ORCID Profile
0000-0002-3328-5634
Current Organisation
University of York
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Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.RADI.2022.01.004
Abstract: Rheumatoid arthritis (RA) affects 1% of the population and is principally associated with joint inflammation. It is suggested however that muscle involvement may be one of the earliest clinical features of RA. It is therefore important that techniques exist to accurately assess muscle health in those with RA to enable successful treatment. This study assesses the inter-rater and intra-rater repeatability of Diffusion Tensor MRI (DTI), 2-Point Dixon fat fraction, and T2 relaxation of the thigh muscle in patients with RA using manual regions of interest (ROI). Nineteen patients (10/19 males mean age 59 range 18-85) diagnosed with RA had an MRI scan of their hamstrings and quadriceps muscles to obtain fat fraction (FF), mean diffusivity (MD), fractional anisotropy (FA), and T2 quantitative measurements. Two raters DB & MF independently contoured ROIs for each patient. DB repeated the ROI for the same 19 patients after a 6-month hiatus to assess intra-rater repeatability. Inter-rater and intra-rater repeatability for the ROI measurements were compared using Inter Class Correlation (ICC) and Bland-Altman plots. There was excellent agreement for both inter-rater and intra-rater repeatability. ICC results ranged from 0.900 to 0.998 (P < 0.001), and intra-rater ICC results ranged from 0.977 to 0.999 (P < 0.001). Bland-Altman plots also showed excellent agreement. ICC measurements and Bland-Altman plots showed excellent repeatability and agreement with no statistically significant differences when assessing the inter-rater and intra-rater repeatability of FF, MD, FA, and T2 relaxation of the thigh muscle using manual regions of interest in patients with RA. Manual ROI drawing does not introduce significant errors obtaining FF, MD, FA, and T2 MRI measurements in an RA population.
Publisher: Research Square Platform LLC
Date: 22-05-2023
DOI: 10.21203/RS.3.RS-2620951/V1
Abstract: Background: Older adults with cancer are a growing population requiring tailored care to achieve optimum treatment outcomes. Their care is complicated by under-recognised and under-treated wasting disorders: malnutrition, sarcopenia, and cachexia. We aimed to investigate the prevalence, overlap, and patients’ views and experiences of malnutrition, sarcopenia, and cachexia, in older adults with cancer. Methods: Mixed-methods study with cross-sectional study and qualitative interviews. Interviews were thematically analysed through a phenomenological lens, with feedback loop analysis investigating relationships between themes and findings synthesised using modified critical interpretative synthesis. Findings: n=30 were screened for malnutrition, sarcopenia, and cachexia, n=8 completed semi-structured interviews. 18 (60.0%) were malnourished, 16 (53.3%) sarcopenic, and 17 (56.7%) cachexic. One or more condition was seen in 80%, and all three in 30%. In univariate analysis, Rockwood clinical frailty score (OR 2.94 [95% CI:1.26–6.89, p=0.013]) was associated with sarcopenia, reported percentage meal consumption (OR 2.28 [95% CI:1.24–4.19, p=0.008]), and visible wasting (OR 8.43 [95% CI:1.9–37.3]) with malnutrition, and percentage monthly weight loss (OR 8.71 [95% CI:1.87–40.60]) with cachexia. Screening tools identified established conditions rather than ‘risk’. Nutritional and functional problems were often overlooked, overshadowed, and misunderstood by both patients and (in patients’ perceptions) by clinicians misattributed to ageing, cancer, or comorbidities. Patients viewed these conditions as both personal impossibilities, yet accepted inevitabilities. Conclusion: Perceptions, identification, and management of these conditions needs to improve and their importance recognised by clinicians and patients so those truly ‘at risk’ are identified whilst conditions are more remediable to interventions.
Publisher: Wiley
Date: 23-12-2023
DOI: 10.1111/MEDU.14011
Abstract: Historically, situational judgement tests (SJTs) have been widely used for personnel selection. Their use in medical selection in Europe is growing, with plans for further expansion into North America and Australasia, in an attempt to measure and select on 'non-academic' personal attributes. However, there is a lack of clarity regarding what such tests actually measure and how they should be designed, scored and implemented within the medical and health education selection process. In particular, the theoretical basis from which such tests are developed will determine the scoring options available, influencing their psychometric properties and, ultimately, their validity. The aim of this article is to create an awareness of the previous theory and practice that has informed SJT development. We describe the emerging interest in the use of the SJT format to measure specific constructs (eg 'resilience', 'dependability', etc.), drawing on the tradition of 'in idual differences' psychology. We compare and contrast this newer 'construct-driven' method with the traditional, pragmatic approach to SJT creation, often employed by organisational psychologists. Making reference to measurement theory, we highlight how the anticipated psychometric properties of traditional vs construct-driven SJTs are likely to differ. Compared to traditional SJTs, construct-driven SJTs have a strong theoretical basis, are uni- rather than multidimensional, and may behave more like personality self-report instruments. Emerging evidence also suggests that construct-driven SJTs have comparable predictive validity for workplace performance, although they may be more prone to 'faking' effects. It is possible that construct-driven approaches prove more appropriate at early stages of medical selection, where candidates have little or no health care work experience. Conversely, traditional SJTs may be more suitable for specialty recruitment, where a range of hypothetical workplace scenarios can be s led in assessments.
Publisher: Wiley
Date: 25-08-2020
DOI: 10.1111/MEDU.14201
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Lewis William Paton.