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Karlijn Overeem Hub Wollersheim Erik Driessen Kiki Lombarts Geertje van de Ven Richard Grol & Onyebuchi Arah 《Medical education》2009,43(9):874-882
Objectives Delivery of 360‐degree feedback is widely used in revalidation programmes. However, little has been done to systematically identify the variables that influence whether or not performance improvement is actually achieved after such assessments. This study aims to explore which factors represent incentives, or disincentives, for consultants to implement suggestions for improvement from 360‐degree feedback. Methods In 2007, 109 consultants in the Netherlands were assessed using 360‐degree feedback and portfolio learning. We carried out a qualitative study using semi‐structured interviews with 23 of these consultants, purposively sampled based on gender, hospital, work experience, specialty and views expressed in a previous questionnaire. A grounded theory approach was used to analyse the transcribed tape‐recordings. Results We identified four groups of factors that can influence consultants’ practice improvement after 360‐degree feedback: (i) contextual factors related to workload, lack of openness and social support, lack of commitment from hospital management, free‐market principles and public distrust; (ii) factors related to feedback; (iii) characteristics of the assessment system, such as facilitators and a portfolio to encourage reflection, concrete improvement goals and annual follow‐up interviews, and (iv) individual factors, such as self‐efficacy and motivation. Conclusions It appears that 360‐degree feedback can be a positive force for practice improvement provided certain conditions are met, such as that skilled facilitators are available to encourage reflection, concrete goals are set and follow‐up interviews are carried out. This study underscores the fact that hospitals and consultant groups should be aware of the existing lack of openness and absence of constructive feedback. Consultants indicated that sharing personal reflections with colleagues could improve the quality of collegial relationships and heighten the chance of real performance improvement. 相似文献
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Marjolein Bonthuis Marco Busutti Karlijn J. van Stralen Kitty J. Jager Sergey Baiko Sevcan Bakkalo?lu Nina Battelino Maria Gaydarova Bruno Gianoglio Paloma Parvex Clara Gomes James G. Heaf Ludmila Podracka Dafina Kuzmanovska Maria S. Molchanova Tatiana E. Pankratenko Fotios Papachristou Gy?rgy Reusz Maria José Sanahuja Rukshana Shroff Jaap W. Groothoff Franz Schaefer Enrico Verrina 《Clinical journal of the American Society of Nephrology》2015,10(5):767-775
Background and objectives
Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal Association–European Dialysis and Transplant Association Registry to study the prevalence and potential determinants of mineral abnormalities, as well as the predictive value of a disturbed mineral level on graft survival in a large cohort of European pediatric renal transplant recipients.Design, setting, participants, & measurements
This study included 1237 children (0–17 years) from 10 European countries, who had serum calcium, phosphorus, and parathyroid hormone measurements from 2000 onward. Abnormalities of mineral metabolism were defined according to European guidelines on prevention and treatment of renal osteodystrophy in children on chronic renal failure.Results
Abnormal serum phosphorus levels were observed in 25% (14% hypophosphatemia and 11% hyperphosphatemia), altered serum calcium in 30% (19% hypocalcemia, 11% hypercalcemia), and hyperparathyroidism in 41% of the patients. A longer time since transplantation was associated with a lower risk of having mineral levels above target range. Serum phosphorus levels were inversely associated with eGFR, and levels above the recommended targets were associated with a higher risk of graft failure independently of eGFR.Conclusions
Abnormalities in mineral metabolism are common after pediatric renal transplantation in Europe and are associated with graft dysfunction. 相似文献55.
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Karen Couder Karlijn van der Straten Lieke Brouwer Gerrit Koen Hetty van Eijk Dasja Pajkrt Jean-Luc Murk Katja C. Wolthers 《Viruses》2021,13(6)
Non-polio enteroviruses (NPEV) and parechoviruses (PeV) are widespread pathogens that cause significant morbidity. Surveillance is based on culturing or genotyping of virus strains found in clinical samples. Sero-surveillance, by measuring neutralising antibodies (nAb) through virus neutralisation assays (VNA), could provide additional information as it offers a more comprehensive overview of exposure to circulating types in the general population. In our study we evaluated Intravenous immunoglobulins (IVIG) to generate sero-surveillance data. We performed VNA of nineteen NPEV and PeV with Dutch IVIG batches from two different time points (2010 and 2017) and an IVIG batch from Vietnam (2011). We compared our findings with geno- and sero-surveillance data and evaluated changes over time and between the two countries. Our findings show a good correlation with what is known from geno-surveillance data. The highest nAb titres were found against strains from Enterovirus B, while we did not observe nAb titres against strains belonging to Enterovirus C. In conclusion, we demonstrated that sero-surveillance by means of IVIG can be used to obtain insight into circulation of EV and PeV genotypes. This is of particular interest for public health, to evaluate changes over time and population susceptibility to emerging genotypes. 相似文献
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BACKGROUND: Injuries increase the risk of venous thrombosis. So far, most research has focused on major injuries that are accompanied by other risk factors for venous thrombosis, such as plaster casts and surgery. We studied the association of venous thrombosis with common minor injuries, such as minor sural muscle ruptures and ankle sprains. METHODS: We performed a large, population-based, case-control study (the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis [MEGA] study), including consecutive patients with a first deep venous thrombosis of the leg or pulmonary embolism and control subjects. Participants with malignant neoplasms, those who underwent surgery, and those who had a plaster cast or extended bed rest were excluded. RESULTS: Of 2471 patients, 289 (11.7%), and of 3534 controls, 154 (4.4%) had a minor injury in the 3 months preceding the venous thrombosis (patients) or completion of the questionnaire (controls). Venous thrombosis was associated with previous minor injury (odds ratio adjusted for sex and age, 3.1; 95% confidence interval, 2.5-3.8). The association was strongest for injuries that occurred in the 4 weeks before thrombosis and was not apparent before 10 weeks. Thrombosis was more strongly associated with minor injuries located in the leg (odds ratio adjusted for sex and age, 5.1; 95% confidence interval, 3.9-6.7), while those located in other body parts were not associated. A 50-fold increased risk was found in factor V Leiden carriers with a leg injury compared with noncarriers without injury (odds ratio, 49.7; 95% confidence interval, 6.8-362.7). CONCLUSIONS: Minor injuries in the leg are associated with greater risk of venous thrombosis. Because minor injuries are common, they could be major contributors to the occurrence of venous thrombosis. 相似文献
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Eva Neufeld Shannon Freeman Karlijn Joling John P. Hirdes 《Clinical gerontologist》2013,36(3):298-315
This study investigated the prevalence of depressive symptoms and diagnoses among older adults newly admitted to long-term care facilities (LTCFs) in Ontario, Canada. Using anonymous cross-sectional and longitudinal Minimum Data Set 2.0 (MDS 2.0) assessments (N = 63,095), changes in depressive symptoms and predictors of depression following admission to institutional care were examined. Depressive symptoms were present in 54.3 cases per 100 residents at initial assessment, increasing to 60.8 cases per 100 residents by follow-up. Although depressive symptoms worsened, approximately 30% of residents showed moderate to significant improvement following LTCF admission. Results are discussed in the context of the MDS 2.0 and interRAI Mood CAP as a resource for LTCF care staff. 相似文献
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Anne-Marieke van Dijk Sjoerd Dingerink Felix Patience Chilunga Karlijn Anna Catharina Meeks Silver Bahendeka Matthias Bernd Schulze Ina Danquah Tracy Bonsu Osei Erik Sern Charles Agyemang Adriaan Georgius Holleboom 《临床与转化肝病杂志(英文版)》2021,9(4):494
Background and AimsMetabolic-associated fatty liver disease (MAFLD) is driven by high caloric intake and sedentary lifestyle. Migration towards high income countries may induce these driving factors; yet, the influence of such on the prevalence of MAFLD is clearly understudied. Here, we investigated the Fatty Liver Index (FLI), a proxy of steatosis in MAFLD, after migration of Ghanaian subjects.MethodsCross-sectional data of 5282 rural, urban and migrant participants from the Research on Obesity and Diabetes among African Migrants (also known as RODAM) study were analyzed with logistic regression for geographical differences in FLI and associations with type 2 diabetes mellitus (T2DM), waist-to-hip ratio, and 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD).ResultsBoth FLI and the proportion with an FLI indicative of MAFLD steatosis (FLI ≥60) were higher in migrants compared with non-migrants. Prevalence of elevated FLI (FLI ≥60) in non-migrant males was 4.2% compared to 28.9% in migrants. For females, a similar gradient was observed, from 13.6% to 36.6% respectively. Compared to rural residents, the odds for a FLI ≥60 were higher in migrants living in urban Europe (odds ratio [OR] 9.02, 95% confidence interval [CI]: 5.02–16.20 for men, and 4.00, 95% CI: 3.00–5.34 for women). Compared to controls, the ORs for FLI ≥60 were 2.43 (95% CI: 1.73–3.41) for male T2DM cases and 2.02 (95% CI: 1.52–2.69) for female T2DM cases. One-unit higher FLI was associated with an elevated (≥7.5%) 10-year ASCVD risk (OR: 1.051, 95% CI: 1.041–1.062 for men, and 1.020, 95% CI: 1.015–1.026 for women).ConclusionsFLI as a proxy for MAFLD increased stepwise in Ghanaians from rural areas, through urban areas, to Europe. Our results clearly warrant awareness for MAFLD in migrant population as well as confirmation with imaging modalities. 相似文献