Adherence to three different strategies to prevent early onset GBS infection in newborns

ProblemDespite the introduction of preventive guidelines, no decrease in the incidence of early onset infection was observed.BackgroundEarly onset group B streptococcal (EOGBS) infection is an important cause of neonatal morbidity and mortality.AimOur study was conducted to determine adherence to three guideline-based group B streptococcus (GBS) preventive strategies.MethodsA prospective experimental study clustered by obstetric collaboration region was performed between March 2013 and August 2014 among midwives, obstetricians and paediatricians in the Netherlands. At baseline, the three regions operated according to the Dutch preventive strategy (founded on the risk-based strategy) in order to prevent EOGBS infection, whereas in the study period they followed either the risk-based, the combination or the Dutch strategy. Adherence was measured prospectively per pregnant woman, using predefined core elements of each preventive strategy: identification of risk factors, maternal GBS screening, application of intrapartum antibiotic prophylaxis and observation of the child. Data about adherence to the core elements were collected from medical records, maternal questionnaires and laboratory test results.FindingsIn the three regions, a total of 121 care providers and 1562 women participated.We found an overall adherence of 90% to the risk-based strategy, 57% to the combination strategy and 89% to the Dutch strategy. Adherence to a strategy in case women had EOGBS risk factors was below 20% in all strategies.DiscussionThe majority of women with EOGBS risk factors did not receive the care prescribed by any of three preventive strategies and were not treated optimally.ConclusionThe risk-based and the Dutch strategy are the recommended strategies for implementation.     

The effectiveness of apprenticeship training: A within-track comparison of workplace-based and school-based vocational training in Hungary

Although apprenticeship training has been praised for its effectiveness in easing the transition of non-college-bound students from school to work, most studies rely on cross-country or cross-track comparisons. This study compares apprenticeship training students with non-apprentices within educational track in a relatively uncoordinated and decentralized institutional setting. Using a rich database and a unique set of observable individual-level characteristics as well as local labor market fixed effects to control for the potential selection bias, the results show that there are no significant differences in employment opportunities between apprentices and non-apprentices within just a year after graduation. This might be due to the failure of the Hungarian firms to enhance the skills of apprentices and thus increase their chances of entering the labor market compared to their school-trained peers. However, some immediate positive effect of apprenticeship training within sub-populations is apparent, which are likely to be the result of screening.     

Honesty and comfort levels in mothers when screened for perinatal depression and anxiety

PurposeTo evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the perinatal period; to investigate if honesty and comfort are associated with perinatal depression or perinatal anxiety; and to examine the reasons why women may not always respond honestly.MethodsQualitative and quantitative data from 1597 women from the cross-sectional perinatal mental health substudy (part of the Australian Longitudinal Study on Women’s Health) were analysed using a mixed methods approach.ResultsWhen questioned by their health practitioner about their emotional wellbeing in the perinatal period, 20.7% of women indicated they had not always responded honestly. Reasons for not being honest reflected four main themes: normalizing of symptoms/coping; negative perceptions (self-and others); fear of adverse repercussions; and fear of involvement of health services (trust and confidentiality). The 38.9% of women who did not feel comfortable when questioned by their health practitioner about their emotional wellbeing were four times more likely to report perinatal depression (odds ratio = 4.09; 95% confidence interval = 2.55, 6.57) and nearly twice as likely to report perinatal anxiety (odds ratio = 1.90; 95% confidence interval = 1.24, 2.94) than other women.ConclusionsWomen who are most likely to need mental health care during the perinatal period are also those least likely to be honest about their mental health. A non-judgemental, open and reassuring approach by clinicians may help to reduce the stigma and fears contributing to lack of honest responses, and improve early diagnosis and treatment of mental health problems.     

Prediction of posttraumatic stress disorder symptomatology after childbirth – A Croatian longitudinal study

Background

Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.

Developing an undue influence screening tool for Adult Protective Services

The study purpose was to develop and pilot an undue influence screening tool for California’s Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature—including existing undue influence models—was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.     

A case-based distance method for screening in multiple-criteria decision aid

Screening is a process of multiple-criteria decision aid (MCDA) in which a large set of alternatives is reduced to a smaller set that most likely contains the best choice. We propose screening using a distance model calibrated on the basis of the decision-maker's own judgement. Viewing MCDA as preference aggregation based on consequence data, we define consequence and preference expressions (values and weights) and describe how they are aggregated. Then we define screening and explain some of its properties. Using an appropriate definition of distance, our case-based distance method screens a set of alternatives using criterion weights and a distance threshold obtained by quadratic optimization using the decision-maker's selection of alternatives from a test set. This case-based method can elicit the decision maker's preferences more expeditiously and accurately than direct inquiry. An application in water supply planning is used to demonstrate the procedure.     

A general method of constructing E(s2)-optimal supersaturated designs

There has been much recent interest in supersaturated designs and their application in factor screening experiments. Supersaturated designs have mainly been constructed by using the E ( s ²)-optimality criterion originally proposed by Booth and Cox in 1962. However, until now E ( s ²)-optimal designs have only been established with certainty for n experimental runs when the number of factors m is a multiple of n-1 , and in adjacent cases where m = q ( n -1) + r (| r | 2, q an integer). A method of constructing E ( s ²)-optimal designs is presented which allows a reasonably complete solution to be found for various numbers of runs n including n ,=8 12, 16, 20, 24, 32, 40, 48, 64.     

A Class of Multivariate Bilateral Selection t Distributions and Its Properties

This article proposes a class of multivariate bilateral selection t distributions useful for analyzing non-normal (skewed and/or bimodal) multivariate data. The class is associated with a bilateral selection mechanism, and it is obtained from a marginal distribution of the centrally truncated multivariate t. It is flexible enough to include the multivariate t and multivariate skew-t distributions and mathematically tractable enough to account for central truncation of a hidden t variable. The class, closed under linear transformation, marginal, and conditional operations, is studied from several aspects such as shape of the probability density function, conditioning of a distribution, scale mixtures of multivariate normal, and a probabilistic representation. The relationships among these aspects are given, and various properties of the class are also discussed. Necessary theories and two applications are provided.     

Analyzing Supersaturated Designs by Means of an Information Based Criterion

The cost and time consumption of many industrial experimentations can be reduced using the class of supersaturated designs since this can be used for screening out the important factors from a large set of potentially active variables. A supersaturated design is a design for which there are fewer runs than effects to be estimated. Although there exists a wide study of construction methods for supersaturated designs, their analysis methods are yet in an early research stage. In this article, we propose a method for analyzing data using a correlation-based measure, named as symmetrical uncertainty. This method combines measures from the information theory field and is used as the main idea of variable selection algorithms developed in data mining. In this work, the symmetrical uncertainty is used from another viewpoint in order to determine more directly the important factors. The specific method enables us to use supersaturated designs for analyzing data of generalized linear models for a Bernoulli response. We evaluate our method by using some of the existing supersaturated designs, obtained according to methods proposed by Tang and Wu (1997 Tang , B. , Wu , C. F. J. (1997). A method for constructing supersaturated designs and its E(s ²)-optimality. Canadian Journal of Statistics 25:191–201.[Crossref], [Web of Science ®] , [Google Scholar]) as well as by Koukouvinos et al. (2008 Koukouvinos , C. , Mylona , K. , Simos , D. E. ( 2008 ). E(s ²)-optimal and minimax-optimal cyclic supersaturated designs via multi-objective simulated annealing . Journal of Statistical Planning and Inference 138 : 1639 – 1646 .[Crossref], [Web of Science ®] , [Google Scholar]). The comparison is performed by some simulating experiments and the Type I and Type II error rates are calculated. Additionally, Receiver Operating Characteristics (ROC) curves methodology is applied as an additional statistical tool for performance evaluation.