Trajectories of Self-Efficacy, Depressed Mood, and Anxiety From Admission to Spinal Cord Injury Rehabilitation to 1 Year After Discharge

OBJECTIVE: Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories. DESIGN: Longitudinal inception cohort study. SETTING: Eight specialized SCI rehabilitation centers. PARTICIPANTS: The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: SE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. RESULTS: Three trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. CONCLUSIONS: In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems

Enhancing our conceptual understanding of state and trait self-efficacy by correlational analysis of four self-efficacy scales in people with spinal cord injury

BACKGROUND: Self-efficacy is an important determinant of adjustment following spinal cord injury. Self-efficacy is defined as the belief that one can successfully execute behavior required to produce the desired outcomes. In its original conceptualization, self-efficacy refers to the confidence that people have in their ability to accomplish specific tasks and behaviors within a specific context. Over the years these situation specific aspects have been unconfined and multiple constructs of self-efficacy have been proposed. The most common is a division in trait and state self-efficacy. Another used division that is utilized is between general, domain-specific and task-specific self-efficacy. The scientific support for these constructs is to date still unclear. The objective of this study was to enhance the understanding of the self-efficacy construct by comparing four self-efficacy scales designed to measure three aspects of self-efficacy (general versus domain-specific versus task-specific) in people with spinal cord injury. METHODS: Dutch and Australian adults with spinal cord injury (N = 140) completed four frequently used self-efficacy scales; the Moorong Self-efficacy Scale, General Self-efficacy Scale, University of Washington Self-efficacy Scale and a Self-care Self-efficacy Scale approximately 6 months after their inpatient rehabilitation. Pearson correlations examined inter-relationships between the scales. RESULTS: Hypothesized strong correlations between scales measuring similar aspects of self-efficacy were found (correlations 0.50-0.65). However, the hypothesized weak to moderate correlations between scales measuring diverging aspects of self-efficacy were only partly found (correlations 0.31-0.74), with 7 out of 12 correlations being strong instead of moderate. CONCLUSIONS: The expected distinctions between the three aspects of self-efficacy was not demonstrated. All four scales measure a common latent construct, most likely general self-efficacy aspects. Further research is necessary to find ways to improve the measurement of domain-specific and task-specific aspects of SE, so that they are sensitive enough to capture change over time, and thus enhance clinical outcomes of people with SCI as they adjust to their disability

Stochastic model to assess bioeconomic impact of PRRS on pig farms in Costa Rica

Despite the economic importance of PRRS and its high prevalence in Costa Rica, there are no studies on the bioeconomic impact of the disease in the country or, even, in Central America. Such studies are essential in finding cost-effective preventive measures tailored for different production circumstances. Therefore, the objective of this study was to evaluate economic and production parameters of a PRRSV-infection for a medium-sized farrow-to-finish pig farm system in Costa Rica with a farm-level stochastic Monte Carlo simulation model. The effect of PRRS was assessed by scenario analysis, in which a baseline PRRS-free situation was compared against three alternative scenarios that assumed low, medium and high PRRS effects. The PRRS effects were based on data from local farms, scientific literature and expert opinion. Sensitivity analyses were performed to assess the impact of key input parameters on output variables. Results show that at the animal level, changes between the baseline and the PRRS-high scenario were estimated as: + 25 d in age to slaughter, - 9.9 pigs to slaughter (per breeding sow/yr), + 6% annual replacement rate, - 255 d in sow productive lifetime, - 6.9 mo in age at culling of sows, and + 24 non- productive days. For a medium size local farm (n = 588 sows), a reduction of 5826 fat pigs to slaughter per farm/yr from baseline compared to PRRS-high scenario was observed. PRRS-induced loss per farm per year was estimated at -US $142,542, US$180,109 and -US $524,719 for PRRS-low, medium and high scenarios, respectively. Revenues/costs ratio changed from 1.12 in the baseline to 0.89 in the PRRS-high scenario. The production cost per kg carcass weight increased from US$2.63 for the baseline to US $3.35 in the PRRS-high scenario. PRRS-induced loss was estimated at US$77.1 per slaughtered pig/yr and US $892 per breeding sow/yr for the PRRS-high scenario. Results from the model indicate that pig farms with medium to high prevalence of PRRS will require optimal market conditions in order to have positive economic outcomes. These results can be helpful in the design of better control strategies for PRRS

Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury:A Longitudinal Cohort Study

Objective: To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI). Design: Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge. Setting: Three rehabilitation centers and the participant's home environment. Participants: Participants (N= 47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay >4wk). Mean age was 54.5 +/- 12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge. Interventions: Not applicable. Main Outcome Measures: Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying). Results: Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, -94 to -35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116 +/- 59 min/d and mean SB was 665 +/- 121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA. Conclusions: At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB. (C) 2020 by the American Congress of Rehabilitation Medicin

Self-Efficacy Predicts Personal and Family Adjustment Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others:A Dyadic Approach

Objectives: To investigate whether the combination of self-efficacy levels of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others, measured shortly after the start of inpatient rehabilitation, predict their personal and family adjustment 6 months after inpatient discharge. Design: Prospective longitudinal study. Setting: Twelve Dutch rehabilitation centers. Participants: Volunteer sample consisting of dyads (N=157) of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. Interventions: Not applicable. Main Outcome Measures: Self-efficacy (General Competence Scale) and personal and family adjustment (Hospital Anxiety and Depression Scale and McMaster Family Assessment Device General Functioning). Results: In 20 dyads, both individuals with SCI or ABI and their significant others showed low self-efficacy at baseline. In 67 dyads, both showed high self-efficacy. In the low-self-efficacy dyads, 61% of the individuals with SCI or ABI and 50% of the significant others showed symptoms of anxiety 6 months after discharge, vs 23% and 30%, respectively, in the high-self-efficacy dyads. In the low-self-efficacy dyads, 56% of individuals with SCI or ABI and 50% of the significant others reported symptoms of depression, vs 20% and 27%, respectively, in the high-self-efficacy dyads. Problematic family functioning was reported by 53% of the individuals with SCI or ABI and 42% of the significant others in the low-self-efficacy dyads, vs 4% and 12%, respectively, in the high-self-efficacy dyads. Multivariate analysis of variance analyses showed that the combination of levels of self-efficacy of individuals with SCI or ABI and their significant others at the start of inpatient rehabilitation predict personal (V=0.12; F-6,F-302=2.8; P=.010) and family adjustment (V=0.19; F-6,F-252=4.3; P Conclusions: Low-self-efficacy dyads appear to be more at risk for personal and family adjustment problems after discharge. Screening for self-efficacy may help healthcare professionals to identify and support families at risk for long-term adjustment problems. (C) 2020 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc

Associations Between Self-Efficacy and Secondary Health Conditions in People Living With Spinal Cord Injury:A Systematic Review and Meta-Analysis

Objective: To describe the association between self-efficacy and secondary health conditions (SHCs) in people living with spinal cord injury (SCI). Data Sources: PubMed, EMBASE, the Cochrane Library, and CINAHL were systematically searched from database inception to September 2016. Study Selection: Studies describing patients living with SCI in which self-efficacy was measured by a standardized questionnaire and an association was made with somatic or psychological SHCs. Data Extraction: An independent extraction by multiple observers was performed based on the Strengthening the Reporting of Observational Studies in Epidemiology statements checklist. A meta-analysis concerning the association between self-efficacy and SHCs in people with SCI was performed if a minimum of 4 comparable studies were available. Data Synthesis: Of 670 unique articles screened, 22 met the inclusion criteria. Seven of these 22 studies investigated associations between self-efficacy and somatic SHCs. Only a trend toward an association between higher self-efficacy and less pain, fatigue, number of SHCs, and limitations caused by SHCs was found. Twenty-one studies described the association between self-efficacy and psychological SHCs. All correlations of higher self-efficacy with fewer depressive (18 studies) and anxiety symptoms (7 studies) were significant, and meta-analysis showed a strong negative correlation of .536 (.584 to.484) and .493 (.577 to .399), respectively. A small number of studies (2) showed a trend toward a positive correlation between self-efficacy and quality of life. Conclusions: Self-efficacy is negatively associated with depressive and anxiety symptoms in SCI. Therefore, self-efficacy seems an important target in the rehabilitation of patients living with SCI. More research is necessary to clarify the associations between self-efficacy and somatic SHCs. Future research should also focus on different types of self-efficacy and their association with SHCs

Application of Global Positioning System and questionnaires data for the study of driver behavior on two-lane rural roads

This paper is a preprint of a paper accepted by IET Intelligent Transport Systems and is subject to Institution of Engineering and Technology Copyright. When the final version is published, the copy of record will be available at IET Digital LibraryMethodologies based on naturalistic observation provide the most accurate data for studying drivers' behaviour. This study presents a new methodology to obtain naturalistic data related to drivers' behaviour in a road segment. It is based on the combination of using global positioning system data and drivers' questionnaires. The continuous speed profiles along a road segment and the characteristics of drivers, of their trips and the type of their vehicles can be obtained for a great amount of drivers. It has already been successfully used for several studies, such as the development of models to estimate operating speed profile in two-lane rural road segments; or the characterisation of driving styles. These operating speed models have been the key for the development of a new geometric design consistency model, allowing an easier road safety evaluation. Besides, knowledge on the human factors that influence speed choice may be useful for road safety media campaigns and education programs designers, and also for the improvement of intelligent driver assistance systems.The authors thank 'Centre for Studies and Experimentation of Public Works (CEDEX)' of the 'Spanish Ministry of Public Works' that partially subsidizes the research. We also wish to thank to the 'General Directorate of Public Works, Urban Projects and Housing' of the 'Infrastructure, Territory and Environment Department' of the 'Valencian Government', to the 'Valencian Provincial Council' and to the 'General Directorate of Traffic' of the 'Ministry of the Interior' for their cooperation in field data gathering.Pérez Zuriaga, AM.; Camacho Torregrosa, FJ.; Campoy Ungria, JM.; García García, A. (2013). Application of Global Positioning System and questionnaires data for the study of driver behavior on two-lane rural roads. IET Intelligent Transport Systems. 7(2):182-189. doi:10.1049/iet-its.2012.0151S18218972Fourie, M., Walton, D., & Thomas, J. A. (2011). Naturalistic observation of drivers’ hands, speed and headway. Transportation Research Part F: Traffic Psychology and Behaviour, 14(5), 413-421. doi:10.1016/j.trf.2011.04.009Gibreel, G. M., Easa, S. M., & El-Dimeery, I. A. (2001). Prediction of Operating Speed on Three-Dimensional Highway Alignments. Journal of Transportation Engineering, 127(1), 21-30. doi:10.1061/(asce)0733-947x(2001)127:1(21)Fitzpatrick, K., & Collins, J. M. (2000). Speed-Profile Model for Two-Lane Rural Highways. Transportation Research Record: Journal of the Transportation Research Board, 1737(1), 42-49. doi:10.3141/1737-06Bella, F. (2008). Driving simulator for speed research on two-lane rural roads. Accident Analysis & Prevention, 40(3), 1078-1087. doi:10.1016/j.aap.2007.10.015Van Nes, N., Houtenbos, M., & Van Schagen, I. (2008). Improving speed behaviour: the potential of in-car speed assistance and speed limit credibility. IET Intelligent Transport Systems, 2(4), 323. doi:10.1049/iet-its:20080036Warner, H. W., & Åberg, L. (2006). Drivers’ decision to speed: A study inspired by the theory of planned behavior. Transportation Research Part F: Traffic Psychology and Behaviour, 9(6), 427-433. doi:10.1016/j.trf.2006.03.004Goldenbeld, C., & van Schagen, I. (2007). The credibility of speed limits on 80km/h rural roads: The effects of road and person(ality) characteristics. Accident Analysis & Prevention, 39(6), 1121-1130. doi:10.1016/j.aap.2007.02.012Zuriaga, A. M. P., García, A. G., Torregrosa, F. J. C., & D’Attoma, P. (2010). Modeling Operating Speed and Deceleration on Two-Lane Rural Roads with Global Positioning System Data. Transportation Research Record: Journal of the Transportation Research Board, 2171(1), 11-20. doi:10.3141/2171-02Ottesen, J. L., & Krammes, R. A. (2000). Speed-Profile Model for a Design-Consistency Evaluation Procedure in the United States. Transportation Research Record: Journal of the Transportation Research Board, 1701(1), 76-85. doi:10.3141/1701-10Park, P. Y., Miranda-Moreno, L. F., & Saccomanno, F. F. (2010). Estimation of speed differentials on rural highways using hierarchical linear regression models. Canadian Journal of Civil Engineering, 37(4), 624-637. doi:10.1139/l10-002Wasielewski, P. (1984). Speed as a measure of driver risk: Observed speeds versus driver and vehicle characteristics. Accident Analysis & Prevention, 16(2), 89-103. doi:10.1016/0001-4575(84)90034-4Williams, A. F., Kyrychenko, S. Y., & Retting, R. A. (2006). Characteristics of speeders. Journal of Safety Research, 37(3), 227-232. doi:10.1016/j.jsr.2006.04.001Lajunen, T., Karola, J., & Summala, H. (1997). Speed and Acceleration as Measures of Driving Style in Young Male Drivers. Perceptual and Motor Skills, 85(1), 3-16. doi:10.2466/pms.1997.85.1.3Af Wåhlberg, A. E. (2006). Speed choice versus celeration behavior as traffic accident predictor. Journal of Safety Research, 37(1), 43-51. doi:10.1016/j.jsr.2005.10.01

Use of probiotics in preventing antibiotic associated diarrhoea and Clostridium difficile associated diarrhoea in spinal injury centres: An international survey of four western European countries

Probiotics may prevent antibiotic-associatedand Clostridium difficile-associated- diarrhoea (AAD/CDAD). Many spinal cord injury centres (SCICs) practitioners consider probiotics generically and may not realise that efficacy can be strain-, dose-, and disease-specific. One to four SCICs per country (depending on population size) were contacted (UK:4; the Netherlands:3; Belgium: I; Republic of Ireland: 1) to (a) determine if they stocked probiotics; (b) determine whether the use of those probiotics was evidence-based; and (c) document their C. difficile infection (CDI) practices. All nine SCICs responded to the survey (7 physicians, 3 microbiologists, 1 nurse and 2 dietitians). Five (55.5%) stocked probiotics; five different probiotics were identified. Four probiotics were preferred choice prevention o f AAD/CDAD were Lactobacillus casei Shirota (44.4%), L. casei D N -114001 (22.2%), L. acidophilus (22.2%) and a mixed-strains probiotic (Ecologic Pro-AD) (11.1%). Only one evidence base study was identified supporting the use of probiotic for prevention of AAD in SCI patients. Mean CDI cases per 10,000 patient-days were 0.307 (s.d: 0.486, range 0.00 to 1.08). Definitions of diarrhoea and CDI varied among SCICs. Stocking probiotics for the prevention of AAD / CDAD is not common. There is only one single study showing efficiency of a particular strain in SCI populations. The study highlighted the importance of using a standardised definition o f diarrhoea when conducting AAD/CDAD research