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1.
Vaccine X ; 15: 100391, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37772201

RESUMEN

Introduction: More than two years after SARS-CoV-2 emerged in Wuhan, China, COVID-19 has become one of the most severe pandemics in modern human history. Prior to the widespread availability of specific vaccines in 2021, public opinion surveys indicated significant vaccine hesitancy in 26 European countries. Materials and methods: Epidemiological data on COVID-19 morbidity and mortality for 26 European countries were collected in November 2021 and compared with the proportions of people willing to receive the SARS-CoV-2 vaccine according to public opinion surveys analysed in 2020. Correlations between various variables were calculated using the Pearson correlation test and visualized with the R programming language. Results: Paired Student's t-test revealed no significant differences between survey results and actual vaccination rates (p = 0.9546), suggesting that the polls were good predictors. The percentage of people willing to receive the SARS-CoV-2 vaccine was significantly positively correlated with actual vaccination rates (R = 0.72, p = 0.00003) and significantly negatively correlated with the number of cumulative deaths per million people (R = -0.78, p = 0.0000024). However, there was no significant correlation with the number of cumulative cases per million people (R = -0.27, p = 0.18). These findings indicate that vaccines used in Europe were particularly effective at preventing severe COVID-19 and disease-related deaths, but did not necessarily provide strong protection against SARS-CoV-2 infection itself. Conclusion: Encouraging widespread immunization through vaccination was crucial for rapidly improving the epidemiological situation in Europe.

2.
J Appl Clin Med Phys ; 24(4): e13952, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36897824

RESUMEN

BACKGROUND: AAPM Task Group (TG) 275 was charged with developing practical, evidence-based recommendations for physics plan and chart review clinical processes for radiation therapy. As part of this charge, and to characterize practices and clinical processes, a survey of the medical physics community was developed and conducted. Detailed analyses and trends based on the survey that exceeded TG report length constraints are presented herein. AIMS: The design, development, and detailed results of the TG- 275 survey as well as statistical analysis and trends are described in detail. This is complementary material to the TG 275 report. METHODS AND MATERIALS: The survey consisted of 100 multiple-choice questions divided into four main sections: 1) Demographics, 2) Initial Plan Check, 3) On-Treatment, and 4) End-of-Treatment Chart Check. The survey was released to all AAPM members who self-reported working in the radiation oncology field, and it was kept open for 7 weeks. Results were summarized using descriptive statistics. To study practice differences, tests of association were performed using data grouped by four demographic questions: 1) Institution Type, 2) Average number of patients treated daily, 3) Radiation Oncology Electronic Medical Record, and 4) Perceived Culture of Safety. RESULTS: The survey captured 1370 non-duplicate entries from the United States and Canada. Differences across practices were grouped and presented based on Process-Based and Check-Specific questions. A risk-based summary was created to show differences amongst the four demographic questions for checks associated with the highest risk failure modes identified by TG-275. CONCLUSION: The TG-275 survey captured a baseline of practices on initial plan, on-treatment, and end-of-treatment checks across a wide variety of clinics and institutions. The results of test of association showed practice heterogeneities as a function of demographic characteristics. Survey data were successfully used to inform TG-275 recommendations.


Asunto(s)
Oncología por Radiación , Humanos , Estados Unidos , Encuestas y Cuestionarios , Canadá
3.
Artículo en Inglés | MEDLINE | ID: mdl-36767615

RESUMEN

'Baby boomers' are the first generation whose representatives-both male and female-are, to a great extent, or plan to be, professionally active in their old age. Increased professional activity of this group influences family relations and the perception of the roles of grandmothers and grandfathers. This article attempts to assess the impact of grandparents' professional and educational activity on relationships with grandchildren. The study relies on data from an international comparative survey conducted using the CAWI method in representative groups of Internet users from seven European countries and a proprietary questionnaire. The study was conducted in May 2022, and the total research sample included 3008 people. The analysis covered answers to the questions on the perceived impact of grandparents' activity on the performance of family roles. To analyze the results, tests of the equality of means (t-test, ANOVA) were used to check for differences in assessments due to respondents' characteristics. The use of exploratory factor analysis made it possible to distinguish two groups of factors-those having a positive impact on the relationship with grandchildren and those having a negative one. The SEM (structural equation modeling) model was used to find an answer to the question of which factor-positive or negative-has a greater impact on trust in grandparents as carers. The results of the conducted analyses indicated the existence of statistically significant differences in the perception of the role of grandmothers and grandfathers due to such characteristics of the respondents as age, gender, or country of residence. It is possible to conclude that positive perceptions of grandparents' professional and educational activity encourage greater confidence in them in the context of performing family roles.


Asunto(s)
Abuelos , Humanos , Masculino , Femenino , Relaciones Intergeneracionales , Relaciones Familiares , Identidad de Género , Europa (Continente)
4.
J Echocardiogr ; 21(2): 74-78, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36306103

RESUMEN

OBJECTIVES: Ultrasonography is an essential examination performed in various clinical fields. The number of clinical sonographers has been increasing. However, the working environments and conditions at each facility are different, leading to diverse problems. Among them, the emerging issue is the sexual disagreement between the sonographer and patient at the time of echocardiography. Since the patient must expose their breast during echocardiography, female patients may refuse to undergo the examination when conducted by a male sonographer. This study aimed to conduct a questionnaire survey to understand the measures for sonographer-patient gender mismatch at different facilities. METHODS: A questionnaire on the implementation of echocardiography by male sonographers for female patients was answered by representatives and specialist technicians of the Japanese Society of Echocardiography. RESULTS: Questionnaire responses were obtained from 50 facilities (59 participants). A total of 70% of the facilities restricted male sonographers from conducting echocardiography examinations for female patients. Among them, 81% of the facilities serviced female patients aged 60 years or younger. CONCLUSIONS: It has become clear that the gender selection of echocardiographic examiners varies from facility to facility, and providing a sufficient explanation before echocardiographic examination is necessary to avoid causing uncomfortable situations for female patients.


Asunto(s)
Pueblos del Este de Asia , Ecocardiografía , Humanos , Masculino , Femenino , Ultrasonografía , Técnicos Medios en Salud , Encuestas y Cuestionarios
5.
J Biotechnol Biomed ; 6(4): 460-467, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38817776

RESUMEN

Objective: We aim to improve job workflow and satisfaction amongst clinic staff at an academic ophthalmology department. Methods: We analyzed survey data given over a 2-week period in July 2021. The participants were support staff (N = 18) from an academic ophthalmology department. Paper surveys were distributed to participants and returned anonymously for analysis. Results: The survey contained 9 Likert-style categorical questions, 2 of which were free response options. A total of 22 participants attempted the survey, 18 of these (82%) were complete and included in analysis. About half of the staff were satisfied with the current workflow 10/18 (56%). Staff who were clinical care coordinators had the lowest average satisfaction (2/5 on a 5-point scale) and the nursing team had the highest average (4.75/5). The most common staff suggestion for improving workflow efficiency was to train residents on forwarding and answering messages more effectively. Conclusion: This survey suggests that assigning patient message processing to the nursing staff can improve job satisfaction and workflow. Staff told us that the most exciting part of the job was appreciation from coworkers 9/30 (30%) and from physicians 8/30 (27%). The findings provide advice to physicians for optimizing communication, and staff experience, within their own ophthalmology clinics.

6.
Artículo en Inglés | MEDLINE | ID: mdl-36078288

RESUMEN

Full inclusion of people with disabilities means their full participation in community life and the same opportunities to work and spend their free time that other members of the community have. This also applies to travel and tourism. Offers available to people with various types of disabilities are seldom adapted to their needs. They face numerous barriers and obstacles when travelling or at their destination. The article presents selected results from an international comparative study concerning travel of people with sensory disabilities. The study was carried out in the first quarter of 2022 using the PAPI method on a group of 131 respondents from Poland, Greece, Cyprus and Portugal. To analyse the results, we relied on statistical inference using an independent two-sample t-test and one-way analysis of variance. Tests of the equality of two means were preceded by Levene's test for homogeneity of variances. According to the study, people with sensory disabilities can see many barriers to travel that pose a significant constraint on their activity. These barriers vary depending on the type of disability, gender or the country of origin of the respondent, but the list of indications often includes the need to train service staff in the specific needs of people with different types of disabilities. Taking into account development opportunities that people with disabilities create for the tourism industry, including people with sensory disabilities who are frequently overlooked, it is worth considering measures aimed at improving knowledge and skills in this area in the future.


Asunto(s)
Personas con Discapacidad , Chipre , Personas con Discapacidad/educación , Humanos , Polonia , Encuestas y Cuestionarios , Viaje
7.
PeerJ ; 10: e13933, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36032954

RESUMEN

This research aimed to understand the needs and habits of researchers in relation to code sharing and reuse; gather feedback on prototype code notebooks created by NeuroLibre; and help determine strategies that publishers could use to increase code sharing. We surveyed 188 researchers in computational biology. Respondents were asked about how often and why they look at code, which methods of accessing code they find useful and why, what aspects of code sharing are important to them, and how satisfied they are with their ability to complete these tasks. Respondents were asked to look at a prototype code notebook and give feedback on its features. Respondents were also asked how much time they spent preparing code and if they would be willing to increase this to use a code sharing tool, such as a notebook. As a reader of research articles the most common reason (70%) for looking at code was to gain a better understanding of the article. The most commonly encountered method for code sharing-linking articles to a code repository-was also the most useful method of accessing code from the reader's perspective. As authors, the respondents were largely satisfied with their ability to carry out tasks related to code sharing. The most important of these tasks were ensuring that the code was running in the correct environment, and sharing code with good documentation. The average researcher, according to our results, is unwilling to incur additional costs (in time, effort or expenditure) that are currently needed to use code sharing tools alongside a publication. We infer this means we need different models for funding and producing interactive or executable research outputs if they are to reach a large number of researchers. For the purpose of increasing the amount of code shared by authors, PLOS Computational Biology is, as a result, focusing on policy rather than tools.


Asunto(s)
Biología Computacional , Difusión de la Información , Humanos , Investigadores , Encuestas y Cuestionarios
8.
Artículo en Inglés | MEDLINE | ID: mdl-35206247

RESUMEN

The perception of people with disability (PwD) is of key importance for the full inclusion of this group in the labour market. The article presents selected results of research on the perception of PwD in the workplace. The analyses are based on the results of semiotics research conducted in Poland and of quantitative study in the form of computer-assisted Internet interviews (CAWI) carried out on representative samples from eight European countries. Opinions of Internet users were collected in Belgium, Bulgaria, Greece, Spain, Germany, Poland, Sweden and Great Britain. The results of semiotic analyses on texts mainly from Polish culture made it possible to identify the prevailing images of disability in Polish popular culture and inspired the authors to seek diversity in perceptions of disability depending on social and cultural patterns in a given country. The results of the international survey were used to compare all eight countries with regard to the relationship between the dimensions of culture according to G. Hofstede, and openness to people with disability in the workplace. The conducted research indicates that the perception of the issue of disability is significantly related to the selected dimensions of culture according to G. Hofstede.


Asunto(s)
Personas con Discapacidad , Lugar de Trabajo , Actitud , Europa (Continente) , Humanos , Polonia
9.
Virus Res ; 302: 198487, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34157336

RESUMEN

Worldwide, potato (Solanum tuberosum L.) is the third most important food crop after rice and wheat. Its production is however constrained by several virus diseases. The occurrence and distribution of the economically important viruses and associated insect vectors is however not known for Rwanda and Burundi, where potato is an important food security and income crop. We surveyed 194 potato fields for viruses and insect vectors. Aphids were commonly found infesting farmers' potato fields in contrast to whiteflies. Testing by Enzyme Linked Immunosorbent Assay (ELISA) for six potato viruses identified five viruses: potato leafroll virus (PLRV), potato virus X, S, M and Y (PVX, PVS, PVM, PVY) in Rwanda and two viruses (PLRV and PVS) in Burundi. A subset of samples were analyzed using small RNA sequencing and assembly (sRSA) and additionally revealed presence of PVX and for the first time, tobacco rattle virus (TRV) in Burundi. PLRV and PVS were most common while PVY was rare and not found in Burundi, which is highly unusual. To our knowledge, this is the first report of TRV infecting potatoes in sub-Saharan Africa. Phylogenetic analysis of 14 complete viral genomes determined by sRSA suggested multiple introductions of viruses into the region.


Asunto(s)
Potyvirus , Solanum tuberosum , Virus , Burundi/epidemiología , Filogenia , Enfermedades de las Plantas , Potyvirus/genética , Rwanda
10.
Artículo en Inglés | MEDLINE | ID: mdl-32993017

RESUMEN

This paper introduces into the analysis the concept of the ambassador of people with disability in the workplace. A kind and friendly person in the workplace, who creates a positive atmosphere around people with disabilities, may play a crucial role in their adaptation on the open labor market. Presence of such a person is especially important in entities that did not previously employ people with disabilities. It is vital that employers who would like to employ people with disability possess knowledge about demographic and professional characteristics that predispose employees to perform this special role. On the one hand, in this article we attempted to evaluate the differentiation in the perception of the issue of disability due to demographic and professional characteristics of respondents, and, on the other hand, to identify features that favor being an "ambassador of people with disabilities" in the workplace. The study was conducted in 2019 on the representative samples of Internet users from 8 European countries using Computer-Assisted Internet Interviews. For the purposes of the study, we used the Attitudes to Disability Scale WHOQOL Group test and a proprietary questionnaire. As for the methods of analysis, we relied on the classical analysis of variance and logistic regression. The conducted study showed that the perception of the issue of disability is significantly related to demographic and professional characteristics of respondents, and that the role of the ambassador is the most appropriate for a middle-aged woman with a good knowledge of disability issues, indecisive in the workplace.


Asunto(s)
Personas con Discapacidad/psicología , Empleo , Conocimientos, Actitudes y Práctica en Salud , Relaciones Interpersonales , Lugar de Trabajo , Adulto , Anciano , Actitud , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación Vocacional/métodos , Evaluación de Capacidad de Trabajo
11.
Energy Sustain Soc ; 10(1): 18, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32215236

RESUMEN

BACKGROUND: Energy cooperatives are a prominent and common form of community energy. Community energy has the potential to increase actor diversity and local acceptance of renewable energies and has therefore been highlighted to be conducive to energy transitions. While research has recognized the importance of both the national and the local governance levels for community energy, it remains unclear how these two levels are related. Against this backdrop, this paper investigates how municipalities support energy cooperatives at the local level and how this support is related to national context conditions. METHODS: The study takes a quantitative approach using own survey data from Germany and Switzerland. Based on a typology of municipal support, we compare limiting factors and municipal support for energy cooperatives between the two countries as well as between energy cooperatives with and without municipal membership. By means of this two-tiered comparison, we analyze how municipal support is related to national contexts, specifically regarding national energy policies, and to municipal involvement in the cooperatives. RESULTS: Our analysis shows that municipal support can benefit energy cooperatives as it addresses some of the major limiting factors for energy cooperatives in Germany and Switzerland. However, our data suggest that municipalities only specifically address cooperatives' limitations with support measures if they are a member in the cooperative. This indicates that organizational involvement of a municipality in energy cooperatives leads to a more targeted support compared to non-members and thus is beneficial to meet the specific cooperatives' challenges due to national energy policy. CONCLUSIONS: Cooperatives can benefit from municipal support, especially if the municipality is a cooperative member. Municipal support is likely to become even more important for energy cooperatives in the future, due to reduced national support for renewable energies in Germany and Switzerland. On their part, municipalities can benefit from collaborating with energy cooperatives, as they gain an additional instrument to implement municipal energy policy. Hence, supporting and seeking membership in energy cooperatives appear to be adequate strategies for municipalities to foster a decentralized energy transition.

13.
J Prosthodont ; 28(1): 49-63, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29896897

RESUMEN

PURPOSE: To review data and results from past surveys of prosthodontists sponsored and conducted by the American College of Prosthodontists (ACP). Specifically, results are examined and presented from the most recently conducted survey in 2017. Trends and changes in characteristics impacting the private practice of prosthodontists over time are discussed using results from six surveys completed in 2002, 2005, 2008, 2011, 2014, and 2017. MATERIALS AND METHODS: Results from the past surveys of prosthodontists are statistically examined and used to estimate several characteristics of the current population of practicing prosthodontists. The selected characteristics include age, gender, hours in the practice, employment of staff, referral sources, and financial conditions (e.g., gross receipts, expenses in the practice, and net income of prosthodontists). While the most recent survey was conducted during the year 2017, the respondents reported survey data for the previous year of 2016. RESULTS: The average age of private practice respondents in 2016 was 50 years; 23 years since graduation from dental school and 18 years since completion of residency; an average of 18 years since starting practice as a prosthodontist, with 52% in solo practice. The mean number of hours per week in the practice was 33.9 hours and the mean number of hours treating patients averaged 28.3 hours per week. The single largest source of referrals is the prosthodontist's patients (24.8%), while general practitioners are a close second source of referrals (21.8%). Salaries paid by prosthodontic practices reached 55% of total practice expenses. The mean nominal net income in 2016 of prosthodontists in private practice was $231,140 while the mean total net income from all prosthodontic sources was $263,850. CONCLUSION: Changes have continued to take place in the private practice of prosthodontics during most of the last decade. The average age of prosthodontists has declined since 2010. Hours in practice and hours treating patients have declined at a rate of about 1% per year since 2001. Mean net earnings of prosthodontists have declined at a rate of 1.6% since 2001 and 3.1% per year since 2007. The prosthodontist private practice industry, not unlike dentistry as a whole, has undergone economic and practice challenges that have affected the conditions of private practice during the last decade.


Asunto(s)
Odontólogos/estadística & datos numéricos , Práctica Privada/estadística & datos numéricos , Adulto , Anciano , Odontólogos/economía , Humanos , Renta , Masculino , Persona de Mediana Edad , Práctica Privada/economía , Encuestas y Cuestionarios , Estados Unidos
14.
Clin Biochem ; 50(7-8): 425-430, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27988326

RESUMEN

OBJECTIVES: Everolimus (EVR), a mTOR inhibitor immunosuppressant approved for renal, liver and cardiac transplants. This study established the appropriate TDM performances of the Thermo Scientific QMS EVR Assay by using the Beckman DxC, followed by comparison to the Thermo Scientific Indiko and a previously published LC-MS/MS assay, and Beckman AU680 and AU5800 analyzers. DESIGN AND METHODS: The study initially established acceptable linearity, precision and accuracy of the QMS EVR turbidimetric assay. Sample preparation was initiated by mixing patient whole blood with methanol and a precipitation reagent. Supernatant was transferred to sample cups. Drug in the supernatant and drug coated on microparticle compete for the limited number of antibody binding sites. If EVR is absent in the sample supernatant, EVR coated microparticles are agglutinated in the presence of antibody reagent. If EVR is present, agglutination is partially inhibited, depending on EVR concentration. Calibrators range was from 1.5 to 20ng/mL. Comparison studies data were analyzed by Deming Regression and Bland-Altman plots. RESULTS: Precision studies showed the following mean concentrations 4.00-4.72, 7.70-8.20 and 14.80-15.56ng/mL, and CVs of 3.1-8.7%, 3.4-8.9% and 2.6-4.4% respectively. Comparison of analyses of 107 de-identified transplant samples by three analyzers - Indiko, DxC and AU680 showed: EVR concentrations from <1.5 to 13.6ng/mL, slopes 1.000 to 1.076, intercepts -0.053 to 0.462, and R 0.945 to 0.981. Another series of comparison studies (n=104) of Indiko and AU680 with LC-MS/MS showed the following: slopes 1.035 to 1.086, intercepts -0.019 to -0.265, and R 0.924 to 0.980. 2013-2016 CAP survey results were acceptable. CONCLUSIONS: Based on the experience of the past 3.5years, Thermo Scientific QMS EVR Immunoassay using four different analyzers offered adequate limit of detection and acceptable accuracy and precision, suitable for monitoring renal and liver transplant recipients.


Asunto(s)
Monitoreo de Drogas/instrumentación , Monitoreo de Drogas/métodos , Everolimus/farmacocinética , Femenino , Humanos , Inmunoensayo/instrumentación , Inmunoensayo/métodos , Masculino , Nefelometría y Turbidimetría/instrumentación , Nefelometría y Turbidimetría/métodos , Sensibilidad y Especificidad
15.
J Prosthodont ; 25(4): 265-81, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26999554

RESUMEN

PURPOSE: To review data and results from past surveys of prosthodontists sponsored and conducted by the American College of Prosthodontists (ACP). Specifically, most results are examined and presented from the surveys conducted in 2008, 2011, and 2014. Selected survey results are examined for prosthodontists in private practice. MATERIALS AND METHODS: Results from past surveys of prosthodontists were statistically examined and used to estimate several characteristics of the current population of practicing prosthodontists. The selected characteristics included age, gender, number of patient visits, hours in the practice, employment of staff, referral sources, and financial conditions (e.g., gross receipts, expenses in the practice, and net income of prosthodontists). While the most recent survey was conducted during the year 2014, the respondents reported survey data for the previous year of 2013. RESULTS: The average age of a private practice prosthodontist in 2013 reached 52 years; 26 years since graduation from dental school and 20 years since completion of residency; an average of 20 years since starting practice as a prosthodontist, with 52.2% in solo practice. The mean number of hours per week in the practice was 32.6 hours, and practicing prosthodontists treated an average of 33 patient visits per week. The single largest source of referrals is the prosthodontist's patients, while general practitioners are a close second source of referrals. The largest percentage of time spent treating patients is for fixed prosthodontics (21%), which has declined from a mean of 24.1% reported in 2007. The mean amount of nominal gross billings in 2013 was $654,270 per prosthodontist, which was lower than the mean gross billings in both 2007 and 2010; average total practice expenses were $577,480; and the mean nominal net earnings in 2013 of prosthodontists in private practice was $225,280. CONCLUSION: Changes have continued to take place in the private practice of prosthodontics during most of the last decade. The prosthodontist private practice industry, not unlike dentistry as a whole, has undergone economic and practice challenges that have affected the conditions of the private practice of prosthodontists.


Asunto(s)
Práctica Privada , Prostodoncia , Odontólogos , Humanos , Renta , Encuestas y Cuestionarios , Estados Unidos
17.
J Prosthodont ; 23(1): 10-20, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24382359

RESUMEN

PURPOSE: The purpose of this article is to review data and results from past surveys of prosthodontists sponsored and conducted by the American College of Prosthodontists. Surveys were conducted in 2002, 2005, 2008, and 2011. Selected survey results are examined for prosthodontists in private practice. MATERIALS AND METHODS: Results from past surveys of prosthodontists were statistically examined and used to estimate several characteristics of the current population of practicing prosthodontists. The selected characteristics included age, gender, number of patient visits, hours in the practice, employment of staff, referral sources, and financial conditions (e.g., gross receipts, expenses in the practice, and net income of prosthodontists). While the most recent survey was conducted in 2011, the results reported by respondents are for the previous year, 2010. RESULTS: The average age of a private practicing prosthodontist in 2010 reached 53 years; 26 years since graduation from dental school and 20 years since completion of residency; an average of 13 years in their current practice. Sixty percent were in solo practice. The mean number of hours per week in the practice was 35 hours, and practicing prosthodontists treated an average of 35 patient visits per week. The patient was the single largest source of referrals, while general practitioners were a close second. The largest percentage of time spent treating patients was for fixed prosthodontics (21%), which declined from a mean of 24.1% in 2007. The mean amount of gross billings in 2010 was $721,970, which was a decline from 2007. Average total practice expenses were $538,230, and the mean net earnings of prosthodontists in private practice were $238,010. CONCLUSION: Changes have occurred since the last survey of prosthodontists in 2008 (with results for the year 2007). The prosthodontist private practice industry, not unlike dentistry as a whole, has undergone economic challenges that have affected the private practice of prosthodontists.


Asunto(s)
Odontólogos/estadística & datos numéricos , Práctica Privada/estadística & datos numéricos , Prostodoncia/estadística & datos numéricos , Contabilidad de Pagos y Cobros , Adulto , Factores de Edad , Anciano , Citas y Horarios , Personal de Odontología/estadística & datos numéricos , Femenino , Administración Financiera/estadística & datos numéricos , Odontología General/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico/estadística & datos numéricos , Práctica Odontológica Asociada/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Salarios y Beneficios/estadística & datos numéricos , Factores de Tiempo , Estados Unidos
19.
World Neurosurg ; 81(3-4): 623-33, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24056096

RESUMEN

OBJECTIVES: To conduct a survey of the AOSpine community to determine international perceptions of key predictors of outcome in patients with cervical spondylotic myelopathy. This knowledge will guide the development of clinical prediction models and allow the alignment of clinical perceptions with evidence-based reality. METHODS: A request to participate in a survey was distributed to members of AOSpine International. The primary question asked surgeons to rank eight clinical factors according to their ability to predict surgical outcome: age, preoperative severity, sex, duration of symptoms, smoking status, signs, and symptoms. Three questions were also included to address the importance of magnetic resonance imaging as a prognostic tool. RESULTS: Six hundred and eighty-nine international spine professionals completed the survey, most of whom were spine surgeons. Duration of symptoms and baseline severity score were ranked as the top two predictors of outcome from all geographic locations, with the exception of Europe, which rated the presence of myelopathic symptoms more important than preoperative severity. There was international agreement that 65 years and a modified Japanese Orthopaedic Association score of 12 were the threshold age and preoperative severity above/below which there becomes a negative impact on outcome. Surgeons most frequently selected diabetes (n = 538) as the comorbidity having the most significant impact on surgical results, followed by neuromuscular disorders (n = 360). Finally, there was international consensus that magnetic resonance imaging is a valuable prognostic tool and that signal changes on T2- and T1/T2-weighted images are the most important parameters in outcome prediction. CONCLUSION: This survey summarizes surgeons' perceptions of the most important predictors of outcome and provides insight into how surgeons undertake decision making.


Asunto(s)
Vértebras Cervicales/patología , Vértebras Cervicales/cirugía , Procedimientos Neuroquirúrgicos/métodos , Espondilosis/patología , Espondilosis/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad , Medicina Basada en la Evidencia , Femenino , Encuestas de Atención de la Salud , Humanos , Internacionalidad , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/normas , Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Valor Predictivo de las Pruebas , Pronóstico , Índice de Severidad de la Enfermedad , Fumar/epidemiología , Espondilosis/epidemiología , Resultado del Tratamiento
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