scholarly journals Does the implementation of a care pathway for patients with hip or knee osteoarthritis lead to fewer diagnostic imaging and referrals by general practitioners? A pre-post-implementation study of claims data

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Esther H. A. van den Bogaart ◽  
Mariëlle E. A. L. Kroese ◽  
Marieke D. Spreeuwenberg ◽  
Ramon P. G. Ottenheijm ◽  
Patrick Deckers ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Knee Osteoarthritis ◽  
Significant Interaction ◽  
Care Pathway ◽  
Interaction Effects ◽  
Stepped Care ◽  
Binary Logistic Regression Analysis ◽  
Orthopaedic Care ◽  
Implementation Period ◽  
Referral Behaviour

Abstract Background The Dutch care for hip and knee osteoarthritis (OA) is of good quality, but there is room for improvement regarding the efficient use of diagnostic imaging and conservative treatment. Therefore a stepped-care approach, in the shape of the care pathway ‘Better exercise in osteoarthritis’, was implemented to reduce the number of diagnostic imaging requested by GPs and referrals of GPs to orthopaedic care. Methods In 2015, the pathway is implemented with the use of educational meetings, distributing guidelines and incorporating reminders in the GPs’ referral application. To evaluate the effect of the pathway on the diagnostic and referral behaviour of GPs, hip and knee related health insurance claims are used together with claims of other joints and of a control region for comparison. The average number of claims and the percentage change in the post-implementation period are described. Binary logistic regression analysis is used to examine the interaction between region (intervention and control) and period (pre- and post-implementation). Using random sampling of patient records, information about the practical application of the pathway and the number of hip or knee arthroplasties is added. Results In both regions, the number of diagnostic imaging decreased and the number of initial orthopaedic consultations increased during the post-implementation period. Significant interaction effects were found in knee-related diagnostics (p ≤ 0.001) and diagnostics of other joints (p = 0.039). No significant interaction effects were found in hip-related diagnostics (p = 0.060) and in initial orthopaedic consultation claims of hip (p = 0.979), knee (p = 0.281), and other joints (p = 0.464). Being referred according to the pathway had no significant effect on the probability of undergoing arthroplasty. Conclusion The implementation of the pathway had a positive effect on GPs diagnostic behaviour related to the knee, but not to the hip. The referral behaviour of GPs to orthopaedic care needs attention for future interventions and research, since an increase (instead of a desired decrease) in the number of initial orthopaedic consultations was found. Focusing on the entire width of care for hip and knee OA could be helpful.

WHEN A SMILE DOES NO GOOD: CREATIVITY REDUCTION AMONG AVOIDANCE- VERSUS APPROACH-ORIENTED INDIVIDUALS IN DYADIC INTERACTIONS

2016 ◽  
Vol 20 (04) ◽  
pp. 1640007 ◽  
Author(s):  
KEN FUJIWARA ◽  
KOSUKE TAKEMURA ◽  
SATOKO SUZUKI
Keyword(s):  
Significant Interaction ◽  
Interaction Effects ◽  
Social Approval ◽  
Dyadic Interactions ◽  
Same Sex ◽  
Popular Belief ◽  
Drawing Task

This study examined the influence of others’ smiles on individuals’ creativity. According to popular belief, individuals get motivated to be more creative when others smile at them. In contrast, we hypothesised that smiles would make avoidance-oriented (versus approach-oriented) individuals less creative, as they may lose the motivation to pursue further novelty once they gain social approval, as implied by a smile. Forty-two participants were paired with a same-sex stranger and randomly assigned to the role of either an “illustrator” or a “commentator.” The illustrators performed the Alien Drawing Task and the commentators gave feedbacks regarding the drawing, which were repeated six times and video-recorded. As expected, the results showed significant interaction effects between others’ smiles and avoidance orientation on creativity: participants high in avoidance orientation showed less creativity when others smiled at them. In addition, nodding had the same effect as a smile did, confirming that social approval decreases the creativity of avoidance-oriented individuals.

scholarly journals Effects of Regular Taekwondo Intervention on Oxidative Stress Biomarkers and Myokines in Overweight and Obese Adolescents

2020 ◽  
Vol 17 (7) ◽  
pp. 2505
Author(s):  
Hee-Tae Roh ◽  
Su-Youn Cho ◽  
Wi-Young So
Keyword(s):  
Oxidative Stress ◽  
Physical Fitness ◽  
Significant Interaction ◽  
Muscular Strength ◽  
Interaction Effects ◽  
Physical Parameters ◽  
Stand Test ◽  
Obese Adolescents ◽  
Leg Strength ◽  
Jump Power

Purpose: Regular exercise can alleviate oxidative stress related to obesity and can induce secretion of myokines that are involved in the regulation of metabolic homeostasis. There are no studies examining changes in these variables as a result of Taekwondo training intervention. We aimed to investigate the effect of Taekwondo training on oxidative stress and myokine levels in overweight and obese adolescents. Methods: We randomly assigned 20 overweight and obese adolescents to control (control group; CG, n = 10) and experimental (experimental group; EG, n = 10) groups. The EG performed Taekwondo training five times a week for 16 weeks. Physical parameters (height, weight, body mass index (BMI)), physical fitness (maximal oxygen uptake (VO2max) (cardiorespiratory endurance), grip and leg strength (muscular strength), sit-and-reach (flexibility), Sargent jump (power), and stork stand test (balance)) were measured before and after intervention. We measured levels of serum oxidative stress markers (plasma malondialdehyde (MDA) and superoxide dismutase (SOD)) and myokines (serum interleukin-15 (IL-15), brain-derived neurotrophic factor (BDNF), irisin, and myostatin). Results: The weight and BMI in the EG after intervention were significantly lower and leg strength (muscular strength), sit-and-reach (flexibility), and Sargent jump (power) were significantly improved compared to those of the CG (p < 0.05). There were no significant interaction effects in terms of height, VO2 max, grip strength, or stork stand test (p > 0.05). The SOD and BDNF level after intervention were significantly higher in the EG after the intervention, whereas MDA and irisin levels were significantly lower than those of the CG (p < 0.05). There were no significant interaction effects in terms of serum IL-15 and myostatin levels (p > 0.05). Conclusions: Taekwondo training can reduce obesity and increase physical fitness with respect to muscular strength, flexibility, and power as well as alleviate oxidative stress and modulate myokine secretion in adolescents.

Effect of 6 Weeks of n-3 Fatty-Acid Supplementation on Oxidative Stress in Judo Athletes

2010 ◽  
Vol 20 (6) ◽  
pp. 496-506 ◽  
Author(s):  
Edith Filaire ◽  
Alain Massart ◽  
Hugues Portier ◽  
Matthieu Rouveix ◽  
Fatima Rosado ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Significant Interaction ◽  
Training Session ◽  
Interaction Effects ◽  
Lag Phase ◽  
Significant Interaction Effect ◽  
Chain Pufa ◽  
Dietary Record ◽  
Before And After ◽  
Exercise Induced

The aim of this investigation was to assess the effects of 6 wk of eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) supplementation on resting and exercise-induced lipid peroxidation and antioxidant status in judoists. Subjects were randomly assigned to receive a placebo or a capsule of polyunsaturated fatty acids (PUFAs; 600 mg EPA and 400 mg DHA). Blood samples were collected in preexercise and postexercise conditions (judo-training session), both before and after the supplementation period. The following parameters were analyzed: α-tocopherol, retinol, lag phase, maximum rate of oxidation (Rmax) during the propagating chain reaction, maximum amount of conjugated dienes (CDmax) accumulated after the propagation phase, nitric oxide (NO) and malondyaldehide (MDA) concentrations, salivary glutathione peroxidase activity, and the lipid profile. Dietary data were collected using a 7-day dietary record. A significant interaction effect between supplementation and time (p < .01) on triglycerides was noted, with values significantly lower in the n-3 long-chain-PUFA (LCPUFA) group after supplementation than in the placebo group. Significant interaction effects between supplementation and time on resting MDA concentrations and Rmax were found (p = .03 and p = .04, respectively), with elevated values in the n-3 LCPUFA group after supplementation and no change in the placebo group’s levels. The authors observed a significantly greater NO and oxidative-stress increase with exercise (MDA, Rmax, CDmax, and NO) in the n-3 LCPUFA group than with placebo. No main or interaction effects were found for retinol and α-tocopherol. These results indicate that supplementation with n-3 LCPUFAs significantly increased oxidative stress at rest and after a judo-training session.

Effects of Walking on Cigarette Cravings and Affect in the Context of Nesbitt’s Paradox and the Circumplex Model

2006 ◽  
Vol 28 (1) ◽  
pp. 18-31 ◽  
Author(s):  
Adrian Taylor ◽  
Magdalena Katomeri ◽  
Michael Ussher
Keyword(s):  
Repeated Measures ◽  
Significant Interaction ◽  
Interaction Effects ◽  
Crossover Design ◽  
Circumplex Model ◽  
Affective Valence ◽  
Repeated Measures Anova ◽  
Exercise Induced ◽  
Cigarette Cravings

The study examined whether walking can mimic the effects of nicotine during temporary abstinence, by eliciting changes in mood and affect and by reducing cravings. In a randomized crossover design, 15 participants did a self-paced 1-mile walk or sat passively on separate days. A repeated-measures ANOVA revealed a significant reduction in desire to smoke during and for up to 20 min following exercise. Further MANOVAs and univariate ANOVAs revealed significant interaction effects for time-by-condition for tension, and affective valence and activation. Walking reduced tension and increased affective valence and activation during and up to 20 min after exercise, but increased activation only at the end of exercise. ANCOVAs revealed that exercise-induced reductions in cravings were mediated through reduced tension. Walking should be recommended for reducing cravings, but further research is needed to understand whether the arousing properties of exercise can help manage cravings.

scholarly journals Pay Knowledge and Referents in a Tiered-Employment Setting

2005 ◽  
Vol 47 (4) ◽  
pp. 654-672 ◽  
Author(s):  
James E. Martin ◽  
Raymond T. Lee
Keyword(s):  
Significant Interaction ◽  
Interaction Effects ◽  
Pay Satisfaction ◽  
Differential Impact ◽  
Employment Setting

This study examines both the main and the interaction effects of knowledge of the pay structure and social and self pay referents on pay attitudes in a setting with wage andjobduty tiers. Knowledge of the pay structure when hired and expected pay were among the most important predictors of pay fairness and pay satisfaction. The significant interaction effects found across tier levels indicated pay knowledge had a differential impact on pay attitudes. The interaction effects, however, did not support the assumption that the reason attitudes differ among employees on various tier levels is that they use différent referents.

scholarly journals “Beating osteoARThritis”: Development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis

2011 ◽  
Vol 30 (12) ◽  
pp. 1623-1629 ◽  
Author(s):  
Agnes J. Smink ◽  
Cornelia H. M. van den Ende ◽  
Thea P. M. Vliet Vlieland ◽  
Bart A. Swierstra ◽  
Joke H. Kortland ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Knee Osteoarthritis ◽  
Stepped Care ◽  
Treatment Modalities ◽  
Non Surgical Treatment

scholarly journals Examining occupational self-efficacy, work locus of control and communication as moderators of the job insecurity—job performance relationship

2010 ◽  
Vol 31 (2) ◽  
pp. 231-247 ◽  
Author(s):  
Cornelius J König ◽  
Maike E Debus ◽  
Stéphanie Häusler ◽  
Nora Lendenmann ◽  
Martin Kleinmann
Keyword(s):  
Locus Of Control ◽  
Job Performance ◽  
Self Efficacy ◽  
Significant Interaction ◽  
Job Insecurity ◽  
Interaction Effects ◽  
Conservation Of Resources ◽  
Conservation Of Resources Theory ◽  
Work Locus Of Control

Employees’ performance has been shown to be moderately hampered by job insecurity. Based on conservation of resources theory, the study examines whether three possible resources (occupational self-efficacy, work locus of control and communication) moderate the negative job insecurity—performance relationship. Analyses of a large Swiss dataset reveal two significant interaction effects: the higher the job insecurity, the less influence work locus of control and perceived communication exert on the job insecurity—performance relationship. This suggests that work locus of control and perceived communication may be resources that can only act beneficially in a situation of low job insecurity.

Sign in / Sign up

Export Citation Format

Share Document