Remote unaffiliated presurgical psychosocial evaluations: a qualitative assessment of the attitudes of ASMBS members

BackgroundA psychosocial evaluation is an important component of the preoperative assessment process for people seeking metabolic and bariatric surgery (MBS), and is required for accreditation of MBS programs. Recently, independent companies without affiliations with MBS programs have been marketing remotely administered, unaffiliated psychosocial evaluations for MBS (RUS), and American Society for Metabolic and Bariatric Surgery (ASMBS) members have raised concerns about these evaluations.ObjectivesTo explore ASMBS members’ beliefs about RUS.SettingOnline survey.MethodsWe developed a survey to evaluate ASMBS members’ opinions, experiences, and/or concerns about in-person and RUS psychosocial evaluations for MBS.ResultsIn total, 635 ASMBS members responded to the online survey and 156 responded to an open-ended question on RUS. Responses were coded based on a manual developed for this study, yielding themes of concerns about the quality of RUS, lack of ongoing relationships in RUS, and conditions under which/reasons why RUS evaluations could be acceptable.ConclusionRespondents expressed both interest in and concerns about RUS in pre-MBS psychosocial evaluations. Use of RUS has the potential to improve access to MBS by providing a convenient and efficient means of completing the psychosocial evaluation. Conversely, respondents expressed concerns about the background and training of RUS providers, the quality of the reports, and the limited relationships between the RUS provider and both the MBS patient and the MBS team. We discuss the clinical and research implications of response themes, particularly for patients in rural areas or those who have other barriers to care.     

The effects of bright light treatment on subjective and objective sleepiness during three consecutive night shifts among hospital nurses – a counter-balanced placebo-controlled crossover study

Objectives:The objective was to investigate effects of timed bright light treatment on subjective and objective measures of sleepiness during three consecutive night shifts among hospital nurses.Methods:Thirty-five nurses were exposed to bright light (10,000 lux) and red dim light (100 lux) during three consecutive night shifts in a counter-balanced crossover trial lasting nine days, which included three days before and three days after the three night shifts. Light exposure for 30 minutes was scheduled between 02:00–03:00 hours on night 1, and thereafter delayed by one hour per night in order to delay the circadian rhythm. Subjective sleepiness was measured daily (heavy eyelids, reduced performance) and every second hour while awake (Karolinska Sleepiness Scale, KSS). Objective sleepiness (Psychomotor Vigilance Task, PVT) was measured at 05:00 hours during each night shift. Beyond nocturnal light exposure on the night shifts, no behavioral restrictions or recommendations were given at or off work.Results:Bright light treatment significantly reduced heavy eyelids during night shifts. However, results on KSS and PVT were unaffected by bright light. There were no differences in subjective sleepiness during the three days following the night shifts.Conclusions:This bright light treatment protocol did not convincingly reduce sleepiness among nurses during three consecutive night shifts. Nor did bright light impede the readaptation back to a day-oriented rhythm following the night shift period. Too few consecutive night shifts, inappropriate timing of light, and possible use of other countermeasures are among the explanations for the limited effects of bright light in the present study.     

孕妇社会资本量表的修订及信效度检验

目的 旨在翻译、修订孕妇社会资本评估量表（Social Capital Assessment Tool for in Pregnancy for Maternal Health, SCAT-MH）,并检验其信效度。方法 采用两阶段便利抽样的方法,样本1（n=253）主要用于修订中文版SCAT-MH量表;样本2（n=335）主要验证该量表的信效度。结果 中文版SCAT-MH主要包含4个维度16个条目,量表总的Cronbach ɑ为0.862,各个维度的信度系数在0.701~0.901之间,分半信度系数为0.819、0.760,重测信度系数为0.854;量表各个条目与总分（r=0.484~0.776,PSymbol|@@0.01）、维度与总分均呈中高度相关（r=0.575~0.807,PSymbol|@@0.01）,具有较好的内容效度;总量表及4个维度得分与效标工具均有相关性;验证性因子结果显示模型拟合度较好。结论 修订、汉化后的中文版SCAT-MH量表具有较好的信度、效度及区分度,适用于我国孕妇社会资本的评估。     

简明自知力评定量表的信度，效度测定

目的 测查简明自知力评定量表的信度和效度。方法 使用简明自知力评定量表对79例精神分裂症患者的自知力进行评定,测查其信度和效度。结果 显示该量表的重测信度为0．83,评定者之间的信度为0．91,分半信度为0．84,与ITAQ及临床自知力评定结果之间的效标效率分别为0．72和0．76,与BPRS的相关系数为－0．31。结论 该量表具有较好的信度和效度。     

血管性痴呆的智能测验与P300的相关性

目的：观察血管性痴呆患者的智能测验分与事件相关电位Ｐ３００潜伏期的相关性。方法：应用长谷川信彦痴呆量表测验血管性痴呆组（２７例）和智能正常对照组（３３例）两组患者智能。同时检测两组患者Ｐ３００潜伏期,并观察两组患者测验与Ｐ３００潜伏期的相关性。结果：两组患者智能测验分有显著差异（Ｐ〈０．０１）,Ｐ３００潜伏期有显著差异（Ｐ〈０．０１）,智能测验分与Ｐ３００潜伏期呈明显负相关。结论：Ｐ３００潜伏期的     

耶鲁抽动症整体严重度量表在儿科临床的初步应用

目的 为量化评估儿童抽动障碍症状的严重程度,翻译并初步应用耶鲁抽动症整体严重度量表（Ｙale Ｇic Ｓeverity Ｓcale,ＹＧＴＳＳ）。方法 对７２例抽动障碍病儿分别于 治疗前和治疗２周后作ＹＧＴＳＳ抽动评分,同时由病儿或监护人按显效、有效和无效自行评定疗效。比较７２例患儿中三种不同类型（暂时性抽动,慢性抽动和抽－秽语综合征）之间的积分差别,比较三组不同疗效病儿之间ＹＧＴＳＳ积分变化的差别。结果 治疗开始前     

Review Article: Normal science? Texts for teaching the sociology of health and illness

Ellen Annandale, The Sociology of Health and Medicine
Rob Baggott, Health and Health Care in Britain
David Field and Steve Taylor (eds), Sociological Perspectives on Health,Illness and Health Care
John Germov (ed), Second Opinion: an Introduction to Health Sociology
Ron Iphofen and Fiona Poland, Sociology in Practice for Health CareProfessionals
Lesley Mackay, Keith Soothill and Kath Melia (eds), Classic Texts inHealth Care
Alan Petersen and Charles Waddell (eds), Health Matters: a Sociology ofIllness, Prevention and Care     

伽玛刀的医学技术评估

伽玛刀是世界上最昂贵的医疗设备之一,我国从１９９２年开始引进。１９９５年卫生部等联合发文暂缓装备。为了规范提供方和患方的行为,以及为卫生行政部门提供决策依据,我们开展了伽玛刀的技术评估。在评估前拟定评估步骤,然后确定评估内容与方法。评估结果,国外１９９４年有５６台伽玛刀,平均每台治疗１９０例,治疗病种是：动静脉畸型病人占３２％,肿瘤病人占６５％,功能性疾病占２％。我国１３台伽玛刀到１９９５年底共治病人７０００例,前６位病种是转移瘤等,虽然比例和顺位与世界有差异,但病例分析结果完全一致。     

转轨时期医院经营管理效益量化评价方法研究

效益评价是医院经营管理中的一项重要工作。医院经营管理的效益分为社会效益和经济效益。两个效益的人为脱节和社会效益指标的虚化,形成了效益评价的难点。本文采取层次分析法,将医院的社会效益、经济效益与医院的投入、消耗和产出的１９个指标有机结合起来,使两个效益在有机统一的前提下指标量化,这样既增强了两个效益评价工作的可操作性,也增强了效益评价结果对医院经济工作指导的操作性。