Bayesian Development of a Dose‐Response Model for Aspergillus fumigatus and Invasive Aspergillosis

Invasive aspergillosis (IA) is a major cause of mortality in immunocompromized hosts, most often consecutive to the inhalation of spores of Aspergillus. However, the relationship between Aspergillus concentration in the air and probability of IA is not quantitatively known. In this study, this relationship was examined in a murine model of IA. Immunosuppressed Balb/c mice were exposed for 60 minutes at day 0 to an aerosol of A. fumigatus spores (Af293 strain). At day 10, IA was assessed in mice by quantitative culture of the lungs and galactomannan dosage. Fifteen separate nebulizations with varying spore concentrations were performed. Rates of IA ranged from 0% to 100% according to spore concentrations. The dose‐response relationship between probability of infection and spore exposure was approximated using the exponential model and the more flexible beta‐Poisson model. Prior distributions of the parameters of the models were proposed then updated with data in a Bayesian framework. Both models yielded close median dose‐responses of the posterior distributions for the main parameter of the model, but with different dispersions, either when the exposure dose was the concentration in the nebulized suspension or was the estimated quantity of spores inhaled by a mouse during the experiment. The median quantity of inhaled spores that infected 50% of mice was estimated at 1.8 × 10⁴ and 3.2 × 10⁴ viable spores in the exponential and beta‐Poisson models, respectively. This study provides dose‐response parameters for quantitative assessment of the relationship between airborne exposure to the reference A. fumigatus strain and probability of IA in immunocompromized hosts.     

The Place of Single Session Family Consultations: Five Years’ Experience in Canberra

Open Day, in the form of two half day single session family clinics, has operated weekly in the ACT Child and Adolescent Mental Health Service since April 1993 and over a thousand families have been seen. Clinicians are often resistant to the concept of single sessions and frequently overestimate the amount of assistance that clients feel they require. However in an era of sharply increasing demand for services, selective use of single family sessions for milder problems, screened by a telephone intake process, has value to both families and workers. Telephone follow-ups of 100 families in 1994 and 70 families in 1996 found that single session family interviews were well accepted by the large majority of families seen. Clinicians see the program as reducing pressure from clients for early attention, enhancing client motivation when seen at crisis times, providing readily available consultation support from peers, increasing learning opportunities and building inter-disciplinary team work.     

Do depressive symptoms in justice‐involved girls reduce the effects of a cognitive‐behavioral program on their disruptive and delinquent behaviors?

The present study evaluated the effects of a cognitive‐behavioral program on disruptive and delinquent behaviors among a sample of adolescent girls placed in a residential center in Quebec (Canada). This study also investigated the moderating impact of depressive symptoms on program effectiveness. The study used a quasi‐experimental design to allow comparisons between 104 girls in the treatment group and 78 girls in the comparison group over 18 months. Findings showed that the program contributed significantly, albeit modestly, to a decline in some forms of disruptive/delinquent behaviors. Results also indicated that girls with a higher level of depressive symptoms at admission also reported higher involvement in a myriad of disruptive/delinquent behaviors and that for some types of problem behaviors, this higher involvement persisted over time. In general, however, the seriousness of the depressive symptoms that the girls reported at admission did not interfere with the effectiveness of the cognitive‐behavioral program.     

Effects of community violence exposure and parental mental health on the internalizing problems of urban adolescents

Previous research has documented an association between adolescent community violence exposure (CVE) and poor psychological functioning. The purpose of this study is to delineate the relations of CVE, parental mental health, and adolescent PTSD and depression. Participants consisted of 121 pairs of junior high and high school students and their parents. Adolescents completed measures to assess their history of violence exposure and current psychological functioning. Parents completed a demographic questionnaire and measures assessing their psychological functioning. Hierarchical regression analyses were conducted, and results indicated that, after controlling for demographic variables and family violence exposure, parental mental health emerged as a moderating variable in the relation between CVE and adolescent-rated PTSD, but not in the association between adolescent CVE and depression. Clinical implications of this study and directions for future research are discussed.     

Factors relevant to a return to work: a multivariate approach

This paper contributes to the understanding of the factors that are significant for returning to work, and identifies factors that might be used early on in a period of sick leave to discern whether people are likely to work again. In the design, the multivariate Partial Least Squares (PLS) of Latent Structures method was used to analyse information from a questionnaire containing socio-demographic items, and information on symptoms, consequences on daily life, expectations and psychosocial factors. Data about the incidence of sickness over a four-year period was included. 121 adults aged 18-64 years on sick leave participated, irrespective of their diagnoses. A reliable prediction of a return to work required the combination of many factors: individual psychosocial instruments are not useful when considered in isolation. The strongest predictive factors for a return to work concern the individuals' expectations, the number of days of sick leave taken in the past, somatic disorders, and a high level of life satisfaction and sense of coherence. Many factors influence the outcome for people on sick leave: PLS analysis demonstrated that a multivariate approach using this method could predict the long-term outcome early on in a period of sick leave.     

Studying Board Context, Process and Dynamics: Some Challenges for the Future

This paper contributes to the timely debate on research into boards and their effectiveness by focusing on context, process and time, which are crucial to understanding board dynamics. It also explores key principles of board process research, and advocates the need to strengthen its theoretical and methodological foundations in order to challenge the analytically particular assumptions of agency theory. The paper concludes that there is still much more to be researched in this area and encourages work that explores variation in board process and director effectiveness in different organizational contexts, as well as seeking to go beyond the board to address their impact and effectiveness in the broader organizational and external context.     

Comparing the Effectiveness of Assignment Strategies for Estimating Likely Undocumented Status in Secondary Data Sources for Latino and Asian Immigrants

Population Research and Policy Review - Researchers are increasingly interested in the role of undocumented status in immigrant economic, social, and health outcomes. A major obstacle to this work...