Defining response to anti-VEGF therapies in neovascular AMD

The introduction of anti-vascular endothelial growth factor (anti-VEGF) has made significant impact on the reduction of the visual loss due to neovascular age-related macular degeneration (n-AMD). There are significant inter-individual differences in response to an anti-VEGF agent, made more complex by the availability of multiple anti-VEGF agents with different molecular configurations. The response to anti-VEGF therapy have been found to be dependent on a variety of factors including patient’s age, lesion characteristics, lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles. Furthermore, a proportion of eyes with n-AMD show a decline in acuity or morphology, despite therapy or require very frequent re-treatment. There is currently no consensus as to how to classify optimal response, or lack of it, with these therapies. There is, in particular, confusion over terms such as ‘responder status’ after treatment for n-AMD, ‘tachyphylaxis’ and ‘recalcitrant’ n-AMD. This document aims to provide a consensus on definition/categorisation of the response of n-AMD to anti-VEGF therapies and on the time points at which response to treatment should be determined. Primary response is best determined at 1 month following the last initiation dose, while maintained treatment (secondary) response is determined any time after the 4th visit. In a particular eye, secondary responses do not mirror and cannot be predicted from that in the primary phase. Morphological and functional responses to anti-VEGF treatments, do not necessarily correlate, and may be dissociated in an individual eye. Furthermore, there is a ceiling effect that can negate the currently used functional metrics such as >5 letters improvement when the baseline VA is good (ETDRS>70 letters). It is therefore important to use a combination of both the parameters in determining the response.The following are proposed definitions: optimal (good) response is defined as when there is resolution of fluid (intraretinal fluid; IRF, subretinal fluid; SRF and retinal thickening), and/or improvement of >5 letters, subject to the ceiling effect of good starting VA. Poor response is defined as <25% reduction from the baseline in the central retinal thickness (CRT), with persistent or new IRF, SRF or minimal or change in VA (that is, change in VA of 0+4 letters). Non-response is defined as an increase in fluid (IRF, SRF and CRT), or increasing haemorrhage compared with the baseline and/or loss of >5 letters compared with the baseline or best corrected vision subsequently. Poor or non-response to anti-VEGF may be due to clinical factors including suboptimal dosing than that required by a particular patient, increased dosing intervals, treatment initiation when disease is already at an advanced or chronic stage), cellular mechanisms, lesion type, genetic variation and potential tachyphylaxis); non-clinical factors including poor access to clinics or delayed appointments may also result in poor treatment outcomes. In eyes classified as good responders, treatment should be continued with the same agent when disease activity is present or reactivation occurs following temporary dose holding. In eyes that show partial response, treatment may be continued, although re-evaluation with further imaging may be required to exclude confounding factors. Where there is persistent, unchanging accumulated fluid following three consecutive injections at monthly intervals, treatment may be withheld temporarily, but recommenced with the same or alternative anti-VEGF if the fluid subsequently increases (lesion considered active). Poor or non-response to anti-VEGF treatments requires re-evaluation of diagnosis and if necessary switch to alternative therapies including other anti-VEGF agents and/or with photodynamic therapy (PDT). Idiopathic polypoidal choroidopathy may require treatment with PDT monotherapy or combination with anti-VEGF. A committee comprised of retinal specialists with experience of managing patients with n-AMD similar to that which developed the Royal College of Ophthalmologists Guidelines to Ranibizumab was assembled. Individual aspects of the guidelines were proposed by the committee lead (WMA) based on relevant reference to published evidence base following a search of Medline and circulated to all committee members for discussion before approval or modification. Each draft was modified according to feedback from committee members until unanimous approval was obtained in the final draft. A system for categorising the range of responsiveness of n-AMD lesions to anti-VEGF therapy is proposed. The proposal is based primarily on morphological criteria but functional criteria have been included. Recommendations have been made on when to consider discontinuation of therapy either because of success or futility. These guidelines should help clinical decision-making and may prevent over and/or undertreatment with anti-VEGF therapy.

Group Work as a Strategy to Improve the Effectiveness of the Learning Process

Report published in the Proceedings of the National Conference on "Education in the Information Society", Plovdiv, May, 2013

Whether social schema violations help or hurt creativity depends on need for structure

Although people and events that disconfirm observers' expectancies can increase their creativity, sometimes such social schema violations increase observers' rigidity of thought and undermine creative cognition. Here we examined whether individual differences in the extent to which people prefer structure and predictability determine whether social schema violations facilitate or hamper creativity. Participants in Study 1 formed impressions of a schema-inconsistent female mechanic (vs. a schema-consistent male mechanic). Following schema-inconsistent rather than -consistent information, participants low (high) in need for structure showed better (impeded) creative performance. Participants in Study 2 memorized a series of images in which individuals were placed on a schema-inconsistent (vs. consistent) background (e.g., an Eskimo on the desert vs. on a snowy landscape). Following schema-inconsistent imagery, participants low (high) in need for structure increased (decreased) divergent thinking. © 2014 by the Society for Personality and Social Psychology, Inc.

Double jeopardy:subordinates' worldviews and poor performance as predictors of abusive supervision

Purpose - To test a moderated mediation model where a positive relationship between subordinates’ perceptions of a dangerous world—the extent to which an individual views the world as a dangerous place—and supervisory abuse is mediated by their submission to authority figures, and that this relationship is heightened for more poorly performing employees. Design/Methodology/Approach - Data were obtained from 173 subordinates and 45 supervisors working in different private sector organizations in Pakistan. Findings - Our model was supported. It appears that subordinates’ dangerous worldviews are positively associated with their perceptions of abusive supervision and that this is because such views are likely to lead to greater submission to authority figures. But this is only for those employees who are performing more poorly. Implications - We highlight the possibility that individual differences (worldviews, attitudes to authority figures, and performance levels) may lead employees to become victims of abusive supervision. As such, our research informs organizations on how they may better support supervisors in managing effectively their subordinate relationships and, in particular, subordinate poor performance. Originality/Value - We add to recent work exploring subordinate-focused antecedents of abusive supervision, finding support for the salience of the previously untested constructs of individual worldviews, authoritarian submission, and individual job performance. In so doing we also extend research on dangerous worldviews into a new organizational setting. Finally, our research takes place within a new Pakistani context, adding to the burgeoning non-US based body of empirical work into the antecedents and consequences of abusive supervision.

The effects of Chinese painting appreciation education on the artistic achievement of junior high school students in Taiwan

For the Chinese, fine art is one of the most important items in human life. The goals of fine arts education enhance the student so that s/he can make reasonable judgments about work, gain knowledge of color and understand the process of designing environmental layouts. Related technique and creativity training are offered students in accordance with individual differences and social expectations.^ Traditionally, Taiwan's junior high school fine art program teaches mainly painting technique. The Ministry of Education in Taiwan determines the curriculum of junior high school fine art education. The purpose of this study was to determine the effects of teaching Chinese painting appreciation on the artistic achievements of junior high school students in Taiwan. The subjects were seventh grade students who had never learned Chinese painting before. Two classes were randomly chosen from each target school and were designated as the experimental or control group. Instruction in all groups was delivered by the researcher himself. At the end of the study, data about subjects' related knowledge, creative technique, and feeling toward Chinese painting were systematically collected and analyzed.^ The result of the study was that students in the experimental group were more motivated to learn Chinese painting than were the students in the control group. Students in the experimental group made better progress in the development of creative skill, had better critical ability, and demonstrated better performance in Chinese painting form, set up, stroke and color of related knowledge than did students in the control group. It was therefore concluded that Chinese painting appreciation education can promote better artistic achievement and that this approach should be used in other areas of art education. ^

The acculturation of middle income Hispanic households

Research on the consumer behavior of the Hispanic population has recently attracted the attention of marketing practitioners as well as researchers. This study's purpose was to develop a model and scales to examine the acculturation process of Hispanic consumers with income levels of $35,000 and above, and its effects on their consumer behavior. The proposed model defined acculturation as a bilinear and multidimensional change process, measuring consumers' selective change process in four dimensions: language preference, Hispanic identification, American identification, and familism. A national sample of 653 consumers was analyzed. The scales developed for testing the model showed good to high internal consistency and adequate concurrent validity. According to the results, consumers' contact with Hispanic and Anglo acculturation agents generates change or reinforces consumers' language preferences. Language preference fully mediates the effects of the agents on consumers' American identification and familism; however, the effects of the acculturation agents on Hispanic identification are only partially mediated by individuals' language preference change. It was proposed that the acculturation process would have an effect on consumers' brand loyalty, attitudes towards high quality and prestigious brands, purchase frequency, and savings allocation for their children. Given the lack of significant differences between Hispanic and Anglo consumers and among Hispanic generations, only savings allocation for children's future was studied intensively. According to these results, Hispanic consumers' savings for their children is affected by consumers' language preference through their ethnic identification and familism. No moderating effects were found for consumers' gender, age, and country of origin, suggesting that individual differences do not affect consumers' acculturation process. Additionally, the effects of familism were tested among ethnic groups. The results suggest not only that familism discriminates among Hispanic and Anglo consumers, but also is a significant predictor of consumers' brand loyalty, brand quality attitudes, and savings allocation. Three acculturation segments were obtained through cluster analysis: bicultural, high acculturation, and low acculturation groups, supporting the biculturalism proposition. ^

Relative importance of false positives in the selection process

This study investigated the role of contextual factors in personnel selection. Specifically, I explored if specific job factors such as the wage, training, available applicant pool and security concerns around a job, influenced personnel decisions. Additionally, I explored if the individual differences of decision makers played a role in how the previously mentioned job factors affected their decisions. A policy-capturing methodology was employed to determine the weight participants place on the job factors when selecting candidates for different jobs. Regression and correlational analyses were computed with the beta weights obtained from individual regression analyses. The results obtained from the two samples (student and general population) revealed that specific job characteristics did indeed influence personnel decisions. Participants were more concerned with making mistakes and thus less likely to accept candidates when selecting candidates for jobs having high salary and/or high training requirements.

Students of Haitian Descent in American Schools: Challenges and Issues

This paper examines the ways the reception of students of Haitian descent in this country has shaped their educational careers. Additionally, this paper explores the racial, cultural, and individual differences that need to be understood in order to help educators, parents, and students make their schooling a positive experience.

Attachment Theory Shaping Adult Development: Impact on Mentoring Experiences

Mentoring is increasingly used for career and psychosocial development. Very few studies that have investigated the role of individual differences in mentoring relationships have addressed the attachment styles of mentors and protégés. The purpose of this study is to find the connections between attachment styles, adult development, and mentoring experiences.

Time orientation in organizations: Polychronicity and multitasking

This dissertation consists of four studies examining two constructs related to time orientation in organizations: polychronicity and multitasking. The first study investigates the internal structure of polychronicity and its external correlates in a sample of undergraduate students (N = 732). Results converge to support a one-factor model and finds measures of polychronicity to be significantly related to extraversion, agreeableness, and openness to experience. The second study quantitatively reviews the existing research examining the relationship between polychronicity and the Big Five factors of personality. Results reveal a significant relationship between extraversion and openness to experience across studies. Studies three and four examine the usefulness of multitasking ability in the prediction of work related criteria using two organizational samples (N = 175 and 119, respectively). Multitasking ability demonstrated predictive validity, however the incremental validity over that of traditional predictors (i.e., cognitive ability and the Big Five factors of personality) was minimal. The relationships between multitasking ability, polychronicity, and other individual differences were also investigated. Polychronicity and multitasking ability proved to be distinct constructs demonstrating differential relationships with cognitive ability, personality, and performance. Results provided support for multitasking performance as a mediator in the relationship between multitasking ability and overall job performance. Additionally, polychronicity moderated the relationship between multitasking ability and both ratings of multitasking performance and overall job performance in Study four. Clarification of the factor structure of polychronicity and its correlates will facilitate future research in the time orientation literature. Results from two organizational samples point to work related measures of multitasking ability as a worthwhile tool for predicting the performance of job applicants.

The relationship between job structure, burnout, and coping methods among public school county bus drivers, bus aides, mechanics, and clerical workers

The purpose of this study was to examine the relationship between the structure of jobs and burnout, and to assess to what extent, if any this relationship was moderated by individual coping methods. This study was supported by the Karasek's (1998) Job Demand-Control-Support theory of work stress as well as Maslach and Leiter's (1993) theory of burnout. Coping was examined as a moderator based on the conceptualization of Lazarus and Folkman (1984). ^ Two overall overarching questions framed this study: (a) what is the relationship between job structure, as operationalized by job title, and burnout across different occupations in support services in a large municipal school district? and (b) To what extent do individual differences in coping methods moderate this relationship? ^ This study was a cross-sectional study of county public school bus drivers, bus aides, mechanics, and clerical workers (N = 253) at three bus depot locations within the same district using validated survey instruments for data collection. Hypotheses were tested using simultaneous regression analyses. ^ Findings indicated that there were statistically significant and relevant relationships among the variables of interest; job demands, job control, burnout, and ways of coping. There was a relationship between job title and physical job demands. There was no evidence to support a relationship between job title and psychological demands. Furthermore, there was a relationship between physical demands, emotional exhaustion and personal accomplishment; key indicators of burnout. ^ Results showed significant correlations between individual ways of coping as a moderator between job structure, operationalized by job title, and individual employee burnout adding empirical evidence to the occupational stress literature. Based on the findings, there are implications for theory, research, and practice. For theory and research, the findings suggest the importance of incorporating transactional models in the study of occupational stress. In the area of practice, the findings highlight the importance of enriching jobs, increasing job control, and providing individual-level training related to stress reduction.^

Work Creativity as a Dimension of Job Performance

To stay competitive, many employers are looking for creative and innovative employees to add value to their organization. However, current models of job performance overlook creative performance as an important criterion to measure in the workplace. The purpose of this dissertation is to conduct two separate but related studies on creative performance that aim to provide support that creative performance should be included in models of job performance, and ultimately included in performance evaluations in organizations. Study 1 is a meta-analysis on the relationship between creative performance and task performance, and the relationship between creative performance and organizational citizenship behavior (OCB). Overall, I found support for a medium to large corrected correlation for both the creative performance-task performance (ρ = .51) and creative performance-OCB (ρ = .49) relationships. Further, I also found that both rating-source and study location were significant moderators. Study 2 is a process model that includes creative performance alongside task performance and OCB as the outcome variables. I test a model in which both individual differences (specifically: conscientiousness, extraversion, proactive personality, and self-efficacy) and job characteristics (autonomy, feedback, and supervisor support) predict creative performance, task performance, and OCB through engagement as a mediator. In a sample of 299 employed individuals, I found that all the individual differences and job characteristics were positively correlated with all three performance criteria. I also looked at these relationships in a multiple regression framework and most of the individual differences and job characteristics still predicted the performance criteria. In the mediation analyses, I found support for engagement as a significant mediator of the individual differences-performance and job characteristics-performance relationships. Taken together, Study 1 and Study 2 support the notion that creative performance should be included in models of job performance. Implications for both researchers and practitioners alike are discussed.

The acculturation of middle income Hispanic households

Research on the consumer behavior of the Hispanic population has recently attracted the attention of marketing practitioners as well as researchers. This study's purpose was to develop a model and scales to examine the acculturation process of Hispanic consumers with income levels of $35,000 and above, and its effects on their consumer behavior. The proposed model defined acculturation as a bilinear and multidimensional change process, measuring consumers' selective change process in four dimensions: language preference, Hispanic identification, American identification, and familism. A national sample of 653 consumers was analyzed. The scales developed for testing the model showed good to high internal consistency and adequate concurrent validity. According to the results, consumers' contact with Hispanic and Anglo acculturation agents generates change or reinforces consumers' language preferences. Language preference fully mediates the effects of the agents on consumers' American identification and familism; however, the effects of the acculturation agents on Hispanic identification are only partially mediated by individuals' language preference change. It was proposed that the acculturation process would have an effect on consumers' brand loyalty, attitudes towards high quality and prestigious brands, purchase frequency, and savings allocation for their children. Given the lack of significant differences between Hispanic and Anglo consumers and among Hispanic generations, only savings allocation for children's future was studied intensively. According to these results, Hispanic consumers' savings for their children is affected by consumers' language preference through their ethnic identification and familism. No moderating effects were found for consumers' gender, age, and country of origin, suggesting that individual differences do not affect consumers' acculturation process. Additionally, the effects of familism were tested among ethnic groups. The results suggest not only that familism discriminates among Hispanic and Anglo consumers, but also is a significant predictor of consumers' brand loyalty, brand quality attitudes, and savings allocation. Three acculturation segments were obtained through cluster analysis: bicultural, high acculturation, and low acculturation groups, supporting the biculturalism proposition.

Preschooler’s Comprehension of Spatial Terms

This study aims to understand individual differences in preschooler’s early comprehension of spatial language. Spatial language is defined as terms describing location, direction, shape, dimension, features, orientation, and quantity (e.g location, shape). Spatial language is considered to be one of the important factors in the development of spatial reasoning in the preschool years (Pruden, Levine, & Huttenlocher, 2011). In recent years, research has shown spatial reasoning is an important predictor of successes in STEM (Science, Technology, Engineering, and Mathematics) fields (e.g. Shea, Lubinski & Benbow, 2001; Wai, Lubinksi &Benbow, 2009). The current study focuses on when children begin to comprehend spatial terms, while previous work has mainly focused on production of spatial language. Identifying when children begin to comprehend spatial terms could lead to a better understanding of how spatial reasoning develops. We use the Intermodal Preferential Looking paradigm (IPLP) to examine three-year-old children’s ability to map spatial terms to visual representations. Fourteen spatial terms were used to test these abilities (e.g. bottom, diamond, longer). For each test trial children were presented with two different stimuli simultaneously on the left and right sides of a television screen. A female voice prompted the child to find the target spatial relation (e.g. “can you find the boy pointing to the bottom of the window”; Figure 1). A Tobii X60 eye-tracker was used to record the child’s eye gaze for each trial. For each child the proportion of looking to the target image divided by their total looking during the trial was calculated; this served as the dependent variable. Proportions above .50 indicated that the child had correctly mapped the spatial term to the target image. Preliminary data shows that the number of words comprehended in the IPLP task is correlated to parental report of the child’s comprehension of spatial terms (r[14]=.500, p<.05).

Preschooler’s Comprehension of Spatial Terms

This study aims to understand individual differences in preschooler’s early comprehension of spatial language. Spatial language is defined as terms describing location, direction, shape, dimension, features, orientation, and quantity (e.g location, shape). Spatial language is considered to be one of the important factors in the development of spatial reasoning in the preschool years (Pruden, Levine, & Huttenlocher, 2011). In recent years, research has shown spatial reasoning is an important predictor of successes in STEM (Science, Technology, Engineering, and Mathematics) fields (e.g. Shea, Lubinski & Benbow, 2001; Wai, Lubinksi &Benbow, 2009). The current study focuses on when children begin to comprehend spatial terms, while previous work has mainly focused on production of spatial language. Identifying when children begin to comprehend spatial terms could lead to a better understanding of how spatial reasoning develops. We use the Intermodal Preferential Looking paradigm (IPLP) to examine three-year-old children’s ability to map spatial terms to visual representations. Fourteen spatial terms were used to test these abilities (e.g. bottom, diamond, longer). For each test trial children were presented with two different stimuli simultaneously on the left and right sides of a television screen. A female voice prompted the child to find the target spatial relation (e.g. “can you find the boy pointing to the bottom of the window”; Figure 1). A Tobii X60 eye-tracker was used to record the child’s eye gaze for each trial. For each child the proportion of looking to the target image divided by their total looking during the trial was calculated; this served as the dependent variable. Proportions above .50 indicated that the child had correctly mapped the spatial term to the target image. Preliminary data shows that the number of words comprehended in the IPLP task is correlated to parental report of the child’s comprehension of spatial terms (r[14]=.500, p<.05).