Arabic validation of a cyberbullying assessment instrument

INTRODUCTION

Cyberbullying is a new form of peer violence that has become a widespread problem in the world. The prevalence of this phenomenon is not known in Tunisia due to the absence of validated assessment instruments. The aim of this study was to translate and validate the questionnaire "Second Revision of the Revised Cyberbullying Inventory".

METHODS

We translated this questionnaire into dialectal Tunisian Arabic using the back-translation method. To study the construct validity and the reliability, we conducted a cross-sectional study involving 962 Tunisian adolescents. Confirmatory factor analysis was performed to study construct validity for the two dimensions of the scale: cyber-victimization and cyber-aggression. To test reliability, the global internal consistency was computed for the two sections of the scale.

RESULTS

The translated version was considered satisfactory. The adjustment indices of the confirmatory factor analysis were satisfactory for both sections confirming the two-dimensional nature of the scale. The values of the cyber-aggression section were as follows: Comparative Fit Index=0.92; Tucker-Lewis Index=0.9; Root Mean Square Error of Approximation=0.04; Standardized Root Mean Square Residual=0.01. As for the cyber-victimization section, fit indices were as follows: Comparative Fit Index=0.92; Tucker-Lewis Index=0.9; Root Mean Square Error of Approximation=0.01; Standardized Root Mean Square Residual=0.07. Both sections showed good reliability. The internal consistency of each section was optimal. In fact, the Cronbach alpha was respectively 0.79 for cyber-aggression and 0.73 for cyber-victimization.

CONCLUSION

The Arabic version of the "Second Revision of the Revised Cyberbullying Inventory" is a psychometrically valid assessment. This scale could be useful to conduct further research and allow us to better understand the phenomenon of cyberbullying.

NRS-2002 components, nutritional score and severity of disease score, and their association with hospital length of stay and mortality

BACKGROUND

Malnutrition is a substantial issue in hospitals, leading to prolonged length of hospital stay, increased perioperative morbidity and increased mortality. There are several validated screening tools for malnutrition, one of which is the Nutritional Risk Screening 2002 (NRS). It screens patients based on recent weight loss, reduction of recent food intake, body mass index (BMI), severity of disease and age. Higher NRS scores have been shown to be negatively associated with patients’ outcomes such as increased morbidity and mortality.

OBJECTIVES

The aim of the study was to evaluate how the two NRS components Nutritional Score (NS) and Severity of Disease Score (SDS) are associated with patients’ length of hospital stay and mortality.

METHODS

All patients admitted to the medical department of a large community hospital in Switzerland were screened for malnutrition using the nutrition screening NRS during the years 2014 to 2017. Data on patients’ NRS, primary diagnosis, number of secondary diagnoses, mortality, length of stay (LOS), discharge, sex and age were collected. The association between the NRS components and LOS/mortality was estimated using a linear mixed-effects regression model and a logistic regression model, respectively, with adjustment for confounders (age, sex, comorbidity, diagnosis group, mode of discharge and year of hospitalisation).

RESULTS

The evaluation of the outcomes of 21,855 hospitalisations demonstrated that the NS was associated with an increment in the LOS of 5.5–12.3% per score point, depending on the diagnosis group. An increase in the SDS by one point was associated with an increase in the LOS of 2.2–11.3%. The odds for all-cause in-hospital mortality were increased by 44.1% (95% confidence interval [CI] 33.7–55.2%) per point in the NS, and by 73% (95% CI 57.5–90.1%) per point in the SDS.

CONCLUSIONS

Increases in both components of the NRS are associated with longer LOS. The NS has a slightly stronger impact on LOS compared to the SDS and its effect is dependent on the patient’s diagnosis group. Increases in the SDS are linked to a higher mortality than increases in the NS.

Ultrasound Based Planning and Navigation for Non-Anatomical Liver Resections – An Ex-Vivo Study

Goal: Non-anatomical resections of liver tumors can be very challenging as the surgeon cannot use anatomical landmarks on the liver surface or in the ultrasound image for guidance. This makes it difficult to achieve negative resection margins (R0) and still preserve as much healthy liver tissue as possible. Even though image-guided surgery systems have been introduced to overcome this challenge, they are still rarely used due to their inaccuracy, time-effort and complexity in usage and setup. Methods: We have developed a novel approach, which allows us to create an intra-operative resection plan using navigated ultrasound. First, the surface is scanned using a navigated ultrasound, followed by tumor segmentation on a midsection ultrasound image. Based on this information, the navigation system calculates an optimal resection strategy and displays it along with the tracked surgical instruments. In this study, this approach was evaluated by three experienced hepatobiliary surgeons on ex-vivo porcine models. Results: Using this technique, an R0 resection could be achieved in 22 out of 23 (95.7% R0 resection rate) cases with a median resection margin of 5.9 mm (IQR 3.5–7.7 mm). The resection margin between operators 1, 2 and 3 was 7.8 mm, 4.15 mm and 5.1 mm respectively (p = 0.054). Conclusions: This approach could represent a useful tool for intra-operative guidance in non-anatomical resection alongside conventional ultrasound guidance. However, instructions and training are essential especially if the operator has not used an image-guidance system before.