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- Czobor, Pal, et al.
(author)
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The European Adolescent Assessment Dialogue (EuroADAD) : A Psychometric Evaluation
- 2011
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In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 17:6, s. 302-315
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Journal article (peer-reviewed)abstract
- Background: The Adolescent Drug Abuse Diagnosis (ADAD) has been a gold standard for assessing drug use and associated problems in adolescents. Criticism of the instrument has been increasing. A new instrument, the European Adolescent Assessment Dialogue (EuroADAD) that builds on ADAD's strengths but seeks to address its limitations is now available, but has not been subjected to comprehensive psychometric evaluation. Objective: To examine the psychometric properties of the EuroADAD across various settings in adolescent populations who developed or were at a high risk of developing substance use and psychosocial adaptation problems. Participants and Settings: Three of the samples were collected in Hungary, including: institutionalized youths from juvenile residential facility (n = 295); adolescents from outpatient psychiatry facility (n = 278), and controls (n = 59). An additional sample was collected in the Netherlands, and consisted of adolescent boys from an independent residential institution for youth with severe behavioral problems (n = 51). Procedure: The EuroADAD was administered by trained interviewers. Data were collected through face-to-face interviews and self-report questionnaires. Results: Reliability: the intraclass correlation was high for all domains of the EuroADAD; reliability analyses indicated good test-retest reliability, and internal consistency. Validity: difference among study samples was significant (p < 0.05) for the majority of the domains, with juvenile institution and psychiatric outpatient subjects exhibiting higher severity in most areas compared to controls. The Hungarian and Dutch samples were comparable, expect for the legal domain, due to the higher severity of behavioral problems in the Dutch sample. Several domains of the instrument, including 'alcohol', 'drugs' and 'legal' showed an association with trait aggression as measured by the Buss-Perry Aggression Questionnaire and with Novelty Seeking on the Cloninger Temperament and Character Inventory. Conclusion: Based on the pattern and significance of group differences, and correlations with other measures, the scale has good criterion, and convergent and discriminant construct validity. The EuroADAD is a reliable and valid tool for the assessment of alcohol and drug use, and related psychosocial problems in adolescents.
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| 3. |
- Klimstra, David S., et al.
(author)
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Pathology reporting of neuroendocrine tumors : application of the Delphic consensus process to the development of a minimum pathology data set
- 2010
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In: American Journal of Surgical Pathology. - 0147-5185 .- 1532-0979. ; 34:3, s. 300-313
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Journal article (peer-reviewed)abstract
- Epithelial neuroendocrine tumors (NETs) have been the subject of much debate regarding their optimal classification. Although multiple systems of nomenclature, grading, and staging have been proposed, none has achieved universal acceptance. To help define the underlying common features of these classification systems and to identify the minimal pathology data that should be reported to ensure consistent clinical management and reproducibility of data from therapeutic trials, a multidisciplinary team of physicians interested in NETs was assembled. At a group meeting, the participants discussed a series of "yes" or "no" questions related to the pathology of NETs and the minimal data to be included in the reports. After discussion, anonymous votes were taken, using the Delphic principle that 80% agreement on a vote of either yes or no would define a consensus. Questions that failed to achieve a consensus were rephrased once or twice and discussed, and additional votes were taken. Of 108 questions, 91 were answerable either yes or no by more than 80% of the participants. There was agreement about the importance of proliferation rate for tumor grading, the landmarks to use for staging, the prognostic factors assessable by routine histology that should be reported, the potential for tumors to progress biologically with metastasis, and the current status of advanced immunohistochemical and molecular testing for treatment-related biomarkers. The lack of utility of a variety of immunohistochemical stains and pathologic findings was also agreed upon. A consensus could not be reached for the remaining 17 questions, which included both minor points related to extent of disease assessment and some major areas such as terminology, routine immunohistochemical staining for general neuroendocrine markers, use of Ki67 staining to assess proliferation, and the relationship of tumor grade to degree of differentiation. On the basis of the results of the Delphic voting, a minimum pathology data set was developed. Although there remains disagreement among experts about the specific classification system that should be used, there is agreement about the fundamental pathology data that should be reported. Examination of the areas of disagreement reveals significant opportunities for collaborative study to resolve unanswered questions.
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| 5. |
- Laplante-Levesque, Ariane, et al.
(author)
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Hearing help-seeking and rehabilitation : Perspectives of adults with hearing impairment
- 2012
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In: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:2, s. 93-102
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Journal article (peer-reviewed)abstract
- OBJECTIVE:This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation.DESIGN:Individual semi-structured interviews were completed.STUDY SAMPLE:In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users.RESULTS:Qualitative content analysis identified four main categories ('perceiving my hearing impairment', 'seeking hearing help', 'using my hearing aids', and 'perspectives and knowledge') and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed.CONCLUSIONS:People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed.
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| 6. |
- Lunner, Thomas, 1965-, et al.
(author)
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The FAS-IT program. From detection to intervention. Reaching and treating persons with hearing disorders using modern technology
- 2012
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In: AHS 2012 Conference. ; , s. 49-49
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Conference paper (other academic/artistic)abstract
- In a program grant from the Swedish Council for Working Life and Social Research we are investigating the use of modern information technology in hearing rehabilitation in a broad sense. We use the Internet in this research when we study hearing impaired persons from when the loss is detected to whe intervention is implemented. In the research we intend to survey online resources, implement selfscreening both in terms of self-assessments and actual hearing screening on the Internet, use online cognitive tests, use the Internet for medical support system aimed to be integrated in health care, test if motivational interviewing methods can be used to facilitate the decision process when seeking treatment, develop and test online counselling for hearing impaired persons, use more open-ended qualitative methods to probe the experiences of acceptance versus experiential avoidance, and finally develop and test web resources for significant others (e.g. parents of children, adult children of older adults without access to the Internet). The program is divided into nine subprojects that are at different stages of their execution. This presentation will give an overview of the activities and outcomes so far in the FAS-IT program.
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| 7. |
- Molander, Peter, et al.
(author)
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Internet-based hearing screening using speech-in-noise : validation and comparisons of self-reported hearing problems, quality of life and phonological representation
- 2013
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In: BMJ Open. - : BMJ Open. - 2044-6055. ; 3:9, s. 3223-
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Journal article (peer-reviewed)abstract
- Objectives For the last decade a host of different projects have been launched to allow persons who are concerned about their hearing status to quickly and at a low cost test their hearing ability. Most often, this is carried out without collecting complementary information that could be correlated with hearing impairment. In this two-part study we first, present the development and validation of a novel Internet-based hearing test, and second, report on the associations between this test and phonological representation, quality of life and self-reported hearing difficulties.Design Cross-sectional study.Setting An opportunity sample of participants was recruited at the Stockholm central station for the first study. All parts of the second study were conducted via the Internet, with testing and self-report forms adapted for online use.Participants The first part of the study was carried out in direct contact with the participants, and participants from the second study were recruited by means of advertisements in newspapers and on webpages. The only exclusion criterion was that participants had to be over 18 years old. Most participants were between 60 and 69 years old. There were almost an equal number of men and women (total n=316).Outcome measures 48 participants failed the Internet-based hearing screening test. The group failing the test reported more problems on the Amsterdam Inventory of Auditory Disability. In addition, they were found to have diminished phonological representational skills. However, no difference in quality of life was found.Conclusions Almost one in five participants was in need of contacting their local hearing clinic. This group had more complaints regarding tinnitus and hyperacusis, rated their own hearing as worse than those who passed, and had a poorer capability of generating accurate phonological representations. This study suggests that it is feasible to screen for hearing status online, and obtain valid data.
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| 9. |
- Naylor, Graham, et al.
(author)
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Exploring narrative effects in hearing aid fitting
- 2012
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Conference paper (other academic/artistic)abstract
- Exploring narrative effectsThe clinical meeting is a narrative (‘story’) in itself. To be able to study narrative effects in isolation, the narrative must be separated from the outcome of the hearing-aid fitting. In this study the test persons were given two hearing aids. These were accompanied by different narratives, but had identical amplification/acoustic signal processing. Testing narrative effectsThe purpose of this study was to demonstrate the power of the narrative in affecting the client’s perception of the dispensing process. The experimental approach was to implement alternative dispensing processes with divergent narratives but identical acoustical results. Then, in a balanced crossover design, to carry out fittings with these processes on a group of hearing-aid clients. The two carefully rehearsed dispensing processes were: a ‘Diagnostic’ process and an ‘Interactive’ process. Narrative 1: ‘Diagnostic’ process. The client is inactive and the dispenser makes a number of adjustments based on hearing assessments, during which the client is passive. Fitting is based on hearing thresholds only. Narrative 2: ‘Interactive’ process. The client is led to believe that they have adjusted the HA settings to their own preferences. Fitting is based on hearing thresholds only (hearing-aid settings identical for Narratives 1 and 2.) Results20 of the 24 subjects had a clear fitting preference. This is surprising, since the two fittings were acoustically identical. We must suppose that it is the subjects’ perception of the fitting process which determined their preferences. However, all subjects except one gave exclusively sound-related reasons for their preferences (“Sounds more clear” etc.). Thus it seems that clinicians may not always hear the ‘true’ reasons for preferences from their clients.
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| 10. |
- Ohlsson, Lina, et al.
(author)
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Lymph node tissue kallikrein-related peptidase 6 mRNA : a progression marker for colorectal cancer
- 2012
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In: British Journal of Cancer. - : Nature Publishing Group. - 0007-0920 .- 1532-1827. ; 107:1, s. 150-157
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Journal article (peer-reviewed)abstract
- Background:A most important characteristic feature for poor prognosis in colorectal cancer (CRC) is the presence of lymph node metastasis. Determination of carcinoembryonic antigen (CEA) mRNA levels in lymph nodes has proven powerful for quantification of disseminated tumour cells. Here, we investigate the utility of human tissue kallikrein-related peptidase 6 (KLK6) mRNA as a progression biomarker to complement CEA mRNA, for improved selection of patients in need of adjuvant therapy and intensified follow-up after surgery.Methods:Lymph nodes of pTNM stage I-IV CRC- (166 patients/503 lymph nodes) and control (23/108) patients were collected at surgery and analysed by quantitative RT–PCR.Results:Lymph node KLK6 positivity was an indicator of poor outcome (hazard ratio 3.7). Risk of recurrence and cancer death increased with KLK6 lymph node levels. Patients with KLK6 lymph node levels above the 90th percentile had a hazard ratio of 6.5 and 76 months shorter average survival time compared to patients with KLK6 negative nodes. The KLK6 positivity in lymph nodes with few tumour cells, that is, low CEA mRNA levels, also indicated poor prognosis (hazard ratio 2.8).Conclusion:In CRC patients, lymph node KLK6 positivity indicated presence of aggressive tumour cells associated with poor prognosis and high risk of tumour recurrence.
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