Shelley A. Blozis

Reading Instruction Grouping for Students with Reading Difficulties

The effects of three grouping formats—1:1 (one teacher with 1 student), 1:3 (one teacher with 3 students), and 1:10 (one teacher with 10 students)—on the reading outcomes of second-grade struggling readers was studied. Students in all groups were given the same supplemental reading intervention for the same number of sessions, thus holding intervention type and intensity constant and varying group size. Students made significant gains in phoneme segmentation, fluency, and comprehension following the intervention, and these gains were maintained at follow-up (4—5 weeks after intervention). Based on effect sizes, both 1:1 and 1:3 were highly effective intervention group sizes for supplemental reading instruction. Although the 1:1 grouping format yielded significantly higher scores for phoneme segmentation, fluency, and comprehension than the 1:10, it was not superior to the 1:3 on any outcome measure.

Factorial Invariance of a Pan-Hispanic Familism Scale

This article considers the validity and factorial invariance of an attitudinal measure of familism. Using a large, nationally representative sample of U.S. Hispanics, the validity and factorial invariance of the measure was tested across country of origin (United States, Mexico, and Latin America) and the language in which the survey was conducted (Spanish and English). Results support the invariance of the measure in both group comparisons, suggesting that the measure assesses a quality of familism that persists across country of origin and language preference. Further, the results also support equality in mean factor levels across these groups.

Personality and serotonin transporter genotype interact with social context to affect immunity and viral set-point in simian immunodeficiency virus disease

From the beginning of the AIDS epidemic, stress has been a suspected contributor to the wide variation seen in disease progression, and some evidence supports this idea. Not all individuals respond to a stressor in the same way, however, and little is known about the biological mechanisms by which variations in individuals responses to their environment affect disease-relevant immunologic processes. Using the simian immunodeficiency virus/rhesus macaque model of AIDS, we explored how personality (Sociability) and genotype (serotonin transporter promoter) independently interact with social context (Stable or Unstable social conditions) to influence behavioral expression, plasma cortisol concentrations, SIV-specific IgG, and expression of genes associated with Type I interferon early in infection. SIV viral RNA set-point was strongly and negatively correlated with survival as expected. Set-point was also associated with expression of interferon-stimulated genes, with CXCR3 expression, and with SIV-specific IgG titers. Poorer immune responses, in turn, were associated with display of sustained aggression and submission. Personality and genotype acted independently as well as in interaction with social condition to affect behavioral responses. Together, the data support an interactionist perspective [Eysenck, H.J., 1991. Personality, stress and disease: an interactionist perspective. Psychol. Inquiry 2, 221-232] on disease. Given that an important goal of HIV treatment is to maintain viral set-point as low as possible, our data suggest that supplementing anti-retroviral therapy with behavioral or pharmacologic modulation of other aspects of an organisms functioning might prolong survival, particularly among individuals living under conditions of threat or uncertainty.

Structured Latent Curve Models for the Study of Change in Multivariate Repeated Measures

This article considers a structured latent curve model for multiple repeated measures. In a structured latent curve model, a smooth nonlinear function characterizes the mean response. A first-order Taylor polynomial taken with regard to the mean function defines elements of a restricted factor matrix that may include parameters that enter nonlinearly. Similar to factor scores, random coefficients are combined with the factor matrix to produce individual latent curves that need not follow the same form as the mean curve. Here the associations between change characteristics in multiple repeated measures are studied. A factor analysis model for covariates is included as a means of relating latent covariates to the factors characterizing change in different repeated measures. An example is provided.

A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome

Objective: To examine the effects of a wellness intervention, Lifestyle Counts, for women with fibromyalgia syndrome on the level of self-efficacy for health-promoting behaviours, health-promoting activity and perceived quality of life. Design: A randomized controlled single-blinded trial with treatment and attention-control groups. Setting: Community in the southwestern United States. Subjects: Convenience sample of 187 women (98 treatment, 89 attention control) with fibromyalgia syndrome (mean age = 53.08 years, SD 9.86). Intervention: The two-phase Lifestyle Counts intervention programme included lifestyle change classes for eight weeks, with goal-setting and telephone follow-up for three months. Participants in the attention-control group were offered an equivalent amount of contact in classes on general disease-related information and health education topics and unstructured follow-up phone calls. Participants were followed for a total of eight months after baseline. Outcome measures: Self-report instruments measuring self-efficacy for health behaviours, health-promotion behaviours and health-related quality of life (SF-36 and the Fibromyalgia Impact Questionnaire) were completed at baseline, two months (after the classes), five months (after telephone follow-up) and at eight months. Results: Both groups improved significantly (P<0.05) over time on the measures of self-efficacy, health behaviours, fibromyalgia impact and quality of life. There were significant group × time interactions for scores on the Health Promoting Lifestyle II subscales of physical activity and stress management. Conclusions: The Lifestyle Counts wellness intervention holds promise for improving health-promoting behaviours and quality of life of women with fibromyalgia syndrome.

On Fitting Nonlinear Latent Curve Models to Multiple Variables Measured Longitudinally.

This article shows how nonlinear latent curve models may be fitted for simultaneous analysis of multiple variables measured longitudinally using Mx statistical software. Longitudinal studies often involve observation of several variables across time with interest in the associations between change characteristics of different variables measured within individuals. Other applications involve repeated measures for distinguishable individuals nested within small groups, such as families, with interest in the associations between change characteristics in variables for individuals within groups. This article shows how Mx can be used to carry out analysis of multiple variables measured over time where at least one variable is described by a function that includes one or more parameters that enter the model nonlinearly. An example is provided.

Overcoming Clinical Inertia: A Randomized Clinical Trial of a Telehealth Remote Monitoring Intervention Using Paired Glucose Testing in Adults With Type 2 Diabetes.

Background Type 2 diabetes mellitus is a worldwide challenge. Practice guidelines promote structured self-monitoring of blood glucose (SMBG) for informing health care providers about glycemic control and providing patient feedback to increase knowledge, self-efficacy, and behavior change. Paired glucose testing—pairs of glucose results obtained before and after a meal or physical activity—is a method of structured SMBG. However, frequent access to glucose data to interpret values and recommend actions is challenging. A complete feedback loop—data collection and interpretation combined with feedback to modify treatment—has been associated with improved outcomes, yet there remains limited integration of SMBG feedback in diabetes management. Incorporating telehealth remote monitoring and asynchronous electronic health record (EHR) feedback from certified diabetes educators (CDEs)—specialists in glucose pattern management—employ the complete feedback loop to improve outcomes. Objective The purpose of this study was to evaluate a telehealth remote monitoring intervention using paired glucose testing and asynchronous data analysis in adults with type 2 diabetes. The primary aim was change in glycated hemoglobin (A1c)—a measure of overall glucose management—between groups after 6 months. The secondary aims were change in self-reported Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Empowerment Scale, and Diabetes Knowledge Test. Methods A 2-group randomized clinical trial was conducted comparing usual care to telehealth remote monitoring with paired glucose testing and asynchronous virtual visits. Participants were aged 30-70 years, not using insulin with A1c levels between 7.5% and 10.9% (58-96 mmol/mol). The telehealth remote monitoring tablet computer transmitted glucose data and facilitated a complete feedback loop to educate participants, analyze actionable glucose data, and provide feedback. Data from paired glucose testing were analyzed asynchronously using computer-assisted pattern analysis and were shared with patients via the EHR weekly. CDEs called participants monthly to discuss paired glucose testing trends and treatment changes. Separate mixed-effects models were used to analyze data. Results Participants (N=90) were primarily white (64%, 56/87), mean age 58 (SD 11) years, mean body mass index 34.1 (SD 6.7) kg/m2, with diabetes for mean 8.2 (SD 5.4) years, and a mean A1c of 8.3% (SD 1.1; 67 mmol/mol). Both groups lowered A1c with an estimated average decrease of 0.70 percentage points in usual care group and 1.11 percentage points in the treatment group with a significant difference of 0.41 percentage points at 6 months (SE 0.08, t159=–2.87, P=.005). Change in medication (SE 0.21, t157=–3.37, P=.009) was significantly associated with lower A1c level. The treatment group significantly improved on the SDSCA subscales carbohydrate spacing (P=.04), monitoring glucose (P=.001), and foot care (P=.02). Conclusions An eHealth model incorporating a complete feedback loop with telehealth remote monitoring and paired glucose testing with asynchronous data analysis significantly improved A1c levels compared to usual care. Trial Registration Clinicaltrials.gov NCT01715649; https://www.clinicaltrials.gov/ct2/show/NCT01715649 (Archived by WebCite at http://www.webcitation.org/6ZinLl8D0).

Conceptualization and Development of the Acceptance of Chronic Health Conditions Scale

Acceptance of chronic conditions often has been studied from the perspective of grief and loss. This paper presents a new conceptualization of acceptance of chronic conditions that is grounded in the perspective of those living with a chronic condition and focuses on adaptation to and acceptance of change in ones life. Data obtained from a sample of 822 persons with multiple sclerosis and a sample of more than 2,000 polio survivors support the reliability and validity of the new Acceptance of Chronic Health Conditions Scale.

Do “birds of a feather flock together” or do “opposites attract”? Behavioral responses and temperament predict success in pairings of rhesus monkeys in a laboratory setting

The growing recognition that social needs of primates in captivity must be addressed can present challenges to staff at primate facilities charged with implementing pair‐housing solutions for animals. Unfortunately, there are few published papers that identify individual characteristics that might facilitate the social pairing process, and those that have looked at pre‐pairing measures of behavior have produced mixed results. Using a database of nu2009=u2009340 isosexual pairing attempts, we report that measures associated with responses to a standardized infant assessment protocol (the BioBehavioral Assessment program) predict success in pairing attempts that occurred years later. Behavioral responses to a brief separation and relocation, to a human intruder challenge, as well as ratings of temperament, were obtained from rhesus monkeys at 3–4 months of age. Logistic regression was used to identify potential predictors of success when animals were paired up to 10 years after the behavioral assessments. Among females, success was higher when members of a pair were more similar (i.e., a smaller difference scores) in patterns of emotional responding (Emotionality, Nervous temperament) during the infant assessments. In contrast, among males, success was higher when the pair had lower mean values for Gentle and Nervous temperament scores; when the members were younger; when pairs had a greater weight difference; and when they came from the same rearing background. Together, our results suggest that broad measures reflecting patterns of emotionality in response to challenge, which can be assessed in infancy (but which remain relatively stable throughout life) can be usefully employed to increase the likelihood of success in pairing attempts. Am. J. Primatol. 79:e22464, 2017.

Co-immunization with IL-15 enhances cellular immune responses induced by a vif-deleted simian immunodeficiency virus proviral DNA vaccine and confers partial protection against vaginal challenge with SIVmac251

Simian immunodeficiency virus (SIV) infection of rhesus macaques is a valuable animal model for human immunodeficiency virus (HIV)-1 vaccine development. Our laboratory recently described the immunogenicity and limited efficacy of a vif-deleted SIVmac239 proviral DNA (SIV/CMVDelta vif) vaccine. The current report characterizes immunogenicity and efficacy for the SIV/CMVDelta vif proviral DNA vaccine when co-inoculated with an optimized rhesus interleukin (rIL)-15 expression plasmid. Macaques co-inoculated with rIL-15 and SIV/CMVDelta vif proviral plasmids showed significantly improved SIV-specific CD8 T cell immunity characterized by increased IFN-gamma ELISPOT and polyfunctional CD8 T cell responses. Furthermore, these animals demonstrated a sustained suppression of plasma virus loads after multiple low dose vaginal challenges with pathogenic SIVmac251. Importantly, SIV-specific cellular responses were greater in immunized animals compared to unvaccinated controls during the initial 12 weeks after challenge. Taken together, these findings support the use of IL-15 as an adjuvant in prophylactic anti-HIV vaccine strategies.