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- Minoia, F, et al.
(author)
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Development and initial validation of the MS score for diagnosis of macrophage activation syndrome in systemic juvenile idiopathic arthritis
- 2019
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In: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 78:10, s. 1357-1362
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Journal article (peer-reviewed)abstract
- To develop and validate a diagnostic score that aids in identifying macrophage activation syndrome (MAS) in patients with systemic juvenile idiopathic arthritis (sJIA).MethodsThe clinical and laboratory features of 362 patients with sJIA-associated MAS and 404 patients with active sJIA without evidence of MAS were collected in a multinational collaborative project. Eighty percent of the study population was used to develop the score and the remaining 20% constituted the validation sample. A Bayesian Model Averaging approach was used to assess the role of each clinical and laboratory variables in the diagnosis of MAS and to obtain the coefficients of selected variables. The final score, named MAS/sJIA (MS) score, resulted from the linear combination of these coefficients multiplied by the values of each variable. The cut-off that best discriminated MAS from active sJIA was calculated by means of receiver operating characteristic (ROC) curve analysis. Score performance was evaluated in both developmental and validation samples.ResultsThe MS score ranges from −8.4 to 41.8 and comprises seven variables: central nervous system dysfunction, haemorrhagic manifestations, active arthritis, platelet count, fibrinogen, lactate dehydrogenase and ferritin. A cut-off value ≥−2.1 revealed the best performance in discriminating MAS from active sJIA, with a sensitivity of 0.85, a specificity of 0.95 and a kappa value of 0.80. The good performance of the MS score was confirmed in the validation sample.ConclusionThe MS score is a powerful and feasible tool that may assist practitioners in making a timely diagnosis of MAS in patients with sJIA.
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- Larsson, Gerry, et al.
(author)
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Leader development in natural context : A grounded theory approach to discovering how military leaders grow
- 2006
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In: Military Psychology. - : Informa UK Limited. - 0899-5605 .- 1532-7876. ; 18, s. S69-S81
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Journal article (peer-reviewed)abstract
- Despite an increasing number of programs that aim to develop or educate leaders, the underlying processes involved in leader development or growth are not well understood. This study was undertaken to discover what factors or processes are involved in leader development for junior military officers, from their own perspective and in the natural context of their career and life experiences. Military officers (N = 51) from 5 different countries were interviewed using a standardized approach, and interview transcripts were analyzed according to the constant comparative method of grounded theory, as elaborated by Glaser and Strauss (1967). Consistently across the 5 countries, the core of the process model of leader development is the social interaction between the young officer and his or her significant others (soldiers, peers, and superiors). In the favorable case, officers end this process feeling secure, being able to flexibly adapt their overt behavior on an underdistanced–overdistanced continuum according to situational demands, and have a firm professional identity.
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