Longitudinal analysis of patterns and predictors of changes in self-reported adherence to antiretroviral therapy: Swiss HIV Cohort Study

Adherence to combination antiretroviral therapy (cART) is a dynamic process, however, changes in adherence behavior over time are insufficiently understood.

Evaluation of Current Repair Criteria for Longitudinal Barrier with Crash Damage

To protect motorists and avoid tort liability, highway agencies expend considerable resources to repair damaged longitudinal barriers, such as w-beam guardrails. With limited funding available, though, highway agencies are unable to maintain all field-installed systems in the ideal as-built condition. Instead, these agencies focus on repairing only damage that has a detrimental effect on the safety performance of the barrier. The distinction between minor damage and more severe performance-altering damage, however, is not always clear. This paper presents a critical review of current United States (US) and Canadian criteria on whether to repair damaged longitudinal barrier. Barrier repair policies were obtained via comprehensive literature review and a survey of US and Canadian transportation agencies. In an analysis of the maintenance procedures of 40 US States and 8 Canadian transportation agencies, fewer than one-third of highway agencies were found to have quantitative measures to determine when barrier repair is warranted. In addition, no engineering basis for the current US barrier repair guidelines could be found. These findings underscore the importance of the development of quantitative barrier repair guidelines based on a strong technical foundation.

The Effects of Airbags and Seatbelts on Occupant Injury in Longitudinal Barrier Crashes

Introduction: Longitudinal barriers, such as guardrails, are designed to prevent a vehicle that leaves the roadway from impacting a more dangerous object while minimizing the risk of injury to the vehicle occupants. Current full-scale test procedures for these devices do not consider the effect of occupant restraints such as seatbelts and airbags. The purpose of this study was to determine the extent to which restraints are used or deployed in longitudinal barrier collisions and their subsequent effect on occupant injury. Methods: Binary logistic regression models were generated to predict occupant injury risk using data from the National Automotive Sampling System / Crashworthiness Data System from 1997 through 2007. Results: In tow-away longitudinal barrier crashes, airbag deployment rates were 70% for airbag-equipped vehicles. Compared with unbelted occupants without an airbag available, seat belt restrained occupants with an airbag available had a dramatically decreased risk of receiving a serious (MAIS 3+) injury (odds-ratio (OR)=0.03; 95% CI: 0.004- 0.24). A similar decrease was observed among those restrained by seat belts, but without an airbag available (OR=0.03; 95% CI: 0.001- 0.79). No significant differences in risk of serious injuries were observed between unbelted occupants with an airbag available compared with unbelted occupants without an airbag available (OR=0.53; 95% CI=0.10-2.68). Impact on Industry: This study refutes the perception in the roadside safety community that airbags rarely deploy in frontal barrier crashes, and suggests that current longitudinal barrier occupant risk criteria may over-estimate injury potential for restrained occupants involved in a longitudinal barrier crash.

Higher Educational Impact on Student Objectives: Longitudinal Change in Clark-Trow "Educational Philosophies"

This study explores the impact of higher education on 3,942 arts and sciences students as measured by change in their freshman and senior ratings of four Clark-Trow "educational philosophies": vocational, academic, collegiate, and nonconformist (Clark and Trow, 1966). A repeated measures analysis of variance was applied to each of the four philosophies, controlling for sex, entering year, major, parents' educational background, scholastic aptitude, and academic motivation. As expected from Clark-Trow theory, students showed significant increases in academic and nonconformist philosophies, and decreases in vocational and collegiate philosophies. Relationships between independent variables and freshman-senior change suggested post hoc reinterpretation of the dimensions underlying the Clark-Trow "phenotypes": i. e., from "identification with the college" and "involvement with ideas" to "social interests" and "academic interests" (the latter suggested by Terenzini and Pascarella, 1977).

The Impact of Greek Affiliation on Students’ Educational Objectives: Longitudinal Change in Clark-Trow Educational Philosophies

Change in 4,119 students' freshman to senior ratings of four educational philosophies (vocational, academic, collegiate, and nonconformist) provided four measures of educational impact. Repeated measures analyses of variance compared changes in philosophy as a function of Greek affiliation, controlling for sex, historical era, major, parents' education, scholastic aptitude, and academic motivation. Small but significantly different degrees of change in the collegiate and nonconformist philosophies suggested that Greek affiliation increased social interests and inhibited some forms of intellectual interests. These small differences across all students masked the moderating effect of major. In the nonconformist philosophy, for example, the Greek × major interaction reflected substantial Greek–independent differences among humanities majors, and progressively smaller differences or reversals among social science, physical science, and engineering majors. Possible interpretations of this interaction are offered.

Real-World Performance of Longitudinal Barriers Struck by Large Trucks

Outside of relatively limited crash testing with large trucks, very little is known regarding the performance of traffic barriers subjected to real-world large truck impacts. The purpose of this study was to investigate real-world large truck impacts into traffic barriers to determine barrier crash involvement rates, the impact performance of barriers not specifically designed to redirect large trucks, and the real-world performance of large-truck-specific barriers. Data sources included the Fatality Analysis Reporting System (2000-2009), the General Estimates System (2000-2009) and 155 in-depth large truck-to-barrier crashes from the Large Truck Crash Causation Study. Large truck impacts with a longitudinal barrier were found to comprise 3 percent of all police-reported longitudinal barrier impacts and roughly the same proportion of barrier fatalities. Based on a logistic regression model predicting barrier penetration, large truck barrier penetration risk was found to increase by a factor of 6 for impacts with barriers designed primarily for passenger vehicles. Although large-truck-specific barriers were found to perform better than non-heavy vehicle specific barriers, the penetration rate of these barriers were found to be 17 percent. This penetration rate is especially a concern because the higher test level barriers are designed to protect other road users, not the occupants of the large truck. Surprisingly, barriers not specifically designed for large truck impacts were found to prevent large truck penetration approximately half of the time. This suggests that adding costlier higher test level barriers may not always be warranted, especially on roadways with lower truck volumes.

Long-term consequences of an intensive care unit stay in older critically ill patients: design of a longitudinal study

Background Modern methods in intensive care medicine often enable the survival of older critically ill patients. The short-term outcomes for patients treated in intensive care units (ICUs), such as survival to hospital discharge, are well documented. However, relatively little is known about subsequent long-term outcomes. Pain, anxiety and agitation are important stress factors for many critically ill patients. There are very few studies concerned with pain, anxiety and agitation and the consequences in older critically ill patients. The overall aim of this study is to identify how an ICU stay influences an older person's experiences later in life. More specific, this study has the following objectives: (1) to explore the relationship between pain, anxiety and agitation during ICU stays and experiences of the same symptoms in later life; and (2) to explore the associations between pain, anxiety and agitation experienced during ICU stays and their effect on subsequent health-related quality of life, use of the health care system (readmissions, doctor visits, rehabilitation, medication use), living situation, and survival after discharge and at 6 and 12 months of follow-up. Methods/Design A prospective, longitudinal study will be used for this study. A total of 150 older critically ill patients in the ICU will participate (ICU group). Pain, anxiety, agitation, morbidity, mortality, use of the health care system, and health-related quality of life will be measured at 3 intervals after a baseline assessment. Baseline measurements will be taken 48 hours after ICU admission and one week thereafter. Follow-up measurements will take place 6 months and 12 months after discharge from the ICU. To be able to interpret trends in scores on outcome variables in the ICU group, a comparison group of 150 participants, matched by age and gender, recruited from the Swiss population, will be interviewed at the same intervals as the ICU group. Discussion Little research has focused on long term consequences after ICU admission in older critically ill patients. The present study is specifically focussing on long term consequences of stress factors experienced during ICU admission.

Effect of Alzheimer Caregiving on Circulating Levels of C-Reactive Protein and Other Biomarkers Relevant to Cardiovascular Disease Risk: A Longitudinal Study

Providing care to a spouse with Alzheimer's disease (AD) may contribute to cardiovascular disease (CVD). The acute phase reactant C-reactive protein (CRP) is a well-established biomarker of an increased CVD risk.

Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep

Findings on sleep disturbances in family dementia caregivers are conflicting. We studied the longitudinal effects of dementia caregiving and major transitions in the caregiving situation on caregivers' sleep and the effect of moderating variables.

A Longitudinal Analysis of the Relations Among Stress, Depressive Symptoms, Leisure Satisfaction, and Endothelial Function in Caregivers

Stress and depressive symptoms have been associated with impaired endothelial function as measured by brachial artery flow-mediated dilation (FMD), possibly through repeated and heightened activation of the sympathetic nervous system. Behavioral correlates of depression, such as satisfaction with leisure activities (i.e., leisure satisfaction), may also be associated with endothelial function via their association with depressive symptoms. This study examined the longitudinal associations between stress, depressive symptoms, leisure satisfaction, and endothelial function as measured by FMD.