Intrarater reliability of the Abilitator—a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position: a test–retest study

ObjectivesThe Abilitator is a patient-reported outcome measure (PROM) of work ability and functioning of those in a weak labour market position. It covers items for work ability and self-rated health, for example, and summary scales for social, psychological, cognitive and physical functioning, as well as everyday skills. The aim of this study was to evaluate the intrarater test–retest reliability, internal consistency and basic psychometric properties of the Finnish version of the Abilitator.Design, setting and outcomeThe test–retest study was conducted in European Social Fund projects in 2018–2019. The participants completed two Abilitator questionnaires over 7–14 days. The internal consistency analysis was based on data collected in 2017–2019 in services for the long-term unemployed. The reliability was assessed using correlations (r, rs, intraclass correlation coefficient (ICC)), agreement with Bland-Altman analysis and internal consistency with Cronbach’s alpha.ParticipantsThe test–retest study had 67 participants (52% men, mean age 43.9 years) and the internal consistency study 10 923 (48% men, mean age 38.58 years), respectively. Of all the participants, 80% had been unemployed for over a year.ResultsThe test–retest r or rs ranged from 0.71 to 0.93 and ICC from 0.74 to 0.93 for the items and summary scales. An exception was the life satisfaction item, with an rs of 0.60 and ICC of 0.45. A statistically significant difference was observed in the summary scale for social functioning (t=−2.01, p=0.049). Agreement was observed for all variables except social functioning. Alphas for summary scales ranged from 0.74 to 0.91.ConclusionsThe Finnish version of the Abilitator is a reliable PROM for the target group and has acceptable to excellent intrarater test–retest reliability and internal consistency, apart from the life satisfaction item. Further testing is needed for the social functioning summary scale.

The association between obesity and quality of life: a retrospective analysis of a large-scale population-based cohort study

Background The relationship between obesity and health-related quality of life (HRQoL) may be confounded by factors such as multimorbidity. The aim of the study was to explore this relationship, controlling for long-term conditions and other health, lifestyle and demographic factors in a general adult population. There was specific interest in the impact of high weight status, measured by body mass index (BMI) levels (obesity, morbid obesity) compared with individuals of normal weight. Methods Health, lifestyle and demographic data were collected from 64,631 individuals aged 16 years and over registered in the Yorkshire Health Study; a long-term cohort study. Data were collected in 2 waves: from patients attending GP surgeries in the South Yorkshire region; and using online recruitment across the entire Yorkshire and Humber area. Univariable and multivariable regression methods were utilised to identify factors associated with HRQoL as measured by the EQ-5D summary score. Long-term conditions were tested as both covariates and mediating factors on the causal pathway between obesity and HRQoL. Results Increasing levels of obesity are associated with reduced HRQoL, although this difference is negligible between those of normal weight and those who are overweight. Individuals with obesity and morbid obesity score 4.9 and 11.3 percentage points less on the EQ-5D summary scale respectively than those of normal weight. Concurrent physical, and particularly mental health-related long-term conditions are substantively related to HRQoL: those with 3 or more reported mental or physical health conditions score 29.8 and 14.6 percentage points less on the EQ-5D summary scale respectively than those with fewer conditions. Long-term conditions can be conceptualised as lying on the causal path between obesity and HRQoL, but there is weak evidence for a partial mediating relationship only. Conclusions To conclude, in agreement with the established literature we have found a clear inverse relationship between increasing weight status and decreasing HRQoL and confirmed the mediating role of long-term conditions in the reduction of HRQoL in people with obesity. Nevertheless, a high BMI remains independently related to HRQoL, suggesting that ‘healthy people with obesity’ may be in transition to an unhealthy future.

Supercutaneous locking compression plate in the treatment of infected non-union and open fracture of the leg

Introduction Salvage of infected tibia and fibula non-union and severe open fractures is challenging and often requires staged treatment. We describe all cases that underwent supercutaneous plating of the leg as external fixation technique and assessed union rate, time to union, rate of infection clearance, and patient-reported outcome measures. Methods This is a retrospective cohort study from a single level 1 trauma center. We included 19 patients that underwent supercutaneous plating—locking compression plate applied as external fixator—of the leg. Indications were: infected non-union of a pilon, cruris, or ankle fracture (n = 13); post-traumatic fistula draining osteomyelitis of the tibia (n = 3); infected mal-reduced subacute cruris fracture (n = 1); acute open pilon fracture (n = 1); and acute open cruris fracture (n = 1). Outcome measures were: union, time to union, infection clearance, the 36-item Short Form (SF-36) physical component summary scale (PCS) and mental component summary scale (MCS), and NRS pain scores. Results Union was achieved in 88% of the patients after a median of 279 days [interquartile range (IQR) 154–440]. Infection clearance was achieved in 94% of the patients. The PCS (median 51, IQR 46–56, p = 0.903) and MCS (median 57, IQR 50–60, p = 0.241) do not differ from normative population values. NRS Pain score at rest was 0 on average (IQR 0–1), 2 on average when walking (IQR 0–4), and 1 on average when climbing stairs (IQR 0–2). Conclusion Supercutaneous plating is a simple and reliable technical trick to bridge and stabilize a nonunion or fracture site while clearing an infection and have soft-tissues heal before subsequent definitive (internal)fixation and/or cancellous bone grafting. Reasonable union and infection clearance rates are achieved, and good functional outcome can generally be expected. Level of evidence Therapeutic level III.

The independent effects of nausea and vomiting and social support on health-related quality of life during early pregnancy: A longitudinal study

Background: Previous studies that have examined the impact of nausea and vomiting (NV) on health-related quality of life (HR-QOL) among early pregnant women have collected data at a single time point, with the timing varying among studies, and even, in one study, among subjects. No previous study has examined the independent association NV and social support have with HR-QOL. We conducted a longitudinal study from August 2018 to February 2019 to investigate the independent association NV and social support have with HR-QOL among early pregnant women using repeated-measurement data. Subjects were 153 pregnant women who were 20 years of age or older and at less than 20 weeks of gestation at their first prenatal visit. They were recruited from a perinatal outpatient unit of a general hospital. Methods: Along with providing sociodemographic data, subjects were asked to complete three self-administered questionnaires: the Index of Nausea, Vomiting, and Retching (INVR); the Multidimensional Scale of Perceived Social Support (MSPSS); and the 12-item Short Form Health Survey (SF-12). Further, at every subsequent visit up to 20 weeks of gestation, they were asked to complete both the SF-12 and the INVR (giving a maximum of three survey completions). Results: After controlling for internal correlations and confounding factors using a mixed model for longitudinal data, the INVR score was found to be significantly negatively associated with the physical component summary scale score of the SF-12; however, the MSPSS score showed no association with the physical component summary scale score. On the other hand, both the INVR score and the MSPSS score were negatively and positively, respectively, significantly associated with the mental component summary scale score of the SF-12, independently of each other. Conclusions: The severity of NV significantly impacts physical quality of life during early pregnancy, but social support has no such impact. However, NV and social support independently and significantly affect mental quality of life, independently of each other. Health professionals should recognize the significant impact of NV on HR-QOL. Additionally, they should be aware that social support contributes to the improvement of mental quality of life, regardless of the degree of NV.

3184 Development of a Leadership Assessment Scale in Translational Science

OBJECTIVES/SPECIFIC AIMS: To create the instrument, we employed a modified Delphi approach by conducting a thorough literature review on Leadership to help concretize the relevant constructs, and then usied these extracted constructs as a springboard for the Rockefeller Team Science Educators (TSE’s) to discuss and refine the leadership domain areas, collectively creating domain-specific survey items, and then further discussed and refining the number, grouping, and wording of the items. METHODS/STUDY POPULATION: We piloted the Leadership Survey by having all of the Rockefeller TSEs rate Clinical Scholars. Each item was answered using a six-point Likert scale where a low score indicated poor expression of the specific leadership attribute and a high score represented excellent expression of the specific leadership attribute. RESULTS/ANTICIPATED RESULTS: Means, medians, standard deviations, and ranges of each item were calculated and tabulated. A complete (Pearson) correlation matrix was computed so that the raw inter-item relationships can be observed. For each a priori Domain an equal weighted summary scale was created and tabulated for review. The internal consistency of each a priori scale was assessed by calculating Cronbach’s Alpha (α). Items with low Item to Construct coefficients were candidates for elimination or modification, and overall scales with low’s will undergo further discussion. To challenge our assumptions of the construction and integrity of each domain, we employed exploratory Principal Components Analysis (PCA), followed by orthogonally rotated Factor Analysis (FA). We also forced the PCA / FA analysis to extract the a priori dimensions that allowed us to compare if the empirical and a priori structures match. DISCUSSION/SIGNIFICANCE OF IMPACT: We are partnering with the CTSA programs at Penn and Yale to assess issues of generalizability and scalability. We are working with Vanderbilt to install survey onto REDCap for ease of dissemination. Will continue to assess psychometric properties and refine as we receive more input.

تاثیر سرد کردن مایع همودیالیز بر کیفیت زندگی بیماران همودیالیزی

مقدمه: نارسایی مزمن کلیوی تاثیرات جدی بر کیفیت زندگی بیماران دارد، امروزه انسان ها نه تنها تمایل به افزایش عمر دارند بلکه خواستار بهبود و پیشرفت کیفیت زندگی نیز هستند. شاید به توان با روش های کم هزینه، کم‌عارضه و آسان مانند سرد‌کردن مایع دیالیز، کیفیت زندگی این بیماران را بهبود بخشید. روش بررسی: مطالعه حاضر از نوع کارآزمایی بالینی Clinical trial بود که به صورت تصادفی، متقاطع و دو سوکور انجام شد. 42 بیمار همودیالیزی به دو گروه 20 و 22 نفری تقسیم شدند. سپس گروه اول به مدت چهار هفته همودیالیز استاندارد (مایع c°37) و به طور هم زمان گروه دوم، همودیالیز سرد (مایع c°35) دریافت کردند، در چهار هفته دوم نوع همودیالیز گروه ها عوض شد. در این مدت کیفیت زندگی سه بار، قبل از انجام مطالعه، بعد از اتمام چهار هفته اول و دوم با استفاده از پرسش نامه کوتاه 36 سوالی کیفیت زندگی (SF-36) Short Form-36 summary scale بررسی شد. برای تجزیه و تحلیل آماری از SPSS22 و آزمون های آماری من‌ویتنی و فریدمن در سطح معنی داری 05/0P< استفاده شد. نتایج: نتایج نشان داد که 2/45‌% از نمونه ها مرد و 8/54‌% زن بودند. بعد از چهار هفته اول، میانگین کیفیت زندگی در مرحله سرد و استاندارد به ترتیب، 45/73 و 30/44 و بعد از چهار هفته دوم، به ترتیب، 83/79 و 51/48 بود. این بدین معنی است که همودیالیز سرد به طور معنی داری کیفیت زندگی مبتنی بر سلامت را بهبود بخشیده است (001/0P<). نتیجه‌گیری: همودیالیز سرد می تواند کیفیت زندگی مبتنی بر سلامت را در بیماران همودیالیزی بهبود ببخشد.

The Influence of Age and Sexual Drive on the Predictive Validity of the Juvenile Sex Offender Assessment Protocol–Revised

The Juvenile Sex Offender Assessment Protocol–Revised (J-SOAP-II) is the most commonly used measure in the assessment of recidivism risk among juveniles who have committed sexual offenses (JSOs), but mixed support exists for its predictive validity. This study compared the predictive validity of the J-SOAP-II across two offender characteristics, age and sexual drive, in a sample of 156 JSOs who had been discharged from a correctional facility or a residential treatment program. The J-SOAP-II appeared to be a better predictor of sexual recidivism for younger JSOs (14-16 years old) than for older ones (17-19 years old), with significant differences found for the Dynamic Summary Scale and Scale III (Intervention). In addition, several of the measure’s scales significantly predicted sexual recidivism for JSOs with a clear pattern of sexualized behavior but not for those without such a pattern, indicating that the J-SOAP-II may have greater clinical utility for JSOs with heightened sexual drive. The implications of these findings are discussed.

Whole-Foods, Plant-Based Diet Alleviates the Symptoms of Osteoarthritis

Objective. To evaluate the effectiveness of a whole-foods, plant-based diet (WFPB) to reduce symptoms of osteoarthritis. Methods. Six-week, prospective randomized open-label study of patients aged 19–70 with osteoarthritis. Participants were randomized to a WFPB (intervention) or continuing current diet (control). Outcomes were assessed by mixed models analysis of participant self-assessed weekly SF-36v2 domain t scores, weekly Patient Global Impression of Change (PGIC) scales, and mean weekly Visual Analog Scale (VAS) pain assessment. Mixed models analysis also evaluated pre-post change from baseline level for standard clinical measures: weight, BMI, body temperature, pulse, and blood pressure. Results. Forty participants were randomized. Thirty-seven of them, 18 control and 19 intervention, completed the study. The intervention group reported a significantly greater improvement than the control group in SF-36v2 energy/vitality, physical functioning, role physical, and the physical component summary scale. The differences between the intervention and control PGIC scales were statistically significant over time. Intervention group improvement in VAS weekly mean was also significantly greater than that of the control group from week 2 onward. Conclusion. Study results suggest that a whole-foods, plant-based diet significantly improves self-assessed measures of functional status among osteoarthritis patients.

The prognostic value of cognition in patients with glioblastoma multiforme.

2078 Background: In patients with glioblastoma multiforme (GBM) progressive disease leads sooner or later to cognitive decline. In this study we evaluated if two cognitive assessments performed early in the treatment course have a prognostic significance for predicting progression free survival (PFS). Methods: We assessed the cognition of 35 patients with GBM using the program NeuroCogFX with four subscales: working memory, attention, verbal and figural memory and verbal fluency. Baseline evaluation was done at initiation of radiotherapy (11-57 days after diagnosis) and second evaluation three months later (82-117 days after baseline). Results in subscales were categorized in “declined”, “stable” and “improved”. Tumor progression was based on MRI scans. Results: The patients (12 women, 23 men) were in median 54 years old (21-75 years). The majority (61%) showed stable cognitive results, 22% improved and 14% decreased in the summary scale of cognition. The median PFS was 11 months (2.6-27.4 months). An improvement of attention correlated significantly with longer PFS (p = 0.015) whereas the other three cognitive subscales were not associated with PFS. Conclusions: The present study shows evidence, that an increase or decrease of attention scales measured within the first 5 months of disease has prognostic value for PFS.

Impact of hearing impairment on quality of life of adolescents

Introduction. Hearing impairment, as a type of sensory disability affects the quality of life of adolescents. The aim of this study was to determine whether the quality of life of adolescents with hearing impairments was different from the quality of life of adolescents without disabilities, and to examine the correlation between self- reported quality of life and proxy- report by their parents. Materials and Methods. The study included 52 adolescents with hearing impairment and 122 adolescents without developmental disabilities, aged from 13 to 18 years and their parents. Data were collected by a standardized questionnaire, the PedsQLTM 4.0 Generic Core Scale. The survey was conducted during May and June 2011 in 6 schools in Novi Sad and Belgrade. Results. Adolescents with hearing impairment and their parents reported lower scores on all scales of questionnaire. The average score of physical health was 77.58; p<0.001 (adolescents), and 75; p=0,006 (parents); on psycho-social summary scale 75.35; p=0.025 (adolescents), and 73.37; p=0.02 (parents). On the overall scale, the adolescents scored 76.13; p<0.001, and parents reported 73.93; p<0.001. The parents assessed the quality of life lower than their children. On the total summary scale, a moderate agreement (r = 0.51) was found between self- report and proxy- report. Conclusion. Hearing loss affects all aspects of the quality of life of adolescents. A multidisciplinary approach is required in order to provide better conditions for functioning of these children and improve their quality of life.