Factors influencing medical staff's intentions to implement family-witnessed cardiopulmonary resuscitation: A cross-sectional, multihospital survey.

BACKGROUND: In Taiwan, the current status of family-witnessed resuscitation (FWR) and the factors associated with behavioural intentions to implement FWR have not been systematically examined using representative medical staff. AIM: We explored predictive factors for behavioural intentions to implement FWR among medical staff using constructs from the theory of planned behaviour. METHODS: A survey of 1605 medical staff from five hospitals in southern Taiwan was conducted. Data were collected using a researcher-made questionnaire containing theory of planned behaviour constructs and demographic items. The dependent variable was intention to implement FWR, and the independent variables were three theory of planned behaviour constructs (attitudes, subjective norms, and perceived behavioural control) and the demographic characteristics. A generalized estimating equation was used to identify factors associated with the behavioural intentions. RESULTS: In total, 1122 valid questionnaires revealed that only 3.7% of participants advocated FWR policies. The construct scores for intention to implement FWR were 2.96 (on a five-point Likert scale), and the theory of planned behaviour constructs that significantly predicted intention to implement FWR were positive attitudes and subjective norms ( p<0.001). Classification of hospitals ( p=0.018) and restrictive provisions for FWR ( p=0.004) were additional significant predictors of intention to implement FWR. Moreover, medical staff employed at regional hospitals demonstrated higher intentions, positive attitudes and subjective norms than did those employed at the medical centre. CONCLUSION: According to the findings of this study, it may be desirable for administrators to prioritize the implementation of the FWR policy in regional hospitals. We recommend affording the factors of positive attitudes and subjective norms high priority to improve the medical staff's behavioural intentions of FWR practice.

Antiandrogenic therapy can cause coronary arterial disease.

AIM: To study the change of lipid metabolism by antiandrogen therapy in patients with prostate cancer. MATERIALS AND METHODS: We studied with a 2.5 years follow-up the changes in plasma cholesterols (C), triglycerides (TG), lipoproteins (LP), and apolipoproteins (Apo) B-100, A-I, and A-II pro fi les in 24 patients of mean age 60 years with low risk prostate cancer (stage: T1cN0M0, Gleason score: 2-5) during treatment with cyproterone acetate (CPA) without surgical management or radiation therapy. RESULTS: Significant decreases of HDL-C, Apo A-I and Apo A-II and an increase of triglyceride levels in VLDL were induced by CPA. After a period of 2.5 years on CPA treatment, four patients out of twenty-four were found to be affected by coronary heart disease. CONCLUSIONS: Ischaemic coronary arteriosclerosis with an incidence rate of 16.6% as caused by prolonged CPA therapy is mediated through changes in HDL cholesterol, Apo A-I and Apo A-II pro fi les, other than the well-known hyperglyceridemic effect caused by estrogen.

Simply modified no-scalpel vasectomy (percutaneous vasectomy)--a comparative study against the standard no-scalpel vasectomy.

BACKGROUND AND PURPOSE: The simply modified no-scalpel vasectomy (SMNSV; percutaneous vasectomy) technique was reported to simplify the standard no-scalpel vasectomy (SNSV) procedure. In this report, we introduce our experiences with SMNSV in comparison with the SNSV. MATERIALS AND METHODS: Between July 1999 and June 2002, 417 men were prospectively randomized to be vasectomized at the Taipei Medical University Hospital: 215 acceptors underwent the SNSV and the remaining 202 received the SMNSV. Using the no-scalpel vasectomy instruments in a percutaneous fashion, the sharp no-scalpel hemostat punctures the skin directly instead of fixating the vas to the skin with the use of a ring clamp, as done in SNSV. The vas is then grasped with the ringed instrument instead of piercing the vas and performing the supination maneuver, as described for SNSV. The intraoperative conditions of each group were recorded. The postoperative pain and life conditions were self-reported. The pain level was assessed using a 10-cm visual analogue scale under various situations. RESULTS: The time required for the SMNSV technique was less than that for the SNSV technique (p < .05). There were no significant differences between the two groups with respect to incision length, postoperative pain, pain at coitus, time of return to work, time of resuming intercourse, self-reported satisfaction in sexual life, postoperative psychological status, postoperative body weight change and postoperative complications (p > .05 for all items). CONCLUSIONS: The simply modified vasectomy technique simplifies the SNSV technique. It combines the minimally invasive nature of SNSV with the simplicity of classical vasectomy while conserving many comparable advantages.