Beyond FEV1 in COPD: a review of patient-reported outcomes and their measurement

Abstract: Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms and pathological consequences. Although primarily viewed as a respiratory disease, COPD has both pulmonary and extrapulmonary effects, which have an impact on many aspects of physical, emotional, and mental well-being. Traditional assessment of COPD relies heavily on measuring lung function, specifically forced expiratory volume in 1 second (FEV1). However, the evidence suggests that FEV1 is a relatively poor correlate of symptoms such as breathlessness and the impact of COPD on daily life. Furthermore, many consequences of the disease, including anxiety and depression and the ability to perform daily activities, can only be described and reported reliably by the patient. Thus, in order to provide a comprehensive view of the effects of interventions in clinical trials, it is essential that spirometry is accompanied by assessments using patient-reported outcome (PRO) instruments. We provide an overview of patient-reported outcome concepts in COPD, such as breathlessness, physical functioning, and health status, and evaluate the tools used for measuring these concepts. Particular attention is given to the newly developed instruments emerging in response to recent regulatory guidelines for the development and use of PROs in clinical trials. We conclude that although data from the development and validation of these new PRO instruments are emerging, to build the body of evidence that supports the use of a new instrument takes many years. Furthermore, new instruments do not necessarily have better discriminative or evaluative properties than older instruments. The development of new PRO tools, however, is crucial, not only to ensure that key COPD concepts are being reliably measured but also that the relevant treatment effects are being captured in clinical trials. In turn, this will help us to understand better the patient's experience of the disease

Adapting Progress Feedback and Emotional Support to Learner Personality

Peer reviewedPostprin

Unveiling What is Written in The Stars: Analyzing Explicit, Implicit, and Discourse Patterns of Sentiment in Social Media

Deciphering consumers' sentiment expressions from big data (e.g., online reviews) has become a managerial priority to monitor product and service evaluations. However, sentiment analysis, the process of automatically distilling sentiment from text, provides little insight regarding the language granularities beyond the use of positive and negative words. Drawing on speech act theory, this study provides a fine-grained analysis of the implicit and explicit language used by consumers to express sentiment in text. An empirical text-mining study using more than 45,000 consumer reviews demonstrates the differential impacts of activation levels (e.g., tentative language), implicit sentiment expressions (e.g., commissive language), and discourse patterns (e.g., incoherence) on overall consumer sentiment (i.e., star ratings). In two follow-up studies, we demonstrate that these speech act features also influence the readers' behavior and are generalizable to other social media contexts, such as Twitter and Facebook. We contribute to research on consumer sentiment analysis by offering a more nuanced understanding of consumer sentiments and their implications

A conceptual model of nurses\u27 workplace social capital: a theory synthesis

BACKGROUND: Research has confirmed the importance of workplace social capital in the nursing workforce. Integration of the empirical evidence about nurses\u27 workplace social capital into a scientific collection can provide a comprehensive presentation of this concept. This scientific collection can be a conduit for further research and advancement of nursing management and leadership. The purpose of this paper, therefore, is to discuss the process of developing a conceptual model of nurses\u27 workplace social capital, an effective and concise approach to illustrate a scientific phenomenon. METHODS: The model of nurses\u27 workplace social capital was developed following Walker and Avant\u27s strategy of theory synthesis. Empirical evidence relevant to nurses\u27 workplace social capital was synthesized by systematically examining the existing literature. PubMed, CINAHL, Web of Science and Google Scholar were searched periodically from October 2017 to July 2020. RESULTS: Our proposed conceptual model lays out the determinants and outcomes of nurses\u27 workplace social capital and specifies the relational statements among these concepts. Nurses\u27 workplace social capital is influenced by the organizational and individual determinants shaped by multiple layers of sub-concepts. The development and implementation of nurses\u27 workplace social capital has three themes of consequences: 1) nurses\u27 outcomes; 2) patients\u27 outcomes; and 3) organizational outcomes. All the concepts and statements have been organized and aligned with the principles of inventory of determinants or results and theoretical blocks . CONCLUSION: Our theoretical synthesis offers a comprehensive picture of the current knowledge of nurses\u27 workplace social capital. Efforts should be dedicated to evaluating, revising, and revamping this newly developed model based on future empirical evidence. Our synthesized conceptual model is the segue to more comprehensive studies about nurses\u27 workplace social capital. Interventional programs for the development of social capital can be structured based on the identified determinants

Resilience–Recovery Factors in Post-traumatic Stress Disorder Among Female and Male Vietnam Veterans: Hardiness, Postwar Social Support, and Additional Stressful Life Events

Structural equation modeling procedures were used to examine relationships among several war zone stressor dimensions, resilience-recovery factors, and post-traumatic stress disorder symptoms in a national sample of 1,632 Vietnam veterans (26% women and 74% men). A 9-factor measurement model was specified on a mixed-gender subsample of the data and then replicated on separate subsamples of female and male veterans. For both genders, the structural models supported strong mediation effects for the intrapersonal resource characteristic of hardiness, postwar structural and functional social support, and additional negative life events in the postwar period. Support for moderator effects or buffering in terms of interactions between war zone stressor level and resiliencerecovery factors was minimal

Ability Versus Trait Emotional Intelligence: Dual Influences on Adolescent Psychological Adaptation

Emotional intelligence (EI) is reliably associated with better mental health. A growing body of evidence suggests that EI acts as a protective buffer against some psychosocial stressors to promote adaptation. However, little is known about how the two principle forms of EI (trait and ability) work together to impact underlying stressor-health processes in adolescence. One thousand one hundred and seventy British adolescents (mean age = 13.03 years; SD = 1.26) completed a variety of standardized instruments assessing EI; coping styles; family dysfunction; negative life events; socioeconomic adversity; depression and disruptive behavior. Path analyses found that trait and ability EI work in tandem to modify the selection and efficacy of avoidant coping to influence the indirect effect of stressors on depression but not disruptive behavior. Nevertheless, actual emotional skill (ability EI) appears dependent on perceived competency (trait EI) to realize advantageous outcomes. Findings are evaluated and discussed with reference to theoretical and practical implications