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1.
Magn Reson Imaging ; 109: 286-293, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38531463

ABSTRACT

INTRODUCTION: The relationship between brain lesions and stroke outcomes is crucial for advancing patient prognosis and developing effective therapies. Stroke is a leading cause of disability worldwide, and it is important to understand the neurological basis of its varied symptomatology. Lesion-symptom mapping (LSM) methods provide a means to identify brain areas that are strongly associated with specific symptoms. However, inner variations in LSM methods can yield different results. To address this, our study aimed to characterize the lesion-symptom mapping variability using three different LSM methods. Specifically, we sought to determine a lesion symptom core across LSM approaches enhancing the robustness of the analysis and removing potential spatial bias. MATERIAL & METHODS: A cohort consisting of 35 patients with either right- or left-sided middle cerebral artery strokes were enrolled and evaluated using the NIHSS at 24 h post-stroke. Anatomical T1w MRI scans were also obtained 24 h post-stroke. Lesion masks were segmented manually and three distinctive LSM methods were implemented: ROI correlation-based, univariate, and multivariate approaches. RESULTS: The results of the LSM analyses showed substantial spatial differences in the extension of each of the three lesion maps. However, upon overlaying all three lesion-symptom maps, a consistent lesion core emerged, corresponding to the territory associated with elevated NIHSS scores. This finding not only enhances the spatial accuracy of the lesion map but also underscores its clinical relevance. CONCLUSION: This study underscores the significance of exploring complementary LSM approaches to investigate the association between brain lesions and stroke outcomes. By utilizing multiple methods, we can increase the robustness of our results, effectively addressing and neutralizing potential spatial bias introduced by each individual method. Such an approach holds promise for enhancing our understanding of stroke pathophysiology and optimizing patient care strategies.


Subject(s)
Brain Mapping , Stroke , Humans , Brain Mapping/methods , Stroke/diagnostic imaging , Stroke/pathology , Brain/pathology , Magnetic Resonance Imaging , Infarction, Middle Cerebral Artery
2.
Patient Educ Couns ; 120: 108102, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38141445

ABSTRACT

OBJECTIVE: To explore breast cancer (BC) patients' participation in breast reconstruction (BR) decision-making and specific decisional needs, especially the manifestations and causes of decisional conflicts, in China. METHODS: A mixed-methods study was conducted using triangulation of data from interviews and a questionnaire survey with health care professionals (HCPs) and BC patients with BR decision-making experience at 5 Beijing centers. The Ottawa Decision Support Framework guided (ODSF) the qualitative and quantitative data analyses. RESULTS: A total of 82.53% of Chinese BC patients would consider BR. Seven themes captured patients' BR decisional needs per the ODSF: inadequate support/resources (100%, 58.82%) and knowledge (75%, 52.94%) were most frequently cited. Health beliefs (unclear values) reflected Chinese characteristics. Patients had inadequate knowledge (M=19.99/50, SD=8.67) but positive BR attitudes (M=59.48/95, SD=10.45). CONCLUSIONS: BR decisions for Chinese BC patients are complex and often accompanied by decisional conflicts. Inadequate knowledge and inadequate support and resources contribute to these conflicts, emphasizing the need for culturally tailored information and support to promote SDM. PRACTICE IMPLICATIONS: HCPs need specialized training in SDM to guide patients in decision-making. It is essential to provide relevant resources and support that are culturally and clinically appropriate for Chinese patients.


Subject(s)
Breast Neoplasms , Mammaplasty , Humans , Female , Breast Neoplasms/surgery , Patient Participation , Research Design , Patients , Decision Making
3.
Psicol. ciênc. prof ; 41: e221076, 2021. tab, graf
Article in Portuguese | LILACS, Index Psychology - journals | ID: biblio-1340411

ABSTRACT

Resumo Médicos residentes estão expostos aos estressores relacionados ao ensino e ao exercício profissional. Nesta pesquisa, objetivamos identificar a prevalência da síndrome de burnout entre os médicos residentes do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG) e explorar sua relação com aspectos sociodemográficos e ocupacionais. Dos médicos residentes, 273 responderam uma ficha sociodemográfica e ocupacional e o Inventário de Burnout de Maslach (MBI), desses, entrevistamos 13. Submetemos as respostas dos questionários à análise estatística e das entrevistas à análise de conteúdo. Encontramos alta exaustão emocional (68,1%), moderado ou alto cinismo (41,7%) e moderada ou alta ineficácia profissional (40,6%). Identificamos a presença de síndrome de burnout em 25,64% dos médicos residentes, além disso, encontramos relações de baixo poder explicativo com as variáveis sociodemográficas e ocupacionais. Os resultados fortaleceram a necessidade de questionarmos as condições de trabalho dos médicos residentes, o papel das variáveis sociodemográficas e ocupacionais, da religiosidade e do processo de socialização organizacional no desenvolvimento da síndrome de burnout. (AU)


Abstract Resident doctors are exposed to stressors related to both the education and the professional practice. This research aimed to identify the prevalence of burnout syndrome among the resident doctors of the Hospital das Clínicas of the Universidade Federal de Minas Gerais (HC-UFMG), exploring its association with sociodemographic and occupational aspects. Of the resident doctors, 273 answered a sociodemographic and occupational form and the Maslach Burnout Inventory (MBI), and we interviewed 13 of them. We submitted the answers of the questionnaires to statistical analysis, whereas we applied content analysis to answers of interviews. The participants showed high emotional exhaustion (68.1%), moderate or high cynicism (41.7%), and moderate or high professional ineffectiveness (40.6%). We found that 25.64% the resident doctors presented with burnout syndrome. Besides, sociodemographic and occupational variables presented low explanatory power to prevalence of the syndrome. These results strengthen the need to question the working conditions of resident doctors, as well as the role of sociodemographic and occupational variables, religiosity, and the process of organizational socialization in the development of burnout syndrome. (AU)


Resumen Los médicos residentes están expuestos a los estresores relacionados con la enseñanza y el ejercicio profesional. En esta investigación, el objetivo es identificar la prevalencia del síndrome de quemarse por el trabajo entre los médicos residentes del Hospital das Clínicas de la Universidade Federal de Minas Gerais (HC-UFMG), así como explorar su relación con aspectos sociodemográficos y ocupacionales. De los médicos residentes, 273 respondieron a una ficha sociodemográfica y ocupacional y al Cuestionario de Burnout de Maslach (MBI); de los cuales entrevistamos a 13 de ellos. Sometemos sus respuestas de los cuestionarios al análisis estadístico; y de las entrevistas, al análisis de contenido. Encontramos un alto agotamiento emocional (68,1%), moderado o alto cinismo (41,7%) y moderada o alta ineficacia profesional (40,6%). Identificamos la presencia de síndrome de quemarse en el 25,64% de los médicos residentes y encontramos relaciones de bajo poder explicativo con las variables sociodemográficas y ocupacionales. Los resultados fortalecieron la necesidad de cuestionar las condiciones de trabajo de los médicos residentes, el papel de las variables sociodemográficas y ocupacionales, de la religiosidad y del proceso de socialización organizacional en el desarrollo del síndrome de quemarse por el trabajo. (AU)


Subject(s)
Humans , Male , Female , Burnout, Psychological , Hospitals, University , Medical Staff, Hospital , Professional Practice , Syndrome , Work , Hospitals
4.
Health Qual Life Outcomes ; 18(1): 124, 2020 May 07.
Article in English | MEDLINE | ID: mdl-32381020

ABSTRACT

BACKGROUND: The Pain Catastrophizing Scale (PCS) is a widely used self-report tool to evaluate pain related catastrophizing. The PCS was developed using classical test theory and has been shown to be psychometrically sound among various populations. However, it's current three subscales are rarely used in clinical practice, offering potential for an abbreviated version that reduces administrative burden and can be used to estimate full scale scores, yet is not bound by the inclusion of items from each subscale. Hence, the aim of the current study was to develop a unidimensional abbreviated version of the PCS through findings from qualitative, classical test theory, and newer Rasch analysis. METHODS: The current cross-sectional study used data from the Quebec Pain Registry (n = 5646) to obtain PCS scores of people seeking care at tertiary chronic pain centres. To develop an abbreviated unidimensional tool, items were removed based on triangulation of qualitative review of each item and response, corrected item-total correlations, and Rasch analysis. Confirmatory factor analysis was conducted on the final remaining items to confirm the tool was assessing a single latent construct (catastrophizing). Fit was assessed using the cumulative fit index (CFI), Tucker Lewis Index (TLI), and root-mean-squared error of approximation (RMSEA). RESULTS: After triangulation, a final abbreviated 4-item scale showed adequate model fit with a strong correlation (r > 0.95) with the original scale and properties that were stable across age, sex, cause, and medicolegal status. Additionally, the brief version addressed some problematic wording on some items on the original scale. Both the original and new abbreviated tool were associated with the Beck Depression Inventory and the Brief Pain Inventory at the same magnitude. CONCLUSION: The abbreviated scale may allow for a decrease in administrator burden and greater clinical uptake when a quick screen for exaggerated negative orientation towards pain is needed.


Subject(s)
Catastrophization/psychology , Pain Measurement/methods , Psychiatric Status Rating Scales/standards , Adult , Cross-Sectional Studies , Factor Analysis, Statistical , Female , Humans , Male , Middle Aged , Psychometrics/methods , Quality of Life
5.
Estud. Psicol. (Campinas, Online) ; 37: e180094, 2020. graf
Article in English | LILACS | ID: biblio-1056175

ABSTRACT

Exposure to school bullying is a situation experienced in children and adolescents' routine and a few bullying complex conditions have not yet been sufficiently explored. Thus, this study's objective aimed at synthesizing empirical evidence concerning the relationship between bullying and family variables in a theoretical model. Adopting a mixed design, the total sample included 2,354 students from 11 public schools who participated in the quantitative stage study. Data were collected using two scales. In the quantitative stage 55 students were randomly selected for semi-structured interviews. The results revealed that positive family interactions have a protective power in relation to bullying and victimization, while negative family interactions increase the risk of students becoming involved in such situations. The factors that influence students' involvement in school bullying belonged to the analytical components of the Bioecological Model. The outcome helped a better understanding of bullying and provided empirical support for family inclusion in the issue.


A exposição ao bullying escolar é uma realidade para crianças e adolescentes, porém ainda não foram exploradas suficientemente algumas complexidades do fenômeno. Assim, este estudo objetivou sintetizar em um modelo teórico evidências empíricas sobre a relação entre bullying e variáveis familiares. Com delineamento misto, a amostra total foi constituída por 2.354 estudantes de 11 escolas públicas, os quais participaram da etapa quantitativa do estudo, respondendo a duas escalas. Na fase qualitativa, 55 estudantes foram selecionados aleatoriamente para participar de entrevistas semiestruturadas. Os resultados revelaram que interações familiares positivas possuem poder protetivo em relação ao bullying e à vitimização, ao passo que interações familiares negativas aumentam o risco de envolvimento dos estudantes nessas situações. Os fatores que influenciam no envolvimento dos estudantes em situações de bullying na escola pertenciam aos componentes analíticos da Teoria Bioecológica. Os resultados permitiram ampliar a compreensão sobre o bullying e dão apoio empírico para incluir a família no debate sobre essa questão.


Subject(s)
Adolescent , Family Relations , Bullying
6.
Estud. Psicol. (Campinas, Online) ; 37: e180094, 2020. graf
Article in English | LILACS | ID: biblio-1090300

ABSTRACT

Exposure to school bullying is a situation experienced in children and adolescents' routine and a few bullying complex conditions have not yet been sufficiently explored. Thus, this study's objective aimed at synthesizing empirical evidence concerning the relationship between bullying and family variables in a theoretical model. Adopting a mixed design, the total sample included 2,354 students from 11 public schools who participated in the quantitative stage study. Data were collected using two scales. In the quantitative stage 55 students were randomly selected for semi-structured interviews. The results revealed that positive family interactions have a protective power in relation to bullying and victimization, while negative family interactions increase the risk of students becoming involved in such situations. The factors that influence students' involvement in school bullying belonged to the analytical components of the Bioecological Model. The outcome helped a better understanding of bullying and provided empirical support for family inclusion in the issue.


A exposição ao bullying escolar é uma realidade para crianças e adolescentes, porém ainda não foram exploradas suficientemente algumas complexidades do fenômeno. Assim, este estudo objetivou sintetizar em um modelo teórico evidências empíricas sobre a relação entre bullying e variáveis familiares. Com delineamento misto, a amostra total foi constituída por 2.354 estudantes de 11 escolas públicas, os quais participaram da etapa quantitativa do estudo, respondendo a duas escalas. Na fase qualitativa, 55 estudantes foram selecionados aleatoriamente para participar de entrevistas semiestruturadas. Os resultados revelaram que interações familiares positivas possuem poder protetivo em relação ao bullying e à vitimização, ao passo que interações familiares negativas aumentam o risco de envolvimento dos estudantes nessas situações. Os fatores que influenciam no envolvimento dos estudantes em situações de bullying na escola pertenciam aos componentes analíticos da Teoria Bioecológica. Os resultados permitiram ampliar a compreensão sobre o bullying e dão apoio empírico para incluir a família no debate sobre essa questão.


Subject(s)
Adolescent , Family Relations , Bullying
7.
Braz. j. med. biol. res ; 44(11): 1105-1111, Nov. 2011. ilus, tab
Article in English | LILACS | ID: lil-604279

ABSTRACT

In 1995, a pioneering MD-PhD program was initiated in Brazil for the training of medical scientists in experimental sciences at the Federal University of Rio de Janeiro. The program’s aim was achieved with respect to publication of theses in the form of papers with international visibility and also in terms of fostering the scientific careers of the graduates. The expansion of this type of program is one of the strategies for improving the preparation of biomedical researchers in Brazil. A noteworthy absence of interest in carrying out clinical research limits the ability of young Brazilian physicians to solve biomedical problems. To understand the students’ views of science, we used qualitative and quantitative triangulation methods, as well as participant observation to evaluate the students’ concepts of science and common sense. Subjective aspects were clearly less evident in their concepts of science. There was a strong concern about "methodology", "truth" and "usefulness". "Intuition", "creativity" and "curiosity" were the least mentioned thematic categories. Students recognized the value of intuition when it appeared as an explicit option but they did not refer to it spontaneously. Common sense was associated with "consensus", "opinion" and ideas that "require scientific validation". Such observations indicate that MD-PhD students share with their senior academic colleagues the same reluctance to consider common sense as a valid adjunct for the solution of scientific problems. Overcoming this difficulty may be an important step toward stimulating the interest of physicians in pursuing experimental research.


Subject(s)
Humans , Biomedical Research/education , Education, Medical, Graduate , Judgment , Science/education , Students, Medical/psychology , Brazil , Education, Medical, Graduate/standards , Intuition/physiology , Program Development , Program Evaluation , Research Personnel/education
8.
Article in Korean | WPRIM (Western Pacific) | ID: wpr-77989

ABSTRACT

The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows: 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.


Subject(s)
Humans , Surveys and Questionnaires , Rehabilitation , Sexuality , Spinal Cord Injuries , Spinal Cord
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