A validity study of the reasons for life scale with emerging adult college students

Thesis (Ph.D.) University of Alaska Fairbanks, 2014This study examined the validity of the Reasons for Life Scale (RFLS) with emerging adult college students. The RFLS measures "reasons for life." It was developed for use with Alaska Native youth as a way to assess potential risk of suicide without directly questioning about suicidal ideation or history of suicide attempts. This study sought to adapt the RFLS for use with emerging adult (age 18-25) college students, and to examine its factor structure and convergent validity with this population. First, a focus group was conducted to assist in rewording two Alaska Native-specific items from the RFLS for non-Natives. Then, with the additional items from the focus group, the revised version of the RFLS (RFLS-R) and other suicide-related measures were administered to a sample of 116 emerging adult college students. Exploratory factor analysis indicated a unidimensional factor structure for the RFLS-R with this sample. The RFLS-R showed a significant and strong correlation with the Reasons for Living Inventory (RLI; r = .70), which, like the RFLS-R, measures reasons for living but makes direct reference to suicide. There also were significant moderate negative correlations with the Suicidal Behavior Questionnaire - Revised (SBQ-R; r = -.36) and the Adult Suicidal Ideation Questionnaire (ASIQ; r = -.29). There was a significant moderate correlation between the RFLSR and a measure of socially desirable responding, the Balanced Inventory of Desirable Responding (BIDR; r = .31), with similar correlations found between the BIDR and other suicide-related measures included in this study. The results suggest that socially desirable responding did not strongly affect participants' responding or explain the associations found among the measures. The high correlation with the RLI suggests that the RFLS-R measures a similar construct, providing evidence of convergent validity; however, the RLI was more highly correlated with measures of suicidality than the RFLS-R -- suggesting that while the RFLS was moderately associated with measures of suicidality, it is a weaker predictor of suicide risk than the RLI. Although the RFLS-R was not as highly correlated with measures of suicidality as the RLI, which directly mentions suicide, the RFLS-R is the only known suicide measure that completely avoids items and instructions that mention suicide, therefore it may be useful in contexts where directly discussing suicide is not acceptable or appropriate.Introduction -- Chapter 1 Literature Review -- 1.1 Suicide -- 1.11 Suicide in Alaska -- 1.12 Suicidality among emerging adult college students -- 1.13 Resilience and suicide risk -- 1.2 Reasons for Living Inventory -- 1.21 Brief Reasons for Living Inventory -- 1.22 College and adolescent versions of the RLI -- 1.221 Brief Reasons for Living Inventory for Adolescents -- 1.222 Reasons for Living Inventory for Adolescents -- 1.223 College Student Reasons for Living Inventory -- 1.224 Reasons for Living Inventory for Young Adults -- 1.23 Cultural Factors and the RLI -- 1.3 Reasons for Life Scale -- 1.4 Current Study -- Chapter 2 Study 1: Method -- 2.1 Participants -- 2.2 Procedure -- 2.3 Results -- Appendices -- Chapter 3 Study 2: Method -- 3.1 Participants -- 3.2 Procedure -- 3.3 Measures -- 3.31 Reasons for living -- 3.32 Reasons for life -- 3.33 Socially desirable response patterns -- 3.34 Suicidal ideation -- 3.35 Suicidal behavior -- 3.4 Statistical analyses -- 3.41 Data preparation -- 3.42 Factor structure of the RFLS-R -- 3.43 Sample size with EFA -- 3.44 Convergent validity -- 3.45 Mediation analyses -- Appendices -- Chapter 4 Results -- 4.1 Internal Structure of the RFLS-R -- 4.11 Sample suitability for factor analysis -- 4.12 Exploratory factor analysis -- 4.2 Convergent Validity -- 4.3 Mediation Analyses -- Chapter 5 Discussion -- 5.1 Functioning of Reworded RFLS Items -- 5.2 Factor Structure of the RFLS-R -- 5.3 Convergent Validity of the Reasons for Life Scale: Revised (RFLS-R) -- 5.31 Relationship with reasons for living -- 5.32 Relationship with suicide measures -- 5.33 Impact of socially desirable responding -- 5.4 Conclusions and Limitations -- References

Analysis of Risk Factors for Fatal Rocky Mountain Spotted Fever: Evidence for Superiority of Tetracyclines for Therapy

Epidemiologic and clinical characteristics of fatal and nonfatal cases of Rocky Mountain spotted fever (RMSF) were compared to identify risk factors for death caused by this disease. Confirmed and probable RMSF cases reported through US national surveillance for 1981- 1998 were analyzed. Among 6388 RMSF patients, 213 died (annual case-fatality rate, 3M; range, 4.9 % in 1982 to 1.1 % in 1996). Use of tetracycline-class antibiotics for treatment of RMSF increased significantly in the 1990s, compared with use in the 1980s. Older patients, patients treated with chloramphenicol only, patients for whom tetracycline antibiotics were not the primary therapy, and patients for whom treatment was delayed ≥5 days after the onset of symptoms were at higher risk for death. Although the case-fatality rate was lower in the 1990s than in the 1980s, risk factors for fatal RMSF were similar. Despite the availability of effective antibiotics, RMSF-related deaths continue to occur because of delayed diagnosis and failure to use appropriate therapy

Analysis of Risk Factors for Fatal Rocky Mountain Spotted Fever: Evidence for Superiority of Tetracyclines for Therapy

Epidemiologic and clinical characteristics of fatal and nonfatal cases of Rocky Mountain spotted fever (RMSF) were compared to identify risk factors for death caused by this disease. Confirmed and probable RMSF cases reported through US national surveillance for 1981- 1998 were analyzed. Among 6388 RMSF patients, 213 died (annual case-fatality rate, 3M; range, 4.9 % in 1982 to 1.1 % in 1996). Use of tetracycline-class antibiotics for treatment of RMSF increased significantly in the 1990s, compared with use in the 1980s. Older patients, patients treated with chloramphenicol only, patients for whom tetracycline antibiotics were not the primary therapy, and patients for whom treatment was delayed ≥5 days after the onset of symptoms were at higher risk for death. Although the case-fatality rate was lower in the 1990s than in the 1980s, risk factors for fatal RMSF were similar. Despite the availability of effective antibiotics, RMSF-related deaths continue to occur because of delayed diagnosis and failure to use appropriate therapy

Household Transmission of Rotavirus in a Community with Rotavirus Vaccination in Quininde, Ecuador

Background: We studied the transmission of rotavirus infection in households in peri-urban Ecuador in the vaccination era. Methods: Stool samples were collected from household contacts of child rotavirus cases, diarrhea controls and healthy controls following presentation of the index child to health facilities. Rotavirus infection status of contacts was determined by RT-qPCR. We examined factors associated with transmissibility (index-case characteristics) and susceptibility (householdcontact characteristics). Results: Amongst cases, diarrhea controls and healthy control household contacts, infection attack rates (iAR) were 55%, 8% and 2%, (n = 137, 130, 137) respectively. iARs were higher from index cases with vomiting, and amongst siblings. Disease ARs were higher when the index child was ,18 months and had vomiting, with household contact ,10 years and those sharing a room with the index case being more susceptible. We found no evidence of asymptomatic infections leading to disease transmission. Conclusion: Transmission rates of rotavirus are high in households with an infected child, while background infections are rare. We have identified factors associated with transmission (vomiting/young age of index case) and susceptibility (young age/sharing a room/being a sibling of the index case). Vaccination may lead to indirect benefits by averting episodes or reducing symptoms in vaccinees

Skunk and Raccoon Rabies in the Eastern United States: Temporal and Spatial Analysis

Since 1981, an epizootic of raccoon rabies has spread throughout the eastern United States. A concomitant increase in reported rabies cases in skunks has raised concerns that an independent maintenance cycle of rabies virus in skunks could become established, affecting current strategies of wildlife rabies control programs. Rabies surveillance data from 1981 through 2000 obtained from the health departments of 11 eastern states were used to analyze temporal and spatial characteristics of rabies epizootics in each species. Spatial analysis indicated that epizootics in raccoons and skunks moved in a similar direction from 1990 to 2000. Temporal regression analysis showed that the number of rabid raccoons predicted the number of rabid skunks through time, with a 1-month lag. In areas where the raccoon rabies virus variant is enzootic, spatio-temporal analysis does not provide evidence that this rabies virus variant is currently cycling independently among skunks

Spectrum of Infection and Risk Factors for Human Monkeypox, United States, 2003

Infection is associated with proximity to virus-infected animals and their excretions and secretions

Decline in Diarrhea Mortality and Admissions after Routine Childhood Rotavirus Immunization in Brazil: A Time-Series Analysis

A time series analysis by Manish Patel and colleagues shows that the introduction of rotavirus vaccination in Brazil is associated with reduced diarrhea-related deaths and hospital admissions in children under 5 years of age

Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

Contains fulltext : 96770.pdf (publisher's version ) (Open Access)BACKGROUND: Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies showed inconsistent results for these vaccines because of lack of consensus on the impact. We aimed to investigate which factors had a major impact on cost-effectiveness and were primarily responsible for the large differences in previously estimated cost-effectiveness ratios. METHODS: Based on updated data on health outcomes and cost estimates, we re-assessed the cost-effectiveness of routine paediatric rotavirus vaccination within the National Immunization Program for the Netherlands. Two consensus meetings were organised with national and international experts in the field to achieve consensus and resolve potential controversies. RESULTS: It was estimated that rotavirus vaccination in the Netherlands could avert 34,214 cases of rotavirus gastroenteritis in children aged less than 5 years. Notably, 2,779 hospitalisations were averted of which 315 were extensions of existing hospital stays due to nosocomial rotavirus infection. With a threshold varying from 20K euro - 50K euro per QALY and according to the base-case scenario, the full vaccination costs per child leading to cost-effectiveness was euro 57.76 -euro 77.71. Results were sensitive to the inclusion of potential vaccine induced herd protection, QALY losses and number of deaths associated with rotavirus gastroenteritis. CONCLUSIONS: Our economic analysis indicates that inclusion of rotavirus vaccination in the Dutch National Immunization Program might be cost-effective depending on the cost of the vaccine and the impact of rotavirus gastroenteritis on children's quality of life