The impact of traumatic brain injury on family members living with patients: a preliminary study in Japan and the UK.

PURPOSE: To ascertain the views of families living with TBI patients about the nature of the problems experienced as a result of TBI, and to compare the views of Japanese family members (J-FM) and British family members (B-FM) in order to find out whether there were cultural differences in family response to TBI. METHODS: Family members involved in providing care were identified by the patients. Face to face interviews were conducted with all 18 carers in B-FM and four carers in J-FM. The remaining eight carers in J-FM participated in the postal questionnaire. Questionnaires were developed to explore the nature of problems and the involvement of family such as social embarrassment. RESULTS: Problems arising in families were almost the same reported from both groups. However families in B-FM were likely to know more about how to cope with these problems. Family members in J-FM reported more statistically significant increases in social embarrassment than those in B-FM. CONCLUSION: The preliminary results showed that family members living with TBI patients in both groups had experienced problems. Appropriate rehabilitation services should be developed to help families as well as TBI patients in Japan.

Development of quality of life questionnaire in Japan: quality of life assessment of cancer patients receiving chemotherapy.

The Japanese Quality of Life Research Group has developed a general questionnaire suitable for assessing the Quality of Life (QOL) in patients undergoing chemotherapy. The questionnaire covers four major categories: (1) daily activities, (2) physical condition, (3) social activities, and (4) mental and psychological status. The State-Trait Anxiety Inventory (STAI), Self-Rating Depression Scale (SDS), and Performance Status (PS) were used as external measures of quality of life and for the validation of our tool. On the basis of two basic surveys and two studies we selected 22 questions from a larger set of items. Validity and reliability were verified for the final 22-question form. This questionnaire, named the QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD), can be used to detect changes in QOL over time. Its use as an additional outcome measure in Phase III chemotherapy trials should be encouraged.

[Molecular mechanics study on Conformation of a homooligopeptide constituted by isovalin].

Conformational energy computations on a homo-hexapeptide of (S)-isovaline were performed using molecular mechanics on MacroModel. Conformational search calculations were carried out by Monte Carlo method. AMBER* was used as the force field. The global minimum energy conformation was found to be a 3(10)-helix coordinated by four hydrogen bonds. The results of the theoretical analysis of the conformation of the peptide are in agreement with its reported conformational properties in the solid state determined by X-ray crystallographic analysis.

[Assessment of QOL in cancer drug therapy using 22-item questionnaire].

In order to integrate quality of life as the end point in the cancer drug therapy, a questionnaire form has been developed over the past four years by a Grant-in-Aid for Cancer Research from the Ministry of Health and Welfare, Japan. Fifty-one items generated by questionnaires were forwarded to oncologists, nurses, psychologists and 121 patients. Then questionnaires were scaled down to 36 items based upon factor analysis considering correlation to State-Trait Anxiety Inventory (STAI) and Self-rating Depression Scale (SDS). These 36 items were administered to 536 patients. Finally, a 22-item questionnaire was completed by rechecking correlations with PS, STAI, SDS and Cronbach's alpha. It includes such components as physical activities (6 items), psychological (5 items) and social variables (5 items), symptoms (5 items) and global well-being (1 item: face scale). In our treatment of G. I. cancer by chemotherapy, NC patients showed improvement (+1.56 score), especially in physical functions (+2.43 score), but with slight deterioration (-0.25 score).

[Clinical studies on the intercostal minithoracotomy method in spontaneous pneumothorax].

The thirty patients with spontaneous pneumothorax were selected and treated with intercostal minithoracotomy (MT). To study the extent of surgical damage and recurrence rate and total hospital cost in this approach, we compared MT to axillary thoracotomy (AT) with respect to nine variables: (1) operative time (2) feverish period (more than 37 degrees C) (3) total drainage volume for two days after operation (4) white blood cell counts in the 1st postoperative day (POD) (5) CRP in the 3rd POD (6) PSTI (pancreatic secretory trypsin inhibitor) in the 3rd POD (7) period of hospital stay after operation (8) total hospital cost (9) postoperative recurrence rate. A control group of twenty patients undergoing AT over the same period was selected. The average length of operation (recorded in minutes) in the MT group was 25 (SD +/- 10) as compared to 41 (SD +/- 12) in the AT group. The difference between two groups proved to be statistically significant (p < 0.005). The average volume of drainage after operation (recorded in ml) in the MT group was 51 (SD +/- 45) versus 114 (SD +/- 93) in the AT group (p < 0.025). The average period of postoperative fever (recorded in days) in the MT group was 2.6 (SD +/- 1.2) versus 3.6 (SD +/- 1.6) in the AT group (p < 0.01). The average value of WBC (recorded in counts/mm2) in the MT group was 10,955 (SD +/- 2,564) versus 9,966 (SD +/- 3,034) in the AT group.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment and maintenance of adequate respiration.

In order to make an adequate assessment of and to maintain respiratory function in patients in the intensive care unit, the nursing responsibilities include: (1) Recognition of physiologic and psychologic changes related to respiratory disease. (2) Appreciation of individual reactions to respiratory stressful situations, particularly during periods of hypoxemia and hypercapnia. (3) Awareness that behavioral changes related to changes in respiratory physiology are reversible with corrective respiratory therapy. (4) Skill in implementing the prescribed medical therapy quickly and efficiently and ability to evaluate the patient's response. (5) Assessment and appropriate involvement of the family as an essential factor in the plan for care.