Active intravenous drug use during chronic hepatitis C therapy does not reduce sustained virological response rates in adherent patients

Reluctance has been expressed about treating chronic hepatitis C in active intravenous (IV) drug users (IDUs), and this is found in both international guidelines and routine clinical practice. However, the medical literature provides no evidence for an unequivocal treatment deferral of this risk group. We retrospectively analyzed the direct effect of IV drug use on treatment outcome in 500 chronic hepatitis C patients enrolled in the Swiss Hepatitis C Cohort Study. Patients were eligible for the study if they had their serum hepatitis C virus (HCV) RNA tested 6 months after the end of treatment and at least one visit during the antiviral therapy, documenting the drug use status. Five hundred patients fulfilled the inclusion criteria (199 were IDU and 301 controls). A minimum exposure to 80% of the scheduled cumulative dose of antivirals was reached in 66.0% of IDU and 60.5% of controls (P = NS). The overall sustained virological response (SVR) rate was 63.6%. Active IDU reached a SVR of 69.3%, statistically not significantly different from controls (59.8%). A multivariate analysis for treatment success showed no significant negative influence of active IV drug use. In conclusion, our study shows no relevant direct influence of IV drugs on the efficacy of anti-HCV therapy among adherent patients.

The Relationship Between Social Support and Self-Advocacy in College Students With Disabilities

This study explored the connection between social support and self-advocacy in college students with disabilities. The College Students with Disabilities Campus Climate Survey (Lombardi, Gerdes, & Murray, 2011) was used to gather data from undergraduate students at a midsize western private university. Social support was found to be a significant predictor of self-advocacy in college students with disabilities. Peer support, family support, and faculty teaching practices made up the construct of social support. Peer support and faculty teaching practices were found to be significant predictors of student self-advocacy. Family support was not found to be significant. The data was examined for group differences between genders, disability types, and disability status (high incidence disabilities versus low incidence disabilities). No significant group differences were found. These findings suggest helping students build social support will increase their level of self-advocacy, which in turn may increase academic success.

An examination of the dynamic relationship between self-efficacy and performance across levels of analysis and levels of specificity

This research used resource allocation theory to generate predictions regarding dynamic relationships between self-efficacy and task performance from 2 levels of analysis and specificity. Participants were given multiple trials of practice on an air traffic control task. Measures of task-specific self-efficacy and performance were taken at repeated intervals. The authors used multilevel analysis to demonstrate differential and dynamic effects. As predicted, task-specific self-efficacy was negatively associated with task performance at the within-person level. On the other hand, average levels of task-specific self-efficacy were positively related to performance at the between-persons level and mediated the effect of general self-efficacy. The key findings from this research relate to dynamic effects - these results show that self-efficacy effects can change over time, but it depends on the level of analysis and specificity at which self-efficacy is conceptualized. These novel findings emphasize the importance of conceptualizing self-efficacy within a multilevel and multispecificity framework and make a significant contribution to understanding the way this construct relates to task performance.

A study of the relationship between parental self-efficacy and indicators of school involvement exhibited by Hispanic parents of elementary school children

The purpose of this study was to examine the relationship between Hispanic parents' sense of self-efficacy at various degrees of acculturation to the United States and specific indicators of school involvement in their elementary school children's education. It assessed the effects of acculturation on the level of parental self-efficacy and their degree of school involvement. The theoretical framework guiding this investigation was Bandura's theory of self-efficacy which advocates that the amount of effort a person devotes to the accomplishment of a specific outcome is related to a person's beliefs in their capabilities regardless of actual competencies.^ The research method involved a correlational design measuring levels of parental self-efficacy, acculturation, degree of school involvement and related demographic characteristics. Multiple regression analysis was performed to determine the degree of relationships existing between the predictor variables of self-efficacy and level of acculturation, and level of school involvement. The data was subjected to a path analysis to test the validity of the causal model advanced in this study specifying a positive relationship between the constructs of acculturation, parental self-efficacy and level of school involvement.^ A total of 109 Hispanic parents of students enrolled in five elementary public schools in Dade County, Florida, were selected for participation in the study. Results revealed a significant positive correlation r =.23, p $<$.05 between level of parental self-efficacy and number of hours parents spent helping their children with homework. A statistically significant positive correlation was found between acculturation and level of self-efficacy r =.21, p $<$.05. Statistically significant positive correlations were also found between acculturation and such indicators of parental school involvement as participation in parent-teacher conferences r =.20, p $<$.05, volunteering at school, r =.22, p $<$.05, attendance at school sponsored sports activities r =.26, p $<$.01, and volunteering in field-trips r =.28, p $<$.01.^ The multiple regression analysis equation predicting level of homework assistance provided by parents and self-efficacy was statistically significant, F(2,106) = 3.59, p $<$.03. The beta weights revealed that self-efficacy contributed the most to the prediction of homework assistance by parents, B =.258, p $<$.009. In turn, the variable of acculturation was the most significant predictor of number of school based parent involvement activities, B =.281, p $<$.05 level. The path analysis confirmed the results obtained in the multiple regression analyses, establishing self-efficacy as having a direct effect on the level of homework assistance provided by parents. Conversely, the variable of acculturation had a direct effect on the number of school based parent involvement activities. ^

Personal and institutional factors: Relationship to self-efficacy of persistence to the senior year in college among self-identified Black undergraduate students in a Hispanic serving institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women's graduation rate is higher than men's; 58% compared to men's at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups' experiences in college, particularly in Hispanic serving institutions. Informed by Tinto's (1975, 1987, 1993) student academic and social integration model, Guiffrida's (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students' self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors' (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants' primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students' interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students' academic and social support.

Personal and Institutional Factors: Relationship to Self-Efficacy of Persistence to the Senior Year in College among Self-Identified Black Undergraduate Students in a Hispanic Serving Institution

While undergraduate enrollment of all racial groups in United States higher education institutions has increased, 6-year graduation rates of Blacks (39%) remain low compared to other races; Asians (69%), Whites (62%), and Hispanics (50%; NCES, 2010). Women’s graduation rate is higher than men’s; 58% compared to men’s at 53% in public institutions (IPEDS, 2011). Retention literature does not address the perceptions of Black ethnic groups’ experiences in college, particularly in Hispanic serving institutions. Informed by Tinto’s (1975, 1987, 1993) student academic and social integration model, Guiffrida’s (2003, 2004, 2005, 2006) model of relationships while at college, and ex-post facto research design, the study investigated personal and institutional factors that relate to Black students’ self-efficacy and persistence to the senior year in college. Data about Black ethnic undergraduate seniors’ (N = 236) academic and social experiences in college were collected using the Student Institutional Integration Survey (SIIS), an online questionnaire. Descriptive statistics were used to collect background information about the sample, correlation was calculated to indicate the degree of relationship between the variables, and multiple linear regressions were used to identify variables that are predictors of self-efficacy of persistence. Independent samples t-test and analyses of variance were computed to determine whether differences in perceptions of personal and institutional factors that relate to self-efficacy of persistence to the senior year in college could be identified between gender and ethnicity. Frequency was summarized to identify themes of participants’ primary motivation for finishing undergraduate degree programs. These themes were: (a) self-pride/personal goal, (b) professional aspiration/career (c) motivation to support family, (d) desire to have financial independence/better job, (e) to serve community, (f) opportunity to go to college, (g) being first-generation college student, and (h) prove to family the value of higher education. The research findings support the tenets of academic and social integration theories which suggest that students’ interaction with peer and faculty, relationships with family and friends, and involvement in institutional activities and organizations influence their persistence in college. Implications based on the findings affect institutional policy, curriculum, and program improvements that relate to Black undergraduate students’ academic and social support.

The Relationship Between Water Level, Prey Availability and Reproductive Success in Roseate Spoonbills Foraging in a Seasonally-Flooded Wetland While Nesting in Florida Bay

The coastal wetlands of northeastern Florida Bay are seasonally-inundated dwarf mangrove habitat and serve as a primary foraging ground for wading birds nesting in Florida Bay. A common paradigm in pulse-inundated wetlands is that prey base fishes increase in abundance while the wetland is flooded and then become highly concentrated in deeper water refuges as water levels recede, becoming highly available to wading birds whose nesting success depends on these concentrations. Although widely accepted, the relationship between water levels, prey availability and nesting success has rarely been quantified. I examine this paradigm using Roseate Spoonbills that nest on the islands in northeastern Florida Bay and forage on the mainland. Spoonbill nesting success and water levels on their foraging grounds have been monitored since 1987 and prey base fishes have been systematically sampled at as many as 10 known spoonbill foraging sites since 1990. Results demonstrated that the relationship between water level and prey abundance was not linear but rather there is likely a threshold, or series of thresholds, in water level that result in concentrated prey. Furthermore, the study indicates that spoonbills require water level-induced prey concentrations in order to have enough food available to successfully raise young.

Validation of the English version of the Scale for Psychosocial Factors in Food Allergy and the relationship with mental health, quality of life, and self-efficacy

Background. The Scale for Psychosocial Factors in Food Allergy (SPS-FA) is based on the biopsychosocial model of health and was developed and validated in Chile to measure the interaction between psychological variables and allergy symptoms in the child. We sought to validate this scale in an English speaking population and explore its relationship with parental quality of life, self-efficacy, and mental health. Methods. Parents (n = 434) from the general population in the UK, who had a child with a clinical diagnosis of food allergy, completed the SPS-FA and validated scales on food allergy specific parental quality of life (QoL), parental self-efficacy, and general mental health. Findings. The SPS-FA had good internal consistency (alphas = .61-.86). Higher scores on the SPS-FA significantly correlated with poorer parental QoL, self-efficacy, and mental health. All predictors explained 57% of the variance in SPS-FA scores with QoL as the biggest predictor (β = .52). Discussion. The SPS-FA is a valid scale for use in the UK and provides a holistic view of the impact of food allergy on the family. In conjunction with health-related QoL measures, it can be used by health care practitioners to target care for patients and evaluate psychological interventions for improvement of food allergy management.

Os Efeitos da Avaliação Psicológica em Crianças com Dificuldades de Aprendizagem

O presente estudo de caso agregado teve como objetivo primordial avaliar em que medida os recursos terapêuticos utilizados durante o tempo de avaliação psicodiagnóstica (psicométrica e projetiva) das crianças encaminhadas para o serviço de psicologia escolar, tem impacto positivo na criança em processo de avaliação, no duplo plano comportamental e cognitivo. O protocolo da investigação foi composto por: desenho de família, WISC-III e CAT, com recurso a algumas sessões de ludoterapia. Os meios utilizados no processo de avaliação permitiram a superação de algumas dificuldades apresentadas pelas crianças, tendo sido, muito particularmente, identificados os contributos que a psicanálise e a psicologia psicodinâmica podem oferecer à psicopedagogia. / The main objective of this aggregated case study was the assessment of the impact of psycho-diagnostic evaluation (psychometric and projective testing) on the improvement of the school-aged children oriented to the cabinet of psychology of their school. The research protocol included: family picture test, WISC -III and CAT, plus some play therapy sessions. Some of the children overcame part of the learning and behavioral difficulties after the evaluation period. Such a result proves, most particularly, the contributions of psychoanalysis and psychodynamic psychology to psycho-pedagogy.

Development of polymeric drug delivery vehicles for targeted cancer therapy

The aim of my Ph. D. thesis is to generalize a method for targeted anti-cancer drug delivery. Hydrophilic polymer-drug conjugates involve complicated synthesis; drug-encapsulated polymeric nanoparticles limit the loading capability of payloads. This thesis introduces the concept of nanoconjugates to overcome difficulties in synthesis and formulation. Drugs with hydroxyl group are able to initiate polyester synthesis in a regio- and chemo- selective way, with the mediation of ligand-tunable Zinc catalyst. Herein, three anti-cancer drugs are presented to demonstrate the high efficiency and selectivity in the method (Chapter 2-4). The obtained particles are stable in salt solution, releasing drugs over weeks in controlled manner. With the conjugation of aptamer, particles are capable to target prostate cancer cells in vitro. These results open the gateway to evaluate the in vivo efficacy of nanoconjugates for target cancer therapy (Chapter 5). Mechanism study of the polymerization leads to the discovery of chemosite selective synthesis of prodrugs with acrylate functional groups. Functional copolymer-drug conjugates will expand the scope of nanoconjugates (Chapter 6). Liposome-aptamer targeting drug delivery vehicle is well studied to achieve reversible cell-specific delivery of non-hydoxyl drugs e.g. cisplatin (Chapter 7). New monomers and polymerization mechanisms are explored for polyester in order to synthesize nanoconjugates with variety on properties (Chapter 8). Initial efforts to apply this type of prodrugs will be focused on the preparation of hydrogels for stem cell research (Chapter 9).

Effects of two teaching strategies on the relationship between nursing students’ self-efficacy and performance in BLS/AED

Purpose: Nurses and nursing students are often first responders to in-hospital cardiac arrest events; thus they are expected to perform Basic Life Support (BLS) and use an automated external defibrillator (AED) without delay. The aim of this study was to explore the relationship between nursing students’ self-efficacy and performance before and after receiving a particular training intervention in BLS/AED. Materials and methods: Explanatory correlational study. 177 nursing students received a 4-h training session in BLS/AED after being randomized to either a self-directed (SDG) or an instructor-directed teaching group (IDG).1 A validated self-efficacy scale, the Cardiff Test and Laerdal SkillReporter® software were used to assess students’ self-efficacy and performance in BLS/AED at pre-test, post-test and 3-month retention-test. Independent t-test analysis was performed to compare the differences between groups at pre-test. Pearson coefficient (r) was used to calculate the strength of the relationship between self-efficacy and performance in both groups at pre-test, post-test and retention-test. Results: Independent t-tests analysis showed that there were non-significant differences (p-values > 0.05) between groups for any of the variables measured. At pre-test, results showed that correlation between self-efficacy and performance was moderate for the IDG (r = 0.53; p < 0.05) and the SDG (r = 0.49; p < 0.05). At post-test, correlation between self-efficacy and performance was much higher for the SDG (r = 0.81; p < 0.05) than for the IDG (r = 0.32; p < 0.05), which in fact was weaker than at pre-test. Finally, it was found that whereas the correlation between self-efficacy and performance increased from the post-test to the retention-test to almost reach baseline levels for the ILG (r = 0.52; p < 0.05), it slightly decreased in this phase for the SDG (r = 0.77; p < 0.05). Conclusion: Student-directed strategies may be more effective than instructor-directed strategies at promoting self-assessment and, therefore, may help to improve and maintain the relationship between nursing student self-efficacy and actual ability to perform BLS/AED.

Application of the self-efficacy model in nursing practice [自我效能模式於護理臨床應用之剖析]

Self-efficacy has two cognitive components, efficacy expectations and outcome expectations, and their influence on behavior change is synergistic. Efficacy expectation is effected by four main sources of information provided by direct and indirect experiences. The four sources of information are performance accomplishments, vicarious experience, verbal persuasion and self-appraisal. How to measure and develop interventions is an important issue at present. This article clearly analyzes the relationship between variables of the self-efficacy model and explains the implementation of self-efficacy enhancing interventions and instruments in order to test the model. Through the process of the use of theory and feasibility in clinical practice, it is expected that professional medical care personnel should firstly familiarize themselves with the self-efficiency model and concept, and then flexibly promote it in professional fields clinical practice, chronic disease care and health promotion.

社会发展与中国人人格变迁——控制测验理论与工具的变异后不同时期的中国人人格差异研究

In non-western society，researches on social development and personality change focused on economic development and social modernization. The present study is aimed at exploring the relationship between the social transformation and personality changes of Chinese people by using so-called indigenous personality measurement of CPAI (Chinese Personality Assessment Inventory). Meanwhile, the influence of CPAI measurement itself and measurement theory were also taken into consideration. In study 1, two sets of CPAI data collected in a 10 year interval were analyzed. At the same time, the CPAI-2 data was analyzed in terms of modernization level of various cities from which the data were collected. However, this study didn’t consider the importance of “equivalence” of the measurement, CPAI. In study 2, we detected DIF (Differential item functioning) across the different period groups to confirm if CPAI was equal to people in different period. In this process, both CTT and IRT method were used. The outcome reminded us that there were some DIF items. In study 3, to make sure that the personality measurement is fair to people in different period, we only saved those items whose DIF effect size lower than 0.01, and used IRT method to estimate test-taker’s personality. Then, cohort analysis was used to explore the pattern of personality change of Chinese people. In study 4, we factor-analyzed the DIF items to find the relation between social transformation and the latent personality variable which were composed of DIF items. From these 4 studies, we could got the following conclusions: (1) The CPAI 22 traits could be divided into two categories, with the changing of age, period and cohort, type I traits didn’t change, they were Logical vs Affective Orientation, Enterprise, Responsibility, Inferiority vs Self-Acceptance, Optimism vs Pessimism, Face, Family, Defensive, Graciousness vs Meanness; While with the changing of age, period and cohort, type II traits changed, they were Leadership, Self vs. Social Orientation, Veraciousness vs Slickness, Traditionalism vs Modernity, Harmony, Renqing, Meticulousness, Extraversion vs Introversion, Emotionality, Practical Mindedness, Internal vs External Locus of Control, Thrift vs Extravagance, Discipline. Meanwhile DIF items measured 5 psychologycial characteristics which changed greatly with the changing of age, period and cohort, they were Life attitude of Cynicism-realism, Psychological maladjustment, Coping style of Waiyuanneifang, Self-efficacy, the value of Individualism. (2) In sum, Chinese people in 1992 were more traditional than those in 2001, and with the 10-year of rapid development, according to the market economy’s needs, Chinese people became more individualism. (3) The DIF method of CTT and IRT were comparable. But, in generally, IRT method was more accurate and valid in detecting DIF as were as estimating personality. (4) The DIF outcomes showed that CPAI had good item validity. Meanwhile, it’s possible to develop a subscale by using CPAI items to assess some psychological characteristics. In this current study, according to their stability and variability, we could divided personality traits and psychological characteristics into 3 categories, and the outcome supported the hypothesis of “Six Factor Model”, these foundings were of some theoretic meanings. Meanwhile, as the relation between social development and personality change being explored, it certain help Chinese people cope with the rapid changing society. In this study, we also found that it’s possible to develop a subscale by using CPAI items to assess obverse personality traits and it had some practical use. Furthermore, the use of different measurement theory and cohort analysis embodied some innovation in methodology.

A physical activity intervention in a workplace setting

Physical inactivity poses a huge burden on Canada's health care system and is detrimental to the health of Canadians (Katzmarzyk & Janssen, 2004). Walking is a viable option for individuals to become physically active on a daily basis and is in fact the most commonly reported leisure time physical activity. It has been associated with many health benefits including weight loss/weight control, reduced risk of coronary artery disease and diabetes, lowered blood pressure, and improved psychological wellbeing (Brisson & Tudor-Locke, 2004). Specifically, individuals' stage of change, selfefficacy and health related quality of life (HRQL) are three psychological constructs that can be greatly improved with increased physical activity (Dishman, 1991; Penedo & Dahn, 2005; Poag & McAuley, 1992). Public health physical activity recommendations exist but many individuals find these difficult to meet due to overly busy lifestyles (Public Health Agency of Canada, 2003). Pedometers are inexpensive devices that can monitor individual bouts of walking so that the incorporation of physical activity into one's daily life is more plausible. They are also excellent tools for motivation, goalsetting, and immediate feedback (Brisson & Tudor-Locke, 2004). Since many people spend a large proportion of their time at their places of employment, workplaces have begun to be a common site for the development of physical activity interventions. These programs have been growing in popUlarity and have shown numerous benefits for both employees and employers (Voit, 2001). The purpose of the current study was to implement and evaluate the use of a pedometer-based physical activity intervention incorporating goal-setting and physical activity logs in a workplace setting, and to examine the relationship between different types of self-efficacy (task, barrier, and scheduling) and different phases of the intervention. Twenty male participants from a local steel manufacturing plant who exhibited health risk factors (e.g. hypertension, diabetes, etc.) were assigned to one of two groups (group A or group B). All participants were asked to wear pedometers on their waists, record their daily steps, set goals that were outlined on a step-tracking sheet (detennined by their baseline number of steps), and keep track of their work days, wakelbed time, sedentary time, and time spent doing other physical activity. Group A began the intervention immediately following the baseline measures, whereas group B continued with their regular routine for 4 weeks before beginning. Physiological measures (height, weight, blood pressure, relative body fat, waist and hip circumference, and body mass index) were taken and a battery of questionnaires that assessed barrier, task and scheduling self-efficacy, HRQL, and stage of change administered at baseline, week 5 (end of intervention for group A), week 9 (end of intervention for group B; follow-up for group A) and week 13 (follow-up for both groups). Results showed that this workplace physical activity intervention was successful at increasing the participants' daily steps, that task self-efficacy is a significant predictor of participants' exercise adherence during the initial stages of participation (intervention phase), and that the participants felt that this intervention was effective. Finally, further exploratory analyses showed that this intervention was effective for all participants, but most valuable for participants most in need of improvement - that is, those who were most sedentary prior to the intervention. This intervention is an inexpensive use of simple and effective tools (e.g. pedometers), has the potential to attract a wide variety of participants and become a pennanent part of any health promotion initiative.