Predictors of perpetration of men's same-sex partner violence.

This study examined alcohol consumption, internalized homophobia, and outness as related to men's (N = 107) reports of the perpetration of violence against a same-sex partner. Higher typical weekly alcohol consumption, higher levels of internalized homophobia, and less outness (e.g., lower levels of disclosure of one's sexual orientation) predicted the perpetration of partner violence. In contrast to what we expected, the interaction between higher alcohol consumption and higher levels of outness about one's sexual orientation (i.e., being open to friends, family members, work colleagues) increased the likelihood of participants' reports of perpetrating physical violence. These results suggest the importance of both alcohol consumption and sexual minority stressors and their interactions in understanding men's perpetration of same-sex partner violence.

An African ancestry-specific allele of CTLA4 confers protection against rheumatoid arthritis in African Americans.

Cytotoxic T-lymphocyte associated protein 4 (CTLA4) is a negative regulator of T-cell proliferation. Polymorphisms in CTLA4 have been inconsistently associated with susceptibility to rheumatoid arthritis (RA) in populations of European ancestry but have not been examined in African Americans. The prevalence of RA in most populations of European and Asian ancestry is approximately 1.0%; RA is purportedly less common in black Africans, with little known about its prevalence in African Americans. We sought to determine if CTLA4 polymorphisms are associated with RA in African Americans. We performed a 2-stage analysis of 12 haplotype tagging single nucleotide polymorphisms (SNPs) across CTLA4 in a total of 505 African American RA patients and 712 African American controls using Illumina and TaqMan platforms. The minor allele (G) of the rs231778 SNP was 0.054 in RA patients, compared to 0.209 in controls (4.462 x 10(-26), Fisher's exact). The presence of the G allele was associated with a substantially reduced odds ratio (OR) of having RA (AG+GG genotypes vs. AA genotype, OR 0.19, 95% CI: 0.13-0.26, p = 2.4 x 10(-28), Fisher's exact), suggesting a protective effect. This SNP is polymorphic in the African population (minor allele frequency [MAF] 0.09 in the Yoruba population), but is very rare in other groups (MAF = 0.002 in 530 Caucasians genotyped for this study). Markers associated with RA in populations of European ancestry (rs3087243 [+60C/T] and rs231775 [+49A/G]) were not replicated in African Americans. We found no confounding of association for rs231778 after stratifying for the HLA-DRB1 shared epitope, presence of anti-cyclic citrullinated peptide antibody, or degree of admixture from the European population. An African ancestry-specific genetic variant of CTLA4 appears to be associated with protection from RA in African Americans. This finding may explain, in part, the relatively low prevalence of RA in black African populations.

Comparing self-reported ethnicity to genetic background measures in the context of the Multi-Ethnic Study of Atherosclerosis (MESA).

BACKGROUND: Questions remain regarding the utility of self-reported ethnicity (SRE) in genetic and epidemiologic research. It is not clear whether conditioning on SRE provides adequate protection from inflated type I error rates due to population stratification and admixture. We address this question using data obtained from the Multi-Ethnic Study of Atherosclerosis (MESA), which enrolled individuals from 4 self-reported ethnic groups. We compare the agreement between SRE and genetic based measures of ancestry (GBMA), and conduct simulation studies based on observed MESA data to evaluate the performance of each measure under various conditions. RESULTS: Four clusters are identified using 96 ancestry informative markers. Three of these clusters are well delineated, but 30% of the self-reported Hispanic-Americans are misclassified. We also found that MESA SRE provides type I error rates that are consistent with the nominal levels. More extensive simulations revealed that this finding is likely due to the multi-ethnic nature of the MESA. Finally, we describe situations where SRE may perform as well as a GBMA in controlling the effect of population stratification and admixture in association tests. CONCLUSIONS: The performance of SRE as a control variable in genetic association tests is more nuanced than previously thought, and may have more value than it is currently credited with, especially when smaller replication studies are being considered in multi-ethnic samples.

Most common single-nucleotide polymorphisms associated with rheumatoid arthritis in persons of European ancestry confer risk of rheumatoid arthritis in African Americans.

OBJECTIVE: Large-scale genetic association studies have identified >20 rheumatoid arthritis (RA) risk alleles among individuals of European ancestry. The influence of these risk alleles has not been comprehensively studied in African Americans. We therefore sought to examine whether these validated RA risk alleles are associated with RA risk in an African American population. METHODS: Twenty-seven candidate single-nucleotide polymorphisms (SNPs) were genotyped in 556 autoantibody-positive African Americans with RA and 791 healthy African American control subjects. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for each SNP were compared with previously published ORs for RA patients of European ancestry. We then calculated a composite genetic risk score (GRS) for each individual based on the sum of all risk alleles. RESULTS: Overlap of the ORs and 95% CIs between the European and African American populations was observed for 24 of the 27 candidate SNPs. Conversely, 3 of the 27 SNPs (CCR6 rs3093023, TAGAP rs394581, and TNFAIP3 rs6920220) demonstrated ORs in the opposite direction from those reported for RA patients of European ancestry. The GRS analysis indicated a small but highly significant probability that African American patients relative to control subjects were enriched for the risk alleles validated in European RA patients (P = 0.00005). CONCLUSION: The majority of RA risk alleles previously validated for RA patients of European ancestry showed similar ORs in our population of African Americans with RA. Furthermore, the aggregate GRS supports the hypothesis that these SNPs are risk alleles for RA in the African American population. Future large-scale genetic studies are needed to validate these risk alleles and identify novel RA risk alleles in African Americans.

Commonality of functional annotation: a method for prioritization of candidate genes from genome-wide linkage studies.

Linkage studies of complex traits frequently yield multiple linkage regions covering hundreds of genes. Testing each candidate gene from every region is prohibitively expensive and computational methods that simplify this process would benefit genetic research. We present a new method based on commonality of functional annotation (CFA) that aids dissection of complex traits for which multiple causal genes act in a single pathway or process. CFA works by testing individual Gene Ontology (GO) terms for enrichment among candidate gene pools, performs multiple hypothesis testing adjustment using an estimate of independent tests based on correlation of GO terms, and then scores and ranks genes annotated with significantly-enriched terms based on the number of quantitative trait loci regions in which genes bearing those annotations appear. We evaluate CFA using simulated linkage data and show that CFA has good power despite being conservative. We apply CFA to published linkage studies investigating age-of-onset of Alzheimer's disease and body mass index and obtain previously known and new candidate genes. CFA provides a new tool for studies in which causal genes are expected to participate in a common pathway or process and can easily be extended to utilize annotation schemes in addition to the GO.

Multiple imputation to correct for measurement error in admixture estimates in genetic structured association testing.

OBJECTIVES: Structured association tests (SAT), like any statistical model, assumes that all variables are measured without error. Measurement error can bias parameter estimates and confound residual variance in linear models. It has been shown that admixture estimates can be contaminated with measurement error causing SAT models to suffer from the same afflictions. Multiple imputation (MI) is presented as a viable tool for correcting measurement error problems in SAT linear models with emphasis on correcting measurement error contaminated admixture estimates. METHODS: Several MI methods are presented and compared, via simulation, in terms of controlling Type I error rates for both non-additive and additive genotype coding. RESULTS: Results indicate that MI using the Rubin or Cole method can be used to correct for measurement error in admixture estimates in SAT linear models. CONCLUSION: Although MI can be used to correct for admixture measurement error in SAT linear models, the data should be of reasonable quality, in terms of marker informativeness, because the method uses the existing data to borrow information in which to make the measurement error corrections. If the data are of poor quality there is little information to borrow to make measurement error corrections.

The Case for Examining and Treating the Combined Effects of Parental Drug Use and Interparental Violence on Children in their Homes.

This review examines what have been, to this point, generally two divergent lines of research: (a) effects of parental drug abuse on children, and (b) effects of children's exposure to interparental violence. A small, but growing body of literature has documented the robust relationship between drug use and intimate partner violence. Despite awareness of the interrelationship, little attention has been paid to the combined effect of these deleterious parent behaviors on children in these homes. Thus, we argue for the need to examine the developmental impact of these behaviors (both individually and combined) on children in these homes and for treatment development to reflect how each of these parent behaviors may affect children of substance abusers.

Regional admixture mapping and structured association testing: conceptual unification and an extensible general linear model.

Individual genetic admixture estimates, determined both across the genome and at specific genomic regions, have been proposed for use in identifying specific genomic regions harboring loci influencing phenotypes in regional admixture mapping (RAM). Estimates of individual ancestry can be used in structured association tests (SAT) to reduce confounding induced by various forms of population substructure. Although presented as two distinct approaches, we provide a conceptual framework in which both RAM and SAT are special cases of a more general linear model. We clarify which variables are sufficient to condition upon in order to prevent spurious associations and also provide a simple closed form "semiparametric" method of evaluating the reliability of individual admixture estimates. An estimate of the reliability of individual admixture estimates is required to make an inherent errors-in-variables problem tractable. Casting RAM and SAT methods as a general linear model offers enormous flexibility enabling application to a rich set of phenotypes, populations, covariates, and situations, including interaction terms and multilocus models. This approach should allow far wider use of RAM and SAT, often using standard software, in addressing admixture as either a confounder of association studies or a tool for finding loci influencing complex phenotypes in species as diverse as plants, humans, and nonhuman animals.

Review and evaluation of methods correcting for population stratification with a focus on underlying statistical principles.

When two or more populations have been separated by geographic or cultural boundaries for many generations, drift, spontaneous mutations, differential selection pressures and other factors may lead to allele frequency differences among populations. If these 'parental' populations subsequently come together and begin inter-mating, disequilibrium among linked markers may span a greater genetic distance than it typically does among populations under panmixia [see glossary]. This extended disequilibrium can make association studies highly effective and more economical than disequilibrium mapping in panmictic populations since less marker loci are needed to detect regions of the genome that harbor phenotype-influencing loci. However, under some circumstances, this process of intermating (as well as other processes) can produce disequilibrium between pairs of unlinked loci and thus create the possibility of confounding or spurious associations due to this population stratification. Accordingly, researchers are advised to employ valid statistical tests for linkage disequilibrium mapping allowing conduct of genetic association studies that control for such confounding. Many recent papers have addressed this need. We provide a comprehensive review of advances made in recent years in correcting for population stratification and then evaluate and synthesize these methods based on statistical principles such as (1) randomization, (2) conditioning on sufficient statistics, and (3) identifying whether the method is based on testing the genotype-phenotype covariance (conditional upon familial information) and/or testing departures of the marginal distribution from the expected genotypic frequencies.

Correcting for measurement error in individual ancestry estimates in structured association tests.

We present theoretical explanations and show through simulation that the individual admixture proportion estimates obtained by using ancestry informative markers should be seen as an error-contaminated measurement of the underlying individual ancestry proportion. These estimates can be used in structured association tests as a control variable to limit type I error inflation or reduce loss of power due to population stratification observed in studies of admixed populations. However, the inclusion of such error-containing variables as covariates in regression models can bias parameter estimates and reduce ability to control for the confounding effect of admixture in genetic association tests. Measurement error correction methods offer a way to overcome this problem but require an a priori estimate of the measurement error variance. We show how an upper bound of this variance can be obtained, present four measurement error correction methods that are applicable to this problem, and conduct a simulation study to compare their utility in the case where the admixed population results from the intermating between two ancestral populations. Our results show that the quadratic measurement error correction (QMEC) method performs better than the other methods and maintains the type I error to its nominal level.

Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

OBJECTIVES: To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. METHODS: A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. SECONDARY OUTCOMES: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. RESULTS: MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. CONCLUSIONS: MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. PRACTICE IMPLICATIONS: MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training.

Burning Out Faculty at Doctoral Research Universities.

The present study examined the importance of time allocation, pressure and support variables together as determinants of faculty burnout. Using a large sample of university faculty (N = 1439), we were able to show that time allocation variables and perceived pressure contribute to faculty burnout. As expected, decreased social support, family, sleep and leisure time were related to higher levels of burnout. Grantsmanship and service activities appeared as the most critical factors associated with faculty burnout. Faculty burnout is an important topic, and the insights provided here help offer some directions for future research as well as the development of effective institutional policies. Copyright © 2015 John Wiley & Sons, Ltd.

A Comparison of Composite Reliability Estimators: Coefficient Omega Confidence Intervals in the Current Literature.

Coefficient omega and alpha are both measures of the composite reliability for a set of items. Unlike coefficient alpha, coefficient omega remains unbiased with congeneric items with uncorrelated errors. Despite this ability, coefficient omega is not as widely used and cited in the literature as coefficient alpha. Reasons for coefficient omega's underutilization include a limited knowledge of its statistical properties. However, consistent efforts to understand the statistical properties of coefficient omega can help improve its utilization in research efforts. Here, six approaches for estimating confidence intervals for coefficient omega with unidimensional congeneric items were evaluated through a Monte Carlo simulation. The evaluations were made through simulation conditions that mimic realistic conditions that investigators are likely to face in applied work, including items that are not normally distributed and small sample size(s). Overall, the normal theory bootstrap confidence interval had the best performance across all simulation conditions that included sample sizes less than 100. However, most methods had sound coverage with sample sizes of 100 or more.

Autonomy and Firefighting: Perceived Competence and Stress.

OBJECTIVE: In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. METHODS: A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. RESULTS: Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. CONCLUSIONS: Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.

Emotional Distress, Alcohol Use, and Bidirectional Partner Violence Among Lesbian Women.

This study examined the relationship between emotional distress (defined as depression, brooding, and negative affect), alcohol outcomes, and bidirectional intimate partner violence among lesbian women. Results lend support to the self-medication hypothesis, which predicts that lesbian women who experience more emotional distress are more likely to drink to cope, and in turn report more alcohol use, problem drinking, and alcohol-related problems. These alcohol outcomes were, in turn, associated with bidirectional partner violence (BPV). These results offer preliminary evidence that, similar to findings for heterosexual women, emotional distress, alcohol use, and particularly, alcohol-related problems are risk factors for BPV among lesbian women.

Type I Error Rates For A One Factor Within-Subjects Design With Missing Values.

Missing data are a common problem in educational research. A promising technique, that can be implemented in SAS PROC MIXED and is therefore widely available, is to use maximum likelihood to estimate model parameters and base hypothesis tests on these estimates. However, it is not clear which test statistic in PROC MIXED performs better with missing data. The performance of the Hotelling-Lawley-McKeon and Kenward-Roger omnibus test statistics on the means for a single factor within-subject ANOVA are compared. The results indicate that the Kenward-Roger statistic performed better in terms of keeping the Type I error close to the nominal alpha level.

Assessment of Parent Orientation towards Autonomy vs. Control in Promoting Children's Healthy Eating and Exercise.

BACKGROUND: Self-determination theory has been widely applied to understanding individuals' health-related behaviors such as eating healthy foods and exercising. Different reasons for engagement are associated with varying levels of personal agency or autonomy. Authority figures in the environment can be supportive of autonomy or, in contrast, controlling. Although researchers have assessed individuals' perceptions of the autonomy-support in their environments, studies have not directly examined the authority figures' orientations to autonomy with respect to health contexts. METHODS: A new scale, Parent Orientations to Health, was created to investigate parent orientation to autonomy and control with respect to healthy eating and exercise in children. One hundred and forty-three parents of elementary school-aged children responded to the scale. RESULTS: Scale validation and reliability results indicate that the scale successfully assessed parent orientation towards autonomy for children in health contexts. Furthermore, parent autonomy orientation varied according to child weight status and the healthiness of the child's diet. CONCLUSIONS: Parent orientation towards autonomy can be evaluated through the use of the Parent Orientations to Health scale. In addition, parent autonomy orientation is associated with both the healthiness of the child's diet (as perceived by the parent) and the child's body mass index.

Predictors of physician use of inpatient electronic health records.

OBJECTIVES: To predict adoption (80% rate of use) of an electronic health record (EHR) by admitting physicians using a heuristic model. METHODS: Administrative data collected for 326 physicians who admitted at least 10 patients to 3 hospitals during the 6 months following EHR activation represented more than 80% of the total admissions. Functions evaluated included computerized physician order entry (CPOE), electronic history and physical (EH and P), and electronic discharge summary (EDS). Independent variables included hospital size, physician alignment, physician group size, use of an office EHR, age, sex, specialty, volume, hospital based, inpatient to outpatient ratio, and loyalty. RESULTS: CPOE adoption was more likely (P <.01) for physicians who were employed, male, and had a high inpatient ratio, a lower patient volume, and a community hospital setting. EH and P and EDS adoption were more likely for physicians with financial alignment and a large academic hospital setting. CONCLUSIONS: Personal factors (loyalty, age, sex) were generally not predictive. Organizational factors (hospital setting, financial alignment) were most predictive of adoption. Study results may help administrators improve EHR installations.

An examination of the association of selected toxic metals with total and central obesity indices: NHANES 99-02.

It is conceivable that toxic metals contribute to obesity by influencing various aspects of metabolism, such as by substituting for essential micronutrients and vital metals, or by inducing oxidative stress. Deficiency of the essential metal zinc decreases adiposity in humans and rodent models, whereas deficiencies of chromium, copper, iron, and magnesium increases adiposity. This study utilized the NHANES 99-02 data to explore the association between waist circumference and body mass index with the body burdens of selected toxic metals (barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten). Some of the associations were significant direct relationships (barium and thallium), and some of the associations were significant inverse relationships (cadmium, cobalt, cesium, and lead). Molybdenum, antimony, and tungsten had mostly insignificant associations with waist circumference and body mass index. This is novel result for most of the toxic metals studied, and a surprising result for lead because high stored lead levels have been shown to correlate with higher rates of diabetes, and obesity may be a key risk factor for developing diabetes. These associations suggest the possibility that environmental exposure to metals may contribute to variations in human weight gain/loss. Future research, such as prospective studies rather than the cross-sectional studies presented here, is warranted to confirm these findings.