scholarly journals Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies

2020 ◽  
Vol 6 (4) ◽  
pp. 252
Author(s):  
James C. Hurley
Keyword(s):  
Antibiotic Prophylaxis ◽  
Latent Variables ◽  
Structural Equation ◽  
Infection Prevention ◽  
Structural Equation Models ◽  
Candida Colonization ◽  
Topical Antibiotic ◽  
Effective Prevention ◽  
Prevention Studies ◽  
Improved Model

Background: Whether Candida interacts to enhance the invasive potential of Acinetobacter and Pseudomonas bacteria cannot be resolved within individual studies. There are several anti-septic, antibiotic, anti-fungal, and non-decontamination-based interventions to prevent ICU acquired infection. These effective prevention interventions would be expected to variably impact Candida colonization. The collective observations within control and intervention groups from numerous ICU infection prevention studies simulates a multi-centre natural experiment with which to evaluate Candida, Acinetobacter and Pseudomonas interaction (CAPI). Methods: Eight Candidate-generalized structural equation models (GSEM), with Candida, Pseudomonas and Acinetobacter colonization as latent variables, were confronted with blood culture and respiratory tract isolate data derived from >400 groups derived from 286 infection prevention studies. Results: Introducing an interaction term between Candida colonization and each of Pseudomonas and Acinetobacter colonization improved model fit in each case. The size of the coefficients (and 95% confidence intervals) for these interaction terms in the optimal Pseudomonas (+0.33; 0.22 to 0.45) and Acinetobacter models (+0.32; 0.01 to 0.5) were similar to each other and similar in magnitude, but contrary in direction, to the coefficient for exposure to topical antibiotic prophylaxis (TAP) on Pseudomonas colonization (−0.45; −0.71 to −0.2). The coefficient for exposure to topical antibiotic prophylaxis on Acinetobacter colonization was not significant. Conclusions: GSEM modelling of published ICU infection prevention data supports the CAPI concept. The CAPI model could account for some paradoxically high Acinetobacter and Pseudomonas infection incidences, most apparent among the concurrent control groups of TAP studies.

scholarly journals Structural equation modelling the ‘control of gut overgrowth’ in the prevention of ICU acquired Gram-negative infection.

2020 ◽  
Author(s):  
James C Hurley
Keyword(s):  
Latent Variables ◽  
Structural Equation ◽  
Infection Prevention ◽  
Structural Equation Models ◽  
Published Data ◽  
Parenteral Antibiotic ◽  
Gram Negative ◽  
Positive Effects ◽  
Prevention Studies ◽  
Negative Effect

Abstract Background: Conceptually, the ‘control of gut overgrowth’ (COGO), including ‘abnormal Gram-negative bacilli’ (AGNB), is key to the mediation of infection prevention by Selective Digestive Decontamination (SDD). However, the relative importance of the SDD components; topical (TAP), enteral (EAP) and protocolized parenteral antibiotic prophylaxis (PPAP), versus other methods of infection prevention and versus other contextual exposures cannot be resolved within individual studies. Methods: Generalized structural equation models (GSEM) based on COGO concepts were confronted with data derived from >200 infection prevention studies reporting incidences of overall, Pseudomonas and Acinetobacter bacteremia as well as ventilator associated pneumonia (VAP) data including the following group level exposures; TAP, EAP and PPAP use versus antiseptic versus non-decontamination mode of infection prevention; proportion receiving mechanical ventilation (MV); trauma ICU; mean length of ICU stay and concurrency versus non-concurrency of TAP study control groups. Results: In GSEM modelling of Pseudomonas and Acinetobacter gut overgrowth (GO) as latent variables, anti-septic interventions had the strongest negative effect against Pseudomonas GO but no intervention was significantly negative against Acinetobacter GO. Strikingly, PPAP and concurrency each have positive effects in the model, EAP is neutral and Acinetobacter bacteremia incidences are high within TAP studies, moreso with PPAP exposure. Paradoxically, TAP (moreso with PPAP) appears to provide the strongest summary prevention effects against bacteremia and VAP overall. Conclusions: GSEM modelling of published data provides novel insights into the COGO concept and the complex and profoundly paradoxical relationships between various interventions, concurrency and other exposures in relation to infection with AGNB.

scholarly journals Structural equation modelling the ‘control of gut overgrowth’ in the prevention of ICU acquired Gram-negative infection.

2020 ◽  
Author(s):  
James C Hurley
Keyword(s):  
Latent Variables ◽  
Structural Equation ◽  
Infection Prevention ◽  
Structural Equation Models ◽  
Control Groups ◽  
Parenteral Antibiotic ◽  
Gram Negative ◽  
Positive Effects ◽  
Prevention Studies ◽  
Negative Effect

Abstract Background: Conceptually, the ‘control of gut overgrowth’ (COGO) is key to the mediation of infection prevention with ‘abnormal Gram-negative bacilli’ (AGNB) by Selective Digestive Decontamination (SDD). However, the relative importance of the SDD components; topical (TAP), enteral (EAP) and protocolized parenteral antibiotic prophylaxis (PPAP), versus other methods of infection prevention and versus other contextual exposures cannot be resolved within individual studies. Methods: Seven candidate generalized structural equation models (GSEM) founded on COGO concepts were confronted with Pseudomonas and Acinetobacter bacteremia as well as ventilator associated pneumonia (VAP) data derived from >200 infection prevention studies. The following group level exposures were included in the GSEM models; use of TAP, EAP, PPAP, antiseptic and non-decontamination methods of infection prevention; proportion receiving mechanical ventilation (MV); trauma ICU; mean length of ICU stay and concurrency versus non-concurrency of TAP study control groups. Results: In GSEM modelling of Pseudomonas and Acinetobacter gut overgrowth (GO) as latent variables, anti-septic interventions had the strongest negative effect against Pseudomonas GO but no intervention was significantly negative against Acinetobacter GO. Strikingly, PPAP and concurrency each have positive effects in the model, EAP is neutral and Acinetobacter bacteremia incidences are high within TAP studies, moreso with PPAP exposure. Paradoxically, TAP (moreso with PPAP) appears to provide the strongest summary prevention effects against overall bacteremia and overall VAP. Conclusions: GSEM modelling of published AGNB infection data enables a test of the COGO concept. Paradoxically, Acinetobacter and Pseudomonas bacteremia incidences are unusually high among studies of TAP.

scholarly journals Structural equation modelling the ‘control of gut overgrowth’ in the prevention of ICU acquired Gram-negative infection.

2020 ◽  
Author(s):  
James C Hurley
Keyword(s):  
Antibiotic Prophylaxis ◽  
Structural Equation Modelling ◽  
Latent Variables ◽  
Structural Equation ◽  
Infection Prevention ◽  
Topical Antibiotic ◽  
Parenteral Antibiotic ◽  
Gram Negative ◽  
Positive Effects ◽  
Equation Modelling

Abstract Background: Conceptually, the ‘control of gut overgrowth’ (COGO) is key in mediating prevention against infection with Gram-negative bacilli by topical antibiotic prophylaxis, a common constituent of Selective Digestive Decontamination (SDD) regimens. However, the relative importance of the other SDD components; enteral and protocolized parenteral antibiotic prophylaxis, versus other methods of infection prevention and versus other contextual exposures cannot be resolved within individual studies. Methods: Seven candidate generalized structural equation models founded on COGO concepts were confronted with Pseudomonas and Acinetobacter bacteremia as well as ventilator associated pneumonia data derived from >200 infection prevention studies. The following group level exposures were included in the models; use and mode of antibiotic prophylaxis, antiseptic and non-decontamination methods of infection prevention; proportion receiving mechanical ventilation; trauma ICU; mean length of ICU stay and concurrency versus non-concurrency of topical antibiotic prophylaxis study control groups. Results: In modelling Pseudomonas and Acinetobacter gut overgrowth as latent variables, anti-septic interventions had the strongest negative effect against Pseudomonas gut overgrowth but no intervention was significantly negative against Acinetobacter gut overgrowth. Strikingly, protocolized parenteral antibiotic prophylaxis and concurrency each have positive effects in the model, enteral antibiotic prophylaxis is neutral and Acinetobacter bacteremia incidences are high within topical antibiotic prophylaxis studies, moreso with protocolized parenteral antibiotic prophylaxis exposure. Paradoxically, topical antibiotic prophylaxis (moreso with protocolized parenteral antibiotic prophylaxis) appears to provide the strongest summary prevention effects against overall bacteremia and overall VAP. Conclusions: Structural equation modelling of published Gram-negative bacilli infection data enables a test of the COGO concept. Paradoxically, Acinetobacter and Pseudomonas bacteremia incidences are unusually high among studies of topical antibiotic prophylaxis.

scholarly journals Candida and the Gram-Positive Trio: Testing the Vibe in the Icu Patient Microbiome Using Structural Equation Modelling of Literature Derived Data.

2021 ◽  
Author(s):  
James Hurley
Keyword(s):  
Staphylococcus Aureus ◽  
Latent Variables ◽  
Structural Equation ◽  
Infection Prevention ◽  
Structural Equation Models ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Icu Patients ◽  
Gram Positive Bacteria ◽  
Interaction Terms

Abstract BackgroundWhether Candida interacts with Gram-positive bacteria to enhance their invasive potential from the microbiome of ICU patients remains unclear. Several effective interventions to prevent ICU acquired infection would be expected to variably impact Candida colonization.MethodsFour candidate generalized structural equation models (GSEM), using Staphylococcus aureus, coagulase negative Staphylococci (CNS) and Enterococci colonization as latent variables, were confronted with blood culture and respiratory tract isolate data derived from > 400 groups from >250 infection prevention studies.ResultsIntroducing interaction terms between Candida colonization and each of Staphylococcus aureus (coefficient +0.34; 95% confidence interval 0.19 to 0.48) and Enterococcal (+0.55; 0.23 to 0.86) colonization (all as latent variables) improved the fit for each model. The magnitude and significance level of the interaction terms were similar to the positive associations between exposure to topical antibiotic prophylaxis (TAP) on Enterococcal (+0.52; 0.06 to 1.0) versus the negative association with Staphylococcus aureus (-0.42; -0.66 to -0.17) colonization.ConclusionsGSEM modelling of published ICU infection prevention data implies interactions between Candida and Gram-positive bacteria in the human microbiome. This interaction might also account for the paradoxically high incidences among studies of TAP in ICU patients.

Clarifying the Factor Structure of the Self-Compassion Scale

2021 ◽  
Author(s):  
Noelle J. Strickland ◽  
Raquel Nogueira-Arjona ◽  
Sean Mackinnon ◽  
Christine Wekerle ◽  
Sherry H. Stewart
Keyword(s):  
Factor Structure ◽  
Lower Order ◽  
Latent Variables ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Well Being ◽  
The Self ◽  
Self Compassion ◽  
The Hierarchical Structure ◽  
Compassion Scale

Abstract. Self-compassion is associated with greater well-being and lower psychopathology. There are mixed findings regarding the factor structure and scoring of the Self-Compassion Scale (SCS). Using confirmatory factor analysis, we tested and conducted nested comparisons of six previously posited factor structures of the SCS. Participants were N = 1,158 Canadian undergraduates (72.8% women, 26.6% men, 0.6% non-binary; Mage = 19.0 years, SD = 2.3). Results best supported a two-factor hierarchical model with six lower-order factors. A general self-compassion factor was not supported at the higher- or lower-order levels; thus, a single total score is not recommended. Given the hierarchical structure, researchers are encouraged to use structural equation models of the SCS with two latent variables: self-caring and self-coldness. A strength of this study is the large sample, while the undergraduate sample may limit generalizability.

scholarly journals Aportaciones de la teoría de la autodeterminación a la predicción de la satisfacción escolar en estudiantes universitarios

2019 ◽  
Vol 37 (2) ◽  
pp. 471-485 ◽  
Author(s):  
José-Manuel Tomás ◽  
Melchor Gutiérrez
Keyword(s):  
University Students ◽  
Latent Variables ◽  
Autonomy Support ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Psychological Needs ◽  
Basic Psychological Needs ◽  
Academic Satisfaction ◽  
Mediational Model ◽  
Estudiantes Universitarios

La literatura especializada ofrece evidencias de que en todo el mundo las tasas de deserción universitaria son elevadas, generando inconvenientes para los propios estudiantes, para la institución a la que pertenecen y para la sociedad en general. Los determinantes del abandono de los estudios son diversos, considerando uno de los más importantes la satisfacción de los estudiantes con su entorno educativo. La satisfacción académica de los estudiantes depende en gran medida del clima motivacional del aula y de la satisfacción de las necesidades psicológicas básicas, fundamento de la teoría de la autodeterminación. En el marco teórico de la motivación autodeterminada y de la psicología positiva, el objetivo de este trabajo es analizar la capacidad predictiva del apoyo a la autonomía por los profesores sobre la satisfacción académica de los alumnos, mediado por la satisfacción de las necesidades psicológicas básicas de los estudiantes. Los participantes son 752 estudiantes universitarios dominicanos. Instrumentos: Percepción de Apoyo a la Autonomía por los Profesores, Satisfacción Necesidades de las Psicológicas Básicas de los Estudiantes, y Conectividad Académica. Los datos se analizan a través de dos Modelos de Ecuaciones Estructurales con variables latentes, uno con mediación total y otro con mediación parcial. Los resultados muestran que el apoyo a la autonomía se relaciona positivamente con la satisfacción de las necesidades psicológicas básicas; las necesidades básicas se relacionan positivamente con la satisfacción académica; y también aparece un efecto positivo y directo del apoyo a la autonomía por los profesores sobre la satisfacción académica de los estudiantes universitarios. The specialized literature offers evidence that university dropout rates are high throughout the world, creating problems for the students themselves, for the institution to which they belong, and for society in general. The determining factors of dropout are diverse, considering the student satisfaction with their educational environment as one of the most important ones. There is also evidence that the students’ satisfaction with their academic environment depends to a large extent on the classroom motivational climate and the satisfaction of basic psychological needs, main elements of the self-determination theory. In the theoretical framework of self-determined motivation and positive psychology, the objective of this paper is to analyze the predictive capacity of teachers’ autonomy support on students’ academic satisfaction, mediated by the satisfaction of the students’ basic psychological needs. Participants are 752 Dominican university students. Instruments: Perceived Teachers’ Autonomy Support, Students’ Basic Psychological Needs Scale, and Academic Connectedness Scale. The data has been analyzed through two Structural Equation Models with latent variables, a total mediational model and a partial mediational model. The results show that support for autonomy is positively related to the satisfaction of basic psychological needs; that basic needs are positively related to academic satisfaction; and that there is also a positive and direct effect of autonomy support by teachers on university students’ academic satisfaction.

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