scholarly journals Interest of a Joint Use of Two Diagnostic Tools of Burnout: Comparison between the Oldenburg Burnout Inventory and the Early Detection Tool of Burnout Completed by Physicians

2021 ◽  
Vol 18 (19) ◽  
pp. 10544
Author(s):  
Céline Leclercq ◽  
Lutgart Braeckman ◽  
Pierre Firket ◽  
Audrey Babic ◽  
Isabelle Hansez
Keyword(s):  
Early Detection ◽  
Diagnostic Accuracy ◽  
General Practitioners ◽  
The Self ◽  
Added Value ◽  
Diagnostic Tools ◽  
Occupational Physicians ◽  
Detection Tool ◽  
Interview Guide ◽  
Oldenburg Burnout Inventory

Most research on burnout is based on self-reported questionnaires. Nevertheless, as far as the clinical judgement is concerned, a lack of consensus about burnout diagnosis constitutes a risk of misdiagnosis. Hence, this study aims to assess the added value of a joint use of two tools and compare their diagnostic accuracy: (1) the early detection tool of burnout, a structured interview guide, and (2) the Oldenburg burnout inventory, a self-reported questionnaire. The interview guide was tested in 2019 by general practitioners and occupational physicians among 123 Belgian patients, who also completed the self-reported questionnaire. A receiver operating characteristic curve analysis allowed the identification of a cut-off score for the self-reported questionnaire. Diagnostic accuracy was then contrasted by a McNemar chi-squared test. The interview guide has a significantly higher sensitivity (0.76) than the self-reported questionnaire (0.70), even by comparing the self-reported questionnaires with the interviews of general practitioners and occupational physicians separately. However, both tools have a similar specificity (respectively, 0.60–0.67), except for the occupational physicians’ interviews, where the specificity (0.68) was significantly lower than the self-reported questionnaire (0.70). In conclusion, the early detection tool of burnout is more sensitive than the Oldenburg burnout inventory, but seems less specific. However, by crossing diagnoses reported by patients and by physicians, they both seem useful to support burnout diagnosis.

Patients’ Perceptions of Caring and Uncaring Nursing Encounters in Inpatient Rehabilitation Settings

2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Joan C Cheruiyot ◽  
Petra Brysiewicz
Keyword(s):  
South Africa ◽  
Content Analysis ◽  
Inpatient Rehabilitation ◽  
Structured Interview ◽  
The Self ◽  
Personal Relationships ◽  
Individual Interviews ◽  
Textual Data ◽  
Interview Guide ◽  
Being There

This study explores and describes caring and uncaring nursing encounters from the perspective of the patients admitted to inpatient rehabilitation settings in South Africa. The researchers used an exploratory descriptive design. A semi-structured interview guide was used to collect data through individual interviews with 17 rehabilitation patients. Content analysis allowed for the analysis of textual data. Five categories of nursing encounters emerged from the analysis: noticing and acting, and being there for you emerged as categories of caring nursing encounters, and being ignored, being a burden, and deliberate punishment emerged as categories of uncaring nursing encounters. Caring nursing encounters make patients feel important and that they are not alone in the rehabilitation journey, while uncaring nursing encounters makes the patients feel unimportant and troublesome to the nurses. Caring nursing encounters give nurses an opportunity to notice and acknowledge the existence of vulnerability in the patients and encourage them to be present at that moment, leading to empowerment. Uncaring nursing encounters result in patients feeling devalued and depersonalised, leading to discouragement. It is recommended that nurses strive to develop personal relationships that promote successful nursing encounters. Further, nurses must strive to minimise the patients’ feelings of guilt and suffering, and to make use of tools, for example the self-perceived scale, to measure this. Nurses must also perform role plays on how to handle difficult patients such as confused, demanding and rude patients in the rehabilitation settings.

Detection of spina bifida in the first trimester of gestation in association with triploidy

2017 ◽  
Author(s):  
K.K. Otaryan , C.G. Gagaev
Keyword(s):  
Spina Bifida ◽  
Early Detection ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
First Trimester ◽  
Termination Of Pregnancy ◽  
Diagnostic Tools ◽  
Prenatal Detection ◽  
Post Abortion

The case of prenatal detection of spina bifida at 12+3 weeks of gestation is described. Termination of pregnancy was performed at 13+3 weeks. Post-abortion karyotyping revealed triploidy (69XXX). Diagnostic tools for early detection of neural tube defects in the 1st trimester of gestation and subsequent appropriate management of pregnancy are discussed.

scholarly journals Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1292
Author(s):  
Luisa Agnello ◽  
Alessandro Iacona ◽  
Salvatore Maestri ◽  
Bruna Lo Sasso ◽  
Rosaria Vincenza Giglio ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Early Detection ◽  
Diagnostic Accuracy ◽  
Positive Likelihood Ratio ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Distribution Width ◽  
Independent Validation ◽  
Sepsis Screening

(1) Background: The early detection of sepsis is still challenging, and there is an urgent need for biomarkers that could identify patients at a high risk of developing it. We recently developed an index, namely the Sepsis Index (SI), based on the combination of two CBC parameters: monocyte distribution width (MDW) and mean monocyte volume (MMV). In this study, we sought to independently validate the performance of SI as a tool for the early detection of patients at a high risk of sepsis in the Emergency Department (ED). (2) Methods: We enrolled all consecutive patients attending the ED with a request of the CBC. MDW and MMV were measured on samples collected in K3-EDTA tubes on the UniCel DxH 900 haematology analyser. SI was calculated based on the MDW and MMV. (3) Results: We enrolled a total of 703 patients stratified into four subgroups according to the Sepsis-2 criteria: control (498), infection (105), SIRS (52) and sepsis (48). The sepsis subgroup displayed the highest MDW (median 27.5, IQR 24.6–32.9) and SI (median 1.15, IQR 1.05–1.29) values. The ROC curve analysis for the prediction of sepsis showed a good and comparable diagnostic accuracy of the MDW and SI. However, the SI displayed an increased specificity, positive predictive value and positive likelihood ratio in comparison to MDW alone. (4) Conclusions: SI improves the diagnostic accuracy of MDW for sepsis screening.

scholarly journals FGFR3 overexpression is a useful detection tool for FGFR3 fusions and sequence variations in glioma

2020 ◽  
Author(s):  
Jens Schittenhelm ◽  
Lukas Ziegler ◽  
Jan Sperveslage ◽  
Michel Mittelbronn ◽  
David Capper ◽  
...  
Keyword(s):  
Coiled Coil ◽  
Growth Factor Receptor ◽  
Gene Mutations ◽  
Diagnostic Tools ◽  
Wild Type ◽  
Rt Pcr ◽  
Fgfr3 Gene ◽  
Detection Tool ◽  
Sequence Variations ◽  
Gene Panel Sequencing

Abstract Background Fibroblast growth factor receptor (FGFR) inhibitors are currently used in clinical development. A subset of glioblastomas carries gene fusion of FGFR3 and transforming acidic coiled-coil protein 3. The prevalence of other FGFR3 alterations in glioma is currently unclear. Methods We performed RT-PCR in 101 glioblastoma samples to detect FGFR3-TACC3 fusions (“RT-PCR cohort”) and correlated results with FGFR3 immunohistochemistry (IHC). Further, we applied FGFR3 IHC in 552 tissue microarray glioma samples (“TMA cohort”) and validated these results in two external cohorts with 319 patients. Gene panel sequencing was carried out in 88 samples (“NGS cohort”) to identify other possible FGFR3 alterations. Molecular modeling was performed on newly detected mutations. Results In the “RT-PCR cohort,” we identified FGFR3-TACC3 fusions in 2/101 glioblastomas. Positive IHC staining was observed in 73/1024 tumor samples of which 10 were strongly positive. In the “NGS cohort,” we identified FGFR3 fusions in 9/88 cases, FGFR3 amplification in 2/88 cases, and FGFR3 gene mutations in 7/88 cases in targeted sequencing. All FGFR3 fusions and amplifications and a novel FGFR3 K649R missense mutation were associated with FGFR3 overexpression (sensitivity and specificity of 93% and 95%, respectively, at cutoff IHC score > 7). Modeling of these data indicated that Tyr647, a residue phosphorylated as a part of FGFR3 activation, is affected by the K649R mutation. Conclusions FGFR3 IHC is a useful screening tool for the detection of FGFR3 alterations and could be included in the workflow for isocitrate dehydrogenase (IDH) wild-type glioma diagnostics. Samples with positive FGFR3 staining could then be selected for NGS-based diagnostic tools.

scholarly journals Radiomics and Magnetic Resonance Imaging of Rectal Cancer: From Engineering to Clinical Practice

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 756
Author(s):  
Francesca Coppola ◽  
Valentina Giannini ◽  
Michela Gabelloni ◽  
Jovana Panic ◽  
Arianna Defeudis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Accuracy Assessment ◽  
Unmet Need ◽  
Quantitative Information ◽  
Added Value ◽  
Diagnostic Tools ◽  
Resonance Imaging ◽  
Cross Sectional

While cross-sectional imaging has seen continuous progress and plays an undiscussed pivotal role in the diagnostic management and treatment planning of patients with rectal cancer, a largely unmet need remains for improved staging accuracy, assessment of treatment response and prediction of individual patient outcome. Moreover, the increasing availability of target therapies has called for developing reliable diagnostic tools for identifying potential responders and optimizing overall treatment strategy on a personalized basis. Radiomics has emerged as a promising, still fully evolving research topic, which could harness the power of modern computer technology to generate quantitative information from imaging datasets based on advanced data-driven biomathematical models, potentially providing an added value to conventional imaging for improved patient management. The present study aimed to illustrate the contribution that current radiomics methods applied to magnetic resonance imaging can offer to managing patients with rectal cancer.

Diagnostic accuracy of different methods of early detection of chronic kidney disease

2017 ◽  
Vol 25 (4) ◽  
pp. 401-407
Author(s):  
Luciana Saraiva da Silva ◽  
Rosângela Minardi Mitre Cotta ◽  
Tiago Ricardo Moreira ◽  
Rodrigo Gomes da Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Detection ◽  
Diagnostic Accuracy

Clinical utility of a functional lumen imaging probe in management of dysphagia following head and neck cancer therapies

Endoscopy ◽  
2017 ◽  
Vol 49 (09) ◽  
pp. 848-854 ◽  
Author(s):  
Peter Wu ◽  
Michal Szczesniak ◽  
Julia Maclean ◽  
Lennart Choo ◽  
Harry Quon ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Neck Cancer ◽  
Characteristic Curve ◽  
Diagnostic Tools ◽  
Cross Sectional ◽  
Imaging Probe ◽  
Functional Lumen Imaging Probe ◽  
Dysphagic Patients

Abstract Background and aims Chemoradiotherapy for head and neck cancer (HNC) with/without laryngectomy commonly causes dysphagia. Pharyngoesophageal junction (PEJ) stricturing is an important contributor. We aimed to validate a functional lumen imaging probe (the EndoFLIP system) as a tool for quantitating pretreatment PEJ distensibility and treatment-related changes in HNC survivors with dysphagia and to evaluate the diagnostic accuracy of EndoFLIP-derived distensibility in detecting PEJ strictures. Methods We studied 34 consecutive HNC survivors with long-term (> 12 months) dysphagia who underwent endoscopic dilation for suspected strictures. Twenty non-dysphagic patients undergoing routine endoscopy served as controls. PEJ distensibility was measured at endoscopy with the EndoFLIP system pre- and post-dilation. PEJ stricture was defined as the presence of a mucosal tear post-dilation. Results PEJ stricture was confirmed in 22/34 HNC patients (65 %). During distension up to 60 mmHg, the mean EndoFLIP-derived narrowest cross-sectional area (nCSA) in HNC patients with strictures, without strictures, and in controls were 58 mm2 (95 % confidence interval [CI] 22 to 118), 195 mm2 (95 %CI 129 to 334), and 227 mm2 (95 %CI 168 to 316), respectively. A cutoff of 114 mm2 for the nCSA at the PEJ had perfect diagnostic accuracy in detecting strictures (area under the receiver operating characteristic curve = 1). In patients with strictures, a single session of dilation increased the nCSA by 29 mm2 (95 %CI 20 to 37; P < 0.001). In patients with no strictures, dilation caused no change in the nCSA (mean difference 13 mm2 [95 %CI −4 to 30]; P = 0.13). Conclusions EndoFLIP is a highly accurate technique for the detection of PEJ strictures. EndoFLIP may complement conventional diagnostic tools in the detection of pharyngeal outflow obstruction.

scholarly journals Improving early exclusion of acute coronary syndrome in primary care: the added value of point-of-care troponin as stated by general practitioners

2017 ◽  
Vol 18 (04) ◽  
pp. 386-397 ◽  
Author(s):  
Michelle M.A. Kip ◽  
Amber M. Noltes ◽  
Hendrik Koffijberg ◽  
Maarten J. IJzerman ◽  
Ron Kusters
Keyword(s):  
Primary Care ◽  
Acute Coronary Syndrome ◽  
Blood Sample ◽  
General Practitioners ◽  
Point Of Care ◽  
Added Value ◽  
Lower Sensitivity ◽  
Test Duration ◽  
Referral Rates ◽  
Coronary Syndrome

AimTo investigate general practitioners’ (GPs’) desire and perceived added value of point-of-care (POC) troponin, its effect on referral decisions, and test requirements.BackgroundExcluding acute coronary syndrome (ACS) in primary care remains a diagnostic challenges for GPs. Consequently, referral rates of chest pain patients are high, while the incidence of a cardiovascular problem is only 8–15%. Previous studies have shown that GPs are interested in a POC troponin test. This test could enhance rapid exclusion of ACS, thereby preventing unnecessary patient distress, without compromising safety and while reducing costs. However, using this test is not recommended in current guidelines due to uncertainty in the test’s potential added value, and the lower sensitivity early after symptom onset as compared with troponin tests in a regular laboratory.MethodsAn online survey containing 34 questions was distributed among 837 Dutch GPs in June 2015.FindingsA total of 126 GPs (15.1%) completed at least 75% of the questions. 67.1% of GPs believe that POC troponin tests have moderate to very high added value. Although the availability of a POC test is expected to increase the frequency at which troponin tests are used, it likely decreases (immediate) referral rates. Of the responding GPs, 78.3% only accept 10 min as the maximum test duration, 78.1% think reimbursement of the POC device is required for implementation, and 68.9% consider it necessary that it can be performed with a finger prick blood sample. In conclusion, according to GPs, the POC troponin test can be of added value to exclude ACS early on. Actual test implementation will depend on test characteristics, including test duration, type of blood sample required, and reimbursement of the analyzer.

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