The purpose of this study was to explore career outcomes in young adulthood for individuals with ADHD and/or high abilities. The sample included respondents who had valid ability and ADHD measures from waves 1 (1995), 3 (2002), and 4 (2009) of the National Longitudinal Study of Adolescent and Adult Health in-home questionnaire. Using multiple group path analysis, we examined the pathways for three groups of individuals (i.e., ADHD, high ability, and both). Our findings indicated shared as well as unique pathways in these three groups, involving their parents’ education, parental educational expectation, family income, school attachment, depression and anxiety symptoms, educational aspiration, high school GPA, and post-secondary educational enrollment modeled on perceived social class, occupational status, and career goal attainment. The findings suggested group differences in some significant pathways. Knowledge about these trajectories will help educational and mental health professionals better understand the potential supports and barriers in career success for these individuals with exceptionalities.

The health care needs of children with hydrocephalus continue beyond childhood and adolescence; however, pediatric hospitals and pediatric neurosurgeons are often unable to provide them care after they become adults. Each year in the US, an estimated 5000–6000 adolescents and young adults (collectively, youth) with hydrocephalus must move to the adult health care system, a process known as health care transition (HCT), for which many are not prepared. Many discover that they cannot find neurosurgeons to care for them. A significant gap in health care services exists for young adults with hydrocephalus. To address these issues, the Hydrocephalus Association convened a Transition Summit in Seattle, Washington, February 17–18, 2017. The Hydrocephalus Association surveyed youth and families in focus groups to identify common concerns with HCT that were used to identify topics for the summit. Seven plenary sessions consisted of formal presentations. Four breakout groups identified key priorities and recommended actions regarding HCT models and practices, to prepare and engage patients, educate health care professionals, and address payment issues. The breakout group results were discussed by all participants to generate consensus recommendations. Barriers to effective HCT included difficulty finding adult neurosurgeons to accept young adults with hydrocephalus into their practices; unfamiliarity of neurologists, primary care providers, and other health care professionals with the principles of care for patients with hydrocephalus; insufficient infrastructure and processes to provide effective HCT for youth, and longitudinal care for adults with hydrocephalus; and inadequate compensation for health care services. Best practices were identified, including the National Center for Health Care Transition Improvement’s “Six Core Elements of Health Care Transition 2.0”; development of hydrocephalus-specific transition programs or incorporation of hydrocephalus into existing general HCT programs; and development of specialty centers for longitudinal care of adults with hydrocephalus. The lack of formal HCT and longitudinal care for young adults with hydrocephalus is a significant health care services problem in the US and Canada that professional societies in neurosurgery and neurology must address. Consensus recommendations of the Hydrocephalus Association Transition Summit address 1) actions by hospitals, health systems, and practices to meet local community needs to improve processes and infrastructure for HCT services and longitudinal care; and 2) actions by professional societies in adult and pediatric neurosurgery and neurology to meet national needs to improve processes and infrastructure for HCT services; to improve training in medical and surgical management of hydrocephalus and in HCT and longitudinal care; and to demonstrate the outcomes and effectiveness of HCT and longitudinal care by promoting research funding.

No description available.

Dam releases increase river stage and can reverse groundwater movement into and out of the river. As the flood, thermal, and solute waves travel downstream in a regulated river, the size of the waves is anticipated to be affected both by river processes and exchanges with near river groundwater. This study established a modeling framework to quantify the influences of the groundwater exchanges on the temperatures and solute concentration dynamics along regulated rivers. The wave properties, volume of exchanges, conservative solute mass exchanges, and heat energy exchanges were calculated as a function of time and distance downstream. Results show that the temperature and solute concentrations are influenced by the arrival of flood waves. Groundwater exchanges were found to affect temperatures along the river with a minimal effect on solute concentration. These findings provide insight regarding the influences of hydropeaking occurring in a large fraction of rivers in the world which has important implications for water quality and the ecology of regulated rivers.

Post-Earnings-Announcement Drift (PEAD) is commonly accepted in the fields of accounting and finance as evidence for stock market inefficiency. Less accepted are the numerous explanations for this anomaly. This project aims to investigate the cause for PEAD by harnessing the power of machine learning algorithms such as Principle Component Analysis (PCA) and a rule-based learning technique, applied to large stock market data sets. Based on the notion that the market is consumer driven, repeated occurrences of irrational behavior exhibited by traders in response to news events such as earnings reports are uncovered. The project produces findings in support of the PEAD anomaly using non-accounting nor financial methods. In particular, this project finds evidence for delayed price response exhibited in trader behavior, a common manifestation of the PEAD phenomenon.

Data arising from Cluster Randomized Trials (CRTs) and longitudinal studies are correlated and generalized estimating equations (GEE) are a popular analysis method for correlated data. Previous research has shown that analyses using GEE could result in liberal inference due to the use of the empirical sandwich covariance matrix estimator, which can yield negatively biased standard error estimates when the number of clusters or subjects is not large. Many techniques have been presented to correct this negative bias; However, use of these corrections can still result in biased standard error estimates and thus test sizes that are not consistently at their nominal level. Therefore, there is a need for an improved correction such that nominal type I error rates will consistently result. First, GEEs are becoming a popular choice for the analysis of data arising from CRTs. We study the use of recently developed corrections for empirical standard error estimation and the use of a combination of two popular corrections. In an extensive simulation study, we find that nominal type I error rates can be consistently attained when using an average of two popular corrections developed by Mancl and DeRouen (2001, Biometrics 57, 126-134) and Kauermann and Carroll (2001, Journal of the American Statistical Association 96, 1387-1396) (AVG MD KC). Use of this new correction was found to notably outperform the use of previously recommended corrections. Second, data arising from longitudinal studies are also commonly analyzed with GEE. We conduct a simulation study, finding two methods to attain nominal type I error rates more consistently than other methods in a variety of settings: First, a recently proposed method by Westgate and Burchett (2016, Statistics in Medicine 35, 3733-3744) that specifies both a covariance estimator and degrees of freedom, and second, AVG MD KC with degrees of freedom equaling the number of subjects minus the number of parameters in the marginal model. Finally, stepped wedge trials are an increasingly popular alternative to traditional parallel cluster randomized trials. Such trials often utilize a small number of clusters and numerous time intervals, and these components must be considered when choosing an analysis method. A generalized linear mixed model containing a random intercept and fixed time and intervention covariates is the most common analysis approach. However, the sole use of a random intercept applies assumptions that will be violated in practice. We show, using an extensive simulation study based on a motivating example and a more general design, alternative analysis methods are preferable for maintaining the validity of inference in small-sample stepped wedge trials with binary outcomes. First, we show the use of generalized estimating equations, with an appropriate bias correction and a degrees of freedom adjustment dependent on the study setting type, will result in nominal type I error rates. Second, we show the use of a cluster-level summary linear mixed model can also achieve nominal type I error rates for equal cluster size settings.

Michelangelo Phenomenon provides an interpersonal model of goal pursuits and suggests that close partners sculpt one another and help them move toward their ideal selves. Attachment theory also provides a parallel explanation of how close others can help one another move toward their goals. The purpose of the current research was to look at the influence of attachment on the Michelangelo Phenomenon and test whether it best fit as a predictor, mediator, or moderator. The hypotheses were tested across three studies (two longitudinal and one cross-sectional) using a maximum likelihood estimation path analysis following APIM assumptions. The results provided strong support for the link between attachment and the Michelangelo Phenomenon. Across three studies, attachment acted as a predictor of the Michelangelo Phenomenon with higher levels of attachment anxiety and avoidance predicting lower levels of affirmation. Relevance to therapy and future directions are also discussed.

L'adolescence est une période importante de la vie caractérisée par des changements majeurs psychologiques et comportementaux qui ont été théoriquement et empiriquement reliés aux changements dans l'environnement social. Les différents milieux de vie des adolescents leur offrent un «terrain de jeu» pour explorer, tester, développer et intégrer des compétences cruciales nécessaires à l’interaction sociale, comme les comportements prosociaux. À l'adolescence, les relations entre pairs deviennent plus saillantes et plus importantes qu’a toute autre période de la vie. Au-delà des contextes familial et scolaire, les adolescents consacrent beaucoup de temps à différentes activités avec des pairs. Parmi ces activités, nous nous sommes focalisées sur la participation à des activités extrascolaires qui sont considérés comme un milieu de vie important dans le développement positif des adolescents.Le premier objectif de cette thèse était de mieux comprendre le rôle des milieux de vie dans l'empathie et les comportements prosociaux à l'adolescence. Nous avons développé et examiné un modèle théorique intégratif des relations entre les caractéristiques positives et négatives des milieux de vie (famille, classe et groupe de pairs extrascolaire), la perception par les adolescents des comportements prosociaux dans chacun de ces milieux de vie et de leurs propres comportements prosociaux, en tenant compte du rôle médiateur de l'empathie.Le deuxième objectif était de mieux comprendre les relations longitudinales bidirectionnelles entre l'empathie et les comportements prosociaux à l'adolescence, en mettant un accent particulier sur les processus internes à la personne.Enfin, le troisième objectif était de mieux comprendre les trajectoires de développement de l’empathie et des comportements prosociaux des adolescents en prenant en compte leur participation à des activités extrascolaires.Nous avons conduit un recueil de données longitudinales à 3 vagues avec un intervalle d’un an. Les adolescents ont répondu à des questions concernant les caractéristiques des trois milieux de vie, les comportements prosociaux dans chacun d’eux, leur participation extrascolaire, ainsi que leur empathie et leurs comportements prosociaux.Nos résultats suggèrent que les caractéristiques des groupes de pairs extrascolaires et de la famille (en particulier les plus négatives) et la perception de leurs comportements prosociaux jouent un rôle majeur dans les comportements prosociaux des adolescents via l'empathie à l'adolescence. Ils montrent également que l’empathie est un prédicteur des comportements prosociaux et que les trajectoires de développement de l’empathie et des comportements prosociaux à l’adolescence sont différentes chez ceux qui participent à des activités extrascolaires où on n’observe pas de trajectoire développementale décroissante comparé à ceux qui n’y participent pas.En utilisant une seule approche théorique dans trois milieux de vie différents, nous avons pu saisir les caractéristiques communes et spécifiques de la famille, du groupe-classe et des groupes de pairs extrascolaires, qui ont une influence sur les comportements prosociaux des adolescents. De plus, prendre en compte les différences entre les individus et les processus de développement intra-individuels, l’hétérogénéité des trajectoires développementales concernant l’empathie et les comportements prosociaux à l’adolescence est essentiel pour saisir l’interaction complexe entre la famille, la classe, le groupe de pairs extrascolaire, l’empathie et le développement prosocial / Adolescence is a significant period in life that is characterized by major changes that have been theoretically and empirically related to changes in social environments. Adolescents different living environments offer the “playground” to explore, to test, to develop and integrate social cues and crucial abilities that are necessary for social interaction, such as prosocial behaviours. During adolescence, peer relationships become more salient and prominent than in any other period in life. Away from the family and the school context, adolescents spend a large amount of time in activities with peers. Among these activities we focused on extracurricular activity participation, that have been conceptualised as an important developmental context of adolescents’ livesThe first aim of this dissertation was to provide more insight into the role of living environments in relation to empathy and prosocial behaviours in adolescence. We developed and examined an integrative model of the relations between positive and negative living environment features, adolescents’ perceptions of prosocial behaviours across the three contexts (family, class and extracurricular peer group) and their own prosocial behaviours, taking into account the potential mediating role of empathy.The second aim was to provide more insight into the bidirectional longitudinal relations between empathy and prosocial behaviours during adolescence, with a special focus on the within-person processes.Finally, the third aim of this dissertation was to provide more insight into adolescents’ prosocial behaviours and empathy developmental trajectories considering extracurricular activity participation.This dissertation used data from a 3-Wave longitudinal study gathered during the three years of the PhD with data collected at one-year intervals. Adolescents answered questions concerning the features of the living environment, their peer group’s and parents’ prosocial behaviours, extracurricular activity participation, and their own empathy and prosocial behaviour.Our findings suggest that extracurricular peer group features, family features (particularly the negative ones) and extracurricular peer group and parents’ prosocial behaviours play a major role in adolescents’ prosocial behaviours via empathy in adolescence.Therefore, we found that empathy is a driver of prosocial behaviours. We also identified that latent class growth for empathy and prosocial behaviour were different in the extracurricular activity group for which there was no downward trend trajectory over time compared to the non-extracurricular group.Using one approach across three living environments allowed us to capture the common and specific features of the family, school and extracurricular peer group contexts that influence adolescents’ prosocial behaviours. Furthermore, our results highlighted the need to acknowledge the between person differences and the within-person processes of development. Moreover, it is important to consider the heterogeneity of developmental trajectories concerning empathy and prosocial behaviours during adolescence if we want to capture the complex interplay between family, class, extracurricular peer group, empathy and prosocial development.

Longitudinal growth patterns are routinely seen in medical studies where developments of individuals on one or more outcome variables are followed over a period of time. Many current methods for modeling growth presuppose a parametric relationship between the outcome and time (e.g., linear, quadratic); however, these relationships may not accurately capture growth over time. Functional mixed effects (FME) models provide flexibility in handling longitudinal data with nonparametric temporal trends because they allow the data to determine the shape of the curve. Although FME methods are well-developed for continuous, normally distributed outcome measures, nonparametric methods for handling categorical outcomes are limited. In this thesis, we propose a Bayesian hierarchical FME model to account for growth curves with non-Gaussian outcomes. In particular, we extend traditional FME models which assume normally distributed outcomes by modeling the probabilities associated with the binomially distributed outcomes and adding an additional level to the hierarchical model to correctly specify the outcomes as binomially distributed. We then extend the proposed binomial FME model to the multinomial setting where the outcomes consist of more than two nominal categories. Current modeling approaches include modeling each category of a multinomial outcome separately via linear and nonlinear mixed effects models; yet, these approaches ignore the inherent correlation among the categories of the outcome. Our model captures this correlation through a sequence of conditional binomial FME models which results in one model simultaneously estimating probabilities in all categories. Lastly, we extend our binomial FME model to address a common medical situation where multiple outcomes are measured on subjects over time and investigators are interested in simultaneously assessing the impact of all outcomes. We account for the relationship between outcomes by altering the correlation structure in the hierarchical model and simultaneously estimating the outcome curves. Our methods are assessed via simulation studies and real data analyses where we investigate the ability of the models to accurately predict the underlying growth trajectory of individuals and populations. Our applications include analyses of speech development data in adults and children with cochlear implants and analyses on eye-tracking data used to assess word processing in cochlear implant patients.

Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit margin and shorter lengths of stay can enable patient turnover and efficiency of care. Higher rates of hospice transfers and lower in-hospital mortality may be considered positive outcomes from a patient perspective, as the majority of patients prefer to die at home or outside of the hospital setting. Several data sources were utilized to obtain information about patient, hospital, and county characteristics; patterns of hospitals’ palliative care provision; and patients’ hospital costs, length of stay, in-hospital mortality, and transfer to hospice (if a patient survived hospitalization). The study sample consisted of 3,763,339 patients; 348 urban, general, short-term, acute care, non-federal hospitals; and 111 counties located in six states over a 5-year study (2007-2011). Hospital-based palliative care provision was measured by the presence of three palliative care services, including inpatient palliative care consultation services (PAL), inpatient palliative care units (IPAL), and hospice programs (HOSPC). Derived from Institutional Theory, Resource Dependence Theory, and Donabedian’s Structure Process-Outcome framework, 13 hypotheses were tested using a hierarchical (generalized) linear modeling approach. The study findings suggested that hospital size was associated with a higher probability of hospital-based palliative care provision. Conversely, the presence of palliative care services through a hospital’s health system, network, or joint venture was associated with a lower probability of hospital-based palliative care provision. The study findings also indicated that hospitals with an IPAL or HOSPC incurred lower hospital costs, whereas hospitals with PAL incurred higher hospital costs. The presence of PAL, IPAL, and HOSPC was generally associated with a lower probability of in-hospital mortality and transfer to hospice. Finally, the effects of hospital-based palliative care services on length of stay were mixed, and further research is needed to understand this relationship.