Predictors of discordance among Chilean families

Parent-youth agreement on parental behaviors can characterize effective parenting. Although discordance in families may be developmentally salient and harmful to youth outcomes, predictors of discordance have been understudied, and existing research in this field has been mostly limited to North American samples. This paper addressed this literature gap by using data from a community-based study of Chilean adolescents. Analysis was based on 1,068 adolescents in Santiago, Chile. The dependent variable was discordance which was measured by the difference between parent and youth’s assessment of parental monitoring. Major independent variables for this study were selected based on previous research findings that underscore youth’s developmental factors, positive parental and familial factors and demographic factors. Descriptive and multivariate analyses were conducted to examine the prevalence and associations between youth, parental and familial measures with parent-youth discordance. There was a sizable level of discordance between parent and youth’s report of parental monitoring. Youth’s gender and externalizing behavior were significant predictors of discordance. Warm parenting and family involvement were met with decreases in discordance. The negative interaction coefficients between parental warmth and youth’s gender indicated that positive parental and familial measures have a greater effect on reducing parent-youth discordance among male youths. Results support the significance of positive family interactions in healthy family dynamics. Findings from this study inform the importance of services and interventions for families that aim to reduce youth’s problem behavior and to create a warm and interactive family environment.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181713/Accepted manuscrip

Influence of bed elevation discordance on flow patterns and head losses in an open-channel confluence

Confluences play a major role in the dynamics of networks of natural and man-made open channels, and field measurements on river confluences reveal that discordance in bed elevation is common. Studies of schematized confluences with a step at the interface between the tributary and the main channel bed reveal that bed elevation discordance is an important additional control for the confluence hydrodynamics. This study aimed to improve understanding of the influence of bed elevation discordance on the flow patterns and head losses in a right-angled confluence of an open channel with rectangular cross-sections. A large eddy simulation (LES)-based numerical model was set up and validated with experiments by others. Four configurations with different bed discordance ratios were investigated. The results confirm that, with increasing bed elevation discordance, the tributary streamlines at the confluence interface deviate less from the geometrical confluence angle, the extent of the recirculation zone (RZ) gets smaller, the ratio of the water depth upstream to that downstream of the confluence decreases, and the water level depression reduces. The bed elevation discordance also leads to the development of a large-scale structure in the lee of the step. Despite the appearance of the large-scale structure, the reduced extent of the RZ and associated changes in flow deflection/contraction reduce total head losses experienced by the main channel with an increase of the bed discordance ratio. It turns out that bed elevation discordance converts the lateral momentum from the tributary to streamwise momentum in the main channel more efficiently. (C) 2019 Hohai University. Production and hosting by Elsevier B.V

Use of Estimating Equations for Dosing Antimicrobials in Patients with Acute Kidney Injury Not Receiving Renal Replacement Therapy.

Acute kidney injury (AKI) can potentially lead to the accumulation of antimicrobial drugs with significant renal clearance. Drug dosing adjustments are commonly made using the Cockcroft-Gault estimate of creatinine clearance (CLcr). The Modified Jelliffe equation is significantly better at estimating kidney function than the Cockcroft-Gault equation in the setting of AKI. The objective of this study is to assess the degree of antimicrobial dosing discordance using different glomerular filtration rate (GFR) estimating equations. This is a retrospective evaluation of antimicrobial dosing using different estimating equations for kidney function in AKI and comparison to Cockcroft-Gault estimation as a reference. Considering the Cockcroft-Gault estimate as the criterion standard, antimicrobials were appropriately adjusted at most 80.7% of the time. On average, kidney function changed by 30 mL/min over the course of an AKI episode. The median clearance at the peak serum creatinine was 27.4 (9.3⁻66.3) mL/min for Cockcroft Gault, 19.8 (9.8⁻47.0) mL/min/1.73 m² for MDRD and 20.5 (4.9⁻49.6) mL/min for the Modified Jelliffe equations. The discordance rate for antimicrobial dosing ranged from a minimum of 8.6% to a maximum of 16.4%. In the event of discordance, the dose administered was supra-therapeutic 100% of the time using the Modified Jelliffe equation. Use of estimating equations other than the Cockcroft Gault equation may significantly alter dosing of antimicrobials in AKI

Deriving consensus rankings via multicriteria decision making methodology

Purpose - This paper seeks to take a cautionary stance to the impact of the marketing mix on customer satisfaction, via a case study deriving consensus rankings for benchmarking on selected retail stores in Malaysia. Design/methodology/approach - The ELECTRE I model is used in deriving consensus rankings via multicriteria decision making method for benchmarking base on the marketing mix model 4P's. Descriptive analysis is used to analyze best practice among the four marketing tactics. Findings - Outranking methods in consequence constitute a strong base on which to found the entire structure of the behavioral theory of benchmarking applied to development of marketing strategy. Research limitations/implications - This study looks only at a limited part of the puzzle of how consumer satisfaction translates into behavioral outcomes. Practical implications - The study provides managers with guidance on how to generate a rough outline of potential marketing activities that can be used to take advantage of capabilities and convert weaknesses and threats. Originality/value - The paper interestingly portrays the effective usage of multicriteria decision-making and ranking method to help marketing managers predict their marketing trends

Transgender theory, queer measurements, cis gender : gender perception discordance and marital quality amongst cisgender couples

Conventionally, surveys measure gender by asking respondents to select whether they identify as a man or woman. While researchers once considered this unproblematic, recent insights from queer theory and transgender studies exemplify that: 1.) binary measurements are insufficient because they obscure variation within groups, and 2.) single measurements are incomplete because how one sees themselves may not align with how others see them. To interrogate the transgender/cisgender binary that undergirds these differential practices, I analyze survey data from 458 cisgender married same-sex and different-sex couples in which actors place themselves and their spouse on a gender typicality scale. First, I critically explore the differences between self-determined and spouse-determined gender, investigating the demographic characteristics that correlate with placement on the gender-typicality scale. Next, I examine whether disagreements in perceptions of gender-typicality between spouses are related to marital quality, with implications for health. I find that higher levels of discordance in gender perceptions correlate with lower levels of marital quality. Results suggest the need to measure gender beyond the binary to capture intimate relationship dynamics.Sociolog

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio