‘Translation is not enough’: using the Global Person Generated Index (GPGI) to assess individual quality of life in Bangladesh,Thailand, and Ethiopia

Currently few subjective measures of Quality of Life (QoL) are available for use in developing countries, which limits their theoretical, methodological, and practical contribution (for example, exploring the relationship between economic development and QoL, and ensuring effective and equitable service provision). One reason for this is the difficulty of ensuring that translated measures preserve conceptual, item, semantic, operational, measurement; and functional equivalence (Herdman, M., Fox-Rushby, J., & Badia, X. (1998). Quality of Life Research, 7, 331), which is illustrated by an account of the translation, pre-piloting, and administration of a new individualised QoL measure, the Global Person Generated Index or 'GPGI'. The GPGI is based on the widely used Patient Generated Index (Ruta, Camfield, & Martin, (2004) Quality of Life Research, 13, 1545.) and offers many of the advantages of the participatory approaches commonly used in developing countries, with added methodological rigour, and quantitative outcomes. It was successfully validated in Bangladesh, Thailand, and Ethiopia, using quantitative and qualitative methods--open-ended, semi-structured interviews (SSIs), conducted immediately post-administration. Both the measure and method of 'qualitative validation' described later in the paper offer an exciting alternative for future researchers and practitioners in this field. The quantitative results suggest the GPGI shows cultural sensitivity, and is able to capture both the areas that are important to respondents, and aspects of life one would expect to impact on QoL in developing countries. There were strong correlation between scores from the GPGI and SSIs for the area of health, and moderate correlations for 'material wellbeing' (MWB)('Material wellbeing' refers to respondents' perceptions of their achievement in the areas of farming, debt reduction, assets, crops, livestock, job, land, property, and agriculture) and children. Weak to moderate correlations were observed between the Satisfaction with Life Scale and the GPGI; however, the highest coefficient was between the GPGI and the most conceptually similar item. Statistically significant differences were seen in GPGI scores between rich and poor, urban and rural respondents, and different countries. Health and material wellbeing scores, derived from the SSIs, also showed a linear relationship with GPGI scores, with a suggestion of curvilinearity at the higher levels, as predicted by a general QoL causal model. In conclusion, the GPGI has great potential for use in this area, especially when supported by extensive interviewer training, and supplemented with a cognitive appraisal schedule.     

Assessment of functional vision and its rehabilitation

This article, based on a report prepared for the International Council of Ophthalmology (ICO) and the International Society for Low Vision Research and Rehabilitation (ISLRR), explores the assessment of various aspects of visual functioning as needed to document the outcomes of vision rehabilitation. Documenting patient abilities and functional vision (how the person functions) is distinct from the measurement of visual functions (how the eye functions) and also from the assessment of quality of life. All three areas are important, but their assessment should not be mixed. Observation of task performance offers the most objective measure of functional vision, but it is time‐consuming and not feasible for many tasks. Where possible, timing and error rates provide an easy score. Patient response questionnaires provide an alternative. They may save time and can cover a wider area, but the responses are subjective and proper scoring presents problems. Simple Likert scoring still predominates but Rasch analysis, needed to provide better result scales, is gaining ground. Selection of questions is another problem. If the range of difficulties does not match the range of patient abilities, and if the difficulties are not distributed evenly, the results are not optimal. This may be an argument to use different outcome questions for different conditions. Generic questionnaires are appropriate for the assessment of generic quality of life, but not for specific rehabilitation outcomes. Different questionnaires are also needed for screening, intake and outcomes. Intake questions must be relevant to actual needs to allow prioritization of rehabilitation goals; the activity inventory presents a prototype. Outcome questions should be targeted at predefined rehabilitation goals. The Appendix cites some promising examples. The Low Vision Intervention Trial (LOVIT) is an example of a properly designed randomized control study, and has demonstrated the remarkable effectiveness of vision rehabilitation. It is hoped that further similar studies will follow.     

不同类型正常乳腺表观扩散系数值差异的研究

目的 研究不同类型正常乳腺表观扩散系数（ADC）值的差异，探讨ADC值与组织学分型之间的关系。方法 采用单次激发平面回波（EPI）技术，扩散敏感因子（b）值分别为0、500、1000s／mm^2，对62个正常乳腺（包括42例乳腺病变患者的对侧正常乳腺及10名健康志愿者20个乳腺）进行MR扫描及MR扩散加权成像（DWI）检查，计算62个正常乳腺分别在不同b值时的ADC值。将62个正常乳腺分为3型，比较3型之间ADC值的差异及不同b值时ADC值的差异。结果 42例乳腺病变患者对侧正常乳腺的DWI及ADC图与组织切片对比，不同类型乳腺组织学结构不同，其DWI及ADC图表现亦有差异。62个正常乳腺分为致密型10个，分叶斑点型42个及退化型10个。致密型和分叶斑点型乳腺随b值降低ADC值升高，而退化型乳腺随b值降低ADC值变化不明显。b=1000—0s／mm^2时，致密型、分叶斑点型、退化型乳腺ADC值分别为（1．70±0．37）、（1．93±0．46）、（1．18±0．65）×10^-3mm^2／s，3组间比较差异有统计学意义（F=12．998，P=0．000）。不同b值时每2种类型间进行单因素方差分析，致密型和分叶斑点型之间差异无统计学意义（F=2．167，P=0．147）；致密型和退化型之间、分叶斑点型和退化型之间差异均有统计学意义（F值分别为5．593、19．128，P值分别为0．029、0．000）。结论 3型正常乳腺ADC值受乳腺组织学结构的影响，致密型和分叶斑点型乳腺ADC值受b值高低的影响。     

一种简单实用的测量气管截面积的方法

目的介绍一种简单实用而较精确的测量狭窄气管截面积的方法.方法利用纤维支气管镜、测长器、模拟气管等制作并校正测量标尺,并利用该标尺测量了3例气管状况异常患者的气管某一截面面积.结果用校正过的4种测量标尺测量了10个模拟气管的直径,和实测真值比较经t检验分析无显著性差异,利用上述标尺测量的3个患者的目的截面面积分别为约96 mm2、 105 mm2和192 mm2.结论本方法提供了一种简单、快速而又较精确的测量大气道某一截面面积的方法,为定量评价患者的通气功能、选择气管支架或采用其他干预手段处理气管病变提供了数据参考.     

C型骨盆骨折合并髋关节中心性脱位的手术治疗

目的:研究C型骨盆骨折合并髋关节中心性脱位的临床疗效。方法:13例患者中男8例,女5例;年龄23～65岁,平均36.5岁。骨盆骨折分型:C1型8例,C2型3例,C3型2例。髋臼“T”形骨折2例,粉碎性骨折9例,双柱骨折2例。均采用手术治疗,术前术后均采用股骨髁上牵引,术中采用髂腹股沟入路,必要时附加患髋后外侧切口,术中采用重建钢板固定。结果:本组随访时间6～28个月,平均13.4个月。髋臼骨折复位后残存移位:0～1mm9例,2～3mm2例,4～5mm2例,无>5mm者。髂骨骨折复位后各向残存移位:0～1mm9例,2～5mm3例,>5mm1例。3例原发性坐骨神经损伤的患者,术后3个月内其感觉、运动功能全部获得恢复。1例继发性坐骨神经损伤,术后6个月恢复。异位骨化2例,股骨头坏死、髋臼及股骨头软骨坏死、髋关节创伤性关节炎5例,患者关节疼痛、活动受限,影响功能。疗效综合评定:优8例,良1例,可2例,差2例。结论:C型骨盆骨折合并髋关节中心性脱位通过手术治疗,能够最大程度恢复其解剖结构,术后关节功能恢复较好。     

He-Ne激光沿经络自动照射治疗仪的研制

介绍He-Ne激光沿经络自动照射治疗仪，它能使激光光束按人们所需要的强度，路径，方式沿经络进行自动照射。     

Image processing in swallowing and speech research

An image processing system for application to studies of the temporal and spatial parameters of movement during swallowing and speech is described. Image sequences from videotape are digitized for computerized manipulation and analysis in an attempt to improve on conventional visual inspection. The system is “interactive” or “event-driven”: after executing a function, the computer waits for guidance from the user who controls the program through keyboard and mouse input, selecting options from menus and responding to prompts. The analyst alters image clarity by the application of filters and heightens contrast through video enhancement. A technique called “remapping” reduces head motion and provides uniform spatial scaling. Animated sequences of images are used, as opposed to frame-by-frame analysis, to preserve temporal context and increase efficiency of measurement. Low cost off-the-shelf personal computer hardware is used along with original software tailored to the application.     

TJS全数字脑电工作站在空军招飞体检中的应用研究

随着科学技术的不断进步,为了尽快适应新形势的发展,招飞体检中我们在脑电图(dectroencephalogram,EEG)检测方面使用了电子计算机技术,并对新仪器应用于脑功能检测工作的价值进行了相关的研究,现报告如下:     

心率及重建相位窗对多层螺旋CT冠状动脉造影图像质量的影响

目的 探讨心率及重建相位窗对多层螺旋CT冠状动脉造影图像质量的影响。方法 80例健康体检者行16层螺旋CT回顾性心电门控条件下冠状动脉造影。结果 每位患者的4条冠状动脉分支(左冠状动脉主干、左前降支、左回旋支、右冠状动脉)分别用于图像质量分析。心率≤60次／min者，有82．1％(46／56支)的图像可用于诊断；心率61～70次／min者，有63．4％(104／164支)的图像可用于诊断；心率71～80次/min者，有41．20h，(28／68支)的图像可用于诊断；心率80次／min以上者有31．2％(10／32支)的图像可用于诊断。左冠状动脉前降支在60％～70％的重建相位窗时图像质量最佳，左冠状动脉回旋支在50％～60％时最佳，右冠状动脉重建相位窗为50％～70％较满意。结论心率及重建相位窗对多层螺旋CT冠状动脉造影图像质量有重要影响作用。     

斑点免疫金渗滤法的改进

目的 :改进斑点免疫金渗滤法的渗滤装置 ,降低成本 ,使之更适用于现场操作。方法 :用自制的圆形渗滤片替代塑料渗滤盒 ,并比较二者的效果。结果 :自制的渗滤片体积更小 ,成本更低 ,为一次性使用材料 ;检测抗体的效果与塑料渗滤盒法一致。结论 :自制的渗滤片优于常用的塑料渗滤盒