Hope as a resource for career exploration: Examining incremental and cross-lagged effects

Hope is believed to be beneficial for vocational pursuits, but the question of how and why hope is related to pivotal career development variables remains largely unaddressed. In a series of three studies, we investigated the relationship between hope and career exploration. Study 1 examined at-risk adolescents (N = 228) in Switzerland and showed that hope explains variance in career exploration beyond the significant effects of generalized self-efficacy beliefs and perceived social support. Study 2 found the same result among a group (N = 223) of first-year students at a Swiss university with a measure of state hope. Study 3 applied a one-year cross-lagged design with a diverse group of students (N = 266) at a German university to investigate the mutual effects of dispositional hope and career exploration over time. Although both variables were found to be related within and over time, we could not confirm lagged effects in either direction. The results suggest that hope is significantly correlated with career exploration because both are related to personality and social–contextual variables.

Incremental value of heart-type fatty acid-binding protein in suspected acute myocardial infarction early after symptom onset.

BACKGROUND The early diagnosis of acute myocardial infarction (AMI) very soon after symptom onset remains a major clinical challenge, even when using high-sensitivity cardiac troponin (hs-cTnT). METHODS AND RESULTS We investigated the incremental value of heart-type fatty acid-binding protein (hFABP) in a pre-specified subgroup analysis of patients presenting with suspected AMI within 1 h of symptom onset to the emergency department (ED) in a multicentre study. HFABP was measured in a blinded fashion. Two independent cardiologists using all available clinical information, including hs-cTnT, adjudicated the final diagnosis. Overall, 1411 patients were enrolled, of whom 105 patients presented within 1 h of symptom onset. Of these, 34 patients (32.4%) had AMI. The diagnostic accuracy as quantified by the area under the receiver-operating characteristics curve (AUC) of hFABP was high (0.84 (95% CI 0.74-0.94)). However, the additional use of hFABP only marginally increased the diagnostic accuracy of hs-cTnT (AUC 0.88 (95% CI 0.81-0.94) for hs-cTnT alone to 0.90 (95% CI 0.83-0.98) for the combination; p=ns). After the exclusion of 18 AMI patients with ST-segment elevation, similar results were obtained. Among the 16 AMI patients without ST-segment elevation, six had normal hs-cTnT at presentation. Of these, hFABP was elevated in two (33.3%) patients. CONCLUSIONS hFABP does not seem to significantly improve the early diagnostic accuracy of hs-cTnT in the important subgroup of patients with suspected AMI presenting to the ED very early after symptom onset.

Incremental Value of the CRUSADE, ACUITY, and HAS-BLED Risk Scores for the Prediction of Hemorrhagic Events After Coronary Stent Implantation in Patients Undergoing Long or Short Duration of Dual Antiplatelet Therapy

BACKGROUND Multiple scores have been proposed to stratify bleeding risk, but their value to guide dual antiplatelet therapy duration has never been appraised. We compared the performance of the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy), and HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) scores in 1946 patients recruited in the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study (PRODIGY) and assessed hemorrhagic and ischemic events in the 24- and 6-month dual antiplatelet therapy groups. METHODS AND RESULTS Bleeding score performance was assessed with a Cox regression model and C statistics. Discriminative and reclassification power was assessed with net reclassification improvement and integrated discrimination improvement. The C statistic was similar between the CRUSADE score (area under the curve 0.71) and ACUITY (area under the curve 0.68), and higher than HAS-BLED (area under the curve 0.63). CRUSADE, but not ACUITY, improved reclassification (net reclassification index 0.39, P=0.005) and discrimination (integrated discrimination improvement index 0.0083, P=0.021) of major bleeding compared with HAS-BLED. Major bleeding and transfusions were higher in the 24- versus 6-month dual antiplatelet therapy groups in patients with a CRUSADE score >40 (hazard ratio for bleeding 2.69, P=0.035; hazard ratio for transfusions 4.65, P=0.009) but not in those with CRUSADE score ≤40 (hazard ratio for bleeding 1.50, P=0.25; hazard ratio for transfusions 1.37, P=0.44), with positive interaction (Pint=0.05 and Pint=0.01, respectively). The number of patients with high CRUSADE scores needed to treat for harm for major bleeding and transfusion were 17 and 15, respectively, with 24-month rather than 6-month dual antiplatelet therapy; corresponding figures in the overall population were 67 and 71, respectively. CONCLUSIONS Our analysis suggests that the CRUSADE score predicts major bleeding similarly to ACUITY and better than HAS BLED in an all-comer population with percutaneous coronary intervention and potentially identifies patients at higher risk of hemorrhagic complications when treated with a long-term dual antiplatelet therapy regimen. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov. Unique identifier: NCT00611286.

(Table 1) 40Ar-39Ar incremental heating ages for ODP Hole 163-988A basalt and plagioclase

Results of 40Ar-39Ar Ar dating constrain the age of the submerged volcanic succession, part of the seaward-dipping reflector sequence of the Southeast Greenland volcanic rifted margin, recovered during Leg 163. At the 63ºN drilling transect, the fully normally magnetized volcanic units at Holes 989B (Unit 1) and 990A (Units 1 and 2) are dated at 57.1 ± 1.3 Ma and 55.6 ± 0.6 Ma, respectively. This correlates with a common magnetochron, C25n. The underlying, reversely magnetized lavas at Hole 990A (Units 3-13) yield an average age of 55.8 ± 0.7 Ma and may correlate with C25r. The argon data, however, are also consistent with eruption of the lavas at Site 990 during the very earliest portion of C24. If so, the normally polarized units have to be correlated to a cryptochron (e.g., C24r-11 at ~55.57 Ma). The lavas at Holes 989B and 990A have typical oceanic compositions, implying that final plate separation between Greenland and northwest Europe took place at ~56 Ma. The age for Hole 989B lava is younger than expected from the seismic interpretations, posing questions about the structural evolution of the margin. An age of 49.6 ± 0.2 Ma for the basaltic lava at Site 988 (~66ºN) points to the importance of postbreakup tholeiitic magmatism at the rifted margin. Together with results from Leg 152, a virtually complete time frame for ~12 m.y. of pre-, syn-, and postbreakup volcanism during rifted margin evolution in Southeast Greenland can now be assembled. This time frame includes continental type volcanism at ~61-60 Ma, synbreakup volcanism beginning at ~57 Ma, and postbreakup volcanism at ~49.6 Ma. These discrete time windows coincide with distinct periods of tholeiitic magmatism from the onshore East Greenland Tertiary Igneous Province and is consistent with discrete mantle-melting events triggered by plume arrival (~61-60 Ma) under central Greenland, continental breakup (~57-54 Ma), and passage of the plume axis beneath the East Greenland rifted margin after breakup (~50-49 Ma), respectively.

40Ar/39Ar analysis for incremental heating experiments at DSDP Holes 77-537 and 77-538A

Drilling penetrated pre-Mesozoic crystalline basement beneath abbreviated sedimentary sequences overlying fault blocks in the southeastern Gulf of Mexico. At Hole 538A, located on Catoche Knoll, a foliated, regional metamorphic association of variably mylonitic felsic gneisses and interlayered amphibolite is intruded by post-tectonic diabase dikes. Hornblende from the amphibolite displays internally discordant 40Ar/39Ar age spectra, suggesting initial post-metamorphic cooling at about 500 Ma followed by a mild thermal disturbance at about 200 Ma. Biotite from the gneiss yields a plateau age of 348 Ma, which is interpreted to result from incorporation of extraneous argon components when the biotite system was opened during the about 200 Ma thermal overprint. A whole-rich diabase sample from Hole 538A records a crystallization age of 190.4 ± 3.4 Ma. A lower grade phyllitic metasedimentary sequence was penetrated at Hole 537, drilled about 30 km northwest of Catoche Knoll. Whole-rock phyllite samples display internally discordant 40Ar/39Ar age spectra, but plateau segments clearly document an early Paleozoic metamorphism at about 500 Ma. The age and lithologic character of the basement terrane penetrated at Holes 537 and 538A suggest that the drilled fault blocks are underlain by attenuated fragments of continental crust of "Pan-African" affinity. This supports pre-Mesozoic tectonic reconstructions that locate Yucatan in the present Gulf recess during the amalgamation of Pangea.