Family Environment Variables as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems, including school absenteeism, are common to many students worldwide, and frameworks to better understand these heterogeneous students include multiple classes or tiers of intertwined risk factors as well as interventions. Recent studies have thus examined risk factors at varying levels of absenteeism severity to demarcate distinctions among these tiers. Prior studies in this regard have focused more on demographic and academic variables and less on family environment risk factors that are endemic to this population. The present study utilized ensemble and classification and regression tree analysis to identify potential family environment risk factors among youth (i.e., children and adolescents) at different levels of school absenteeism severity (i.e., 1 + %, 3 + %, 5 + %, 10 + %). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 341 youth aged 5–17 years (M = 12.2; SD = 3.3) and their families from an outpatient therapy clinic (68.3%) and community (31.7%) setting, the latter from a family court and truancy diversion program cohort. Family environment risk factors tended to be more circumscribed and informative at higher levels of absenteeism, with greater diversity at lower levels. Higher levels of absenteeism appear more closely related to lower achievement orientation, active-recreational orientation, cohesion, and expressiveness, though several nuanced results were found as well. Absenteeism severity levels of 10–15% may be associated more with qualitative changes in family functioning. These data may support a Tier 2-Tier 3 distinction in this regard and may indicate the need for specific family-based intervention goals at higher levels of absenteeism severity

Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6–19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems

Cortical plasticity in response to median nerve trauma

Median nerve injuries in adults, repaired with nerve suture, lead to incomplete functional recovery despite improved surgical technique. This results in a reduction in quality of life, poorer working ability and a considerable expense for society. Misrouting of axons at the suture site connects regenerating axons to the wrong distal end organs. When distorted signals are conveyed to the dorsal root ganglia, spinal cord, thalamus and the somatosensory cortex, somatotopic maps at all levels become reorganised in a disorderly fashion. Children often regain full sensory function after median nerve injury and repair despite impaired conduction across the injured segment. There is growing evidence that cortical plasticity is the main mechanism behind the superior recovery seen in young patients, but the exact pattern of reorganisation and its impact on functional recovery are not fully understood. The general aim of this thesis was to investigate various aspects of cortical plasticity, in particular the response to median nerve injury. To this end we used two non-invasive brain imaging techniques, functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG). In Paper I we investigated the concept of audio-tactile interaction in a healthy population. We found an increased overlap between cortical activation areas (fMRI) in patients trained with coupled tactile and auditory stimuli indicating modulation of cortical plasticity induced by cross-modal training. In Paper II we studied ageand time-dependent effects on cortical activity patterns in patients with median nerve injury by correlating age at the time of injury and time passed since injury to sensory function, and cortical activation. We found a time-dependent decline in the size of the cortical activation area during stimulation of both the median and the ulnar nerve (fMRI). Furthermore, there was greater ipsilateral activation in the patient group than in a control group from a previous study. However, the results were not conclusive on this point because the stimulation paradigms differed between the two studies (event-related in the present and block paradigm in the previous study). Paper III was performed using MEG in order to further study cortical plasticity in patients with median nerve injury. We found decreased N1 and P1 amplitudes during stimulation of the injured median nerve, and an increase in these amplitudes during ulnar nerve stimulation. Paper IV was designed to reveal any possible differences in lateralisation of cortical activation after median nerve injury and to see if this was influenced by the stimulus paradigm used. By means of a laterality index (LI) the extent of contra- and ipsilateral activation was calculated. LI is decreased (more ipsilateral activation) in patients with a median nerve injury compared to controls. This means that median nerve injury causes a shift of activity from the contralateral to the ipsilateral SI. The type of stimulus paradigm (event-related or block) did not affect LI. Our findings add to the evolving knowledge of the cortical plasticity following median nerve injury

Identifying Youth at Risk for Problematic Absenteeism Using Nonparametric Modeling: The Impact of Youth Psychopathology and Family Environment Risk Factors

The best cutoff to differentiate problematic school absenteeism from nonproblematic school absenteeism has yet to be identified in the literature (Lyon & Cotler, 2007). Contemporary classification systems, including Multi-Tiered Systems of Support (MTSS), depend upon cutoffs to clearly define the various tiers (Jimerson, Burns, & VanDerHeyden, 2016). The current study aimed to inform the MTSS approach while also contributing to early identification, assessment, and intervention methods for those youth and families at the highest risk of problematic school absenteeism and its negative consequences. The current study identified subgroups of youth at the highest risk of problematic absenteeism, defined as equal to or greater than 1% of full days missed and equal to or greater than 10% of full school days missed cutoffs (Egger et al., 2003; NCES, 2016). Interactions among family environment and youth psychopathology risk factors were evaluated at each cutoff. Participants included 378 elementary, middle, and high school students and their families from clinic and community settings. The current study utilized nonparametric Classification and Regression Tree (CART) procedures via SPSS decision tree software. CART’s procedures are meant for generating hypotheses and not testing hypotheses (Markham, Young, & Doran, 2013). Therefore, hypotheses provided were based on the extensive literature base of problematic school absenteeism risk factors. Hypothesis one was that Family Environment Scale (FES) items addressing family conflict were expected to be the most important FES items to the model while independence items were expected to be the second most important. Hypothesis two was that Revised Children’s Anxiety and Depression Scale (RCADS) items addressing generalized anxiety were expected to be the most important RCADS items to the model while major depression items were expected to be the second most important. Post-hoc analyses were also conducted to explore additional cutoff scores (i.e.

Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1)

School attendance is an important foundational competency for children and adolescents, and school absenteeism has been linked to myriad short- and long-term negative consequences, even into adulthood. Many efforts have been made to conceptualize and address this population across various categories and dimensions of functioning and across multiple disciplines, resulting in both a rich literature base and a splintered view regarding this population. This article (Part 1 of 2) reviews and critiques key categorical and dimensional approaches to conceptualizing school attendance and school absenteeism, with an eye toward reconciling these approaches (Part 2 of 2) to develop a roadmap for preventative and intervention strategies, early warning systems and nimble response, global policy review, dissemination and implementation, and adaptations to future changes in education and technology. This article sets the stage for a discussion of a multidimensional, multi-tiered system of supports pyramid model as a heuristic framework for conceptualizing the manifold aspects of school attendance and school absenteeism

Grön lönsamhet i svenska fonder

Intresset för hållbarhet har ökat markant de senaste decennierna vilket tydligt kommer till uttryck i EU-direktiv samt andra insatser som syftar till att främja arbetet med de globala målen. Det ökade intresset sätter hög press på svenska företag som förväntas att kontinuerligt förbättra sin miljöprestanda. Den intressent som anses vara av betydande vikt för den gröna omställningen är investerarna, som med allokering av kapital avgör vilken typ av företagsstyrning som gynnas. Tidigare forskning har studerat sambanden mellan hållbarhetsfonder och dess lönsamhet utan att framgångsrikt konstatera ett kausalt samband mellan de två variablerna. Den tidigare forskningen har i många avseenden tillämpat en annan tidsaspekt samt en annan typ av data än vad denna studie har gjort. Denna studie syftar till att agera empiriskt underlag till den tidigare litteraturen genom att applicera ett kompletterande fokus på den svenska marknaden, i utvärderingen av sambandet svenska hållbarhetsfonder och dess lönsamhet. En kvantitativ metod med deduktiv ansats har valts för denna studie. Insamlad data om de svenska hållbarhetsfonderna analyserades genom regressionsanalyser i programmet Minitab, för möjligheten att studera potentiella samband mellan de svenska fondernas hållbarhetsbetyg och dess lönsamhet. För att säkerställa sambanden har även kontrollvariabler inkluderats i analysen, de valda kontrollvariablerna är fondålder, fondavgifter samt fondförmögenhet. Den teori som ligger till grund för studien är Corporate social responsibility (CSR), Socially responsible investing (SRI), Modern portföljteori och den effektiva marknadshypotesen. Samtliga teorier utgör grund för analys av resultaten. Studien lyckas påvisa signifikanta samband mellan variablerna hållbarhetsbetyg och lönsamhet, då samtliga p-värden för högt respektive lågt hållbarhetsbetyg understiger den valda signifikansnivån. Det indikerar att det finns ett positivt samband mellan dessa variabler för det urval och den tidsaspekten som samtliga fonder tillämpar inom ramen för studien. Studien bidrar till den tidigare forskningen genom att agera kompletterande underlag för utvärdering kring sambandet mellan hållbarhetsbetyg och lönsamhet.Sustainable investing plays a crucial role in the green transition that is taking place in our modern society. There is a notable interest among investors to allocate capital to investment objectives that promote economic, societal and environmental sustainability. One popular form of sustainable investing is through equity funds that use different methods to create portfolios consisting of green securities. Past research regarding the financial performance of sustainable funds in contrast to traditional funds have resulted in contradictory conclusions. This study is based on data proceeding from 147 funds from Morningstars database categorized as “Sweden”. A quantitative/deductive approach was applied using a multiple linear regression model. Variables such as Morningstar Sustainability Rating, Sharperatio, age, total fund asset value and annual fee was recorded for each fund in a software program in order to discover statistical relationships within the dataset. The results from our regression model were related to past research and the theoretical framework composed of SRI, CSR, modern portfolio theory and efficient market hypothesis. We found that there is a significant relationship between the funds financial performance and sustainability rating the last three years

Placental weight and mortality in premenopausal breast cancer by tumor characteristics

Placental weight may be regarded as an indirect marker of hormone exposures during pregnancy. There is epidemiological evidence that breast cancer mortality in premenopausal women increases with placental weight in the most recent pregnancy. We investigated if this association differs by tumor characteristics, including expression of estrogen and progesterone receptors. In a Swedish population-based cohort, we followed 1,067 women with premenopausal breast cancer diagnosed from 1992 to 2006. Using Cox regression models, we estimated hazard ratios for the association between placental weight and risk of premenopausal breast cancer mortality. In stratified analyses, we estimated mortality risks in subjects with different tumor stages, estrogen receptor (ER) or progesterone receptor (PR) status. Compared with women with placental weight less than 600 g, women with a placental weight between 600 and 699 g were at a 50 % increased risk of mortality, however, not significant change in risk was observed for women with placental weight �700 g. Mortality risks associated with higher placental weight were more pronounced among ER- and PR- breast cancer tumors, where both a placental weight 600-699 g and �700 g were associated with a more than doubled mortality risks compared with tumors among women with placental weight less than 600 g. Moreover, stratified analyses for joint receptor status revealed that a consistent increased mortality risk by placental weight was only apparent in women with ER-/PR- breast cancer. The increased mortality risk in premenopausal breast cancer associated with higher placental weight was most pronounced among ER- and PR- tumors. © 2012 Springer Science+Business Media New York

Risk and Mortality of Recurrent Breast Cancer in Stockholm 1985-2005

The purpose of this study was to estimate the risk and mortality of breast cancer recurrences in Swedish women, and to analyse changes over time and variations between patients in different risk groups. Such estimates are of key importance for modelling the cost-effectiveness of different strategies for adjuvant treatment of breast cancer. The study was based on all women diagnosed with breast cancer in Stockholm County between 1985 and 2005. Information about dates for locoregional recurrences, metastatic relapses, new contralateral tumours and death was collected. Cox proportional hazard and Weibull regression models were used to estimate survival functions, where year of diagnosis (dived into 5-year intervals), were included as explanatory variables in the models. The risk of recurrences has decreased during the last 20 years for all three types of recurrence; for metastatic relapse the 5-year risk was reduced from 12.9% to 6.0% from 1985-90 to 2000-2005 . Mortality has also been reduced, resulting in an increased 5-year survival from 52.6% to 64.1% after locoregional recurrence and from 10.4% to 15.5% for metastatic relapse. For contralateral tumours, with a 5-year survival rate of 74.6% in 1985-1990 and 78% 2000-2005, no significant increase was observed. Analysis of risk groups according to TNM classification showed large difference in the risk of metastatic breast cancer between the three defined groups, but small differences for the risk of locoregional recurrences and new contralateral tumours. The findings indicate that the early detection and new treatments have been successful in improving outcome for breast cancer patients and that it is important to use up-to-date information, when assessing the value of new treatment options.Breast cancer; Mortality; Survival; Recurrence; Sweden

Who should participate in clinical trials and who not? Can clinical trials be made more efficient and effective?

Clinical trials objectives Although it may seem self-evident, it is important when establishing a clinical trial that there is an important question to be answered. Once such a question has been posed and an appropriate design established to answer that question, all efforts should be made to enrol as many patients into the trial as expeditiously as possible. The design of the trial should support that aim. Eligibility criteria Eligibility criteria should not be too elaborate or complex. For example, in an adjuvant breast cancer trial, specific details of the exact handling of tumour margins, exact doses of radiation therapy or number of nodes dissected may not be particularly important in comparison with entering a wide variety of patients from the adjuvant setting. Broader entr

Defining Problematic School Absenteeism: Identifying Youth at Risk

Study 1: School attendance is an important foundational competency for children and adolescents, and school absenteeism has been linked to myriad short- and long-term negative consequences, even into adulthood. Many efforts have been made to conceptualize and address this population across various categories and dimensions of functioning and across multiple disciplines, resulting in both a rich literature base and a splintered view regarding this population. This article (Part 1 of 2) reviews and critiques key categorical and dimensional approaches to conceptualizing school attendance and school absenteeism, with an eye toward reconciling these approaches (Part 2 of 2) to develop a roadmap for preventative and intervention strategies, early warning systems and nimble response, global policy review, dissemination and implementation, and adaptations to future changes in education and technology. This article sets the stage for a discussion of a multidimensional, multi-tiered system of supports pyramid model as a heuristic framework for conceptualizing the manifold aspects of school attendance and school absenteeism. Study 2: School attendance problems, including school absenteeism, are common to many students worldwide, and frameworks to better understand these heterogeneous students include multiple classes or tiers of intertwined risk factors as well as interventions. Recent studies have iii thus examined risk factors at varying levels of absenteeism severity to demarcate distinctions among these tiers. Prior studies in this regard have focused more on demographic and academic variables and less on family environment risk factors that are endemic to this population. The present study utilized ensemble and classification and regression tree analysis to identify potential family environment risk factors among youth (i.e., children and adolescents) at different levels of school absenteeism severity (i.e., 1 + %, 3 + %, 5 + %, 10 + %). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 341 youth aged 5–17 years (M = 12.2; SD = 3.3) and their families from an outpatient therapy clinic (68.3%) and community (31.7%) setting, the latter from a family court and truancy diversion program cohort. Family environment risk factors tended to be more circumscribed and informative at higher levels of absenteeism, with greater diversity at lower levels. Higher levels of absenteeism appear more closely related to lower achievement orientation, active-recreational orientation, cohesion, and expressiveness, though several nuanced results were found as well. Absenteeism severity levels of 10–15% may be associated more with qualitative changes in family functioning. These data may support a Tier 2-Tier 3 distinction in this regard and may indicate the need for specific family-based intervention goals at higher levels of absenteeism severity. Study 3: School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The iv present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6–19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems