Factorial structure of the Chinese version of the 12‐item General Health Questionnaire in adolescents

Aims. To evaluate the underlying factor structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents and find out which factor model proposed by previous empirical research is the best‐fit model. Background. The 12‐item General Health Questionnaire has been extensively used with adolescents in the West. Yet, it has not been used with adolescents in a Hong Kong Chinese context. Design. A cross‐sectional study was employed. Method. Chinese students between the ages of 12–19 from four secondary schools were invited to participate in the study using the multiple‐stage stratified random sampling method during the period from December 2007–February, 2008. The total sample size included in the final analysed was 1883. Results. The General Health Questionnaire‐12 was found to be internally consistent. The results of exploratory factor analysis showed that there are two factors underlying the General Health Questionnaire‐12. Of nine factor models were tested by means of confirmatory factor analysis, only three factor model: the eight‐item two‐factor model, 12‐item three‐factor model and 10‐item two‐factor model, demonstrated good model fit across all model fit indices. Conclusion. This study addressed a gap in the literature by evaluating the factorial structure of the Chinese version of General Health Questionnaire‐12 using exploratory and confirmatory factor analyses in Chinese adolescents. The findings revealed that the eight‐item two‐factor model is the best‐fit model. Relevance to clinical practice. The adolescent mental health problem is alarming and aggravating and warrants special attention. It is essential for community nurses to differentiate psychological distress in adolescents and to identify those adolescents who are at a higher risk of suffering from mental health problems. The availability of a valid and reliable instrument that measures adolescents’ psychological distress is crucial before any nursing interventions to promote their mental health can be appropriately planned, implemented and evaluated.     

Telmisartan in migraine prophylaxis: a randomized, placebo-controlled trial

We evaluated telmisartan 80 mg for migraine prophylaxis. Migraine patients ( n  = 95) with three to seven migraine attacks in 3 months were randomized, double-blind to telmisartan or placebo. The primary end-point was the reduction in the number of migraine days (i.e. a day with ≥ 1 h of symptoms) between the 4-week baseline period and the last 4 weeks of the 12-week treatment period. A responder was recorded when there was a symptom reduction of ≥ 50% in these 4-week baseline and treatment periods. The reduction in migraine days was 1.65 with telmisartan and 1.14 with placebo ( P  > 0.05). Post hoc analyses adjusting for baseline and centre showed a 38% reduction in migraine days with telmisartan vs. 15% with placebo ( P  = 0.03), and a borderline significant difference in responders (40% vs. 25%, P  = 0.07). The incidence of adverse events was similar between treatments. This study indicates that telmisartan might be effective in migraine prophylaxis.     

Laser corneal biofilm disruption for infectious crystalline keratopathy

Crystalline keratopathy can be successfully treated by the Nd:YAG laser. We present two cases of crystalline keratopathy managed this way. A 36-year-old female contact lens wearer presented with crystalline keratopathy following recent treatment with topical steroids and antibiotics for a corneal abscess. In this case crystalline keratopathy developed despite the intensive topical antibiotic treatment. A 55-year-old man with a history of acne rosacea, chronic myelomonocytic leukaemia, asthma and Crohn's disease presented with crystalline keratopathy following an episode of infectious keratitis. Treatment with the Nd:YAG laser to the area of involvement was instituted in both cases. Noticeable resolution occurred within days, with subsequent full recovery. No side-effects from the use of the Nd:YAG laser were noted. There have been only two cases previously reported using this treatment modality.