Background: Modern modeling techniques may potentially provide more accurate predictions of dichotomous outcomes than classical techniques. Objective: In this study, we aimed to examine the predictive performance of eight modeling techniques to predict mortality by frailty. Methods: We performed a longitudinal study with a 7-year follow-up. The sample consisted of 479 Dutch community-dwelling people, aged 75 years and older. Frailty was assessed with the Tilburg Frailty Indicator (TFI), a self-report questionnaire. This questionnaire consists of eight physical, four psychological, and three social frailty components. The municipality of Roosendaal, a city in the Netherlands, provided the mortality dates. We compared modeling techniques, such as support vector machine (SVM), neural network (NN), random forest, and least absolute shrinkage and selection operator, as well as classical techniques, such as logistic regression, two Bayesian networks, and recursive partitioning (RP). The area under the receiver operating characteristic curve (AUROC) indicated the performance of the models. The models were validated using bootstrapping. Results: We found that the NN model had the best validated performance (AUROC=0.812), followed by the SVM model (AUROC=0.705). The other models had validated AUROC values below 0.700. The RP model had the lowest validated AUROC (0.605). The NN model had the highest optimism (0.156). The predictor variable “difficulty in walking” was important for all models. Conclusions: Because of the high optimism of the NN model, we prefer the SVM model for predicting mortality among community-dwelling older people using the TFI, with the addition of “gender” and “age” variables. External validation is a necessary step before applying the prediction models in a new setting.
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OBJECTIVE: This work aims to gain insight into the long-term impact of depression course on social network size and perceived loneliness in older people living in the community. METHODS: Within a large representative sample of older people in the community (Longitudinal Aging Study Amsterdam (LASA)), participants with clinically relevant levels of depressive symptoms (scores >16 on the Center for Epidemiological Studies Depression Scale) were followed up over a period of 13 years of the LASA study (five waves). General estimating equations were used to estimate the impact of depression course on network size and loneliness and the interaction with gender and age. RESULTS: An unfavorable course of depression was found to be associated with smaller network sizes and higher levels of loneliness over time, especially in men and older participants. CONCLUSIONS: The findings of this study stress the importance of clinical attention to the negative consequences of chronicity in depressed older people. Clinicians should assess possible erosion of the social network over time and be aware of increased feelings of loneliness in this patient group.
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Background:Current technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically connected to individuals as if they are part of the body, similar to a physical prosthesis. Additionally, while several studies have been performed on the phenomenology of receiving and wearing a physical prosthesis, it is unknown whether similar subjective experiences arise with technology.Objective:In one of the first qualitative studies to track wearables in a longitudinal investigation, we explore whether a wearable can be embodied similar to a physical prosthesis. We hoped to gain insights and compare the phases of embodiment (ie, initial adjustment to the prosthesis) and the psychological responses (ie, accept the prosthesis as part of their body) between wearables and limb prostheses. This approach allowed us to find out whether this pattern was part of a cyclical (ie, period of different usage intensity) or asymptotic (ie, abandonment of the technology) pattern.Methods:We adapted a limb prosthesis methodological framework to be applied to wearables and conducted semistructured interviews over a span of several months to assess if, how, and to what extent individuals come to embody wearables similar to prosthetic devices. Twelve individuals wore fitness trackers for 9 months, during which time interviews were conducted in the following three phases: after 3 months, after 6 months, and at the end of the study after 9 months. A deductive thematic analysis based on Murray’s work was combined with an inductive approach in which new themes were discovered.Results:Overall, the individuals experienced technology embodiment similar to limb embodiment in terms of adjustment, wearability, awareness, and body extension. Furthermore, we discovered two additional themes of engagement/reengagement and comparison to another device or person. Interestingly, many participants experienced a rarely reported phenomenon in longitudinal studies where the feedback from the device was counterintuitive to their own beliefs. This created a blurring of self-perception and a dilemma of “whom” to believe, the machine or one’s self.Conclusions:There are many similarities between the embodiment of a limb prosthesis and a wearable. The large overlap between limb and wearable embodiment would suggest that insights from physical prostheses can be applied to wearables and vice versa. This is especially interesting as we are seeing the traditionally “dumb” body prosthesis becoming smarter and thus a natural merging of technology and body. Future longitudinal studies could focus on the dilemma people might experience of whether to believe the information of the device over their own thoughts and feelings. These studies might take into account constructs, such as technology reliance, autonomy, and levels of self-awareness.
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In this contribution, we evaluate the degree of measurement equivalence between countries and over time for a measure of experienced holiday quality that has repeatedly been included in a public opinion survey series of high policy relevance: the Flash Eurobarometer survey series (2014–2016). The results indicate that using the measurement instrument for cross-national comparisons between 35 countries may be quite problematic, as neither metric nor scalar measurement equivalence was established. The longitudinal analyses show that for 19 out of 28 countries, scalar measurement equivalence holds between the waves. For the countries for which longitudinal scalar measurement equivalence was established, the comparison of the mean overall score of satisfaction with the holiday shows a very high level of stability. In general, the findings underscore the importance of assessing measurement equivalence of empirical tourism and leisure-related constructs when making systematic comparisons between groups or over time.
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Background: Over the years, a plethora of frailty assessment tools has been developed. These instruments can be basically grouped into two types of conceptualizations – unidimensional, based on the physical–biological dimension – and multidimensional, based on the connections among the physical, psychological, and social domains. At present, studies on the comparison between uni- and multidimensional frailty measures are limited. Objective: The aims of this paper were: 1) to compare the prevalence of frailty obtained using a uni- and a multidimensional measure; 2) to analyze differences in the functional status among individuals captured as frail or robust by the two measures; and 3) to investigate relations between the two frailty measures and disability.
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Introduction: Previous longitudinal studies indicate that physical activity (PA) significantly declines from primary-to secondary school, and report both changes in individual and environmental determinants of PA. In order to understand this transition and to prevent this negative trend, it is important to gather contextually rich data on possible mechanisms that drive this decline. Therefore, the aim of this study was to investigate changes of PA patterns in transition between primary and secondary school, and to add domain-specific insights of how, where, and when these changes occur. Methods: In total, 175 children participated in a 7-day accelerometer- and Global Positioning System (GPS) protocol at their last year of primary and their first year of secondary school. GPS data-points were overlaid with Geographical Information Systems (GIS) data using ArcGIS 10.1 software. Based on the GPS locations of individual data-points, we identified child’s PA at home, school, local sports grounds, shopping centers, and other locations. Also, trips in active and passive transport were identified according to previously validated GPS speed-algorithms. Longitudinal multi-level linear mixed models were fitted adjusting for age, gender, meteorological circumstances, and the nested structure of days within children and children within schools. Outcome measures were minutes spent in light PA and moderate-to-vigorous PA, specified for the time-segments before school, during school, after school and weekend days. Results: Total PA significantly declined from primary to secondary school. Although transport-related PA increased before- and during school, decreases were found for especially afterschool time spent at sports grounds and transport-related PA during weekends.
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Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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Longitudinal criminological studies greatly improved our understanding of the longitudinal patterns of criminality. These studies, however, focused almost exclusively on traditional types of offending and it is therefore unclear whether results are generalizable to online types of offending. This study attempted to identify the developmental trajectories of active hackers who perform web defacements. The data for this study consisted of 2,745,311 attacks performed by 66,553 hackers and reported to Zone-H between January 2010 and March 2017. Semi-parametric group-based trajectory models were used to distinguish six different groups of hackers based on the timing and frequency of their defacements. The results demonstrated some common relationships to traditional types of crime, as a small population of defacers accounted for the majority of defacements against websites. Additionally, the methods and targeting practices of defacers differed based on the frequency with which they performed defacements generally.
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Background. One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients. Objective. Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study. Methods. This longitudinal study measured data in 1992, 1997 and 2007. The 1992 LISREL path model (Hiddink GJ, Hautvast J, vanWoerkumCMJ, Fieren CJ, vantHofMA. Nutrition guidance by primary-care physicians: LISREL analysis improves understanding. Prev Med 1997; 26: 29–36.) demonstrated that ‘noticing patients’ overweight and guidance of treatment’ was directly and indirectly influenced by predisposing factors, driving forces and perceived barriers. This article defines and discusses the path analysis of the 2007 data (compared with 1997). Results. This analysis shows both similarity and differences inworking mechanism of determinants of noticing patients’ overweight and guidance of treatment between 1997 and 2007. The backbone of themechanism with four predisposing factors is the similarity. The number of driving forces and of paths through intermediary factors to the dependent variable constitutes the difference. Conclusions. The backbone of the working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs was similar in 2007 and 1997. The influence of GPs task perception on noticing patients’ overweight and guidance of treatment considerably increased in 2007 compared to 1997. The longitudinal character of this article gives a strong practice-based evidence for weight management by GPs.
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OBJECTIVE: Perceived fatigue significantly impacts quality of life after burns, yet how often it occurs is unknown. Therefor this study assessed the prevalence of perceived fatigue of burn survivors.METHODS: In February 2023, a systematic literature search was performed in CINAHL, Embase, PsycInfo, PubMed and Web of Science. Studies reporting the prevalence of post-burn perceived fatigue were included.RESULTS: In ten cross-sectional studies of moderate-high quality with measurements between 5.3 days and 42 years post burn, the prevalence of perceived fatigue varied between 5 % and 78 % with no apparent time trends. Broad study populations hindered explaining this varying prevalence by age or %TBSA. In four high-quality longitudinal studies with 3-5 measurements between 1 and 24 months post burn, the prevalence decreased over time, dropping from approximately 70 to 50 % in adults and 65 to 28 % in children. Studies used various measurement instruments and cut-off points for operationalizing perceived fatigue, severely limiting the interpretation and comparison of prevalence rates across studies.CONCLUSIONS: The high prevalence and persistent nature of perceived fatigue among burn survivors emphasize its crucial role in burn rehabilitation. Future studies should prioritize identifying individuals with adverse trajectories of perceived fatigue and unravelling underlying mechanisms to develop effective treatments for reducing post-burn perceived fatigue.
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