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Supervised machine learning algorithms are powerful classification techniques commonly used to build prediction models that help diagnose the disease early. However, some challenges like overfitting and underfitting need to be overcome while building the model. This paper introduces hybrid classifiers using the ensembled model with a majority voting technique to improve prediction accuracy. Furthermore, a proposed preprocessing technique and features selection based on a genetic algorithm is suggested to enhance prediction performance and overall time consumption. In addition, the 10-folds cross-validation technique is used to overcome the overfitting problem. Experiments were performed on a dataset for cardiovascular patients from the UCI Machine Learning Repository. Through a comparative analytical approach, the study results indicated that the proposed ensemble classifier model achieved a classification accuracy of 98.18% higher than the rest of the relevant developments in the study.

OBJETIVO: Estudar a concordância no diagnóstico radiológico das infecções respiratórias agudas baixas em crianças. MÉTODOS: Sessenta radiogramas do tórax de crianças menores de cinco anos foram avaliados, individualmente, por três médicos: um radiologista pediátrico (RP), um pneumologista pediatra (PP) e um pediatra experiente no atendimento de sala de emergência (PE). Todas as crianças tinham procurado atendimento por apresentar um quadro agudo de infecção respiratória com aparente participação pulmonar. Os avaliadores desconheciam os diagnósticos originais, mas receberam uma ficha padrão com dados clínicos e laboratoriais dos pacientes no momento da consulta inicial. As variáveis investigadas foram agrupadas em cinco categorias: a) qualidade técnica do filme; b) localização da alteração; c) padrões radiográficos; d) outras alterações radiográficas; e) diagnóstico. Utilizou-se a estatística de Kappa para estudar a concordância entre as três duplas possíveis de observadores, aceitando-se os valores ajustados para viés de prevalência (KAVIP). RESULTADOS: Os valores de Kappa totais de cada dupla de observadores (RP x PP, RP x PE e PP x PE) foram 0,41, 0,43, e 0,39, respectivamente, o que representa, em média, uma concordância interobservadores moderada (0,41). Em relação às outras variáveis, "qualidade técnica" teve uma concordância regular (0,30); "localização", moderada (0,48); "padrões radiográficos" regular (0,29); "outras alterações radiográficas", moderada (0,43); e "diagnóstico", regular (0,33). Quanto à concordância global intraobservadores, a mesma foi moderada (0,54), com valores menores do que os descritos na literatura. CONCLUSÕES: A variabilidade interobservadores é inerente à interpretação dos achados radiológicos. A determinação do diagnóstico exato das infecções respiratórias agudas baixas nas crianças impõe desafios. Nossos resultados foram similares aos descritos na literatura.

Background/objectives: Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics-restricted repetitive behaviors and sensory features-and high levels of stress and anxiety. For a better understanding of the issue, it is necessary to consider the cognitive aspects that can help explain variations in stress and anxiety levels among adults with autism. We therefore aimed to model the contributions of worry and intolerance of uncertainty on the relationship between autism characteristics (sensory sensitivities and repetitive behaviors) and psychological distress (stress and anxiety)., Methods: The sample comprised 144 autistic individuals with a mean age of 35.15 (SD = 11.44). They participated in the study by completing an online questionnaire to assess the study variables. Most of the participants reported being diagnosed with Asperger syndrome (63.6%) or Level 1 autism spectrum disorder (27.1%)., Results: The model fit index values tested through path analysis indicated a good fit (χ 2 = 5.65; p = 0.13 ns; CFI = 0.993; NFI = 0.985; RMSEA = 0.079; SRMR = 0.025) and identified worry and intolerance of uncertainty as significant mediating variables within a comprehensive explanatory model., Conclusions: These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults.

Objectives: The main objective was to analyze the variables Sense of Coherence, Resilience and Emotional Regulation as predictors of satisfaction with care in caregivers of older adults people with dementia., Methods: An ex post facto cross-sectional study design with a single group. The data were collected between June and October 2020.63 caregivers of older adults people with severe dementia participated, by responding to questionnaires concerning the study variables during a telephone interview. Information was also collected regarding the characteristics of the care provided (years of evolution, degree of dementia, index of independence) and regarding the caregiver (age and years of caregiving) which will be analyzed as control variables. The data were analyzed using correlation analysis and multiple linear regression analysis., Results: The participants presented average levels for Sense of Coherence, Resilience, Emotional Regulation (M = 16.93) and a high degree of Satisfaction with care. Sense of Coherence was the main predictor of Satisfaction with care, explaining up to 67% of the variance, through its Significance and Comprehensibility dimensions. Although the Resilience variable presented a significant association with Satisfaction, its role in the predictive model was displaced by Sense of Coherence., Conclusions: Sense of Coherence and Resilience are relevant psychological variables because of their positive relationship with satisfaction with care among caregivers of older adults people with dementia. The caregivers' perception of the significance and comprehensibility of the situation are important positive predictors of their satisfaction with the care of older people with dementia. These results are suggestive to guide the follow-up and psychological support of caregivers., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

The objective of this study was to examine the relationships of participants' home characteristics (living space) and job prospects after the coronavirus disease 2019 (COVID-19) pandemic to their subjective psychological well-being (SWB) (in terms of both affective and cognitive aspects). We also examined the role of participants' resilience as a possible mediator in the relationships among the aforementioned variables. The sample comprised 474 Spanish adults who completed an online questionnaire between 14 and 24 April 2020, when COVID-19 confinement was very strict in Spain. We proposed a path analysis model including the described variables. The model presented a good fit (χ 2 = 7.41, df = 5, p = 0.376, comparative fit index = 0.996, Tucker-Lewis index = 0.987; root mean square error of approximation = 0.032). The results indicated that living space and future job prospects predicted resilience, which, in turn, was related to SWB. Moreover, the bootstrapping results revealed a mediating effect of resilience that showed indirect relationships between living space and SWB and between job prospects and SWB. Our results underline the importance of environmental (living space) and job-related variables to predict SWB as well as the mediating role that resilience may play during the confinement period.

Parents' perception of the positive contributions associated with raising children with autism is considered to be a protective factor in the process of psychological adaptation. Thus, it is essential to unveil what factors are related to this perception. We explore how parents' psychological distress (parental stress and anxiety) predicts the perception of positive contributions in fathers and mothers who raise individuals with different levels of autism severity. The sample comprises 135 couples (270 fathers and mothers) parenting individuals diagnosed with autism aged 3-38 years. Participants completed different self-report questionnaires, including measures of parental stress, anxiety, and positive contributions. To estimate the actor-partner interdependence model, data were analyzed using structural equation modeling (SEM) to explore transactional effects between fathers' and mothers' psychological distress and their perceptions of positive contributions associated with autism. Two separate multigroup models were tested, respectively, analyzing parental stress and anxiety. Each multigroup model considers two levels of disorder severity. The findings revealed that actor and partner effects of stress and anxiety were important predictors of the perception of positive contributions in both disorder severity groups. We conclude that it is necessary to develop family support programs that focus on controlling fathers' and mothers' stress and anxiety symptoms, as these mental states negatively impact the ability to perceive positive contributions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 García-López, Recio, Pozo and Sarriá.)

The use of humanoid robots as assistants in therapy processes is not new. Several projects in the past several years have achieved promising results when combining human-robot interaction with standard techniques. Moreover, there are multiple screening systems for autism; one of the most used systems is the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10), which includes ten questions to be answered by the parents or caregivers of a child. We present Q-CHAT-NAO, an observation-based autism screening system supported by a NAO robot. It includes the six questions of the Q-CHAT-10 that can be adapted to work in a robotic context; unlike the original system, it obtains information from the toddler instead of from an indirect source. The detection results obtained after applying machine learning models to the six questions in the Autistic Spectrum Disorder Screening Data for Toddlers dataset were almost equivalent to those of the original version with ten questions. These findings indicate that the Q-CHAT-NAO could be a screening option that would exploit all the benefits related to human-robot interaction., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: As reported in other high-income countries, around the 2008 Great Recession the Spanish banking sector engaged abusive practices that satisfy the definition of fraud. Our objective is to examine the association between self-reported bank fraud and physical health, using a gender perspective., Methods: With data from the 2017 Madrid Health Survey, we examined the association between the economic impact of fraud and poor self-rated health (SRH), comorbidity and pain (N = 4425). Interactions of time since fraud and sex with economic impact were tested by Poisson regression models with robust variance., Results: In total, 11% of adults in Madrid reported bank fraud since 2006. Among men, those who experienced frauds with severe economic impact were more likely to report adverse health than those who did not experience fraud (PR comorbidity: 1.46; PR pain conditions: 2.17). Among men time elapsed since fraud strengthened the association between severe economic impact and poor SRH (p = 0.022; p = 0.006, respectively). Among women, associations did not reach statistical significance., Conclusions: Bank frauds are an emerging phenomenon which is likely to damage public health. Stricter regulation to protect people from fraudulent bank practices is needed.

Over the past few decades, the financial system has engaged in abusive practices that meet the definition of fraud. Our objective is to compare the prevalence of psychological distress and levels of health-related quality of life according to having been exposed to financial fraud and its economic impact on family finances. The City of Madrid Health Survey 2017 included specific questions on exposure to financial fraud-this section was administered to half of the participants ( n = 4425). Mental health need or caseness was defined by a score greater than two on the 12-item version of the Goldberg health questionnaire. Health-related quality of life was assessed by the Darmouth Coop Functional Health Assessment Charts/WONCA (COOP/WONCA). The prevalence of financial fraud was 10.8%. The prevalence rate ratio for caseness of those who experienced severe economic impact due to fraud was 1.62 (95%, CI 1.17-2.25; reference: no fraud), after adjustment by age, sex, social class, and immigrant status. Women experienced a decreased quality of life, even with a moderate impact of fraud, while men experienced a decreased quality of life related to fraud with severe economic impact. The current study contributes to a growing body of literature showing the effects of economic shocks on health as a result of financial fraud.

In couples parenting children with Autism Spectrum Disorder (ASD), the partner becomes a primary source of support for addressing the additional parenting demands. The purpose of this study was to examine the associations between supportive dyadic coping and parental adaptation, and to assess the mediating role of relationship satisfaction between them. Seventy-six couples parenting children with ASD participated. Data were gathered through self-report questionnaires and an Actor-Partner Interdependence Mediation Model was used. Mothers' and fathers' supportive dyadic coping was related to both their own and partner's relationship satisfaction and parental adaptation. Findings also revealed the mediation role of relationship satisfaction, in the association between supportive dyadic coping and parental adaptation. The implications for research and clinical practice are discussed.

Couples affect each other cognitively, emotionally and behaviorally. The goal of this study is to test the benefits and potential use of the actor-partner interdependence model in examining how parental self-efficacy and positive contributions of fathers and mothers of children with Autism Spectrum Condition influence each other's psychological adaptation. The sample includes 76 Spanish couples who completed validated questionnaires measuring predictors, i.e., self-efficacy and positive contributions, and adaptation outcomes i.e., stress, anxiety, depression and psychological well-being. Multilevel analysis revealed many actor and some partner effects of parental self-efficacy and positive contributions to be important determinants of adaptation above and beyond child and sociodemographic factors, and as such, these effects should be targeted in clinical intervention programs.

The transition to adulthood and adulthood itself have been identified as times of stress for parents of individuals with autism spectrum disorder. Longitudinal studies, however, show improvements in the well-being of mothers of adolescents and young adults with autism spectrum disorder. This article presents a cross-sectional study of 102 Spanish parents (51 mothers and 51 fathers) of 102 individuals with autism spectrum disorder. The aim was to examine parental well-being (evaluated based on stress, anxiety, depression and psychological well-being) in three groups of parents of adults, adolescents and young children with autism spectrum disorder. In addition, the relationships between parental well-being and the characteristics of their children, social support, parental age and sense of coherence were analysed. The results showed that although parental stress and psychological well-being levels were similar across the groups, depression and anxiety were lower in parents of adolescents or adults compared with parents of young children. Different factors predicted different measures of parental well-being, but sense of coherence emerged as the main predictive factor for all parental well-being measures. These findings are discussed in relation to parental adaptation over the lifespan and the implications for interventions in autism spectrum disorder families., (© The Author(s) 2015.)

Raising a child with autism spectrum disorders presents families with exceptional caregiving challenges. Consequently, parents, particularly mothers, evidence unusually high stress levels. Previous research has identified relevant variables that help explain maternal stress: the child's behavior problems, social support and the sense of coherence (SOC) as a perception of problem. However, there are few longitudinal studies demonstrating how these variables correlate over time. We present a longitudinal study of 21 Spanish mothers of children with autism spectrum disorders (ASD) at two measurement time points over an interval of 4.5 years. Our aims are to examine the predictive relationships of these variables (behavior problems, social support and SOC) to stress and to analyse their changes over time. Data were collected through questionnaires. The results of the regression analysis (multiple adjusted R 2= .45, ƒ2 = .82) highlight the predictive values of SOC (adjusted R 2 = .31) and the initial stress levels (Δ adjusted R 2 = .14) for stress levels 4.5-years later. Our study used t-tests to compare measurements at the two time points; results demonstrate the permanence of stress levels and behavior problems and the effects of reduced social support and increased SOC levels (t(20) = 2.48, p = .02, Cohen's d = .63; t(20) = -4.22, p < .001, Cohen' d = .58). Implications for interventions are discussed.

This article explores the possible cognitive function associated with pointing gestures from a Vygotskian perspective. In Study 1, 39 children who were 2-4years of age were observed in a solitary condition while solving a mnemonic task with or without an explicit memory demand. A discriminant analysis showed that children used noncommunicative pointing gestures only in the task with an explicit memory demand. In Study 2, 39 children who were 4-6years of age completed an attentional task with and without the possibility of pointing. An analysis of variance showed that only those children who spontaneously pointed to solve the first task performed significantly worse in a second condition where pointing was impossible. These results suggest that besides its social interactive functions, pointing may also subserve private cognitive functions for children., (Copyright © 2011 Elsevier Inc. All rights reserved.)