What's the procedure? Your guide to costing methods and terminology

A firmer understanding of healthcare costing methods and relevant terms can facilitate clinical leader involvement and confidence in the costing process.     

Does God Determine Your Health? The God Locus of Health Control Scale

Although perceptions of internal control havebeen related to physical and psychosocial outcomes inchronic illness,less attention has been paid toperceptions of external sources of control and theirimplications for adaptation. One reason for this has beenthe dearth of adequate measures for assessing specificexternal control constructs. The God Locus of HealthControl (GLHC) scale was developed to assess the extent of an individual's belief that God controls hisor her health status. The GLHC was designed as anadjunct to the widely used Multidimensional Health Locusof Control (MHLC) scales. Initial studies of the psychometric properties of the GLHC scale insamples of persons with two rheumatic diseases,rheumatoid arthritis and systemic sclerosis, provideevidence of the scale's reliability andvalidity.     

Is the DDAVP-test helpful to diagnose children?

It is very difficult to determine if patients with a moderate low level of VWF parameters have mild disease or if they are just low normal (so called grey area of VWD). This applies particularly to pediatrics, because it is difficult to evaluate the bleeding history of children. Al our centres every child diagnosed with vWD gets DDAVP to test the response for it. This study was done to evaluate the DDAVP- test as a diagnostic tool. Patients, methods: A retrospective analysis of data obtained with routine DDAVP administration for test purposes in 52 patients with borderline von Willebrand disease at the haemophilia centre Graz was done. The increase of VWF:Ag, VWF:RiCof and FVIII:C has been document and compared. Results: All of our patients had a very good response after application of DDAVP. The increase of VWF:Ag, VWF:RiCof and FVIII:C was compared in patients with positive and negative bleeding anamneses. The patients with positive anamneses had significantly lower parameters at the beginning. The increase of VWF parameters did not differ significantly between the groups at the different time-points. These results demonstrate that a positive anamnesis is not significantly associated with a lower increase. On the other side a high increase is not associated with a negative anamnesis. Conclusion: It is not possible to use the DDAVP test as a diagnostic tool for patients within the diagnostic grey area of VWD.     

Where Is the Future Heading for Women's Health Nurse Practitioners?

The role of the women's health nurse practitioner (WHNP) has evolved since it was established in the early 1970s. However, the number of WHNP programs and graduates has declined significantly since the specialty's inception, partly because of the perception, and often the reality, that family nurse practitioners have more employment opportunities. This article reviews the evolution of the specialty. Strategies for maintaining the specialty and expertise in this practice area are examined. Considerations for creating opportunities for WHNPs are also discussed.     

Is tendon stiffness correlated to the dissipation coefficient?

The assessment of Achilles tendon mechanical properties in vivo has received much attention in the literature. Many studies investigated mechanical properties by assessing tendon stiffness. Despite tendon dissipative properties being representative of a storage-recoil process, its determination has received minimal attention in the literature. The aim of this study was to determine if Achilles tendon stiffness is associated with dissipative properties. The cross-sectional area, stiffness and dissipation coefficient of the Achilles tendon were measured in 35 subjects. No significant correlation was found between stiffness and the dissipation coefficient, irrespective of stiffness normalization with cross-sectional area (P > 0.05). Thus, it appears that both stiffness and dissipative properties must be assessed to determine the storage-recoil process capacities of the Achilles tendon in order to precisely characterize changes in the tendon mechanical properties after chronic interventions or rehabilitation programs.     

Is dengue a threat to the blood supply?

summary .  Dengue is the most common arthropod-borne infection worldwide, affecting at least 50 million people every year and endemic in more than 100 countries. The dengue virus is a single-stranded RNA virus with four major serotypes. Infection with one serotype confers homotypic immunity but not heterologous immunity, and secondary infection with another serotype may lead to more severe disease. The major route of transmission occurs through the Aedes aegypti mosquito vector, but dengue has also been transmitted through blood transfusion and organ transplantation. Infection results in a spectrum of clinical illness ranging from asymptomatic infection, undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF) to dengue shock syndrome (DSS). Dengue is spreading rapidly to new areas and with increasing frequency of major outbreaks. A trend has also been observed towards increasing age among infected patients. This will impact blood supply availability as more blood donors are deferred because of dengue infection or exposure to infection. The risk of transmission through transfusion of blood from asymptomatic viraemic donors will also increase. Although screening tests for dengue and effective pathogen reduction processes are now available for the blood supply, the value of implementing these costly measures needs to be carefully considered. Demand for platelets and fresh frozen plasma will rise with increasing number of DHF/DSS. Evidence-based guidelines for the clinical use of these blood components in the management of patients with DHF/DSS have not been well established, and inappropriate use will contribute to the challenges faced by blood services.