and JS. This finding is consistent with Deci's (1992) Self-Determination Theory and Wehmeyer's (1996) argument that SD skills in individuals with disabilities have important consequences for the success in transitioning from school to adult and work life. This study provides job retention strategies that offer rehabilitation and HR professionals a useful structure for understanding and implementing job retention interventions for people with MR. ^ The study concluded that workers with mental retardation who had more self-determination skills were employed longer, more satisfied, and better performers on the job. Also, individuals whose jobs were matched to their interests and abilities (person-job congruency) were better at self-determination skills. ^

Employee engagement: An examination of antecedent and outcome variables

This nonexperimental, correlational study (N = 283) examined the relation among job fit, affective commitment, psychological climate, discretionary effort, intention to turnover, and employee engagement. An internet-based self-report survey battery of six scales were administered to a heterogeneous sampling of organizations from the fields of service, technology, healthcare, retail, banking, nonprofit, and hospitality. Hypotheses were tested through correlational and hierarchical regression analytic procedures. Job fit, affective commitment, and psychological climate were all significantly related to employee engagement and employee engagement was significantly related to both discretionary effort and intention to turnover. For the discretionary effort model, the hierarchical regression analysis results suggested that the employees who reported experiencing a positive psychological climate were more likely to report higher levels of discretionary effort. As for the intention to turnover model, the hierarchical regression analysis results indicated that affective commitment and employee engagement predicted lower levels of an employee’s intention to turnover. The regression beta weights ranged from to .43 to .78, supporting the theoretical, empirical, and practical relevance of understanding the impact of employee engagement on organizational outcomes. Implications for HRD theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of employee engagement as a means for improving organizational performance.

Chemical characteristics of dissolved organic matter in an oligotrophic subtropical wetland/estuarine ecosystem

Fluorescence properties of whole water samples and molecular characteristics of ultrafiltrated dissolved organic matter (UDOM > 1,000 D) such as lignin phenol and neutral sugar compositions and 13C nuclear magnetic resonance (NMR) spectra were determined along a freshwater to marine gradient in Everglades National Park. Furthermore, UDOM samples were categorized by hierarchical cluster analysis based on their pyrolysis gas chromatography/mass spectrometry products. Fluorescence properties suggest that autochthonous DOM leached/exuded from biomass is quantitatively important in this system. 13C NMR spectra showed that UDOM from the oligotrophic Taylor Slough (TS) and Florida Bay (FB) ecosystems has low aromatic C (13% ± 3% for TS; 2% ± 2% for FB) and very high O-alkyl C (54% ± 4% for TS; 75% ± 4% for FB) concentrations. High O-alkyl C concentrations in FB suggest seagrass/phytoplankton communities as dominant sources of UDOM. The amount of neutral sugars was not appreciably different between the TS and FB sites (115 ± 12 mg C g C-1 UDOM) but their concentrations suggest a low level of diagenesis and high production rates of this material in this oligotrophic environment. Total yield of lignin phenols (vanillyl + syringyl phenols) in TS was low (0.20–0.39 mg 100 mg C-1 UDOM) compared with other riverine environments and even lower in FB (0.04–0.07 mg 100 mg C-1 UDOM) and could be a result of photodegradation and/or dilution by other utochthonous DOM. The high O-alkyl and low aromatic nature of this UDOM suggests significant biogenic inputs (as compared with soils) and limited bioavailability in this ecosystem.

The relationship between the secondary mathematics curriculum, college persistence, and success at an urban community college

According to Venezia, Kirst, and Antonio (2003) and Barth’s 2002 Thinking K16 Ticket to Nowhere report, the disconnect between K-12 and postsecondary education was a contributing factor to high attrition rates. Since mathematics emerged as a primary concern for college readiness, Barth (2002) called for improving student transitions from K-12 to postsecondary institutions through the use of state or local data. The purpose of the present study was to analyze mathematics course-taking patterns of secondary students in a local context and to evaluate high school characteristics in order to explore their relationships with Associate degree attainment or continuous enrollment at an urban community college. Also, this study extended a national study conducted by Clifford Adelman (The Toolbox Revisited, 2006) as it specifically focused on community college students that were not included his study. Furthermore, this study used the theoretical framework that human capital, social capital, and cultural capital influence habitus—an individual’s or a group’s learned inclination to behave within the parameters of the imposed prevailing culture and norms. Specifically, the school embedded culture as it relates to tracking worked as a reproduction tool of ultimate benefit for the privileged group (Oakes, 1994). ^ Using multilevel analysis, this ex post facto study examined non-causal relationships between math course-taking patterns and college persistence of public high school graduates who enrolled at the local community college for up to 6 years. One school-level variable (percent of racial/ethnic minorities) and 7 student-level variables (community college math proportion, remedial math attempts, race, gender, first-year credits earned, socioeconomic status, and summer credits earned) emerged as predictors for college persistence. Study results indicated that students who enter higher education at the community college may have had lower opportunities to learn and therefore needed higher levels of remediation, which was shown to detract students from degree completion. Community college leaders are called to partner with local high schools with high percentages of racial/ethnic minorities to design academic programs aimed at improving the academic preparation of high school students in mathematics and promote student engagement during the first year and summers of college. ^

Mortalidade em idosos longevos e "mais jovens" no Brasil

The aim of the present study was to trace the mortality profile of the elderly in Brazil using two neighboring age groups: 60 to 69 years (young-old) and 80 years or more (oldest-old). To do this, we sought to characterize the trend and distinctions of different mortality profiles, as well as the quality of the data and associations with socioeconomic and sanitary conditions in the micro-regions of Brazil. Data was collected from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IBGE). Based on these data, the coefficients of mortality were calculated for the chapters of the International Disease Classification (ICD-10). A polynomial regression model was used to ascertain the trend of the main chapters. Non-hierarchical cluster analysis (K-Means) was used to obtain the profiles for different Brazilian micro-regions. Factorial analysis of the contextual variables was used to obtain the socio-economic and sanitary deprivation indices (IPSS). The trend of the CMId and of the ratio of its values in the two age groups confirmed a decrease in most of the indicators, particularly for badly-defined causes among the oldest-old. Among the young-old, the following profiles emerged: the Development Profile; the Modernity Profile; the Epidemiological Paradox Profile and the Ignorance Profile. Among the oldest-old, the latter three profiles were confirmed, in addition to the Low Mortality Rates Profile. When comparing the mean IPSS values in global terms, all of the groups were different in both of the age groups. The Ignorance Profile was compared with the other profiles using orthogonal contrasts. This profile differed from all of the others in isolation and in clusters. However, the mean IPSS was similar for the Low Mortality Rates Profile among the oldest-old. Furthermore, associations were found between the data quality indicators, the CMId for badly-defined causes, the general coefficient of mortality for each age group (CGMId) and the IPSS of the micro-regions. The worst rates were recorded in areas with the greatest socioeconomic and sanitary deprivation. The findings of the present study show that, despite the decrease in the mortality coefficients, there are notable differences in the profiles related to contextual conditions, including regional differences in data quality. These differences increase the vulnerability of the age groups studied and the health iniquities that are already present.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

Frontline employees’ innovative service behavior as key to customer loyalty:insights into FLEs’ resource gain spiral

Many service firms require frontline service employees (FLEs) to follow routines and standardized operating procedures during the service encounter, to deliver consistently high service standards. However, to create superior, pleasurable experiences for customers, featuring both helpful services and novel approaches to meeting their needs, firms in various sectors also have begun to encourage FLEs to engage in more innovative service behaviors. This study therefore investigates a new and complementary route to customer loyalty, beyond the conventional service-profit chain, that moves through FLEs' innovative service behavior. Drawing on conservation of resources (COR) theory, this study introduces a resource gain spiral at the service encounter, which runs from FLEs' emotional job engagement to innovative service behavior, and then leads to customer delight and finally customer loyalty. In accordance with COR theory, the proposed model also includes factors that might hinder (customer aggression, underemployment) or foster (colleague support, supervisor support) FLEs' resource gain spiral. A multilevel analysis of a large-scale, dyadic data set that contains responses from both FLEs and customers in multiple industries strongly supports the proposed resource gain spiral as a complementary route to customer loyalty. The positive emotional job engagement-innovative service behavior relationship is undermined by customer aggression and underemployment, as hypothesized. Surprisingly though, and contrary to the hypotheses, colleague and supervisor support do not seem to foster FLEs' resource gain spiral. Instead, colleague support weakens the engagement-innovative service behavior relationship, and supervisor support does not affect it. These results indicate that if FLEs can solicit resources from other sources, they may not need to invest as many of their individual resources. In particular, colleague support even appears to serve as a substitute for FLEs' individual resource investments in the resource gain spiral.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Memória e envelhecimento: Qual o real impacto da idade?

RESUMO Objetivos. O défice mnésico é uma das alterações cognitivas que mais afeta as pessoas idosas. A idade é considerada um dos fatores de relevo nas alterações de memória, inclusivamente pelas próprias pessoas idosas. A investigação tem mostrado que existem outros fatores além da idade que afetam a memória das pessoas idosas. Contudo, fica por esclarecer qual o real papel da idade sobre a memória quando é controlada a influência de outras variáveis. Assim, o presente estudo pretende analisar o impacto da idade no funcionamento mnésico de pessoas idosas e verificar se, ao controlar o papel de outras variáveis (sexo, escolaridade, profissão, situação civil, situação residencial e situação clínica), esse potencial impacto se mantém. Métodos. A amostra global foi constituída por 1126 participantes (283 homens e 843 mulheres; 226 residentes na comunidade e 900 em resposta social dirigida à população idosa) com idades compreendidas entre os 60 e os 100 anos. A avaliação foi realizada com recurso aos itens do Mini-Mental State Examination (memória de trabalho), o fator do Montreal Cognitive Assessment (memória declarativa verbal) e Figura Complexa de ReyOsterrieth (memória visuoespacial). Resultados. Globalmente, a idade, escolaridade, profissão, situação civil, residencial e clínica influenciaram a memória de forma diferenciada consoante o tipo de memória. As análises de regressão hierárquica mostraram que a idade é um fator preditivo em todos os tipos de memória. Emergiram ainda outros fatores preditivos com coeficientes de regressão superiores à idade conforme o tipo de memória (exceto na memória de trabalho). Conclusões. A idade, a escolaridade e a profissão influenciam a memória, assim como os fatores que potencialmente estimulam cognitiva e socialmente (como ter um companheiro e residir na comunidade). Os resultados apontam para a importância de intervir em pessoas em respostas sociais, mais idosas, sem companheiro, com baixa escolaridade e profissão manual. ABSTRACT Goals. Memory impairment is one of the types of cognitive impairment that most affects the elderly. Age is considered one of the major factors in memory impairment, including by the elderly themselves. Research has shown that there are other factors affecting memory of elderly persons. It remains, however, unclear what is the real impact of age in memory when controlling the influence of other variables. Thus, this study aims to analyze the impact of age on memory functioning of elderly persons and check if the potential impact remains when controlling the role of other variables (sex, education, profession, marital status, residential status, and clinical situation). Methods. The global sample comprised 1126 subjects (283 men and 843 women, 226 residents in the community and 900 institutionalized elderly) aged from 60 to 100 years. The assessment included items from the MiniMental State Examination (working memory), the Montreal Cognitive Assessment factor (verbal declarative memory), and Rey-Osterrieth Complex Figure (visuospatial memory). Results. Overall, age, education, profession, marital, residential, and clinical condition have differently influenced memory, depending on the type of memory. The hierarchical regression analysis showed that age is a predictive factor in all types of memory. However, other predictors have emerged with higher regression coefficients compared to age, according to the type of memory (except in working memory). Conclusions. Age, education and profession influence memory, as well as factors that potentially stimulate cognitively and socially (like having a partner and living in the community). The results indicate the importance of intervening, especially among institutionalized elderly, older, unmarried, with low education, and manual profession.

Job-demand for Learning, Job-related Learning and Need for Achievement

Individual learning is important, as it is both a precursor and an outcome of learning in organisations. Job-related learning is driven by external factors (e.g., the demands of the job) and internal factors (i.e., the personality of the individual). The study examined whether need for achievement moderates the relationship between job-demand for learning and job-related learning. Data were obtained from 153 full-time, white-collar employees from a range of industries. Hierarchical regression analysis using the product term revealed that need for achievement moderates the relationship between job-demand for learning and job-related learning. Specifically, although job-demand for learning is correlated positively to job-related learning for both the high and the low need for achievement groups, this correlation is stronger amongst the high group. The findings are discussed in terms of their implications for future research and practice.

Transcriptome-Wide Mapping of Pea Seed Ageing Reveals a Pivotal Role for Genes Related to Oxidative Stress and Programmed Cell Death

Understanding of seed ageing, which leads to viability loss during storage, is vital for ex situ plant conservation and agriculture alike. Yet the potential for regulation at the transcriptional level has not been fully investigated. Here, we studied the relationship between seed viability, gene expression and glutathione redox status during artificial ageing of pea (Pisum sativum) seeds. Transcriptome-wide analysis using microarrays was complemented with qRT-PCR analysis of selected genes and a multilevel analysis of the antioxidant glutathione. Partial degradation of DNA and RNA occurred from the onset of artificial ageing at 60% RH and 50 degrees C, and transcriptome profiling showed that the expression of genes associated with programmed cell death, oxidative stress and protein ubiquitination were altered prior to any sign of viability loss. After 25 days of ageing viability started to decline in conjunction with progressively oxidising cellular conditions, as indicated by a shift of the glutathione redox state towards more positive values (>-190 mV). The unravelling of the molecular basis of seed ageing revealed that transcriptome reprogramming is a key component of the ageing process, which influences the progression of programmed cell death and decline in antioxidant capacity that ultimately lead to seed viability loss.

COACHES, CLIMATES, “FIELD” GOALS, AND EFFICACY: A “DE-CONSTRUCTION” OF THE MASTERY-APPROACH TO COACHING AND EXAMINATION OF RELATIONSHIPS TO PSYCHOSOCIAL OUTCOMES IN A YOUTH FOOTBALL PLAYER DEVELOPMENT PROGRAM.

In support of the achievement goal theory (AGT), empirical research has demonstrated psychosocial benefits of the mastery-oriented learning climate. In this study, we examined the effects of perceived coaching behaviors on various indicators of psychosocial well-being (competitive anxiety, self-esteem, perceived competence, enjoyment, and future intentions for participation), as mediated by perceptions of the coach-initiated motivational climate, achievement goal orientations and perceptions of sport-specific skills efficacy. Using a pre-post test design, 1,464 boys, ages 10-15 (M = 12.84 years, SD = 1.44), who participated in a series of 12 football skills clinics were surveyed from various locations across the United States. Using structural equation modeling (SEM) path analysis and hierarchical regression analysis, the cumulative direct and indirect effects of the perceived coaching behaviors on the psychosocial variables at post-test were parsed out to determine what types of coaching behaviors are more conducive to the positive psychosocial development of youth athletes. The study demonstrated that how coaching behaviors are perceived impacts the athletes’ perceptions of the motivational climate and achievement goal orientations, as well as self-efficacy beliefs. These effects in turn affect the athletes’ self-esteem, general competence, sport-specific competence, competitive anxiety, enjoyment, and intentions to remain involved in the sport. The findings also clarify how young boys internalize and interpret coaches’ messages through modification of achievement goal orientations and sport-specific efficacy beliefs.