What are we measuring? A critique of range of motion methods currently in use for Dupuytren's disease and recommendations for practice

Background: Range of motion is the most frequently reported measure used in practice to evaluate outcomes. A goniometer is the most reliable tool to assess range of motion yet, the lack of consistency in reporting prevents comparison between studies. The aim of this study is to identify how range of motion is currently assessed and reported in Dupuytren’s disease literature. Following analysis recommendations for practice will be made to enable consistency in future studies for comparability. This paper highlights the variation in range of motion reporting in Dupuytren’s disease. Methods: A Participants, Intervention, Comparison, Outcomes and Study design format was used for the search strategy and search terms. Surgery, needle fasciotomy or collagenase injection for primary or recurrent Dupuytren’s disease in adults were included if outcomes were monitored using range of motion to record change. A literature search was performed in May 2013 using subject heading and free-text terms to also capture electronic publications ahead of print. In total 638 publications were identified and following screening 90 articles met the inclusion criteria. Data was extracted and entered onto a spreadsheet for analysis. A thematic analysis was carried out to establish any duplication, resulting in the final range of motion measures identified. Results: Range of motion measurement lacked clarity, with goniometry reportedly used in only 43 of the 90 studies, 16 stated the use of a range of motion protocol. A total of 24 different descriptors were identified describing range of motion in the 90 studies. While some studies reported active range of motion, others reported passive or were unclear. Eight of the 24 categories were identified through thematic analysis as possibly describing the same measure, ‘lack of joint extension’ and accounted for the most frequently used. Conclusions: Published studies lacked clarity in reporting range of motion, preventing data comparison and meta-analysis. Percentage change lacks context and without access to raw data, does not allow direct comparison of baseline characteristics. A clear description of what is being measured within each study was required. It is recommended that range of motion measuring and reporting for Dupuytren’s disease requires consistency to address issues that fall into 3 main categories:- Definition of terms Protocol statement Outcome reportin

Alternative approaches to the employee-organizational relationship: Does investment in employees pay off?

This article describes four approaches to the employee-organization relationship, as defined from the employer's perspective. An empirical study of employees from ten companies found support for the basic hypothesis that employee responses differ under the four types of relationship. In general, employees performed better on core tasks, demonstrated more citizenship behavior, and expressed a higher level of affective commitment to an employer when they worked in an overinvestment (by the employer) or mutual investment relationship than when they worked in a quasi-spot-contract or underinvestment relationship. These results were obtained even after we controlled for several other variables that could affect employee performance and attitudes

Alternative approaches to the employee-organization relationship: Does investment in employees pay off?

This article describes four approaches to the employee-organization relationship, as defined from the employer's perspective. An empirical study of employees from ten companies found support for the basic hypothesis that employee responses differ under the four types of relationship. In general, employees performed better on core tasks, demonstrated more citizenship behavior, and expressed a higher level of affective commitment to an employer when they worked in an overinvestment (by the employer) or mutual investment relationship than when they worked in a quasi-spot-contract or underinvestment relationship. These results were obtained even after we controlled for several other variables that could affect employee performance and attitudes

Differential perceptions of employers' inducements: Implications for psychological contracts

This paper reports findings from an exploratory study that addresses the question of whether or not measures of perceptual 'gaps' in organizational inducements contribute unique explanatory power above and beyond such familiar measures as employee job attitudes. Perceptions of inducements were obtained from both employees and representatives of their organizations. An average of 12 executives responded for each of four organizations to provide the organizations' view of the inducements offered to their employees, and a total of 339 employees across the four organizations reported their views of the inducements in the respective organizations. It was found that the larger the gap between what the employees viewed as the inducements offered them and what their employers reported offering them the lower was the employees' satisfaction with their organization, even after controlling for employee job satisfaction and employee performance. This finding, as well as the finding that in a substantial number of cases the employees report greater amounts of inducements than do their organizations' representatives, was explored for its implications for research on psychology contracts. © 1998 John Wiley & Sons, Ltd

Social disadvantage and psychosis: a case control study on italian First-Episodes of Psychosis (FEP)

Introduction: A growing body of literature suggests that people affected by psychotic disorders are more likely to be unemployed, tend to live alone, have a poor social network, and are not able to establish long-term relationships (Morgan et al., 2008). Aims: To investigate social disadvantage in a sample of first-episode of psychosis patients and geographically matched controls. Methods: The study sample consists of 52 healthy controls and 37 FEP who were assessed using the MRC Sociodemographic Schedules. Results: Preliminary results suggest that, consistently with the literature, cases are more exposed than controls to social disadvantage. They tend to reach a lower education degree (OR 6.66; CI 95%, 1.67-26.50, p 0.005) and to have an underpaid job 5 years before the onset (OR 2.84; CI 95%, 1.08-7.45, p 0.03). Furthermore, cases are more likely to live longer with their parents rather than independently (OR 3.33; CI 95%, 1.25- 8.86, p 0.01) and are more exposed to house overcrowding (OR 3.92; CI 95%, 1.03-14.93, p 0.05). It was also found that an higher percentage of cases have never been in a stable relationship in the previous 5 years (OR 2.61; CI 95%, 1.08-6.27, p 0.03). Conclusions: In line with the previous literature, we found that lower educational and occupational status and poor relationship status are associated to risk for psychosis. However, in contrast with North European cases, Italian FEP are more likely to live with their family rather than alone and, therefore, to be exposed to house overcrowding. Morgan C, Kirkbride J, Hutchinson G, Craig T, Morgan K, Dazzan P, Boydell J, Doody GA, Jones PB, Murray RM, Leff J, Fearon P. Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychol Med. 2008; 38(12):1701-15

Effetti dell’uso di cannabis e sintomi psicopatologici in un campione di primi episodi psicotici

Introduction: Cannabis is one of the most common substances used by patients with a first episode of psychosis. The aim of the study was to investigate the most frequent effects of cannabis use, their relationship with psychotic symptoms and characteristics of the consumption. Methods: 116 first episode psychosis were recruited, 50% of which (n=58) used cannabis lifetime. We investigated the characteristics of the consumption and the effects of cannabis using the Cannabis Experience Questionnaire-mv (CEQmv) and the psychotic symptoms using the Positive and Negative Symptoms Scale (PANSS). Results: The effects more often experienced by cannabis users were slowed down thinking and feeling to be able to understand the world better. Feeling fearful was associated with interruption of consumption (U= 287,500, p=0.046). Hearing voices was associated with more than 50 times lifetime cannabis use (U=223,00, p=0.043). In addition, we found correlations between feeling fearful and like going crazy after cannabis use and positive and general PANSS. Conclusions: Those who have experienced more psychotic-like effects of cannabis present stronger positive symptoms. In addition, awareness of negative effects involves the interruption of consumption. These evidences underline the importance of primary and secondary prevention regarding the effects of cannabis use among people at high risk for psychotic disorders

Apoptotic Effects of Quercitrin on DLD-1 Colon Cancer Cell Line

Quercetin, which is the most abundant bioflavonoid compound, is mainly present in the glycoside form of quercitrin. Although different studies indicated that quercitrin is a potent antioxidant, the action of this compound is not well understood. In this study, we investigated whether quercitrin has apoptotic and antiproliferative effects in DLD-1 colon cancer cell lines. Time and dose dependent antiproliferative and apoptotic effects of quercitrin were subsequently determined by WST-1 cell proliferation assay, lactate dehydrogenase (LDH) cytotoxicity assay, detection of nucleosome enrichment factor, changes in caspase-3 activity, loss of mitochondrial membrane potential (MMP) and also the localization of phosphatidylserine (PS) in the plasma membrane. There were significant increases in caspase-3 activity, loss of MMP, and increases in the apoptotic cell population in response to quercitrin in DLD-1 colon cancer cells in a time- and dose-dependent manner. These results revealed that quercitrin has antiproliferative and apoptotic effects on colon cancer cells. Quercitrin activity supported with in vivo analyses could be a biomarker candicate for early colorectal carcinoma