896 research outputs found
Development of an Index of Socio-Emotional Competence for Preschool Children in the Growing Up in New Zealand Study
Growing international recognition of the importance of socio-emotional competence has led to calls to understand the prevalence and development of such competence in young children. However, socio-emotional competence is a multifaceted concept and hence difficult to track. The present research describes the processes we used to develop an index of socio-emotional competence in preschool children taking part in the Growing Up in New Zealand (GUiNZ) study. We draw on data collected from 6,156 children when they were 9 months, 2 years and 4.5 years of age. Twenty-six variables from seven measures were found to provide conceptual coverage of socio-emotional competence and had adequate discriminatory power and internal consistency. Our final sample consisted of 4,839 participants who had adequate data on the variables of interest. Exploratory factor analysis led to the emergence of three dimensions: easy-going, regulation, and exuberance. Multiple methods of weighting (equal, empirical, and time-based) were used to calculate the index, which resulted in eight possible index versions. The index with equally weighted variables (including observations scores) and dimension scores, and time weighted scores of socio-emotional competence at each data collection wave, was found to be the most empirically sound. Both categorical and continuous index scores were calculated to allow for variety of later analytical usage. Our findings may be of interest to policy-makers and clinicians who could use this knowledge to better understand the trajectories of development of socio-emotional competence, and factors associated with any derived patterns and change. This may also help identify children at risk of poor socio-emotional development as early as possible, which may be of interest to those looking to mitigate the risk of poor socio-emotional development
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Patterns of Exposure to Cumulative Risk Through Age 2 and Associations with Problem Behaviors at Age 4.5: Evidence from Growing Up in New Zealand.
Exposure to cumulative risk (CR) has important implications for child development, yet little is known about how frequency, persistence, and timing of CR exposure during early childhood predict behavioral problems already before school start. We examine prospective longitudinal associations between patterns of CR exposure from third trimester through 2 years and subsequent behavior problems at 4.5 years. In 6156 diverse children in the Growing Up in New Zealand longitudinal study, the presence of 12 risk factors, spanning maternal health, social status, and home and neighborhood environment, defined CR and were assessed at last trimester and 9 months and 2 years of age. At child age 4.5 years, mothers completed the Strengths and Difficulties Questionnaire, where a score ≥ 16 indicated an abnormal level of problem behaviors (ALPB). Children exposed to a CR ≥ 1 at least once in early development, compared to those with consistent CR = 0, showed a significantly higher likelihood of ALPB at 4.5 years. Consistent high exposure to CR ≥ 4 across all three assessments had the highest prevalence (44%) of ALPB at age 4.5. Children with high CR exposure on two of three, compared to on all three, time points in early development did not evidence a significantly reduced prevalence (32%-41%) of ALPB. The common co-occurrence of risk factors and their significant developmental impact when accumulated early in life underscore the need for systematic multisector intervention and policy implementation during pregnancy and shortly after birth to improve outcomes for vulnerable children
The impact of statistical adjustment on economic profiles of interventional cardiologists
AbstractOBJECTIVESThe objective of this study was to identify preprocedure patient factors associated with percutaneous intervention costs and to examine the impact of these patient factors on economic profiles of interventional cardiologists.BACKGROUNDThere is increasing demand for information about comparative resource use patterns of interventional cardiologists. Economic provider profiles, however, often fail to account for patient characteristics.METHODSData were obtained from Duke Medical Center cost and clinical information systems for 1,949 procedures performed by 13 providers between July 1, 1997, and December 31, 1998. Patient factors that influenced cost were identified using multiple regression analysis. After assessing interprovider variation in unadjusted cost, mixed linear models were used to examine how much cost variability was associated with the provider when patient characteristics were taken into account.RESULTSTotal hospital costs averaged 13,809), $6,515 of which represented catheterization laboratory costs. Disease severity, acuity, comorbid illness and lesion type influenced total costs (R2= 38%), whereas catheterization costs were affected by lesion type and acuity (R2= 32%). Patient characteristics varied significantly among providers. Unadjusted total costs were weakly associated with provider, and this association disappeared after accounting for patient factors. The provider influence on catheterization costs persisted after adjusting for patient characteristics. Furthermore, the pattern of variation changed: the adjusted analysis identified three new outliers, and two providers lost their outlier status. Only one provider was consistently identified as an outlier in the unadjusted and adjusted analyses.CONCLUSIONSEconomic profiles of interventional cardiologists may be misleading if they do not adequately adjust for patient characteristics before procedure
Exogenous leukemia inhibitory factor (LIF) attenuates retinal vascularization reducing cell proliferation not apoptosis
To study the effect of leukemia inhibitory factor (LIF) on rat retinal vascular development, Sprague–Dawley rats at postnatal age 3 days (p3) were given intraperitoneal (IP) LIF and analysis performed at p6 (p3/6). p7 rats were given intravitreous (IV) LIF and analysis performed at p9 (p7/9). Control animals were PBS injected. At the time of analysis retinal flatmounts were prepared and stained with Griffonia lectin and activated caspase-3. The retinal peripheral avascular area was measured and number of apoptotic cells counted. In vitro, human retinal microvascular endothelial cells (RMVECs) were cultured in media containing LIF, with and without neutralizing antibody to LIF. Cells were stained with activated caspase-3 and apoptotic cells counted. Proliferation was measured by counting cell numbers, and cell cycle stage was determined using propidium iodide staining and FACS analysis. LIF injected either IP or IV had no effect on body weight or total retina area, but significantly increased the peripheral retinal avascular area. In both IP and IV injected groups there was no difference in the number of apoptotic cells between PBS-or LIF-injected groups; although in the p7/9 retinas, both injected groups had significantly more apoptotic cells than the non-injected group. In vitro, there was no effect of LIF on RMVEC apoptosis; however, cell counts were significantly lower in the LIF-treated group. Antibody to LIF restored the cell counts to untreated levels. LIF reduced the number of cells in S phase. LIF attenuates retinal vascular development in vivo through growth arrest, and not apoptosis, of endothelial cells
Potential for cost savings in high cost coronary bypass surgery patients: A New York State analysis
920-52 Are Provider Profiles Affected by Risk-adjustment Methodology? Results from the Cooperative Cardiovascular Project
Health care payors and consumers have a growing interest in risk-adjusted provider profiles. Using chart-abstracted clinical data from the Cooperative Cardiovascular Project, we ranked 28 hospitals performing bypass surgery in Alabama and Iowa by their risk-adjusted surgical mortality rates using three published risk-adjustment methodologies: Parsonnet (PI, O’Connor (a) and Hannan (H). In total. 3653 bypass surgery cases performed from 6/92 to 3/93 were reviewed (mean 130 cases/hospital). The discriminatory abilities of each method for predicting surgical mortality were quite similar (area under ROC curves 0.72–0.75). Below, we display the risk-adjusted hospital rankings (comparing observed with expected mortality) by these three riskadjustment techniques:In terms of hospital rankings, there was generally close correlation between any two of the methods (Spearman's R=0.87,0.88, and 0.93, comparing P-O, P-H, and H-O). Rankings for an individual hospital varied, however, an average of ±3.3 ranks (range 0–12 ranks) depending on which riskadjustment methodology was used.ConclusionIn general. published methods of risk-adjustment for bypass surgery accurately identify institutions with low, moderate and high adjusted mortality outcomes. The precise ranking of an individual hospital. however, may vary depending on the risk adjustment method applied
The Effects of Nicotine in the Neonatal Quinpirole Rodent Model of Psychosis: Neural Plasticity Mechanisms and Nicotinic Receptor Changes
Neonatal quinpirole (NQ) treatment to rats increases dopamine D2 receptor sensitivity persistent throughout the animal’s lifetime. In Experiment 1, we analyzed the role of α7 and α4β2 nicotinic receptors (nAChRs) in nicotine behavioral sensitization and on the brain-derived neurotrophic factor (BDNF) response to nicotine in NQ- and neonatally saline (NS)-treated rats. In Experiment 2, we analyzed changes in α7 and α4β2 nAChR density in the nucleus accumbens (NAcc) and dorsal striatum in NQ and NS animals sensitized to nicotine. Male and female Sprague-Dawley rats were neonatally treated with quinpirole (1 mg/kg) or saline from postnatal days (P)1–21. Animals were given ip injections of either saline or nicotine (0.5 mg/kg free base) every second day from P33 to P49 and tested on behavioral sensitization. Before each injection, animals were ip administered the α7 nAChR antagonist methyllycaconitine (MLA; 2 or 4 mg/kg) or the α4β2 nAChR antagonist dihydro beta erythroidine (DhβE; 1 or 3 mg/kg).
Results revealed NQ enhanced nicotine sensitization that was blocked by DhβE. MLA blocked the enhanced nicotine sensitization in NQ animals, but did not block nicotine sensitization. NQ enhanced the NAcc BDNF response to nicotine which was blocked by both antagonists. In Experiment 2, NQ enhanced nicotine sensitization and enhanced α4β2, but not 7, nAChR upregulation in the NAcc. These results suggest a relationship between accumbal BDNF and α4β2 nAChRs and their role in the behavioral response to nicotine in the NQ model which has relevance to schizophrenia, a behavioral disorder with high rates of tobacco smoking
The Ionized Gas and Nuclear Environment in NGC 3783 V. Variability and Modeling of the Intrinsic Ultraviolet Absorption
We present results on the location, physical conditions, and geometry of the
outflow in the Seyfert 1 galaxy NGC 3783 from a study of the variable intrinsic
UV absorption. Based on 18 observations with HST/STIS and 6 observations with
FUSE, we find: 1) The absorption from the lowest-ionization species in each of
the three strong kinematic components varied inversely with the continuum flux,
indicating the ionization structure responded to changes in the photoionizing
flux over the weekly timescales sampled by our observations. 2) A multi-
component model with an unocculted NLR and separate BLR and continuum
line-of-sight covering factors predicts saturation in several lines, consistent
with the lack of observed variability. 3) Column densities for the individual
metastable levels are measured from the resolved C III *1175 absorption complex
observed in one component. Based on our computed metastable level populations,
the electron density of this absorber is ~3x10^4 cm^-3. Photoionization
modeling results place it at ~25 pc from the central source. 4) Using
time-dependent calculations, we are able to reproduce the detailed variability
observed in this absorber, and derive upper limits on the distances for the
other components of 25-50 pc. 5) The ionization parameters derived for the
higher ionization UV absorbers are consistent with the modeling results for the
lowest-ionization X-ray component, but with smaller total column density. They
have similar pressures as the three X-ray ionization components. These results
are consistent with an inhomogeneous wind model for the outflow in NGC 3783. 6)
Based on the predicted emission-line luminosities, global covering factor
constraints, and distances derived for the UV absorbers, they may be identified
with emission- line gas observed in the inner NLR of AGNs. (abridged)Comment: 30 pages, 18 figures (7 color), emulateapj, accepted for publication
in The Astrophysical Journa
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