Image processing in digital radiography

Image processing is a critical part of obtaining high-quality digital radiographs. Fortunately, the user of these systems does not need to understand image processing in detail, because the manufacturers provide good starting values. Because radiologists may have different preferences in image appearance, it is helpful to know that many aspects of image appearance can be changed by image processing, and a new preferred setting can be loaded into the computer and saved so that it can become the new standard processing method.Image processing allows one to change the overall optical density of an image and to change its contrast. Spatial frequency processing allows an image to be sharpened, improving its appearance. It also allows noise to be blurred so that it is less visible. Care is necessary to avoid the introduction of artifacts or the hiding of mediastinal tubes.     

Evaluating the responsiveness of the endometriosis health profile questionnaire: The EHP-30

OBJECTIVES: To evaluate the sensitivity to change of the Endometriosis Health Profile-30 (EHP-30) questionnaire. SETTING: The Women's Center, John Radcliffe Hospital, Oxford. DESIGN: Postal survey to 66 women undergoing conservative surgery for the treatment of endometriosis-associated pain. The EHP-30 and the Short Form-36 (SF-36) were administered 2 weeks before the operation, and 4 months post-operatively. At T2 a transition question was included to evaluate changes in patients health status. To evaluate responsiveness effect sizes, standardised response means, the index of responsiveness and the minimally and clinically important differences were calculated. RESULTS: Forty (66.6%) patients returned the questionnaires at time 1 and 2. Overall less responsive effect size scores were found for the SF-36 (0.1-0.5) compared to the EHP-30 (-0.1-1.1) for all patients who had undergone treatment. Minimally important differences and the index of responsiveness were overall higher for the EHP-30 (0.4-2.0) compared to the SF-36 (0.1-1.0). Change scores for four of the five scales were significantly correlated with women's responses to the transition question. CONCLUSIONS: Results suggest that the EHP-30 is sensitive to change. Its application in clinical trials should prove beneficial in assessing the impact of medical and surgical interventions upon quality of life for women with endometriosis.     

军事飞行员生活事件量表的编制

目的 根据军事飞行员的职业特点，编制适用于该群体的生活事件量表，建立军事飞行员群体心理负荷的来源及其强度的标准化测量工具。方法 为确定量表结构分别采用三个同质样本(n=152、n2=157和n3=437)进行了项目施测。其中前两个样本作为项目甄选的预测样本，进行二次项目增减，同时采用20人分组讨论的形式对项目进行了反复修订。在项目选择上，采用职业应激事件与一般性生活事件相结合的构念，尽可能涵盖与军事飞行员工作及生活密切相关的特殊生活事件。在质的研究基础上，对正式施测的437名被试的数据进行统计分析。结果 军事飞行员生活事件量表共有六个分量表，包含36个项目。经检验，其信度和效度的各项指标均达到了心理测量学的要求。结论 该量表尚有待进一步扩大样本进行更严格的检验。     

滥用药物与生命质量退化的伦理思考

本文从生命质量的内涵入手,分析了滥用药物的直接和间接、近期和远期的危害,通过论证得出了滥用药物必将引起人类生命质量退化的结论.以期从一个新的认识度唤起人们对滥用药物问题的重视、并由此引出了一些对医学目的以及滥用药物控制措施的思考.     

西雅图心绞痛调查量表对冠心病患者机体功能及生活质量的评估研究

目的对冠心病患者机体功能状态及生活质量进行评估。方法采用Ｓｐｅｔｕｓ等设计的ＳｅａｔｔｌｅＡｎｇｉｎａＱｕｅｓｔｉｏｎｎａｉｒｅ问卷对１００例冠心病患者躯体活动受限程度、心绞痛稳定状态及发作情况、治疗满意程度和疾病认识程度进行测评研究。结果重复测定显示该量表有良好的重复性，心理疗法配合药物治疗组的评分明显优于单纯药物治疗组（Ｐ＜０．０５）。结论该量表用于我国冠心病患者有较满意的信度，同时也证实了心理疗法在冠心病治疗中的重要地位。     

Life satisfaction in patients with chest pain subsequently diagnosed as coronary heart disease – connection through depressive symptoms?

The aim of this study was to investigate factors associated with life dissatisfaction in symptomatic patients (n = 144) with chest pain subsequently diagnosed as coronary heart disease (CHD) by coronary angiography. Life dissatisfaction was assessed with a four-item life satisfaction scale (LS), depression with the 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with the symptom check list (SCL). DSM-III-R Axis I and Axis II psychiatric diagnoses were performed by means of the Structured Clinical Interview. All assessments took place one day before angiography. Twenty-four per cent of CHD patients were dissatisfied with their lives. Life dissatisfaction was associated with being unmarried. Dissatisfied patients had Axis I mental disorders and Axis II personality disorders more frequently than others. Psychiatric and depressive symptoms according to the SCL and BDI, respectively, were also higher among dissatisfied patients. In multiple logistic regression analyses, mental disorders were related to life dissatisfaction when age, sex, employment status, New York Heart Association class, duration of chest pain symptoms and work load were controlled in the model. Married subjects had a lower probability of being dissatisfied with their lives than other subjects (Odds Ratio, OR: 0.23). When BDI scores were included in the model, the only factor independently associated with life dissatisfaction was the severity of depressive symptoms (OR: 1.81). To conclude, life dissatisfaction is not primarily determined by the severity of CHD but by the existence of depressive symptoms.     

The Relative Contribution of Domains of Quality of Life to Overall Quality of Life for Different Chronic Diseases

This study examined the contribution of the quality of life (QoL) domains physical, social and psychological functioning to the explanation of overall QoL. Various disorders may differentially affect QoL domains due to disease-specific factors and, consequently, the relationship between QoL domains and overall QoL may vary between diseases. We therefore studied this relationship for several diseases as well as the differential impact of these diseases on QoL. The present study had a cross-sectional design. We selected patients (aged 57 years and older) with one of the following eight chronic medical conditions: lung disorder, heart condition, hypertension, diabetes mellitus, back problems, rheumatoid arthritis, migraine, or dermatological disorders. The total group of respondents included 1457 patients and 1851 healthy subjects. Regression analyses showed that the domain of psychological functioning contributed to overall QoL for all disorders, whereas physical and social functioning contributed to overall QoL for some disorders. Differences were found between most patient groups and healthy subjects with respect to physical functioning; with respect to social and psychological functioning some groups differed from the healthy group. Explanations for the findings and implications for clinical practice are discussed.     

应激相关因素对护士生活质量作用模型的理论构建和结构方程分析

目的应用结构方程分析研究应激相关因素对护士生活质量的影响机制。方法通过随机抽样,采用生活质量综合评定问卷、压力反应问卷、生活事件量表、特质应对方式问卷、领悟社会支持量表、艾森克人格问卷对405名护士进行调查,并应用结构方程分析方法对其作用机制进行探索。结果在5个理论可行的竞争模型中获取了最佳模型(CMINDF2.344;GFI0.928;AGFI0.891;CFI0.945;RMSEA0.060),即应激相关5因素(压力反应、生活事件、社会支持、应对方式和个性特征)中除应对方式外均能直接影响生活质量,而应对方式则以其他应激相关因素为中介对生活质量产生间接影响,这5个因素均可互为中介对护士生活质量产生间接作用。结论结构方程分析方法证实应激对护士生活质量的影响是一个交叉作用系统,在干预应激对护士生活质量的影响时应综合运用直接和间接方法。     

与时俱进 全面开展生活方式教育

该文从疾病谱和死因谱的改变、医学模式的转变、卫生经费的降低、自我保健意识的改变四个角度,论述了全面开展 生活方式教育的必要性和重要性;从以社区为依托、以医院为基础、以生活方式为指导三个方面,探讨了生活方式教 育的工作模式.     

预期无残疾寿命的计算及应用

预期无残疾寿命（ＥＬＷＤ）在国外公共卫生及老年医学研究中已得到普遍重视，但ＥＬＷＤ的计算中却存在着若干错误，直接影响着ＥＬＷＤ的正确使用。文章简述了ＥＬＷＤ的概念及原理，推导了正确的计算公式，并以实例说明了计算步骤及方法，对ＥＬＷＤ在医学研究中的应用进行了讨论。