Evaluating the Relationship between Preadmission Assessment Examination Scores and First-time NCLEX-RN Success

The relationship between preadmission assessment composite and reading scores and first-time National Council Licensure Examination for Registered Nurses (NCLEX-RN) success was evaluated in this study. Following an extensive literature review, the researcher hypothesized that students who score at or above the national average on the Test of Essential Academic Skills (TEAS) composite score and/or reading score are more likely to be successful on the first attempt of the NCLEX-RN examination. Utilizing archived student records from a rural community college in western North Carolina, a convenience sample of 59 graduates from May 2012 and 2013 was used. Findings of this study revealed there is significant positive correlation between TEAS preadmission assessment composite and reading scores and first-time NCLEX-RN success. Based on the results of this study, nursing programs can evaluate their admission criteria as well as remediation policies in an attempt to increase retention and first-time NCLEX-RN success

The Role of Parenting Practices in Adolescent Aggression and Impulsivity

Parents have an influential role in adolescent development. Previous findings have found a relationship between parenting practices and adolescent behavioral problems. The purpose of this study was to analyze different parenting practices’ influence on impulsive and aggressive behaviors in adolescents. This study uses data gathered from a unique population of at-risk adolescents from a military-style bootcamp who were asked about their parents’ behaviors and their own behaviors. Findings from this study expand upon previous research on parenting practices by analyzing a specific population of at-risk youth and looking at specific forms of impulsive and aggressive behaviors. Data was collected through computerized questionnaires at the adolescents’ residential facility. A total of 173 adolescents, consisting of 146 males and 27 females (63.8% Caucasian, 25.9% African American, 9.8% Other race/ethnicity), completed questionnaires asking about their upbringing when living at home and their display of aggressive and impulsive behaviors. The results found that positive parenting practices (e.g., parental involvement) were associated with fewer aggressive and impulsive behaviors. In contrast, negative parenting practices (e.g., inconsistent discipline) were correlated with more aggressive and impulsive behaviors. The results of this study could be used to promote healthier parenting practices for the betterment of adolescent development and parent-child relationships

Statistical Methods for Modeling Count Data with Overdispersion and Missing Time Varying Categorical Covariates

In studying the association between count outcomes and covariates using Poisson regression, the necessary requirement that the mean and variance of responses are equivalent for each covariate pattern is not always met in real datasets. This violation of equidispersion can lead to invalid inference unless proper alternative models are considered. There is currently no comprehensive and definitive assessment of the different methods of dealing with overdispersion, nor is there a standard approach for determining the threshold of overdispersion such that statistical intervention is necessary. The issue of overdispersion can be further complicated by the presence of missing covariate data in count outcome models. In this dissertation we have (1) compared the performance of different statistical models for dealing with overdispersion, (2) determined an appropriate threshold of the ratio of the Pearson chi-squared goodness of fit statistic to degrees of freedom σp such that statistical intervention is necessary to address the overdispersion, (3) developed a latent transition multiple imputation (LTMI) approach for dealing with missing time varying categorical covariates in count outcome models, and (4) compared the performance of LTMI with complete case analysis (CCA) and latent class multiple imputation (LCMI) in addressing missing time varying categorical covariates in the presence of overdispersion. Latent class assignment was determined via both SAS software and random effect modeling, and missing observation imputation was performed using predictive mean matching multiple imputation methods. We utilized extensive simulation studies to assess the performance of the proposed methods on a variety of overdispersion and missingness scenarios. We further demonstrated the application of the proposed models and methods via real data examples. We conclude that the negative binomial generalized linear mixed model (NB-GLMM) is superior overall for modeling count data characterized by overdispersion. Furthermore, a general threshold for relying on the simple Poisson model for cross-sectional and longitudinal datasets is in cases where σp \u3c=1.2. LTMI methods outperform CCA and LCMI in many scenarios, particularly when there is a higher percentage of missingness and data are MAR. Lastly, NBGLMM is preferable to address overdispersion while LTMI is preferable for imputing covariate observations when jointly considering both issues

The representation of tabooed love in Lillian Smith\u27s fiction

My study explores Lillian Smith\u27s autobiographical relationship to her fiction, particularly two novels, Strange Fruit, and One Hour. The focus of this work is Smith\u27s challenge to the category of sexual orientation and her related use of fiction as a source of social commentary and self-reflection. Smith\u27s uses veiled and encoded language and other kinds of tabooed love to study her own lesbian love. She also assumes a male persona to understand and express her erotic attraction to women. I approach Smith\u27s life and literature in chronological order with an emphasis upon characterization, symbolism, narrative technique, and metaphors of nature. My fictional interpretations are supported by excerpts from Smith\u27s letters and essays

Value Co-creation in Buy Online Pickup In-store (BOPIS)

The purpose of this study is to identify consumer attitudes toward buy online pickup in-store (BOPIS). This study examines how value perceptions change as consumers progress in the online ordering and physical pickup processes within the BOPIS channel. We use a multivariate regression and two separate multiple regression analyses to examine the differential effects of multiple constructs on BOPIS customer satisfaction. As consumers start the process by engaging with the retailer online, perceived usefulness and hedonic value online play a critical role in customer satisfaction. Consumer attitudes change as they pick up their order at the store where the degree of ease and hedonic pickup in collecting their products increases in importance in customer satisfaction. Furthermore, the study findings suggest a halo-effect for trust on BOPIS customer satisfaction. As BOPIS continues to expand into various industries, understanding the complexity of consumer value will be of importance to improve the omni-channel experience

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis

Background: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing.Objectives: To evaluate the diagnostic accuracy and cost-effectiveness of PlGF-based tests for patients referred to secondary care with suspected PE in weeks 20–37 of pregnancy.Design: Systematic reviews and an economic analysis.Data sources: Bibliographic databases including MEDLINE, EMBASE, Web of Science and The Cochrane Library and Database of Abstracts of Reviews of Effects were searched up to July 2015 for English-language references. Conferences, websites, systematic reviews and confidential company submissions were also accessed.Review methods: Systematic reviews of test accuracy and economic studies were conducted to inform an economic analysis. Test accuracy studies were required to include women with suspected PE and report quantitatively the accuracy of PlGF-based tests; their risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria. The economic studies review had broad eligibility criteria to capture any types of economic analysis; critical appraisal employed standard checklists consistent with National Institute for Health and Care Excellence criteria. Study selection, critical appraisal and data extraction in both reviews were performed by two reviewers.Economic analysis: An independent economic analysis was conducted based on a decision tree model, using the best evidence available. The model evaluates costs (2014, GBP) from a NHS and Personal Social Services perspective. Given the short analysis time horizon, no discounting was undertaken.Results: Four studies were included in the systematic review of test accuracy: two on Alere’s Triage® PlGF test (Alere, Inc., San Diego, CA, USA) for predicting PE requiring delivery within a specified time and two on Roche Diagnostics’ Elecsys® sFlt-1 to PlGF ratio test (Roche Diagnostics GmbH, Mannheim, Germany) for predicting PE within a specified time. Three studies were included in the systematic review of economic studies, and two confidential company economic analyses were assessed separately. Study heterogeneity precluded meta-analyses of test accuracy or cost-analysis outcomes, so narrative syntheses were conductedto inform the independent economic model. The model predicts that, when supplementing routine clinical assessment for rule-out and rule-in of PE, the two tests would be cost-saving in weeks 20–35 of gestation, and marginally cost-saving in weeks 35–37, but with minuscule impact on quality of life. Length of neonatal intensive care unit stay was the most influential parameter in sensitivity analyses. All othersensitivity analyses had negligible effects on results.Limitations: No head-to-head comparisons of the tests were identified. No studies investigated accuracy of PlGF-based tests when used as a replacement for proteinuria testing. Test accuracy studies were found to be at high risk of clinical review bias.Conclusions: The Triage and Elecsys tests would save money if added to routine clinical assessment for PE. The magnitude of savings is uncertain, but the tests remain cost-saving under worst-case assumptions. Further research is required to clarify how the test results would be interpreted and applied in clinical practice.Study registration: This study is registered as PROSPERO CRD42015017670.Funding: The National Institute for Health Research Health Technology Assessment programme

Biomechanical properties of bone in a mouse model of Rett syndrome

Rett syndrome (RTT) is an X-linked genetic disorder and a major cause of intellectual disability in girls. Mutations in the methyl-CpG binding protein 2 (<i>MECP2</i>) gene are the primary cause of the disorder. Despite the dominant neurological phenotypes, <i>MECP2</i> is expressed ubiquitously throughout the body and a number of peripheral phenotypes such as scoliosis, reduced bone mineral density and skeletal fractures are also common and important clinical features of the disorder. In order to explore whether MeCP2 protein deficiency results in altered structural and functional properties of bone and to test the potential reversibility of any defects, we have conducted a series of histological, imaging and biomechanical tests of bone in a functional knockout mouse model of RTT. Both hemizygous <i>Mecp2</i><sup>stop/y</sup> male mice in which <i>Mecp2</i> is silenced in all cells and female <i>Mecp2</i><sup>stop/+</sup> mice in which <i>Mecp2</i> is silenced in ~ 50% of cells as a consequence of random X-chromosome inactivation, revealed significant reductions in cortical bone stiffness, microhardness and tensile modulus. Microstructural analysis also revealed alterations in both cortical and cancellous femoral bone between wild-type and MeCP2-deficient mice. Furthermore, unsilencing of <i>Mecp2</i> in adult mice cre-mediated stop cassette deletion resulted in a restoration of biomechanical properties (stiffness, microhardness) towards wild-type levels. These results show that MeCP2-deficiency results in overt, but potentially reversible, alterations in the biomechanical integrity of bone and highlights the importance of targeting skeletal phenotypes in considering the development of pharmacological and gene-based therapies