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Non-medical opioid use (NMOU) is a growing crisis. Cancer patients at elevated risk of NMOU (+risk) are frequently underdiagnosed. The aim of this paper was to develop a nomogram to predict the probability of +risk among cancer patients receiving outpatient supportive care consultation at a comprehensive cancer center.
3,588 consecutive patients referred to a supportive care clinic were reviewed. All patients had a diagnosis of cancer and were on opioids for pain. All patients were assessed using the Edmonton Symptom Assessment Scale (ESAS), Screener and Opioid Assessment for Patients with Pain (SOAPP-14), and CAGE-AID (Cut Down-Annoyed-Guilty-Eye Opener) questionnaires. “+risk” was defined as an SOAPP-14 score of ≥7. A nomogram was devised based on the risk factors determined by the multivariate logistic regression model to estimate the probability of +risk.
731/3,588 consults were +risk. +risk was significantly associated with gender, race, marital status, smoking status, depression, anxiety, financial distress, MEDD (morphine equivalent daily dose), and CAGE-AID score. The C-index was 0.8. A nomogram was developed and can be accessed at https://is.gd/soappnomogram. For example, for a male Hispanic patient, married, never smoked, with ESAS scores for depression = 3, anxiety = 3, financial distress = 7, a CAGE score of 0, and an MEDD score of 20, the total score is 9 + 9+0 + 0+6 + 10 + 23 + 0+1 = 58. A nomogram score of 58 indicates the probability of +risk of 0.1.
Significance of results
We established a practical nomogram to assess the +risk. The application of a nomogram based on routinely collected clinical data can help clinicians establish patients with +risk and positively impact care planning.
In 2017, the Onassis Cultural Center in New York hosted an exhibition called “A World of Emotions” (Levere, 2017). This exhibition was publicized as “Bringing to vivid life the emotions of the people of ancient Greece, and prompting questions about how we express, control, and manipulate feelings in our own society” (Onassis USA, 2017). The historical epoch covered was from 700 BC to AD 200, very roughly from a time near the end of the classical period to the middle of the Hellenistic period. One commentary on this exhibition suggested: “These objects provide a timely opportunity to think about the role of feelings in our personal, social and political lives and help advance the relatively new field of the history of emotions” (Levere, 2017).
Over the past few decades, researchers have made notable strides in understanding the processes underlying workplace affect. In particular, rigorous measures and new theoretical models for the study of workplace affect have been developed, validated, and updated with data gathered from employee samples across different industries, countries, and cultures (e.g. Bledow, Schmitt, Frese, & Kühnel, 2011; McCullough, Emmons, & Tsang, 2002; Watson, 2000; Weiss & Cropanzano, 1996; Yang, Simon, Wang, & Zheng, 2016). As shown in the array of chapters in this volume, exciting progress has been made on many fronts. Yet there are many separate streams of research that have been developed in a relatively independent fashion. This chapter will propose some directions for future research that could integrate different areas of research on emotional experiences at work. We propose and discuss the following ideas: integration of research on general and discrete emotions; research taking a broader view of emotional management; new research methods and new perspectives; and the implications of social changes for research on workplace affect and for the application of such research.
Differential susceptibility theory (DST) posits that individuals differ in their developmental plasticity: some children are highly responsive to both environmental adversity and support, while others are less affected. According to this theory, “plasticity” genes that confer risk for psychopathology in adverse environments may promote superior functioning in supportive environments. We tested DST using a broad measure of child genetic liability (based on birth parent psychopathology), adoptive home environmental variables (e.g., marital warmth, parenting stress, and internalizing symptoms), and measures of child externalizing problems (n = 337) and social competence (n = 330) in 54-month-old adopted children from the Early Growth and Development Study. This adoption design is useful for examining DST because children are placed at birth or shortly thereafter with nongenetically related adoptive parents, naturally disentangling heritable and postnatal environmental effects. We conducted a series of multivariable regression analyses that included Gene × Environment interaction terms and found little evidence of DST; rather, interactions varied depending on the environmental factor of interest, in both significance and shape. Our mixed findings suggest further investigation of DST is warranted before tailoring screening and intervention recommendations to children based on their genetic liability or “sensitivity.”
To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.
Are you struggling to improve a hostile or uncomfortable environment at work, or interested in how such tension can arise? Experts in organizational psychology, management science, social psychology, and communication science show you how to implement interventions and programs to manage workplace emotion. The connection between workplace affect and relevant challenges in our society, such as diversity and technological changes, is undeniable; thus learning to harness that knowledge can revolutionize your performance in tackling workday issues. Applying major theoretical perspectives and research methodologies, this book outlines the concepts of display rules, emotional labor, work motivation, well-being, and discrete emotions. Understanding these ideas will show you how affect can promote team effectiveness, leadership, and conflict resolution. If you require a foundation for understanding workplace affect or a springboard into deeper, more interdisciplinary research, this book presents an integrative approach that is indispensable.