scholarly journals Spiritual Struggle in Parents of Children with Cystic Fibrosis Increases Odds of Depression

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Rhonda D. Szczesniak ◽  
Yuanshu Zou ◽  
Sophia M. Stamper ◽  
Daniel H. Grossoehme
Keyword(s):  
Cystic Fibrosis ◽  
Depressive Symptoms ◽  
Mixed Effects ◽  
Spiritual Struggle ◽  
Linear Mixed Effects ◽  
Mixed Effects Modeling ◽  
Prevalence Of Depression ◽  
Generalized Linear Mixed Effects ◽  
Over Time

Objective. Spiritual struggle (SS) is associated with poorer health outcomes including depression. The study’s main objectives were to characterize change in depression over time, examine longitudinal associations between SS and depression, and determine the extent to which experiencing SS at baseline was predictive of developing depression at follow-up. Methods. A two-site study collected questionnaire responses of parents (N=112; 72% female) of children with cystic fibrosis followed longitudinally. Generalized linear mixed effects modeling examined the association between depression and SS over time and assessed potential mediators, moderators, and confounders. Results. Prevalence of depression increased from baseline to follow-up (OR: 3.6, P<0.0001), regardless of degree of SS. Parents with Moderate/Severe SS were more likely to have depressive symptoms, compared to parents without SS (OR: 15.2, P=0.0003) and parents who had Mild SS (OR: 10.2, P=0.0001). Being female and feeling less “at peace” also significantly predicted increased depression (OR: 2.5, P=0.0397, and OR: 1.15, P=0.0419, resp.). Experiencing SS at baseline was not predictive of having depression subsequently at follow-up. Conclusions. Parents experiencing SS were significantly more likely to report depressive symptoms. Interventions to reduce SS have shown efficacy and may be considered.

scholarly journals Change in Dyslipidemia with Declining Glomerular Filtration Rate and Increasing Proteinuria in Children with CKD

2019 ◽  
Vol 14 (12) ◽  
pp. 1711-1718 ◽  
Author(s):  
Jeffrey M. Saland ◽  
Juan C. Kupferman ◽  
Christopher B. Pierce ◽  
Joseph T. Flynn ◽  
Mark M. Mitsnefes ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Filtration Rate ◽  
Hdl Cholesterol ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Changes Over Time ◽  
Over Time

Background and objectivesDyslipidemia, a risk factor for cardiovascular disease, is common in CKD but its change over time and how that change is influenced by concurrent progression of CKD have not been previously described.Design, setting, participants, & measurementsIn the CKD in Children study we prospectively followed children with progressive CKD and utilized multivariable, linear mixed-effects models to quantify the longitudinal relationship between within-subject changes in lipid measures (HDL cholesterol, non-HDL cholesterol, triglycerides) and within-subject changes in GFR, proteinuria, and body mass index (BMI).ResultsA total of 508 children (76% nonglomerular CKD, 24% glomerular CKD) had 2–6 lipid measurements each, with a median follow-up time of 4 (interquartile range [IQR], 2.1–6.0) years. Among children with nonglomerular CKD, dyslipidemia was common at baseline (35%) and increased significantly as children aged; 43% of children with glomerular CKD had dyslipidemia at baseline and demonstrated persistent levels as they aged. Longitudinal increases in proteinuria were independently associated with significant concomitant increases in non-HDL cholesterol (nonglomerular: 4.9 [IQR, 3.4–6.4] mg/dl; glomerular: 8.5 [IQR, 6.0–11.1] mg/dl) and triglycerides (nonglomerular: 3% [IQR, 0.8%–6%]; glomerular: 5% [IQR, 0.6%–9%]). Decreases in GFR over follow-up were significantly associated with concomitant decreases of HDL cholesterol in children with nonglomerular CKD (−1.2 mg/dl; IQR, −2.1 to −0.4 mg/dl) and increases of non-HDL cholesterol in children with glomerular CKD (3.9 mg/dl; IQR, 1.4–6.5 mg/dl). The effects of increased BMI also affected multiple lipid changes over time. Collectively, glomerular CKD displayed stronger, deleterious associations between within-subject change in non-HDL cholesterol (9 mg/dl versus 1.2 mg/dl; P<0.001) and triglycerides (14% versus 3%; P=0.004), and within-subject change in BMI; similar but quantitatively smaller differences between the two types of CKD were noted for associations of within-subject change in lipids to within-subject change in GFR and proteinuria.ConclusionsDyslipidemia is a common and persistent complication in children with CKD and it worsens in proportion to declining GFR, worsening proteinuria, and increasing BMI.

scholarly journals The power of modelling pulsatile profiles

2021 ◽  
Author(s):  
Michiel J. van Esdonk ◽  
Jasper Stevens
Keyword(s):  
Growth Hormone ◽  
Statistical Power ◽  
Quantitative Description ◽  
Mixed Effects ◽  
Post Dose ◽  
Deconvolution Analysis ◽  
Linear Mixed Effects ◽  
Non Linear ◽  
Over Time ◽  
Modelling Approach

AbstractThe quantitative description of individual observations in non-linear mixed effects models over time is complicated when the studied biomarker has a pulsatile release (e.g. insulin, growth hormone, luteinizing hormone). Unfortunately, standard non-linear mixed effects population pharmacodynamic models such as turnover and precursor response models (with or without a cosinor component) are unable to quantify these complex secretion profiles over time. In this study, the statistical power of standard statistical methodology such as 6 post-dose measurements or the area under the curve from 0 to 12 h post-dose on simulated dense concentration–time profiles of growth hormone was compared to a deconvolution-analysis-informed modelling approach in different simulated scenarios. The statistical power of the deconvolution-analysis-informed approach was determined with a Monte-Carlo Mapped Power analysis. Due to the high level of intra- and inter-individual variability in growth hormone concentrations over time, regardless of the simulated effect size, only the deconvolution-analysis informed approach reached a statistical power of more than 80% with a sample size of less than 200 subjects per cohort. Furthermore, the use of this deconvolution-analysis-informed modelling approach improved the description of the observations on an individual level and enabled the quantification of a drug effect to be used for subsequent clinical trial simulations.

Six-month trajectories of self-reported depressive symptoms in long-term care

2015 ◽  
Vol 28 (1) ◽  
pp. 71-81 ◽  
Author(s):  
Jane McCusker ◽  
Martin G. Cole ◽  
Philippe Voyer ◽  
Johanne Monette ◽  
Nathalie Champoux ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Long Term Care ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Depression Symptom ◽  
Term Care ◽  
Symptom Trajectory ◽  
Over Time

ABSTRACTBackground:Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.Methods:This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.Results:Three clusters of depression symptom trajectory were found that described “lower,” “intermediate,” and “higher” levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.Conclusions:The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.

The Hub

2019 ◽  
pp. 141-181
Author(s):  
James N. Stanford
Keyword(s):  
Social Class ◽  
New England ◽  
Social Factors ◽  
Mixed Effects ◽  
Regression Modeling ◽  
Linear Mixed Effects ◽  
Eastern Massachusetts ◽  
Over Time

This is the first of two chapters (Chapters 6 and 7) that analyze fieldwork results in eastern Massachusetts. This chapter analyzes the eastern Massachusetts “Hub” region as a whole, providing a statistical overview of speakers interviewed in the Dartmouth-based fieldwork in this area. It examines the results in terms of major traditional Eastern New England dialect features, including Linear Mixed Effects regression modeling in terms of phonetic environments and social factors like age, gender, social class, and ethnicity. The chapter also plots these dialect features in terms of speakers’ birth year and other factors, showing how these features are changing over time.

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