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LI S, DUAN S, DONG Z, QU Y, LUO Y, KE J, WANG C, PENG Y, ZHOU X, CHEN X. Distribution of Traditional Chinese Medicine syndromes in diabetic kidney disease chronic kidney disease 1-5: a correlation study. J TRADIT CHIN MED 2024; 44:572-580. [PMID: 38767642 PMCID: PMC11077161 DOI: 10.19852/j.cnki.jtcm.20230802.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/25/2023] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To analyze the distribution of Traditional Chinese medicine (TCM) syndromes in patients with diabetic kidney disease (DKD) and its related factors. METHODS We enrolled 435 patients with DKD, who were not undergoing dialysis, admitted to the Department of Nephrology, First Medical Center, Chinese PLA General Hospital from April 2020 to August 2021. Analysis of their TCM syndromes and related factors was carried out. RESULTS The 435 patients included 109, 117, 86, and 123 chronic kidney disease (CKD) 1-2, CKD3, CKD4, and CKD5 cases, respectively. With the progression of CKD1-5, the proportion of Yin deficiency and dry heat syndrome, and that of Qi and Yin deficiency syndrome showed a downward trend, whereas the proportion of spleen-kidney Yang deficiency, blood deficiency, blood stasis, water stagnation, and phlegm turbidity syndromes showed an upward trend; the differences were statistically significant (P < 0.05). Multivariate logistic regression analysis showed that Yin deficiency and dry heat syndrome was positively correlated with hemoglobin [odds ratio (OR) = 1.022, P = 0.005], albumin (OR = 1.058, P = 0.006), and estimated glomerular filtration rate (eGFR) (OR = 1.020, P < 0.001) but negatively correlated with male sex (OR = 0.277, P = 0.004). Qi and Yin deficiency syndrome was positively correlated with albumin (OR = 1.056, P < 0.001) and eGFR (OR = 1.008, P = 0.022) but negatively correlated with age (OR = 0.977, P = 0.023). Liver-kidney Yin deficiency syndrome was positively correlated with age (OR = 1.028, P = 0.021) and glycosylated hemoglobin (OR = 1.223, P = 0.007) but negatively correlated with total cholesterol (OR = 0.792, P = 0.006). Spleen-kidney Yang deficiency syndrome was negatively correlated with hemoglobin (OR = 0.977, P < 0.001), albumin (OR = 0.891, P < 0.001), and eGFR (OR = 0.978, P < 0.001) but positively correlated with high density lipoprotein (OR = 3.376, P = 0.001). CONCLUSION With CKD1-5 progression, TCM syndromes changed from Yin deficiency and dry heat syndrome to syndrome of deficiency of both Qi and Yin, liver-kidney Yin, and spleen-kidney Yang deficiency syndromes. TCM syndromes were correlated with laboratory test results.
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Affiliation(s)
- Shuang LI
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Shuwei DUAN
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Zheyi DONG
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Yilun QU
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Yayong LUO
- 2 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China; School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jianghua KE
- 2 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China; School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Conghui WANG
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Yangzhi PENG
- 3 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China; Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Xuefeng ZHOU
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
| | - Xiangmei CHEN
- 1 Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing 100853, China
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Semenzin Rodrigues A, de Moraes Melo Neto CL, Santos Januzzi M, Dos Santos DM, Goiato MC. Correlation between Periotest value and implant stability quotient: a systematic review. BIOMED ENG-BIOMED TE 2024; 69:1-10. [PMID: 37489593 DOI: 10.1515/bmt-2023-0194] [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: 05/11/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ). CONTENT Methods to evaluate the stability of dental implants. SUMMARY A search was performed in the PubMed, Scopus, and Web of Science databases for articles on the proposed subject up to January 29, 2023, using search terms that combined "resonance frequency analysis" and "Periotest" with "correlation" or "relationship"; and combinations of "implant stability quotient" and "Periotest" with "correlation" or "relationship." The inclusion criteria were clinical studies in English involving human subjects who received dental implants and evaluating the correlation between PTV and ISQ. A total of 46 articles were screened, of which 10 were selected for full-text analysis, and eight articles were included in this review. Based on three articles, 75 % of the results of this systematic review showed a negative correlation between PTV and ISQ, regardless of the type of stability assessed. Based on the remaining five articles, 100 % (regardless of the patient's gender) and 66.66 % of the results showed a negative correlation for primary and secondary stability, respectively. There is a negative correlation between PTV and ISQ for both primary and secondary dental implant stability. OUTLOOK This review can serve as a reference for the development of methodologies for future clinical studies on this topic.
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Affiliation(s)
- Alana Semenzin Rodrigues
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Clóvis Lamartine de Moraes Melo Neto
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Marcella Santos Januzzi
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Daniela Micheline Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
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Wang M, Qian Y, Yang Y, Chen H, Rao WF. Improved stacking ensemble learning based on feature selection to accurately predict warfarin dose. Front Cardiovasc Med 2024; 10:1320938. [PMID: 38312950 PMCID: PMC10834785 DOI: 10.3389/fcvm.2023.1320938] [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: 10/27/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
Background With the rapid development of artificial intelligence, prediction of warfarin dose via machine learning has received more and more attention. Since the dose prediction involve both linear and nonlinear problems, traditional machine learning algorithms are ineffective to solve such problems at one time. Objective Based on the characteristics of clinical data of Chinese warfarin patients, an improved stacking ensemble learning can achieve higher prediction accuracy. Methods Information of 641 patients from southern China who had reached a steady state on warfarin was collected, including demographic information, medical history, genotype, and co-medication status. The dataset was randomly divided into a training set (90%) and a test set (10%). The predictive capability is evaluated on a new test set generated by stacking ensemble learning. Additional factors associated with warfarin dose were discovered by feature selection methods. Results A newly proposed heuristic-stacking ensemble learning performs better than traditional-stacking ensemble learning in key metrics such as accuracy of ideal dose (73.44%, 71.88%), mean absolute errors (0.11 mg/day, 0.13 mg/day), root mean square errors (0.18 mg/day, 0.20 mg/day) and R2 (0.87, 0.82). Conclusions The developed heuristic-stacking ensemble learning can satisfactorily predict warfarin dose with high accuracy. A relationship between hypertension, a history of severe preoperative embolism, and warfarin dose is found, which provides a useful reference for the warfarin dose administration in the future.
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Affiliation(s)
- Mingyuan Wang
- Department of Pharmacy, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
- School of Mechanical Engineering (Shandong Institute of Mechanical Design and Research), Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
| | - Yiyi Qian
- Department of Pharmacy, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Yaodong Yang
- School of Mechanical Engineering (Shandong Institute of Mechanical Design and Research), Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
| | - Haobin Chen
- Department of Pathology, Qujing First People's Hospital, Qujing, Yunnan, China
| | - Wei-Feng Rao
- School of Mechanical Engineering (Shandong Institute of Mechanical Design and Research), Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
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Zhang YY, Li W, Sheng Y, Wang Q, Zhao F, Wei Y. Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study. Patient Prefer Adherence 2024; 18:111-130. [PMID: 38234632 PMCID: PMC10793120 DOI: 10.2147/ppa.s442838] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
Purpose To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes. Patients and Methods During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher's exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further. Results The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (β=-1.118, p=0.019, "have hypoglycemic" as reference) and Brief Illness Perception Questionnaire (β=0.090, p<0.001) were significant positive correlators for DD, while diet intervention (β=0.803, p=0.022, "have diet intervention" as reference), money spent on diabetes treatment (β<-0.001, p=0.035), and SES (β=-0.257, p<0.001) were significant negative correlators. Conclusion More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.
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Affiliation(s)
- Yu-Yun Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Wei Li
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Qun Wang
- Endocrinology and Metabolism Department, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Fang Zhao
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, People’s Republic of China
| | - Ying Wei
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, People’s Republic of China
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Shekleton FE, Donovan RL, Wylde V, Whitehouse MR. Is it possible to predict which patients are most likely to benefit from intra-articular corticosteroid injections? A systematic review. Int J Rheum Dis 2024; 27:e15005. [PMID: 38185993 DOI: 10.1111/1756-185x.15005] [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: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
AIM Intra-articular corticosteroid injections (IACIs) can reduce osteoarthritis-related pain, with differing levels of response across patient groups. This systematic review investigates what is known about the positive and negative predictors of outcomes in patients with osteoarthritis who undergo IACIs. METHODS We systematically searched the Medline, Embase, and Cochrane databases to May 2023 for studies that evaluated patients undergoing IACIs for osteoarthritis and reported on predictors of outcomes in these patients. RESULTS Eight studies were included. Two were placebo-controlled trials, six were observational studies. Due to the heterogeneity of outcomes and variables between the studies, it was not possible to pool the results for formal meta-analysis. Higher baseline pain, older age, higher BMI, lower range of movement, higher Kellgren-Lawrence radiographic score, joint effusion, and aspiration were shown to be predictors of a positive response to IACIs in some of the included studies. However, other studies showed no difference in response with these variables, or a negative correlation with response. Sex, smoking, mental health status, hypertension/ischaemic heart disease, diabetes mellitus, duration of symptoms, and socioeconomic status did not demonstrate any correlation with the prediction of positive or negative outcomes after IACIs. CONCLUSION Several patient features have been identified as positive predictors of outcomes following IACIs. However, this systematic review has identified inconsistent and variable findings across the existing literature. Further research with standardization of IACI administration and outcome measures is required to facilitate further analysis of the reliability and significance of predictive factors for response to IACIs.
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Affiliation(s)
| | | | - Vikki Wylde
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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Ding Y, Li G, Shi X, Wang M, Peng Y, Deng H, Yang Z, Liang Q, Wang Z. Correlation of lifestyle behaviors during pregnancy with postpartum depression status of puerpera in the rural areas of South China. Front Public Health 2023; 11:1304226. [PMID: 38192564 PMCID: PMC10773618 DOI: 10.3389/fpubh.2023.1304226] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Background Postpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China. Methods A cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42nd day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors. Results A total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not (В = 1.386, β = 0.141, p = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043). Conclusion Employment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Genyuan Li
- Jiaxing Center for Disease Control and Prevention, Jiaxing, China
| | - Xi Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mengyi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Yanxia Peng
- Zijin Maternal and Child Health Hospital, Heyuan, China
| | - Huiqin Deng
- Longchuan Maternal and Child Health Hospital, Heyuan, China
| | - Ziqi Yang
- Tianyang Maternal and Child Health Hospital, Baise, China
| | - Qingfen Liang
- Lingshan Maternal and Child Health Hospital, Qinzhou, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Carvalho C, Helena Gonçalves G, Fernando Approbato Selistre L, Petrella M, De Oliveira Sato T, Da Silva Serrão PRM, Márcia Mattiello S. Association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis. Arch Rheumatol 2023; 38:387-396. [PMID: 38046241 PMCID: PMC10689021 DOI: 10.46497/archrheumatol.2023.9386] [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: 11/27/2021] [Accepted: 12/09/2022] [Indexed: 12/05/2023] Open
Abstract
Objectives This study aimed to investigate the association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis (OA). Patients and methods The cross-sectional study was conducted with 39 individuals (24 females, 15 males; mean age: 57.3±6.2 years; range, 40 to 65 years) with knee OA between January 2014 and July 2015. Ankle torque was determined using an isokinetic dynamometer. The 40-m fast-paced walk test and a stair climb test were used to assess functional performance. Self-reported pain and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pearson's correlation coefficients were calculated to test correlations between the dependent variables (40-m fast-paced walk test, stair climb test, WOMAC pain and physical function domains, sex, age, body mass index, and radiologic evidence of OA) and the independent variables (mean plantar flexor torque and dorsiflexor peak torque). A multiple linear regression analysis was applied to quantify the association between the dependent and independent variables. Results Dorsiflexor and plantar flexor peak torques in the concentric and eccentric modes were negatively correlated with the 40-m fast-paced walk and stair climb tests (r=-0.33 to -0.51, p≤0.05). A negative correlation was found between concentric plantar flexor torque and the WOMAC physical function score (r=-0.35, p=0.03). No correlation was found between ankle torques and the WOMAC pain score (p>0.05). The multiple linear regression analysis showed that the eccentric plantar flexor and dorsiflexor torques were significantly associated with the stair climb test (β=-0.001, 95% confidence interval [CI]: -0.001 to 0.000, p=0.03, and β=-0.002, 95% CI: -0.004 to 0.000, p=0.05, respectively). No significant associations were found between concentric plantar flexor and dorsiflexor torques and the stair climb test (p>0.05). No significant associations were found between the ankle torques and the 40-m fast-paced walk test and WOMAC physical function (p>0.05). Conclusion Ankle torque plays an important role in functional performance. Thus, ankle torque deficit, especially eccentric plantar flexor and dorsiflexor torques, may exert a negative influence on stair climbing performance in patients with knee osteoarthritis.
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Affiliation(s)
- Cristiano Carvalho
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | | | - Marina Petrella
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
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Pontón YD, Narváez VPD, Andrade BM, Terán JJL, Reyes-Reyes A, Calzadilla-Núñez A. Working nurses' empathy with patients in public hospitals. Rev Lat Am Enfermagem 2023; 31:e3968. [PMID: 37556616 PMCID: PMC10408249 DOI: 10.1590/1518-8345.6591.3968] [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: 11/30/2022] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE to determine the levels of empathy in professional nurses of a high-complexity hospital, to relate age to empathy (and each one of its dimensions), and to establish if there are differences between these levels according to the type of working schedules. METHOD comparative, correlational and cross-sectional design. The sample used (n=271) constituted 40.9% of the total number of nursing professionals. Psychometric properties of the Jefferson Scale of Empathy for Health Professionals were studied. Descriptive statistics were calculated: mean and standard deviation. The association between empathy and age was estimated using regression equations and statistical significance of the regression coefficients, after evaluating the type of curve using variance analysis. RESULTS the underlying model of three dimensions of empathy was identified. The values of the descriptive statistics observed were relatively low in empathy and its dimensions. Empathy levels were not associated with the age range. No differences in empathy were found between the types of work schedules. Variability was found in the dimensions: "compassionate care" and "Walking on the patient's shoes". CONCLUSION these results show that the levels of empathy observed may imply a deficient performance in empathetic care for patients. (1) The levels of empathy are low in the nursing professionals studied. (2) These levels are not associated with age and type of work performed. (3) Low levels of empathy could imply a negative alteration of humanized attention.
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Affiliation(s)
| | | | | | | | - Alejandro Reyes-Reyes
- Universidad Santo Tomás, Facultad de Ciencias Sociales y Comunicación, Concepción, Región del Bío Bio, Chile
| | - Aracelis Calzadilla-Núñez
- Universidad Bernardo O'Higgins, Departamento de Investigaciones, Santiago, Región Metropolitana, Chile
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Cinnera AM, Marrano S, De Bartolo D, Iosa M, Bisirri A, Leone E, Stefani A, Koch G, Ciancarelli I, Paolucci S, Morone G. Convergent Validity of the Timed Walking Tests with Functional Ambulatory Category in Subacute Stroke. Brain Sci 2023; 13:1089. [PMID: 37509020 PMCID: PMC10377380 DOI: 10.3390/brainsci13071089] [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: 06/22/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Determining the walking ability of post-stroke patients is crucial for the design of rehabilitation programs and the correct functional information to give to patients and their caregivers at their return home after a neurorehabilitation program. We aimed to assess the convergent validity of three different walking tests: the Functional Ambulation Category (FAC) test, the 10-m walking test (10MeWT) and the 6-minute walking test (6MWT). Eighty walking participants with stroke (34 F, age 64.54 ± 13.02 years) were classified according to the FAC score. Gait speed evaluation was performed with 10MeWT and 6MWT. The cut-off values for FAC and walking tests were calculated using a receiver-operating characteristic (ROC) curve. Area under the curve (AUC) and Youden's index were used to find the cut-off value. Statistical differences were found in all FAC subgroups with respect to walking speed on short and long distances, and in the Rivermead Mobility Index and Barthel Index. Mid-level precision (AUC > 0.7; p < 0.05) was detected in the walking speed with respect to FAC score (III vs. IV and IV vs. V). The confusion matrix and the accuracy analysis showed that the most sensitive test was the 10MeWT, with cut-off values of 0.59 m/s and 1.02 m/s. Walking speed cut-offs of 0.59 and 1.02 m/s were assessed with the 10MeWT and can be used in FAC classification in patients with subacute stroke between the subgroups able to walk with supervision and independently on uniform and non-uniform surfaces. Moreover, the overlapping walking speed registered with the two tests, the 10MeWT showed a better accuracy to drive FAC classification.
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Affiliation(s)
- Alex Martino Cinnera
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
| | - Serena Marrano
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
| | - Daniela De Bartolo
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Marco Iosa
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessio Bisirri
- Villa Sandra Institute, Via Portuense, 798, 00148 Rome, Italy
| | - Enza Leone
- School of Allied Health Professions, Faculty of Medicine and Health Sciences, Keele University, Staffordshire ST5 5BG, UK
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Alessandro Stefani
- Department of System Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giacomo Koch
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara and Center for Translational Neurophysiology of Speech and Communication (CTNSC), Italian Institute of Technology (IIT), 44121 Ferrara, Italy
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Stefano Paolucci
- Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS), 00179 Rome, Italy
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- San Raffaele Institute of Sulmona, Viale dell'Agricoltura, 67039 Sulmona, Italy
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10
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Hyun DG, Ji W, Ahn JH, Oh DK, Huh JW, Hong SB, Koh Y, Lim CM. Reliability of Central Venous Blood Gas Values Compared With Arterial Blood Gas Values in Critically Ill Patients. Respir Care 2022; 67:863-870. [PMID: 35580909 PMCID: PMC9994087 DOI: 10.4187/respcare.09732] [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: 11/05/2022]
Abstract
BACKGROUND Central venous blood gas (cVBG) values are correlated with arterial blood gas (ABG) values. However, the substitution of cVBG values for ABG values in critically ill patients remains uninvestigated. Thus, we investigated the reliability between cVBG and ABG values and sought to define the conditions that could improve the reliability of cVBG values as a substitute. METHODS We conducted a prospective comparison of 292 sets of cVBG values and ABG values from 82 subjects admitted to the medical ICU between October 2017-July 2018. Paired cVBG and ABG samples were collected daily during the first 5 d of ICU treatment and on days 8, 15, 22, and 29. Intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement (LOA) were obtained. RESULTS The ICC between ABG and cVBG was 0.626 for pH, 0.696 for PCO2 , 0.869 for bicarbonate, 0.866 for base excess, and 0.989 for lactic acid. Bland-Altman plots showed clinically unacceptable LOA between all parameters. Subgroup analysis indicated a significant increase in the ICCs of PCO2 in samples with mechanical ventilation (0.0574-0.735, P = .02) and central venous oxygen saturation (ScvO2) ≥ 70% (0.611-0.763, P = .008). After adjustment, the 95% LOA between ABG and cVBG was -0.06 to 0.07 for pH and -7.09 to 7.05 for PCO2 in mechanically ventilated subjects with ScvO2 ≥ 70%. CONCLUSIONS ABG and cVBG values showed clinically acceptable agreements and improved reliability in mechanically ventilated subjects with ScvO2 ≥ 70%. cVBG analysis may be a substitute for ABG analysis in mechanically ventilated patients once tissue perfusion is restored.
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Affiliation(s)
- Dong-Gon Hyun
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Hwan Ahn
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong Kyu Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Won Huh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Bum Hong
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Younsuck Koh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chae-Man Lim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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11
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Itagaki H, Nishida M, Kodaira Y, Sakanaka M, Ichikawa R, Arai Y, Satoh T. Relationship between the serum cancer antigen 125 level and the weight of surgically enucleated adenomyosis. J OBSTET GYNAECOL 2022; 42:2064-2068. [PMID: 35653768 DOI: 10.1080/01443615.2022.2065906] [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] [Indexed: 10/18/2022]
Abstract
Elevated serum levels of cancer antigen 125 (CA125) are known to occur in adenomyosis. However, the relationship between the severity of adenomyosis and serum CA125 levels has not yet been elucidated. The present study aimed to examine the correlation between the weight of adenomyosis and the serum CA125 level. This retrospective study, after applying exclusion criteria, investigated 308 patients who underwent conservative surgery for adenomyosis. Serum CA125 levels were measured before surgery and weights of surgically enucleated adenomyosis were measured in the operating room. Both serum CA125 and surgically enucleated adenomyosis weight showed log-normal distributions. Pearson's product-moment correlation coefficient for the logarithmically converted values was 0.617 (95% confidence interval, 0.54-0.68).The serum CA125 level correlated positively with the weight of adenomyosis. Although the qualitative characteristics and clinical significance of adenomyosis lesions remain unclear, it seems that the investigation of the relative relationship between the serum CA125 level and the size of the affected lesion is useful to observe one of the qualitative features of adenomyosis. Furthermore, the present study supports the use of postoperative serum CA125 levels as an important indicator for determining the therapeutic effects of conservative surgical treatment for adenomyosis and detecting early signs of recurrence. Impact StatementWhat is already known on this subject? Elevated serum cancer antigen 125 (CA125) levels are known to occur in adenomyosis and are widely recognised as helpful in the diagnosis of adenomyosis.What do the results of this study add? There is a positive correlation between the serum CA125 level and the weight of adenomyosis.What are the implications of these findings for clinical practice and/or further research? The postoperative serum CA125 level is an important indicator for evaluating the extent of the affected lesion remaining after conservative surgical treatment for adenomyosis and also helpful for detecting early signs of recurrence. Further study is required to examine whether it is possible to clarify the qualitative characteristics of adenomyosis in each different case based on the CA125-producing ability of the lesion.
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Affiliation(s)
- Hiroya Itagaki
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masato Nishida
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yuichi Kodaira
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Miyako Sakanaka
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Ryota Ichikawa
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yuko Arai
- Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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12
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Adarkwah CC, Labenz J, Hirsch O. Burnout and work satisfaction are differentially associated in gastroenterologists in Germany. F1000Res 2022; 11:368. [PMID: 35673351 PMCID: PMC9152463 DOI: 10.12688/f1000research.110296.2] [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] [Accepted: 05/31/2022] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. METHODS We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. RESULTS An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. CONCLUSIONS Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.
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Affiliation(s)
- Charles Christian Adarkwah
- Department of General Practice and Family Medicine, Philipps-University, Marburg, 35043, Germany
- CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Joachim Labenz
- Medizinische Klinik, Diakonie Klinikum, Siegen, 57074, Germany
- Bundesverband Gastroenterologie Deutschland (BVGD) e. V., Berlin, 10707, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, 57078, Germany
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13
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Adarkwah CC, Labenz J, Hirsch O. Burnout and work satisfaction are differentially associated in gastroenterologists in Germany. F1000Res 2022; 11:368. [PMID: 35673351 PMCID: PMC9152463 DOI: 10.12688/f1000research.110296.3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. METHODS We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. RESULTS An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. CONCLUSIONS Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.
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Affiliation(s)
- Charles Christian Adarkwah
- Department of General Practice and Family Medicine, Philipps-University, Marburg, 35043, Germany
- CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Joachim Labenz
- Medizinische Klinik, Diakonie Klinikum, Siegen, 57074, Germany
- Bundesverband Gastroenterologie Deutschland (BVGD) e. V., Berlin, 10707, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, 57078, Germany
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14
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Adarkwah CC, Labenz J, Hirsch O. Burnout and work satisfaction are differentially associated in gastroenterologists in Germany. F1000Res 2022; 11:368. [PMID: 35673351 PMCID: PMC9152463 DOI: 10.12688/f1000research.110296.1] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. METHODS We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. RESULTS An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. CONCLUSIONS Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.
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Affiliation(s)
- Charles Christian Adarkwah
- Department of General Practice and Family Medicine, Philipps-University, Marburg, 35043, Germany
- CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Joachim Labenz
- Medizinische Klinik, Diakonie Klinikum, Siegen, 57074, Germany
- Bundesverband Gastroenterologie Deutschland (BVGD) e. V., Berlin, 10707, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, 57078, Germany
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15
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Celotti C, Martín-Granizo R, De La Sen Ó. Correlation of arthroscopic findings with clinical-radiological signs and symptoms of temporomandibular joint dysfunction: retrospective study of 829 joints. Int J Oral Maxillofac Surg 2022; 51:1069-1073. [PMID: 35115221 DOI: 10.1016/j.ijom.2022.01.010] [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: 04/29/2021] [Revised: 10/31/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Temporomandibular joint (TMJ) arthroscopic findings are difficult to predict based on clinical criteria. Few studies have attempted to correlate signs, symptoms, and characteristics of patients with the final arthroscopic findings. The aim of this study was to assess the correlation between clinical-radiological signs and symptoms and arthroscopic findings in patients with TMJ dysfunction undergoing arthroscopy. A retrospective study was performed involving 487 patients (829 joints) with TMJ dysfunction who underwent TMJ arthroscopy between 2000 and 2019. The clinical-radiological variables recorded were pain, maximum mouth opening, joint noises, Wilkes classification, and disc displacement. The arthroscopic findings evaluated were synovitis, chondromalacia, adhesions, disc perforation, disc displacement, and roofing. Pain symptoms were significantly associated with the intensity of synovitis (P = 0.005) and disc displacement evaluated arthroscopically (P < 0.001). A statistically significant relationship was observed between Wilkes stage and the level of synovitis (P < 0.001) and chondromalacia (P < 0.001). Mouth opening was negatively correlated with adhesions (P < 0.001). Based on this study, pain symptomatology was associated with the intensity of synovitis and disc displacement evaluated arthroscopically, the Wilkes stage was a good predictor of the severity of synovitis and chondromalacia, and mouth opening was negatively correlated with adhesions.
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Affiliation(s)
- C Celotti
- Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain.
| | - R Martín-Granizo
- Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - Ó De La Sen
- Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
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16
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Nyangulu W, Thole H, Chikhoza A, Msakwiza M, Nyirenda J, Chisala M, Iroh Tam PY. Performance and safety of the induced sputum procedure in young children in Malawi: a prospective study. Trans R Soc Trop Med Hyg 2021; 115:1247-1250. [PMID: 34590145 PMCID: PMC8849123 DOI: 10.1093/trstmh/trab151] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 09/13/2021] [Indexed: 11/14/2022] Open
Abstract
Background Collecting sputum specimens is a challenge in infants and young children. We assessed the performance and safety of induced sputum (IS) collection in this population, embedded in a prospective study evaluating respiratory cryptosporidiosis in Malawian children with diarrheal disease. Methods We assessed the sputum quality and correlation with detection of Cryptosporidium spp. and evaluated safety and adverse events in 162 children. Results Among 159 stool specimens tested, 34 (21%, 95% CI 15.0 to 28%) were positive for Cryptosporidium spp. There were 160 IS and 161 nasopharyngeal (NP) specimens collected. IS and NP specimen collection was performed for each patient. The majority of IS specimens (122/147; 83%) were clear in appearance and 132/147 (90%) were of good quality. Among the respiratory specimens tested, 10 (6.3%, 95% CI 2.5 to 10%) IS and 4 (3%, 95% CI 0 to 5%) NP were positive for Cryptosporidium spp. When stool cryptosporidium PCR was the gold standard, IS PCR sensitivity was higher (29%, 95% CI 22 to 37%) compared with NP PCR (12%, 95% CI 7 to 17%) for detection of Cryptosporidium spp. One (0.4%) adverse event occurred, consisting of a drop in oxygen saturations at the 30-min postprocedure evaluation. Consciousness level, median respiratory rate and oxygen saturations were unchanged, before or after IS. Conclusions IS provides good quality specimens, is more sensitive than NP specimens for diagnosis of respiratory cryptosporidiosis, and collection can be performed safely in children hospitalized with diarrheal disease.
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Affiliation(s)
- Wongani Nyangulu
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Herbert Thole
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Angella Chikhoza
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Mike Msakwiza
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - James Nyirenda
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Mphatso Chisala
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Pui-Ying Iroh Tam
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Trust, Queen Elizabeth Central Hospital, College of Medicine, P.O. Box 30096, Chichiri, Blantyre 3, Malawi.,Department of Paediatrics, University of Malawi, College of Medicine, Private Bag 360, Chichiri, Blantyre 3, Malawi.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
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17
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Matsumoto H, Horita N, Ito K, Ebina-Shibuya R, Hara Y, Kobayashi N, Kaneko T. Disease control and objective responsive rates in randomized phase II trials evaluating non-first-line chemotherapy for non-small cell lung cancer: a systematic review of 74 trials. Transl Lung Cancer Res 2021; 10:2278-2289. [PMID: 34164275 PMCID: PMC8182707 DOI: 10.21037/tlcr-20-1120] [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] [Indexed: 11/06/2022]
Abstract
Although objective response rate and disease control rate are commonly used as primary endpoints of lung cancer trials, it remains unclear whether objective response rate and disease control rate correctly reflect the overall survival in a non-small cell lung cancer phase II trial evaluating a non-first-line chemotherapy. Objective response rate might be easily affected by chance because the small number of patients in each trial achieved complete or partial response in the phase II non-first-line setting. This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (UMIN000040412). Four databases were searched for eligible trials. A Spearman's rank correlation with hazard ratio of overall survival was calculated each for odds ratio of objective response rate, difference of objective response rate (%), odds ratio of disease control rate, and difference of disease control rate (%). Of 74 eligible trials, 73 reported objective response rate and 68 reported disease control rates. Nine (12%) trials included patients with driver mutation status. Thirteen (18%) and two (3%) RCTs specifically included adenocarcinoma/non-squamous and squamous subtype of non-small cell lung cancer, respectively. The Eastern Cooperative Oncology Group performance status 0-2 (N=41, 55%) and the performance status 0-1 (N=25, 34%) were frequently used performance status criteria. The median number of patients in the two arms was 116 (interquartile range, 82-159). The correlation between trial-level odds ratio of objective response rate and hazard ratio of overall survival was weak (r=-0.29, 95% CI: -0.49 to -0.05, P=0.014). An exploratory subgroup analysis suggested that fewer responders were associated with poorer correlation. Odds ratio of disease control survival (r=-0.53, 95% CI: -0.68 to -0.32, P<0.001) had moderate rank correlations with hazard ratio of overall survival. Instead of objective response rate, disease control rate should be used as the primary endpoint in a randomized phase II trial evaluating non-first-line chemotherapy for non-small cell lung cancer.
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Affiliation(s)
- Hiromi Matsumoto
- Department of Pulmonology, Yokohama City University Graduate School of Medicine. Yokohama, Japan
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University Graduate School of Medicine. Yokohama, Japan
| | - Kentaro Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
| | - Risa Ebina-Shibuya
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine. Yokohama, Japan
| | - Nobuaki Kobayashi
- Department of Pulmonology, Yokohama City University Graduate School of Medicine. Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine. Yokohama, Japan
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Dupuy AM, Bargnoux AS, Montagnon V, Kuster N, Badiou S, Cristol JP. Analytical evaluation of the novel VITROS BRAHMS procalcitonin immunoassay. Scand J Clin Lab Invest 2020; 80:541-545. [PMID: 33124916 DOI: 10.1080/00365513.2020.1804071] [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] [Indexed: 10/23/2022]
Abstract
To determine the analytical performance of Novel VITROS BRAHMS Procalcitonin Immunoassay on VITROS 3600 and correlation with BRAHMS PCT sensitive KRYPTOR reference method. Analytical performances including imprecision studies, linearity, limit of detection (LoD) and determination of hemolysis index were performed for VITROS BRAHMS PCT assay. Imprecision was assessed on plasma pool and internal control with 2 levels. The method comparison was performed using 162 plasma obtained from clinical departments. The total imprecision was acceptable and all CV were <5%. The LoD was in accordance with manufacturer's claims. The equation of linearity in the lower range was found to be y = 1.0014x - 0.0091, with r2 = 1. No interference to hemoglobin up to 11 g/L was observed. Correlation studies showed a good correlation between PCT measurements using VITROS BRAHMS PCT assay against KRYPTOR system including for values lower than 2 µg/L. The novel VITROS BRAHMS PCT assay from OrthoClinical Diagnostics shows analytical performances acceptable for clinical use. In addition, the concordance with KRYPTOR method was fine at all clinical cut-offs.
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Affiliation(s)
- Anne Marie Dupuy
- Laboratoire de Biochimie et Hormonologie, CHU Montpellier, Univ Montpellier 1, Montpellier, France
| | - Anne Sophie Bargnoux
- Laboratoire de Biochimie et Hormonologie, PhyMedExp, Université de Montpellier, INSERM, CNRS, CHU de Montpellier, Montpellier, France
| | - Valentin Montagnon
- Laboratoire de Biochimie et Hormonologie, CHU Montpellier, Univ Montpellier 1, Montpellier, France
| | - Nils Kuster
- Laboratoire de Biochimie et Hormonologie, PhyMedExp, Université de Montpellier, INSERM, CNRS, CHU de Montpellier, Montpellier, France
| | - Stéphanie Badiou
- Laboratoire de Biochimie et Hormonologie, PhyMedExp, Université de Montpellier, INSERM, CNRS, CHU de Montpellier, Montpellier, France
| | - Jean Paul Cristol
- Laboratoire de Biochimie et Hormonologie, PhyMedExp, Université de Montpellier, INSERM, CNRS, CHU de Montpellier, Montpellier, France
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Schallert W, Fluet MC, Kesselring J, Kool J. Evaluation of upper limb function with digitizing tablet-based tests: reliability and discriminative validity in healthy persons and patients with neurological disorders. Disabil Rehabil 2020; 44:1465-1473. [PMID: 32757680 DOI: 10.1080/09638288.2020.1800838] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate discriminative validity, relative reliability and absolute reliability of four tablet-based tests for the evaluation of upper limb motor function in healthy persons and patients with neurological disorders. METHODS Cross-sectional study in 54 participants: 29 patients with upper limb movement impairment due to a neurological condition recruited from an inpatient rehabilitation centre and 25 healthy persons. Accuracy, speed and path length were analysed for four tablet-based tests: "Spiral drawings," "Tapping," "Follow the dot" and "Trace a star." The area under the receiver operating characteristic curve (AUC) was used to evaluate discriminative validity. Relative reliability was analysed with the intra-class correlation coefficient (ICC), and absolute reliability by limits of agreement (LoA) and minimal detectable difference (MDD). RESULTS All four tests showed excellent discriminative validity for the parameter accuracy (AUC 0.93-0.98). Tapping was the best test for discriminating patients from healthy persons. Test-retest reliability was good for accuracy in all tests (ICC = 0.76-0.88), but poor to moderate for speed and path length (ICC = 0.20-0.69). The MDD varied between 14% and 38%. Performance on the four tablet-based tests was stable between sessions, indicating that there was no learning effect. CONCLUSION The parameter accuracy showed excellent discriminative validity and reliability in all four tablet-based tests. Discriminative validity was excellent for all three parameters in the Tapping test. In the other tasks speed showed good to poor reliability, while the reliability of path-length was poor in all tasks. Results were comparable for the dominant and non-dominant hand. Tablet-based tests have the advantage that patients can use them for self-monitoring of upper limb motor function.Implications for rehabilitationFour tablet-based tests for the assessment of upper limb motor function in patients with upper limb neurological dysfunction were evaluated: "Spiral drawings", "Tapping", "Follow the dot" and "Trace a star". The parameter accuracy in these four tests had excellent discriminative validity and good reliability.Patients can perform the tests independently at home for self-monitoring of progress. This may increase patients' motivation to exercise at home.The results can be sent to physicians, enabling the earlier detection of deterioration, which may require medical attention.
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Affiliation(s)
- Wolfgang Schallert
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland.,Department of Physiotherapy, Berner Fachhochschule, Bern, Switzerland
| | - Marie-Christine Fluet
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.,ReHaptix GmbH, Rehabilitation Products, Zurich, Switzerland
| | - Juerg Kesselring
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland
| | - Jan Kool
- Department of Rehabilitation Research, Rehabilitation Centre Valens, Valens, Switzerland
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Sekulić S, John MT, Davey C, Rener-Sitar K. Association Between Oral Health-Related and Health-Related Quality of Life. Zdr Varst 2020; 59:65-74. [PMID: 32952705 PMCID: PMC7478079 DOI: 10.2478/sjph-2020-0009] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/06/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population. METHODS A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL. RESULTS Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit. CONCLUSIONS OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.
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Affiliation(s)
- Stella Sekulić
- Department of Prosthetic Dentistry, Dental Division, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000Ljubljana, Slovenia
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, USA
| | - Mike T. John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, USA
| | - Cynthia Davey
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, USA
| | - Ksenija Rener-Sitar
- Department of Prosthetic Dentistry, Dental Division, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000Ljubljana, Slovenia
- Department of Prosthodontics, University Dental Clinics, University Medical Center Ljubljana, Ljubljana, Slovenia
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Adarkwah CC, Hirsch O. The Association of Work Satisfaction and Burnout Risk in Endoscopy Nursing Staff-A Cross-Sectional Study Using Canonical Correlation Analysis. Int J Environ Res Public Health 2020; 17:E2964. [PMID: 32344778 DOI: 10.3390/ijerph17082964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022]
Abstract
Background: Burnout is known to have detrimental effects on healthcare staff with regard to both personal and occupational matters. The association between burnout symptoms and work satisfaction in endoscopy nursing staff in Germany has not been studied previously. We aimed to investigate the association between work satisfaction and risk of burnout in endoscopy nursing staff in Germany and to extract predictors for burnout in the area of work satisfaction, which can inform the design of future interventions. Setting: All members of the German Association of Endoscopy Staff in Germany (Deutsche Gesellschaft für Endoskopiefachberufe e.V.—DEGEA) were invited to take part in an online survey. Methods: The total sample consisted of 674 endoscopy staff members. Of those, 579 were female (85.9%) and 95 were male (14.1%). The mean age of the participants was 44.3 years (SD 10.6), with a median age of 46 years, a minimum age of 20, and a maximum age of 64 years. We used confirmatory factor analyses to examine the Maslach burnout inventory (MBI) and, a questionnaire for assessing general and facet-specific job satisfaction (KAFA), regarding their postulated internal structure in our special sample. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy staff members. Results: We were able to replicate the factorial structures of the MBI and the KAFA, both showing an acceptable model fit. The canonical correlation analysis resulted in three canonical functions, with canonical correlations of 0.64 (p < 0.001), 0.32 (p < 0.001), and 0.17 (p < 0.001). The first canonical function revealed that KAFA scales for colleagues, professional development, payment, supervisor, and general job satisfaction were good predictors for less exhaustion, less depersonalization and lack of empathy, and higher personal accomplishment. Commonality analysis revealed that general job satisfaction was the most significant factor in explaining the squared canonical correlation. The second canonical function showed that occupational function and colleagues were good predictors for exhaustion and personal accomplishment. Conclusions: Interventions aimed at ameliorating symptoms of burnout in endoscopy staff should be tailored to address specific needs as experienced by the employees. Therefore, the results of this study could contribute to the design of various interventions, which could be employed to address the issue of work satisfaction and burnout in endoscopy staff most effectively.
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Guida P, Iacoviello M, Passantino A, Scrutinio D. Intra-hospital correlations among 30-day mortality rates in 18 different clinical and surgical settings. Int J Qual Health Care 2017; 28:793-801. [PMID: 27655789 DOI: 10.1093/intqhc/mzw112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 09/03/2016] [Accepted: 08/22/2016] [Indexed: 02/06/2023] Open
Abstract
Objective To examine whether a correlation exists in hospitals among 30-day mortality rates for different types of hospitalizations. Design Cross-sectional study of hospital care based on publically available Italian data from the National Outcome Evaluation Program Edition 2015 of the Italian Agency for Regional Health Services. Setting and Participants Patients hospitalized with a diagnosis of congestive heart failure, acute myocardial infarction, chronic renal failure, chronic obstructive pulmonary disease exacerbation, femoral neck fracture, ischemic stroke and non-variceal upper gastrointestinal bleeding, or those who underwent isolated cardiac valve procedure, isolated coronary artery bypass graft surgery, non-ruptured abdominal aortic aneurysm repair and interventions for the following tumors: colon, kidney, brain, lung, stomach, rectal, liver or pancreatic cancer. Main Outcome Measures Condition-specific 30-day crude and risk-adjusted mortality rates. Results A total of 808 280 admissions were reported from 844 institutions (median of 4 conditions evaluated per hospital; interquartile range 2-8). Volumes and outcome varied by clinical and surgical conditions across hospitals. Out of 153 pairs of different conditions, 41 were statistically significant in terms of concordance with crude mortality rates and 44 for their adjusted values. The hospital mean percentile rank for 30-day mortality, a composite measure that summarized the multiple indicators, increased significantly alongside number of conditions per hospital with a significant reduction of mortality when most of the studied conditions were treated in the same hospital. Conclusions The variability in 30-day mortality rates at hospital level and the correlation between risk mortality rates suggest that there may be common hospital-wide factors influencing short-term mortality.
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Affiliation(s)
- Pietro Guida
- Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy
| | - Massimo Iacoviello
- Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Andrea Passantino
- Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy
| | - Domenico Scrutinio
- Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy
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Liu-Seifert H, Siemers E, Price K, Han B, Selzler KJ, Henley D, Sundell K, Aisen P, Cummings J, Raskin J, Mohs R. Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease. J Alzheimers Dis 2016; 47:205-14. [PMID: 26402769 PMCID: PMC4923754 DOI: 10.3233/jad-142508] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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] [Indexed: 01/21/2023]
Abstract
Background: The temporal relationship of cognitive deficit and functional impairment in Alzheimer’s disease (AD) is not well characterized. Recent analyses suggest cognitive decline predicts subsequent functional decline throughout AD progression. Objective: To better understand the relationship between cognitive and functional decline in mild AD using autoregressive cross-lagged (ARCL) panel analyses in several clinical trials. Methods: Data included placebo patients with mild AD pooled from two multicenter, double-blind, Phase 3 solanezumab (EXPEDITION/2) or semagacestat (IDENTITY/2) studies, and from AD patients participating in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Cognitive and functional outcomes were assessed using AD Assessment Scale-Cognitive subscale (ADAS-Cog), AD Cooperative Study-Activities of Daily Living instrumental subscale (ADCS-iADL), or Functional Activities Questionnaire (FAQ), respectively. ARCL panel analyses evaluated relationships between cognitive and functional impairment over time. Results: In EXPEDITION, ARCL panel analyses demonstrated cognitive scores significantly predicted future functional impairment at 5 of 6 time points, while functional scores predicted subsequent cognitive scores in only 1 of 6 time points. Data from IDENTITY and ADNI programs yielded consistent results whereby cognition predicted subsequent function, but not vice-versa. Conclusions: Analyses from three databases indicated cognitive decline precedes and predicts subsequent functional decline in mild AD dementia, consistent with previously proposed hypotheses, and corroborate recent publications using similar methodologies. Cognitive impairment may be used as a predictor of future functional impairment in mild AD dementia and can be considered a critical target for prevention strategies to limit future functional decline in the dementia process.
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Affiliation(s)
- Hong Liu-Seifert
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Eric Siemers
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Karen Price
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Baoguang Han
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | | | - David Henley
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA.,Indiana University School of Medicine, Indianapolis, IN, USA
| | - Karen Sundell
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Paul Aisen
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | | | - Richard Mohs
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
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Liu-Seifert H, Siemers E, Sundell K, Price K, Han B, Selzler K, Aisen P, Cummings J, Raskin J, Mohs R. Cognitive and functional decline and their relationship in patients with mild Alzheimer's dementia. J Alzheimers Dis 2015; 43:949-55. [PMID: 25125457 DOI: 10.3233/jad-140792] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In patients with Alzheimer's disease (AD), the relationship between cognitive and functional progression is not fully understood; however, functional decline has been postulated to follow cognitive decline. OBJECTIVE To assess the relationship between cognitive and functional treatment effects in mild AD dementia patients. METHODS Data of patients with mild AD were pooled from two multicenter, double-blind, Phase 3 studies. Patients were randomized to infusions of 400-mg solanezumab (n = 654), or placebo (n = 660) every 4 weeks for 18 months. Cognitive and functional outcome measures were assessed using the AD Assessment Scale-Cognitive subscale (ADAS-Cog) and the AD Cooperative Study-Activities of Daily Living (ADCS-ADL), respectively. Analyses included comparisons among normalized scales, correlations between outcome measures, and path analyses to model the relationship of treatment effect on cognition and function. RESULTS Normalized ADAS-Cog and ADCS-ADL scales showed cognitive impairment was more evident than functional impairment in mild AD. The correlation between cognition and function increased over time. Path analyses demonstrated that 87% of the treatment effect on function was driven by the treatment effect on cognition, with the remaining 13% due to direct treatment effect. CONCLUSION Findings from this study are consistent with the hypothesis that functional impairment is primarily driven by and follows cognitive decline in mild AD dementia. The cognitive treatment effect appeared to explain the majority of the functional treatment effect. It is possible that a cognitive treatment effect may be considered as a leading indicator for functional outcomes in an 18-month clinical trial for milder stages of AD.
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Affiliation(s)
- Hong Liu-Seifert
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Eric Siemers
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Karen Sundell
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Karen Price
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Baoguang Han
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Katherine Selzler
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - Paul Aisen
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | | | - Richard Mohs
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
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Abstract
In a contemporary clinical laboratory it is very common to have to assess the agreement between two quantitative methods of measurement. The correct statistical approach to assess this degree of agreement is not obvious. Correlation and regression studies are frequently proposed. However, correlation studies the relationship between one variable and another, not the differences, and it is not recommended as a method for assessing the comparability between methods.
In 1983 Altman and Bland (B&A) proposed an alternative analysis, based on the quantification of the agreement between two quantitative measurements by studying the mean difference and constructing limits of agreement.
The B&A plot analysis is a simple way to evaluate a bias between the mean differences, and to estimate an agreement interval, within which 95% of the differences of the second method, compared to the first one, fall. Data can be analyzed both as unit differences plot and as percentage differences plot.
The B&A plot method only defines the intervals of agreements, it does not say whether those limits are acceptable or not. Acceptable limits must be defined a priori, based on clinical necessity, biological considerations or other goals.
The aim of this article is to provide guidance on the use and interpretation of Bland Altman analysis in method comparison studies.
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Affiliation(s)
- Davide Giavarina
- Clinical Chemistry and Hematology Laboratory, San Bortolo Hospital, Vicenza, Italy
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26
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Cook LS, Moon BL, Dong Y, Neilson HK. Reliability of self-reported sun exposure in Canadian women and estimation of lifetime exposure to vitamin D from sun and diet. Public Health Nutr 2014; 17:747-55. [PMID: 23885709 PMCID: PMC10282289 DOI: 10.1017/s136898001300178x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/04/2012] [Revised: 03/25/2013] [Accepted: 06/04/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess the inter-method reliability of the Ovarian Cancer in Alberta (OVAL) survey developed to estimate adult vitamin D exposure from sun and diet for every tenth year, against the longer Geraldton Skin Cancer Prevention Survey (the assumed 'gold standard'). We also estimated total vitamin D exposure using the OVAL survey. DESIGN A randomized crossover design to assess the inter-method reliability of sun exposure (OVAL v. Geraldton survey), using intra-class correlation and estimated total vitamin D exposure from sun and diet. SETTING Calgary, Alberta, Canada. SUBJECTS Randomly selected women (n 90) aged 40-79 years. RESULTS The average lifetime sun exposure of 13,913 h (average 411 h/year) from the Geraldton survey was not significantly different from the 13,034 h (average 385 h/year) from the OVAL survey for periods with sufficient UV radiation to stimulate vitamin D production. The intra-class correlation coefficient for average lifetime sun exposure was 0.77 (95% CI 0.69, 0.86); the annual average was 0.60 (95% CI 0.47, 0.74). Estimated vitamin D from diet and supplements increased with age. CONCLUSIONS Our OVAL survey reliably estimated adult sun exposure relative to the Geraldton survey, suggesting that assessing sun exposure every tenth year is a reliable and efficient method for estimating sun contributions to lifetime vitamin D exposure.
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Affiliation(s)
- Linda S Cook
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
- Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Bevin L Moon
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Yan Dong
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
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