International Development of the Unidimensional Fatigue Impact Scale (U-FIS)

ObjectiveThe 22-item Unidimensional Fatigue Impact Scale (U-FIS) provides an index of the impact of fatigue on patients with multiple sclerosis (MS). The objective is to produce eight new language versions of the U-FIS: Canadian-English, Canadian-French, French, German, Italian, Spanish, Swedish, and US-English.MethodsThe U-FIS was translated via two translation panels. Cognitive debriefing interviews conducted with patients in each country assessed face and content validity. Scaling and psychometric properties were assessed via survey data with patients in each country completing the U-FIS, Nottingham Health Profile (NHP), and demographic questions.ResultsCognitive debriefing interviews demonstrated U-FIS acceptability. Analysis of postal survey data showed all new language versions to be unidimensional. Reliability was high, with test-retest correlations and internal-consistency coefficients exceeding 0.85. Initial evidence of validity was provided by moderate to high correlations with NHP scales. The U-FIS was able to discriminate between groups based on employment status, perceived MS severity, and general health.ConclusionThe U-FIS is a practical new measure of the impact of fatigue. It was successfully adapted into eight new languages to broaden availability for researchers. Psychometric analyses indicated that the new language versions were unidimensional and reproducible with promising construct validity.     

Effect of hospital on variation in visual acuity and vision‐specific quality of life after cataract surgery

Objective To evaluate the contribution of hospital‐to‐hospital variability in changes in clinical and health‐related quality of life outcomes among patients undergoing cataract extraction by phacoemulsification. Methods Prospective observational study of 14 public hospitals. We recruited consecutive patients on waiting lists for cataract extraction. Clinical data were collected prior to the intervention and 6 weeks afterward. Subjects completed the visual function index (VF‐14) prior to the procedure and 3 months afterward. Univariate and multivariate analysis were performed for visual acuity and VF‐14 scores. Results Substantial differences were observed across the 14 hospitals. At baseline, mean visual acuity ranged from 0.16 to 0.34, and mean VF‐14 scores ranged from 48.06 to 75.89. Following cataract extraction, the mean improvement in visual acuity ranged from 0.35 to 0.57 and in VF‐14 scores from 10.94 to 41.70. The ranges were even more pronounced among patients with low visual acuity or low VF‐14 scores prior to the intervention. Significant differences remained in multivariate analysis. Within the multivariate analysis, the variable ‘hospitals’ had an R² of 0.069 for the visual acuity model and of 0.073 for the VF‐14 model, 20% and 13%, respectively, of the total variability explained. Variation was also observed within geographic regions. Conclusions Outcomes of patients undergoing cataract extractions vary widely from hospital to hospital, even within the same geographic region, explaining an important part of the results. Quality improvement efforts should concentrate on patients with low pre‐intervention visual acuity or vision‐related disability to reduce this variability in outcomes.     

Characteristics of antiviral drugs

This article summarizes the principal characteristics of the drugs used to treat viral infections, with the exception of human immunodeficiency virus infection. It includes antiviral agents active against herpes virus, cytomegalovirus, hepatitis B and C virus, and respiratory viruses, such as influenza and respiratory syncytial virus. Dosage according to the indication, dose adjustment in the case of renal or hepatic insufficiency, significant pharmacokinetic characteristics, and the main adverse effects and interactions are described.     

Age-period-cohort analysis of mortality caused by ischemic cardiopathy in Spain 1965-1985]

With the objective of studying the temporal evolution of ischaemic cardiopathy (IC), or coronary heart disease mortality, in Spain, we carried out a cohort analysis with conventional graphic techniques and modern statistical methods. This permits better understanding and quantification of the age-period-cohort effects and identification of the potential factors operating upon them. To this end, loglineal (Poisson regression) models were constructed of the IC mortality rates for both sexes, using the GLIM package, in which the regression coefficients are the natural Relative Risk (RR) logarithms of the various age groups (35-74 years), period of death (1970-1985) and birth cohort (1985-1960) with respect to the reference group mortality, controlled by the effect of other groups. In respect of the results, the maximum RR value corresponds to decrease year 1975, and falls progressively to 1985, though at all times remaining above the 1970 value. The effect of 1985, though less than 1980, does not present significant differences from the latter. Nevertheless, no clear cohort effect was found. As a probable explanation for the pattern observed, this would suggest recent changes in life style and in medical attention. There is a discussion of the consistency of the models selected with the graphical results and with present knowledge of the natural history of IC and with the evolution of its determining factors, together with validation of the models. In summary, the IC mortality patterns observed show an increase up to the mid-seventies, and stabilization from that date onwards, in all age and sex groups, which is consistent with an age-period effect.     

Nursing role versus European role. The difficult bridge between teaching and health assistance in the new Europe

The goal is to achieve that the maximum possible number of nurses arrive at the deep conviction that practice without theory is only routine and that theory without practice which justifies it is empty erudition. Therefore, the objective of this article is to reflect about the excessively frequent incoherence between that which is taught in schools and the practice which is carried out by the great number of nurses in our country.     

Guidelines for nursing methodology implantation

The authors introduce three guidelines as part of the process to implant the nursing methodology based on the Virginia Henderson Conceptual Model; they propose to help nurses adopt the aforementioned method in their daily practice. These three guidelines shall be published in successive articles: Guidelines to identify attitudes and aptitudes related to the nursing profession; Guidelines to implant the nursing methodology based on the Virginia Henderson Conceptual Model; and Guidelines to plan areas for improvement.     

Risk assessment of domestic and industrial effluents unloaded into a freshwater environment

An ecotoxicologic study was performed to assess the environmental status of the Lujan River. It is an important freshwater system in the northeast of Buenos Aires Province, Argentina. Surface waters (SWs) and liquids effluents (LEs), before they reached the river, and sediments were assessed via acute toxicity screening using a battery of tests with native species. Additionally, the presence, in each LE and SW sample, of bioaccumulatable compounds was checked by SPME extraction and gas chromatograph-MS determination. An environmental risk assessment of each LE was carried out via toxic units and assessment factors approach and through extrapolation methods. Hazardous concentrations for each LE were compared with their river effluent concentrations. Ninety-one percent (91%) of the total toxic load of the river was due to 4 of 11 LEs (37%) evaluated. Although SW samples were not toxic, a real environmental risk was found for this freshwater environment. Sediment toxicity was found to be related to the proximity to pipe discharges. Bioaccumulatable compounds were found in SWs and in LEs. Esters of phthalic acids, morpholine, hydroquinone, and nonylphenol were found throughout the river at different sample sites and in different months during the 1-year sampling program.