Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery. METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference (MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured. RESULTS: A total of 155 residents were enrolled. The average visual acuity (VA) preoperatively was 0.08 (SD=0.05), and it increased to 0.47 (SD=0.28) at the end of follow-up. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL (scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness. CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishing cataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.     

高龄患者生活行为与冠心病发病的相关性研究

目的研究生活行为与高龄患者冠心病发病的关系。方法对91例年龄≥80岁的高龄老年冠心病人的生活行为及5年来的生活事件进行流行病学调查。采用问卷访问、体格检查、查阅住院病历的方法获得数据。结果对高龄老年冠心病人影响较大的负性生活事件依次为丧偶、子女病重或去世、重大财产损失、搬家等。心绞痛组和心肌梗死组A型行为倾向与正常组比较差异有统计学意义。结论负性生活行为与冠心病有关,起诱导剂的作用。     

升降餐桌在PICC置管患者中的应用

随着外科肿瘤患者的逐年上升,术后需要化疗的患者也逐渐增多。PICC置管是术后化疗患者治疗的最好途径,它留置时间长,化疗药不易渗出,风险小。PICC置管需要选择仰卧位,上肢外展90°。保持患者合适的体位,方便护士操     

Assistance respiratoire veino-veineuse et assistance circulatoire veino-artérielle avec oxygénation extracorporelle. Questions,réponses

A round table, organized by the French Society of Perfusion (Sofraperf) at the French national congress on extracorporeal circulations (Perfusion 2013), was attended by perfusionists, anaesthesiologists, intensivists and surgeons around the theme of respiratory veno-venous support and veno-arterial circulatory support with extracorporeal oxygenation in intensive care units. The debate was conducted in a participatory manner by bi-directional questions–answers session between moderators and assistance. The authors report management of this type of therapy that is not perfectly homogeneous, supported on literature data. Cannulae, cannulation, circuit, oxygenator, anticoagulation, control, surveillance, weaning are subject to paragraphs with defined entry whose contents are mutually enriching.     

STAFFING PATTERNS

Unsolved staffing pattern issues are viewed in the current context of funding pressures, third party payment, and management necessity for program and cost projections. Relevant factors are mustered for consideration with their implications. Use of differentiated skill levels and response as well as development of departmental services mandate are considered. The author also shares his experientially derived throughts on staff ratio to certain institutional assignments.     

研究生时间管理倾向、个人奋斗与生活满意度的关系

目的探讨研究生时间管理倾向、个人奋斗与生活满意度之间的关系。方法以219名硕士研究生作为被试,采用问卷调查法和访谈法进行研究。结果①研究生重视自己的个人奋斗,但生活满意度较低(x-±s=3.85±0.32);②个人奋斗与时间管理倾向相关显著(r=0.170~0.383),个人奋斗对时间管理倾向有一定预测作用,解释变异量达到17.0%。;个人奋斗与生活满意度相关显著(r=0.154~0.295),并对其有预测作用,解释变异量达到12.3%;时间管理倾向也对生活满意度有一定预测作用,解释量达到13.4%。结论研究生的时间管理倾向、个人奋斗与其生活满意度显著相关。那些以往成就经验较多,时间效能感较强的个体拥有较高的生活满意度。     

Behavior Change Following Implementation of Home‐Based Life‐Saving Skills in Liberia,West Africa

Introduction: Home‐Based Life‐Saving Skills (HBLSS) has been fully integrated into Liberia's long‐term plan to decrease maternal and newborn mortality and morbidity, coordinated through the Ministry of Health and Social Welfare. The objective of this article is to disseminate evaluation data from project monitoring and documentation on translation of knowledge and skills obtained through HBLSS into behavior change at the community level. Methods: One year after completion of HBLSS training, complication audits were conducted with 434 postpartum women in 1 rural county in Liberia. Results: Sixty‐two percent (n = 269) of the women were attended during birth by an HBLSS‐trained traditional midwife or family member, while 38% (n = 165) were attended by a traditional midwife or family member who did not receive HBLSS training. Home‐Based Life‐Saving Skills–trained birth attendants performed significantly more first actions (life‐saving actions taught to be performed after every birth) than the attendants not HBLSS trained. Fourteen percent of our sample (n = 62) reported too much bleeding following the birth. Of these women, approximately half (n = 29) were attended by an HBLSS‐trained traditional midwife or family member. There was a significant difference in secondary actions (those actions taught to be performed when a woman experiences too much bleeding following childbirth) that were reported to have been performed by HBLSS‐trained attendants (mean 5.26, standard deviation [SD] 1.88) and untrained attendants (mean 2.73, SD 1.97; P < .0001). Discussion: Our findings suggest that HBLSS knowledge is being transferred into behavior change and used at the community level by traditional midwives and family members.     

The triage-function of a psychosomatic liaison-service for gynecological patients

The psychosomatic psychotherapeutic consultation liaison (CL)-service for gynecological patients at the Vienna University has been evaluated. Research interest focused on success and failure of the initial interview, conceptualized for a specific clientele. The interview has a triage function for treatment planning. By the type of treatment that was applied, patients were divided into three groups: Group A, patients with one single contact with the unit; Group B, patients who were referred to external psychotherapy; Group C, patients who were treated with short-term psychoanalytic psychotherapy as offered by the service unit. The drop-outs figured as Group D. The questionnaires completed by the patients at the first consultation and 6 months after their final contact with the clinic covered socio-demographic data, ego functions; the motivation for psychotherapy, a complaints list and finally, at the second contact only, an individual retrospective judgement concerning personal consequences of the consultation. Patients needs in CL-seruices call for quick decisions, which therapeutic measure would be most adequate. An experienced clinician's decision is based on several circumstances: individual feeling of suffering therapy-motivation and ego-strength, as well as social and demographic facts. Comparing groups with different therapeutic recommendations showed that the psychometric tests discriminated well between these four groups and thus the validity of the clinical recommendation has been confirmed.