Multiple Hierarchical Linear Regression Analysis Research Articles

The added value of frailty assessment as the premorbid stroke status on activities of daily living in patients with acute stroke, stratified by stroke severity

BackgroundThe modified Rankin scale (mRS) is extensively used for premorbid evaluation in patients with stroke; however, its limited capacity to assess functional status highlights the need for additional indicators such as frailty. AimsThis study aimed to assess the impact of the premorbid mRS score and frailty on daily living (ADL) activities at hospital discharge, focusing on varying stroke severities. MethodsThis single-centre, prospective cohort study included patients with acute stroke aged ≥60 years. Key metrics included the frailty index for frailty assessment or mRS for functional status premorbid and the functional independence measure of the motor domain (FIM-M) at discharge for ADL outcomes. The patients were categorized into mild (0–4), moderate (5–15), and severe (16–42) groups based on the National Institute of Health Stroke Scale. Multiple hierarchical linear regression analyses were performed for each group to evaluate the influence of mRS and frailty on FIM-M scores. ResultsIn the mild stroke group, significant associations were observed with premorbid mRS3 (β = −0.183, p = 0.004), mRS4 (β = −0.234, p < 0.001), and frailty status (β = −0.227, p = 0.005) and FIM-M scores. Premorbid frailty did not show a significant association with the FIM-M scores in the moderate or severe stroke group. Frailty status notably contributed to changes in R², particularly in the mild stroke group (R² change = 0.031, p = 0.002). However, such changes were not evident in the other stroke severity groups. ConclusionThis study emphasizes the importance of incorporating frailty assessments into premorbid evaluations, particularly when considering ADL outcomes in patients with mild stroke. Conversely, the significance of frailty in moderate-to-severe stroke was less evident.

The Impact of Resilience, Alexithymia and Subjectively Perceived Helplessness of Myocardial Infarction on the Risk of Posttraumatic Stress

The aim of this study was to investigate the impact of resilience, alexithymia and the subjectively perceived severity (fear of death, pain intensity, helplessness) of myocardial infarction (MI) on posttraumatic symptom severity (PTSS) after MI. Patients were assessed with the Posttraumatic Diagnostic Scale (PDS), Resilience Scale (RS-11) and Toronto Alexithymia Scale (TAS-20). Subjectively perceived severity of MI was measured with three items on a 10-point Likert scale. To test our hypothesis, we applied Pearson correlations as well as multiple hierarchical linear regression analyses. A higher resilience score was significantly associated with lower (r = − .39, p < .001) PTSS. Higher scores of alexithymia (r = .38, p < .01) and subjectively perceived helplessness (r = .42, p < .001) were associated with higher PTSS. Multiple hierarchical linear regression analyses revealed that resilience, the TAS-20 subscale difficulty identifying feelings (DIF) and especially subjectively perceived helplessness were independent significant predictors for the PTSS, adjusted R2 = .29, F(5, 102) = 9.57, p < .001. Our results suggest that resilience reduces the PTSS whereas alexithymia and subjectively perceived helplessness increase the risk. Especially the subjectively perceived helplessness explains a high degree of variance of PTSS and should be assessed to hindering further mental health burden.

Perceived causes of poverty in the context of objective poverty, subjective poverty and selected sociodemographic variables

Perceived causes of poverty in the context of objective poverty, subjective poverty and selected sociodemographic variables

The relationship between stigma and help-seeking intentions in college students

IntroductionFew people seek mental health care despite the high prevalence of mental illnesses and their serious consequences. Barriers explaining this lack or absence of help-seeking have been the subject of several studies with stigma being the most prominent barrier.ObjectivesWe aimed to assess the relationship between stigma and help-seeking intentions in a sample of Tunisian college students.MethodsThis was a cross-sectional survey. The “Mental Health Knowledge Schedule”, and the “Reported and Intended Behavior Scale” were administered to a total of 714 college students (62.2% female; mean age =20.9).ResultsMore than one-third of students (39.6%) felt that it would be “unlikely” or “very unlikely” to seek the help of a health professional for mental health problems. Pearson product moment correlations indicated that help-seeking intentions significantly and positively correlated with behavior (p&lt;0.001, r=0,103) and knowledge (p&lt;0.001, r=0,163). The multiple hierarchical linear regression analysis found that after controlling for demographic variables (gender, age) and other personal-related variables (marital status, family income, living environment, substance use, personal psychiatric history), help-seeking intentions were significant contributors to behaviors and knowledge.ConclusionsGiven that stigma and discrimination against people with mental illness is a real and perceived barrier to seeking help and treatment, psycho-educational campaigns should be put in place to address the negative perceptions and attitudes of the general population about mental health issues, and should be tailored to the needs of specific groups (including students in different disciplines), taking into account their attitudes, fear and concerns about mental illness.

Good patriotism, social consideration, environmental problem cognition, and pro-environmental attitudes and behaviors: a cross-sectional study of Chinese attitudes

Recent studies have indicated a positive association between patriotism and environmentalism; however, the correlation between them has not yet been quantitatively verified. Additionally, differences in “good” versus “blind” patriotism have been ignored in environmental behavior studies; thus, theoretical concepts related to their effects on environmentalism have not been empirically tested. The present study aims to reveal the effects of good patriotism and social consideration on pro-environmental attitudes and behaviors, and the mediating effect of social consideration on the relationship between patriotism and pro-environmental attitudes and behaviors, while removing national or political prejudice or ideology from the measurement of patriotism. Data collected using a self-report questionnaire were analyzed for Chinese university students and workers. Results of multiple hierarchical linear regression analysis of five pro-environmental attitudes/behaviors estimation models showed that patriotism was correlated with pro-environmental attitudes and behaviors, and this correlation was completely mediated by individual social consideration, which was strongly and positively correlated with both patriotism and pro-environmental attitudes and behaviors. Our findings show that patriotism encourages people to focus on societal structures and environmental problems. The effect of good patriotism on individual pro-environmental attitudes and behaviors is clearly different from that of blind nationalism, as shown in previous literature. The present study highlights implications for future policy-making and education on patriotism and environmentalism in China.

How Incivility and Academic Stress Influence Psychological Health Among College Students: The Moderating Role of Gratitude.

Many students suffer from academic stress and uncivil behaviors at colleges and there is a need to identify to what extent these negative phenomena might impact students’ mental health. The main purpose of this study is to examine the relationships between incivility, academic stress, and psychological health, as well as investigate the moderating role of gratitude. The study design of this research is cross-sectional. The final sample consisted of 895 university students in China; The Statistical Package for the Social Sciences (SPSS) version 22 was utilized to conduct statistical analysis. Sample t-tests were used to examine whether there were gender differences in terms of four continuous variables: incivility, stress, gratitude, and psychological wellbeing. We also used multiple hierarchical linear regression analysis to test the relationships between the aforementioned four variables and the moderating effect of gratitude. The results of our study indicate that academic stress and incivility are positively associated with psychological distress, and gratitude moderates the relationship between incivility and psychological distress. However, no significant moderating effect of gratitude was found in the relationship between academic stress and psychological distress.

The Role of Personal Factors and Learning Environment in Suicidal Ideation Among Tunisian Medical Students.

Objective: Little is known about specific professional factors influencing medical students' suicidal ideation and behavior. We aimed to evaluate the prevalence and correlates of suicidal ideation in Tunisian medical students. Method: This was a cross-sectional study; 390 second-cycle medical students were enrolled at the Faculty of Medicine of Tunis. Participants responded to an anonymous questionnaire containing sociodemographic data, educational factors, the Suicidal Ideation Questionnaire (SIQ), and the Depression, Anxiety and Stress scales (DASS-21). Results: Eleven students (2.8%) had made one or more suicide attempts in their lifetime. For a threshold value of 41 based on the SIQ scale, 7.9% of students were considered to have a potential risk of suicide. The multiple hierarchical linear regression analysis identified as main factors independently associated with suicidal ideation: tobacco consumption, perceived sleep quality, depression symptoms, the personal historyofsuicide attempt, the satisfaction with student-supervisor relationship, and choosingto study medicine. Conclusion: Suicide prevention efforts should target high-risk students with prior personal or family history of suicidal behavior. Moreover, medical school authorities should put in place effective strategies to optimize the learning environment at their institutions.

International ambidexterity in firms' innovation of multinational enterprises from emerging economies: an investigation of TMT attributes

PurposeExtant research has integrated ambidexterity perspective into international business studies and calls for emerging market multinational enterprises (EM MNEs) to implement exploration and exploitation activities simultaneously in foreign markets. However, less attention has been paid to empirically test whether and how international ambidexterity can benefit the innovation performance of EM MNEs. Based on the data of international manufacturing firms in China, this paper explores the relationship between international ambidexterity and innovation performance and investigates four contingency factors of top management team (TMT): two external resource accumulation elements (i.e. TMT business ties and TMT political ties) and two internal resource integration elements (i.e. TMT contingency rewards and TMT social integration).Design/methodology/approachThe author conducts multiple hierarchical linear regression analysis to test the hypothesis by collecting survey data from 227 MNEs from several Economic Development Zones located in Zhejiang province in China.FindingsThe results show that international ambidexterity is positively related to innovation performance, and the international ambidexterity–innovation performance relationship is amplified when TMTs build strong ties with external business partners and political departments, when EM MNEs link top managers' income to team collective performance and create a highly social integrated TMT.Originality/valueThe results contributes to answer the question that how well EM MNEs will succeed and enrich the context specificity of international ambidexterity. The findings also help us better understand the inconsistent empirical findings in organizational ambidexterity by uncovering the contingency role of several TMT attributes.

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Apathy is prevalent in first-episode psychosis (FEP) and associated with reduced global functioning. Investigations of the trajectory of apathy and its early predictors are needed to develop new treatment interventions. We here measured the levels of apathy over the first 10 years of treatment in FEP and in healthy controls (HC). We recruited 198 HC and 198 FEP participants. We measured apathy with the Apathy Evaluation Scale, self-report version, psychotic symptoms with the Positive and Negative Syndrome Scale, depression with the Calgary Depression Scale for Schizophrenia, functioning with the Global Assessment of Functioning Scale, and also estimated the duration of untreated psychosis (DUP). The longitudinal development of apathy and its predictors were explored using linear mixed models analyses. Associations to functioning at 10 years were investigated using multiple hierarchical linear regression analyses. In HC, mean apathy levels were low and stable. In FEP, apathy levels decreased significantly during the first year of treatment, followed by long-term stability. High individual levels of apathy at baseline were associated with higher apathy levels during the follow-up. Long DUP and high baseline levels of depression predicted higher apathy levels at follow-ups. The effect of DUP was persistent, while the effect of baseline depression decreased over time. At 10 years, apathy was statistically significantly associated with reduced functioning. The early phase of the disorder may be critical to the development of apathy in FEP.

Course and Predictors of Subjective Cognitive Complaints During the First 12 Months after Stroke

Background: Subjective Cognitive Complaints (SCC) are common after stroke. This study documents the prevalence and course of SCC in the first year after stroke and determines which patient characteristics in the first 3 months predict subsequent SCC at 1-year follow-up. Methods: Using a longitudinal design, 155 patients (mean age 64.0 ± 11.9 years; 69.7% men) were assessed at 3 and 12 months after stroke. SCC were assessed using the Checklist for Cognitive and Emotional consequences following stroke (CLCE) inventory (content component [CLCE-c] and worry component [CLCE-w]). Potential predictors of 12 months SCC included demographics, stroke severity, objective cognitive impairment, psychological factors (depression, anxiety, perceived stress, fatigue, personality traits, coping style), and activities of daily life functioning assessed at 3 months poststroke. Multiple hierarchical linear regression analyses were used to determine predictors of SCC at 12 months poststroke. Results: SCC remained stable from 3 to 12 months over time (CLCE-c from 3.3 ± 2.4 to 3.3 ± 2.6; CLCE-w: from 1.9 ± 2.2 to 2.1 2.5). Independent predictors of SCC at 12 months were baseline CLCE-c (β = 0.54) and perceived stress (β = 0.23) for content, and baseline CLCE-w (β = 0.57) and depressive symptoms (β = 0.23) for worry. Conclusions: Patients who report SCC at 3 months after stroke are likely to continue having these complaints at 1 year follow-up. Perceived stress and depressive symptoms additionally increase the likelihood of having SCC at 12 months, independent of SCC at 3 months poststroke. Rehabilitation programs that target reduction of stress and depression in the first months after stroke might reduce sustained SCC and improve well-being.

Further Specifying the Cognitive Model of Depression: Situational Expectations and Global Cognitions as Predictors of Depressive Symptoms

The cognitive model of depression assumes that depressive symptoms are influenced by dysfunctional cognitions. To further specify this model, the present study aimed to examine the influence of different types of cognitions on depressive symptoms, i.e., situational expectations and global cognitions. It was hypothesized that situational expectations predict depressive symptoms beyond global cognitions. The present study examined a clinical (N = 91) and a healthy sample (N = 80) using longitudinal data with a baseline assessment and a follow-up five months later. Although the study was not designed as an interventional trial, participants from the clinical study received non-manualized cognitive-behavioral treatment after the baseline assessment. We examined situational expectations, intermediate beliefs, dispositional optimism, and generalized expectancies for negative mood regulation as predictors of depressive symptoms. Hypotheses were tested using multiple hierarchical linear regression analyses. Results indicate that, although there were significant correlations between the cognitive factors and depressive symptoms, in both samples neither global cognitions, nor situational expectations significantly predicted depressive symptoms at the five-month follow-up. The present study could, contrary to the hypotheses, not provide evidence for a significant impact of cognitive vulnerabilities on depressive symptoms, presumably due to high drop-out rates at follow-up. Limitations of the study and directions for future research are critically discussed. Situational and global cognitions were examined as predictors of depressive symptoms. In a healthy and a clinical sample, cognitive factors were correlated with depressive symptoms. However, in both samples depressive symptoms at follow-up were not predicted by cognitive factors. Situational and global cognitions were examined as predictors of depressive symptoms. In a healthy and a clinical sample, cognitive factors were correlated with depressive symptoms. However, in both samples depressive symptoms at follow-up were not predicted by cognitive factors.

Human Leukocyte Antigens Class II Alleles Affecting the Response to 5–7 Year Antiretroviral Therapy in A Latvian Cohort

Abstract Antiretroviral therapy (ART) aims at suppressing viral replication and strengthening immune system in patients with HIV-1. Human Leukocyte Antigens (HLA) are among factors responsible for effectiveness of ART. The aim of this study was to determine the effect of HLA Class II alleles on the response to long-time ART, assessed by a change in CD4+ T-cell count in relation to viral load. The sample included 69 patients (17 females and 52 males) aged 20 to 50 with HIV-1 infection, who were undergoing ART in the Latvian Centre of Infectious Diseases. The median period of observation was 5.7 years. CD4+ T-cell count and viral load were analysed at the baseline and end of the period of observation. HLA typing was performed by polymerase chain reaction with low resolution sequence specific primers. Multiple hierarchical linear regression analysis confirmed that an increase in HIV-1 viral load was associated with a decrease in the level of CD4+ T-cell count. In addition, HLA-DRB1*04 and HLA-DQB1*06:01 alleles contributed negatively to the level of CD4+ T-cell count.

Effects of inclusive leadership on leader-member exchange and affective commitment among nurses

Objective To explore the effects of inclusive leadership on affective commitment of nurses and to test the mediating effect of leader-member exchange. Methods From November 2016 to December 2016, we investigated 293 nurses from two Class Ⅲ Grade A governmental hospitals of Harbin with the Inclusive Leadership Scale, Leader-member Exchange Scale and Affective Commitment Scale. Pearson correlation analysis and multiple hierarchical linear regression analysis were used to test the correlations and mediating effect among the variables. A total of 293 questionnaires were sent out and 251 valid questionnaires retained finally. Results Among 251 nurses, the scores of inclusive leadership scale, leader-member exchange scale and affective commitment scale were (5.283±1.184), (5.216±1.139) and (4.902±1.061) respectively. Pearson correlation analysis showed that inclusive leadership had positive correlations with the leader-member exchange (r=0.771, P<0.01) and affective commitment (r=0.537, P<0.01); leader-member exchange had a positive correlation with affective commitment (r=0.543, P<0.01). Multiple hierarchical linear regression analysis indicated that inclusive leadership had positive effects on leader-member exchange and affective commitment of nurses; leader-member exchange played a partial mediating role between them. Conclusions As a whole, the inclusiveness of nursing managers on nurses is in the upper level and the leader-member exchange of nurses has a high level. Inclusive leadership has positive correlations with the leader-member exchange and affective commitment of nurses. Nursing managers should lead nurses to contribute their wisdoms with the manner of inclusive leadership so as to provide the high quality of nursing service. Key words: Nurses; Inclusive leadership; Leader-member exchange; Affective commitment

Intimate relationship quality, self-concept and illness acceptance in those with multiple sclerosis

Lower levels of Intimate Relationship Quality (IRQ) have been found in those with Multiple Sclerosis (MS) compared to the general population. This study examined an MS sample to see whether IRQ was positively associated with self-concept, whether IRQ was positively associated with MS illness acceptance and whether IRQ was predicted by self-concept and illness acceptance. In this cross-sectional study, 115 participants with MS who were in an intimate relationship completed an online survey advertised on MS related websites. The survey assessed demographic variables, MS illness variables and levels of IRQ, self-concept and illness acceptance. Results revealed that IRQ was significantly positively associated with self-concept and with illness acceptance. Multiple hierarchical linear regression analysis revealed that, after controlling for illness duration and level of disability, self-concept significantly predicted IRQ but illness acceptance did not significantly predict IRQ. This study addressed several gaps and methodological flaws in the literature and was the first known to assess predictors of IRQ in those with MS. The results suggest that self-concept could be a potential target for individual and couple psychological interventions to improve IRQ and contribute to improved outcomes for those with MS.

Adherence to Internet-Based Mobile-Supported Stress Management: A Pooled Analysis of Individual Participant Data From Three Randomized Controlled Trials.

BackgroundNonadherence to treatment is a prevalent issue in Internet interventions. Guidance from health care professionals has been found to increase treatment adherence rates in Internet interventions for a range of physical and mental disorders. Evaluating different guidance formats of varying intensity is important, particularly with respect to improvement of effectiveness and cost-effectiveness. Identifying predictors of nonadherence allows for the opportunity to better adapt Internet interventions to the needs of participants especially at risk for discontinuing treatment.ObjectiveThe goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees.MethodsThe data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement.ResultsIn all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω2=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI –0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence.ConclusionsGuidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained.Clinical TrialDRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE)

A commentary on "Antipsychotic-induced Parkinsonism is associated with working memory deficits in schizophrenia-spectrum disorders".

A commentary on "Antipsychotic-induced Parkinsonism is associated with working memory deficits in schizophrenia-spectrum disorders".

Organizational Ambidexterity, Exploration, Exploitation and Firms Innovation Performance

Abstract Background and Purpose: The construct of organizational ambidexterity (OA) has attracted the growing attention in management research. Previous empirical research has investigated the effect of organisational ambidexterity on performance from various perspectives. This study aims to resolve the contradictory previous research findings on the relationship between organisational ambidexterity and innovation performance. We unpack this construct with combined dimension of ambidexterity, which relates to a combination of high levels of both exploration and exploitation (introduction of products or services that were new to the market and new to the firm). Methodology: We frame our ambidexterity hypothesis in terms of firm’s innovation orientation. The hypothesis is tested by using Community Innovation Survey (CIS) 2006 micro data at the organizational level in twelve countries. To operationalize an ambidexterity and firms innovation outcome, we used self-reported measures of innovativeness. Results: To test our hypothesis, we developed a set of models and tested them with multiple hierarchical linear regression analyses. The results indicate that exploration and exploitation are positively related to firm’s innovation performances which supports our assumption that both are complementary. Furthermore, we find that above and over their independent effects, through combining them into a single construct of organizational ambidexterity, this variable remains negatively and significantly related to innovation performance. Conclusion: These results provides the managers with an idea of when managing trade-offs between exploration and exploitation would be more favorable versus detrimental. For firms with lower organizational ambidexterity, the relationship between exploration-exploitation and the firm’s innovation performance is a more positive one.

Associations Between Functioning and PTSD Symptom Clusters in a Dismantling Trial of Cognitive Processing Therapy in Female Interpersonal Violence Survivors

This study conducted secondary analyses of a published trial and sought to determine if different domains of psychosocial functioning (e.g., daily living, work, nonfamily relationships) improved following trauma-focused treatment for posttraumatic stress disorder (PTSD). Cognitive processing therapy (CPT), an empirically supported treatment that involves evaluating trauma-related beliefs and written trauma accounts, was compared to its components: CPT without the written accounts or written accounts only in a sample of 78 women with PTSD secondary to interpersonal violence. Overall and individual domains of functioning significantly improved with treatment and results were similar across treatment groups, Fs (2, 150) ≥ 11.87, ps < .001. Additionally, we investigated whether changes in different PTSD symptom clusters were associated with outcomes in domains of psychosocial functioning, after collapsing across treatment condition. Multiple hierarchical linear regression analyses revealed that overall clinician-assessed PTSD symptom reduction was associated with outcomes in all domains of functioning, βs = .44 to .68, ps < .001. Additionally, improvements in the emotional numbing symptom cluster were associated with outcomes in the nonfamily relationships domain, β = .42, p < .001, and improvements in the hyperarousal symptom cluster were associated with outcomes in the overall, daily living, and household tasks domains, βs = .34 to .39, ps < .01. Results suggest that it may be important to monitor improvements in emotional numbing and hyperarousal symptoms throughout treatment to increase the likelihood of changes in psychosocial functioning.

GR gene BclI polymorphysm changes the path, but not the level, of dexamethasone-induced cortisol suppression

BackgroundThe hypothalamo-pituitary-adrenocortical (HPA) axis self-regulation is achieved via cortisol binding to mineralocorticoid (MR) and glucocorticoid receptors (GR). It is often disturbed in mental disorders, particularly in those where traumatic stress has been implicated, such as posttraumatic stress disorder and depression. Although dexamethasone suppression test (DST) is often used as diagnostic aid, the findings still vary. In search of the factors influencing the DST outcome, we examined the glucocorticoid receptor (GR) gene BclI polymorphism. MethodsA total of 229 male subjects were classified into three BclI groups: two groups with homozygous carriers (of the G allele, N=108, and of the C allele, N=26), and one with heterozygous carriers (N=95). Multiple hierarchical linear regression analysis was done, where the dependent variable was the dexamethasone-induced cortisol suppression, and predictors included receptor variables. The interactions of the count of ‘G׳s with the predictors were introduced to single out the effects of the G allele. ResultsThe means of all studied variables, including suppression, are statistically the same in the three groups. However, the mechanism of suppression involves MRs only in the G allele carriers. LimitationsThe subjects were selected by criteria suited for the aim of the large project whose part is this study, hence the relatively small number of CC carriers. Also, we did not assess MR functional properties that would probably sharpen the results. ConclusionOur finding that MRs participate in cortisol suppression in the G allele carriers suggests that research aimed at refining HPA axis-based therapy might require its adjustment for such patients.

Factors Associated With the Ability to Estimate Actual Speeds in Recreational Alpine Skiers

To measure on-slope speeds of alpine skiers and to compare their ability to accurately estimate their actual speed with regard to measured speed, age, sex, skill level, helmet use, and risk-taking behavior. Skiing speeds of 416 adult skiers (62% men, 38% women) were measured with a radar speed gun. Skiers were interviewed about their age, sex, skiing ability, helmet use, and risk-taking behavior. Additionally, skiers had to estimate their measured speed as accurately as possible. The difference between estimated and measured speed was described as error of estimation (EE). Mean measured speed (±SD) of all participants was 48.2 (±14.3) km/h. Pearson correlation coefficient between the actual speed and the estimated speed was 0.57 (P < .001) for all participants. Skiers underestimated their measured speed on average by 5.8 km/h or 8.1%. A multiple hierarchical linear regression analysis revealed that when skiing speed is increased by 1 km/h the EE significantly decreases by 0.5 km/h. Male sex, higher skill level, risky skiing behavior, and younger age groups showed a significantly better ability to estimate skiing speed, whereas ski helmet use did not. Skiing speed, age, sex, skill level, and risk-taking behavior seem to influence the ability to estimate actual speeds in recreational alpine skiers.