Development of a Reliable Surgical Quality Assurance System for 2-stage Esophagectomy in Randomized Controlled Trials

Objective: The aim was to develop a reliable surgical quality assurance system for 2-stage esophagectomy. This development was conducted during the pilot phase of the multicenter ROMIO trial, collaborating with international experts. Summary of Background Data: There is evidence that the quality of surgical performance in randomized controlled trials influences clinical outcomes, quality of lymphadenectomy and loco-regional recurrence. Methods: Standardization of 2-stage esophagectomy was based on structured observations, semi-structured interviews, hierarchical task analysis, and a Delphi consensus process. This standardization provided the structure for the operation manual and video and photographic assessment tools. Reliability was examined using generalizability theory. Results: Hierarchical task analysis for 2-stage esophagectomy comprised fifty-four steps. Consensus (75%) agreement was reached on thirty-nine steps, whereas fifteen steps had a majority decision. An operation manual and record were created. A thirty five-item video assessment tool was developed that assessed the process (safety and efficiency) and quality of the end product (anatomy exposed and lymphadenectomy performed) of the operation. The quality of the end product section was used as a twenty seven-item photographic assessment tool. Thirty-one videos and fifty-three photographic series were submitted from the ROMIO pilot phase for assessment. The overall Gcoefficient for the video assessment tool was 0.744, and for the photographic assessment tool was 0.700. Conclusions: A reliable surgical quality assurance system for 2-stage esophagectomy has been developed for surgical oncology randomized controlled trials

Psychometric validation of trait emotional intelligence in middle and late childhood

Trait emotional intelligence (trait El or trait emotional self-efficacy) is a constellation of emotion-related self-perceptions and dispositions located at the lower levels of personality hierarchies (see Petrides & Furnharn, 2000,2003; Petrides, Furnham, & Mavroveli, 2007). Trait El provides comprehensive coverage of the affective aspects of Personality and has been validated in several studies with adults and, less often, with adolescent samples. Research with children within the domain has been generally neglected. Therefore, the main goal of the thesis was the psychometric validation of trait El in middle and late childhood where research was lacking. This venture included both the development of an age-appropriate conceptual definition and a measure of trait El. The initial operationalisation of the construct was based on data generated through a qualitative method, which aimed at identifying and defining salient facets of children's affective personality. The preliminary pool of facets in children's trait El sampling domain included II theoretical constructs, which were subsequently reduced to 9 constructs based on correlational methods (see Robinson, Shaver, & Wrightsman, 1991).\ud The Trait Emotional Intelligence Questionnaire-Child Forrn (TEIQue-CF) was developed to measure trait El in children. The structure of the measure mirrored the conceptual definition of trait El and provided comprehensive coverage of children's trait El sampling domain. The psychometric properties of the TElQue-CF were examined in a string of seven studies, which provided sufficient evidence for the measure's internal consistency, temporal stability, and construct validity. Specifically, internal consistency indices varied from 73 to 84, and the evidence for construct validity was consistent with the theoretical postulates of trait El and related research with adults and adolescents. Overall,, the empirical findings showed low to zero Vill correlations between trait El and indices of cognitive ability, such as verbal and nonverbal IQ, reading and spelling scores, and SAT scores on English, math, and science. Additionally, trait El scores differentiated between a) pupils with unauthorised I., V..absences or exclusions from school and their well-adjusted peers and b) pupils with special educational needs and those without such needs. Higher trait EI scores were also positively related to teacher- and peer-rated positive (prosocial) behaviour, negatively related to negative (antisocial) behaviour, and predicted emotion perception accuracy. The data from all seven studies showed that the TEIQue-CF has sound psychometric properties and is a potentially useful trait El tool. On the whole, our findings provided support for the validity of trait El and for its saliency in predicting and explaining important psychological, socioemotional, and behavioural criteria in middle and late childhood. \u

Residential mobility, neighbourhood deprivation and children’s behaviour in the UK

Using data from the first two waves (in 2001/02 and 2004) of the UK's Millennium Cohort Study (MCS), we attempted to separate the effect of residential mobility from the effect of neighbourhood deprivation on children's emotional and behavioural problems. Our sample was 23,162 children (aged 3–16 years) clustered in 12,692 families. We measured neighbourhood deprivation with the Index of Multiple Deprivation, a measure of neighbourhood-level socio-economic disadvantage, and residential mobility as household move between waves. Being in a lower deprivation neighbourhood at Wave 1 was related to lower scores of both emotional and behavioural problems 2 years later, even after adjustment for child's age and sex, family adversity, family structure and maternal psychological distress. However, children whose families subsequently moved—even within or between lower deprivation neighbourhoods—were at higher risk of emotional and behavioural problems. Adjusting for family socio-economic disadvantage at Wave 1 explained the association of residential mobility with emotional but not with behavioural problems, which remained significant even after accounting for change in family's socio-economic disadvantage between waves

Modeling risks: effects of area deprivation, family socio-economic disadvantage and adverse life events on young children’s psychopathology

Background: The effects of contextual risk on young children’s behavior are not appropriately modeled.Aims: To model the effects of area and family contextual risk on young children’s psychopathology.Method: The final study sample consisted of 4,618 Millennium Cohort Study (MCS) children, who were 3 years old, clustered in lower layer super output areas in nine strata in the UK. Contextual risk was measured by socio-economic disadvantage (SED) at both area and family level, and by distal and proximal adverse life events at family level. Multivariate response multilevel models that allowed for correlated residuals at both individual and area level, and univariate multilevel models estimated the effect of contextual risk on specific and broad psychopathology measured by the Strengths and Difficulties Questionnaire. Results: The area SED/broad psychopathology association remained significant after family SED was controlled, but not after maternal qualifications and family adverse life events were added to the model. Adverse life events predicted psychopathology in all models. Family SED did not predict emotional symptoms or hyperactivity after child characteristics were added to the model with the family-level controls. Conclusions: Area-level SED predicts child psychopathology via family characteristics; family-level SED predicts psychopathology largely by its impact on development; and adverse life events predict psychopathology independently of earlier adversity, SED and child characteristics, as well as maternal psychopathology, parenting and education. <br/

Validation of the Serbian adaptation of the Trait Emotional Intelligence Questionnaire-Child Form (TEIQue-CF)

This study investigated trait EI in childhood in a Serbian population by validating a Serbian adaptation of the Trait Emotional Intelligence Questionnaire - Child Form (TEIQue-CF). All 606 participants (Mage = 10.33, SD = 1.55) completed the TEIQue-CF, the Reading the Mind in the Eyes Test (revised version), and the Guess Who peer assessment. Data on academic achievement and truancy were also obtained. The Serbian TEIQue-CF demonstrated robust psychometric properties with satisfactory internal consistencies and extensive evidence of validity in relation to criteria such as emotion recognition, academic grades, truancy rates, and peer ratings. Factor analyses suggested a two-factor solution for the total sample, but a unifactorial structure for the two groups of younger children aged 8 to 9 and 10 to 11. Overall, the results corroborate the validity of the Serbian adaptation and the theoretical and practical importance of the construct of trait EI in children. [Projekat Ministarstva nauke Republike Srbije, br. 179018

Challenges to quality assurance of surgical interventions in clinical oncology trials: A systematic review

Where surgery forms the primary curative modality in surgical oncology trials the quality of this intervention has the potential to directly influence outcomes. Many trials however lack a robust framework to ensure surgical quality. We aim to report existing published challenges to quality assurance of surgical interventions within oncological trials. A systematic on-line literature search of Embase and Medline identified 34 relevant studies, including 19 RCTs, 11 further analyses of the primary RCTs, and 4 trial protocols. Inclusion criteria: oncological RCTs with a surgical intervention and/or associated publications relevant to the research question; ‘Challenges to quality assurance of surgery in clinical oncology trials’. Selected articles were assessed by two reviewers to identify reported challenges to quality assurance of surgical intervention within these trials. Reported challenges to surgical quality could be classified as those affecting credentialing, standardisation and monitoring of surgical interventions. Constraints of using case volume for credentialing surgeons; inter-centre variation in the definition and execution of interventions; insufficient training, and monitoring of surgical quality, were the most commonly encountered challenges within each of these three domains. Findings confirmed an inadequacy in the implementation and reporting of effective surgical quality assurance measures. The surgical community should enable implementation of agreed upon mitigating strategies to overcome challenges to surgical quality in oncology trials