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Anderson SF. A Confidence Interval for the Difference Between Standardized Regression Coefficients. MULTIVARIATE BEHAVIORAL RESEARCH 2024:1-23. [PMID: 38560991 DOI: 10.1080/00273171.2024.2318784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Researchers are often interested in comparing predictors, a practice commonly done via informal comparisons of standardized regression slopes. However, formal interval-based approaches offer advantages over informal comparison. Specifically, this article examines a delta-method-based confidence interval for the difference between two standardized regression coefficients, building upon previous work on confidence intervals for single coefficients. Using Monte Carlo simulation studies, the proposed approach is evaluated at finite sample sizes with respect to coverage rate, interval width, Type I error rate, and statistical power under a variety of conditions, and is shown to outperform an alternative approach that uses the standard covariance matrix found in regression textbooks. Additional simulations evaluate current software implementations, small sample performance, and multiple comparison procedures for simultaneously testing multiple differences of interest. Guidance on sample size planning for narrow confidence intervals, an R function to conduct the proposed method, and two empirical demonstrations are provided. The goal is to offer researchers a different tool in their toolbox for when comparisons among standardized coefficients are desired, as a supplement to, rather than a replacement for, other potentially useful analyses.
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Li R, Wang L. Investigating weight constraint methods for causal-formative indicator modeling. Behav Res Methods 2024:10.3758/s13428-024-02365-9. [PMID: 38504078 DOI: 10.3758/s13428-024-02365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/21/2024]
Abstract
Causal-formative indicators are often used in social science research. To achieve identification in causal-formative indicator modeling, constraints need to be applied. A conventional method is to constrain the weight of a formative indicator to be 1. The selection of which indicator to have the fixed weight, however, may influence statistical inferences of the structural path coefficients from the causal-formative construct to outcomes. Another conventional method is to use equal weights (e.g., 1) and assumes that all indicators equally contribute to the latent construct, which can be a strong assumption. To address the limitations of the conventional methods, we proposed an alternative constraint method, in which the sum of the weights is constrained to be a constant. We analytically studied the relations and interpretations of structural path coefficients from the constraint methods, and the results showed that the proposed method yields better interpretations of path coefficients. Simulation studies were conducted to compare the performance of the weight constraint methods in causal-formative indicator modeling with one or two outcomes. Results showed that higher biases in the path coefficient estimates were observed from the conventional methods compared to the proposed method. The proposed method had ignorable bias and satisfactory coverage rates in the studied conditions. This study emphasizes the importance of using an appropriate weight constraint method in causal-formative indicator modeling.
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Affiliation(s)
- Ruoxuan Li
- Department of Psychology, University of Notre Dame, Notre Dame, IN, 46530, USA
| | - Lijuan Wang
- Department of Psychology, University of Notre Dame, Notre Dame, IN, 46530, USA.
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Palaiothodorou D, Vagenas G. Inter-arm bone mass and size asymmetries in children tennis players are maturity status specific: a 9-month study on the effects of training time across pubertal change and somatic growth. Eur J Appl Physiol 2024:10.1007/s00421-024-05425-2. [PMID: 38413390 DOI: 10.1007/s00421-024-05425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/22/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Bone growth with exercise is best assessed by tennis-induced inter-arm asymmetries. Yet, the effects of training and maturation across puberty were unclear. This study explored arm bone growth across 9 months of training in 46 tennis players 7-14 years (25 boys, 21 girls). METHODS Bone mineral content (BMC) and bone area (BA) were measured from DXA scans. Pubertal status was assessed by Tanner stage (TS) and somatic growth by maturity offset (MO). Children were grouped as pre- (TS I-I), early (TS I-II), and mid/late pubertal (TS II-III). RESULTS Training time (TT) change in the three groups was 160-170, 190-230, and 200-220 h, respectively. Bone asymmetries were large in all groups (d > 0.8, P < 0.001): 5-18 g (9-21%) and 9-17 g (17-23%) in girls and boys, respectively, for BMC, and 5-15 cm2 (6-13%) and 9-15 cm2 (12-15%) in girls and boys (10-13%), respectively, for BA. BMC and BA change asymmetry peaked at pre-puberty in girls (56%, 46%) and at early puberty in boys (57%, 43%). Asymmetry gains varied with baseline asymmetry (41%) and change in TT (38%) and TS (17%) in BMC, and with baseline asymmetry (58%) and change in MO (17%) and TS (12%) in BA. CONCLUSION All bone asymmetries were substantial. Tennis-induced bone gains were higher at pre- to early puberty in girls and at early to mid/late puberty in boys. Training enhanced mostly bone mass and maturity status enhanced mostly bone size; sex was not bone-change modeling impactful. Implications are discussed considering certain limitations.
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Affiliation(s)
- Dimitria Palaiothodorou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.
| | - George Vagenas
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
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Deek H, Massouh A. Effect of psychosocial aspects on medication adherence in patients with heart failure amid socioeconomic challenges. Open Heart 2024; 11:e002550. [PMID: 38367984 PMCID: PMC10875507 DOI: 10.1136/openhrt-2023-002550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/11/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE To evaluate stress, depression and quality of life among community-dwelling patients with heart failure (HF) and evaluate their effect on perceived medication adherence in a socioeconomically challenged setting. DESIGN A cross-sectional design with self-administered questionnaire with data collected between October 2021 and September 2022. METHODS Patients with confirmed diagnosis of HF were sought for data collection in the community and cardiology clinics through an electronic platform. Confirmation of cases was done through the ejection fraction, medication list and frequent symptoms of the patients. The Patient Health Questionnaire-9, the COVID-19 Stress Scale, the Minnesota Living with HF Questionnaire and the Lebanese Medication Adherence Scale were used to evaluate depression, stress, quality of life and medication adherence, respectively. Univariate analysis was done to present the descriptive statistics, whereas bivariate and multivariate analyses were done to evaluate the relationship between the variables. RESULTS A total of 237 participants were included in the final analysis. The mean age was 61.3±17.36 years, and the majority (57.8%) were male participants. Only 44.7% were on ACE inhibitors/angiotensin receptor blockers and 54.9% on beta-blockers. The mean scores for stress, depression, quality of life and medication adherence were 75.86 (SD=24.5), 14.03 (SD=5.7), 55.73 (SD=23.05) and 6.79 (SD=6.93), respectively, indicating high stress levels, depression, poor quality of life and medication adherence. Those with a history of hypertension and depression were significantly more adherent to their medications than those who were not. Multivariate analysis showed that anxiety, medical follow-up, quality of life and functionality class were predictors of medication adherence. CONCLUSION The study showed the population with HF in Lebanon to have psychological health problems with these variables acting as predictors for medication adherence. Sociodemographic characteristics also played a role on the outcome, which can be targeted when planning interventions to improve outcomes. Future studies should compare prescribed medication with consumed medication through longitudinal approaches and medical refilling techniques when possible.
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Affiliation(s)
- Hiba Deek
- Nursing, Beirut Arab University, Beirut, Lebanon
| | - Angela Massouh
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
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Pattanakuhar S, Kammuang-Lue P, Komaratat N, Chotiyarnwong C, Kovindha A, Gemperli A. Do individuals from an SCI-specialized rehabilitation facility have fewer secondary health conditions than those from a non-SCI-specialized rehabilitation facility? Analysis of the InSCI database from a middle-income country. J Spinal Cord Med 2024:1-10. [PMID: 38251980 DOI: 10.1080/10790268.2023.2289690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES To determine whether attending an SCI-specialized rehabilitation facility (SSRF) is independently associated with having fewer secondary health conditions (SHCs) in middle-income country contexts. STUDY DESIGN Cross-sectional observational study. SETTING Four rehabilitation facilities in Thailand (one SSRF and three non-SSRF). METHODS Data from a Thai arm of the International Spinal Cord Injury Community Survey (InSCI) were analyzed. SHCs occurring within the last three months were evaluated using the Spinal Cord Injury Secondary Condition Scale. A causal diagram was applied to create a multivariable regression model to determine the independent effect of attending in the SSRF on having SHC as a single condition and as a sum score. RESULTS Three hundred and thirteen individuals with chronic SCI were included in this study. Two hundred and nineteen participants (70%) were recruited from the SSRF. Being recruited from the SSRF was an independent negative correlating factor of the SHC sum score with an unstandardized coefficient of -1.12 (95% CI: -2.00-0.24). Being recruited from the SSRF was also an independent negative correlating factor of having bladder dysfunction, sexual dysfunction, and pressure ulcer SHC with an odds ratio of 0.32 (95% CI: 0.16-0.59), 0.43 (95% CI: 0.22-0.84), and 0.46 (95% CI: 0.24-0.89), respectively. CONCLUSION Attending an SSRF was significantly associated with having fewer SHCs, specifically, bladder dysfunctions, sexual dysfunctions, and pressure ulcers. These results suggest the importance of having SSRF in middle-income countries for delivering effective care to people with SCI and standardized education to health care providers.
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Affiliation(s)
- Sintip Pattanakuhar
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Health Services and Clinical Care Unit, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Pratchayapon Kammuang-Lue
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Napasakorn Komaratat
- Department of Medical Services, Ministry of Health, Sirindhorn National Medical Rehabilitation Institute, Nonthaburi, Thailand
| | - Chayaporn Chotiyarnwong
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apichana Kovindha
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Armin Gemperli
- Health Services and Clinical Care Unit, Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center of Primary and Community Care, University of Lucerne, Lucerne, Switzerland
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Kim HJ, Kim J, Yook KH, Choi TK, Lee SH. Early Trauma Subtypes are Differentially Related to Anxiety Symptomatology and Suicidal Ideation in Panic Disorder. Psychiatry Investig 2023; 20:1211-1220. [PMID: 38163660 PMCID: PMC10758330 DOI: 10.30773/pi.2023.0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Early trauma significantly affects the severity of panic disorder (PD) symptoms and suicidal ideation. However, few studies have explored the specific effects of different early trauma subtypes on PD. This study analyzed how childhood trauma subtypes, including general, physical, emotional, and sexual, influence panic and phobia levels and suicidal ideation in adults with PD and healthy controls (HCs). METHODS In total, 455 adults with PD and 149 HCs participated in this study. The independent variables were sociodemographic and clinical variables such as coping strategies and early trauma subtypes from the Early Trauma Inventory Self Report-Short Form. The dependent variables were the Albany Panic and Phobia Questionnaire (APPQ), the Panic Disorder Severity Scale, and the Scale for Suicide Ideation (SSI). RESULTS Early emotional trauma significantly influenced the APPQ scores, whereas early physical trauma significantly influenced the SSI scores in patients with PD. However, in HCs, only early emotional trauma was significantly associated with the APPQ and SSI scores. CONCLUSION These findings highlight the influence of early trauma subtypes on the phobic symptom severity of PD and suicidal ideation among patients with PD. Early emotional trauma is associated with the severity of phobic symptoms, whereas early physical trauma is associated with suicidal ideation, suggesting distinct clinical outcomes based on the type of trauma in patients with PD.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Jieun Kim
- Department of Family Environment and Welfare, Chonnam National University, Gwangju, Republic of Korea
| | - Ki-Hwan Yook
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Huynh TLT, Silveira SL, Motl RW. Physical Activity and Quality of Life in Persons Newly Diagnosed With Multiple Sclerosis: A Cross-sectional Study. Arch Phys Med Rehabil 2023; 104:1820-1826. [PMID: 37119953 DOI: 10.1016/j.apmr.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/22/2023] [Accepted: 04/04/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To examine the association between physical activity (PA) and quality of life (QOL) in persons newly diagnosed with multiple sclerosis (MS) who have been under-represented in MS research. DESIGN Cross-sectional study with secondary data analysis. SETTING General community. PARTICIPANTS The study included 152 persons newly diagnosed with MS (ie, diagnosed with MS within the past 2 years) aged 18 and older (N=152). MAIN OUTCOME MEASURES Participants completed the Godin Leisure-Time Exercise Questionnaire to measure PA. QOL, disability status, fatigue, mood, and comorbidity were assessed using the 12-Item Short Form Survey (SF-12), Patient Determined Disease Steps, Hamburg Quality of Life Questionnaire Multiple Sclerosis, and comorbidity questionnaire. RESULTS The bivariate correlations indicated that PA was significantly and positively associated with the physical component of QOL (ie, SF-12 PCS) (r=0.46). The stepwise multiple linear regression analysis indicated PA as associated with SF-12 PCS (β=0.43, R2=0.17) when solely included in the model. After controlling for fatigue, mood, disability status, and comorbidity as covariates (R2=0.63), the association between PA and SF-12 PCS was still statistically significant, but attenuated in magnitude (β=0.11). CONCLUSIONS This study observed that PA was significantly associated with the physical component of QOL in persons newly diagnosed with MS, even after controlling for covariates. The findings underscore the importance of developing behavior change interventions targeting PA while addressing the roles of fatigue and disability status for enhancing the physical component of QOL of this MS subpopulation.
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Affiliation(s)
- Trinh L T Huynh
- Department of Physical Therapy, the University of Alabama at Birmingham, Birmingham, AL.
| | - Stephanie L Silveira
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL
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Polatcı S, Antalyalı ÖL, Alparslan AM, Yastıoğlu S. Young people's happiness in the context of negative life events and coping strategies: a latent profile and latent class analysis. BMC Psychol 2023; 11:335. [PMID: 37838737 PMCID: PMC10576293 DOI: 10.1186/s40359-023-01343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 09/21/2023] [Indexed: 10/16/2023] Open
Abstract
Young people have to cope with many negative life events and stress factors to maintain their happiness. Although there are studies on how they benefit from different coping strategies and their results, there is no study that profiles/groups young people according to negative life events and coping styles. From this point of view, the study aims to determine different life events classes and stress coping profiles in young people, and to examine the differences in happiness among the new groups created according to the discovered classes and profiles. Participants consisted of 1093 young people (M = 21.08) from different state universities in Turkey. Latent profile analysis (LPA) was conducted, resulting in a 3 profile solution characterizing coping strategies: Positive-oriented (26.8%), slightly positive-oriented (50%), and negative-oriented (23.2%) coping strategy profiles. Latent class analysis (LCA) was conducted, resulting in a 2 class solution characterizing negative life events: More negative (40.1%) and less negative (59.9%) life events classes. For the purpose of the study, the profiles created with the latent profile analysis and the latent class analysis were considered together and the participants were divided into 6 groups. These groups differed significantly in terms of happiness. The group with the highest level of happiness is the group with positive-oriented coping strategies and less negative life conditions (μ = 4.35, p < .001), and the group with the lowest level of happiness is the group with negative-oriented coping strategies and more negative life conditions (μ = 3.48, p < .001). However, the findings indicated that a positive-oriented coping strategy profile (the profile that scored high on positive coping strategies and low on negative coping strategies) offers the most promising route to happiness whether experienced negative life events are less or more.
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Affiliation(s)
- Sema Polatcı
- Department of Business Administration, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Ömer Lütfi Antalyalı
- Department of Business Administration, Süleyman Demirel University, Isparta, Turkey
| | - Ali Murat Alparslan
- Department of Public Relations and Publicity, Süleyman Demirel University, Isparta, Turkey
| | - Seher Yastıoğlu
- Department of Business Administration, Burdur Mehmet Akif Ersoy University, Burdur, Turkey.
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Mahajan P, Patil V. 'College choice' under the COVID-19 pandemic: Sustainability of engineering campuses for future enrollments. PLoS One 2023; 18:e0291876. [PMID: 37756345 PMCID: PMC10530044 DOI: 10.1371/journal.pone.0291876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Engineering profession for students and diverse students for Engineering Campuses (ECs) is the prestige to have for both. Worldwide higher education has been impacted by COVID-19 pandemic, but particularly pulling padlocked doors of Indian engineering campuses (ECs) down. Students' attitudes regarding choice, liking, and preferences were also affected. Knowing how tough 'college choice' was before the pandemic, one can guess how difficult it will be today. The objective of this study was to explore students' perceptions of choice characteristics related to ECs and diverse students enabling choice decisions under the COVID-19 situation, and to discover any possible relationships among them. Research questions were qualitatively examined with the statistical confirmation of related hypothesizes by utilizing ANOVA and Regression analysis. A self-reported quantitative survey composed of a closed-ended structured questionnaire was administered on the students of first-year engineering who had recently enrolled in ECs of North Maharashtra Region of India, after pandemic hitting India. According to the study, ECs have several characteristics impacting students' selection of ECs under pandemic. The influence of proximity, image and reputation, educational quality, and curriculum delivery was significant in contributing sustainability of ECs. This influence was significant across students' psychological and behavioural biases on likes, choices, and preferences. Furthermore, multiple relationships were noted within the sub-groups of demographic, geographic, socioeconomic, academic performance, and psychological and behavioural traits due to the impact of ECs' characteristics on sustainability. The study has provided a framework for policymakers and administrators to strengthen repositioning towards sustainability while capturing potentially diverse enrolments. Even if we have to coexist with pandemic forever or with more similar pandemics, the findings of this study may undergo a fundamental transformation for ECs (existing and forthcoming). On the other hand, by understanding the importance and relations of choice characteristics may smoothen the complex nature of "college choice" for prospective students.
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Affiliation(s)
| | - Vaishali Patil
- Institute of Management Research and Development, RCPET’s, Shirpur, India
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Innes S, Granger R, Théroux J. Creating and testing a questionnaire to predict immediate and strong positive responders to spinal manipulative therapy for non-specific low back pain. A pilot study. Chiropr Man Therap 2023; 31:40. [PMID: 37752488 PMCID: PMC10523686 DOI: 10.1186/s12998-023-00510-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT. We sought to create a 'pen and paper' questionnaire that would measure these items and then pilot its use in a clinical setting to determine its 'usability' for a larger study. Knowing this information would inform a more efficacious use of SMT. METHOD Of the 18 items identified in the Delphi study, 13 were deemed historical in nature and readily provided by the chiropractor and patient. A literature search revealed reliable and valid measures for two more items. The remaining three items were generated by creating descriptive questions matched to an appropriate Likert scale. A panel of six chiropractors who had used SMT for at least 7 years when treating non-specific low back pain was formed to evaluate the items for clarity and relevance. Ten Western Australian chiropractors were then recruited to pilot the questionnaire on ten consecutive patients with non-specific low back pain where SMT was used from March to June 2020. Ethics approval was obtained from Murdoch University. RESULTS COVID-19 restrictions impacted on practitioner recruitment and delayed the data collection. Of the intended 100 participants, only 63 could be recruited over a 3-month period from seven chiropractors. Time constraints forced the closure of the data collection. The measures of all predictor items demonstrated ceiling effects. Feedback from open-ended practitioner questions was minimal, suggesting an ease of use. CONCLUSION The length of time and level of participation required to collect the calculated sample size was inadequate and suggested that incentivization may be required for a larger investigation. Significant ceiling effects were found and suggested that participants did so because of a positive bias toward chiropractic care and the use of SMT. The questionnaires in this pilot study require alternative measures and further validation before use in a larger study.
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Affiliation(s)
- Stanley Innes
- School of Allied Health, Murdoch University, Perth, Australia
- Eastern Health, Adult Mental Health Wellbeing Program, Victoria, Australia
| | - Reece Granger
- School of Allied Health, Murdoch University, Perth, Australia
| | - Jean Théroux
- School of Allied Health, Murdoch University, Perth, Australia
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Monteiro RL, Drechsel TJ, Ferreira JSSP, Zippenfennig C, Sacco ICN. Potential predictive effect of mechanical properties of the plantar skin and superficial soft tissue, and vibration perception on plantar loading during gait in individuals with diabetes. BMC Musculoskelet Disord 2023; 24:712. [PMID: 37674163 PMCID: PMC10483699 DOI: 10.1186/s12891-023-06851-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/02/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND This exploratory study aimed to investigate the extent to which mechanical properties of the plantar skin and superficial soft tissue (hardness, stiffness, and thickness) and vibration perception thresholds (VPTs) predict plantar pressure loading during gait in people with diabetes compared to healthy controls. METHODS Mechanical properties, VPTs, and plantar loadings during gait at the heel and first metatarsal head (MTH) of 20 subjects with diabetes, 13 with DPN, and 33 healthy controls were acquired. Multiple regression analyses were used to predict plantar pressure peaks and pressure-time integrals at both locations based on the mechanical properties of the skin and superficial soft tissues and VPTs. RESULTS In the diabetes group at the MTH, skin hardness associated with 30-Hz (R2 = 0.343) and 200-Hz (R2 = 0.314) VPTs predicted peak pressure at the forefoot. In the controls at the heel, peak pressure was predicted by the skin thickness, hardness, and stiffness associated with 30-Hz (R2 = 0.269, 0.268, and 0.267, respectively) and 200-Hz (R2 = 0.214, 0.247, and 0.265, respectively) VPTs. CONCLUSION The forefoot loading of people with diabetes can be predicted by the hardness of the skin when combined with loss of vibration perception at low (30-Hz) and high (200-Hz) frequencies. Further data from larger sample sizes are needed to confirm the current findings.
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Affiliation(s)
- Renan L Monteiro
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Health and Biological Science, Federal University of Amapá, Macapá, Brazil
| | - Tina J Drechsel
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Jane Suelen S P Ferreira
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Claudio Zippenfennig
- Department of Human Locomotion, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Isabel C N Sacco
- Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 51 - Cidade Universitária, São Paulo, 05360-160, Brazil.
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Hirsch K, Cubbidge RP, Heitmar R. Dual wavelength retinal vessel oximetry - influence of fundus pigmentation. Eye (Lond) 2023; 37:2246-2251. [PMID: 36460856 PMCID: PMC9716545 DOI: 10.1038/s41433-022-02325-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Clinical methods examining oxygenation parameters in humans have been used in many different care settings, but concerns have been raised regarding their clinical utility when assessing people with darker skin pigmentation. While saturation values can be crucial in emergency medicine, they are equally valuable in assessing disease mechanisms and monitoring change in disease progression. Retinal pigmentation varies across individuals and hence, can impact on retinal oxygen parameters. The objective of this study was to quantify and eliminate the impact of retinal pigmentation on retinal vessel oxygen saturation parameters measured in the superficial retinal arterioles and venules. METHODS 105 healthy individuals of varying skin colour, iris colour and heritage were included. Following a full eye exam to exclude any ocular abnormality, all participants underwent intraocular pressure, systemic blood pressure measurements and dilated dual wavelength retinal photography. Rotation matrices were employed to minimise the dependency of retinal pigmentation on arterial and venous oxygen saturation measurements determined in a concentric measurement annulus. RESULTS Retinal oxygen saturation in venules showed a linear correlation with retinal pigmentation (y = 0.34 × x + 38.598), whereas arterial saturation followed a polynomial pattern (y = 0.0089 × x2 + 0.7499 × x + 85.073). Both arterial and venous saturation values were corrected using local fundus pigmentation. Pre-correction retinal arterial and venous oxygen saturation were 89.0% (±13.1) and 43.7% (±11.5), respectively, and post- correction values were 94.8% (±8.7) for arteries and 56.3% (±7.0) veins. CONCLUSIONS When assessing multi-ethnic cohorts, it is important to consider the impact of pigmentation on imaging parameters and to account for it prior to clinical interpretation.
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Affiliation(s)
- Katrin Hirsch
- The University of the West of England, School of Health and Social Wellbeing, Glenside Campus, Bristol, BS16 1DD, UK.
| | - Robert P Cubbidge
- ABDO College, Godmersham Park, Canterbury, Kent, CT4 7DT, UK
- Aston University, Aston Triangle, Birmingham, B4 7ET, UK
| | - Rebekka Heitmar
- University of Huddersfield, School of Applied Sciences, Centre for Vision across the Life Span, Queensgate, HD1 3DH, UK.
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Fuhr K, Meisner C, Batra A. Long-Term Outcomes of Depression Treatment With Hypnotherapy or Cognitive Behavioral Therapy. J Nerv Ment Dis 2023; 211:519-524. [PMID: 36928627 DOI: 10.1097/nmd.0000000000001647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
ABSTRACT In a recent randomized controlled trial of mild to moderate depression, hypnotherapy (HT) was noninferior to cognitive behavioral therapy (CBT) after 6 months of outpatient treatment. In the present article, we extended the results in a secondary analysis and investigated how HT compares with CBT 1) during the course of the self-rated depressive symptoms throughout the 12-month follow-ups, 2) with regard to the rates of full remission, and 3) for the time to remission after treatment. Of the 152 randomized patients with current depression, 136 were available for the follow-up analyses. The course of self-rated depressive symptoms during follow-ups was analyzed with linear mixed-effects models. Time to a full remission, defined as eight consecutive weeks without depression, was compared between groups in a survival analysis. The self-reported depressive symptoms could be maintained on a low symptom level during the 12-month follow-up for both HT and CBT. Overall, both treatments achieved comparably high long-term remission rates of 73% after a median of 30 weeks. Outpatient psychotherapy with HT achieved good long-term results mostly comparable to CBT.
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Affiliation(s)
- Kristina Fuhr
- Department of Psychiatry and Psychotherapy at the University Hospital of Tuebingen, Tuebingen
| | - Christoph Meisner
- Study Center, Robert Bosch Society for Medical Research, Stuttgart, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy at the University Hospital of Tuebingen, Tuebingen
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Guan T, Alam MK, Rao MB. Sample Size Calculations in Simple Linear Regression: A New Approach. ENTROPY (BASEL, SWITZERLAND) 2023; 25:e25040611. [PMID: 37190399 PMCID: PMC10137477 DOI: 10.3390/e25040611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 05/17/2023]
Abstract
The problem tackled is the determination of sample size for a given level and power in the context of a simple linear regression model. The standard approach deals with planned experiments in which the predictor X is observed for a number n of times and the corresponding observations on the response variable Y are to be drawn. The statistic that is used is built on the least squares' estimator of the slope parameter. Its conditional distribution given the data on the predictor X is utilized for sample size calculations. This is problematic. The sample size n is already presaged and the data on X is fixed. In unplanned experiments, in which both X and Y are to be sampled simultaneously, we do not have data on the predictor X yet. This conundrum has been discussed in several papers and books with no solution proposed. We overcome the problem by determining the exact unconditional distribution of the test statistic in the unplanned case. We have provided tables of critical values for given levels of significance following the exact distribution. In addition, we show that the distribution of the test statistic depends only on the effect size, which is defined precisely in the paper.
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Affiliation(s)
- Tianyuan Guan
- College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH 44240, USA
- Department of Environmental Health and Public Health Sciences, University of Cincinnati, 160 Panzeca Way, Cincinnati, OH 45221, USA
| | - Mohammed Khorshed Alam
- Department of Environmental Health and Public Health Sciences, University of Cincinnati, 160 Panzeca Way, Cincinnati, OH 45221, USA
| | - Marepalli Bhaskara Rao
- Department of Environmental Health and Public Health Sciences, University of Cincinnati, 160 Panzeca Way, Cincinnati, OH 45221, USA
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15
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Altmeyer K, Barz M, Lauer L, Peschel M, Sonntag D, Brünken R, Malone S. Digital ink and differentiated subjective ratings for cognitive load measurement in middle childhood. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023:e12595. [PMID: 36967475 DOI: 10.1111/bjep.12595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/28/2023]
Abstract
BACKGROUND New methods are constantly being developed to adapt cognitive load measurement to different contexts. However, research on middle childhood students' cognitive load measurement is rare. Research indicates that the three cognitive load dimensions (intrinsic, extraneous, and germane) can be measured well in adults and teenagers using differentiated subjective rating instruments. Moreover, digital ink recorded by smartpens could serve as an indicator for cognitive load in adults. AIMS With the present research, we aimed at investigating the relation between subjective cognitive load ratings, velocity and pressure measures recorded with a smartpen, and performance in standardized sketching tasks in middle childhood students. SAMPLE Thirty-six children (age 7-12) participated at the university's laboratory. METHODS The children performed two standardized sketching tasks, each in two versions. The induced intrinsic cognitive load or the extraneous cognitive load was varied between the versions. Digital ink was recorded while the children drew with a smartpen on real paper and after each task, they were asked to report their perceived intrinsic and extraneous cognitive load using a newly developed 5-item scale. RESULTS Results indicated that cognitive load ratings as well as velocity and pressure measures were substantially related to the induced cognitive load and to performance in both sketching tasks. However, cognitive load ratings and smartpen measures were not substantially related. CONCLUSIONS Both subjective rating and digital ink hold potential for cognitive load and performance measurement. However, it is questionable whether they measure the exact same constructs.
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Kamimoto T, Shindo K, Shimomura T, Akimoto T, Yamada T, Mori N, Nakao K, Tsujikawa M, Honaga K, Kutsuna T, Hiramatsu K, Kondo K, Liu M. Response to the Letter to the editor, JSCVD-D-22-01922. J Stroke Cerebrovasc Dis 2023; 32:106955. [PMID: 36682971 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Takayuki Kamimoto
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Keiichiro Shindo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Hikarigaoka Hospital, Shirankai Medical Corporation Takaoka, Toyama, Japan.
| | - Tadasuke Shimomura
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Saiseikai Yokohama-shi Tobu Hospital, Kanagawa, Japan.
| | - Tomonori Akimoto
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Takeshi Yamada
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
| | - Naoki Mori
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Hatsudai Rehabilitation Hospital, Tokyo, Japan.
| | - Keiko Nakao
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan; Oriental Medicine Research Center, Kitasato University, Tokyo, Japan.
| | - Masahiro Tsujikawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Takeshi Kutsuna
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
| | - Kazuhisa Hiramatsu
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Meigen Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.
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17
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Chien SC, Chen CY, Chien CH, Iqbal U, Yang HC, Hsueh HC, Weng SF, Jian WS. Investigating nurses' acceptance of patients' bring your own device implementation in a clinical setting: A pilot study. Asia Pac J Oncol Nurs 2023; 10:100195. [PMID: 36915387 PMCID: PMC10006526 DOI: 10.1016/j.apjon.2023.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/19/2023] [Indexed: 02/07/2023] Open
Abstract
Objective The popularity of the "bring your own device (BYOD)" concept has grown in recent years, and its application has extended to the healthcare field. This study was aimed at examining nurses' acceptance of a BYOD-supported system after a 9-month implementation period. Methods We used the technology acceptance model to develop and validate a structured questionnaire as a research tool. All nurses (n = 18) responsible for the BYOD-supported wards during the study period were included in our study. A 5-point Likert scale was used to assess the degree of disagreement and agreement. Statistical analysis was performed in SPSS version 24.0. Results The questionnaire was determined to be reliable and well constructed, on the basis of the item-level content validity index and Cronbach α values above 0.95 and 0.87, respectively. The mean constant values for all items were above 3.95, thus suggesting that nurses had a positive attitude toward the BYOD-supported system, driven by the characteristics of the tasks involved. Conclusions We successfully developed a BYOD-supported system. Our study results suggested that nursing staff satisfaction with BYOD-supported systems could be effectively increased by providing practical functionalities and reducing clinical burden. Hospitals could benefit from the insights generated by this study when implementing similar systems.
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Affiliation(s)
- Shuo-Chen Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Artificial Intelligence Research and Development Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chun-You Chen
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Artificial Intelligence Research and Development Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Office of Public Affairs, Taipei Medical University, Taipei, Taiwan
| | - Usman Iqbal
- Health ICT, Department of Health, Tasmania, Australia
- Global Health and Health Security Department, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hsuan-Chia Yang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Huei-Chia Hsueh
- Department of Artificial Intelligence in Medicine, Professional Master Program, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuen-Fu Weng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Shan Jian
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
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18
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Association Between Self-care and Resilience: A Cross-sectional Study in Heart Failure Patients. J Cardiovasc Nurs 2023; 38:E70-E77. [PMID: 35389927 DOI: 10.1097/jcn.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Self-care (SC) is a cornerstone in heart failure management and is related to patient outcomes. The continuous and complex demands of SC can be experienced as stressful and may require patients to apply resilient behaviors as they manage their conditions. Resilience may be a helpful factor in performing SC. OBJECTIVE The aim of this study was to determine the association between resilience and SC in patients with heart failure. METHODS A cross-sectional study was performed between January 2020 and January 2021. Participants were asked to complete a questionnaire addressing baseline characteristics, the 2-item Patient Health Questionnaire, the Resilience Evaluation Scale, and the Self-Care of Chronic Illness Inventory, which measures 3 concepts of SC: SC maintenance, SC monitoring, and SC management. Multiple regression analysis was performed to determine whether resilience was associated with SC. RESULTS Eighty-six patients were included, and 74 patients completed the questionnaire. In the univariate analysis, an association was found between resilience and SC maintenance, resulting in an increase in SC for patients with higher resilience (β = 0.24; 95% confidence interval, 0.03-0.96). In the multivariate analysis adjusted and corrected for confounders, no significant associations between resilience and all SC scales were found. CONCLUSION This study could not demonstrate significant associations between resilience and all SC scales. This study contributes to the body of knowledge on factors that can mediate or moderate SC. Further longitudinal research should be performed to study cause-effect relationships.
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19
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Van Horn LT, Wright L, Arikawa AY, Sealey-Potts C, Hamadi H. Determinant factors associated with the use of evidence-based dietetics practice among registered dietitian nutritionists. Nutr Diet 2022. [PMID: 36193686 DOI: 10.1111/1747-0080.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Abstract
AIMS There is a lack of research assessing perceived and actual evidence-based dietetics practice knowledge among registered dietitian nutritionists. This cross-sectional research examined the association between determinant factors (i.e., education attainment) and objective knowledge (i.e., quiz items) of evidence-based dietetics practices. Other determinant factors associated with perceived knowledge and skill, attitudes, behaviours and outcomes related to evidence-based dietetics practice were also assessed. Perceived knowledge items were compared to objective knowledge items to evaluate the accuracy of self-assessed evidence-based dietetics practice knowledge among dietitians in the United States. METHODS A modified and adapted evidence-based practice survey was emailed to registered dietitian nutritionists in the United States via the Commission on Dietetic Registration database between November and December 2020. Analysis of variance assessed the relationship between highest degree held and actual knowledge of evidence-based dietetics practices. Multiple linear regression and ordinal logistic regression determined participant-level characteristics associated with survey subscales and survey items, respectively. Pearson's correlation coefficient evaluated the relationship between subjective and objective items. RESULTS Four hundred and eighty-two dietitians completed the survey. Each increase in degree type was associated with an increase in objective knowledge score (all comparisons p < 0.001). Other determinants included recency of degree completion and peer-reviewed publications. Moderate positive associations (r = 0.35, p < 0.001) were found between subjective and objective measures. CONCLUSION Graduate-level education, recency of degree completion and peer-reviewed publications were supportive of evidence-based dietetics practice-related outcomes. Future research should evaluate the efficacy of training, particularly among those further from their highest completed degree.
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Affiliation(s)
- Leslie Thompson Van Horn
- Brooks College of Health, Department of Nutrition and Dietetics, University of North Florida, Jacksonville, Florida, USA
| | - Lauri Wright
- Brooks College of Health, Department of Nutrition and Dietetics, University of North Florida, Jacksonville, Florida, USA
| | - Andrea Y Arikawa
- Brooks College of Health, Department of Nutrition and Dietetics, University of North Florida, Jacksonville, Florida, USA
| | - Claudia Sealey-Potts
- Brooks College of Health, Department of Nutrition and Dietetics, University of North Florida, Jacksonville, Florida, USA
| | - Hanadi Hamadi
- Brooks College of Health, Department of Health Administration, University of North Florida, Jacksonville, Florida, USA
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20
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Dhamodharavadhani S, Rathipriya R. Enhanced regression model using cluster based sampling techniques. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-211736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper aims to develop the methodology for enhancing the regression models using Cluster based sampling techniques (CST) to achieve high predictive accuracy and can also be used to handle large datasets. Hard clustering (KMeans Clustering) or Soft clustering (Fuzzy C-Means) to generate samples called clusters, which in turn is used to generate the Local Regression Models (LRM) for the given dataset. These LRMs are used to create a Global Regression Model. This methodology is known as Enhanced Regression Model (ERM). The performance of the proposed approach is tested with 5 different datasets. The experimental results revealed that the proposed methodology yielded better predictive accuracy than the non-hybrid MLR model; also, fuzzy C-Means performs better than the KMeans clustering algorithm for sample selection. Thus, ERM has potential to handle data with uncertainty and complex pattern and produced a high prediction accuracy rate.
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Affiliation(s)
| | - R. Rathipriya
- Department of Computer Science, Periyar University, Salem, Tamil Nadu, India
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21
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Xu W, Zhang H, Sukjairungwattana P, Wang T. The roles of motivation, anxiety and learning strategies in online Chinese learning among Thai learners of Chinese as a foreign language. Front Psychol 2022; 13:962492. [PMID: 36051198 PMCID: PMC9426342 DOI: 10.3389/fpsyg.2022.962492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022] Open
Abstract
The impact of motivation, anxiety and learning strategies on the achievement of foreign language proficiency has been widely acknowledged in the context of traditional offline classroom settings. However, this issue has not been extensively documented in relation to online learning, which has become the predominant form of language learning during the period of the COVID-19 pandemic. The current study was conducted to investigate the relative prediction of motivation, anxiety and learning strategies for second language achievement among 90 Thai adult learners of Chinese as a foreign language (CFL) who took online Chinese courses. The participants completed a questionnaire dealing with motivation, anxiety, learning strategies, and their Chinese proficiency was measured by self-report and a Chinese vocabulary size test. A series of hierarchical regression analyses revealed two major findings. First, anxiety emerged as the most stable factor for the participants' CFL achievement, followed by learning strategies and motivation. Second, motivation, anxiety and learning strategies only significantly predicted the participants' self-rated Chinese language proficiency, but not their performance on the Chinese vocabulary size test. The overall results indicate the relative importance of motivation, anxiety and learning strategies to Chinese language learning in the online environment and suggest different measures of CFL achievement may lead to different research findings. The general findings were of theoretical and pedagogical significance for understanding and addressing individual differences factors in online language learning.
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Affiliation(s)
- Wei Xu
- Faculty of Humanities and Social Sciences, City University of Macau, Macao, Macao SAR, China
| | - Haiwei Zhang
- School of Chinese as a Second Language, Peking University, Beijing, China
- *Correspondence: Haiwei Zhang
| | | | - Tianmiao Wang
- School of Chinese as a Second Language, Peking University, Beijing, China
- Tianmiao Wang
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22
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Luh WM. Tests of equality and equivalence of regression slopes: R Shiny apps for optimal sample sizes. COMMUN STAT-SIMUL C 2022. [DOI: 10.1080/03610918.2022.2103566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Wei-ming Luh
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
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23
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Al Sabei SD, Labrague LJ, Al-Rawajfah O, AbuAlRub R, Burney IA, Jayapal SK. Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout. Nurs Forum 2022; 57:568-576. [PMID: 35152423 DOI: 10.1111/nuf.12706] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship. AIM To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout. METHODS A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout. RESULTS Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout. CONCLUSION Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.
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Affiliation(s)
- Sulaiman D Al Sabei
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Leodoro J Labrague
- Department of Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al-Rawajfah
- Department of Adult and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
- Department of Adult, College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram A Burney
- Medical Oncology, Women's Health Program, The Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman
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Brazzelli E, Pepe A, Grazzani I. Prosocial Behavior in Toddlerhood: The Contribution of Emotion Knowledge, Theory of Mind, and Language Ability. Front Psychol 2022; 13:897812. [PMID: 35719532 PMCID: PMC9198648 DOI: 10.3389/fpsyg.2022.897812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Abstract
While scholars have previously investigated the respective contributions of emotional knowledge and language ability to toddlers' prosociality, no studies to date have featured a battery of multiple direct measures assessing both of these abilities plus theory of mind on the one hand, and prosocial behavior on the other hand. In contrast, we conducted the present cross-sectional study with a view to evaluating the unique contributions of each of these three social cognition variables as antecedents of prosocial conduct during toddlerhood, measuring them via a series of individually administered standardized tasks. Furthermore, given that the existing literature documents mixed gender effects, we also set out to explore the role of gender in toddlers' prosociality. Finally, we also controlled for any effects of age on the patterns of association among the key variables. Participants were 127 children aged between 24 and 36 months (M = 29.2 months; SD = 3.5). We identified significant correlations among the variables under study. In addition, stepwise multiple regression analysis suggested that each of the social cognition (SC) abilities – i.e., emotion knowledge, theory of mind, and language - made a unique contribution to explaining variance in prosocial behaviors (PB). These findings show that SC is already associated with PB in toddlerhood and suggest the importance of fostering social cognition competence from the early years, with a view to increasing children's propensity to engage in prosocial conduct.
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Affiliation(s)
- Elisa Brazzelli
- Lab for Developmental and Educational Studies in Psychology (https://www.labpse.it/en/), "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Alessandro Pepe
- Lab for Developmental and Educational Studies in Psychology (https://www.labpse.it/en/), "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Ilaria Grazzani
- Lab for Developmental and Educational Studies in Psychology (https://www.labpse.it/en/), "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
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25
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Khairnar R, DeMora L, Sandler HM, Lee WR, Villalonga-Olives E, Mullins CD, Palumbo FB, Bruner DW, Shaya FT, Bentzen SM, Shah AB, Malone S, Michalski JM, Dayes IS, Seaward SA, Albert M, Currey AD, Pisansky TM, Chen Y, Horwitz EM, DeNittis AS, Feng F, Mishra MV. Methodological Comparison of Mapping the Expanded Prostate Cancer Index Composite to EuroQoL-5D-3L Using Cross-Sectional and Longitudinal Data: Secondary Analysis of NRG/RTOG 0415. JCO Clin Cancer Inform 2022; 6:e2100188. [PMID: 35776901 DOI: 10.1200/cci.21.00188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare the predictive ability of mapping algorithms derived using cross-sectional and longitudinal data. METHODS This methodological assessment used data from a randomized controlled noninferiority trial of patients with low-risk prostate cancer, conducted by NRG Oncology (ClinicalTrials.gov identifier: NCT00331773), which examined the efficacy of conventional schedule versus hypofractionated radiation therapy (three-dimensional conformal external beam radiation therapy/IMRT). Health-related quality-of-life data were collected using the Expanded Prostate Cancer Index Composite (EPIC), and health utilities were obtained using EuroQOL-5D-3L (EQ-5D) at baseline and 6, 12, 24, and 60 months postintervention. Mapping algorithms were estimated using ordinary least squares regression models through five-fold cross-validation in baseline cross-sectional data and combined longitudinal data from all assessment periods; random effects specifications were also estimated in longitudinal data. Predictive performance was compared using root mean square error. Longitudinal predictive ability of models obtained using baseline data was examined using mean absolute differences in the reported and predicted utilities. RESULTS A total of 267 (and 199) patients in the estimation sample had complete EQ-5D and EPIC domain (and subdomain) data at baseline and at all subsequent assessments. Ordinary least squares models using combined data showed better predictive ability (lowest root mean square error) in the validation phase for algorithms with EPIC domain/subdomain data alone, whereas models using baseline data outperformed other specifications in the validation phase when patient covariates were also modeled. The mean absolute differences were lower for models using EPIC subdomain data compared with EPIC domain data and generally decreased as the time of assessment increased. CONCLUSION Overall, mapping algorithms obtained using baseline cross-sectional data showed the best predictive performance. Furthermore, these models demonstrated satisfactory longitudinal predictive ability.
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Affiliation(s)
- Rahul Khairnar
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Lyudmila DeMora
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | - Howard M Sandler
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - W Robert Lee
- Department of Radiation Oncology, Duke University, Durham, NC
| | - Ester Villalonga-Olives
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - C Daniel Mullins
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Francis B Palumbo
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | | | - Fadia T Shaya
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Soren M Bentzen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - Amit B Shah
- WellSpan Health-York Cancer Center, York, PA
| | - Shawn Malone
- Ottawa Hospital and Cancer Center, Ottawa, Ontario, Canada
| | - Jeff M Michalski
- Department of Radiation Oncology, Washington University, St Louis, MO
| | - Ian S Dayes
- Juravinski Cancer Center at Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | | | - Adam D Currey
- Zablocki VAMC and the Medical College of Wisconsin, Milwaukee, WI
| | - Thomas M Pisansky
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN
| | - Yuhchyau Chen
- Department of Radiation Oncology, University of Rochester, Rochester, NY
| | - Eric M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | - Felix Feng
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - Mark V Mishra
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
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26
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Kawagoe T. Executive failure hypothesis explains the trait-level association between motivation and mind wandering. Sci Rep 2022; 12:5839. [PMID: 35393489 PMCID: PMC8990005 DOI: 10.1038/s41598-022-09824-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
Mind wandering (MW) is commonly observable in daily life. Early studies established an association between motivation and MW at the trait level using a questionnaire survey. Considering that the mechanism of state-level association between them is known, this study was conducted to replicate the trait-level association and determine its possible mechanisms. Two independent samples were analysed using several questionnaires, which included motivation and MW. General one- and multi-dimensional scales were administered for both variables. Besides the successful replication of the significant association between motivation and MW at the trait level, we found that people with low levels of executive function experience high rates of spontaneous MW. This finding indicates that the underlying mechanism of trait-level association is the executive failure hypothesis, which postulates that a failure of executive control during task-related objectives evokes MW. Further, the motivation–MW relationship exhibits a different psychological basis at the state and trait levels.
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Affiliation(s)
- Toshikazu Kawagoe
- School of Humanities and Science, Kyushu Campus, Tokai University, Higashi-Ku, Toroku 9-1-1, Kumamoto, 862-8652, Japan.
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Rohner SL, Bernays F, Maercker A, Thoma MV. Salutary mechanisms in the relationship between stress and health: The mediating and moderating roles of Sense of Coherence—Revised. Stress Health 2022; 38:388-401. [PMID: 34448521 PMCID: PMC9291615 DOI: 10.1002/smi.3093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/05/2022]
Abstract
While chronic and acute stress are often associated with negative health, the sense of coherence-revised (SOC-R) is proposed to facilitate coping with stress and promote health. However, research is lacking on the specific mechanisms. Therefore, the current study aimed to investigate potential mediating and moderating mechanisms of SOC-R in the relationship between stress and health. Using a cross-sectional design, standardized questionnaires assessed SOC-R, acute (perceived) stress, early-life adversity (ELA; indicator for early-life chronic stress), mental and physical health, and satisfaction with life. Mediation and moderation analyses were conducted with N = 531 Irish adults (mean age: 59.5 years; 58.4% female). Regarding acute (perceived) stress, results showed that SOC-R and its Manageability subscale significantly mediated the association between perceived stress and mental health, and satisfaction with life. SOC-R and its Manageability subscale also significantly moderated the association between perceived stress and mental health. Regarding ELA, the Manageability subscale significantly mediated the association between ELA and mental health, and satisfaction with life; and the Balance subscale significantly mediated the association between ELA and physical health. SOC-R may provide a useful focus for stress-related research, with future longitudinal studies needed to examine SOC-R as a long-term modulating pathway between stress and health.
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Affiliation(s)
- Shauna L. Rohner
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
| | - Florence Bernays
- Department of Business AdministrationChair of Human Resource Management and LeadershipUniversity of ZürichZürichSwitzerland
| | - Andreas Maercker
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
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28
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Zhang HS, Lin J, Cheng X, Wang C, Wei X. Concurrent and longitudinal contributions of phonological awareness to early adolescent Chinese reading acquisition. The Journal of General Psychology 2022:1-17. [PMID: 35289722 DOI: 10.1080/00221309.2022.2047003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study investigated universal and language-specific phonological awareness in reading development among Chinese early adolescent students. Seventy-six children participated in this study and completed a series of reading tasks at two data collection points across Grades 5 and 6. In Grade 5, universal phonological awareness (syllable, onset, rhyme, and phoneme awareness), language-specific phonological awareness (tone awareness) as well as character recognition and production measurements were administered to the participants. Lexical inferencing ability was measured in Grade 6. Character recognition and lexical inference were coded as the outcome variables. Subsequent multiple regression analyses showed that Time 1 (Grade 5) language-universal onset and phoneme awareness predicted character recognition and production at Time 1. More strikingly, the study demonstrated that language-specific tone awareness exerted a longitudinal effect on later lexical inferencing ability after controlling for age and nonverbal intelligence. Results underscored both the universality and language specificity of phonological awareness and provided empirical evidence to substantiate the facilitative role of early language-specific psycholinguistic grain size in later reading performance.
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Affiliation(s)
| | | | | | | | - Xiaobao Wei
- East China University of Science and Technology
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29
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Al-Rawajfah OM, Al Hadid L, Madhavanprabhakaran GK, Francis F, Khalaf A. Predictors of effective clinical teaching - nursing educators' perspective. BMC Nurs 2022; 21:55. [PMID: 35255923 PMCID: PMC8900108 DOI: 10.1186/s12912-022-00836-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/01/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The clinical teaching is the core component of the nursing curriculum, the alarming pandemic rates brought uncertainty to clinical teaching, weighing the safety of patients, students, and faculty, which demanded essential modification in clinical teaching and resulted in challenges in relation to effective response to clinical teaching requirements. This study aimed to assess the effective clinical teaching from the nurse educators' perspective during the remote teaching that followed the COVID-19 pandemic. METHODS This study is a national Web-based descriptive study. Participants were recruited from five major Nursing Colleges in Oman. Descriptive and inferential as well as multiple linear regression analyses were conducted. RESULTS A total of 127 nurse educators completed the survey with mean age of 43.9 (SD = 6.9) years. The overall effective clinical teaching score was 54.4 (SD = 10.9) which is considered acceptable, although the nurse educators in Oman reported the highest score on the safety dimension of the effective clinical teaching. Furthermore, females, doctoral prepared nurse educators, and those who acted as preceptors reported higher effective clinical teaching levels compared to their counterparts. The regression analysis showed that age, gender, and attending infection control training are significant predictors of effective clinical teaching. CONCLUSION The paradigm shift in clinical teaching requires adequate measures including identification and appropriate training of clinical instructors and preceptors to meet clinical teaching demands in remote teaching. It is also important to take actions that promote and maintain the safety prioritization in bedside clinical teaching. These measures might positively impact on the nursing education process.
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Affiliation(s)
- O M Al-Rawajfah
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khoud, Muscat, Oman
| | - L Al Hadid
- Faculty of Nursing, Al Balqa Applied University, P.O. Box 206, Salt, 19117, Jordan
| | | | - F Francis
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khoud, Muscat, Oman
| | - A Khalaf
- College of Nursing, Sultan Qaboos University, P.O. Box 66, Al Khoud, Muscat, Oman. .,Faculty of Health Sciences, Kristianstad University, Elmetorpsvägen 15, SE-291 88, Kristianstad, Sweden.
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30
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Jian WS, Wang JY, Rahmanti AR, Chien SC, Hsu CK, Chien CH, Li YC, Chen CY, Chin YP, Huang CL. Voice-based control system for smart hospital wards: a pilot study of patient acceptance. BMC Health Serv Res 2022; 22:287. [PMID: 35236341 PMCID: PMC8892698 DOI: 10.1186/s12913-022-07668-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The smart hospital's concept of using the Internet of Things (IoT) to reduce human resources demand has become more popular in the aging society. OBJECTIVE To implement the voice smart care (VSC) system in hospital wards and explore patient acceptance via the Technology Acceptance Model (TAM). METHODS A structured questionnaire based on TAM was developed and validated as a research tool. Only the patients hospitalized in the VSC wards and who used it for more than two days were invited to fill the questionnaire. Statistical variables were analyzed using SPSS version 24.0. A total of 30 valid questionnaires were finally obtained after excluding two incomplete questionnaires. Cronbach's α values for all study constructs were above 0.84. RESULT We observed that perceived ease of use on perceived usefulness, perceived usefulness on user satisfaction and attitude toward using, and attitude toward using on behavioral intention to use had statistical significance (p < .01), respectively. CONCLUSION We have successfully developed the VSC system in a Taiwanese academic medical center. Our study indicated that perceived usefulness was a crucial factor, which means the system function should precisely meet the patients' demands. Additionally, a clever system design is important since perceived ease of use positively affects perceived usefulness. The insight generated from this study could be beneficial to hospitals when implementing similar systems to their wards.
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Affiliation(s)
- Wen-Shan Jian
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan. .,School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan. .,Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ju-Yu Wang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Annisa Ristya Rahmanti
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Shuo-Chen Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chun-Kung Hsu
- Information Technology Office, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-You Chen
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Information Technology Office, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yen-Po Chin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Biomedical Informatics, Harvard Medical School, Boston, USA.,Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - Chen-Ling Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
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31
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An Evaluation of a Virtual Food Safety Program for Low-Income Families: Applying the Theory of Planned Behavior. Foods 2022; 11:foods11030355. [PMID: 35159504 PMCID: PMC8834591 DOI: 10.3390/foods11030355] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Low-income families are reported to have a limited knowledge of food safety and resources to follow food safety practices compared with the rest of the population. This paper evaluated a virtual food safety educational program targeting food handlers in low-income families. Trained native speakers of English and Spanish delivered course materials in both languages. A total of 60 individuals participated in the program, with 30 participants in each language group. Most were female, and most had fewer than three children. After the program, participants’ food safety knowledge and self-reported safe food practice behavior scores increased significantly from 5.32 to 7.43 (out of 8.00) and from 24.78 to 29.30 (out of 35.00), respectively. The theory of planned behavior (TPB) was used to understand individuals’ behavior change intention of food safety practices. All the TPB constructs’ scores, including attitudes toward the behavior, perceived behavioral control, subjective norms, and behavior change intentions, were improved significantly; however, only the subjective norms and perceived behavioral control were significantly correlated with the behavior change intentions. This virtual educational program improved low-income individuals’ food safety knowledge and changed their food safety attitudes and behaviors, giving a path to develop and evaluate more virtual food safety educational programs in the future.
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McIntosh MJ. Conservative sample size for multiple regression models. COMMUN STAT-THEOR M 2021. [DOI: 10.1080/03610926.2021.2012198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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33
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Anderson SF. Power(ful) myths: misconceptions regarding sample size in quality of life research. Qual Life Res 2021; 31:2917-2929. [PMID: 34716528 DOI: 10.1007/s11136-021-03020-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Carefully selecting the sample size for a research study is one of the most fundamental ways to utilize resources in an ethical manner, maximize impact and replicability, and minimize research waste when investigating questions relevant to health-related quality of life (HRQOL). Despite an increased focus on sample size in the methodological literature, the topic has received limited attention in the HRQOL field, and there are still misconceptions that can weaken even well-intentioned sample size planning. This article aims to highlight common misconceptions, provide accessible and non-technical corrections to these misconceptions, and show how HRQOL researchers can benefit from a more nuanced understanding of sample size planning. METHOD Misconceptions were identified broadly through examples within the health, psychology, and HRQOL literatures. In examining these misconceptions, study-level (e.g., missing data, multilevel designs, multiple reported outcomes) and field-level (e.g., publication bias, replicability) issues relevant to HRQOL research were considered. RESULTS Misconceptions include: (a) researchers should use rules of thumb or the largest sample size possible, (b) sample size planning should always focus on power, (c) planned power = actual power, (d) there is only one level of power per study, and (e) power is only relevant for the individual researcher. Throughout the article, major themes linked to these misconceptions are mapped onto recent HRQOL studies to make the connections more tangible. CONCLUSION By clarifying several challenges and misconceptions regarding sample size planning and statistical power, HRQOL researchers will have the tools needed to augment the research literature in effective and meaningful ways.
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Affiliation(s)
- Samantha F Anderson
- Department of Psychology, Arizona State University, 950 S. McAllister Ave, Tempe, AZ, 85287, USA.
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34
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Spektor E, Fietze I, Poluektov MG. Periodic Limb Movements Syndrome in Patients With Cerebral Small Vessel Disease: Protocol for a Prospective Observational Study. Front Neurol 2021; 12:700151. [PMID: 34646228 PMCID: PMC8503532 DOI: 10.3389/fneur.2021.700151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Cerebrovascular diseases are the leading cause of cognitive decline and dementia. Therefore, the investigation of the potential ways to slow down the disease progression is an important research field. Periodic limb movements in sleep (PLMS) are known to be associated with transient changes in heart rate and blood pressure. These changes might influence the course of cerebral small vessel disease (cSVD). Nevertheless, the clinical significance of PLMS, particularly its influence on cardiovascular diseases course, is still controversial and underinvestigated. Methods/design: Patients from 60 to 75 years old diagnosed with cSVD will undergo nocturnal polysomnography. Subjects with apnea/hypopnea index under 5 will be enrolled. Sleep quality and daytime functioning will be assessed at baseline with self-reported questionnaires. Brain MRI and cognitive assessment will be performed at baseline and in the 2-year follow-up. Progression of cSVD markers and cognitive dysfunction will be compared between patients with PLMS index (PLMI) equal to or more than 15 movements per hour of sleep and controls (PLMI <15/h). Discussion: The negative role of PLMS in cSVD progression and related cognitive decline is expected. We suppose that patients with PLMS tend to worsen in cognitive performance more rapidly than age-, gender-, and comorbidity-matched controls. We also expect them to have more rapid white matter hyperintensities and other cSVD marker progression. The limitations of the study protocol are the short follow-up period, the absence of a treatment group, and inability to make a conclusion about causality.
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Affiliation(s)
- Ekaterina Spektor
- Department of Sleep Medicine, Chair of Neurology and Neurosurgery, University Clinical Hospital No. 3, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ingo Fietze
- Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,The Fourth People's hospital of Guangyuan, Guangyuan City, China.,The Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Mikhail G Poluektov
- Department of Sleep Medicine, Chair of Neurology and Neurosurgery, University Clinical Hospital No. 3, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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35
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Mahajan P, Patil V. Making it normal for 'new' enrollments: effect of institutional and pandemic influence on selecting engineering institutions under the COVID-19 pandemic situation. Heliyon 2021; 7:e08217. [PMID: 34693065 PMCID: PMC8525191 DOI: 10.1016/j.heliyon.2021.e08217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/25/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has forced Indian engineering institutions (EIs) to bring their previous half-shut shades completely down. Attracting new admissions to EI campuses during the pandemic have become a 'now or never' situation for EIs. During crisis situations, EIs have struggled to return to their normal track. The pandemic has drastically changed students' behavior and family preferences due to mental stress and the emotional life associated with it. Consequently, it has become the need of hour to examine the choice characteristics influencing the selection of EIs during the COVID-19 pandemic. The purpose of this study is to critically examine institutional influence and pandemic influence that affects students' choice about engineering institutions (EIs) during COVID-19 pandemic situation and consequently to study relationships between them. A quantitative research, conducted through a self-report survey composed by a closed-ended structured questionnaire was performed on the students who were recently enrolled in the EIs (academic year 2020-2021) belonging to North Maharashtra region of India during the pandemic. The findings of this study have revealed that institutional and pandemic influence have directed EI choice under the COVID-19 pandemic. It is also found that pandemic influence is positively affected by institutional influence. The study demonstrated that EIs can attract new enrollments by repositioning their institutional characteristics that regulate pandemic influence. The study can be a measuring tool for policy makers to attract new enrollments under pandemic situation.
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Affiliation(s)
| | - Vaishali Patil
- RCPET's, Institute of Management Research and Development, Shirpur, India
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36
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Imamura Y, Chebib N, Ohta M, Maria Schulte-Eickhoff R, Mekki M, Schimmel M, Arakawa I, Graf C, Sato Y, Müller F. Validation of a novel diagnostic tool for decreased tongue pressure. J Oral Rehabil 2021; 48:1219-1225. [PMID: 34425018 PMCID: PMC9291622 DOI: 10.1111/joor.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Reduced tongue pressure may render eating and swallowing difficult. The purpose of this study was to investigate whether the tongue training device can also be used as a diagnostic device and whether its sensitivity and specificity are equal to the numerical tongue pressure measuring device. MATERIAL AND METHODS The target group is patients aged 70 years and over who are hospitalised for rehabilitation. Tongue pressure was measured by both, a tongue pressure measuring instrument and a tongue training tool. The diagnosis of the reduced tongue pressure was made with the tongue pressure measuring instrument and set the verified with the novel tongue training tool. RESULTS Sixty-two participants were included in the study. Forty-five were classified by the tongue pressure measuring device and 53 by the tongue training device as 'low tongue pressure'. Spearman correlation confirmed a positive correlation between the tongue pressure measuring device and the tongue training device rs = 0.800, p = 0.01 level (2-tailed). The tongue training device test identified sensitivity was 100%, and its specificity was 52.9%. The AUC of the ROC curve is 0.901. CONCLUSION The tongue training device seems a simple, safe and readily available alternative to the tongue pressure measuring device for the diagnosis of low tongue pressure, with an excellent sensitivity and very good specificity.
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Affiliation(s)
- Yoshiki Imamura
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan.,Yoshiki Imamura Meikai University, School of Dentistry, Division of Fixed Prosthodontics, Saitama, Japan
| | - Najla Chebib
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Midori Ohta
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Removable Prosthodontics & Gerodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Mustapha Mekki
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Itsuka Arakawa
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, University Hospitals Geneva, Geneva, Switzerland
| | - Yuji Sato
- Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Mukhtar A, Abdelghany M, Hasanin A, Hamimy W, Abougabal A, Nasser H, Elsayed A, Ayman E. The Novel Use of Point-of-Care Ultrasound to Predict Resting Energy Expenditure in Critically Ill Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1581-1589. [PMID: 33085099 DOI: 10.1002/jum.15538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/15/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Accurate estimation of a critically ill patient's caloric requirements is essential for a proper nutritional plan. This study aimed to evaluate the use of point-of-care ultrasound (US) to predict the resting energy expenditure (REE) in critically ill patients. METHODS In 69 critically ill patients, we measured the REE using indirect calorimetry (REE_IC), muscle layer thicknesses (MLTs), and cardiac output (CO). Muscle thickness was measured at the biceps and the quadriceps muscles. Patients were randomly split into a model development group (n = 46) and a cross-validation group (n = 23). In the model development group, a multiple regression analysis was applied to generate REE using US (REE_US) values. In the cross-validation group, REE was calculated by the REE_US and the resting energy expenditure using the Harris-Benedict equation (REE_HB), and both were compared to the REE_IC. RESULTS In the model development group, the REE_US was predicted by the following formula: predicted REE_US (kcal/d) = 206 + 173.5 × CO (L/min) + 137 × MLT (cm) - 230 × (women = 1; men = 0) (R2 = 0.8; P < .0001). In the cross-validated group, the REE_IC and REE_US values were comparable (mean difference, -66 [-3.3%] kcal/d; P = .14). However, the difference between the mean REE_IC and the mean REE_HB was 455.8 (26%) kcal/d (P < .001). According to a Bland-Altman analysis, the REE_US agreed well with the REE_IC, whereas the REE_HB did not. CONCLUSIONS Resting energy expenditure could be estimated from US measurements of MLTs and CO. Our point-of-care US model explains 80% of the change in the REE in critically ill patients.
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Affiliation(s)
- Ahmed Mukhtar
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Abdelghany
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Hasanin
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
| | - Walid Hamimy
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
| | - Ayman Abougabal
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
| | - Haytham Nasser
- Department of Radiology, Ain Shams University, Cairo, Egypt
| | - Allam Elsayed
- Department of Radiology, Ain Shams University, Cairo, Egypt
| | - Eslam Ayman
- Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
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Testing Kumpfer’s Resilience Model Among Adults With Serious Mental Illness. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211006770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Having a serious mental illness (SMI) is often associated with significant adversities, and people respond differently to adversities. The existing research supports that people with SMI can achieve and maintain positive life outcomes despite experiencing adversities. Resilience, the ability to cope with (or bounce back quickly from) crisis, can help buffer the negative effects of various types of adversities, including chronic illness and disability, and facilitate the psychosocial adaptation process to SMI. Kumpfer’s resilience model, a person-process-context framework, has been widely used to conceptualize, and assess for, resilience in various populations, including people with chronic illnesses and disabilities. However, the research in resilience among people with SMI is very limited. The purpose of this study was to empirically assess the utility of Kumpfer’s resilience model and its proposed predictive components for conceptualizing the adaptation process to SMI. One hundred forty-four participants completed a Qualtrics survey containing demographic questions and a series of validated instruments representing the major components of Kumpfer’s resilience model. Hierarchical regression analysis was used to analyze the data, and the final model explained 71% of the variance of the dependent variable—adaptation to disability. Avoidance coping, internalized stigma, and optimism were significant independent predictors of adaptation to disability. This study supports the utilization of Kumpfer’s resilience model to conceptualize the adaptation to disability process among people with SMI. Implications for rehabilitation counseling practices are discussed.
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Wang YA, Rhemtulla M. Power Analysis for Parameter Estimation in Structural Equation Modeling: A Discussion and Tutorial. ADVANCES IN METHODS AND PRACTICES IN PSYCHOLOGICAL SCIENCE 2021. [DOI: 10.1177/2515245920918253] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the widespread and rising popularity of structural equation modeling (SEM) in psychology, there is still much confusion surrounding how to choose an appropriate sample size for SEM. Currently available guidance primarily consists of sample-size rules of thumb that are not backed up by research and power analyses for detecting model misspecification. Missing from most current practices is power analysis for detecting a target effect (e.g., a regression coefficient between latent variables). In this article, we (a) distinguish power to detect model misspecification from power to detect a target effect, (b) report the results of a simulation study on power to detect a target regression coefficient in a three-predictor latent regression model, and (c) introduce a user-friendly Shiny app, pwrSEM, for conducting power analysis for detecting target effects in structural equation models.
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Affiliation(s)
- Y. Andre Wang
- Department of Psychology, University of California, Davis
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Lannoy S, Duka T, Carbia C, Billieux J, Fontesse S, Dormal V, Gierski F, López-Caneda E, Sullivan EV, Maurage P. Emotional processes in binge drinking: A systematic review and perspective. Clin Psychol Rev 2021; 84:101971. [PMID: 33497920 PMCID: PMC8275688 DOI: 10.1016/j.cpr.2021.101971] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/10/2020] [Accepted: 01/08/2021] [Indexed: 12/24/2022]
Abstract
Binge drinking is a widespread alcohol consumption pattern commonly engaged by youth. Here, we present the first systematic review of emotional processes in relation to binge drinking. Capitalizing on a theoretical model describing three emotional processing steps (emotional appraisal/identification, emotional response, emotional regulation) and following PRISMA guidelines, we considered all identified human studies exploring emotional abilities among binge drinkers. A literature search was conducted in PubMed, Scopus, and PsychINFO, and a standardized methodological quality assessment was performed for each study. The main findings offered by the 43 studies included are: 1) regarding emotional appraisal/identification, binge drinking is related to heightened negative emotional states, including greater severity of depressive and anxiety symptoms, and have difficulties in recognizing emotional cues expressed by others; 2) regarding emotional response, binge drinkers exhibit diminished emotional response compared with non-binge drinkers; 3) regarding emotional regulation, no experimental data currently support impaired emotion regulation in binge drinking. Variability in the identification and measurement of binge drinking habits across studies limits conclusions. Nevertheless, current findings establish the relevance of emotional processes in binge drinking and set the stage for new research perspectives to identify the nature and extent of emotional impairments in the onset and maintenance of excessive alcohol use.
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Affiliation(s)
- Séverine Lannoy
- Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, California, USA; Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Theodora Duka
- Behavioral and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, UK; Sussex Addiction and Intervention Centre, University of Sussex, Brighton, UK
| | - Carina Carbia
- APC Microbiome Ireland, Biosciences Building, University College Cork, Cork, Ireland
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Sullivan Fontesse
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Valérie Dormal
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Fabien Gierski
- Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, Reims, France; Psychiatry and Addictology Departments, CHU de Reims & EPSM Marne, Reims, France
| | - Eduardo López-Caneda
- Psychological Neuroscience Laboratory, Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus, Gualtar, Braga, Portugal
| | - Edith V Sullivan
- Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, California, USA
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
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Ranieri V, Sem Stoltenberg A, Pizzo E, Montaldo C, Bizzi E, Edwards S, Kamboj S. COVID-19 welbeing study: a protocol examining perceived coercion and psychological well-being during the COVID-19 pandemic by means of an online survey, asynchronous virtual focus groups and individual interviews. BMJ Open 2021; 11:e043418. [PMID: 33495259 PMCID: PMC7839305 DOI: 10.1136/bmjopen-2020-043418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has resulted in many countries applying restrictive measures, such as lockdown, to contain and prevent further spread. The psychological impact of lockdown and working as a healthcare worker on the frontline has been chronicled in studies pertaining to previous infectious disease pandemics that have reported the presence of depressive symptoms, anxiety, insomnia, and post-traumatic stress symptoms. Potentially linked to psychological well-being and not yet studied is the possibility that lockdown and working on the frontline of the pandemic are associated with perceptions of coercion. METHODS AND ANALYSIS The present study aimed to examine perceived coercion in those who have experienced COVID-19-related lockdown and/or worked as a frontline healthcare worker across three European countries. It aimed to describe how such perceptions may impact on psychological well-being, coping and post-traumatic growth. It will employ an explanatory mixed-methods research methodology consisting of an online survey and online asynchronous virtual focus groups (AVFGs) and individual interviews. χ2 tests and analyses of variance will be used to examine whether participants from different countries differ according to demographic factors, whether there are differences between cohorts on perceived coercion, depression, anxiety and post-traumatic growth scores. The relationship between coercion and symptoms of distress will be assessed using multiple regression. Both the AVFGs and the narrative interviews will be analysed using thematic narrative analysis. ETHICS AND DISSEMINATION The study has been approved by University College London's Research Ethics Committee under Project ID Number 7335/004. Results will be disseminated by means of peer-reviewed publications and at national and/or international conferences.
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Affiliation(s)
- Veronica Ranieri
- Psychology and Language Sciences, University College London, London, UK
- Science and Technology Studies, University College London, London, UK
| | | | - Elena Pizzo
- Applied Health Research, University College London, London, UK
| | - Chiara Montaldo
- Ambulatorio di Medicina Tropicale e del Viaggiatore, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Lazio, Italy
| | - Emanuele Bizzi
- Dipartimento di Medicina Interna, San Pietro Fatebenefratelli Hospital, Rome, UK
| | - Sarah Edwards
- Science and Technology Studies, University College London, London, UK
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Wu W, Wang W, Yuan Y, Lin L, Tan Y, Yang J, Dai L, Wang Y. Knowledge, attitude and practice concerning healthcare-associated infections among healthcare workers in Wuhan, China: cross-sectional study. BMJ Open 2021; 11:e042333. [PMID: 33402407 PMCID: PMC7786794 DOI: 10.1136/bmjopen-2020-042333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To assess the knowledge, attitude and practice (KAP) concerning healthcare-associated infections (HAIs) among healthcare givers and to identify the factors influencing KAP. DESIGN This was a hospital-based, cross-sectional study. SETTING Two public hospitals in Wuhan, central China. PARTICIPANTS Participants were recruited among healthcare workers (HCWs) of one general hospital and one children's hospital in Wuhan city between 1 June and 30 September 2019. PRIMARY AND SECONDARY OUTCOME MEASURES The outcomes were KAPs concerning HAIs. RESULTS Data from 455 HCWs were included in the final data analysis. The mean scores of KAP and total KAP were 15.67±3.32, 25.00±2.75, 43.44±5.15 and 84.76±6.72, respectively. The following factors were significantly associated with the total KAP score concerning HAIs, explaining 61% of the variance (p<0.001): gender (β=2.36, 95% CI 1.11 to 4.40), age (β=6.65, 95% CI 5.07 to 7.74), position (β=7.02, 95% CI 3.88 to 8.45), type of employment (β=-1.08, 95% CI -2.08 to -0.07), with HAI education within last year (β=-2.98, 95% CI -4.23 to -1.72), with invasive operation authority (β=-4.22, 95% CI -5.46 to -2.99), antibacterial drug training (β=-4.38, 95% CI -5.45 to -3.31) and with antibacterial drug training and clinical consultation (β=-4.35, 95% CI -5.38 to -3.32). CONCLUSION The controllable factors identified in this study can be used by hospital managers to implement measures that improve KAP among HCWs. Moreover, these measures should be customised, based on uncontrollable factors to suit the specific characteristics of medical staff and to improve KAP. Training programmes should be designed for medical workers to increase their awareness of HAIs and to foster positive attitudes and practices.
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Affiliation(s)
- Wenwen Wu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, Hubei, China
| | - Wenru Wang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yufeng Yuan
- Department of Nosocomial Infection Management, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Likai Lin
- Institute of Hospital Management, Wuhan University, Wuhan, Hubei, China
| | - Yibin Tan
- Department of Nosocomial Infection Management, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Jinru Yang
- School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Li Dai
- Department of Cardiovascular Medicine, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Ying Wang
- Department of Nosocomial Infection Management, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
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Ichinose M, Minakata Y, Motegi T, Takahashi T, Seki M, Sugaya S, Hayashi N, Kuwahira I. A Non-Interventional, Cross-Sectional Study to Evaluate Factors Relating to Daily Step Counts and Physical Activity in Japanese Patients with Chronic Obstructive Pulmonary Disease: STEP COPD. Int J Chron Obstruct Pulmon Dis 2020; 15:3385-3396. [PMID: 33376319 PMCID: PMC7764701 DOI: 10.2147/copd.s277782] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/24/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose Patients with chronic obstructive pulmonary disease (COPD) have decreased physical activity (PA) compared with healthy adults. As lower PA is associated with increased mortality, improving PA is an important objective for COPD management. This large-scale, multicenter, non-interventional, cross-sectional study examined the activity status of COPD patients in Japan and explored factors related to PA. Patients and Methods Outpatients aged ≥40 years with confirmed COPD diagnosis and pulmonary function test data were enrolled. Primary study outcomes were measurement of daily steps (over 14 consecutive days, using an activity monitor), assessment of activity time by activity intensity (using metabolic equivalents [METs]), and evaluation of correlation between PA and patient characteristics. Secondary outcomes included further investigation of the influence of patient characteristics on PA. Results Data from 417 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I (29.5%), II (43.9%), III (23.5%), and IV (3.1%) were evaluated. Median (Q1, Q3) daily step count was 3440.8 (1831.3, 5709.3). Median (Q1, Q3) durations of PA at ≥3 (moderate-to-vigorous) and ≥2 METs (light-to-vigorous) were 18.7 (6.5, 41.3) and 186.9 (126.9, 259.2) minutes, respectively. For >30% of patients, time spent in ≥3 METs activity was ≤10 minutes. Unemployment was significantly correlated with reduced activity time (≥3 and ≥2 METs) and step count. Severe GOLD stage was significantly correlated with reduced activity time (≥3 and ≥2 METs). High modified Medical Research Council (mMRC) dyspnea score was significantly correlated with reduced activity time (≥3 METs) and step count. Patients tended to overestimate the time spent in activities requiring ≥2 METs in their subjective reports compared with activity monitor measurements. Conclusion Reduced PA was observed in the Japanese COPD patients with the majority of them being GOLD stage I/II. Employment status, GOLD stage, and mMRC dyspnea score could help identify patients at risk of reduced PA. Clinical Trial Registration NCT03642613 (ClinicalTrials.gov); UMIN000032962 (UMIN-CTR, umin.ac.jp).
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Affiliation(s)
| | - Yoshiaki Minakata
- Respiratory Medicine, National Hospital Organization Wakayama Hospital, Wakayama 644-0044, Japan
| | - Takashi Motegi
- Respiratory Care Clinic Tokyo, Institute of Clinical Respirology, Tokyo 104-0031, Japan
| | - Tsuneyuki Takahashi
- Department of Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Sendai 984-8560, Japan
| | - Munehiro Seki
- Medical Department, AstraZeneca K.K., Osaka 530-0011, Japan
| | - Satoko Sugaya
- Medical Department, AstraZeneca K.K., Osaka 530-0011, Japan
| | - Nobuya Hayashi
- Biometrics Department, AstraZeneca K.K., Osaka 530-0011, Japan
| | - Ichiro Kuwahira
- Department of Pulmonary Medicine, Tokai University Tokyo Hospital, Tokyo 151-0053, Japan
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Shreeves M, Gugerty L, Moore D. Individual differences in strategy use and performance during fault diagnosis. COGNITIVE RESEARCH-PRINCIPLES AND IMPLICATIONS 2020; 5:49. [PMID: 33095326 PMCID: PMC7584695 DOI: 10.1186/s41235-020-00250-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022]
Abstract
Background Research on causal reasoning often uses group-level data analyses that downplay individual differences and simple reasoning problems that are unrepresentative of everyday reasoning. In three empirical studies, we used an individual differences approach to investigate the cognitive processes people used in fault diagnosis, which is a complex diagnostic reasoning task. After first showing how high-level fault diagnosis strategies can be composed of simpler causal inferences, we discussed how two of these strategies—elimination and inference to the best explanation (IBE)—allow normative performance, which minimizes the number of diagnostic tests, whereas backtracking strategies are less efficient. We then investigated whether the use of normative strategies was infrequent and associated with greater fluid intelligence and positive thinking dispositions and whether normative strategies used slow, analytic processing while non-normative strategies used fast, heuristic processing. Results Across three studies and 279 participants, uses of elimination and IBE were infrequent, and most participants used inefficient backtracking strategies. Fluid intelligence positively predicted elimination and IBE use but not backtracking use. Positive thinking dispositions predicted avoidance of backtracking. After classifying participants into groups that consistently used elimination, IBE, and backtracking, we found that participants who used elimination and IBE made fewer, but slower, diagnostic tests compared to backtracking users. Conclusions Participants’ fault diagnosis performance showed wide individual differences. Use of normative strategies was predicted by greater fluid intelligence and more open-minded and engaged thinking dispositions. Elimination and IBE users made the slow, efficient responses typical of analytic processing. Backtracking users made the fast, inefficient responses suggestive of heuristic processing.
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Affiliation(s)
- Michael Shreeves
- Psychology Department, Clemson University, Clemson, USA. .,Arizona State University at Lake Havasu City, 100 University Way, Lake Havasu City, AZ, 86403, USA.
| | - Leo Gugerty
- Psychology Department, Clemson University, Clemson, USA
| | - DeWayne Moore
- Psychology Department, Clemson University, Clemson, USA
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O'Connor EE, Holly LE, Chevalier LL, Pincus DB, Langer DA. Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms. J Clin Psychol 2020; 76:1390-1407. [PMID: 32060945 PMCID: PMC7282941 DOI: 10.1002/jclp.22941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Parental accommodation contributes to the maintenance of child anxiety and related symptoms. The current study examines the contributions of parent and child factors to parental accommodation in a sample of anxious youth. METHODS Sixty-four treatment-seeking youth (6-16 years) and their mothers, as well as a subset of fathers (N = 41) reported on parental accommodation, parental distress and emotion regulation, child psychopathology, child externalizing behaviors, and child intolerance of uncertainty. RESULTS Parental accommodation was not related to parental distress or emotion regulation. Parents who viewed their child as being more symptomatic (e.g., anxious, externalizing, and intolerant of uncertainty) were more likely to engage in accommodation. For mothers, child anxiety and externalizing symptoms were notable predictors of accommodation. CONCLUSIONS Parent perceptions of child symptomology is an important factor significantly related to accommodation behaviors. This finding can be used to inform programming designed to target parental responses to child anxiety and related disorders.
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Affiliation(s)
- Erin E O'Connor
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lindsay E Holly
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lydia L Chevalier
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Donna B Pincus
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - David A Langer
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
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Lee SY, Shim YJ, Han JH, Song JJ, Koo JW, Oh SH, Lee S, Oh DY, Choi BY. The molecular etiology of deafness and auditory performance in the postlingually deafened cochlear implantees. Sci Rep 2020; 10:5768. [PMID: 32238869 PMCID: PMC7113281 DOI: 10.1038/s41598-020-62647-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/02/2020] [Indexed: 11/09/2022] Open
Abstract
Recent advances in molecular genetic testing (MGT) have improved identification of genetic aetiology of candidates for cochlear implantation (CI). However, whether genetic information increases CI outcome predictability in post-lingual deafness remains unclear. Therefore, we evaluated the outcomes of CI with respect to genetic aetiology and clinical predictors by comparing the data of study subjects; those with an identified genetic aetiology (GD group), and those without identifiable variants (GUD group). First, we identified the genetic aetiology in 21 of 40 subjects and also observed genetic etiologic heterogeneity. The GD group demonstrated significantly greater improvement in speech perception scores over a 1-year period than did the GUD group. Further, inverse correlation between deafness duration and the 1-year improvement in speech perception scores was tighter in the GD group than in the GUD group. The weak correlation between deafness duration and CI outcomes in the GUD group might suggest the pathophysiology underlying GUD already significantly involves the cortex, leading to lesser sensitivity to further cortex issues such as deafness duration. Under our MGT protocol, the correlation between deafness duration and CI outcomes were found to rely on the presence of identifiable genetic aetiology, strongly advocating early CI in individual with proven genetic aetiologies.
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Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ye Ji Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - Jin-Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Seungmin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Doo-Yi Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Fischer T, Stumpf P, Reinhardt G, Schwarz PEH, Timpel P. Video-based smartphone app ('VIDEA bewegt') for physical activity support in German adults: a study protocol for a single-armed observational study. BMJ Open 2020; 10:e034027. [PMID: 32234743 PMCID: PMC7170646 DOI: 10.1136/bmjopen-2019-034027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/06/2019] [Accepted: 01/22/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Insufficient physical activity is one of the most important risk factors for non-communicable diseases. Physical activity should therefore be intensively promoted in all age groups. Several trials suggest that it can be effectively increased through smartphone interventions.However, few of the smartphone-interventions available on the market have been scientifically evaluated. Therefore, the described study aims to assess the short-term and long-term effects of the smartphone intervention 'VIDEA bewegt' to increase physical activity. The trial is designed as a single-armed observational trial to assess effects under real-life conditions. METHODS AND ANALYSIS The intervention consists of the smartphone-application 'VIDEA bewegt', which is a video-based preventative programme to improve physical activity in everyday life. The application contains several features and components including educational videos, documentation of activity and motivational exercises. A sample size of at least 106 participants is aimed for.The primary objective of this study is to determine the effect of the application on physical activity in German adults. Secondary objectives are to evaluate the self-efficacy, health-related quality of life and usability of 'VIDEA bewegt'.Data collection is based on online questionnaires, as well as system-internal recorded data.Changes of outcomes from baseline to programme completion and follow-up will be calculated. ETHICS AND DISSEMINATION The Ethics Committee of the Technical University Dresden approved the study on 25 May 2019 (EK 272062019). All data are processed anonymously and stored on servers only accessible by authorised personnel. The results of the study and the results of the usability test are aimed to be published in a scientific journal. TRIAL REGISTRATION NUMBER German Clinical Trials Registry (DRKS00017392).
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Affiliation(s)
- Tillmann Fischer
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Paul Stumpf
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gesine Reinhardt
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter E H Schwarz
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Massouh F, Martin R, Chan B, Ma J, Patel V, Geary MP, Laffey JG, Wijeysundera DN, Abdallah FW. Is Activity Tracker-Measured Ambulation an Accurate and Reliable Determinant of Postoperative Quality of Recovery? A Prospective Cohort Validation Study. Anesth Analg 2020; 129:1144-1152. [PMID: 30379677 DOI: 10.1213/ane.0000000000003913] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Quality of recovery (QOR) instruments measure patients' ability to return to baseline health status after surgery. Whether, and the extent to which, postoperative ambulation contributes to QOR is unclear, in part due to the lack of valid tools to measure ambulation in clinical settings. This cohort study of the cesarean delivery surgical model examines the accuracy and reliability of activity trackers in quantifying early postoperative ambulation and investigates the correlation between ambulation and QOR. METHODS A prospective cohort of 200 parturients undergoing cesarean delivery between July 2015 and June 2017 was fitted with wrist-worn activity trackers immediately postpartum. The trackers were collected 24 hours later, along with QOR assessments (QoR-15 scale). The relationship between QOR and various covariates, including ambulation, was explored using multivariable linear regression and Spearman correlation (ρ). Forty-eight parturients fitted with 2 trackers also completed a walk exercise accompanied by a step-counting assessor, to evaluate accuracy, inter-, and intradevice reliability using interclass correlation (ICC). RESULTS Compared to step counting, activity trackers had high accuracy (ICC = 0.93) and excellent inter- and intradevice reliability (ICC = 0.98 and 0.96, respectively). Correlation analysis suggested that early ambulation is moderately correlated with postcesarean QoR-15 scores, with a ρ (95% confidence interval) equivalent to 0.56 (0.328-0.728). Regression analysis suggested that ambulation is a determinant of postcesarean QoR-15 scores, with an effect estimate (95% confidence interval) equivalent to 0.002 (0.001-0.003). Ambulation was also associated with all QoR-15 domains, except psychological support. The patient's acceptable symptom state (subjective threshold for good ambulation) in the first 24 hours was 287 steps. CONCLUSIONS This study demonstrated the accuracy and reliability of activity trackers in measuring ambulation in clinical settings and suggested that postoperative ambulation is a determinant of postoperative QOR. A hypothetical implication of our findings is that interventions that improve ambulation may also help to enhance QOR, but further research is needed to establish a causal relationship.
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Affiliation(s)
- Faraj Massouh
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Martin
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Bokman Chan
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Julia Ma
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vikita Patel
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.,Department of Interdisciplinary Medical Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Michael P Geary
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
| | - John G Laffey
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, School of Medicine, National University of Ireland, Galway, Ireland
| | - Duminda N Wijeysundera
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia and Pain Management, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Faraj W Abdallah
- From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Hiemstra LA, Kerslake SA, Lafave MR. Influence of Risky Pathoanatomy and Demographic Factors on Clinical Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction: A Regression Analysis. Am J Sports Med 2019; 47:2904-2909. [PMID: 31411896 DOI: 10.1177/0363546519866452] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Multiple studies have demonstrated that a number of demographic and pathoanatomic characteristics are associated with patellofemoral instability, recurrence of instability, and less satisfactory results following medial patellofemoral ligament reconstruction (MPFL-R). Despite the growing volume of research, the relationship of risk factors to patient-reported outcome after MPFL-R is unclear. PURPOSE To determine if certain pathoanatomic and demographic factors predict disease-specific quality-of-life outcome after isolated MPFL-R for symptomatic patellofemoral instability. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS The study analyzed 224 isolated MPFL-Rs. Demographic data were collected, including age at first dislocation, sex, and presence of bilateral instability. Pathoanatomic risk factors included the presence of high-grade trochlear dysplasia, tibial tubercle-trochlear groove (TT-TG) distance, patella alta ratio, Beighton score, and patellar tilt. Other factors included femoral tunnel position accuracy and WARPS/STAID score. Descriptive analyses were conducted, followed by calculation of individual Spearman rank correlation coefficients for the predictor variables versus the Banff Patellofemoral Instability Instrument (BPII) scores. A multivariable regression with stepwise selection was employed to establish the final model predicting BPII score, with all significant variables for alpha ≤ .05 included in the final model. RESULTS The cohort of 224 patients included 66 (29.5%) males and 158 (70.5%) females, with a mean age of 24.1 years and a mean body mass index of 23.9 kg/m2. The mean age of first patellar dislocation was 15.7 years, and 41.4% of patients had bilateral instability. Pathoanatomic variables within the cohort included the following: high-grade trochlear dysplasia = 41%; mean TT-TG = 14.6 mm, with 16.8% of patients demonstrating a TT-TG ≥18 mm; mean Caton-Deschamps ratio = 1.09, with 22% of patients demonstrating a ratio ≥1.2; and positive Beighton score = 37.5%. The mean BPII score at postoperative 2 years was 67.1 out of 100. A stepwise elimination in the regression model demonstrated no statistically significant 3- or 2-way relationships. Assessment of individual variables indicated that bilateral symptoms (P = .004), higher age at first dislocation (P = .024), and femoral tunnel position >10 mm from the Schöttle point (P = .042) were statistically significant predictors of lower quality-of-life scores. The R2 value for the regression analysis model was 0.07. CONCLUSION In this large cohort of patients undergoing isolated MPFL-R for symptomatic lateral patellofemoral instability, a multivariable forward stepwise regression demonstrated that bilateral symptoms, femoral tunnel position, and age at first dislocation were statistically significant predictors of lower postoperative BPII scores. No anatomic risk factors were predictive of quality-of-life outcome score 2 years after MPFL-R surgery. The R2 value indicated that there were many other important contributing factors affecting BPII outcome scores than those explored in this study.
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Affiliation(s)
- Laurie A Hiemstra
- Banff Sport Medicine, Banff, Canada.,Department of Surgery, University of Calgary, Calgary, Canada
| | | | - Mark R Lafave
- Department of Physical Education and Recreation Studies, Mount Royal University, Calgary, Canada
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Brinkman M, Barten D, Pisters M, Verheij R. Current use of PROMs and factors associated with their use in patients with nonspecific low back pain. Learn Health Syst 2019; 3:e10194. [PMID: 31641686 PMCID: PMC6802530 DOI: 10.1002/lrh2.10194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 04/18/2019] [Accepted: 05/14/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Patient-related outcome measures (PROMs) can guide clinicians in providing evidence-based treatment and have the potential to empower patients, support clinical decision making, and improve quality of care. In order to make the information coming from PROMs useful, it is important to know to what extent the use of PROMs is biased in any way. Therefore, we assessed (a) the current level of use of PROMs among primary care physiotherapists and (b) which factors on the patient level, therapist level, and primary care practice level are associated with the use of PROMs in patients with nonspecific low back pain (LBP). DESIGN An observational study based on electronic health record data recorded routinely in Nivel Primary Care Database. PARTICIPANTS A total of 2916 patients aged 18 years or older with nonspecific LBP consulting a primary care physiotherapist. METHODS Multilevel logistic regression analyses were used to identify factors at the level of the patient, physiotherapist, and primary care practice, which may affect the use of PROMs. RESULTS PROMs were used in 46% of the patients, by 72% of the physiotherapists, and in 71% of the physiotherapy practices. None of the included independent variables were associated with the use of PROMs. Only 1% of the variance was explained by the final model. CONCLUSION This study shows that the use of PROMs is mostly dependent on characteristics of patients. However, we did not succeed in identifying characteristics of patients that are responsible for that. This could mean that therapists randomly choose patients for PROMs or that there is some other unmeasured patient characteristic determining the use of PROMs. The former explanation implies no systematic bias in the information resulting from PROMs. More research is needed to examine possible related factors to improve implementation and a more frequent use of PROMs in the future.
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Affiliation(s)
- Marjon Brinkman
- Nivel Primary Care Database (Nivel‐PCD)Netherlands Institute for Health Services Research (NIVEL)UtrechtNetherlands
| | - Di‐Janne Barten
- Research Group Innovation of Human Movement CareUniversity of Applied Sciences UtrechtUtrechtNetherlands
| | - Martijn Pisters
- Department of Health Innovation and TechnologyFontys University of Applied SciencesEindhovenNetherlands
- Center for Physical Therapy Research and Innovation in Primary CareJulius Health Care CentersUtrechtNetherlands
- Physical Therapy Research, Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrechtNetherlands
| | - Robert Verheij
- Nivel Primary Care Database (Nivel‐PCD)Netherlands Institute for Health Services Research (NIVEL)UtrechtNetherlands
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