Measuring satisfaction with health care in young persons with inflammatory bowel disease -an instrument development and validation study

Background: Patient satisfaction is a relevant prognostic factor in young persons with chronic disease and may be both age and disease specific. To assess health care quality from the patient's view in young persons with inflammatory bowel disease, an easy to use, valid, reliable and informative specific instrument was needed. Methods: All parts of the study were directed at persons with inflammatory bowel disease aged 15 to 24 (" youth"). A qualitative internet patient survey was used to generate items, complemented by a physician survey and literature search. A 2nd internet survey served to reduce items based on perceived importance and representativeness. Following pilot testing to assess ease of use and face validity, 150 respondents to a postal survey in patients from a paediatric clinical registry were included for validation analyses. Construct validity was assessed by relating summary scores to results from global questions on satisfaction with care using ANOVA. To assess test-retest reliability using intraclass correlation coefficients (ICC),a subset of patients were assessed twice within 3 months. Results: 302 persons with IBD and 55 physicians participated in the item generating internet survey, resulting in 3, 954 statements. After discarding redundancies 256 statements were presented in the 2nd internet survey. Of these, 32 items were retained. The resulting instrument assesses both the perceived relevance (importance) of an item as well as the performance of the care giver for each item for calculation of a summary satisfaction score (range 0 to 1). Sensibility testing showed good acceptance for most items. Construct validity was good, with mean scores of 0.63 (0.50 to 0.76),0.71 (0.69 to 0.74) and 0.81 (0.79 to 0.83) for no, some and good global satisfaction (ANOVA, p < 0.001). Test-retest reliability was satisfactory (ICC 0.6 to 0.7). Conclusions: We developed an easy to use, patient oriented, valid instrument to assess satisfaction with care in young persons with IBD for use in survey research

Stickstoffdynamik im Umfeld von Rinderanlagen

An zwei sächsischen Rinderanlagen in Waldnähe wurde zwei Jahre lang der Einfluss der Ammoniakemission auf die räumliche und zeitliche Dynamik der Stickstoffbelastung im Umfeld der Betriebe durch Messung von Immission, Deposition und Transmissionsbedingungen untersucht. Zur Anwendung kam eine neue Methode, die auf Basis kontinuierlicher Messungen von Ammoniakimmissionen und meteorologischen Parametern die Rückrechnung auf anlagenbezogene Emissionen ermöglicht. Dabei wurden zwei Messverfahren bewertet: DOAS-Trasse und Passivsammler. Alle Messpunkte im Umfeld der Betriebe zeigten einen deutlich erhöhten Ammoniumanteil am anorganischen Stickstoffeintrag. An den Referenzpunkten im Freiland wurden ca. 15 kg/(ha a) höhere Stickstoffdepositionen als an den Dauerbeobachtungsflächen des ländlichen Hintergrunds ermittelt. Die Stickstoffgesamtdeposition lag an allen Messpunkten deutlich über den für Nadelwald definierten empirischen Critical Loads. Dennoch sind die Wälder bisher nicht geschädigt

Stickstoffdynamik im Umfeld von Rinderanlagen

An zwei sächsischen Rinderanlagen in Waldnähe wurde zwei Jahre lang der Einfluss der Ammoniakemission auf die räumliche und zeitliche Dynamik der Stickstoffbelastung im Umfeld der Betriebe durch Messung von Immission, Deposition und Transmissionsbedingungen untersucht. Zur Anwendung kam eine neue Methode, die auf Basis kontinuierlicher Messungen von Ammoniakimmissionen und meteorologischen Parametern die Rückrechnung auf anlagenbezogene Emissionen ermöglicht. Dabei wurden zwei Messverfahren bewertet: DOAS-Trasse und Passivsammler. Alle Messpunkte im Umfeld der Betriebe zeigten einen deutlich erhöhten Ammoniumanteil am anorganischen Stickstoffeintrag. An den Referenzpunkten im Freiland wurden ca. 15 kg/(ha a) höhere Stickstoffdepositionen als an den Dauerbeobachtungsflächen des ländlichen Hintergrunds ermittelt. Die Stickstoffgesamtdeposition lag an allen Messpunkten deutlich über den für Nadelwald definierten empirischen Critical Loads. Dennoch sind die Wälder bisher nicht geschädigt

Stickstoffdynamik im Umfeld von Rinderanlagen

An zwei sächsischen Rinderanlagen in Waldnähe wurde zwei Jahre lang der Einfluss der Ammoniakemission auf die räumliche und zeitliche Dynamik der Stickstoffbelastung im Umfeld der Betriebe durch Messung von Immission, Deposition und Transmissionsbedingungen untersucht. Zur Anwendung kam eine neue Methode, die auf Basis kontinuierlicher Messungen von Ammoniakimmissionen und meteorologischen Parametern die Rückrechnung auf anlagenbezogene Emissionen ermöglicht. Dabei wurden zwei Messverfahren bewertet: DOAS-Trasse und Passivsammler. Alle Messpunkte im Umfeld der Betriebe zeigten einen deutlich erhöhten Ammoniumanteil am anorganischen Stickstoffeintrag. An den Referenzpunkten im Freiland wurden ca. 15 kg/(ha a) höhere Stickstoffdepositionen als an den Dauerbeobachtungsflächen des ländlichen Hintergrunds ermittelt. Die Stickstoffgesamtdeposition lag an allen Messpunkten deutlich über den für Nadelwald definierten empirischen Critical Loads. Dennoch sind die Wälder bisher nicht geschädigt

Human cardiac and bone marrow stromal cells exhibit distinctive properties related to their origin

Aims Bone marrow mesenchymal stromal cell (BMStC) transplantation into the infarcted heart improves left ventricular function and cardiac remodelling. However, it has been suggested that tissue-specific cells may be better for cardiac repair than cells from other sources. The objective of the present work has been the comparison of in vitro and in vivo properties of adult human cardiac stromal cells (CStC) to those of syngeneic BMStC.Methods and resultsAlthough CStC and BMStC exhibited a similar immunophenotype, their gene, microRNA, and protein expression profiles were remarkably different. Biologically, CStC, compared with BMStC, were less competent in acquiring the adipogenic and osteogenic phenotype but more efficiently expressed cardiovascular markers. When injected into the heart, in rat a model of chronic myocardial infarction, CStC persisted longer within the tissue, migrated into the scar, and differentiated into adult cardiomyocytes better than BMStC.ConclusionOur findings demonstrate that although CStC and BMStC share a common stromal phenotype, CStC present cardiovascular-associated features and may represent an important cell source for more efficient cardiac repair

Same data, different analysts: variation in effect sizes due to analytical decisions in ecology and evolutionary biology

Gould E, Fraser H, Parker T, et al. Same data, different analysts: variation in effect sizes due to analytical decisions in ecology and evolutionary biology. 2023.Although variation in effect sizes and predicted values among studies of similar phenomena is inevitable, such variation far exceeds what might be produced by sampling error alone. One possible explanation for variation among results is differences among researchers in the decisions they make regarding statistical analyses. A growing array of studies has explored this analytical variability in different (mostly social science) fields, and has found substantial variability among results, despite analysts having the same data and research question. We implemented an analogous study in ecology and evolutionary biology, fields in which there have been no empirical exploration of the variation in effect sizes or model predictions generated by the analytical decisions of different researchers. We used two unpublished datasets, one from evolutionary ecology (blue tit, Cyanistes caeruleus, to compare sibling number and nestling growth) and one from conservation ecology (Eucalyptus, to compare grass cover and tree seedling recruitment), and the project leaders recruited 174 analyst teams, comprising 246 analysts, to investigate the answers to prespecified research questions. Analyses conducted by these teams yielded 141 usable effects for the blue tit dataset, and 85 usable effects for the Eucalyptus dataset. We found substantial heterogeneity among results for both datasets, although the patterns of variation differed between them. For the blue tit analyses, the average effect was convincingly negative, with less growth for nestlings living with more siblings, but there was near continuous variation in effect size from large negative effects to effects near zero, and even effects crossing the traditional threshold of statistical significance in the opposite direction. In contrast, the average relationship between grass cover and Eucalyptus seedling number was only slightly negative and not convincingly different from zero, and most effects ranged from weakly negative to weakly positive, with about a third of effects crossing the traditional threshold of significance in one direction or the other. However, there were also several striking outliers in the Eucalyptus dataset, with effects far from zero. For both datasets, we found substantial variation in the variable selection and random effects structures among analyses, as well as in the ratings of the analytical methods by peer reviewers, but we found no strong relationship between any of these and deviation from the meta-analytic mean. In other words, analyses with results that were far from the mean were no more or less likely to have dissimilar variable sets, use random effects in their models, or receive poor peer reviews than those analyses that found results that were close to the mean. The existence of substantial variability among analysis outcomes raises important questions about how ecologists and evolutionary biologists should interpret published results, and how they should conduct analyses in the future