A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

Background  

We assessed preferences for current health using the visual analogue scale (VAS), standard gamble (SG), time trade-off (TTO), and willingness to pay (WTP) in patients with cerebral aneurysms, a population vulnerable to cognitive deficits related to aneurysm bleeding or treatment.     

Comparing performance of computational tools for combinatorial library design

In using computational tools for library design it is necessary to understand the performance and limitations of available methods. This letter reports systematic comparisons of applying ligand-based and structure-based tools across therapeutic project-derived data sets. Included are assessments of performance in real-world iterative design applications and the utility of target structural information. The results suggest that combining screening and target structure information is robust; further, a well-designed screening library can compensate for lacking structural information.     

Psychometric qualities of the Dutch version of the Pediatric Inventory for Parents (PIP): a multi‐center study

Objectives: Diagnosis and treatment of childhood cancer are continuous stressors in the lives of the entire family involved. Disease‐related tools for the assessment of parental stress and adaptation are scarce. For that reason, the Pediatric Inventory for Parents (PIP), a disease‐related measure, was translated into Dutch and its psychometric qualities were determined to prove its value. Methods: The PIP and three other measures (State‐Trait Anxiety Inventory, General Health Questionnaire and Parenting Stress Index, Short Form) were administered to 174 parents of 107 children diagnosed with cancer in three university medical centers in the Netherlands. Results: Internal consistency (Crohnbach's α=0.94 and 0.95) and test–retest reliability (Pearson's r between 0.67 and 0.87) of the Dutch PIP total scales are satisfactory. Validity was illustrated by a high correlation between PIP‐scores and anxiety and general stress. Confirmatory factor analysis showed acceptable fit to the data for the original four‐factor and the one‐factor models; the four‐factor model showed slightly better fit. Conclusion: The PIP can be used in clinical practice to assess disease‐related parental stress. Further psychometric testing is highly recommended. Copyright © 2009 John Wiley & Sons, Ltd.     

Quality of life in children three and nine months after discharge from a paediatric intensive care unit: a prospective cohort study

Background  

Improved survival in children with critical illnesses has led to new disease patterns. As a consequence evaluation of the well being of survivors of Pediatric Intensive Care Units (PICU) has become important. Outcome assessment should therefore consist of evaluation of morbidity, functional health and Health Related Quality of Life (HRQoL). Awareness of HRQoL consequences and physical sequelae could lead to changes in support during the acute phase and thereafter. The aim of this study was to evaluate HRQoL in PICU survivors.     

Inhibin reduces spermatogonial numbers in testes of adult mice and Chinese hamsters

Bovine follicular fluid (bFF) injected ip in mice during 2 days (65,000 U inhibin/day, 1 U inhibin the activity in 1 micrograms bFF protein) caused a significant decrease in the numbers of A4, intermediate (In), and B spermatogonia to 91%, 74%, and 67% of the control values, respectively. The numbers of undifferentiated spermatogonia remained unchanged. These injections suppressed peripheral FSH levels to 6% of the control values, suggesting that FSH might be the modulator of the effects on spermatogenesis. However, in the Chinese hamster, intratesticular injections of bFF during 4 days (6500 U inhibin/day into one testis) also caused a significant decrease in the numbers of A3. In, B1, and B2 spermatogonia to 86%, 61%, 55%, and 94% of the control values, respectively. Similarly, treatment with a partially purified inhibin preparation from rat Sertoli cell-conditioned medium (rSCCM) during 4 days (Mono Q fraction; 1512 U inhibin/day; 37.8 micrograms protein) caused a significant decrease in the numbers of A3, In, B1, and B2 spermatogonia to 90%, 87%, 66%, and 93% of the control values, respectively. Treatment with a highly purified inhibin preparation from rSCCM during 4 days (30K inhibin; 750 U inhibin/day; 100 ng protein) significantly decreased the numbers of In and B1 spermatogonia to, respectively, 87% and 91% of the control values. These effects were limited to the testis into which the material was injected; the contralateral testis or testes injected with control fluid always showed normal numbers of spermatogonia. This implies that the effects on the seminiferous epithelium are not FSH mediated. Intratesticular injections of bFF or pure inhibin did not affect the number of undifferentiated spermatogonia. However, the Mono Q fraction caused a significant increase in the numbers of undifferentiated spermatogonia in stages IV-VII of the cycle, suggesting the presence of a mitogenic factor for undifferentiated spermatogonia in rSCCM which is not present or is counteracted in bFF. The results suggest that inhibin may have a role in the regulation of spermatogonial development in the adult animal.     

Intra-individual variation of glucose,specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study

Summary We studied the intra-individual variation in plasma glucose, specific serum insulin and serum pro-insulin concentrations, measured by two 75-g oral glucose tolerance tests in an age, sex, and glucose tolerance stratified random sample from a 50–74-year-old Caucasian population without a history of diabetes mellitus. The intra-individual variation was assessed by the standard deviation of the test-retest differences (SD_dif). For subjects with normal (n=246), impaired glucose tolerance (n=198), and newly detected diabetes (n=80) classified at the first test, the following (SD_dif/median level of individual average scores) were found: fasting glucose: 0.4/5.4, 0.5/5.9 and 0.7/7.2 mmol/l; 2-h glucose: 1.3/5.6, 1.8/8.5 and 2.3/12.8 mmol/l; fasting insulin: 23/76, 32/89 and 30/ 116 pmol/l; 2-h insulin: 190/303, 278/553 and 304/626 pmol/l; fasting proinsulin: 4/8, 6/13 and 9/18 pmol/l; 2-h proinsulin: 19/49, 23/84 and 33/90 pmol/l, respectively. In both glucose, proinsulin and insulin concentrations the total intra-individual variation was predominantly determined by biological variation, whereas analytical variation made only a minor contribution. The SD_dif can easily be interpreted, as 95% of the random test-retest differences will be less than 2 · SD_dif, or in terms of percentage, less than (2 · SD_dif/median level of individual average scores) · 100. Therefore, for subjects with normal glucose tolerance, 95% of the random test-retest differences will be less than 15% (fasting glucose), 46% (2-h glucose), 61% (fasting insulin), 125% (2-h insulin), 100% (fasting proinsulin) and 78% (2-h proinsulin) of the median value of the individual average scores. No substantial independent association of either age, gender or obesity with the intra-individual variation in glucose, proinsulin, or insulin concentrations was found.Abbreviations OGTT Oral glucose tolerance test - NGT_1st, IGT_1st new DM_1st normal glucose tolerance, impaired glucose tolerance and newly detected diabetes mellitus, respectively, as classified at first OGTT - SD_dif standard deviation of the difference scores - CV_intra intra-individual coefficient of variation - CV_bi biological intra-individual coefficient of variation - CV_a analytical intra-individual coefficient of variation - Cl₉₅ 95% confidence interval     

The incidence of theilerial parasites in East African buffalo (Syncerus caffer).

245 buffalo from 13 areas of East Africa were examined for theilerial infections. The vast majority of buffalo (97.1%) examined had piroplasms in their erythrocytes. Theileria lawrencei was isolated from the buffalo by tick feeding and cell culture and was found to be common in most of these buffalo populations. Also over 50% of the buffalo had indirect fluorescent antibody (IFA) titres to T. lawrencei. T. mutans was only isolated from 3 buffalo populations but is probably common. Haematoxenus sp. was detected in the blood of 56% of the buffalo sampled. In the light of these results the role of buffalo as a reservoir of cattle pathogenic theilerioses in East Africa is discussed.