scholarly journals 269 Early Identification of Frailty: Developing an International Delphi Consensus for a Definition of Pre-frailty

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Duygu Sezgin ◽  
Mark O’Donovan ◽  
Jean Woo Wong ◽  
Karen Bandeen-Roche ◽  
Giuseppe Liotta ◽  
...  
Keyword(s):  
Early Identification ◽  
Quantitative Methods ◽  
Operational Definition ◽  
Linear Process ◽  
Consensus Meeting ◽  
Physical Factors ◽  
Delphi Consensus ◽  
International Consensus ◽  
Targeted Interventions ◽  
Definition Of

Abstract Background Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent condition before frailty becomes established. Despite this, there is no widely accepted definition of pre-frailty to support its early identification and management. This study applied an international consensus approach to define and better understand pre-frailty. Methods A modified electronic two-round Delphi Consensus study was conducted. In all, 23 experts from 12 countries with different backgrounds participated. The questionnaire was developed following a systematic literature review. An online consensus meeting was conducted with eight Delphi participants and two external experts. Qualitative and quantitative methods were employed for data analysis. An agreement level of 70% was applied for accepting statements. Results A total of 71 statements were circulated in Round 1. Of these, 52.8% were accepted. Fifty-one statements were re-circulated in Round 2, of which 92.1% were accepted. The online consensus meeting produced a consensus statement describing the concept, multi-factorial nature, and mechanism of pre-frailty as well as assessment, prevention and management approaches. All experts agreed that physical and non-physical factors such as psychological and social capacity are involved in the development of pre-frailty, potentially adversely affecting health and health-related quality of life outcomes. Practitioners should regard pre-frailty as a multi-factorial, multi-dimensional, and non-linear process that does not inevitably lead to frailty. It might be reversed or attenuated by targeted interventions. Brief, feasible and validated tools are recommended for opportunistic screening or case-finding followed by confirmation with multi-dimensional assessment. Conclusion It is difficult to establish consensus on one compact definition of pre-frailty, which is a multi-dimensional concept not only associated with physical impairment, but also with cognitive, nutritional, socioeconomic and other aspects of frailty. However, it may be too early to agree on an operational definition of pre-frailty since none yet exists for frailty.

scholarly journals An Integrative Literature Review on the Nomenclature and Definition of Dementia at a Young Age

2021 ◽  
pp. 1-26
Author(s):  
Dennis van de Veen ◽  
Christian Bakker ◽  
Kirsten Peetoom ◽  
Yolande Pijnenburg ◽  
Janne M. Papma ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Operational Definition ◽  
Young Age ◽  
Future Research ◽  
International Consensus ◽  
Young Onset ◽  
Age Related ◽  
Young Onset Dementia ◽  
Age Limits ◽  
Definition Of

Background: There has been growing interest in young people living with dementia. Future research requires consensus on the terminology and operational definition of this group. Objective: The purpose of this integrative review was to explore and include all operational definitions used to define dementia at a young age. Methods: On August 14, 2020, the PubMed, Embase, Cinahl, and PsycInfo databases were searched for empirical and theoretical literature using Google. Various terms to describe and define ‘dementia’ and ‘at a young age’ were used to collect literature concerning terminology; age-related aspects, including cut-off ages and criteria; and etiologies of dementia at a young age. Results: The search yielded 6,891 empirical and 4,660 theoretical publications, resulting in the inclusion of 89 publications, including 36 publications containing an explicit discussion and 53 publications as confirmation. ‘Young-onset dementia’ was the most commonly used term of seven identified terms, in the last two decades. The age of 65 years at symptom onset was used most frequently when considering a total of six upper age limits and four criteria to define a cut-off age. Eight lower age limits and an option for subdivision based on age were included. We identified 251 different etiologies and 27 categories of etiologies. Conclusion: Despite relative consensus on the term young-onset dementia and an age at symptom onset being used as a cut-off criterion, much is still unclear concerning possible etiologies of dementia at a young age. In the current study, controversies were detected for discussion in an international consensus study.

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: the definition of periprosthetic shoulder infection

2019 ◽  
Vol 28 (6) ◽  
pp. S8-S12 ◽  
Author(s):  
Grant E. Garrigues ◽  
Benjamin Zmistowski ◽  
Alexus M. Cooper ◽  
Andrew Green ◽  
Jason Hsu ◽  
...  
Keyword(s):  
Consensus Meeting ◽  
International Consensus ◽  
Definition Of ◽  
Shoulder Infection ◽  
Periprosthetic Shoulder Infection

scholarly journals A critical review of the definition of ‘wellbeing’ for doctors and their patients in a post Covid-19 era

2021 ◽  
pp. 002076402110322
Author(s):  
Gemma Simons ◽  
David S Baldwin
Keyword(s):  
Operational Definition ◽  
Full Potential ◽  
International Consensus ◽  
Consensus Definition ◽  
Global Challenges ◽  
The World ◽  
The Face ◽  
Positive Feelings ◽  
Definition Of

Background: There is no international consensus definition of ‘wellbeing’. This has led to wellbeing being captured in many different ways. Aims: To construct an inclusive, global operational definition of wellbeing. Methods: The differences between wellbeing components and determinants and the terms used interchangeably with wellbeing, such as health, are considered from the perspective of a doctor. The philosophies underpinning wellbeing and modern wellbeing research theories are discussed in terms of their appropriateness in an inclusive definition. Results: An operational definition is proposed that is not limited to doctors, but universal, and inclusive: ‘Wellbeing is a state of positive feelings and meeting full potential in the world. It can be measured subjectively and objectively, using a salutogenic approach’. Conclusions: This operational definition allows the differentiation of wellbeing from terms such as quality of life and emphasises that in the face of global challenges people should still consider wellbeing as more than the absence of pathology.

Towards a pragmatic and operational definition of relapse in schizophrenia: A Delphi consensus approach

2015 ◽  
Vol 19 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Luis San ◽  
Manuel Serrano ◽  
Fernando Cañas ◽  
Samuel Leopoldo Romero ◽  
Ángeles Sánchez-Cabezudo ◽  
...  
Keyword(s):  
Operational Definition ◽  
Consensus Approach ◽  
Delphi Consensus ◽  
Definition Of

scholarly journals International consensus guideline for reporting transmission electron microscopy results in the diagnosis of primary ciliary dyskinesia (BEAT PCD TEM Criteria)

2020 ◽  
Vol 55 (4) ◽  
pp. 1900725 ◽  
Author(s):  
Amelia Shoemark ◽  
Mieke Boon ◽  
Christoph Brochhausen ◽  
Zuzanna Bukowy-Bieryllo ◽  
Maria M. De Santi ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Primary Ciliary Dyskinesia ◽  
Supporting Evidence ◽  
Consensus Guideline ◽  
Delphi Consensus ◽  
International Consensus ◽  
Transmission Electron ◽  
Definition Of ◽  
Ciliary Dyskinesia

Primary ciliary dyskinesia (PCD) is a heterogeneous genetic condition. European and North American diagnostic guidelines recommend transmission electron microscopy (TEM) as one of a combination of tests to confirm a diagnosis. However, there is no definition of what constitutes a defect or consensus on reporting terminology. The aim of this project was to provide an internationally agreed ultrastructural classification for PCD diagnosis by TEM.A consensus guideline was developed by PCD electron microscopy experts representing 18 centres in 14 countries. An initial meeting and discussion were followed by a Delphi consensus process. The agreed guideline was then tested, modified and retested through exchange of samples and electron micrographs between the 18 diagnostic centres.The final guideline a) provides agreed terminology and a definition of Class 1 defects which are diagnostic for PCD; b) identifies Class 2 defects which can indicate a diagnosis of PCD in combination with other supporting evidence; c) describes features which should be included in a ciliary ultrastructure report to assist multidisciplinary diagnosis of PCD; and d) defines adequacy of a diagnostic sample.This tested and externally validated statement provides a clear guideline for the diagnosis of PCD by TEM which can be used to standardise diagnosis internationally.

Missing cases of injury death: use of quantitative methods and case reviews to inform future improvements in case definition

2021 ◽  
pp. injuryprev-2021-044371
Author(s):  
Colin Cryer ◽  
Pauline Gulliver ◽  
Gabrielle Davie ◽  
Ari Samaranayaka ◽  
Christine Fowler
Keyword(s):  
Quantitative Methods ◽  
Premature Death ◽  
Operational Definition ◽  
Case Definition ◽  
Injury Death ◽  
Detection Rates ◽  
Hospital Patients ◽  
Injury Event ◽  
Underlying Cause Of Death ◽  
Definition Of

BackgroundKnowledge of fatal injuries is required to inform prevention activities. Where hospital patients with an injury principal diagnosis (PDx) died and were certified to a medical underlying cause of death (UCoD), there is the potential to underestimate injury mortality. We sought to characterise injury/non-injury (NI) mismatches between PDx and UCoD by identifying which subgroups had small/large mismatches, and to understand why mismatches had occurred using informative examples.MethodHospital records (n=10 234) with a PDx of injury were linked to the mortality collection using a unique personal identifier. Percentages UCoD coded to a NI were tabulated, for three follow-up periods and by selected variables. Additionally, we reviewed a sample of 70 records for which there was a mismatch.Results%NIs were 39%, 66% and 77% for time from injury to death of <1 week, <90 days and <1 year, respectively. Variations in %NI were found for all variables. Illustrative examples of 70 medical UCoD deaths showed that for 12 cases the injury event was unequivocally judged to have resulted in premature death. A further 16 were judged as injury deaths using balance of probability arguments.ConclusionThere is variation in rates of mismatch between PDx of injury and UCoD of NI. While legitimate reasons exist for mismatches in certain groups, a material number of injury deaths are not captured using UCoD alone; a new operational definition of injury death is needed. Early solutions are proposed. Further work is needed to investigate operational definitions with acceptable false positive and negative detection rates.

Understanding functional illiteracy from a policy, adult education, and cognition point of view: Towards a joint referent framework

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann
Keyword(s):  
Adult Education ◽  
Operational Definition ◽  
Literacy Skills ◽  
Point Of View ◽  
Industrialized Countries ◽  
Functional Illiteracy ◽  
Scale Levels ◽  
Components Of Reading ◽  
The One ◽  
Definition Of

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.

“The Unconscious” in Current Psychology

2010 ◽  
Vol 15 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Elisabeth Norman
Keyword(s):  
Cognitive Psychology ◽  
Verbal Report ◽  
Psychological Research ◽  
Operational Definition ◽  
The Unconscious ◽  
Apparent Lack ◽  
Unconscious Processing ◽  
Unconscious Processes ◽  
Intermediate States ◽  
Definition Of

A series of vignette examples taken from psychological research on motivation, emotion, decision making, and attitudes illustrates how the influence of unconscious processes is often measured in a range of different behaviors. However, the selected studies share an apparent lack of explicit operational definition of what is meant by consciousness, and there seems to be substantial disagreement about the properties of conscious versus unconscious processing: Consciousness is sometimes equated with attention, sometimes with verbal report ability, and sometimes operationalized in terms of behavioral dissociations between different performance measures. Moreover, the examples all seem to share a dichotomous view of conscious and unconscious processes as being qualitatively different. It is suggested that cognitive research on consciousness can help resolve the apparent disagreement about how to define and measure unconscious processing, as is illustrated by a selection of operational definitions and empirical findings from modern cognitive psychology. These empirical findings also point to the existence of intermediate states of conscious awareness, not easily classifiable as either purely conscious or purely unconscious. Recent hypotheses from cognitive psychology, supplemented with models from social, developmental, and clinical psychology, are then presented all of which are compatible with the view of consciousness as a graded rather than an all-or-none phenomenon. Such a view of consciousness would open up for explorations of intermediate states of awareness in addition to more purely conscious or purely unconscious states and thereby increase our understanding of the seemingly “unconscious” aspects of mental life.

Sentinel node biopsy in breast cancer

2004 ◽  
Vol 43 (01) ◽  
pp. 4-9 ◽  
Author(s):  
A. Bembenek ◽  
H. Büchels ◽  
T. Decker ◽  
J. Dunst ◽  
U. Müllerleile ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
German Society ◽  
Consensus Conference ◽  
Consensus Meeting ◽  
Axillary Staging ◽  
International Consensus ◽  
Node Biopsy ◽  
Complete Lymph Node Dissection

SummaryThe international consensus conference from St. Gallen concerning the treatment of early breast cancer concluded in 2003, that sentinel node biopsy was now accepted as method allowing axillary staging in breast cancer. This procedure may avoid complete lymph node dissection in appropriate cases. Since numerous questions associated with the technique are still not defined and the procedure itself is not yet standardized, the German Society of Senology defined the conditions for the routine clinical use of sentinel node biopsy in an interdisciplinary consensus meeting.

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