Harold S. Haller

Coping-Related Variables Associated with Individual Differences in Adjustment to Cancer

This study examined relationships between emotional adjustment and a number of coping styles and strategies in people with cancer. Two-hundred eighty-three adults completed measures of positive and negative emotions, subjective ratings of cancer-related symptoms and functional impairment, coping strategies, hope, benefit finding, emotional approach/avoidance, and cancer-related social support. Among the coping strategies, self-blame and behavioral disengagement were consistently associated with poor adjustment, while acceptance and humor were consistently associated with good adjustment. Among the broader measures of coping style, there were associations between poor adjustment and emotional processing, and between good adjustment and hope, benefit finding, and cancer-related social support.

Fall Risk Assessment in Geriatric-Psychiatric Inpatients to Lower Events (FRAGILE)

The objectives of this retrospective case-control study were to identify risk factors of falls in geriatric-psychiatric inpatients and develop a screening tool to accurately predict falls. The study sample consisted of 225 geriatric-psychiatric inpatients at a Midwestern referral facility. The sample included 136 inpatients who fell and a random stratified sample of 89 inpatients who did not fall. Data collected included age, gender, activities of daily living, and nursing parameters such as bathing assistance, bed height, use of bed rails, one-on-one observation, fall warning system, Conley Scale fall risk assessment, medical diagnosis, and medications. History of falls, impaired judgment, impaired gait, dizziness, delusions, delirium, chronic use of sedative or antipsychotic agents, and anticholinergic urinary bladder medications significantly increased fall risk. Alzheimers disease, acute use of sedative or anti-psychotic agents, and depression reduced fall risk. A falls risk tool, Fall Risk Assessment in Geriatric-psychiatric Inpatients to Lower Events (FRAGILE), was developed for assessment and risk stratification with new diagnoses or medications.

Utilising infant growth to predict obesity status at 5 years

This study determines if an early life growth pattern in healthy infants can predict obesity at age 5.

A Pilot Study Does Obesity Begin in the First Year of Life

Aim. To determine if growth patterns in healthy infants can identify associations with obesity at age 5 years. Method. Body mass index growth patterns from birth to 1 year were described for cohorts of children who were classified at 5 years as normal weight (n = 61), overweight (n = 47), obese (n = 41), and morbidly obese (n = 72). A longitudinal analysis of body mass index means based on the age postbirth was conducted and graphed. Results. Distinctions in growth patterns were evident before 1 year postbirth. Children who were normal weight at 5 years demonstrated a growth pattern in the first year that differed from children who were overweight, obese, or morbidly obese at 5 years. Conclusions. Obesity growth patterns were seen in infancy and are clinically important because identification of infants who do not fit a normal weight pattern can occur and thus guide individualized interventions in the first year postbirth while precursors of later health are still forming.

Bidirectional NK/DC interactions promote CD4 expression on NK cells, DC maturation, and HIV infection

Interactions between natural killer (NK) and dendritic cells (DCs) are integral to immune response development, potentially leading to bidirectional NK/DC activation. We demonstrate that autologous NK/DC interactions induce CD4 expression on NK cells, influencing degranulation. Cell contact is required, with high NK:DC ratios and mature DCs most effectively inducing CD4 expression. CD4(+) NK cells, in turn, mediate DC maturation via contact-dependent and independent pathways, more effectively maturing DCs than CD4(-) NK cells. Bidirectional NK/DC interactions also impact HIV infection, as NK-matured DCs effectively deliver infectious HIV to T cells, via trans-infection. DC-induced CD4 expression also renders NK cells susceptible to HIV infection. Focusing on NK/DC interactions, DCs can transfer infectious virus and enhance HIV infection of CD4(+) NK cells, strongly suggesting that these interactions influence HIV pathogenesis. Findings provide new insight regarding NK/DC interactions, defining a mechanism by which cellular interactions in the absence of pathogens promote DC-mediated amplification of HIV infection.

A Naturalistic Evaluation of Psychosocial Interventions for Cancer Patients in a Community Setting

We used a naturalistic methodology to examine associations between change in cancer patients’ emotional functioning and their use of interventions in a community organization. One-hundred ninety-two patients completed measures at baseline and 6 months later. During this time, they utilized the organizations various interventions as they wished. Attendance at educational events was associated with decreased well-being. Use of art therapy groups was not associated with decreases in negative emotion but was consistently associated with increases in positive emotion. Improved functioning on some measures was associated with use of psychoeducational groups, expressive/supportive groups, movement classes, healing arts, and a buddy-matching service.

Combining Computational Fluid Dynamics Analysis Data with Experimentally Measured Data

ABSTRACT This article presents an approach to reducing the time and cost of experimentation in large wind tunnels, such as the 10 × 10 ft. supersonic wind tunnel at NASA Glenn Research Center, by combining computer simulations of test models from Reynolds averaged Navier-Stokes analysis with small sets of wind tunnel data. To demonstrate the viability of the approach, the impact of microramp flow control on the shock wave boundary layer interaction using paired sets of data from both computational fluid dynamics (CFD) analysis and experimental measurements was compared. By combining the CFD results consisting of 15 central composite face-centered (CCF) simulations with a smaller subset of four/five experimental wind tunnel cases, augmented, interlocking combined data sets were generated from which models were developed that allow the prediction of wind tunnel results. No statistically significant differences were found to exist between the predictions from models generated using the augmented interlocking data sets and the models generated using the complete set of 15 wind tunnel cases based on a paired t-test. From an engineering perspective, the same optimal microramp configuration was obtained using models derived from the combined data set as obtained with the complete set of experimental wind tunnel data.

A 9-year comparison of practice profiles of candidates for primary and recertification examinations of the American Board of Plastic Surgery relative to economic indicators.

Background: This study compared the practice profiles of plastic surgeons applying for recertification/maintenance of certification with those applying for primary certification by the American Board of Plastic Surgery between 2003 and 2011. Methods: American Board of Plastic Surgery case logs from both recertification and primary certification candidates from 2003 to 2011 were examined. Deidentified data included operative year, Current Procedural Terminology codes, and the candidates designation of the case relative to (1) cosmetic or reconstructive and (2) the Maintenance of Certification in Plastic Surgery module (i.e., comprehensive, cosmetic, craniomaxillofacial, and hand). Department of Commerce unemployment data from 2003 to 2011 served as an economic indicator for the period studied. Results: A negative trend in the median number of cases per candidate was observed for both groups for cosmetic, reconstructive, and total number of cases, corresponding to a rise in unemployment. With every 1 percent increase in the unemployment rate, recertification candidates demonstrated a greater loss of cosmetic cases relative to primary candidates and an accelerated decline in reconstructive cases starting in 2007. Distribution of the four Maintenance of Certification modules demonstrated a negative trend for cosmetic and comprehensive cases in both groups. Hand and craniofacial consistently constituted approximately 20 percent of cases for primary and 14 percent of cases for recertification candidates. There was a shift away from hand cases toward craniofacial cases in both groups. Conclusions: Both primary and recertification candidates reported a decline in overall caseload from 2003 to 2011. Negative economic trends have a greater impact on the practice profile of recertification candidates.

Use of Serial Weight and Length Measurements in Children from Birth to Two Years of Age to Predict Obesity at Five Years of Age

Childhood obesity is a major health concern. The associated health risks dramatically reduce lifespan and increase healthcare costs. The goal was to develop methodology to identify as early in life as possible whether or not a child would become obese at age five. This diagnostic tool would facilitate clinical monitoring to prevent and or minimize obesity. Obesity is measured by Body Mass Index (BMI), but an improved metric, the ratio of weight to height (or length) (WOH), is proposed from this research for detecting early obesity. Results of this research demonstrate that WOH performs better than BMI for early detection of obesity in individuals using a longitudinal decision analysis (LDA), which is essentially an individuals type control chart analysis about a trend line. Utilizing LDA, the odds of obesity of a child at age five is indicated before the second birthday with 95% sensitivity and 97% specificity. Further, obesity at age five is indicated with 75% specificity before two months and with 84% specificity before three months of age. These results warrant expanding this study to larger cohorts of normal, overweight, and obese children at age five from different healthcare facilities to test the applicability of this novel diagnostic tool.

Empirical Study Redux on Choice of Law and Forum in M&A: The Data and Its Limits

The legal community has long recognized that business corporations heavily favor Delaware as the state of incorporation. However, a recent study of merger agreements from 2002 by Eisenberg and Miller suggested that despite Delaware’s prominence as the place of incorporation, companies “flee” from Delaware with respect to both choice of law and forum, and instead prefer New York. We set out to study data from 343 merger and acquisitions contracted on between January 1, 2011 and June 30, 2011 in an attempt to verify this conjecture. Our study is important for two reasons. First, the 2011 data set show that the Eisenberg and Miller conjecture is not valid. Specifically, we find that the state of incorporation has no effect on the choice of law for the state of New York, thus negating the earlier finding that Delaware corporations flee to New York law. The choice of forum being New York or some other forum is the major factor in our model as it alone explains about 50% of the variation in the choice of law for the state of New York. Thus, Eisenberg and Miller may have identified a transient phenomenon. Second, the article also makes a contribution to the debate about how much raw data can contribute to an understanding of a phenomenon such as the choice of law without further context such as a survey of the lawyers drafting the merger agreements.