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An SPSS Companion for the Third Edition of The Fundamentals of Political Science Research offers students a chance to delve into the world of SPSS using real political science data sets and statistical analysis techniques directly from Paul M. Kellstedt and Guy D. Whitten's best-selling textbook. Built in parallel with the main text, this workbook teaches students to apply the techniques they learn in each chapter by reproducing the analyses and results from each lesson using SPSS. Students will also learn to create all of the tables and figures found in the textbook, leading to an even greater mastery of the core material. This accessible, informative, and engaging companion walks through the use of SPSS step-by-step, using command lines and screenshots to demonstrate proper use of the software. With the help of these guides, students will become comfortable creating, editing, and using data sets in SPSS to produce original statistical analyses for evaluating causal claims. End-of-chapter exercises encourage this innovation by asking students to formulate and evaluate their own hypotheses.
Surface melt on the coastal Antarctic ice sheet (AIS) determines the viability of its ice shelves and the stability of the grounded ice sheet, but very few in situ melt rate estimates exist to date. Here we present a benchmark dataset of in situ surface melt rates and energy balance from nine sites in the eastern Antarctic Peninsula (AP) and coastal Dronning Maud Land (DML), East Antarctica, seven of which are located on AIS ice shelves. Meteorological time series from eight automatic and one staffed weather station (Neumayer), ranging in length from 15 months to almost 24 years, serve as input for an energy-balance model to obtain consistent surface melt rates and energy-balance results. We find that surface melt rates exhibit large temporal, spatial and process variability. Intermittent summer melt in coastal DML is primarily driven by absorption of shortwave radiation, while non-summer melt events in the eastern AP occur during föhn events that force a large downward directed turbulent flux of sensible heat. We use the in situ surface melt rate dataset to evaluate melt rates from the regional atmospheric climate model RACMO2 and validate a melt product from the QuikSCAT satellite.
Numerous studies reported on the frequency of, and factors associated with inappropriate or unnecessary emergency department (ED) visits using clinician judgment as the gold standard of appropriateness. This study evaluated the reliability of clinician judgment for assessing appropriateness of pediatric ED visit.
We conducted a retrospective cohort study comparing 3 clinicians’ determination of ED visit appropriateness with and without guidance from a three-question structured algorithm. We used a cohort of scheduled ED return visits deemed appropriate by the index treating clinician between May 1, 2012, and April 30, 2013. We measured the level of agreement among three clinician investigators with and without use of the structured algorithm.
A total of 207 scheduled ED return visits were reviewed by the primary clinician reviewer who agreed with the index treating clinician for 79/207 visits (38.2%). Among a random subset of 90 return visits reviewed by all three clinicians, agreement was 67% with a Fleiss’ Kappa of 0.30 (0.17–0.44). Using a three-question algorithm based on objective criteria, agreement with the index treating provider increased to 115/207 (55.6%).
Although an important contributor to pediatric ED overcrowding, unnecessary or inappropriate visits are difficult to identify. We demonstrated poor reliability of clinician judgment to determine appropriateness of ED return visits, likely due to variability in clinical decision-making and risk-tolerance, social and systems factors impacting access and use of health care. We recommend that future studies evaluating the appropriateness of ED use standardized, objective criteria rather than clinician judgment alone.
Antidepressants have limited efficacy in older adults with depression and cognitive impairment, and psychosocial interventions for this population have been inadequately investigated. Problem Adaptation Therapy (PATH) is a psychosocial intervention for older adults with major depression, cognitive impairment, and disability.
This study tests the efficacy of PATH versus Supportive Therapy for Cognitively Impaired Older Adults (ST-CI) in reducing depression (Montgamery Asberg Depression Rating Scale [MADRS]) and disability (World Health Organization Disability Assessments Schedule-II [WHODAS-II]) and improving cognitive outcomes (Mini Mental State Examination [MMSE]) over 24 weeks (12 weeks of treatment and 12-week post-treatment follow-up).
Participants were recruited through collaborating community agencies of Weill Cornell Institute of Geriatric Psychiatry. Both interventions and all research assessments were conducted at home.
Thirty-five older adults (age ≥ 65 years) with major depression and cognitive impairment no dementia (CIND).
PATH aims to increase emotion regulation by incorporating a problem-solving approach, teaching compensatory strategies, and inviting caregiver participation. Supportive Therapy aims to facilitate the expression of affect, as well as promote empathy.
Depression was measured using the MADRS, disability using the WHODAS-II, and cognition using the MMSE.
PATH participants showed significantly greater reduction in MADRS total score (7.04 points at 24 weeks, treatment group by time interaction: F[1,24.4] = 7.61, p = 0.0108), greater improvement in MMSE total score (2.30 points at 24 weeks, treatment group by time interaction: F[1,39.8] = 13.31, p = 0.0008), and greater improvement in WHODAS-II total score (2.95 points at 24 weeks, treatment group by time interaction: F[1,89] = 4.93, p = 0.0290) than ST-CI participants over the 24-week period.
PATH participants had better depression, cognitive, and disability outcomes than ST-CI participants over 6 months. PATH may provide relief to depressed older adults with CIND who currently have limited treatment options.
To develop and validate the Discrepancy-based Evidence for Loss of Thinking Abilities (DELTA) score. The DELTA score characterizes the strength of evidence for cognitive decline on a continuous spectrum using well-established psychometric principles for improving detection of cognitive changes.
DELTA score development used neuropsychological test scores from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort (two tests each from Memory, Executive Function, and Language domains). We derived regression-based normative reference scores using age, gender, years of education, and word-reading ability from robust cognitively normal ADNI participants. Discrepancies between predicted and observed scores were used for calculating the DELTA score (range 0–15). We validated DELTA scores primarily against longitudinal Clinical Dementia Rating-Sum of Boxes (CDR-SOB) and Functional Activities Questionnaire (FAQ) scores (baseline assessment through Year 3) using linear mixed models and secondarily against cross-sectional Alzheimer’s biomarkers.
There were 1359 ADNI participants with calculable baseline DELTA scores (age 73.7 ± 7.1 years, 55.4% female, 100% white/Caucasian). Higher baseline DELTA scores (stronger evidence of cognitive decline) predicted higher baseline CDR-SOB (ΔR2 = .318) and faster rates of CDR-SOB increase over time (ΔR2 = .209). Longitudinal changes in DELTA scores tracked closely and in the same direction as CDR-SOB scores (fixed and random effects of mean + mean-centered DELTA, ΔR2 > .7). Results were similar for FAQ scores. High DELTA scores predicted higher PET-Aβ SUVr (ρ = 324), higher CSF-pTau/CSF-Aβ ratio (ρ = .460), and demonstrated PPV > .9 for positive Alzheimer’s disease biomarker classification.
Data support initial development and validation of the DELTA score through its associations with longitudinal functional changes and Alzheimer’s biomarkers. We provide several considerations for future research and include an automated scoring program for clinical use.
Invasive species drive biodiversity loss and lead to changes in parasite–host associations. Parasites are linked to invasions and can mediate invasion success and outcomes. We review theoretical and empirical research into parasites in biological invasions, focusing on a freshwater invertebrate study system. We focus on the effects of parasitic infection on host traits (behaviour and life history) that can mediate native/invader trophic interactions. We review evidence from the field and laboratory of parasite-driven changes in predation, intraguild predation and cannibalism. Theoretical work shows that the trait-mediated effects of parasites can be as strong as classical density effects and their impact on the host’s trophic interactions merits more consideration. We also report on evidence of broader cascading effects warranting deeper study. Biological invasion can lead to altered parasite–host associations. Focusing on amphipod invasions, we find patterns of parasite introduction and loss that mirror host invasion pathways, but also highlight the risks of introducing invasive parasites. Horizon scanning and impact predictions are vital in identifying future disease risks, potential pathways of introduction and suitable management measures for mitigation.
Few expected the contentious, disruptive politics that dominated the Confederacy. In the first exciting days of independence, Southern leaders looked forward to a purified, harmonious government. Liberated at last, they said, from unconstitutional aggressions and the pollution of Northern parties and demagogues, the Confederate government had a bright future. Even Jefferson Davis, the newly chosen president, who was more realistic than most, proclaimed a new era based on the ties uniting all whites in a slaveholding society. “It is joyous to look around upon a people united in heart,” he declared as he took up his duties.
To update current estimates of non–device-associated pneumonia (ND pneumonia) rates and their frequency relative to ventilator associated pneumonia (VAP), and identify risk factors for ND pneumonia.
Academic teaching hospital.
All adult hospitalizations between 2013 and 2017 were included. Pneumonia (device associated and non–device associated) were captured through comprehensive, hospital-wide active surveillance using CDC definitions and methodology.
From 2013 to 2017, there were 163,386 hospitalizations (97,485 unique patients) and 771 pneumonia cases (520 ND pneumonia and 191 VAP). The rate of ND pneumonia remained stable, with 4.15 and 4.54 ND pneumonia cases per 10,000 hospitalization days in 2013 and 2017 respectively (P = .65). In 2017, 74% of pneumonia cases were ND pneumonia. Male sex and increasing age we both associated with increased risk of ND pneumonia. Additionally, patients with chronic bronchitis or emphysema (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.40–3.06), congestive heart failure (HR, 1.48; 95% CI, 1.07–2.05), or paralysis (HR, 1.72; 95% CI, 1.09–2.73) were also at increased risk, as were those who were immunosuppressed (HR, 1.54; 95% CI, 1.18–2.00) or in the ICU (HR, 1.49; 95% CI, 1.06–2.09). We did not detect a change in ND pneumonia risk with use of chlorhexidine mouthwash, total parenteral nutrition, all medications of interest, and prior ventilation.
The incidence rate of ND pneumonia did not change from 2013 to 2017, and 3 of 4 nosocomial pneumonia cases were non–device associated. Hospital infection prevention programs should consider expanding the scope of surveillance to include non-ventilated patients. Future research should continue to look for modifiable risk factors and should assess potential prevention strategies.