12 research outputs found
Measuring empathy in pediatrics: validation of the Visual CARE measure
Background: Empathy is a key element of âPatient and Family Centered Careâ, a clinical approach recommended
by the American Academy of Pediatrics. However, there is a lack of validated tools to evaluate paediatrician
empathy. This study aimed to validate the Visual CARE Measure, a patient rated questionnaire measuring physician
empathy, in the setting of a Pediatric Emergency Department (ED).
Methods: The empathy of physicians working in the Pediatric ED of the University Hospital of Udine, Italy, was
assessed using an Italian translation of the Visual Care Measure. This test has three versions suited to different age
groups: the 5Q questionnaire was administered to children aged 7â11, the 10Q version to those older than 11, and
the 10QâParent questionnaire to parents of children younger than 7.
The internal reliability, homogeneity and construct validity of the 5Q and 10Q/10QâParent versions of the Visual
Care Measure, were separately assessed. The influence of family background on the rating of physician empathy
and satisfaction with the clinical encounter was also evaluated.
Results: Seven physicians and 416 children and their parents were included in the study. Internal consistency
measured by Cronbachâs alpha was 0.95 for the 10Q/10QâParent versions and 0.88 for the 5Q version. The
item-total correlation was > 0.75 for each item. An exploratory factor analysis showed that all the items load
onto the first factor.
Physiciansâ empathy scores correlated with patientsâ satisfaction for both the 10Q and 10QâParent questionnaires
(Spearmanâs rho = 0.7189; p < 0.001) and for the 5Q questionnaire (Spearmanâs rho = 0.5968; p < 0,001). Trust in the
consulting physician was lower among immigrant parents (OR 0.43. 95% CI 0.20â0.93).
Conclusions: The Visual Care Measure is a reliable second-person test of physician empathy in the setting of a
Pediatric Emergency Room. More studies are needed to evaluate the reliability of this instrument in other pediatric
settings distinct from the Emergency Room and to further evaluate its utility in measuring the impact of
communication and empathy training programmes for healthcare professionals working in pediatrics
Nationwide Analysis of Cardiac Arrest Outcomes During the COVID-19 Pandemic
The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the chain of survival following cardiac arrest. However, large population-based reports of COVID-19 in patients hospitalized after cardiac arrest are limited. The National Inpatient Sample database was queried for cardiac arrest admissions during 2020 in the United States. Propensity score matching was used to match patients with and without concurrent COVID-19 according to age, race, sex, and comorbidities. Multivariate logistic regression analysis was used to identify predictors of mortality. A weighted total of 267,845 hospitalizations for cardiac arrest were identified, among which 44,105 patients (16.5%) had a concomitant diagnosis of COVID-19. After propensity matching, cardiac arrest patients with concomitant COVID-19 had higher rate of acute kidney injury requiring dialysis (64.9% vs 54.8%) mechanical ventilation \u3e24 hours (53.6% vs 44.6%) and sepsis (59.4% vs 40.4%) compared to cardiac arrest patients without COVID-19. In contrast, cardiac arrest patients with COVID-19 had lower rates of cardiogenic shock (3.2% vs 5.4%, P \u3c 0.001), ventricular tachycardia (9.6% vs 11.7%, P \u3c 0.001), and ventricular fibrillation (6.7% vs 10.8%, P \u3c 0.001), and a lower utilization of cardiac procedures. In-hospital mortality was higher in patients with COVID-19 (86.9% vs 65.5%, P \u3c 0.001) and, on multivariate analysis, a diagnosis of COVID-19 was an independent predictor of mortality. Among patients hospitalized following a cardiac arrest during 2020, concomitant COVID-19 infection was associated with significantly worse outcomes characterized by an increased risk of sepsis, pulmonary and renal dysfunction, and death
Optimizing performance of plasmonic devices for photonic circuits
We demonstrate the feasibility of fabricating thermo-optic plasmonic devices for variable optical attenuation and/or low-frequency (kHz) signal modulation. Results of finite-element simulations and experimental characterization of prototype devices indicate that a plasmonic device can reach specifications similar to or better than commercially available thermo-optic integrated optical components. Specifically, we have considered the insertion loss, power consumption, footprint, polarization-dependent loss, extinction ratio, and frequency response of the plasmonic devices, in addition to fabrication and material-related issues. The most serious fabrication challenge is to realize metallic nanowire waveguides with a sufficiently accurate cross-section to ensure low polarization-dependent loss at high extinction ratios