Assessing the utility of a distress screening tool at capturing sexual concerns in a gyne-oncology follow-up clinic

2017 ◽  
Vol 26 (3) ◽  
pp. 887-893 ◽  
Author(s):  
Lauren M. Walker ◽  
Majken P. Villiger ◽  
John W. Robinson
Keyword(s):  
Screening Tool ◽  
Distress Screening ◽  
Sexual Concerns

scholarly journals Prediction of functional loss in emergency surgery is possible with a simple frailty screening tool

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Davide Zattoni ◽  
Isacco Montroni ◽  
Nicole Marie Saur ◽  
Anna Garutti ◽  
Maria Letizia Bacchi Reggiani ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Emergency Surgery ◽  
Screening Tool ◽  
Functional Decline ◽  
Healthcare Facility ◽  
Nursing Home Admission ◽  
Emergency Setting ◽  
Senior Adults ◽  
Functional Loss

Abstract Background Senior adults fear postoperative loss of independence the most, and this might represent an additional burden for families and society. The number of geriatric patients admitted to the emergency room requiring an urgent surgical treatment is rising, and the presence of frailty is the main risk factor for postoperative morbidity and functional decline. Frailty assessment in the busy emergency setting is challenging. The aim of this study is to verify the effectiveness of a very simple five-item frailty screening tool, the Flemish version of the Triage Risk Screening Tool (fTRST), in predicting functional loss after emergency surgery among senior adults who were found to be independent before surgery. Methods All consecutive individuals aged 70 years and older who were independent (activity of daily living (ADL) score ≥5) and were admitted to the emergency surgery unit with an urgent need for abdominal surgery between December 2015 and May 2016 were prospectively included in the study. On admission, individuals were screened using the fTRST and additional metrics such as the age-adjusted Charlson Comorbidity Index (CACI) and the ASA score. Thirty- and 90-day complications and postoperative decline in the ADL score where recorded. Regression analysis was performed to identify preoperative predictors of functional loss. Results Seventy-eight patients entered the study. Thirty-day mortality rate was 12.8% (10/78), and the 90-day overall mortality was 15.4% (12/78). One in every four patients (17/68) experienced a significant functional loss at 30-day follow-up. At 90-day follow-up, only 3/17 patients recovered, 2 patients died, and 12 remained permanently dependent. On the regression analysis, a statistically significant correlation with functional loss was found for fTRST, CACI, and age≥85 years old both at 30 and 90 days after surgery. fTRST≥2 showed the highest effectiveness in predicting functional loss at 90 days with AUC 72 and OR 6.93 (95% CI 1.71–28.05). The institutionalization rate with the need to discharge patients to a healthcare facility was 7.6% (5/66); all of them had a fTRST≥2. Conclusion fTRST is an easy and effective tool to predict the risk of a postoperative functional decline and nursing home admission in the emergency setting.

scholarly journals P106 Depressive symptoms and anxiety and their screening in IBD patients: performance of the distress thermometer in Italian IBD patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
C Canaletti ◽  
F Colombo ◽  
A Dessì ◽  
E Geccherle ◽  
A Tongiorgi ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Emotional Distress ◽  
Screening Tool ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cutoff Score ◽  
Distress Screening ◽  
Single Item ◽  
Mayo Score ◽  
Clinical Indices

Abstract Background Roughly 50% of patients with IBD have symptoms of psychological distress (Mikocka-Walus et al. 2019) but only 15.2% receive attention for their mental health although the effect on disease severity can be profound. It is necessary to have an easy-to-administer psychological distress screening tool. The distress thermometer (DT) is a single-item distress screening scale with 11-likert response widely used in oncological patients. The aim of study was to determine whether the single-item DT compared favourably with IBD clinical indices and time consuming measures currently used to screen for distress. Methods Two hundered and twenty IBD patients (51.43% male) who were recruited in eight Italian hospitals completed the DT and identified the presence or absence of 34 problems using standardised problem list (PL). They completed the 14-item Hospital Anxiety and Depression Scale (HADS) and the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ). Disease clinical indices have been collected for each patient (Mayo score, Harvey–Bradshaw Index–HBI, years of illness, and exacerbation in the last year). Using receiver operating characteristic (ROC) analyses validated the use of the DT in Italian IBD population. Results 47.6% reported anxiety and depression symptoms (HADS ≥15) and needs emotional care. Anxiety is much more associated (43.8%) than depressive problems (26.2%). Data are confirmed by responses to DT and PL: 44.5% of patients reported moderate–severe emotional distress (TD ≥ 5), 43.1% of patients report nervousness and worry, 27.1% reported depression. We observed a strong positive correlation between IBDQ and HADS (r = 0.74, p < 0.001) and DT (r = 0.58, p < 0.001), while there was a slightly smaller association with Mayo score (r = 0.46, p < 0.001) and HBI (r = 0.39, p < 0.001). There was not a statistical significant correlation between disease indices and the emotional distress as measured by HADS or DT. ROC analyses showed that a DT cutoff score of 5 or higher had optimal sensitivity (83%) and specificity (68%) relative to the HADS score as ‘gold’ standard. DT scores yielded area under the curve estimates relative to the HADS cutoff score indicative of good overall accuracy (AUC = 0.81–95% CI: 0.77–0.85). Conclusion Our study confirms that anxiety and depression symptoms are associated with IBD. This is the first study that demonstrated that DT is an easy-to-administer screening tool of psychosocial distress in IBD population. We propose that gastroenterologists use DT to identify patients with psychological distress: an early psychological support and a multidisclinar equipe can determinate a patient’s better disease course (Mawdsley et al. 2005). Our analyses indicated that using a DT’s cutoff of 5 to indicate high levels of distress.

scholarly journals Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Koohi ◽  
Ewout W. Steyerberg ◽  
Leila Cheraghi ◽  
Alireza Abdshah ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Simple Model ◽  
Risk Score ◽  
Screening Tool ◽  
Middle Eastern ◽  
Predictive Ability ◽  
Eastern Population ◽  
Hypertension Risk ◽  
Graphical Comparison ◽  
Middle Eastern Population

Abstract Background The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.

scholarly journals A cross-sectional audit of distress in patients undergoing adjuvant therapy or follow-up in central nervous system malignancies

2018 ◽  
Vol 6 (4) ◽  
pp. 305-310
Author(s):  
Vijay M Patil ◽  
Mridul Malhotra ◽  
Raees Tonse ◽  
Jayita Deodhar ◽  
Arun Chandrasekharan ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Negative Impact ◽  
Distress Screening ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Distress Score ◽  
High Distress ◽  
Cancer Network

Abstract Background Unaddressed high distress leads to noncompliance with treatment, negatively affects quality of life, and may also have a negative impact on the prognosis of cancer patients. Patients with brain tumors have higher levels of distress than the general population and hence we hypothesize that even routine visits during adjuvant treatment or follow-up are likely to be stressful. This analysis was performed to identify the incidence of distress and factors affecting it. Methods This was an audit of 84 consecutive patients seen in an adult neuro-medical oncology outpatient department who were either receiving adjuvant chemotherapy or were on follow-up. Distress screening with the National Comprehensive Cancer Network (NCCN) distress thermometer was performed. Patients in whom distress was scored as 4 or above were considered as having high distress. Descriptive statistics and logistic regression analysis were performed to identify factors affecting distress. Results The median age of the cohort was 40 years (interquartile range, 28.3 to 50 years). Actionable distress defined as a distress score of 4 or more was seen in 52 patients (61.9%, 95% CI 51.2% to 71.5%). Presence of physical deficit (odds ratio [OR] = 3.412, P = .020) and treatment under the private category (OR = 5.273, P = .003) had higher odds of having high distress. Conclusion A high proportion of brain tumor patients either on adjuvant chemotherapy or on follow-up have high distress levels that need to be addressed even during follow-up.

scholarly journals Hearing Screening of Newborns using Distortion Product Otoacoustic Emissions

2021 ◽  
Vol 29 (2) ◽  
pp. 189-195
Author(s):  
Vybhavi MK ◽  
Srinivas V
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Screening Tool ◽  
Hearing Screening ◽  
Distortion Product Otoacoustic Emissions ◽  
Profound Hearing Loss ◽  
Distortion Product ◽  
Lost To Follow Up ◽  
Evoked Response Audiometry

Introduction  The present study was devised to estimate the prevalence of neonatal hearing loss and document the importance of using DPOAE as a screening tool for identifying hearing loss in newborns. Materials and Methods This hospital based descriptive study was conducted from August 2018 to August 2019. A total of 928 newborn babies were included in the study. These newborn babies were subjected to hearing screening by distortion product otoacoustic emissions (DPOAE) at 24-72 hrs after birth. For pass cases, no further testing was done. For refer cases, repeat testing with DPOAE was done within 15-30 days. Newborns with refer result on repeat DPOAE testing were subjected to Brainstem evoked response audiometry (BERA) within 3 months to confirm hearing loss. Results Nine hundred and twenty eight newborn babies were screened by DPOAE. 851 newborns passed the first DPOAE hearing screening and 77 newborns gave refer result. 21 newborns were lost to follow-up. 56 newborns underwent repeat DPOAE testing and 5 newborns were referred for BERA. Amongst the 5 newborns who underwent BERA testing, one newborn was diagnosed with bilateral profound hearing loss. Hence, the prevalence of hearing loss of 1.08 per thousand newborn babies was estimated in this study. Conclusion Hearing screening of newborns using DPOAE followed by BERA in refer cases to confirm hearing loss is useful for early detection followed by timely intervention and rehabilitation.

A Visual-Analogue Screening Tool for Assessing Mood and Quality of Daily Life Complications in Family Members of People Living With Cancer: Portuguese Version of the Emotion Thermometers: Burden Version

2019 ◽  
Vol 43 (4) ◽  
pp. 264-269
Author(s):  
Neide P. Areia ◽  
Alex Mitchell ◽  
Gabriela Fonseca ◽  
Sofia Major ◽  
Ana P. Relvas
Keyword(s):  
Diagnostic Accuracy ◽  
Screening Tool ◽  
Family Members ◽  
Cross Sectional Study ◽  
Brief Symptom Inventory ◽  
Distress Screening ◽  
Entire Family ◽  
Cross Sectional ◽  
Emotional Upset ◽  
Living With Cancer

Cancer is a disease that impacts not only the patient but also affects the entire family. Family members experience high levels of distress. Therefore, screening for cancer-specific distress among family members of people with cancer is important but relatively unexplored. This cross-sectional study aims to analyze the psychometric properties of a screening tool for family members of people with cancer. We examined the usefulness of the emotional thermometers burden version (ET-BV) in detecting caregiver emotional distress. The ET-BV is a simple multidomain visual analogue scale distributed in two major domains: “emotional upset” and “impact.” A total of 364 cancer patients’ family members completed the ET-BV and Brief Symptom Inventory. Analyses were aimed to examine the diagnostic accuracy (receiver operating characteristic) of the ET-BV. A fair to good diagnostic accuracy was achieved for ET-BV. For emotional upset thermometers, a cutoff of ≥5 was determined and for impact thermometers, a cutoff of ≥4 was established. ET-BV seems to be a useful, quick, and simple tool for distress screening in family members of people with cancer. A revision of a specific thermometer is discussed in order to increase ET screening performance and clinical utility.

scholarly journals The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

2015 ◽  
Vol 50 (6) ◽  
pp. 589-595 ◽  
Author(s):  
Darin A. Padua ◽  
Lindsay J. DiStefano ◽  
Anthony I. Beutler ◽  
Sarah J. de la Motte ◽  
Michael J. DiStefano ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Screening Tool ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Receiver Operator Characteristic ◽  
Acl Injuries ◽  
Youth Soccer ◽  
Jump Landing ◽  
Anterior Cruciate

Context Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics. Objective To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population. Design Cohort study. Setting Field-based functional movement screening performed at soccer practice facilities. Patients or Other Participants A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age = 13.9 ± 1.8 years, age range = 11 to 18 years), of whom 25% (n = 207) were less than 13 years of age. Intervention(s) Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up). Main Outcome Measure(s) Landings were scored for “errors” in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed. Results Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 ± 1.71) than injured participants (6.24 ± 1.75; t1215 = −2.784, P = .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%. Conclusions Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.

scholarly journals Postpartum depression screening: are we doing a competent job?

2019 ◽  
Vol 8 (4) ◽  
pp. e000616 ◽  
Author(s):  
Sathyanarayan Sudhanthar ◽  
Zile-e-huma Sheikh ◽  
Kripa Thakur
Keyword(s):  
Postpartum Depression ◽  
Local Community ◽  
Screening Tool ◽  
Stakeholder Participation ◽  
Depression Scale ◽  
First Year ◽  
Educational Strategies ◽  
American Academy Of Pediatrics ◽  
Pdsa Cycle

Postpartum depression (PPD) is one of the most common and severe postpartum morbidity, affecting 10%–20% of mothers within the first year of childbirth. The adverse effects of PPD, namely, prevention of mother-baby bonding and early cessation of breastfeeding, adversely affects infant growth and brain development. Studies have found that up to 50% of women with PPD go undiagnosed. Despite the American Academy of Pediatrics (AAP) recommendations, only a small percentage of paediatricians are currently screening for PPD. This project aimed to improve PPD screening using a validated tool to 75% in a primary care inner-city clinic serving a predominantly underserved population as per AAP recommendations. Baseline data for 40 charts of 2-month-old and 4-month-old well-child visits showed no documentation of PPD screening. The screening tool used for this project was the Edinburgh Postpartum Depression Scale (EPDS), which is a validated 10-item screening questionnaire for PPD. Three Plan-Do-Study-Act (PDSA) cycles were implemented involving educational strategies, system-based practice improvement and stakeholder participation. Improvement seen after PDSA cycle 1 was minimal. At the end of cycle 2, 16/50 (33%) charts had documentation of screening using EPDS. At the end of cycle 3, 33/40 (82%) charts had EPDS documentation, an increase of 49% from cycle 2. There were eight in total positive PPD screenings between cycles 2 and 3. These patients were provided counselling support through a social worker and referral services through the local community mental health organisation. We achieved more than our 75% target goal for PPD screening implementation at the residency clinic, thereby increasing residents’ awareness of PPD and the importance of PPD screening. Poststudy follow-up shows that screening was maintained at a higher rate but never reached 100%.

scholarly journals Infertility treatment and autism risk using the Modified Checklist for Autism in Toddlers (M-CHAT)

2020 ◽  
Vol 35 (3) ◽  
pp. 684-693 ◽  
Author(s):  
S L Robinson ◽  
T Parikh ◽  
T Lin ◽  
E M Bell ◽  
E Heisler ◽  
...  
Keyword(s):  
New York ◽  
Study Design ◽  
Screening Tool ◽  
New York State ◽  
Population Based ◽  
Infertility Treatment ◽  
Autism Spectrum ◽  
Fertility Treatment ◽  
York State

Abstract STUDY QUESTION Are toddlers conceived by fertility treatment at higher risk of failing a screening tool for autism spectrum disorders (ASD) than toddlers not conceived by treatment? SUMMARY ANSWER Compared with children not conceived by infertility treatment, children conceived by any infertility treatment, ovulation induction with or without intrauterine insemination (OI/IUI), or assisted reproductive technologies (ART) appeared to have had higher odds of failing an ASD screening; however, results were inconclusive and need replication. WHAT IS KNOWN ALREADY Although most of the studies which have examined risk of ASD after ART show no association, the results are mixed. Thus, further studies are needed to clarify this association. STUDY DESIGN SIZE, DURATION The Upstate KIDS Study is a population-based, prospective cohort study of children born in New York State between 2008 and 2010. Children were screened for ASD using the Modified Checklist for Autism in Toddlers (M-CHAT) at ages 18 and 24 months. PARTICIPANTS/MATERIALS, SETTING, AND METHODS The New York State live-birth registry was used to identify newborns conceived with and without fertility treatment with a 1:3 ratio, frequency matched on region of birth. At 18 and 24 months, 3183 and 3063 mothers, respectively, completed the M-CHAT questionnaire. The current analysis included 2586 singletons and 1296 twins with M-CHAT information at 18 and/or 24 months. Multivariable logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (aOR) and 95% confidence intervals (CI) after adjustment for covariates such as maternal age, education and plurality. MAIN RESULTS AND THE ROLE OF CHANCE We found that 200 (5.2%) and 115 (3.0%) children failed the M-CHAT at 18 and 24 months, respectively. The associations between use of infertility treatment and failing the M-CHAT at 18 and/or 24 months were positive but inconclusive as they failed to exclude no association (18 months aOR 1.71, 95% CI: 0.81–3.61; 24 months aOR 1.78, 95% CI: 0.66–4.81; and both 18 and 24 months aOR 1.53, 95% CI: 0.78–2.99). The relationships between OI/IUI and ART with M-CHAT failure at 18 and/or 24 months were similar to those of using any fertility treatment. In vitro fertilization with intracytoplasmic sperm injection was not consistently positively or inversely associated with M-CHAT failure at each time point (18 months aOR 1.20, 95% CI: 0.51–2.83; 24 months aOR 0.93, 95% CI: 0.37–2.31; and both 18 and 24 months aOR 1.09, 95% CI: 0.50–2.60). LIMITATIONS REASONS FOR CAUTION The M-CHAT is a screening tool used for ASD risk assessment, and therefore, M-CHAT failure does not indicate ASD diagnosis. In addition, we did not have power to detect associations of small magnitude. Finally, non-response to follow-up may bias the results. WIDER IMPLICATIONS OF THE FINDINGS Despite lack of precision, the positive associations between ART and M-CHAT failure suggest that larger population-based studies with longer follow-up are needed. STUDY FUNDING/COMPETING INTEREST(S) Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; contracts HHSN275201200005C, HHSN267200700019C). The sponsor played no role in the study design, data collection, data analysis or interpretation, writing of the manuscript or decision to submit the article for publication. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

scholarly journals Validation of the detection of elder abuse through emergency care technicians (DETECT) screening tool: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037170
Author(s):  
Brad Cannell ◽  
Julie Weitlauf ◽  
Melvin D Livingston ◽  
Jason Burnett ◽  
Megin Parayil ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Care ◽  
Screening Tool ◽  
Elder Abuse ◽  
Well Being ◽  
Living Environment ◽  
Community Dwelling ◽  
Screening Tools ◽  
Semistructured Interview

IntroductionElder mistreatment (EM) is a high prevalence threat to the health and well-being of older adults in the USA. Medics are well-positioned to help with identification of older adults at risk for EM, however, field robust screening tools appropriate for efficient, observation-based screening are lacking. Prior work by this team focused on the development and initial pilot testing of an observation-based EM screening tool named detection of elder abuse through emergency care technicians (DETECT), designed to be implemented by medics during the course of an emergency response (911) call. The objective of the present work is to validate and further refine this tool in preparation for clinical dissemination.Methods and analysisApproximately 59 400 community-dwelling older adults who place 911 calls during the 36-month study observation period will be screened by medics responding to the call using the DETECT tool. Next, a random subsample of 2520 of the 59 400 older adults screened will be selected to participate in a follow-up interview approximately 2 weeks following the completion of the screening. Follow-up interviews will consist of a medic-led semistructured interview designed to assess the older adult’s likelihood of abuse exposure, physical/mental health status, cognitive functioning, and to systematically evaluate the quality and condition of their physical and social living environment. The data from 25% (n=648) of these follow-up interviews will be presented to a longitudinal, experts and all data panel for a final determination of EM exposure status, representing the closest proxy to a ‘gold standard’ measure available.Ethics and disseminationThis study has been reviewed and approved by the Committee for the Protection of Human Subjects at the University of Texas School of Public Health. The results will be disseminated through formal presentations at local, national and international conferences and through publication in peer-reviewed scientific journals.

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