Predictors of substance use reduction in an epidemiological first-episode psychosis cohort

Aim To assess the predictors of a significant decrease or cessation of substance use (SU) in a treated epidemiological cohort of first-episode psychosis (FEP) patients. Method Participants were FEP patients of the Early Psychosis Prevention and Intervention Centre in Australia. Patients' medical files were reviewed using a standardized file audit. Data on 432 patients with FEP and baseline co-morbid substance use disorder (SUD) were available for analysis. Predictors of reduction/cessation of SU at follow up were examined using logistic regression analyses. Results In univariate analyses, a reduction/cessation of SU was predicted by baseline measures reflecting higher education, employment, accommodation with others, cannabis use disorder (CUD) only (rather than poly-SUDs), better global functioning and better premorbid social and occupational functioning, later age at onset of psychosis, and a diagnosis of non-affective psychosis. In multivariate analysis, CUD alone and better premorbid social and occupational functioning remained significant predictors. Conclusions Addressing SUDs and social and occupational goals in people with FEP may offer opportunities to prevent SUDs becoming more severe or entrenched. Further longitudinal research on recovery from SU and FEP is needed to disentangle directions of influence and identify key targets for intervention.

Anti-Müllerian hormone and inhibin B as predictors of pregnancy after treatment by in vitro fertilization/intracytoplasmic sperm injection

OBJECTIVE: To evaluate anti-Müllerian hormone (AMH) as a marker of reproductive outcome after IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Longitudinal study. SETTING: University hospital. PATIENT(S): Two hundred seventy-six consecutive women undergoing IVF/ICSI. INTERVENTION(S): Ovarian stimulation, oocyte retrieval, IVF, ICSI, embryo transfer, AMH, and inhibin B determinations in serum and follicular fluid (FF). MAIN OUTCOME MEASURE(S): The AMH and inhibin B concentrations in 276 matched FF/serum pairs have been determined. Different outcome groups have been compared and set in relation to the oocyte count, morphological parameters, and steroid hormone levels. RESULT(S): The concentrations of AMH and inhibin B in both serum and FF were significantly higher in the group of women who became pregnant in the corresponding treatment cycle than in those who did not conceive. Positive correlations were observed between serum inhibin B concentrations and embryo morphology (r = 0.126, 95% confidence interval 0.026-0.284). Serum and FF AMH or inhibin B correlated positively with the oocyte count and negatively with the pretreatment cycle day 3 FSH level and the total administered gonadotropin dose. CONCLUSION(S): The AMH and inhibin B levels on the day of oocyte retrieval are correlated to reproductive outcome.

Long-term patterns of subjective wellbeing in schizophrenia: cluster, predictors of cluster affiliation, and their relation to recovery criteria in 2842 patients followed over 3 years

To study the longitudinal patterns of subjective wellbeing in schizophrenia using cluster analysis and their relation to recovery criteria, further to examine predictors for cluster affiliation, and to evaluate the sensitivity and specificity of baseline subjective wellbeing cut-offs for cluster affiliation.

A longitudinal study on delirium in nursing homes

OBJECTIVE To investigate the evolution of delirium of nursing home (NH) residents and their possible predictors. DESIGN Post-hoc analysis of a prospective cohort assessment. SETTING Ninety NHs in Switzerland. PARTICIPANTS Included 14,771 NH residents. MEASUREMENTS The Resident Assessment Instrument Minimum Data Set and the Nursing Home Confusion Assessment Method were used to determine follow-up of subsyndromal or full delirium in NH residents using discrete Markov chain modeling to describe long-term trajectories and multiple logistic regression analyses to determine predictors of the trajectories. RESULTS We identified four major types of delirium time courses in NH. Increasing severity of cognitive impairment and of depressive symptoms at the initial assessment predicted the different delirium time courses. CONCLUSION More pronounced cognitive impairment and depressive symptoms at the initial assessment are associated with different subsequent evolutions of delirium. The presence and evolution of delirium in the first year after NH admission predicted the subsequent course of delirium until death.

Predictors of depressed mood 12 months after injury. Contribution of self-efficacy and social support

Abstract Purpose: There is evidence that depressed mood and perception of pain are related in patients with chronic illness. However, how individual resources such as self-efficacy and social support play a role in this association remains unclear. The aim of this study was to investigate the influence of both variables as either moderator or mediator. Method: In a longitudinal study, 274 injured workers (M = 43.24 years) were investigated. Data were collected on sociodemographics, depressed mood, pain, social support, and self-efficacy at three months post-injury, and depressed mood one year post-injury. Results: Hierarchical multiple linear regression analyses revealed that pain (β = 0.14; p < 0.01) and social support (β = -0.18; p < 0.001) were significant predictors of depressed mood. Self-efficacy moderated the relationship of pain (β = -0.12; p < 0.05) and depressed mood after one year. Lower self-efficacy in combination with pain had a stronger impact than higher self-efficacy and pain on depressed mood. Social support did not moderate the association. Conclusions: Self-efficacy for managing pain is important in the development of depressed mood. According to the results of this study, we suggest that the detection of low social support and low self-efficacy might be important in long-term rehabilitation process. Implications for Rehabilitation Risk for depressed mood one year after an accident is high: One in five workers report depressed mood. Protective factors for depressed mood in injured workers needs to be considered in the rehabilitation. Focusing on resources like social support and self-efficacy could be protective against depressed mood. The early detection of low social support and low self-efficacy might be important in long-term rehabilitation processes

Changes in situational and dispositional factors as predictors of job satisfaction

Arguably, job satisfaction is one of the most important variables with regard to work. When explaining job satisfaction, research usually focuses on predictor variables in terms of levels but neglects growth rates. Therefore it remains unclear how potential predictors evolve over time and how their development affects job satisfaction. Using multivariate latent growth modeling in a study with 1145 young workers over five years, we analyzed how well job satisfaction is predicted a) by levels of situational (i.e., job control) and dispositional (i.e., Core Self-Evaluations (CSE)) factors and b) by growth per year of these predictors. Results showed both intercepts and slopes to be related to each other, suggesting a joint growth of job control and CSE during early careers. Job satisfaction after five years was best predicted by the slopes of job control (β = .31, p < .001) and CSE (β = .34, p < .01). These findings provide further longitudinal evidence for the role of situational as well as dispositional factors for predicting job satisfaction. In addition, growth rates per year were better predictors than initial levels. Furthermore, a lack of change in job control or CSE went along with a drop in job satisfaction, implying that young workers need to perceive things to be improving in order to increase, or at least maintain, their level of job satisfaction. In terms of theory, the relative importance of levels versus changes deserves more attention. In terms of practical implications, our results suggest a double emphasis on job design (i.e., granting sufficient, and increasing, control) and on personal development (e.g., through training) so that people experience a match between both. Finally, negative associations between initial levels and growth rates suggest that people are quite successful in achieving a reasonable fit between their job characteristics and their needs and goals.

Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: results of the swiss inflammatory bowel disease cohort study

BACKGROUND Inflammatory bowel disease can decrease the quality of life and induce work disability. We sought to (1) identify and quantify the predictors of disease-specific work disability in patients with inflammatory bowel disease and (2) assess the suitability of using cross-sectional data to predict future outcomes, using the Swiss Inflammatory Bowel Disease Cohort Study data. METHODS A total of 1187 patients were enrolled and followed up for an average of 13 months. Predictors included patient and disease characteristics and drug utilization. Potential predictors were identified through an expert panel and published literature. We estimated adjusted effect estimates with 95% confidence intervals using logistic and zero-inflated Poisson regression. RESULTS Overall, 699 (58.9%) experienced Crohn's disease and 488 (41.1%) had ulcerative colitis. Most important predictors for temporary work disability in patients with Crohn's disease included gender, disease duration, disease activity, C-reactive protein level, smoking, depressive symptoms, fistulas, extraintestinal manifestations, and the use of immunosuppressants/steroids. Temporary work disability in patients with ulcerative colitis was associated with age, disease duration, disease activity, and the use of steroids/antibiotics. In all patients, disease activity emerged as the only predictor of permanent work disability. Comparing data at enrollment versus follow-up yielded substantial differences regarding disability and predictors, with follow-up data showing greater predictor effects. CONCLUSIONS We identified predictors of work disability in patients with Crohn's disease and ulcerative colitis. Our findings can help in forecasting these disease courses and guide the choice of appropriate measures to prevent adverse outcomes. Comparing cross-sectional and longitudinal data showed that the conduction of cohort studies is inevitable for the examination of disability.

Who is likely to develop persistent low back pain? A longitudinal analysis of prognostic occupational factors

OBJECTIVE: Occupational low back pain (LBP) is considered to be the most expensive form of work disability, with the socioeconomic costs of persistent LBP exceeding the costs of acute and subacute LBP by far. This makes the early identification of patients at risk of developing persistent LBP essential, especially in working populations. The aim of the study was to evaluate both risk factors (for the development of persistent LBP) and protective factors (preventing the development of persistent LBP) in the same cohort. PARTICIPANTS: An inception cohort of 315 patients with acute to subacute or with recurrent LBP was recruited from 14 health practitioners (twelve general practitioners and two physiotherapists) across New Zealand. METHODS: Patients with persistent LBP at six-month follow-up were compared to patients with non-persistent LBP looking at occupational, psychological, biomedical and demographic/lifestyle predictors at baseline using multiple logistic regression analyses. All significant variables from the different domains were combined into a one predictor model. RESULTS: A final two-predictor model with an overall predictive value of 78% included social support at work (OR 0.67; 95%CI 0.45 to 0.99) and somatization (OR 1.08; 95%CI 1.01 to 1.15). CONCLUSIONS: Social support at work should be considered as a resource preventing the development of persistent LBP whereas somatization should be considered as a risk factor for the development of persistent LBP. Further studies are needed to determine if addressing these factors in workplace interventions for patients suffering from acute, subacute or recurrent LBP prevents subsequent development of persistent LBP.

Left ventricular growth from age 8 to 18 and its anthropometric determinants: Longitudinal results from Project Heartbeat!

Left ventricular mass (LVM) is a strong predictor of cardiovascular disease (CVD) in adults. However, normal growth of LVM in healthy children is not well understood, and previous results on independent effects of body size and body fatness on LVM have been inconsistent. The purpose of this study was (1) to establish the normal growth curve of LVM from age 8 to age 18, and evaluate the determinants of change in LVM with age, and (2) to assess the independent effects of body size and body fatness on LVM.^ In Project HeartBeat!, 678 healthy children aged 8, 11 and 14 years at baseline were enrolled and examined at 4-monthly intervals for up to 4 years. A synthetic cohort with continuous observations from age 8 to 18 years was constructed. A total of 4608 LVM measurements was made from M-mode echocardiography. The multilevel linear model was used for analysis.^ Sex-specific trajectories of normal growth of LVM from age 8 to 18 was displayed. On average, LVM was 15 g higher in males than females. Average LVM increased linearly in males from 78 g at age 8 to 145 g at age 18. For females, the trajectory was curvilinear, nearly constant after age 14. No significant racial differences were found. After adjustment for the effects of body size and body fatness, average LVM decreased slightly from age 8 to 18, and sex differences in changes of LVM remained constant.^ The impact of body size on LVM was examined by adding to a basic LVM-sex-age model one of 9 body size indicators. The impact of body fatness was tested by further introducing into each of the 9 LVM models (with one or another of the body size indicators) one of 4 body fatness indicators, yielding 36 models with different body size and body fatness combinations. The results indicated that effects of body size on LVM can be distinguished between fat-free body mass and fat body mass, both being independent, positive predictors. The former is the stronger determinant. When a non-fat-free body size indicator is used as predictor, the estimated residual effect of body fatness on LVM becomes negative. ^

Push and Pull Motivations for Quitting: A three-wave investigation of predictors and consequences of turnover

We report a new analysis of data from a multi-year study, some of which were previously published in the current journal. A longitudinal sample of 380 computer specialists was followed over two years, yielding three measures each of job satisfaction, organizational commitment, and turnover intentions, as well as actual turnover, and reasons for leaving, at Times 2 and 3. Career paths were more diverse than the classical distinction between stayers and leavers implies. Furthermore, although the largest single group of leavers cited “push” reasons, conforming to the classical withdrawal model, a sizable number were attracted to another job (“pull motivation”). In a three-wave structural equation model, job (dis)satisfaction predicted turnover, while organizational commitment exerted its influence only via its association with job satisfaction. As expected, however, attitudes predicted turnover only for participants with push motivation. Quitting, in turn, predicted an improvement in both satisfaction and commitment, indicating that it paid off for the individual. The necessity to study consequences of turnover and to distinguish between different subgroups of stayers and leavers is emphasized.

Patterns of motor abilities and technical skills as predictors of success for young elite football players

Sport-motor tests play an important role in football talent selections. However, single tests represent only parts of the complex game performance. The best game performance therefore does not necessarily need to go hand in hand with the best results in all tests of a test battery. Considering the complexity of the game performance appropriately, a holistic perspective together with a person-oriented approach are applied. Thereby, systems consisting of several variables are identified and analysed in a longitudinal study. Following this idea, six sport-motor tests were aggregated into a subsystem. 106 young male elite football players were tested three times (2011, 2012, 2013; Mage, t2011=12.26, SD=0.29). One year later (2014) their performance level was enquired. Data were analysed using the LICUR method, a cluster analytical method. Four patterns were identified, which remained stable at all measuring points. The players frequently show intraindividual and structurally similar patterns over time. At the third measuring point, a pattern occurred out of which the players are significantly more likely to advance to the highest performance level one year later. This pattern appears consistently above average, but does not always show best test performances. The significantly frequent development along structurally stable patterns suggests a predictive validity of the subsystem sport-motor tests between the ages of 12 to 15. Above average, but not necessarily outstanding performances both in the motor abilities as well as in the football specific tests appears to be particularly promising. This finding emphasizes the need of a holistic perspective in the talent selection.

Patterns of motor abilities and technical skills as predictors of success for young elite football players

Sport-motor tests play an important role in football talent selections. However, single tests represent only parts of the complex game performance. The best game performance therefore does not necessarily need to go hand in hand with the best results in all tests of a test battery. Considering the complexity of the game performance appropriately, a holistic perspective together with a person-oriented approach are applied. Thereby, systems consisting of several variables are identified and analysed in a longitudinal study. Following this idea, six sport-motor tests were aggregated into a subsystem. 106 young male elite football players were tested three times (2011, 2012, 2013; Mage, t2011=12.26, SD=0.29). One year later (2014) their performance level was enquired. Data were analysed using the LICUR method, a cluster analytical method. Four patterns were identified, which remained stable at all measuring points. The players frequently show intraindividual and structurally similar patterns over time. At the third measuring point, a pattern occurred out of which the players are significantly more likely to advance to the highest performance level one year later. This pattern appears consistently above average, but does not always show best test performances. The significantly frequent development along structurally stable patterns suggests a predictive validity of the subsystem sport-motor tests between the ages of 12 to 15. Above average, but not necessarily outstanding performances both in the motor abilities as well as in the football specific tests appears to be particularly promising. This finding emphasizes the need of a holistic perspective in the talent selection.

Psychosocial and environmental predictors of calcium intake, physical activity and bone health among adolescent girls

Objectives. The purpose of this study was to identify the psychosocial and environmental predictors and the pathways they use to influence calcium intake, physical activity and bone health among adolescent girls. Methods. A secondary data analysis using a cross-sectional and longitudinal study design was implemented to examine the associations of interest. Data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001-2003 were utilized for the analyses. IMPACT was a 1½ year nutrition and physical activity intervention study conducted among 718 middle-school girls in central Texas. Hierarchical regression modeling and Structural Equation Modeling (SEM) were used to determine the psychosocial predictors of calcium intake, physical activity and bone health at baseline. Hierarchical regression was used to determine if psychosocial factors at baseline were significant predictors of calcium intake and physical activity at follow-up. Data was adjusted for included BMI, lactose intolerance, ethnicity, menarchal status, intervention and participation in 7th grade PE/athletics. Results. Results of the baseline regression analysis revealed that calcium self-efficacy and milk availability at home were the strongest predictors of calcium intake. Friend engagement in physical activity, physical activity self-efficacy and participation in sports teams were the strongest predictors of physical activity. Finally, physical activity outcome expectations, social support and participation in sports teams were significant predictors of stiffness index at baseline. Results of the baseline SEM path analysis found that outcome expectations and milk availability at home directly influenced calcium intake. Knowledge and calcium self-efficacy indirectly influenced calcium intake with outcome expectations as the mediator. Physical activity self-efficacy and social support had significant direct and indirect influence on physical activity with participation in sports teams as the mediator. Participation in sports teams had a direct effect on both physical activity and stiffness index. Results of regression analysis for baseline predicting follow-up showed that participation in sports teams, self-efficacy, outcome expectations and social support at baseline were significant predictors of physical activity at follow-up. Conclusion. Results of this study reinforce the relevance of addressing both, psychosocial and environmental factors which are critical when developing interventions to improve bone health among adolescent girls. ^

Predictors of survival in Alzheimer's disease

Alzheimer's disease (AD) is associated with greater mortality and reduced survival among individuals with Alzheimer's disease as compared to those without dementia. It is uncertain how these survival estimates change when the clinical signs and/or symptoms of comorbid conditions are present in individuals' with Alzheimer's disease. Cardiovascular risk factors such as hypertension, hyperlipidemia, congestive heart failure, coronary artery disease, and diabetes mellitus are common conditions in the aged population. Independently, these factors influence mortality and may have an additive effect on reduced survival in an individual with concomitant Alzheimer's disease. The bulk of the evidence from previous research efforts suggests an association between vascular co-morbidities and Alzheimer's disease incidence, but their role in survival remains to be elucidated. The objective of this proposed study was to examine the effects of cardiovascular comorbidities on the survival experience of individuals with probable Alzheimer's disease in order to identify prognostic factors for life expectancy following onset of disease. This study utilized data from the Baylor College of Medicine Alzheimer's Disease Center (ADC) longitudinal study of Alzheimer's disease and other memory disorders. Individuals between the ages of 55-69, 70-79, and ≥80 had a median survival from date of onset of 9.2 years, 8.0 years, and 7.2 years, respectively (p<0.001) and 5.5 years, 4.3 years, and 3.4 years from diagnosis. Sex was the strongest predictor of death from onset of AD, with females having a 30 percent lower risk compared to males. These findings further support the notion that age (both from onset and from diagnosis) and sex are the strongest predictors of survival among those with AD. ^

The influence of social connectedness and self-esteem on participant retention in a bi-ethnic longitudinal study

In prospective studies it is essential that the study sample accurately represents the target population for meaningful inferences to be drawn. Understanding why some individuals do not participate, or fail to continue to participate, in longitudinal studies can provide an empirical basis for the development of effective recruitment and retention strategies to improve response rates. This study examined the influence of social connectedness and self-esteem on long-term retention of participants, using secondary data from the “San Antonio Longitudinal Study of Aging” (SALSA), a population-based study of Mexican Americans (MAs) and European Americans (EAs) aged over 65 years residing in San Antonio, Texas. We tested the effect of social connectedness, self-esteem and socioeconomic status on participant retention in both ethnic groups. In MAs only, we analyzed whether acculturation and assimilation moderated these associations and/or had a direct effect on participant retention. ^ Low income, low frequency of social contacts and length of recruitment interval were significant predictors of non-completer status. Participants with low levels of social contacts were almost twice as likely as those with high levels of social contacts to be non-completers, even after adjustment for age, sex, ethnic group, education, household income, and recruitment interval (OR = 1.95, 95% CI: 1.26–3.01, p = 0.003). Recruitment interval consistently and strongly predicted non-completer status in all the models tested. Depending on the model, for each year beyond baseline there was a 25–33% greater likelihood of non-completion. The only significant interaction, or moderating, effect observed was between social contacts and cultural values among MAs. Specifically, MAs with both low social contacts and low acculturation on cultural values (i.e., placed high value on preserving Mexican cultural origins) were three and half times more likely to be non-completers compared with MAs in other subgroups comprised of the combination of these variables, even after adjustment for covariates. ^ Long term studies with older and minority participants are challenging for participant retention. Strategies can be designed to enhance retention by paying special attention to participants with low social contacts and, in MAs, participants with both low social contacts and low acculturation on cultural values. Minimizing the time interval between baseline and follow-up recruitment, and maintaining frequent contact with participants during this interval should also be is integral to the study design.^