Despite a consensus that psychosocial adversity plays a role in the onset of psychosis, the nature of this role and the underlying neurobiological mechanisms remain unclear. This study examined the complex relationship between perceived ethnic discrimination (PED) and paranoid ideation and its mediating factors, in individuals with Attenuated Psychotic Syndrome (APS) using a virtual reality paradigm to objectively quantify paranoia. Secondly, a sensory gating deficit, indexed by P50 Event Related Potential (ERP) abnormalities was examined, and the combined effect of electrophysiological sensory gating deficits and psycho-social adversity on the development of psychosis was explored. Results showed that perceived maternal neglect and antipathy in childhood, PED and perceived social support were key factors in young adults with APS. Also PED was positively correlated with persecutory paranoia. Furthermore, individuals with APS displayed sensory gating impairments. Therefore, perceived exposure to adverse experiences and sensory gating deficits observed in individuals with APS are present before the first episode and are consistent with current biopsychosocial models in which early psychosocial stress, later psychosocial adversity and neurocognitive functioning plays a key role in the development of psychosis.

This study was performed as the result of gaps in the literature in the area of transition to independent living (IL) using secondary data from the National Longitudinal Transition Study 2 (NLTS-2). Its findings identify individual, skills, family, and school factors that predict postsecondary living status and moderators of the relationships between predictors and the outcome. Specifically, results indicated the following factors as predicting postsecondary living status: individual factors (ethnicity and disability label), skills (self-care, functional mental, personal autonomy, self-realization, and social), family factors (parental expectations and parental involvement in school), and school factors (student’s role in transition planning and having IL as the primary IEP goal). The following factors also emerged as moderators: ethnicity, disability label, mental skills, social skills, personal autonomy, and having IL as the primary goal. Performing analyses on secondary data, although providing the advantage of large numbers of participants, also result in limitations that were considered when making recommendations. Future research should investigate the accuracy of findings regarding skills predictors, and probe for better understanding of decision making during transition planning and participants’ experiences. Policy should include transition planning specifically for IL and postsecondary follow-up for this outcome, while practice should focus on incorporating planning for IL during transition planning, addressing cultural diversity in transition, and helping parents develop high and realistic expectations for their children.

The purpose of this study was to examine the extent to which controllable institutional variables, as perceived by Black college students, are related to their academic performance. The population for this study came from an historically Black college in Atlanta, Georgia. Using an Ex Post Facto research design, the study focused on the freshman year experience by asking 38 second year computer science and mathematics majors to review their freshman year retrospectively. Data were collected from the population using the Student Survey on Awareness and Utilization Instrument. Pearson correlation and regression were used to analyze the data. The study revealed that there is a significant relationship between 7 of the awareness and utilization variables (independent) and students• academic performance (dependent). The study concludes by recommending that colleges institutionalize certain practices for freshmen in order to enhance their academic prowess.

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Imperfect patient adherence to treatment leads to adverse individual and social outcomes: it has negative effect on patient health and, consequently, it increases health care costs. The adherence is low particularly in chronically ill patients with complex regimen, such as hemodialysis. This thesis provides an in-depth study of the phenomenon and presents a survey targeted at hemodialysis patients in the Czech Republic. The survey assesses prevalence of nonadherence, identifies predictors of nonadherence, and analyzes patients' attitude to a hypothetical incentive program to promote adherence. Then, an optimal design of an intervention to promote adherence is discussed. Results show that 72% of patients do not adhere to one or more areas of hemodialysis treatment. Prevalence of nonadherence is highest for following fluid restrictions (62.8%) and diet guidelines (55.7%). On the contrary, medication and appointment nonadherence is not frequent. Strongest predictors for nonadherence are: young age, male sex, treatment for depression, number of prescribed pills, and length of dialysis treatment. Most of patients (83%) indicated that they would change their behavior when involved in an incentive program to promote adherence. With regard to broad prevalence of nonadherence, an intervention targeted at...

Background Musculoskeletal disorders (MSDs) are one of the most important causes of temporary and permanent disability, causing acute or persistent pain, resulting in reduced and/or lost ability to work. Return to work (RTW) is multidimensional problem including many different factors and aspects. Few recent studies have analyzed factors predicting RTW after multimodal rehabilitation (MMR). Identification of predictors for RTW may help to improve the planning and optimization of the RTW strategy. The REHSAM II project is a randomized controlled trial with the aim to evaluate if MMR together with a web Behavior Change Program for Activity could increase work ability among persons with persistent MSDs as compared to MMR. Therefore the aim of this study was to identify factors explaining RTW 12 month after baseline in the REHSAM II project. Methods The present study is a secondary assessment of the data from the randomized controlled trial REHSAM II. A total of 97 participants with persistent musculoskeletal pain were randomly allocated to MMR + web-based education or only MMR group. The subjects were followed from baseline to 12 months. Information on potential predictors was obtained from self-administered questionnaires. Data were analyzed with univariate and multiple logistic regression models. Results In the final multiple regression model RTW was predicted by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ score) (p=0.003, OR=0.961) and EuroQol (EQ-5D index) (p=0.017, OR=7.283). The univariate regression analyses showed that pain and disability level, the capacity to perform a task in relation to pain and other symptoms, hospital and psychiatric care, medication for insomnia, catastrophizing, self-assessed work ability compared with the lifetime best, satisfaction with life, ability for coping and controlling work situation, ability for coping with life outside work and sense of responsibility for managing health condition were significantly associated with RTW. Conclusion In conclusion, psychosocial pain-related variable and health-related quality of life predicted RTW in the final model. The result confirms the fact that RTW is a multidimensional problem involving a complex interaction of many factors.

In recent years, the functional outcomes of patients with right hemisphere stroke (RHS) received considerable attention due to their impact on disability, independent living, quality of life and economic burden. Hemi-inattention (HI) is a complex condition which often accompanies RHS. It is characterised by reduced alertness, attention and low spatial awareness levels. Past studies reported poor outcomes in patients with HI and inconsistent findings in regard to the relationship of HI with functional outcome. Literature review of 13 relevant studies highlighted poor research methodology which complicated interpretation of previous results. Aims: The aim of this study was to address the clinically important question “What is the relationship between early HI status (HI±) and functional change in the 1st six months after right hemisphere stroke?” by improving on research methodology from past studies. Methods: An all-inclusive stroke severity RHS sample (58 with and 35 without HI) were recruited from two stroke units and assessed on motor and cognitive factors with validated measurement tools on four occasions; baseline, hospital discharge, 6 weeks after discharge, and 6 months after stroke. A multi-level modelling approach was used to analyse change in functional progress over time with potential explanatory motor and cognitive factors. Results: HI status was only statistically significant when modelled alone. Its predictive importance greatly diminished when modelled with other factors e.g. stroke severity, time since stroke and age. Conclusion: On average, HI group membership at baseline is unrelated to functional recovery when other influential factors are also considered. The findings extend current knowledge in stroke recovery research and provide suggestions for optimal therapeutic and rehabilitation outcomes. In contrast with traditional methods of regression analysis, multi-level modelling techniques enabled important relationships to be studied in depth. This resulted in new insights into the data which can be used to inform patient management and future research in the field.

Previous research has focused on developmental trends in parent-adolescent conflict without extensively describing individual differences in conflict. The current study tested child factors, parent factors, contextual factors, and adolescence-specific factors as concurrent correlates and longitudinal predictors of parent-adolescent conflict. Participants include 218 mother-child dyads, adolescents’ mean age (11years, 11months). Parent and adolescent data was collected during the summers following the adolescents’ 5th and 6th grade years. All four groups of variables were associated with parent-adolescent conflict. The child group of factors emerged as the most consistent group of variables concurrently and longitudinally.

Student Number : 0411802R - MSc (Med) research report - Faculty of Health Sciences / Unintended pregnancy among the youth is a serious public health problem for it exposes the young women and the foetuses to higher risk of morbidity and mortality. Although recognised as a major public health problem, studies on it have been limited and localised in South Africa. Using the 1998 South African Demographic and Health Survey (SADHS) data set, this study examines the distribution of and factors associated with unintended pregnancy among South African youth. The 1998 SADHS was a nationally representative cross-sectional survey with a probability sample of twelve thousand (12 000) women between the ages of 15 and 49. The survey used a structured questionnaire to collect information on fertility issues in general from the respondents. Analysis was based on 1 395 observations which was arrived at after sub setting observations of women aged 15-24 that had pregnancy at the time of and/or three years preceding the survey. Logistic regression model was employed to estimate the effects of identified predictors on unintended pregnancy. The results show a high level of unintended pregnancy with only 29% of the pregnancies wanted. The level of unintended pregnancy varies by region and some socio-economic variables. Respondents from KwaZulu Natal had the highest percentage (81%) of unintended pregnancy while North West had the lowest at 56%. It was also found that the higher the educational level of the respondents, the higher the incidence of unwanted pregnancy. Among the respondents using modern method of contraception, 74% reported having unintended pregnancy while the probability of unintended pregnancy was found to decrease with increase in age at first intercourse. Overall, about 69% of respondents who reported unintended pregnancy had last sexual relation with their regular partners, 21% with marital partners and 10% with casual partners. Using stepwise logistic regression, five critical predictors of unintended pregnancy among South African youth were identified. These are: age group, region, marital status, education and relationship to the last sexual partner. The findings of this study have implications for reproductive health policies and programs in designing appropriate national programs for reducing the incidence of unintended pregnancy among South African youth. The need for further research into this area using triangulated methodology is recommended.

Orientador: Silméia Garcia Zanati Bazan / Resumo: Introdução: A doença arterial coronariana é a primeira causa isolada de morte e responsável por elevado número de hospitalizações em todo o mundo. O desenvolvimento de remodelação ventricular está associado com pior prognóstico após o infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCST), representando fator de risco para a disfunção ventricular e insuficiência cardíaca. Objetivos: Identificar quais variáveis são preditoras da remodelação ventricular após o IAMCST e avaliar as características clínicas, laboratoriais e ecocardiográficas em pacientes na fase aguda do IAMCST de parede anterior submetidos à angioplastia primária e após seis meses do infarto. Metodologia: Foi realizado um estudo prospectivo, observacional e longitudinal, composto por pacientes com diagnóstico de IAMCST de parede anterior admitidos na Unidade Coronariana (UCO) do Hospital das Clínicas da Faculdade de Medicina de Botucatu no período de julho de 2017 a agosto de 2018. Foram incluídos 50 pacientes, sendo que quatro perderam o seguimento em seis meses e cinco evoluíram a óbito no mesmo período. Durante o período da internação na UCO, os pacientes foram avaliados diariamente e submetidos ao primeiro ecocardiograma em 2 a 3 dias após o IAMCST. No sexto mês após o IAMCST, os pacientes foram submetidos à reavaliação clínica e a novo ecocardiograma, conforme protocolo do serviço. A remodelação cardíaca foi considerada como aumento no volume diastólico superior a 15%. Análise estatística... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Coronary arterial disease is the first isolated death cause and is responsible for an elevated number of hospitalizations all over the world. The development of ventricular remodeling is associated with worse prognosis after ST segment elevation myocardial infarction (STEMI), representing a risk factor for ventricular dysfunction and heart failure. Objectives: To identify which variables are predictors of ventricular remodeling after STEMI and to evaluate clinical, laboratorial and echocardiographic characteristics of patients early post anterior STEMI who went through primary percutaneous intervention and six month after infarction. Methods: This was a prospective, observational and longitudinal study, with anterior STEMI patients admitted to the coronary care unit (CCU) of the Botucatu Medical School Clinics Hospital within July 2017 and August 2018. A total of 50 patients were included, four lost follow-up in six months and five died within the same period. During CCU stay, patients were daily evaluated and submitted to an echocardiogram within the first three days after STEMI. After six months, patients were submitted to a new clinical evaluation and a new echocardiogram, according to local protocol. Ventricular remodeling was considered as a raise in diastolic volume greater than 15%. Statistical analysis: continuous variable both normal and non-normal distribution were presented in either average and standard deviation or median and 25 and 75 percentiles, ... (Complete abstract click electronic access below) / Mestre