Differences In Significant Predictors Research Articles

Predictors of fuel poverty and the equity of local fuel poverty support: secondary analysis of data from Bradford, England.

Addressing fuel poverty is a critical public health issue given its recent rise in prevalence across Europe. Although previous research identifies national risk markers of fuel poverty, evidence is lacking on whether these are consistent across local geographies, and the equity of local interventions. In the UK's current economic climate, it is more crucial than ever that services benefit households in greatest need. This study aimed to determine significant predictors of fuel poverty among households in Bradford, England, comparing them to national-level predictors, and evaluate if households possessing significant fuel poverty predictors were equitably referred to a local fuel poverty service (Warm Homes Healthy People, WHHP). A multivariate logistic regression model determined significant fuel poverty predictors in Bradford using household-level data from the Energy Saving Trust and the Low Income High Costs fuel poverty definition. Statistical testing highlighted significant differences in predictors of fuel poverty between households referred to WHHP and all Bradford households. Significant (p < .05) predictors of fuel poverty included: living in an area with lower average household incomes and higher proportion of ethnic minority individuals, and living in a property with a lower energy efficiency rating. Households living in a detached or older property, and homeowners were more likely to be fuel poor. Differences in the direction of the relationship with fuel poverty were identified between some national and local predictors. Most predictors were significantly (p < .05) overrepresented among WHHP households, suggesting equitable service reach. Ethnic minorities, younger people, and multiperson households were underrepresented. Local fuel poverty predictors were similar to many national-level predictors, but identified differences in the direction of the relationship between some national and local predictors reaffirm the value of locally focused research. WHHP successfully targeted households possessing key predictors, but should ensure that ethnic minorities, younger people, and multiperson households are equitably referred.

A sex-stratified analysis of suicidal ideation correlates among deployed post-9/11 veterans: Results from the survey of experiences of returning veterans

BackgroundSuicide rates are higher among veterans than non-veterans; this difference is particularly salient for females. Knowledge is sparse regarding correlates of suicidal ideation (SI) among female veterans, particularly in non-VHA samples. As such, and given that SI confers a strong risk for subsequent suicidal behavior, this study aimed to: (1) compare prevalence of recent SI by sex; and (2) determine whether deployment stressors, mental health symptoms, and recent psychosocial stressors are associated with recent SI, by sex, among post-9/11 veterans. MethodsA sex-stratified analysis of cross-sectional data from 809 post-9/11, deployed veterans was conducted using the Survey of Experiences of Returning Veterans (SERV); statistical interactions between sex and correlates of interest were assessed. ResultsSelf-reported prevalence of recent SI did not differ by sex. A statistically significant interaction between sex and combat was observed; greater combat experience was associated with increased SI for females only. While significant interactions were not observed for other correlates, differences in significant predictors and predictor effect sizes were noted across sex-stratified models. Recent housing and financial concerns were only associated with increased SI prevalence among females, whereas concern about other recent stressful life events was associated with increased SI prevalence only among males. LimitationsThis is a cross-sectional analysis of a national survey with limited power to detect statistical sex interactions. ConclusionsWhile correlates of SI are relatively consistent for males and females notable differences suggest that tailored assessment and intervention based on sex may hold merit in mitigating SI among post-9/11 era Veterans.

Socioeconomic inequality in functional deficiencies and chronic diseases among older Indian adults: a sex-stratified cross-sectional decomposition analysis

ObjectivesOlder adults with adverse socioeconomic conditions suffer disproportionately from a poor quality of life. Stratified by sex, income-related inequalities have been decomposed for functional deficiencies and chronic diseases among older...

The profile of social functioning in children with Down syndrome

Background: Practitioners and researchers have asserted for decades that social functioning is a strength in children with Down syndrome (DS). Nevertheless, some studies have concluded that children with DS may be at greater risk of impaired social functioning compared to typically developing controls. This cross-sectional study explores the profile of social functioning (social capabilities and social problems) in six-year-old children with DS, compares it with that of typically developing children and reveals possible differences in predictors between groups.Method: Parental reports and clinical tests were utilized.Results: The children with DS had generally weaker social capabilities compared to nonverbal mental age-matched controls, but no significant differences were found for social interactive play, community functioning and prosocial behaviour. No significant differences in predictors for social capabilities between the groups were found. The children with DS had more social problems than the typically developing controls with a similar chronological age and those with a similar nonverbal mental age, but no significant differences in emotional symptoms were found between the children with DS and either comparison group. Vocabulary was a more important predictor of social problems in the children with DS than in the typically developing control groups.Conclusion: Interventions for children with DS should strongly focus on integrating vocabulary skills and social functioning starting at an early age. Implications for RehabilitationChildren with Down syndrome need help and support in social functioning.Systematic training to optimize social capabilities and to prevent social problems should be prioritized.Structured and explicit learning of words important for social interaction with peers and for conflict solutions should be emphasized.Integrated interventions focusing on social functioning and vocabulary should begin in preschool to prepare children for participation in mainstream education.

(717) - Lung Transplantation in Russian Federation

s S263 Results: Overall, 11 pts (55%) have died (7 in-hospital mortality, 4 late-mortality). 50% of the overall pts. had an INTERMACS 4 score and the remaining pts were of lower INTERMACS score, while there was no difference in the score between the surviving and expired pts. Of the relevant pre-op parameters, there was no significant difference between the survival groups: RV function was generally slightly decreased (FAC 21±10% vs 30±13%, TAPSE 1,5±0,4 cm vs 1.3±0.5 cm, alive vs expired, NS), the cardiac index was low (1.7±0.5 L/min/m2 vs 1.8±0.5 L/min/m2, alive vs expired, NS), TPG values were borderline (13±5.3 mmHg vs 12.6±8.3 mmHg, alive vs expired, NS) and PVR was moderately elevated (3.7±1.4 WU vs 3.2±2.6 WU, alive vs expired, NS). Preoperative data significantly differed only in the platelet count being lower in the expired pts (250±64x103/mm3 vs. 154±65x103/ mm3, p< 0.01). Significantly higher post-implant PVR was found in the expired compared to the living pts (3.8±2.8 WU vs. 1.8±0.4 WU, p< 0.05). Notably, all of the expired pts had a significant increase in postoperative PVR values (0.59±0.25 WU), while it was decreased in all but one of the surviving pts (2.02±1.74 WU, p= 0.02). Conclusion: These preliminary data show that there is no significant difference in predictors of survival among our patients with a generally low INTERMACS score, apart from a low platelet count. However, there is a clear increase in postoperative PVR values in the expired pts, which warrants further investigation.

Changing Demographic Trends in Elderly Homeless: Findings in a Homeless Sample from Little Rock

Changing Demographic Trends in Elderly Homeless: Findings in a Homeless Sample from Little Rock

Efficacy of thoracic endovascular stent repair for chronic type B aortic dissection with aneurysmal degeneration

The Food and Drug Administration has approved devices for endovascular management of thoracic endovascular aortic aneurysm repair (TEVAR); however, limited data exist describing the outcomes of TEVAR for aneurysms attributable to chronic type B aortic dissection (cTBAD). This study was undertaken to determine the results of endovascular treatment of cTBAD with aneurysmal degeneration. A retrospective analysis of all patients treated for cTBAD with aneurysmal degeneration at the University of Florida from 2004 to 2011 was performed. Computed tomograms with centerline reconstruction were analyzed to determine change in aortic diameter, relative proportions of aortic treatment lengths, and false lumen perfusion status. Reintervention and mortality were estimated using life-tables. Cox regression analysis was completed to predict mortality. Eighty patients underwent TEVAR for aneurysm due to cTBAD (mean age [± standard deviation], 60 ± 13 years [male, 87.5%; n = 70]; median follow-up, 26 [range, 1-74] months). Median time from diagnosis of TBAD to TEVAR was 16 (range, 1-72) months. Prior aortic root/arch replacement had been performed in 29% (n = 23) at a median interval of 28.5 (range, 0.5-312) months. Mean preoperative aneurysm diameter was 62.0 ± 9.9 mm. In 75% (n = 60) of cases, coverage was proximal to zone 3, and 24% (n = 19) underwent carotid-subclavian bypass or other arch debranching procedure. Spinal drains were used in 78% (pre-op 71%, n = 57; post-op 6%, n = 5). Length of stay was 6.5 ± 4.7 days with a composite morbidity of 26% and in-hospital mortality of 2.5% (n = 2). Overall neurologic event rate was 17% (spinal cord ischemia 10% [n = 8], with a permanent deficit observed in 6.2% [n = 5]; stroke 7.5%). Aneurysm diameter reduced or stabilized in 65%. The false lumen thrombosed completely within the thoracic aorta in 52%, and reintervention within the treated aortic segment was required in 16% (n = 13).One- and 3-year freedom from reintervention (with 95% confidence interval [CI]) was 80% (range, 68%-88%) and 70% (range, 57%-80%), respectively. Survival at 1 and 5 years was 89% (range, 80%-94%) and 70% (range, 55%-81%) and was not significantly different among patients requiring reintervention or experiencing favorable aortic remodeling. Multivariable analysis identified coronary artery disease (hazard ratio [HR], 6.4; 95% CI, 2.3-17.7; P < .005), prior infrarenal aortic surgery (HR, 8.6; 95% CI, 2.3-31.7; P = .001), and congestive heart failure (HR, 11.9; 95% CI, 1.9-73.8; P = .008) as independent risk factors for mortality. Hyperlipidemia was found to be protective (HR, 0.2; 95% CI, 0.05-0.6; P = .004). No significant difference in predictors of mortality were found between patients who underwent reintervention vs those who did not (P = .2). TEVAR for cTBAD with aneurysmal degeneration can be performed safely but spinal cord ischemia rates may be higher than previously reported. Liberal use of procedural adjuncts to reduce this complication, such as spinal drainage, is recommended. Reintervention is common, but long-term survival does not appear to be impacted by remediation.

Predictors of quality of life in carers for people with a progressive neurological illness: a longitudinal study

The aim of the present research was to determine the predictors of quality of life (QOL) among carers for people living with a chronic degenerative neurological illness, with comparisons of the differences in significant predictors of QOL between illness groups. Psychosocial and economic variables were examined among 192 carers for people living at home with motor neurone disease, Huntington's disease, multiple sclerosis, and Parkinson's, over a twelve-month period, to determine their contribution to the prediction of carer QOL. Mood was the only consistent predictor of carer QOL across groups; however, marital relationship satisfaction, social support satisfaction, income, and economic pressure significantly predicted carer QOL for at least one of the illness groups, in addition to mood. The findings highlight the importance of recognising the varying roles that psychosocial and economic variables play on the prediction of carer QOL within each of these illness groups.

Predictors of Initiating Rapid-Acting Insulin Analog Using Vial/Syringe, Prefilled Pen, and Reusable Pen Devices in Patients with Type 2 Diabetes

Limited data are available on the predictors of insulin delivery device choice. This study assessed the patient- and health-care-system-related factors that predict the initiation of one rapid-acting insulin analog (RAIA) delivery system over another. A retrospective analysis using a claims database (January 1, 2007, through March 31, 2009) was conducted. Patients were required to be diagnosed with type 2 diabetes mellitus, and have >or=12 months of continuous eligibility prior to their first prescription of a RAIA on or after January 1, 2008. The three cohorts in the study were vial/syringe (n = 6820), prefilled pen (n = 5840), and reusable pen (n = 2052). Multiple factors were examined using stepwise logistic regression. Factors that increased the likelihood of initiating RAIA using prefilled pen versus vial/syringe included endocrinologist visit [odds ratio (OR) = 3.13, 95% confidence interval (CI) = 2.56, 3.82], prior basal insulin use with pen (OR = 4.85, 95% CI = 4.21, 5.59), and use of >or=1 oral antihyperglycemic agents (OR = 1.32, 95% CI = 1.20, 1.45). Factors that decreased the likelihood included inpatient admission (OR = 0.76, 95% CI = 0.70, 0.83), nursing home visit (OR = 0.22, 95% CI = 0.18, 0.27), and obesity (OR = 0.67, 95% CI = 0.53, 0.83). There were fewer differences between prefilled and reusable pen initiators. Factors that increased the likelihood of initiating with prefilled versus reusable pen included endocrinologist visit (OR = 1.87, CI = 1.50, 2.34) and inpatient admission (OR = 1.46, 95% CI = 1.30, 1.64). Significant differences in predictors were observed between prefilled pen and vial/syringe initiators. The differences were fewer between prefilled and reusable pen initiators. These differences should be taken into consideration when evaluating outcomes associated with specific insulin delivery systems.

Coronary Heart Disease Risk in Cuban Americans with and without Type 2 Diabetes

Background and AimsCoronary heart disease can be greatly reduced by lifestyle changes. The death rate from diabetes for Cuban Americans is more than twice that for non-Hispanic Whites; yet, recent studies of risk factors and health outcomes for Cuban Americans are lacking. The purpose of this study was to assess dietary, biometric and clinical predictors of coronary heart disease (CHD) in Cuban Americans by diabetes status and gender. Secondary objectives were to assess predictors of the incidence of stroke, angina and coronary or peripheral artery disease (CAD/PAD). Methods and ResultsCuban American adults: N = 367; 190 with type 2 diabetes (72 males, 118 females) and 177 (59 males, 118 females) without diabetes were recruited from a randomly generated mailing list from Broward and Miami-Dade counties, Florida, USA. Significant differences in predictors of CHD risk were found by gender and diabetes status. As expected, we found a positive association between diabetes and stroke; however, female participants were less likely to report having stable angina than male participants. The probable CAD/PAD was predicted by SBP and age; whereas, probable unstable angina was associated with family history of coronary heart disease, being male and smoking.ConclusionsWe found gender and diabetes status delineated risk factor patterns among a Cuban American sample. These findings suggest the need to revise health policies to promote early screening and aggressive treatment of CHD risk factors for both men and women. Prospective studies of CHD risk factors and mortality for Cuban Americans are warranted.

Predicting Fear of Crime

The current research tests the vulnerability, disorder, and social integration models to determine their relative predictive capacity across separate female and male citizen samples on fear of crime. Although previous literature typically includes gender as a control variable, the present analysis goes beyond this to determine whether the models function differently according to gender. Findings indicate that there are in fact significant differences in predictors of female and male fear of crime. Increased age reduces fear for women but not men, and increased income leads to higher levels of fear for men but lower levels for women. Theoretical implications and future research directions are discussed.

Job Satisfaction and Organizational Commitment in Prisons

Staff are the most valuable and expensive resources in prisons. Although correctional officers have received considerable academic attention, we know very little about their noncustody counterparts. This study examines and compares the predictors of job satisfaction, institutional commitment, and commitment to a prison system among three noncustody groups: psychological staff, teachers, and unit management personnel. Data are taken from the 2005 Prison Social Climate Survey, a questionnaire sent annually to a stratified random sample of federal prison staff. Results of Hierarchical Linear Modeling analyses indicate that supervision and perceived effectiveness with inmates had a significant and positive impact on all dependent variables for each noncustody group. The amount of time spent working in a prison was also a common predictor of institutional commitment for all groups. Some differences in significant predictors were found across noncustody groups for several independent variables including security level, amount of inmate contact, and months in current institution.

Impact of Perioperative Myocardial Infarction on Angiographic and Clinical Outcomes Following Coronary Artery Bypass Grafting (from PRoject of Ex-vivo Vein graft ENgineering via Transfection [PREVENT] IV)

Myocardial infarction (MI) after coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. Frequency, management, mechanisms, and angiographic and clinical outcomes associated with perioperative MI remain poorly understood. PREVENT IV was a multicenter, randomized, placebo-controlled trial of edifoligide in 3,014 patients undergoing CABG. Angiographic and 2-year clinical follow-up were complete for 1,920 and 2,956 patients, respectively. Perioperative MI was defined as creatinine kinase-MB increase >or=10 times the upper limit of normal or >or=5 times the upper limit of normal with new 30-ms Q waves within 24 hours of surgery. Baseline characteristics, in-hospital management, and angiographic and clinical outcomes of patients with and without perioperative MI were compared. Perioperative MI occurred in 294 patients (9.8%). Patients with perioperative MI had longer surgery (250 vs 230 minutes; p <0.001), more on-pump surgery (83% vs 78%; p = 0.048), and worse target-artery quality (p <0.001). Patients with perioperative MI more frequently underwent angiography within 30 days of enrollment (1.7% vs 0.6%; p = 0.021). One-year angiographic vein graft failure occurred in 62.4% of patients with and 43.8% of patients without perioperative MI (p <0.001). Two-year composite clinical outcome (death, MI, or revascularization) was worse in patients with perioperative MI before (19.4% vs 15.2%; p = 0.039) and after (hazard ratio 1.33, 95% confidence interval 1.00 to 1.76, p = 0.046) adjusting for differences in significant predictors. In conclusion, perioperative MI was relatively common, was associated with worse outcomes, and mechanisms other than vein graft failure accounted for a substantial proportion of these MIs. Further research is needed into the prevention and treatment of perioperative MI in patients undergoing CABG.

Coronary Artery Bypass Graft Failure After On-Pump and Off-Pump Coronary Artery Bypass: Findings From PREVENT IV

This analysis compares 1-year vein graft patency and major adverse cardiac and cerebral events (MACCE [death, myocardial infarction, or stroke]) in on-pump and off-pump patients enrolled in PREVENT IV (the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV). The PREVENT IV was a multicenter (107 sites) randomized trial of edifoligide to prevent vein graft failure from neointimal hyperplasia in 3,014 patients undergoing primary, isolated coronary artery bypass grafting (CABG) with at least two vein grafts. One-year angiographic follow-up was completed on 1,920 patients (4,736 grafts) with MACCE follow-up on 99.4% of enrolled patients. In all, 2,377 procedures (78.9%) were on pump and 637 (21.1%) were off pump. On-pump patients had more chronic lung disease (17% versus 11%; p < 0.001), congestive heart failure (10% versus 7%; p = 0.03), lower mean ejection fraction (50% versus 55%; p < 0.001), and worse target artery quality (good 63.8% versus 68.1%; fair 26.4% versus 22.7%; poor 9.8% versus 9.2%; p < 0.001). Vein graft failure (more than 75% graft stenosis) in on- versus off-pump patients was 25.3% versus 25.7% (p = 0.62). After adjusting for differences in significant predictors of vein graft failure (target artery quality, surgery time, endoscopic vein harvest, more than 1 distal anastomosis/graft, and patient weight), the odds of vein graft failure was 0.82 (95% confidence interval: 0.67 to 1.00; p = 0.05) for on-pump versus off-pump patients. One-year mortality for on- versus off-pump patients was 3.3% versus 2.5% (p = 0.30); and MACCE was 15.4% versus 11.3% (p = 0.01). The adjusted hazard ratio for 1-year MACCE was 1.31 (95% confidence interval: 1.01-1.69; p = 0.01) for on pump versus off pump. Observed saphenous vein failure rate was 25% in both groups. One-year clinical outcomes (MACCE) were better with off-pump than with on-pump CABG, suggesting benefits not related to vein graft patency.

Examining predictive models of HRQOL in a population-based, multiethnic sample of women with breast carcinoma

This study examined health related quality of life (HRQOL) and its predictors among African-, Asian-, Latina-, and European American breast cancer survivors (BCS) using a socio-ecologically and culturally contextual theoretical model of HRQOL. We employed a case-control, cross sectional design with a population-based sample from the California Cancer Registry. Descriptive, bivariate, and multivariate regression analyses were conducted. The sample included 703 BCS: 135 (19%) African-, 206 (29%) Asian-, 183 (26%) Latina-, and 179 (26%) European Americans. Latinas reported the lowest HRQOL (p < 0.0001). The final regression model explained 70% of variance in HRQOL. Years since diagnosis, number of comorbidities, role limitation, emotional wellbeing, quality of doctor-patient relationship, social support, and life stress are significant HRQOL determinants. Exploratory regression analyses indicate ethnic differences in significant predictors for HRQOL. HRQOL among this multiethnic sample ranged from fair to good. Bivariate analysis suggests that ethnic differences in HRQOL exist. However, regression analyses demonstrated that socio-ecological factors in conjunction with medical characteristics are more salient to HRQOL outcomes, and that ethnic group membership may be a proxy for socio-ecological context. Furthermore, the influence of ethnicity, culture, and social-ecology are complex; research with large, population-based samples are necessary to disentangle the impact of contextual factors on HRQOL.

A Regional Study of Risk Factors for Drug Abuse and Delinquency: Sex and Racial Differences

Many juveniles are at high risk for delinquency and drug abuse by virtue of the characteristics of their neighborhoods, which are often economically impoverished, socially unstable, physically neglected, and rife with crime, drug use, and drug selling. However, a significant proportion of these youth do not engage in deviant behavior, while others participate to varying degrees. This study examined what factors discriminate between high-risk youth who do and who do not exhibit deviant behavior. Self-reported measures of several attitudes and behaviors known to correlate with drug abuse and delinquency were assessed in relation to reports of property offenses, person offenses, drug use, and drug selling. Additional analyses were conducted to distinguish between sex and racial groups to further qualify the relationships between deviant behaviors and attitudes. The most notable finding was that types of deviance that primarily involve material and monetary gain may be largely influenced by relationships with significant others, while deviance with potentially harmful consequences to both self and others are influenced largely by personal attitudes. Examination of individual variables showed that negative peer influences and positive attitudes toward fighting significantly increased the likelihood of reporting involvement in three of the four deviance measures, and that positive relationship with the father and prosocial values were inversely related to two of the behavioral deviance measures. There were very few differences in significant predictors of deviance for males versus females. Several self-reported attitudes and behaviors distinguished African Americans from Hispanics and Whites, even though Whites were reportedly responsible for a higher incidence of deviant behaviors.