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Hameed M, Yeung J, Boone D, Mallett S, Halligan S. Meta-research: How many diagnostic or prognostic models published in radiological journals are evaluated externally? Eur Radiol 2024; 34:2524-2533. [PMID: 37696974 PMCID: PMC10957714 DOI: 10.1007/s00330-023-10168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Prognostic and diagnostic models must work in their intended clinical setting, proven via "external evaluation", preferably by authors uninvolved with model development. By systematic review, we determined the proportion of models published in high-impact radiological journals that are evaluated subsequently. METHODS We hand-searched three radiological journals for multivariable diagnostic/prognostic models 2013-2015 inclusive, developed using regression. We assessed completeness of data presentation to allow subsequent external evaluation. We then searched literature to August 2022 to identify external evaluations of these index models. RESULTS We identified 98 index studies (73 prognostic; 25 diagnostic) describing 145 models. Only 15 (15%) index studies presented an evaluation (two external). No model was updated. Only 20 (20%) studies presented a model equation. Just 7 (15%) studies developing Cox models presented a risk table, and just 4 (9%) presented the baseline hazard. Two (4%) studies developing non-Cox models presented the intercept. Just 20 (20%) articles presented a Kaplan-Meier curve of the final model. The 98 index studies attracted 4224 citations (including 559 self-citations), median 28 per study. We identified just six (6%) subsequent external evaluations of an index model, five of which were external evaluations by researchers uninvolved with model development, and from a different institution. CONCLUSIONS Very few prognostic or diagnostic models published in radiological literature are evaluated externally, suggesting wasted research effort and resources. Authors' published models should present data sufficient to allow external evaluation by others. To achieve clinical utility, researchers should concentrate on model evaluation and updating rather than continual redevelopment. CLINICAL RELEVANCE STATEMENT The large majority of prognostic and diagnostic models published in high-impact radiological journals are never evaluated. It would be more efficient for researchers to evaluate existing models rather than practice continual redevelopment. KEY POINTS • Systematic review of highly cited radiological literature identified few diagnostic or prognostic models that were evaluated subsequently by researchers uninvolved with the original model. • Published radiological models frequently omit important information necessary for others to perform an external evaluation: Only 20% of studies presented a model equation or nomogram. • A large proportion of research citing published models focuses on redevelopment and ignores evaluation and updating, which would be a more efficient use of research resources.
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Affiliation(s)
- Maira Hameed
- Centre for Medical Imaging, University College London UCL, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK
| | - Jason Yeung
- Centre for Medical Imaging, University College London UCL, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK
| | - Darren Boone
- Centre for Medical Imaging, University College London UCL, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK
| | - Sue Mallett
- Centre for Medical Imaging, University College London UCL, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK
| | - Steve Halligan
- Centre for Medical Imaging, University College London UCL, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
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Hardy L, Vermoesen T, Genbrugge E, Natale A, Franquesa C, Gleeson B, Ferreyra C, Dailey P, Jacobs J. Affordable blood culture systems from China: in vitro evaluation for use in resource-limited settings. EBioMedicine 2024; 101:105004. [PMID: 38350332 PMCID: PMC10874707 DOI: 10.1016/j.ebiom.2024.105004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Bloodstream infections (BSI) pose a significant threat due to high mortality rates and the challenges posed by antimicrobial resistance (AMR). In 2019, an estimated 4.95 million deaths were linked to bacterial AMR. The highest impact was seen in resource-limited settings (RLS). For diagnosis of BSI, performant continuously-monitoring blood culture systems (CMBCS) have been optimized. However, in RLS, the implementation of CMBCS is hindered by budget constraints and unsuitable environmental conditions. Manufacturers from growing economies are currently producing affordable in vitro diagnostics, which could fill the gap in capacity, but so far these are not established outside their domestic markets. METHODS This study evaluated the performance, usability, and interchangeability of Chinese CMBCS in a laboratory setting using simulated blood cultures with a panel of 20 BSI-associated strains. Four systems were selected for the assessment: Autobio BC60, Mindray TDR60, Scenker Labstar50, and DL-biotech DL-60. FINDINGS Overall, all evaluated CMBCS demonstrated good performance with high yield (96.7-100%) and specificity (97.5-100%), comparable to the reference system (bioMérieux 3D). In addition, when used as "manual" blood cultures in a conventional incubator with visual growth detection, performance was also satisfactory: yield was between 90 and 100% and specificity was 100% for all BCBs. Both the CMBCS and the BCBs were easy to use and lot-to-lot variability in BCBs was minimal. The interchangeability testing indicated that the BCBs from different brands (all except Scenker) were compatible with the various automates, further highlighting the potential for a harmonized "universal BCB." INTERPRETATION Based on this in vitro study, we recommend the use of these systems in settings with challenging environments and limited resources. The Autobio system performed best for automatic detection and DL-Biotech BCBs for manual cultures respectively (combination of performance, price, usability). The appropriateness for use in RLS should still be confirmed in a field study. FUNDING The study was funded by FIND.
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Affiliation(s)
| | | | - Els Genbrugge
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | | | | | | | | | | | - Jan Jacobs
- Institute of Tropical Medicine (ITM), Antwerp, Belgium; KULeuven, Leuven, Belgium
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Mortelmans L, Dilles T. The development and evaluation of a medication diary to report problems with medication use. Heliyon 2024; 10:e26127. [PMID: 38375256 PMCID: PMC10875575 DOI: 10.1016/j.heliyon.2024.e26127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
Purpose The study aimed to develop and evaluate a medication diary for patients to report problems with medication use to enable shared-decision making and improve medication adherence. Methods Based on a search for existing diaries, a review of the content, and a list of medication self-management problems compiled from previous research, a paper and pencil version of a medication diary was developed. The diary was reviewed for clarity and overall presentation by five healthcare providers and nine patients. Afterwards, user-friendliness was evaluated by 69 patients with polypharmacy discharged from hospital during a quantitative prospective study. Results The medication diary consists of several parts: (1) a medication schedule allowing patients to list their medicines, (2) information sheets allowing patients to write down specific medication-related information, (3) a monthly overview to indicate daily whether medication-related problems were experienced, (4) problem sheets elaborating on the problems encountered, (5) space for specific medication-related questions for healthcare providers to facilitate shared-decision making. The review phase resulted in minor textual adjustments and one extra problem in the problem sheet. Most participants, who tested the medication diary for two months, found the diary user-friendly (80%) and easy to fill in (89%). About 40% of participants reported problems with medication use. Half of the patients indicated that the diary can facilitate discussing problems with healthcare providers. Conclusion The medication diary offers patients the opportunity to report problems regarding their medication use in a proven user-friendly manner and to discuss these problems with healthcare providers. Reporting and discussing problems with medication use can serve as a first step towards making shared decisions on how to address the problems encountered.
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Affiliation(s)
- Laura Mortelmans
- Department of Nursing Science and Midwifery, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Tinne Dilles
- Department of Nursing Science and Midwifery, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Tseli E, Monnier A, LoMartire R, Vixner L, Äng B, Bohman T. Protocol for identifying and characterising critical physical tasks in the military: Development and validation. Work 2024; 77:1261-1272. [PMID: 38393871 DOI: 10.3233/wor-230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND When establishing Physical Employment Standards, validity is dependent on the correct identification and characterisation of critical job tasks. OBJECTIVE To develop and validate a standardised protocol for the identification, characterisation, and documentation of critical physical job tasks in military occupational specialities in the Swedish Armed Forces (SwAF), and propose a definition of critical physical job tasks for use in the SwAF. METHODS A protocol was drafted with three content domains, including a preliminary definition. Protocol content validity was iteratively assessed in two consecutive stages where ten subject experts rated relevance and simplicity. A consensus panel revised the protocol after each stage. Content validity index (CVI) was calculated as item-CVI (I-CVI) per each feature and as scale average (S-CVI/Ave) per content domain. Acceptable content validity thresholds were 0.78 and 0.90, respectively. RESULTS The validated protocol consisted of 35 items with an I-CVI≥0.90 and≥0.80 for relevance and simplicity, respectively. The S-CVI/Ave was 0.97 for relevance and 0.98 for simplicity. The protocol was language reviewed, reorganised for easy use, and approved by the consensus panel. The final protocol includes: background and aim of the protocol, the accepted generic and critical physical job task definitions, protocol instructions, subject expert-qualifications, job task source and characteristics. CONCLUSION A standardised protocol for identification and characterisation of critical job tasks in SwAF military occupational specialties was developed. The protocol content was rated relevant and simple by experts and will be of importance in future work establishing physical requirements in the SwAF.
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Affiliation(s)
- Elena Tseli
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Andreas Monnier
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Military Academy Karlberg, Swedish Armed Forces, Solna, Sweden
| | - Riccardo LoMartire
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Research and Higher Education, The Administration of Regional Board, Center for Clinical Research Dalarna - Uppsala University, Falun, Sweden
| | - Linda Vixner
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Björn Äng
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Research and Higher Education, The Administration of Regional Board, Center for Clinical Research Dalarna - Uppsala University, Falun, Sweden
- Department of Physical Education and Sport Sciences, Biomechanics and Ergonomics Laboratory, University of Thessaly, Trikala, Greece
| | - Tony Bohman
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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El Mouaddib H, Sebbani M, Mansouri A, Adarmouch L, Amine M. Cross-cultural adaptation of the Moroccan Arabic dialect version of the Primary Care Assessment Tool. Gac Sanit 2023; 37:102350. [PMID: 38052119 DOI: 10.1016/j.gaceta.2023.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To adapt the Primary Primary Care Assessment Tool-Adult Edition into the Moroccan Arabic dialect and to assess its reliability and validity from the perspective of Moroccan adult patients. METHOD A committee of experts carried out the cross-cultural adaptation of the Primary Care Assessment Tool. The adapted questionnaire was subject to forward and backward translation and a pilot study. Exploratory factor analysis assessed the internal consistency, reliability, and construct validity of items and scales. Finally, descriptive statistics were performed on the final factor structure. RESULTS A 43-item Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition was developed. It consisted of six multi-item scales that represented the four main dimensions of primary care: first contact, continuity, comprehensiveness, and coordination. Four derived dimensions were included: cultural competence, communication, advice, and community orientation. All six scales demonstrated robust internal consistency, item-total solid correlations, and construct validity. The calculated Cronbach's alpha coefficients ranged from 0.78 to 0.90. CONCLUSIONS Comprehensive metric analyses supported the reliability and validity of the Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition in assessing core primary care domains from the patients' experience. This tool could be used for future research on primary care in Morocco.
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Affiliation(s)
- Hicham El Mouaddib
- Biosciences & Health Laboratory, Cadi Ayyad University, Marrakesh, Morocco.
| | - Majda Sebbani
- Biosciences & Health Laboratory, Cadi Ayyad University, Marrakesh, Morocco; Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco; Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco; Unit of Development and Research in Medical Education, Geneva University, Geneva, Switzerland
| | - Adil Mansouri
- Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco; Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco
| | - Latifa Adarmouch
- Biosciences & Health Laboratory, Cadi Ayyad University, Marrakesh, Morocco; Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco; Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco
| | - Mohamed Amine
- Biosciences & Health Laboratory, Cadi Ayyad University, Marrakesh, Morocco; Clinical Research Unit, Mohammed VI University Hospital, Marrakesh, Morocco; Community Medicine and Public Health Department, School of Medicine, Cadi Ayyad University, Marrakesh, Morocco
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Berwinkel A, Driessen M, Beblo T, Weigelt M. Combined physical activity training versus aerobic activity training in unipolar depressive disorder: a quasi-randomised evaluation study. Neuropsychiatr 2023; 37:206-213. [PMID: 37084073 DOI: 10.1007/s40211-023-00464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The positive effect of sport and exercise interventions on the treatment of unipolar depressive disorder (UDD) is well documented with respect to aerobic exercise. However, few studies have determined the effectiveness of other types of interventions (e.g., weight training, body and mind oriented, qigong or progressive muscle relaxation). Additionally, the effectiveness of specific combined sport and exercise approaches has rarely been investigated. Therefore, recommendations for the use of sport and exercise therapy to treat UDD have been developed. METHODS This quasi-randomised study used a pretest/posttest design to compare the effectiveness of two different interventions (aerobic activity training vs. combined physical activity training) on psychiatric outcome parameters in a day clinic psychiatric setting. A total of 62 participants were quasi-randomised to one of the two conditions. Affective, cognitive, psychosocial and neuropsychological changes were assessed by a battery of questionnaires before (t1) and after (t2) treatment. Accelerometers were used to assess energy consumption. RESULTS The results show that both training interventions have similar effects on the treatment of UDD. CONCLUSION These findings highlight the effectiveness of different physical activities in the treatment of UDD and provide further information for good clinical practice.
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Affiliation(s)
- Andre Berwinkel
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany.
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Matthias Weigelt
- Department Sport & Gesundheit, Universität Paderborn, Paderborn, Germany
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Cassetti V, López-Ruiz MV, Gallego-Royo A, Egea-Ronda A, Gea-Caballero V, Aviñó Juan Ulpiano D, Baraza Cano MP, Romero Rodríguez E. [Attend, consult, involve: do we need to redefine the concept of community engagement?]. Gac Sanit 2023; 37:102344. [PMID: 38039621 DOI: 10.1016/j.gaceta.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To describe how a sample of people working in community health promotion projects perceive and implement community engagement approaches. METHOD Mixed qualitative-quantitative study. Data was collected through: semi-structured interviews with 10 people representing the projects, and workshops in which 53 people participated and responded to a questionnaire prepared ad hoc to identify levels of community engagement. Descriptive statistical analysis of the questionnaires and framework analysis of the interviews, observations and workshops recordings. RESULTS Although the projects are described as highly participatory, community engagement appeared mainly in the form of attending events, with few examples of consultation or community involvement. CONCLUSIONS This difference may be due to the lack of a culture of participation, both in individuals and institutions, and lack of training in community engagement. It is proposed to change the language from participation-attendance to using expressions such as consulting or involving people.
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Affiliation(s)
| | - María Victoria López-Ruiz
- Unidad de Gestión Clínica Palma del Río, Distrito Córdoba Guadalquivir, Servicio Andaluz de Salud, Palma del Río (Córdoba), España; Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España
| | - Alba Gallego-Royo
- Servicio de Medicina Preventiva, Hospital Miguel Servet, Servicio Aragonés de Salud, Zaragoza, España; Grupo de Investigación en Atención Primaria Aragón (GIIS011), IIS Aragón, Universidad de Zaragoza, Zaragoza, España
| | - Ana Egea-Ronda
- Departamento de Salud Valencia Arnau de Vilanova-Llíria, San Antonio de Benagéber (Valencia), España.
| | - Vicente Gea-Caballero
- Facultad de Ciencias de la Salud, Valencian International University, Valencia, España; Research Group Community Health and Care, Valencian International University, Valencia, España
| | - Dory Aviñó Juan Ulpiano
- Área de Desigualdades en Salud, Fundación para la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, España
| | - María Pilar Baraza Cano
- Unidad de Gestión Clínica Vicar-La Mojonera, Distrito de Atención Primaria Poniente de Almería, Servicio Andaluz de Salud, Almería, España
| | - Esperanza Romero Rodríguez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España; Distrito Sanitario de Atención Primaria de Córdoba, Servicio Andaluz de Salud, Córdoba, España
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Schmidt FR, Coutinho ES, Lima MA, Silva MT, Leite AC, Fonseca IO, Araujo AQ. Performance of the National Institute of Infectious Diseases disability scale in HTLV-1-associated myelopathy/tropical spastic paraparesis. J Neurovirol 2023; 29:555-563. [PMID: 37400732 DOI: 10.1007/s13365-023-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling disease. However, there is a lack of an adequate and specific health measurement instrument validated and with good performance to assess their degree of physical disability. This led us to carry out this study and to evaluate the performance of Fiocruz's National Institute of Infectious Diseases (IDS) disability scale, a specific instrument for HAM/TSP. Ninety-two HAM/TSP patients participated in the study. One researcher applied the IDS, IPEC scale, Disability Status Scale (DSS), Expanded DSS (EDSS), Osame scale, Beck Depression Inventory, and the WHOQOL-BREF questionnaire. In parallel, blindly, and separately, other researchers applied the IDS. An inter-rater reliability analysis of the IDS, correlation analysis with the other scales, and depression and quality of life questionnaires were performed. The applicability of the IDS was also evaluated. The IDS showed high reliability in all scores. The inter-rater reliability test for the total IDS score was 0.94 (0.82-0.98) on its four dimensions. The scale adequately indicated the different degrees of disability, presenting a distribution similar to normal. There was a high correlation with the other scales (Spearman coefficients > 0.80, p < 0.001). The scale had good acceptance among users and a short application time. IDS for HAM/TSP was reliable, consistent, easy, and fast to use. It can be used for both prospective evaluations and clinical trials. The present study supports the IDS as a valid instrument to measure disability in patients with HAM/TSP compared to previously used scales.
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Affiliation(s)
- Felipe R Schmidt
- Department of Neurology, Pedro Ernesto University Hospital, the University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Evandro Sf Coutinho
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, the University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marco A Lima
- Laboratory for Clinical Research in Neuroinfections (Lapclin-Neuro), National Institute of Infectious Diseases (INI), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Marcus Tt Silva
- Laboratory for Clinical Research in Neuroinfections (Lapclin-Neuro), National Institute of Infectious Diseases (INI), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Ana Ccb Leite
- Laboratory for Clinical Research in Neuroinfections (Lapclin-Neuro), National Institute of Infectious Diseases (INI), FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Igor O Fonseca
- Department of Neurology and Psychiatry, Paulista State University (UNESP), Botucatu, SP, Brazil
| | - Abelardo Qc Araujo
- Laboratory for Clinical Research in Neuroinfections (Lapclin-Neuro), National Institute of Infectious Diseases (INI), FIOCRUZ, Rio de Janeiro, RJ, Brazil.
- Postgraduate Program in Neurology and Neurosciences, Fluminense Federal University (UFF), Niteroi, RJ, Brazil.
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Oliveira CB, Coombs D, Machado GC, McCaffery K, Richards B, Pinto RZ, O'Keeffe M, Maher CG, Christofaro DGD. Process evaluation of the implementation of an evidence-based model of care for low back pain in Australian emergency departments. Musculoskelet Sci Pract 2023; 66:102814. [PMID: 37421758 DOI: 10.1016/j.msksp.2023.102814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND The Sydney Health Partners Emergency Department (SHaPED) trial targeted ED clinicians and evaluated a multifaceted strategy to implement a new model of care. The objective of this study was to investigate attitudes and experiences of ED clinicians as well as barriers and facilitators for implementation of the model of care. DESIGN A qualitative study. METHODS The EDs of three urban and one rural hospital in New South Wales, Australia participated in the trial between August and November 2018. A sample of clinicians was invited to participate in qualitative interviews via telephone and face-to-face. The data collected from the interviews were coded and grouped in themes using thematic analysis methods. RESULTS Non-opioid pain management strategies (i.e., patient education, simple analgesics, and heat wraps) were perceived to be the most helpful strategy for reducing opioid use by ED clinicians. However, time constraints and rotation of junior medical staff were seen as the main barriers for uptake of the model of care. Fear of missing a serious pathology and the clinicians' conviction of a need to provide something for the patient were seen as barriers to reducing lumbar imaging referrals. Other barriers to guideline endorsed care included patient's expectations and characteristics (e.g., older age and symptoms severity). CONCLUSIONS Improving knowledge of non-opioid pain management strategies was seen as a helpful strategy for reducing opioid use. However, clinicians also raised barriers related to the ED environment, clinicians' behaviour, and cultural aspects, which should be addressed in future implementation efforts.
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Affiliation(s)
- Crystian B Oliveira
- Faculty of Medicine, University of Western São Paulo (Unoeste), Presidente Prudente, Sao Paulo, Brazil; Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, Brazil; Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia.
| | - Danielle Coombs
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Gustavo C Machado
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Kirsten McCaffery
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bethan Richards
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Department of Rheumatology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Rafael Z Pinto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Mary O'Keeffe
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia
| | - Chris G Maher
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Diego G D Christofaro
- Departamento de Educação Física, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, Brazil
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van Leeuwen K, Becks M, Grob D, de Lange F, Rutten J, Schalekamp S, Rutten M, van Ginneken B, de Rooij M, Meijer F. AI-support for the detection of intracranial large vessel occlusions: One-year prospective evaluation. Heliyon 2023; 9:e19065. [PMID: 37636476 PMCID: PMC10458691 DOI: 10.1016/j.heliyon.2023.e19065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose Few studies have evaluated real-world performance of radiological AI-tools in clinical practice. Over one-year, we prospectively evaluated the use of AI software to support the detection of intracranial large vessel occlusions (LVO) on CT angiography (CTA). Method Quantitative measures (user log-in attempts, AI standalone performance) and qualitative data (user surveys) were reviewed by a key-user group at three timepoints. A total of 491 CTA studies of 460 patients were included for analysis. Results The overall accuracy of the AI-tool for LVO detection and localization was 87.6%, sensitivity 69.1% and specificity 91.2%. Out of 81 LVOs, 31 of 34 (91%) M1 occlusions were detected correctly, 19 of 38 (50%) M2 occlusions, and 6 of 9 (67%) ICA occlusions. The product was considered user-friendly. The diagnostic confidence of the users for LVO detection remained the same over the year. The last measured net promotor score was -56%. The use of the AI-tool fluctuated over the year with a declining trend. Conclusions Our pragmatic approach of evaluating the AI-tool used in clinical practice, helped us to monitor the usage, to estimate the perceived added value by the users of the AI-tool, and to make an informed decision about the continuation of the use of the AI-tool.
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Affiliation(s)
- K.G. van Leeuwen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M.J. Becks
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - D. Grob
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - F. de Lange
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J.H.E. Rutten
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - S. Schalekamp
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M.J.C.M. Rutten
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Radiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - B. van Ginneken
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M. de Rooij
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - F.J.A. Meijer
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
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11
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Stevely AK, Mackay D, Alava MH, Brennan A, Meier PS, Sasso A, Holmes J. Evaluating the effects of minimum unit pricing in Scotland on the prevalence of harmful drinking: a controlled interrupted time series analysis. Public Health 2023; 220:43-49. [PMID: 37263177 DOI: 10.1016/j.puhe.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/06/2023] [Accepted: 04/21/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES In May 2018, the Scottish Government introduced a minimum unit price (MUP) for alcohol of £0.50 (1 UK unit = 8 g ethanol) to reduce alcohol consumption, particularly among people drinking at harmful levels. This study aimed to evaluate MUP's impact on the prevalence of harmful drinking among adults in Scotland. STUDY DESIGN This was a controlled interrupted monthly time series analysis of repeat cross-sectional data collected via 1-week drinking diaries from adult drinkers in Scotland (N = 38,674) and Northern England (N = 71,687) between January 2009 and February 2020. METHODS The primary outcome was the proportion of drinkers consuming at harmful levels (>50 [men] or >35 [women] units in diary week). The secondary outcomes included the proportion of drinkers consuming at hazardous (≥14-50 [men] or ≥14-35 [women] units) and moderate (<14 units) levels and measures of beverage preferences and drinking patterns. Analyses also examined the prevalence of harmful drinking in key subgroups. RESULTS There was no significant change in the proportion of drinkers consuming at harmful levels (β = +0.6 percentage points; 95% confidence interval [CI] = -1.1, +2.3) or moderate levels (β = +1.4 percentage points; 95% confidence interval = -1.1, +3.8) after the introduction of MUP. The proportion consuming at hazardous levels fell significantly by 3.5 percentage points (95% CI = -5.4, -1.7). There were no significant changes in other secondary outcomes or in the subgroup analyses after correction for multiple testing. CONCLUSIONS Introducing MUP in Scotland was not associated with reductions in the proportion of drinkers consuming at harmful levels but did reduce the prevalence of hazardous drinking. This adds to previous evidence that MUP reduced overall alcohol consumption in Scotland and consumption among those drinking above moderate levels.
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Affiliation(s)
- A K Stevely
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK.
| | - D Mackay
- School of Health and Wellbeing, University of Glasgow, UK
| | - M H Alava
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - A Brennan
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, UK
| | - P S Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - A Sasso
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK; European Commission, Joint Research Center (JRC), Ispra, Italy
| | - J Holmes
- Sheffield Alcohol Research Group, School of Health and Related Research (ScHARR), University of Sheffield, UK
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12
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Elvik R. Effects on accidents of technical inspections of heavy goods vehicles in Norway: A re-analysis and a replication. J Safety Res 2023; 84:212-217. [PMID: 36868649 DOI: 10.1016/j.jsr.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/26/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This paper presents a re-analysis of a previous study of the effects on accidents of technical inspections of heavy vehicles in Norway and a replication of the study using more recent data. METHOD Increasing the number of technical inspections is associated with a reduction in the number of accidents. Reducing the number of inspections is associated with an increase in the number of accidents. The relationship between changes in the number of inspections and changes in the number of accidents is well described by means of logarithmic dose-response curves. RESULTS These curves show that inspections had a larger effect on accidents in the recent period (2008-2020) than in the first period (1985-1997). Based on recent data, a 20% increase in the number of inspections is associated with a 4-6% reduction in the number of accidents. A 20% reduction of the number of inspections is associated with a 5-8% increase in the number of accidents.
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Affiliation(s)
- Rune Elvik
- Institute of Transport Economics, Gaustadalleen 21, 0349 Oslo, Norway.
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13
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Hardin-Fanning F, Hartson KR, Galloway L, Kern N, Gesler R. Students' perceptions of a community health advocacy skills building activity: A descriptive analysis. Nurse Educ Today 2023; 120:105627. [PMID: 36455496 DOI: 10.1016/j.nedt.2022.105627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/10/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Skills to promote advocacy, a nursing competency, are vital to today's cohorts of nursing students, who often struggle with discourse. Opportunities to develop, defend, and rebut science-based arguments enhance resilience and self-efficacy when advocating for health policy. A community health discussion activity was developed to enhance advocacy skills in undergraduate and graduate nursing students at a midwestern university. OBJECTIVES The purposes of this study were to explore students' perceptions of the benefits of a discussion activity about a controversial health issue, and to describe the impact of the opportunities to form valid arguments using empirical evidence on students' perceptions of their ability to be advocates. DESIGN Cross-sectional post-activity survey evaluation. SETTINGS Enrollment in a community health nursing course. PARTICIPANTS Students from two undergraduate (n = 110) and one graduate (n = 20) nursing cohorts. METHODS Following completion of the online discussion activity, students were invited to provide feedback on their perceptions of activity benefits. Descriptive analyses were conducted. RESULTS Undergraduate and graduate nursing students reported the activity helped them learn to form a valid argument using scientific evidence (88.6 %), use credible sources when forming their own opinions (91.7 %), and begin to see themselves as advocates for improving the health of individuals and communities (87.1 %). CONCLUSIONS Online discussion boards are potential venues for development of advocacy skills.
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Affiliation(s)
- Frances Hardin-Fanning
- University of Louisville School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, United States of America.
| | - Kimberly R Hartson
- University of Louisville School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, United States of America
| | - Lynette Galloway
- University of Louisville School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, United States of America
| | - Nancy Kern
- University of Louisville School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, United States of America
| | - Rebecca Gesler
- University of Louisville School of Nursing, 555 S. Floyd Street, Louisville, KY 40202, United States of America
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14
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Vossen E, van der Gulden JWJ, van Genabeek JA, Schaap R, Anema JR, Schaafsma FG. Process evaluation of the 'Grip on Health' intervention in general and occupational health practice. BMC Health Serv Res 2022; 22:1459. [PMID: 36451237 PMCID: PMC9713133 DOI: 10.1186/s12913-022-08801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND For working patients with a lower socioeconomic position, health complaints often result from a combination of problems on multiple life domains. To prevent long-term health complaints and absence from work, it is crucial for general and occupational health professionals to adopt a broad perspective on health and to collaborate when necessary. This study aimed to evaluate how the 'Grip on Health' intervention is implemented in general and occupational health practice to address multi-domain problems and to promote interprofessional collaboration. METHOD A process evaluation was performed among 28 general and occupational health professionals, who were trained and implemented the Grip on Health intervention during a six-month period. The 'Measurement Instrument for Determinants of Innovations' was used to evaluate facilitators and barriers for implementing Grip on Health. Data included three group interviews with 17 professionals, a questionnaire and five individual interviews. RESULTS While most health professionals were enthusiastic about the Grip on Health intervention, its implementation was hindered by contextual factors. Barriers in the socio-political context consisted of legal rules and regulations around sickness and disability, professional protocols for interprofessional collaboration, and the Covid-19 pandemic. On the organizational level, lack of consultation time was the main barrier. Facilitators were found on the level of the intervention and the health professional. For instance, professionals described how the intervention supports addressing multi-domain problems and has created awareness of work in each other's healthcare domain. They recognized the relevance of the intervention for a broad target group and experienced benefits of its use. The intervention period was, nevertheless, too short to determine the outcomes of Grip on Health. CONCLUSION The Grip on Health intervention can be used to address problems on multiple life domains and to stimulate interprofessional collaboration. Visualizing multi-domain problems appeared especially helpful to guide patients with a lower socioeconomic position, and a joint training of general and occupational health professionals promoted their mutual awareness and familiarity. For a wider implementation, stakeholders on all levels, including the government and professional associations, should reflect on ways to address contextual barriers to promote a broad perspective on health as well as on collaborative work.
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Affiliation(s)
- Emma Vossen
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands ,grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, Laan van Scheut 10, 6525 EM Nijmegen, The Netherlands
| | - Joost W. J. van der Gulden
- grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboudumc, Geert Grooteplein Noord 21, 6525 EZ Nijmegen, The Netherlands
| | | | - Rosanne Schaap
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Johannes R. Anema
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
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15
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Tietz S, Wagner-Skacel J, Angel HF, Ratzenhofer M, Fellendorf FT, Fleischmann E, Körner C, Reininghaus EZ, Seitz RJ, Dalkner N. Believing processes during the COVID-19 pandemic in individuals with bipolar disorder: An exploratory study. World J Psychiatry 2022; 12:929-943. [PMID: 36051599 PMCID: PMC9331453 DOI: 10.5498/wjp.v12.i7.929] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/27/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Believing or “credition” refers to psychological processes that integrate the cognitions and emotions that influence our behavior. In the credition model by Angel and Seitz, four parameters are postulated: proposition, certainty, emotion and mightiness. It is assumed that believing processes are influenced by both the individual as well as socio-cultural factors and external circumstances. External or environmental circumstances can include threatening situations such as the ongoing pandemic. It has been hypothesized that believing processes related to the pandemic differ between individuals with bipolar disorder (BD) and healthy controls (HC).
AIM To investigate credition in individuals with BD during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS Psychiatrically stable individuals with BD (n = 52) and age- and sex matched HC (n = 52) participated in an online survey during the first lockdown of the COVID-19 pandemic. The survey took place between April 9th and June 4th, 2020, in Austria. Participants completed the Brief Symptom Inventory-18, the Beck Depression Inventory-II, the Altman Self-Rating Mania Scale, the Pittsburgh Sleep Quality Index and a dedicated Believing Questionnaire assessing four parameters of credition (proposition, certainty, emotion and mightiness). The MAXQDA software was used to analyze the qualitative data. Statistical analyses included analyses of variance, a multivariate analysis of variance and a multivariate analysis of co-variance.
RESULTS Individuals with BD reported significantly more negative propositions [F (1,102) = 8.89, P = 0.004, η2p = 0.08] and negative emotions [Welch´s F (1,82.46) = 18.23, P < 0.001, η2p = 0.18], while HC showed significantly more positive propositions [F (1,102) = 7.78, P = 0.006, η2p = 0.07] and emotions [F (1,102) = 14.31, P < 0.001, η2p = 0.12]. In addition, individuals with BD showed a higher incongruence between their propositions and their emotions [F (1,102) = 9.42, P = 0.003, η2p = 0.08] and showed strong correlations between the parameters of the Believing Questionnaire and their psychiatric symptoms (r = 0.51-0.77, all P < 0.001). Positive as well as negative emotions and propositions were associated with scores measuring symptoms of depression, anxiety and sleep quality.
CONCLUSION Believing parameters were associated with psychiatric symptoms in BD during the pandemic. Findings broaden knowledge about the susceptibility of believing processes for ambient challenges in individuals with BD.
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Affiliation(s)
- Sophie Tietz
- Institute of Psychology, University of Graz, Graz 8010, Austria
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Jolana Wagner-Skacel
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz 8036, Austria
| | - Hans-Ferdinand Angel
- Department of Catechetics and Religious Education, University of Graz, Graz 8010, Austria
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Christof Körner
- Institute of Psychology, University of Graz, Graz 8010, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Rüdiger J Seitz
- Department of Neurology, Centre of Neurology and Neuropsychiatry Heinrich-Heine-University Düsseldorf, Medical Faculty, Düsseldorf D-40629, Germany
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
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Godoy P, Castilla J, Astray J, Godoy S, Tuells J, Barrabeig I, Domínguez Á. [Towards COVID-19 control through vaccination: obstacles, challenges and opportunities. SESPAS Report 2022]. Gac Sanit 2022; 36 Suppl 1:S82-S86. [PMID: 35781154 PMCID: PMC9244662 DOI: 10.1016/j.gaceta.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 01/09/2023]
Abstract
En España se inició el programa de vacunación en un contexto de alta transmisión y baja disponibilidad de vacunas. El objetivo de este artículo es revisar el programa de vacunación frente a la COVID-19 (3-3-2022) y valorar los obstáculos, los desafíos y las oportunidades que plantea el control de esta enfermedad. Se dispone actualmente de cinco vacunas: dos basadas en la tecnología ARNm (Comirnaty® y Spikevax®), dos basadas en un vector no replicativo (Vaxzevria® y Janssen) y una basada en la subunidad S (Novavax®). Las autoridades sanitarias han desarrollado estrategias de vacunación priorizando la prevención de hospitalizaciones y defunciones. En marzo de 2022 se superó el 90% de la población diana con vacunación completa y el 95% de cobertura en mayores de 50 años. El nuevo reto es conseguir coberturas similares para una tercera dosis. La vacunación en la infancia y la adolescencia se ha convertido en una prioridad por las implicaciones educativas y sociales que comporta la COVID-19. Se deberán renovar las estrategias comunicativas y eliminar las barreras de acceso para conseguir buenas coberturas. En España se han publicado estudios que muestran una alta efectividad de la vacunación. La principal estrategia para el control de la pandemia y para recuperar la actividad social es la vacunación, pero todo indica que serán necesarios niveles muy altos de cobertura vacunal y seguir con medidas no farmacológicas. En un mundo globalizado, el control de la COVID-19 solo se alcanzará con una estrategia global coordinada y el apoyo a la vacunación en los países con pocos recursos.
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Affiliation(s)
- Pere Godoy
- Agència de Salut Pública de Catalunya, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España.
| | - Jesús Castilla
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, España
| | - Jenaro Astray
- Dirección General de Salud Pública, Subdirección General de Epidemiología, Comunidad de Madrid, Madrid, España
| | - Sofía Godoy
- Institut Català de la Salut (ICS), Lleida, España
| | - José Tuells
- Departamento de Salud Pública, Universidad de Alicante, Alicante, España
| | - Irene Barrabeig
- Agència de Salut Pública de Catalunya, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Ángela Domínguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departament de Medicina, Universitat de Barcelona, Barcelona, España
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Bernard M, Lehmann T, Hecht L, Fabisch G, Harder A, Müller N, Luck-Sikorski C. Efficacy of DiaLife, an Education Program for Relatives of Adults with Diabetes - A Cluster Randomized Controlled Trial. Patient Educ Couns 2022; 105:2158-2165. [PMID: 34838412 DOI: 10.1016/j.pec.2021.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Diabetes affects the lives of patients and their close relatives. Considering the proven benefit of patient education programs, DiaLife was elaborated as the first German education program addressing the needs of relatives. The objective of this study was to investigate its efficacy. METHODS The evaluation was implemented in the form of a cRCT with longitudinal design and waiting list condition.In total, 179 relatives were recruited. Participants' diabetes-related knowledge was defined as the primary outcome. Diabetes-related strains, family interaction and other psychosocial factors were determined as secondary outcomes. RESULTS A generalized estimating equation model showed a persistent increase of diabetes-related knowledge in the intervention group compared to the control group regardless of the type of diabetes. Concerning secondary outcomes, mixed linear models showed an improvement for relatives of people with type 2 diabetes who participated in the DiaLife program. CONCLUSION This study provides evidence of DiaLife's efficacy regarding a persistent increase of diabetes-related knowledge and a positive effect on psychosocial outcomes in relatives of people with type 2 but not in type 1 diabetes. Adding (an)other psychosocial module(s) might improve their well-being and psychosocial outcomes. PRACTICE IMPLICATIONS Diabetes centers should consider implementing an education program for relatives, such as DiaLife, in their curriculum. TRIAL REGISTRATION The study was registered at the German Clinical Trials Register (DRKS00015157; date of registration: 24.08.2018).
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Affiliation(s)
- Marie Bernard
- SRH University of Applied Health Sciences, Neue Straße 28-30, 07548 Gera, Germany; Institute of Medical Sociology (IMS), Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8 - 06112 Halle (Saale), Germany.
| | - Thomas Lehmann
- University Hospital Jena, Center for Clinical Studies, Salvador-Allende-Platz 27, 07747 Jena, Germany
| | - Lars Hecht
- VDBD e.V. - German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115 Berlin, Germany; VDBD AKADEMIE GmbH, Habersaathstr. 31, 10115 Berlin, Germany; Institute for Research and Education in Diabetes (RED), Markt 15, 23758 Oldenburg, Germany
| | - Gottlobe Fabisch
- VDBD e.V. - German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115 Berlin, Germany; VDBD AKADEMIE GmbH, Habersaathstr. 31, 10115 Berlin, Germany
| | - Asja Harder
- VDBD e.V. - German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115 Berlin, Germany
| | - Nicolle Müller
- University Hospital Jena, Department of Internal Medicine III, Am Klinikum 1, 07747 Jena, Germany
| | - Claudia Luck-Sikorski
- SRH University of Applied Health Sciences, Neue Straße 28-30, 07548 Gera, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health, Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), Philipp-Rosenthal-Straße 27, 04103 Leipzig, Germany
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Wataya T, Yanagawa M, Tsubamoto M, Sato T, Nishigaki D, Kita K, Yamagata K, Suzuki Y, Hata A, Kido S, Tomiyama N; Osaka University Reading Team. Radiologists with and without deep learning-based computer-aided diagnosis: comparison of performance and interobserver agreement for characterizing and diagnosing pulmonary nodules/masses. Eur Radiol 2022. [PMID: 35751697 DOI: 10.1007/s00330-022-08948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 06/08/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the performance of radiologists in characterizing and diagnosing pulmonary nodules/masses with and without deep learning (DL)-based computer-aided diagnosis (CAD). METHODS We studied a total of 101 nodules/masses detected on CT performed between January and March 2018 at Osaka University Hospital (malignancy: 55 cases). SYNAPSE SAI Viewer V1.4 was used to analyze the nodules/masses. In total, 15 independent radiologists were grouped (n = 5 each) according to their experience: L (< 3 years), M (3-5 years), and H (> 5 years). The likelihoods of 15 characteristics, such as cavitation and calcification, and the diagnosis (malignancy) were evaluated by each radiologist with and without CAD, and the assessment time was recorded. The AUCs compared with the reference standard set by two board-certified chest radiologists were analyzed following the multi-reader multi-case method. Furthermore, interobserver agreement was compared using intraclass correlation coefficients (ICCs). RESULTS The AUCs for ill-defined boundary, irregular margin, irregular shape, calcification, pleural contact, and malignancy in all 15 radiologists, irregular margin and irregular shape in L and ill-defined boundary and irregular margin in M improved significantly (p < 0.05); no significant improvements were found in H. L showed the greatest increase in the AUC for malignancy (not significant). The ICCs improved in all groups and for nearly all items. The median assessment time was not prolonged by CAD. CONCLUSIONS DL-based CAD helps radiologists, particularly those with < 5 years of experience, to accurately characterize and diagnose pulmonary nodules/masses, and improves the reproducibility of findings among radiologists. KEY POINTS • Deep learning-based computer-aided diagnosis improves the accuracy of characterizing nodules/masses and diagnosing malignancy, particularly by radiologists with < 5 years of experience. • Computer-aided diagnosis increases not only the accuracy but also the reproducibility of the findings across radiologists.
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Molto A, Mortamet G, Kempf H, Thiron JM, Vié le Sage F. Implementation of a nutritional supplementation program in a population of Cambodian children and its impact on statural growth. Arch Pediatr 2022; 29:439-443. [PMID: 35705386 DOI: 10.1016/j.arcped.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/06/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Stunting is a major health problem in low-income countries. We aimed to describe the implementation of a lipid-based nutrient supplement (LNS) program in a rural neighborhood in Cambodia and to assess its impact on statural growth. METHOD This was a before-after comparative study. The program was promoted by the Pédiatres du Monde (PDM) organization between 2011 and 2019 in six villages in a rural area in Cambodia. The supplementation program consisted of daily administration of LNS during the third semester of pregnancy for the mothers and then between 6 and 24 months of age for the toddlers. Anthropometric data of the children were recorded during PDM visits before and after the program implementation, which allowed us to compare child growth in the two groups: control and intervention groups. Primary outcome was height-for-age between 24 and 35 months of age. RESULTS Overall, 198 data were collected for children between 24 and 35 months of age in the control group. A total of 347 pregnant women were enrolled in the intervention phase. A total of 188 data were collected for children between 24 and 35 months of age in the intervention group. The mean height-for-age z-score in the population receiving LNS was higher than in the control group (-1.14 vs. -1.60, p < 0.001). There was no significant difference between the two groups regarding the weight-for-height z-score (WHZ; -1.11 vs. -1.26, p = 0.18) and children in the intervention group had a higher middle upper-arm circumference z-score (MUACZ; -0.75 vs.. -1.1, p < 0.001). CONCLUSION LNS supplementation significantly and increased the HAZ between 24 and 35 months of age. However, the fight against malnutrition is complex and needs intervention on multiple levels.
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Affiliation(s)
- A Molto
- Pédiatres du Monde (PDM) Organization, Sèvres, France.
| | - G Mortamet
- Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - H Kempf
- Pédiatres du Monde (PDM) Organization, Sèvres, France
| | - J-M Thiron
- Pédiatres du Monde (PDM) Organization, Sèvres, France; Association Française de Pédiatrie Ambulatoire, Bagnols-sur-Cèze, France
| | - F Vié le Sage
- Pédiatres du Monde (PDM) Organization, Sèvres, France; Association Française de Pédiatrie Ambulatoire, Bagnols-sur-Cèze, France
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20
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Holzmann-Littig C, Zerban NL, Storm C, Ulhaas L, Pfeiffer M, Kotz A, Wijnen-Meijer M, Keil S, Huber J. One academic year under COVID-19 conditions: two multicenter cross-sectional evaluation studies among medical students in Bavarian medical schools, Germany students' needs, difficulties, and concerns about digital teaching and learning. BMC Med Educ 2022; 22:450. [PMID: 35681177 PMCID: PMC9183753 DOI: 10.1186/s12909-022-03480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/20/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Since March 2020, COVID-19 has created a need for adaptation in many areas of life. This study explores medical students' perspectives on digital teaching under conditions of the COVID-19 pandemic. It focuses on expectations and concerns about digital teaching, the evaluation of specific aspects of teaching, and requests for future teaching. METHODS Six German faculties have joined forces within the Bavarian network for medical education to develop and deploy a common core questionnaire. Cross-sectional surveys were conducted at the end of the summer semester 2020 and winter semester 2020/21. Medical students from different semesters participated in the online survey. Data was analyzed descriptively and/or inferentially. Item differences across semesters were examined using contingency tables and Chi2 tests. Mean values were compared using the independent samples t-test; answer frequencies in retrospective and prospective concerns were compared using contingency tables and Chi2 tests with Yates' correction. RESULTS In the summer semester 2020, 1565 students and in winter semester 2020/21, 1727 students took part in the survey. Students' main prospective concern was lack of social exchange between fellow students (70%), but also with teachers. Second and third most often concerns were a lack of practical training (68%) and lack of integration of on-site digital teaching (50%). Approximately 7% of the students lacked sufficient access to technical equipment.. Approximately 39% of the students lacked a sufficient internet connection for synchronous digital teaching, 17% for asynchronous digital teaching. On-site teaching was the preferred form of teaching (60%), and there was a preference for asynchronous (24%) over synchronous (15%) digital teaching. Teaching recordings (79%) were particularly popular to complement future on-site teaching. CONCLUSIONS The following areas of education under COVID-19 conditions are highly important to medical students: adequacy of information sharing, integration of opportunities for exchange with fellow students and teachers, possibility to perform practical trainings. After the normalization of the pandemic situation, on-site teaching should be supplemented with blended learning concepts such as the inverted classroom model. Percentages of results are rounded averages from summer and winter semesters.
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Affiliation(s)
- Christopher Holzmann-Littig
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany.
- Department of Nephrology, University Hospital rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Nina L Zerban
- Institute of Medical Teaching and Medical Education Research, University Hospital of Würzburg, Würzburg, Germany
- Simulated Patient Program, Faculty of Medicine, Julius-Maximilians-Universität of Würzburg, Würzburg, Germany
| | - Clara Storm
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Lilian Ulhaas
- Faculty of Medicine, Dean's Office and Department of Medical Education Augsburg DEMEDA, Augsburg University, Augsburg, Germany
| | - Mona Pfeiffer
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Alexander Kotz
- Faculty of Medicine, Office of the Dean for Student Affairs, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Stephanie Keil
- Faculty of Medicine, Dean's Office, University of Regensburg, Regensburg, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
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21
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Chico-Sánchez P, Gras-Valentí P, Algado-Sellés N, Jiménez-Sepúlveda N, Rodríguez-Díaz JC, Merino-deLucas E, Galiana-Ivars M, Fuster-Pérez M, Cartagena-Llopis L, Balboa-Esteve S, Cánovas-Jávega S, Esclapez-Martínez A, Monerris-Palmer M, Cerezo-Milán P, Sánchez-Payá J, Ronda-Pérez E. Effectiveness of the systematic use of antimicrobial filters in the water taps of critical care units for the prevention of healthcare-associated infections with Pseudomonas aeruginosa. Am J Infect Control 2022; 50:435-439. [PMID: 35369937 DOI: 10.1016/j.ajic.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Pseudomonas aeruginosa (PA) is the third leading aetiological agent in healthcare-associated infections (HAIs) and the one most frequently found in patients with pneumonia associated with mechanical ventilation. In intensive care units (ICU), its appearance is associated with higher mortality, an increase in the days spent on ventilation, and hospital stay length and costs. Thus, evaluating strategies for preventing these infections is essential for their control. Therefore, our objective was to evaluate the effectiveness of the systematic use of antimicrobial filters in preventing PA infections in critical care units. METHODS This was an open experimental crossover study. A total of 2,156 patients admitted for more than 24 hours in critical care units were included, 1,129 of them in units with filters, and 1,027 in units without filters. The study groups were followed-up for 24 months and HAIs were checked for the presence of PA. Chi-squared test were used to compare the rate of HAIs between groups and we calculated 95% confidence intervals adjusted by Poisson regression for the rate ratio (RR) of the association magnitude. RESULTS Both groups were homogeneous in terms of intrinsic and extrinsic patient factors. The incidence of PA infections in the units with filters was 5.5 cases/1,000 hospitalized days and 5.4/1,000 hospitalized days for the units without water filters (RR = 1.09 [0.67-1.79]). CONCLUSIONS Routine placing antimicrobial filters in the water taps in critical care units was not an effective means of preventing the emergence of HAIs caused by PA.
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22
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Kautz-Freimuth S, Redaèlli M, Isselhard A, Shukri A, Vodermaier A, Rhiem K, Schmutzler R, Stock S. Evaluation of two evidence-based decision aids for female BRCA1/2 mutation carriers in Germany: study protocol for a randomised controlled parallel-group trial. Trials 2022; 23:157. [PMID: 35172875 DOI: 10.1186/s13063-022-06081-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 02/03/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Women with BRCA1/2 mutations have a higher risk of developing breast and ovarian cancer compared to women of the general population. Various preventive options are available to deal with the increased risk of developing cancer. These include intensified breast cancer screening and risk-reducing bilateral mastectomy and salpingo-oophorectomy. The choice of a preventive option can lead to increased decisional conflict. To support these women in their decision-making process, two evidence-based decision aids were developed in an upstream research process and adapted to the German healthcare context. These will be evaluated within a randomised controlled trial (RCT) in terms of their effects on decision-making, women's level of information and psychological outcome variables. METHODS A sample of 310 women carrying BRCA1/2 mutations (A) without a history of cancer or (B) with a history of unilateral breast cancer who have received post-test genetic counselling will be enrolled. Upon study consent, women will be randomly assigned to either the intervention or the control group. All participants will receive standard care including a physician's letter summarising the counselling content. After baseline data collection (t0), the intervention group receives the respective decision aid while the control group receives standard care only. The primary outcome variable assessed at a 3-month follow-up (t1) is the change of extent in decisional conflict (measured with the Decisional Conflict Scale). Secondary outcome variables comprise the stage of decision-making, self-reported symptoms of anxiety, depression and stress due to the genetic test result, and knowledge regarding cancer risks and preventive options. At t1, the extent of preparation for decision-making and acceptability of the decision aids will also be examined. Another secondary outcome variable assessed at 6-month follow-up (t2) is the extent of decision regret. DISCUSSION These will be the first decision aids available for BRCA1/2 mutation carriers in Germany to be evaluated regarding their effectiveness and acceptability in clinical use within an RCT. Subsequently, they are to be integrated into the care concept of the centres of the German Consortium for Hereditary Breast and Ovarian Cancer and the affiliated breast centres. TRIAL REGISTRATION {2A}: DRKS DRKS00015823 . Retrospectively registered on 14 June 2019.
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23
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Gimenez MM, Fitz FF, de Azevedo Ferreira L, Bortolini MAT, Lordêlo PVS, Castro RA. Pelvic floor muscle function differs between supine and standing positions in women with stress urinary incontinence: an experimental crossover study. J Physiother 2022; 68:51-60. [PMID: 34952814 DOI: 10.1016/j.jphys.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/12/2021] [Accepted: 12/10/2021] [Indexed: 02/08/2023] Open
Abstract
QUESTION In women with stress urinary incontinence, how does pelvic floor muscle (PFM) function differ between supine and standing when assessed using manometry, vaginal palpation, dynamometry and electromyography? DESIGN An experimental crossover study. PARTICIPANTS A total of 101 women with stress urinary incontinence were included. INTERVENTION The PFM evaluations were performed and compared in supine and standing positions. The participants were assigned to either Group 1 (assessments in supine followed by standing) or Group 2 (assessments in standing followed by supine). OUTCOME MEASURES The primary outcome was the PFM pressure during the maximum voluntary contraction (MVC). Secondary outcomes were the measures of PFM pressure at rest; PFM function (PERFECT scheme); active and passive forces (dynamometry); and PFM electromyography (EMG) activity. RESULTS The mean MVC pressure was significantly lower in standing (MD -7 cmH2O, 95% CI -10 to -4). The mean PFM resting pressure was higher in standing (7 cmH2O, 95% CI 5 to 10). Three measures of PFM function derived from vaginal palpation were better in supine than in standing. The PFM active and the passive forces measured using dynamometry were higher in standing (0.18 kgf, 95% CI 0.16 to 0.20). The resting EMG activity was higher in standing than in supine (MD 3.6 μV, 95% CI 2.6 to 4.5), whereas EMG activity during MVC was higher in supine than standing (MD -8.7 μV, 95% CI -12.5 to -4.8). CONCLUSION The pressure and EMG activity during MVC, and PFM function were lower in standing. The resting pressure, the passive and active forces of the PFM and the resting EMG activity of the PFM were higher in standing.
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Affiliation(s)
| | - Fátima Faní Fitz
- Department of Gynecology, Universidade Federal de São Paulo, São Paulo, Brazil
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Friedli T, Gantschnig BE. The role of contextual factors on participation in the life area of work and employment after rehabilitation: A qualitative study on the views of persons with chronic pain. Work 2021; 71:119-132. [PMID: 34924419 PMCID: PMC8842774 DOI: 10.3233/wor-205173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: A deeper understanding of how contextual factors affect the ability to participate in the life area of work and employment despite chronic musculoskeletal pain is needed as a basis for interprofessional rehabilitation programs. OBJECTIVE: To investigate which contextual factors influence rehabilitation program clients’ ability to participate in the life area of work and employment, and how they do this. METHODS: Nested case study using a realist evaluation framework of interprofessional interventions. Qualitative content analysis of problem-centered interviews to identify influential context-mechanism-outcome configurations. RESULTS: We identified several important context-mechanism-outcome configurations. In the pre-interventional phase, socioeconomic and environmental factors affected two mechanisms, “exhaustion” and “discrimination”. In the intra-interventional phase, the social skills of health professionals and opportunities for discussion with peers affected the ability of program participants to engage with program content. In the post-intervention phase, volitional competences of the social system affected the sustainable application of program content in everyday life. CONCLUSION: The identified context-mechanism-outcome configurations shows that the ability to participate in the life area of work is interdependent with the ability to participate in other areas of life. In practice and research, assessment and treatment should be carried out based on this understanding.
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Affiliation(s)
- Thomas Friedli
- Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, and University of Bern
| | - Brigitte E Gantschnig
- Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, and University of Bern.,Institute of Occupational Therapy, School ofHealth Professions ZHAW Zurich University of Applied Sciences, Switzerland
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Hyafil A, Moriña D. Analysis of the impact of lockdown on the reproduction number of the SARS-Cov-2 in Spain. Gac Sanit 2021; 35:453-458. [PMID: 32571528 PMCID: PMC7245209 DOI: 10.1016/j.gaceta.2020.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The late 2019 COVID-19 outbreak has put the health systems of many countries to the limit of their capacity. The most affected European countries are, so far, Italy and Spain. In both countries (and others), the authorities decreed a lockdown, with local specificities. The objective of this work is to evaluate the impact of the measures undertaken in Spain to deal with the pandemic. METHOD We estimated the number of cases and the impact of lockdown on the reproducibility number based on the hospitalization reports up to April 15th 2020. RESULTS The estimated number of cases shows a sharp increase until the lockdown, followed by a slowing down and then a decrease after full quarantine was implemented. Differences in the basic reproduction ratio are also significant, dropping from 5.89 (95% confidence interval [95%CI]: 5.46-7.09) before the lockdown to 0.48 (95%CI: 0.15-1.17) afterwards. CONCLUSIONS Handling a pandemic like COVID-19 is complex and requires quick decision making. The large differences found in the speed of propagation of the disease show us that being able to implement interventions at the earliest stage is crucial to minimise the impact of a potential infectious threat. Our work also stresses the importance of reliable up to date epidemiological data in order to accurately assess the impact of Public Health policies on viral outbreak.
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Affiliation(s)
- Alexandre Hyafil
- Centre de Recerca Matemàtica, Edifici C, Universitat Autònoma de Barcelona, Cerdanyola del Vallès (Barcelona), Spain; Barcelona Graduate School of Mathematics, Departament de Matemàtiques, Universitat Autònoma de Barcelona, Cerdanyola del Vallès (Barcelona), Spain.
| | - David Moriña
- Barcelona Graduate School of Mathematics, Departament de Matemàtiques, Universitat Autònoma de Barcelona, Cerdanyola del Vallès (Barcelona), Spain; Department of Econometrics, Statistics and Applied Economics, Riskcenter-IREA, Universitat de Barcelona, Barcelona, Spain
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26
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Zhao L, Liang M, Wu PY, Yang Y, Zhang H, Zhao X. A preliminary study of synthetic magnetic resonance imaging in rectal cancer: imaging quality and preoperative assessment. Insights Imaging 2021; 12:120. [PMID: 34420097 PMCID: PMC8380206 DOI: 10.1186/s13244-021-01063-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To compare the imaging quality, T stage and extramural venous invasion (EMVI) evaluation between the conventional and synthetic T2-weighted imaging (T2WI), and to investigate the role of quantitative values obtained from synthetic magnetic resonance imaging (MRI) for assessing nodal staging in rectal cancer (RC). METHODS Ninety-four patients with pathologically proven RC who underwent rectal MRI examinations including synthetic MRI were retrospectively recruited. The image quality of conventional and synthetic T2WI was compared regarding signal-to-noise ratio (SNR), contrast-to-noise (CNR), sharpness of the lesion edge, lesion conspicuity, absence of motion artifacts, and overall image quality. The accuracy of T stage and EMVI evaluation on conventional and synthetic T2WI were compared using the Mc-Nemar test. The quantitative T1, T2, and PD values were used to predict the nodal staging of MRI-evaluated node-negative RC. RESULTS There were no statistically significant differences between conventional and synthetic T2WI in SNR, CNR, overall image quality, lesion conspicuity, and absence of motion artifacts (p = 0.058-0.978). There were no significant differences in the diagnostic accuracy of T stage and EMVI between conventional and synthetic T2WI from two observers (p = 0.375 and 0.625 for T stage; p = 0.625 and 0.219 for EMVI). The T2 value showed good diagnostic performance for predicting the nodal staging of RC with the area under the receiver operating characteristic, sensitivity, specificity, and accuracy of 0.854, 90.0%, 71.4%, and 80.3%, respectively. CONCLUSIONS Synthetic MRI may facilitate preoperative staging and EMVI evaluation of RC by providing synthetic T2WI and quantitative maps in one acquisition.
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Affiliation(s)
- Li Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Meng Liang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Pu-Yeh Wu
- GE Healthcare, MR Research China, No. 1 Tongji South Road Beijing Economic Technology Development Area, Beijing, 100176, China
| | - Yang Yang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Hongmei Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
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Hakme E, Poulsen ME. Evaluation of the automated micro-solid phase extraction clean-up system for the analysis of pesticide residues in cereals by gas chromatography-Orbitrap mass spectrometry. J Chromatogr A 2021; 1652:462384. [PMID: 34261021 DOI: 10.1016/j.chroma.2021.462384] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
Food analysis is a tremendously broad field that is constantly evolving. New methods have emerged to increase productivity, such as modern miniaturized and robotic analytical techniques. In this paper, a micro-solid-phase extraction system (µ-SPE) for clean-up was combined with a robotic autosampler to yield ready-to-analyze extracts. The system was evaluated for its applicability in routine laboratories. The new, automated, high-throughput µ-SPE clean-up method was applied to acetonitrile extracts and was developed for the analysis of pesticide residues in cereals by gas chromatography-Orbitrap mass spectrometry (GC-Orbitrap-MS). The µ-SPE clean-up efficiency was demonstrated in the removal of matrix-interfering components and in the recovery of pesticides. The sorbent bed mixture consisted of magnesium sulfate, primary-secondary amine, C18, and CarbonX, and effectively retained matrix components without loss of target analytes. Analysis of five types of cereals (barley, oat, rice, rye, and wheat) by GC-Orbitrap-MS showed that the method removed more than 70% of matrix components. The clean-up method was validated for 170 pesticides in rye, 159 pesticides in wheat, 142 pesticides in barley, 130 pesticides in oat, and 127 pesticides in rice. Spike recovery values were 70-120% for all pesticides and the repeatability, calculated as the relative standard deviation, was less than 20%. The limits of quantitation achieved were 0.005 mg kg-1 for almost all analytes, ensuring compliance with the maximum residue limits.
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Affiliation(s)
- Elena Hakme
- National Food Institute, Technical University of Denmark, Søborg, Denmark.
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Laureano-Eugenio J, Gómez-Rodríguez RO, Tasejo-Corzantes J, Silvestre Ramírez A, Pretell Aguilar RM, Alcalde-Rabanal JE. Sustainability of the Healthy Municipalities Strategy in Guatemala. Rev Panam Salud Publica 2021; 45:e70. [PMID: 34131424 PMCID: PMC8196337 DOI: 10.26633/rpsp.2021.70] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/09/2021] [Indexed: 11/28/2022] Open
Abstract
Objective. Evaluate the sustainability of the Healthy Municipalities strategy in Guatemala in order to have solid evidence to support decision-making. Methods. A concurrent mixed-methods study was carried out in five phases: 1) theoretical-conceptual (based on a narrative review of the literature on sustainability, dimensions and categories were proposed for evaluation); 2) empirical (four municipalities were selected for convenience and 29 semi-structured interviews and four focus groups were conducted with key actors to explore sustainability; with this information, a score was assigned to each category and dimension); 3) analytical, by category and dimension (content analysis was performed for qualitative information, and totals and averages were calculated for quantitative information); 4) integrative (qualitative data were integrated into matrices by category and dimension, and quantitative data were supported by qualitative information); and 5) meta-inference (consideration was given to the context and its influence on the results). Results. Ninety-two (92) informants participated. In operational terms, progress was observed in the transfer and use of results, and in rotations in leadership. In the legal and political sphere, accountability and local planning were highlighted. In the economic sphere, progressive investment in health, water and sanitation was emphasized, as well as insufficient investment in social determinants of health. In the social sphere, few mechanisms were observed to promote and strengthen social participation. Conclusions. In the municipalities that participated in the study, a fair level of sustainability was observed in the Healthy Municipalities strategy.
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Affiliation(s)
| | - Raúl Otoniel Gómez-Rodríguez
- Ministry of Health and Social Welfare Guatemala City Guatemala Ministry of Health and Social Welfare, Guatemala City, Guatemala
| | - Jhunny Tasejo-Corzantes
- Ministry of Health and Social Welfare Guatemala City Guatemala Ministry of Health and Social Welfare, Guatemala City, Guatemala
| | - Augusto Silvestre Ramírez
- Ministry of Health and Social Welfare Guatemala City Guatemala Ministry of Health and Social Welfare, Guatemala City, Guatemala
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Seitz MW, Haux C, Smits KPJ, Kalmus O, Van Der Zande MM, Lutyj J, Listl S. Development and evaluation of a mobile patient application to enhance medical-dental integration for the treatment of periodontitis and diabetes. Int J Med Inform 2021; 152:104495. [PMID: 34010786 DOI: 10.1016/j.ijmedinf.2021.104495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/19/2021] [Accepted: 05/11/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION People around the world are increasingly affected by multimorbidity, where conditions in different medical specialties can correlate in complex ways. This increases the relevance of multidisciplinary integrated care pathways. Modern software solutions provide vast opportunities to enhance information exchange between patients and various healthcare professionals, thereby improving patient-centered and inter-professional care. This paper describes the development and validation of a mobile patient application which exploits Patient Reported Outcomes to enhance patient-centered medical-dental integration with a focus on integrated management of periodontitis and diabetes. METHODS This study was part of a multidisciplinary project for enhancement of medical-dental integration. The Intervention Mapping Protocol was supplemented by the RAND/UCLA Appropriateness Method, including literature reviews, focus group discussions and a Delphi panel in cooperation with various stakeholders. A mobile application was developed in close collaboration with patients, physicians and dentists. The usability of the application's core components was validated in two medical and two dental practices using the System Usability Scale (SUS). RESULTS 39 questions were identified to provide relevant patient-reported information which can be collected via a mobile application to enhance integrated management of periodontitis and diabetes. Usability testing of the application's core components (14 questions) among 137 participants in medical and dental practices indicated a good SUS score of 77.88 (±12.17). DISCUSSION The systematically developed mobile application offers the potential to provide physicians and dentists with treatment-relevant information to enhance medical-dental integration, thereby reducing the workload of medical staff, improving the quality of routinely collected data, and enabling automated data processing. This unique, novel, and validated approach can serve as an open framework for the development and evaluation of interdisciplinary healthcare software.
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Affiliation(s)
- Max W Seitz
- University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany
| | - Christian Haux
- University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany
| | - Kirsten P J Smits
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Health Care, Nijmegen, the Netherlands
| | - Olivier Kalmus
- University Hospital Heidelberg, Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg, Germany
| | - Marieke M Van Der Zande
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Health Care, Nijmegen, the Netherlands; University Hospital Heidelberg, Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg, Germany; University of Liverpool, Department of Public Health, Policy and Systems, Liverpool, United Kingdom
| | - Julia Lutyj
- University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany
| | - Stefan Listl
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Quality and Safety of Oral Health Care, Nijmegen, the Netherlands; University Hospital Heidelberg, Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg, Germany.
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Laureano-Eugenio J, Gómez-Rodríguez RO, Tasejo-Corzantes J, Silvestre Ramírez A, Pretell Aguilar RM, Alcalde-Rabanal JE. [Sustainability of the Healthy Municipalities strategy in GuatemalaSustentabilidade da estratégia de Municípios Saudáveis na Guatemala]. Rev Panam Salud Publica 2021; 45:e37. [PMID: 33833788 PMCID: PMC8021209 DOI: 10.26633/rpsp.2021.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/09/2021] [Indexed: 11/26/2022] Open
Abstract
Objetivo. Evaluar la sostenibilidad de la estrategia Municipios Saludables en Guatemala, para disponer de evidencia sólida que permita apoyar la toma de decisiones. Métodos. Se realizó un estudio mixto concurrente en cinco fases: 1) teórica-conceptual, se realizó una revisión narrativa de literatura en sostenibilidad, con base en la cual se propusieron dimensiones y categorías para su evaluación; 2) empírica, se seleccionaron por conveniencia cuatro municipios y se realizaron 29 entrevistas semiestructuradas y cuatro grupos focales a actores clave para explorar la sostenibilidad; con esta información, se asignó un puntaje a cada categoría y dimensión; 3) analítica, por categoría y dimensión, se realizó el análisis del contenido para la información cualitativa y sumatorias y promedios para la información cuantitativa; 4) integrativa, los datos cualitativos se integraron en matrices por categoría y dimensión; y los datos cuantitativos se respaldaron con información cualitativa; y 5) metainferencia, se reflexionó sobre el contexto y su influencia en los resultados. Resultados. Participaron 92 informantes. En la dimensión operativa, se destacan avances en la transferencia y el uso de resultados, así como en el relevo de liderazgo. En la dimensión legal y política, se destacaron la rendición de cuentas y los planes locales. En la dimensión económica, se destacó la inversión progresiva en salud, agua y saneamiento, con deficiencia de inversiones en determinantes sociales de la salud. En la dimensión social, se observaron pocos mecanismos para impulsar y fortalecer la participación social. Conclusiones. En los municipios que participaron del estudio se observó un nivel regular de sostenibilidad de la estrategia Municipios Saludables.
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Affiliation(s)
- Jorge Laureano-Eugenio
- Secretaría de Salud de Jalisco Jalisco México Secretaría de Salud de Jalisco, Jalisco, México
| | - Raúl Otoniel Gómez-Rodríguez
- Ministerio de Salud y Asistencia Social Ciudad de Guatemala Guatemala Ministerio de Salud y Asistencia Social, Ciudad de Guatemala, Guatemala
| | - Jhunny Tasejo-Corzantes
- Ministerio de Salud y Asistencia Social Ciudad de Guatemala Guatemala Ministerio de Salud y Asistencia Social, Ciudad de Guatemala, Guatemala
| | - Augusto Silvestre Ramírez
- Ministerio de Salud y Asistencia Social Ciudad de Guatemala Guatemala Ministerio de Salud y Asistencia Social, Ciudad de Guatemala, Guatemala
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Bai YH, Li SP, Ding S, Lu Q, Yang LQ, Zhang YL, Zhang JN, Li L, Zhang Z. [Safety analysis of 12 241 infants inoculated in three sites of diphtheria, tetanus, acellular pertussis and haemophilus influenzae type b combined vaccine in Chaoyang District of Beijing]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:953-957. [PMID: 32907284 DOI: 10.3760/cma.j.cn112150-20200316-00342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To observe the adverse reactions of Diphtheria, Tetanus, Acellular Pertussis and Haemophilus Influenzae Type b Combined Vaccine conjugate vaccine at the anterolateral thigh muscle, upper arm deltoid muscle and upper gluteal region. Methods: A total of 12 241 infants who were voluntarily vaccinated DTaP-Hib from April 2015 to April 2019 in Beijing were selected for the study. DTaP-Hib vaccine is recommended for 3, 4, 5 months of age for basic immunization and 18 to 24 months of age to strengthen immunization. Subjects were divided into the groups of lateral thigh muscle, the upper arm deltoid and upper gluteal region according to the actual inoculation sites. Adverse reactions were collected within 30 minutes and 7 days after each does of vaccination at different sites and compared between three groups. The incidence of adverse reactions at the three different inoculation sites was compared by Chi-square test. Results: A total of 12 241 infants and toddlers received combined DTaP-Hib and 35 027 doses of DTaP-Hib were investigated. The number and of lateral thigh muscles, upper arm deltoids and gluteal muscles were 3 461 infants and 11 129 doses, 2 659 infants and 7 957 doses, 6 121 infants and 15 941 doses respectively. A total of 2 489 adverse reactions occurred. The incidence of adverse reactions was 7.11%. The incidence of adverse reactions in deltoid muscle of upper arm was 9.69%(771 doses), which was higher than that in gluteal muscle (7.58%, 1 211 doses) and anterolateral muscle of thigh (4.56%, 507 doses). The incidence of mild, moderate and severe adverse reactions in the upper arm deltoid group were higher than those in the other two groups. The incidence rates were 4.85% (386 doses), 3.77% (300 doses) and 1.07% (85 doses) respectively. The differences between groups were statistically significant(P<0.001). The total adverse reactions of the three doses of basic immunization and the fourth dose of enhanced immunization had the same trend in different parts. The incidence of adverse reactions was in the order of the upper arm deltoid injection, upper gluteal injection and lateral thigh muscle injection from high to low. The differences were statistically significant (P<0.001). Conclusion: The incidence of adverse reactions of DTaP-Hib vaccination in three different sites was low, which confirmed that the DTaP-Hib vaccination got expected safety regardless of the sites of inoculation. The lateral femoral muscle group had the lowest incidence of adverse reactions, hence it should be preferred as the inoculation site of DTaP-Hib vaccination.
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Affiliation(s)
- Y H Bai
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - S P Li
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - S Ding
- Baotou Medical College, Baotou 014040, China
| | - Q Lu
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - L Q Yang
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - Y L Zhang
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - J N Zhang
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - L Li
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
| | - Z Zhang
- Department of Biological Products,Chaoyang District Center for Disease Control and Prevention, Beijing 100021, China
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Nakagawa Y, Kurimoto S, Maheu E, Matsui Y, Kanno Y, Menuki K, Hayashi M, Nemoto T, Nishizuka T, Tatebe M, Yamamoto M, Iwatsuki K, Dreiser RL, Hirata H. Cross-cultural translation, adaptation and validation of a Japanese version of the functional index for hand osteoarthritis (J-FIHOA). BMC Musculoskelet Disord 2020; 21:173. [PMID: 32178665 PMCID: PMC7333425 DOI: 10.1186/s12891-020-03193-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/09/2020] [Indexed: 11/22/2022] Open
Abstract
Background Hand osteoarthritis (OA) has a wide spectrum of clinical presentations and physical function is one of the core domains where patients suffer. The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment. Our objective was to make a Japanese version of FIHOA (J-FIHOA) and validate it among Japanese hand OA patients. Methods Forward and backward translation processes were completed to create a culturally adapted J-FIHOA. A prospective, observational multicenter study was undertaken for the validation process. Seventeen collaborating hospitals recruited Japanese hand OA patients who met the American College of Rheumatology criteria. A medical record review and responses to the following patient-rated questionnaires were collected: J-FIHOA, Hand20, Health Assessment Questionnaire (HAQ), numerical rating scale for pain (NRS pain) and Short Form 36 Health Survey (SF-36). We explored the structure of J-FIHOA using factor analysis. Cronbach’s alpha coefficients and item-total correlations were calculated. Correlations between J-FIHOA and other questionnaires were evaluated for construct validity. Participants in clinically stable conditions repeated J-FIHOA at a one- to two-week interval to assess test-retest reliability. To evaluate responsiveness, symptomatic patients who started new pharmacological treatments had a 1-month follow-up visit and completed the questionnaires twice. Effect size (ES) and standardized response mean (SRM) were calculated with pre- and post-treatment data sets. We assessed responsiveness, comparing ES and SRM of J-FIHOA with other questionnaires (construct approach). Results A total of 210 patients participated. J-FIHOA had unidimensional structure. Cronbach’s alphas (0.914 among females and 0.929 among males) and item-total correlations (range, 0.508 to 0.881) revealed high internal consistency. Hand20, which measures upper extremity disability, was strongly correlated with J-FIHOA (r = 0.82) while the mental and role-social components of SF-36 showed no correlations (r = − 0.24 and − 0.26, respectively). Intraclass correlation coefficient for test-retest reliability was 0.83 and satisfactory. J-FIHOA showed the highest ES and SRM (− 0.68 and − 0.62, respectively) among all questionnaires, except for NRS pain. Conclusions Our results showed J-FIHOA had good measurement properties to assess physical function in Japanese hand OA patients both for ambulatory follow-up in clinical practice, and clinical research and therapeutic trials.
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Affiliation(s)
- Yasunobu Nakagawa
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Shigeru Kurimoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Emmanuel Maheu
- Department of Rheumatology, AP-HP, Hospital Saint-Antoine, Paris, France
| | - Yuichiro Matsui
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuri Kanno
- Hand Surgery and Microsurgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Kunitaka Menuki
- Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanori Hayashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuya Nemoto
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | | | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Katsuyuki Iwatsuki
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | | | - Hitoshi Hirata
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Kusmiati M, Bahari R, Sanip S, Hamid NAA, Emilia O. The development of an evaluation tool to assess professional behavior and clinical competencies from the graduates' perspective. Korean J Med Educ 2020; 32:1-11. [PMID: 32130846 PMCID: PMC7066429 DOI: 10.3946/kjme.2020.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/27/2019] [Accepted: 12/27/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE This study was designed to develop an evaluation tool for assessing professional behavior and clinical competencies from the graduates' perspective. METHODS This study employed mixed method in a sequential exploratory design. The semi-structured interviews were conducted with three graduates from different cohorts. The qualitative analysis of the interviews found six emerging themes for professional behavior and clinical competencies development. These themes were then developed into a 55-item questionnaire. The questionnaire was then distributed to 84 medical graduates for exploratory factor analysis (EFA) from February to April 2019. The quantitative data were analyzed using IBM SPSS ver. 21.0 (IBM Corp., Armonk, USA) for principal axis factoring. After conducting EFA, we proceeded with confirmatory factor analysis (CFA) with another 120 graduates to validate the tool. RESULTS Eighty-four graduates completed the questionnaire for EFA. Upon completion of EFA, 35 out of 55 items of the questionnaire were found to be valid and reliable. The most appropriate fit was seven factors, which explained 58.18% of variance between them after 15 iterations with Cronbach's α of 0.916. The personal satisfaction factor was noted to be weak. It was therefore added to patient management factor due to its similar intention. The final EFA factor after the modification was six. The CFA found that 34 out of 35 items was valid and reliable that representation of the latent variables. CONCLUSION The questionnaire has achieved the desired construct validity score and can be used as an evaluation tool to assess professional behavior and clinical competencies from the graduates' perspective.
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Affiliation(s)
- Mia Kusmiati
- Department of Medical Education, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia
- Department of Psychiatry, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Rafidah Bahari
- Department of Psychiatry, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Suhaila Sanip
- Department of Medical Education, Faculty of Medicine & Health Sciences, University Sains Islam Malaysia, Kualalumpur, Malaysia
| | - Noor Aini Abdul Hamid
- Department of Medical Education, International Medical School, Management & Science University, Shah Alam, Malaysia
| | - Ova Emilia
- Department of Medical Education and Bioethic, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Luig T, Wicklum S, Heatherington M, Vu A, Cameron E, Klein D, Sharma AM, Campbell-Scherer DL. Improving obesity management training in family medicine: multi-methods evaluation of the 5AsT-MD pilot course. BMC Med Educ 2020; 20:5. [PMID: 31910854 PMCID: PMC6947955 DOI: 10.1186/s12909-019-1908-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Quality, evidence-based obesity management training for family medicine residents is needed to better support patients. To address this gap, we developed a comprehensive course based on the 5As of Obesity Management™ (ASK, ASSESS, ADVISE, AGREE, ASSIST), a framework and suite of resources to improve residents' knowledge and confidence in obesity counselling. This study assessed the course's impact on residents' attitudes, beliefs, and confidence with obesity counselling. METHODS The course combines lectures with a bariatric empathy suit experience, standardized and in-clinic patient practice, and narrative reflections. Using a multi-methods design we measured changes in 42 residents' attitudes, beliefs, and self-confidence and thematically analyzed the narrative reflections to understand residents' experience with the course content and pedagogy. RESULTS Following the course, residents reported improved attitudes towards people living with obesity and improved confidence for obesity counselling. Pre/post improvement in BAOP scores (n = 32) were significant (p < .001)., ATOP scores did not change significantly. Residents showed improvement in assessing root causes of weight gain (p < .01), advising patients on treatment options (p < .05), agreeing with patients on health outcomes (p < .05), assisting patients in addressing their barriers (p < .05), counseling patients on weight gain during pregnancy, (p < .05), counseling patients on depression and anxiety (p < .01), counseling patients on iatrogenic causes of weight gain (p < .01), counseling patients who have children with obesity (p < .05), and referring patients to interdisciplinary providers for care (p < .05). Qualitative analysis of narrative reflections illustrates that experiential learning was crucial in increasing residents' ability to empathically engage with patients and to critically reflect on implications for their practice. CONCLUSION The 5AsT-MD course has the potential to increase residents' confidence and competency in obesity prevention and management. Findings reflect the utility of the 5As to improve residents' confidence and competency in obesity management counselling.
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Affiliation(s)
- Thea Luig
- Office of Lifelong Learning & Physician Learning Program, University of Alberta, Edmonton, Canada
| | - Sonja Wicklum
- Cummings School of Medicine, University of Calgary, Calgary, Canada
| | - Melanie Heatherington
- Office of Lifelong Learning & Physician Learning Program, University of Alberta, Edmonton, Canada
| | - Albert Vu
- Core Internal Medicine, University of Alberta, Edmonton, Canada
| | - Erin Cameron
- Department of Human Sciences, Northern Ontario School of Medicine, Sudbury, Canada
| | - Doug Klein
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Arya M. Sharma
- Department of Medicine, Division of Endocrinology, University of Alberta, Edmonton, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Canada
| | - Denise L. Campbell-Scherer
- Office of Lifelong Learning & Physician Learning Program, University of Alberta, Edmonton, Canada
- Department of Family Medicine, University of Alberta, Edmonton, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Canada
- 2-590 Edmonton Clinic Health Academy, Office of Lifelong Learning/Physician Learning Program, University of Alberta, Edmonton, AB T6G 1C9 Canada
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Bernard M, Müller N, Hecht L, Fabisch G, Harder A, Luck-Sikorski C. Efficacy of DiaLife, an education program for relatives of adult patients with diabetes - study protocol of a cluster randomized controlled trial. Trials 2019; 20:523. [PMID: 31439049 PMCID: PMC6704511 DOI: 10.1186/s13063-019-3600-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/18/2019] [Indexed: 11/11/2022] Open
Abstract
Background The global prevalence of diabetes mellitus (DM) has been increasing over recent decades. In Germany, the prevalence for DM type 1 and type 2 in adults is estimated at about 7.7%. Hence, diabetes has to be classified as a serious public health concern. Being diagnosed with DM and facing possible sequelae might have a negative impact on patients’ mental and physical well-being. However, diabetes not only affects patients themselves, but also their close relatives. To improve the quality of life for patients and relatives alike, the German Association of Diabetes Nurses and Education experts (VDBD) elaborated the first education program tailor-made for relatives of diabetes patients. This article describes the concept and design of the trial evaluating the efficacy of this education program called “DiaLife—Living Together with Diabetes”. Methods This evaluation study is a cluster randomized controlled trial, in which the study centers will be randomly assigned either to the intervention group or the control group. Study centers will recruit relatives of and patients with DM type 1 and type 2. Members of the intervention group will participate in the education program DiaLife, whereas participants randomized in the control group will act as waiting-list controls. The study will assess the efficacy of DiaLife by comparing diabetes-related knowledge between the intervention and control groups as the primary outcome for participants. As the primary outcome in patients, the Hba1c value will be assessed. In addition, diabetes-related distress, family interaction, and other secondary endpoints will be considered as secondary outcomes. Long-term efficacy will be assessed 6 and 12 months after intervention. Hierarchical regression models will be used to analyze effects over time. Discussion While there is scientific evidence for the efficacy of education programs addressed to (diabetes) patients, there is a research gap with regard to intervention studies evaluating the efficacy of education programs designed for patients’ relatives. The study results will provide information on the efficacy of the DiaLife education program. In addition, factors that might hinder a successful implementation of an education program for relatives will be identified. Trial registration German Clinical Trials Register, DRKS00015157. Registered on 24 August 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3600-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Bernard
- Integrated Research and Treatment Center Adiposity Diseases (IFB), University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany. .,SRH University of Applied Health Sciences, Neue Straße 28-30, 07548, Gera, Germany.
| | - N Müller
- Department of Internal Medicine III, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - L Hecht
- VDBD e.V.-German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115, Berlin, Germany.,VDBD AKADEMIE GmbH, Habersaathstr. 31, 10115, Berlin, Germany.,Research and Education in Diabetes (RED) Institute, Mühlenkamp 5, 23758, Oldenburg, Germany
| | - G Fabisch
- VDBD e.V.-German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115, Berlin, Germany.,VDBD AKADEMIE GmbH, Habersaathstr. 31, 10115, Berlin, Germany
| | - A Harder
- VDBD e.V.-German Association of Diabetes Nurses and Education Experts, Habersaathstr. 31, 10115, Berlin, Germany
| | - C Luck-Sikorski
- Integrated Research and Treatment Center Adiposity Diseases (IFB), University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany.,SRH University of Applied Health Sciences, Neue Straße 28-30, 07548, Gera, Germany
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Anheyer D, Kern C, Dobos G, Cramer H. "I think you can achieve quite a lot if all of the staff stands behind it"-A qualitative study about the experience, knowledge and application of complementary therapies and integrative medicine in pediatrics. Complement Ther Med 2018; 41:186-191. [PMID: 30477837 DOI: 10.1016/j.ctim.2018.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the United States there is an increasing use of complementary and alternative medicine (CAM) as well as integrative medicine (IM) in pediatrics. This study investigates the extent of knowledge and practical application of and attitudes towards the use and integration of CAM/IM therapies in two German pediatric clinics. METHODS A semi-standardized qualitative interview study was conducted in a rural children's hospital in Bavaria and in a children's clinic in the metropolitan area of Ruhr. Sixteen employees (7 nurses, 9 medical doctors, 68.8% female), who had volunteered through a local contact, were questioned during their shift on CAM/IM therapies. The data collected were analyzed with MAXQDA 12 using a qualitative technique for content analysis (by Mayring). RESULTS On average all respondents had little to superficial knowledge about the possibilities or evidence base of the therapies concerned, but did believe that CAM/IM could be an enhancement. In addition, many took interest in learning more about CAM/IM medical options. Nurses desired more practical and theoretical knowledge; while medical doctors focused on standardization and evidence base. All of them agreed that self-care strategies could enhance parental independence when treating symptoms of minor illnesses. They further agreed, that a symbiosis of conventional medicine and CAM/IM has great potential for patients and employees. It was stated that training of staff would be indispensable in order to implement standardized procedures. CONCLUSIONS There is great potential and interest in CAM/IM among pediatric care employees. Regardless of the challenges, this investigation did find that implementing CAM/IM might be a promising extension to the daily care routine.
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Affiliation(s)
- Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Christine Kern
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Sagberg F, Ingebrigtsen R. Effects of a penalty point system on traffic violations. Accid Anal Prev 2018; 110:71-77. [PMID: 29107858 DOI: 10.1016/j.aap.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/11/2017] [Accepted: 11/01/2017] [Indexed: 06/07/2023]
Abstract
We analysed data from the Norwegian driver's licence penalty point register over a three-year period, in order to investigate whether the number of incurred penalty points in a given time period can predict the probability of incurring additional points in the subsequent period. Data for all category B drivers without penalty points at the start of the study period were included in the analyses. Norway's penalty point system implies that speeding and various other traffic violations result in two or three penalty points for full-license drivers and four or six points for probationary-license drivers. Eight points within a three-year period results in a six-month disqualification. Two hypotheses were formulated: 1) A "driving style effect" implying that drivers with previous penalty points have a higher probability of incurring new points than drivers without previous points; and 2) a "deterrence effect" implying that drivers with more than four points have a reduced probability of incurring new points, due to impending risk of license revocation. Results showed an inverted U-shaped relationship between number of penalty points incurred during a one-year period and the number of additional penalty points incurred in the subsequent year, with the highest number for drivers with four previous points. Thus, both hypotheses were clearly supported, and it is concluded that the penalty point system has a significant deterring effect for drivers who are at high risk of losing their license at the next infraction.
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Affiliation(s)
- Fridulv Sagberg
- Institute of Transport Economics, Gaustadalléen 21, 0349 Oslo, Norway.
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Mueller T, Egger M, Leitner I, Gabriel C, Haltmayer M, Dieplinger B. Reference values of galectin-3 and cardiac troponins derived from a single cohort of healthy blood donors. Clin Chim Acta 2016; 456:19-23. [PMID: 26920637 DOI: 10.1016/j.cca.2016.02.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/21/2016] [Accepted: 02/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Here we describe the determination of upper reference limits (URL) for galectin-3, high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in a single cohort of healthy blood donors using routine assays. METHODS For this reference value study, we used a cohort of 402 consecutive blood donors (64% were male and 36% were female). The median individuals' age was 35.0 years (range, 18.0-64.4). Individuals of this reference population were free of cardiovascular disease, diabetes mellitus, renal disease, cancer, current infection and chronic inflammatory disease. Plasma concentrations of galectin-3 were measured with the "routine Galectin-3" assay (Abbott Diagnostics), of hs-cTnI with the "STAT High Sensitive Troponin-I" assay (Abbott Diagnostics), and of hs-cTnT with the "Troponin T hs" assay (Roche Diagnostics). URLs were calculated by using a non-parametric percentile method. RESULTS The 97.5th percentile URL for galectin-3 was 16 ng/mL in males and 17 ng/mL in females; the 99 th percentile URL for hs-cTnI was 39 ng/L in males and 24 ng/L in females; and the 99 th percentile URL for hs-cTnT was 14 ng/L in males and 11 ng/L in females. Those individuals with hs-cTnI values ≥ 15 ng/L (n=8) were different from those individuals with hs-cTnT values ≥ 10 ng/L (n=7). Of the 402 individuals, none had galectin-3 values below the limit of detection (LOD, <1.0 ng/mL), 290 (72%) had hs-cTnI values below the LOD (i.e., 1.9 ng/L), and 359 (89%) had hs-cTnT values below the LOD (i.e., 5.0 ng/L). CONCLUSION Plasma concentrations of galectin-3, hs-cTnI and hs-cTnT and corresponding 99 th percentile URLs were rather low in our cohort of healthy blood donors compared with previously published data. In our reference population, analyte plasma concentrations above the LOD were detectable in 100% of the individuals with the Abbott galectin-3 assay, but only in less than 50% for both the Abbott hs-cTnI assay and the Roche hs-cTnT assay.
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Affiliation(s)
- Thomas Mueller
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria.
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | - Isabella Leitner
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | | | - Meinhard Haltmayer
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Linz, Austria
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Abstract
Based on recent studies, this paper examines whether an increased use of electronic stability control can replace studded tyres. A re-analysis of a study that evaluated the effects on accidents of changes in the use of studded tyres in major cities in Norway is presented. It is found that if all cars have electronic stability control, the use of studded tyres can be reduced to about 15 percent before any increase in the number of accidents occurs. Even if studded tyres were eliminated entirely, any increase in the number of accidents is likely to be considerably smaller than it would have been if electronic stability control had never been invented.
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Affiliation(s)
- Rune Elvik
- Institute of Transport Economics, Gaustadalleen 21, NO-0349 Oslo, Norway; Department of Civil Engineering, Aalborg University, Sofiendalsvej 11, DK-9210 Aalborg SV, Denmark.
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Häggman-Laitila A, Rekola L. Factors influencing partnerships between higher education and healthcare. Nurse Educ Today 2014; 34:1290-1297. [PMID: 24565808 DOI: 10.1016/j.nedt.2014.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 01/28/2014] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to describe the factors influencing partnerships between higher education and healthcare. BACKGROUND Partnerships have often been studied as organisations' internal processes or multi-professional team activities. However, there has been less research on the partnership as a phenomenon between organisations and, until now, the research has mainly focused on experiences in the US and the UK. SETTING, PARTICIPANTS AND METHODS The study was carried out in Finland. Staff from a university of applied sciences and a service unit for the elderly took part in nine focus group interviews (n=39) and produced self-evaluations based on diaries (n=13) and essays (n=24). The data were analysed by qualitative content analysis. RESULTS The factors influencing partnerships were: a joint development target, agreeing on collaboration, providing resources for partnership, enhancing mutual understanding, sharing operational culture, commitment and participatory change management and communication. CONCLUSIONS This study updates, and complements, previous reviews on factors influencing partnerships, by providing some new concepts and a new cultural perspective from Finland on a partnership between higher education and healthcare. The results provide information on factors that influence partnerships and develop and manage their sustainability.
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Affiliation(s)
- Arja Häggman-Laitila
- University of Eastern Finland, Kuopion kampus, PO Box 1627, FIN-70211 Kuopio, Finland.
| | - Leena Rekola
- Metropolia University of Applied Sciences, Tuhkolmankatu 10, FIN-00290 Helsinki, Finland.
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Zhu FF, He QR, Li ZY, Dang LQ, Xia Q. Correlation between severity of liver diseases and left ventricular function in patients with liver diseases. Shijie Huaren Xiaohua Zazhi 2014; 22:1289-1293. [DOI: 10.11569/wcjd.v22.i9.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the correlation between the severity of liver diseases and left ventricular function in patients with liver diseases.
METHODS: Ninety-four patients who would undergo orthotopic liver transplantation were enrolled in this study. According to the MELD (model for end-stage liver disease) scoring system, these subjects were categorized into three groups by the severity of liver diseases: mild (n = 34, MELD score ≤ 9 points), moderate (n = 44, 10 ≤ MELD score ≤ 19 points) and severe (n = 16, MELD score ≥ 20 points). The relationship between the severity of liver disease and cardiac function was determined by analysis of variance and correlation analysis.
RESULTS: Serum creatinin, total bilirubin and international normalized ratio (INR) were significantly different among the three groups (P < 0.05), and the severity of liver disease was significantly correlated with serum creatinin, total bilirubin and INR (r = 0.594, 0.763, 0.653; P = 0.000, 0.000, 0.000, respectively). With the increase in the severity of liver diseases, left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular end-diastolic diameter (LVEDD), aortic valve flow (AF), corrected QT interval (QTc) and cardiac output (CO) were gradually increased, and the differences were statistically significant between groups.
CONCLUSION: The MELD scoring system can effectively reflect the severity of liver diseases, and with the progression of end-stage liver diseases, the structure, function and electrical activity of the heart gradually subside.
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Genitsaridi I, Kondylakis H, Koumakis L, Marias K, Tsiknakis M. Evaluation of personal health record systems through the lenses of EC research projects. Comput Biol Med 2013; 59:175-185. [PMID: 24315661 DOI: 10.1016/j.compbiomed.2013.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 07/16/2013] [Accepted: 11/08/2013] [Indexed: 10/26/2022]
Abstract
Personal health record (PHR) systems are a rapidly expanding area in the field of health information technology which motivates an ongoing research towards their evaluation in several different aspects. In this direction, we present a systematic review of the currently available PHR systems. Initially, we define a clear and concise set of requirements for efficient PHR systems which is based on real-world implementation experiences of several European research projects and also on established and widely used formal standards. Subsequently, these requirements are used to perform a systematic evaluation of existing PHR system implementations. Our evaluation study provides a thorough requirement analysis and an insight on the current status of personal health record systems. The results of the present work can therefore be used as a basis for future evaluation studies which should be conducted periodically as technology evolves and requirements are revised.
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Affiliation(s)
- Irini Genitsaridi
- Computational Medicine Laboratory, FORTH-ICS N. Plastira 100, Vassilika Vouton, GR-71110 Heraklion, Crete, Greece.
| | - Haridimos Kondylakis
- Computational Medicine Laboratory, FORTH-ICS N. Plastira 100, Vassilika Vouton, GR-71110 Heraklion, Crete, Greece
| | - Lefteris Koumakis
- Computational Medicine Laboratory, FORTH-ICS N. Plastira 100, Vassilika Vouton, GR-71110 Heraklion, Crete, Greece
| | - Kostas Marias
- Computational Medicine Laboratory, FORTH-ICS N. Plastira 100, Vassilika Vouton, GR-71110 Heraklion, Crete, Greece
| | - Manolis Tsiknakis
- Computational Medicine Laboratory, FORTH-ICS N. Plastira 100, Vassilika Vouton, GR-71110 Heraklion, Crete, Greece; Department of Applied Informatics and Multimedia Technological Educational Institute, Estavromenos, GR-71004 Heraklion, Crete, Greece
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