Significant Difference In Total Score Research Articles

Longitudinal Impact on Quality of Life for School-aged Children with Amblyopia Treatment: Perspective from Children

Background: To evaluate the longitudinal impact on health-related quality of life (HRQOL) during amblyopia treatment for school-aged children from children’s perspective.Methods: School-aged children prescribed amblyopia treatment for the first time were recruited into the current study. Using a questionnaire, subjects’ HRQOL was assessed before patching treatment, and at 8 weeks and 16 weeks after the commencement of patching treatment. Evaluation of visual function and psychosocial aspect was included in the questionnaire. Visual acuity and demographic data of the subjects were recorded.Results: Forty-four children, aged 7–12 years, with anisometropic amblyopia were included in the study. Visual acuity in the amblyopic eye improved 1.90 (0.41–3.74) and 3.98 (2.22–5.11) lines at follow-up weeks 8 and 16, respectively. Both the total score and subscales of the questionnaire were reduced at the first follow-up and recovered at the second follow-up. Scores at week 16 were higher than those before treatment in the psychosocial aspect (p = 0.003), and lower in the visual function aspect (p < 0.001), without significant difference in total score (p = 0.207). Visual acuity in the amblyopic eye and psychosocial expectations for treatment were the most important factors that influenced HRQOL during treatment.Conclusions: From the children’s perspective, the impacts on visual function and psychosocial aspect were significant in the first two months of treatment, and could be adapted during therapy for school-aged children. More attention should be paid to negative effects of treatment on daily life and study at the stage of amblyopia treatment for school-aged children. Meanwhile, necessary precautions should be taken to help reduce the impacts.

The Effect of Swedish Massage on Relieving Fatigue of Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy

Background: Fatigue is the most annoying side effect of cancer treatment in children who experience it from the time of diagnosis till conclusion of therapy. About 75% to 90% of children undergoing chemotherapy suffer from this complication. To relieve this problem, massage therapy is recommended which is the most widely applied adjuvant therapy. The purpose of this study was to determine the effect of Swedish massage on fatigue relieve in children aged 7-12 years suffering from acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy at the Children’s Medical Center of Tehran, Iran. Methods: In this clinical trial, 50 children with ALL undergoing chemotherapy were assigned into 2 groups of intervention and control. First, the severity of fatigue in both groups was measured employing a child fatigue scale questionnaire. Then, in the intervention group, the Swedish massage with the effleurage technique was applied by the child’s mother daily for 4 weeks. The fatigue in both groups was measured at the end of each week. The obtained data were analyzed, using descriptive and inferential statistics (repeated measures analysis). Results: Indicated a significant difference in total score of quality of life and the mean score of fatigue between two groups after intervention (P<0.001). The mean score of fatigue intensity and total score of quality of life, had significant decrease in experimental group than control group after intervention. Conclusion: Considering the results of this study, applying the Swedish massage by the mother as a supplemental and non-invasive intervention can be effective in reducing fatigue in children suffering from ALL who are undergoing chemotherapy. A B S T R A C T

Iminodibenzyl class antipsychotics for schizophrenia: a systematic review and meta-analysis of carpipramine, clocapramine, and mosapramine.

BackgroundWe conducted a meta-analysis of the iminodibenzyl antipsychotics carpipramine, clocapramine, and mosapramine, which are classified as second-generation antipsychotics (SGAs) for schizophrenia treatment.MethodsWe searched data that had been published in PubMed, the Cochrane Library databases, PsycINFO, CiNii, and the Japan Medical s Society up to August 29, 2014. Randomized controlled trials that compared iminodibenzyl antipsychotics with other antipsychotics in patients with schizophrenia were included. Odds ratios and standardized mean differences were evaluated.ResultsWe included four randomized controlled trials on carpipramine (number of patients [n]=290), six on clocapramine (n=1,048), and five on mosapramine (n=986) in the meta-analysis. There were no significant differences in the response rates or in the discontinuation rates either between carpipramine and the other pooled antipsychotics or between clocapramine and the other pooled antipsychotics. On the Positive and Negative Syndrome Scale, mosapramine’s positive subscale scores were superior to those of the other pooled antipsychotics (standard mean of difference =−0.22); however, on that same scale, there were no significant differences in total scores, negative scores, general subscale scores, response rates, or the discontinuation rates between mosapramine and the other pooled antipsychotics. Furthermore, the incidences of extrapyramidal symptoms and of hyperprolactinemia were significantly greater with mosapramine than with the other pooled antipsychotics.ConclusionThe pharmacological profiles of carpipramine and clocapramine, which are classified as SGAs, were similar to those of first-generation antipsychotics because there were no significant differences in efficacy and safety outcomes. However, mosapramine was associated with a greater risk of extrapyramidal symptoms and hyperprolactinemia than the other SGAs were, although it may be beneficial for the improvement of positive symptoms.

Effect of hypnotherapy on smoking cessation among secondary school students

Background: Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is proposed to act on underlying impulses to weaken the desire to smoke or strengthen the will to stop. The aim of this study was to examine the effect of hypnotherapy on smoking cessation among secondary school students. Method: A random sample of 59 male smokers was selected from two governmental secondary schools. Design: A quasi- experimental design was used. Tools: Data were collected using; A- an Interview Questionnaire included; I- smoking assessment tool to determine the smoking rate among males students. II-Characteristics of studied students regarding smoking pattern. III- Smoking Cessation Questionnaire. B- Wisconsin smoking withdrawal scale. The hypnotherapy was implemented after assessing the rate of male smokers, the researchers trained the students in practicing self hypnosis, and asked them to practice it at home and to document the frequency of daily smoked packs for nine weeks. Results: The present study findings indicated that the rate of male smokers among secondary school students in Beni-Suef city was 52.4%, about two third of studied students (65.4%) stopped smoking after nine weeks of practicing hypnosis and the percentage of smoked packs of cigarettes/ day decreased after implementing the program. Conclusion: The present study findings showed that hypnotherapy has a therapeutic effectiveness in achieving a high rate of smoking cessation among secondary school students. There was a highly significant difference in total score of smoking withdrawal index before and after intervention. Recommendation: Community and school education programs should include sessions on quitting smoking, implementing school-based interventions in combination with antitobacco mass media campaigns.

Physiotherapy and physical functioning post-stroke: Exercise habits and functioning 4 years later? Long-term follow-up after a 1-year long-term intervention period: A randomized controlled trial

Introduction: Physical activity is mandatory if patients are to remain healthy and independent after stroke.Objective: Maintenance of motor function, tone, grip strength, balance, mobility, gait, independence in personal and instrumental activities of daily living, health-related quality-of-life and an active lifestyle 4 years post-stroke.Methods: A prospective randomized controlled trial.Results: Four years post-stroke, 37 of the 75 participating persons were eligible for follow-up; 19 (54.3%) from the intensive exercise group and 18 (45%) from the regular exercise group. Both groups were performing equally well with no significant differences in total scores on the BI (p = 0.3), MAS (p = 0.4), BBS (p = 0.1), TUG (p = 0.08), 6MWT (p = 0.1), bilateral grip strength (affected hand, p = 0.8; non-affected hand, p = 0.9) nor in the items of NHP (p > 0.005). Independence in performing the IADL was 40%, while 60% had help from relatives or community-based services.Conclusion: This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes. Both groups maintained function and had a relatively active life style 4 years after the acute incident. The results underline the importance of follow-up testing and encouragement to exercise, to motivate and sustain physical activity patterns, to maintain physical function, not only in the acute but also in the chronic phase of stroke.

Psychosocial and contextual determinants of health among infertile women: A cross-cultural study

The purpose of this study was to assess the impact of emotional intelligence, social support and contextual factors on the general health of infertile women. A sample of involuntarily childless women aged 25–45 living in the UK (n = 148) and Pakistan (n = 164) completed a self-administered questionnaire. Although there were no significant differences in total scores on the General Health Questionnaire (GHQ), British women reported greater anxiety, insomnia and social dysfunction, and Pakistani women reported greater depression and somatic symptoms. Important differences in putative correlates of GHQ scores were found between the samples. British women reported significantly greater emotional satisfaction, greater satisfaction with medical information, greater satisfaction with medical care, and greater actual received support Pakistani women reported greater emotional intelligence. Regression analysis to identify correlates of higher GHQ scores revealed that greater received social support was a common correlate of better GHQ scores among British and Pakistani women. Additional correlates of better GHQ scores among British women were greater emotional intelligence and more emotional satisfaction in their relationships (overall R2 = 0.41). Additional correlates among Pakistani women were greater education, greater perceived available social support and a nuclear family system rather than an extended family (overall R2 =0. 40). Results suggest that psychological facets of infertility should be addressed as part of a holistic approach to the care of infertile women. They highlight a need to improve social support and to incorporate emotional intelligence training in therapeutic interventions to improve the psychological well-being of infertile women.

Comparison of the motor development in preterm infants from two brazilian regional samples

Objective: The present study sought to compare the motor development of the preterm infants of two Brazilian regional samples, using a reliable scale evaluation to determine the influence that the environment can have on infants exposed to perinatal conditions and similar risk factors. Materials and Methods: Two cross-sectional samples of preterm low-birthweight infants were used: a study group (SG = 70) and a control group (CG = 43). The assessment tool used was the Alberta Infant Motor Scale (AIMS). Results: There were no statistically significant differences in total score on the AIMS, although some differences were noted in the gestational age variable (at 2, 3 and 4 months of age) and the birth weight variable (weight slightly above that of the CG) among infants. There was also a difference in the classification of motor development at 2 and 3 months of age corrected in accordance with the standard scale, on which the SG was ranked as behindhand in relation to the CG. Conclusion: The results suggest that preterm infants from different regions show the same rate of progress in their motor development, even when subject to different environmental influences. It is, further, suggested that this study should be extended so as to permit a more detailed control of the environment (including the maternal practices) in which the infant is being brought up.

Speech Methodologies in Cleft Palate Assessment: A Pilot Project to Compare Two Phonetically Different Sentence Sets

Objective: To investigate the impact of the phonetic content of two sentence sets on speech outcomes, specifically the effects of nasal phonemes. Method: Audio-video recordings of a consecutive series of 15 participants (age range 4–22 years), with cleft palate (syndromic or non-syndromic), with and without velopharyngeal dysfunction were taken. Participants repeated Sentence Set 1 (with nasals across sentences) and Sentence Set 2 (without nasals except the three nasal target sentences) during a routine speech recording. Two experienced Specialist Speech and Language Therapists, blinded to the study’s purpose, analyzed participants’ speech using the Cleft Audit Protocol for Speech-Augmented (CAPS-A). On day 1, recordings included Sentence Set 1. On day 2, 23 days later, recordings included Sentence Set 2. Main results: The difference between Sentence Set 1 and Sentence Set 2 ‘total scores’ (sum of scores on all CAPS-A parameters) was significant. The Pearson Product Moment showed high correlation. A Wilcoxon test revealed a significant difference between Sets 1 and 2 on the hypernasality parameter, and this alone accounted for the significant difference in total scores. Conclusion: The inclusion or exclusion of nasal consonants in the sentence set significantly affected perceptual ratings of hypernasality but none of the other CAPS-A parameters, highlighting the need for further investigation into perceptual nasality ratings.

P.10.4 The analysis of the factors associated with quality of life in patients with Neuromuscular diseases

The aim of this study was to analyze the factors associated with quality of life such as age, gender, pain etc. in patients with different types of neuromuscular diseases. A hundred ninety patients with NMD, who applied to a neurological rehabilitation outpatient clinic, were included to this prospective study. After noted the demographic characteristics (age, gender, BMI, duration of illness), falling history (have you falled the past 6 months, do you have a fear of falling) and pain history (severity, quality,localization) were recorded and Nottingham health profile (NHP) was applied to all patients for assessment of health related quality of life. The mean age of NMD patients were 29.80 ± 11.70 years. There was a significant difference in total score of the NHP between the faller and non-faller patients (p 0.05). Total score of the NHP was found to be correlated with age (r = 0,146) (p 0.05). It can be concluded that pain and falling are the most important risk factors that effects negatively QoLin patients with NMD.

Clinical features, quality of life and psychological factors in functional dyspepsia patients with weight loss

Objective To investigate clinical characteristics, quality of life, and psychological fac- tors in functional dyspepsia （FD） patients with weight loss. Methods A multi-center and prospective investigation was conducted （Clinical trial registration number： ChiCTR-TRC-12001968 ） which recruited 1341 consecutive FD outpatients from three Guangdong hospitals according to Rome In criteria between June and September in 2012. Of these, 1057 patients with complete information were divided into group A as having weight loss more than 5% （n =207） and group B as having weight loss less than 5% （n =850）. Nepean Dyspepsia Index-symptom checklist, appetite, Hamilton Rating Scale of Anxiety/Depression （HAMA/ HAMD）, Pittsburgh Sleep Quality Index （PSQI）, Nepean Dyspepsia Index-quality of life, direct medical costs were used to compare the differences between the two groups. Results There were no significant differences in total scores of NDI-symptom checklist, the severity or bothersome items between two groups （t = - 1. 301, -0. 918,0. 138,P =0. 193,0. 359,0. 890）, but significant differences were observed in the frequence item and the rating of appetite as poor or very poor between two groups （ t = - 2. 122 ,P = 0. 035 ;X2 =35. 448,P =0. 000;X2 =35. 274,P =0. 000）. Significant differences were observed in the incidence of anxiety and depression and total scores of PSQI between the two groups （X2 = 73. 939, P = 0. 000 ;X2 = 47. 046, P = O. 000 ; t = - 4. 904, P = 0. 000）. Subscales scores of NDI-quality of life in group B were all sig- nificantly higher than those in group A （t = 5. 348,2. 569,5. 809,4. 704, P = 0. 000,0. 010,0. 000,0. 000 ）. There were significant differences in the frequency of care-seeking and direct medical costs between the two groups （t = -4. 860, -3.011, P = 0. 000,0. 003 ）. The frequency of gastroseopic examinations in group A was slightly higher than that in group B （ t = - 1. 505,P = 0. 133 ）. Conclusion FD patients with weight loss is not rare, and most of them have psychological disorders, loss of appetite and sleep disturbance. More- over, care-seeking are more frequent, direct medical costs are more expensive, and impairment as assessed by NDI-QOL is more severe. Therefore, we should pay more attention to FD with weight loss in clinical setting. Key words: Dyspepsia; Quality of life ; Anxiety; Depression

Dimensions of Hallucinations and Delusions in Affective and Nonaffective Illnesses

The aim of the study was to examine the dimensions of hallucinations and delusions in affective (manic episode, bipolar affective disorder, and depressive episode) and nonaffective disorders (schizophrenia, acute and transient psychotic disorders, and unspecified psychosis). Sixty outpatients divided equally into two groups comprising affective and nonaffective disorders were taken up for evaluation after screening, as per inclusion and exclusion criteria. Scores of 3 or above on delusion and hallucinatory behavior subscales of positive and negative syndrome scale were sufficient to warrant rating on the psychotic symptom rating scales with which auditory hallucination and delusion were assessed on various dimensions. Insight was assessed using the Beck cognitive insight scale (BCIS). There were no significant differences between the two groups on age, sex, marital status, education, and economic status. There were significant differences in total score and emotional characteristic subscale, cognitive interpretation subscale, and physical characteristic subscale of auditory hallucination scales in between the two groups. Correlation between BCIS-total and total auditory hallucinations score was negative (Spearman Rho −0.319; P < 0.05). Hallucinating patients, more in nonaffective group, described a negative impact of hallucinating voices along with emotional consequences on their lives which lead to distress and disruption.

Validity and reliability of a German version of the Neck Disability Index (NDI-G)

The Neck Disability Index (NDI) is a widely used questionnaire in the assessment of disability of neck patients. The aim of this study was to translate the NDI according to established guidelines into German (NDI-G) and to test the psychometric properties. Patients with acute (ACU) and chronic neck pain (CHR) and a healthy control group (HCG) completed the NDI-G twice with a mean test–retest interval of 3 days. The total score of NDI-G showed high reliability (Intraclass correlation coefficient (ICC2,1) = 0.92) and a high Cronbach's alpha (α = 0.96). The minimal detectable change was 7 points. The Bland–Altman plot revealed a small positive systematic error of 1.02 points. The Kruskal–Wallis test showed significant differences in the NDI-G total score among the three groups (χ2 = 29.77, p < 0.001). Mann–Whitney U tests showed significant differences in the total score between ACU and HCG (p < 0.001), and CHR and HCG (p < 0.001). The factor analysis of NDI-G yielded 2 factors that together explained 67% of the variance. Spearman's phi coefficients showed no correlation between the NDI-G total score and the visual analogue scale (VAS) in the ACU group (phi = 0.23, p = 0.40), and a moderate correlation in the CHR group (phi = 0.55, p = 0.03). The item analysis of the NDI-G revealed moderate to good reliability for all items. Only the item ‘work’ could differentiate between the ACU and CHR group. The NDI-G emerged from this study as a valid and reliable assessment. Its psychometric properties are comparable with the original version. Thus, the NDI-G is recommended for research and clinical settings in neck pain in German speaking countries.

633 QUALITY OF LIFE ON ACTIVE SURVEILLANCE FOR A SMALL RENAL MASSES VERSUS IMMEDIATE INTERVENTION: INTERIM ANALYSIS OF THE DISSRM (DELAYED INTERVENTION AND SURVEILLANCE FOR SMALL RENAL MASSES) REGISTRY

INTRODUCTION AND OBJECTIVES: Quality-of-life (QOL) measures have not been evaluated in a rigorous fashion for patients undergoing active surveillance (AS) for small renal masses (SRM). The prospective, multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry was opened January 1, 2009, enrolling patients with SRM 4.0 cm who chose intervention or AS. METHODS: Patients were enrolled following consultation and choice of AS or intervention. Those electing AS followed an imaging protocol every 4-6 months for 2 years, then 6 months for 3 years. SF12 QOL questionnaires were completed at enrollment, at 6 and 12 months, and annually thereafter. Mental Component Summary (MCS), Physical Component Summary (PCS) and overall score were evaluated among groups and over time with analysis of variance. RESULTS: At 46 months, 327 patients have enrolled: 226 (69.1%) elected immediate intervention and 101 (30.9%) elected AS. At a median follow-up of 18 months (6-42 months), 782 questionnaires have been completed. QOL Scores are shown in the Table. At baseline there was a significant difference in total score (p 0.008) among groups. There was not a significant trend in change of total score over time in either group. Compared with AS, PCS scores were significantly higher for immediate intervention at baseline (p 0.0001), 6 months (p 0.0002) and 1 year (p 0.0446). There was no difference in MCS among groups at any time point. CONCLUSIONS: In a large, multi-institutional, prospective registry of patients undergoing AS or immediate intervention for SRM, patients undergoing immediate intervention have higher QOL scores at baseline specifically in domains that reflect their physical health. The perceived benefit in physical health persists for at least one year following intervention. Mental health, which includes domains of depression and anxiety, is not adversely affected while on AS.

Anxiety state of the pregnant women in Serbia with gestational diabetes mellitus class A1

The psychological impact of developing gestational diabetes mellitus (GDM) has been investigated widely in both children and adults. Although these studies suggest that person who develop GDM is at risk for emotional/ psychological distress, this finding is not universal. The aim of our study was to look at the state of anxiety in the group of pregnant women with well controlled GDM class A1 patients at 36 weeks of gestation and to compare it with the healthy controls at the same gestational age in population of pregnant women in Belgrade, Serbia. The study was carried on in 48 pregnant women with GDM and 80 healthy controls. The anxiety state of the two groups was evaluated with Hamilton Anxiety Scale (HAMA). The incidence rate of anxiety in the pregnant women with GDM were 27.03% (13/48), and in the healthy pregnant women 13.75% (11/80). The incidence rate of anxiety in pregnant women with GDM was higher significantly than control group, and there were significant difference in total score and its factorial score of HAMA in the two groups. The incidence rate of anxiety in the pregnant women with GDM is higher, and anxiety is the dangerous factor of GDM. Psychological state in pregnant woman, especially in pregnant women with GDM must be noticed, and psychological counseling and psychological therapy may be carried on as early as possible.

간호대학 신입생의 생명의료윤리 의식에 관한 연구

This study sought to provide basic for the establishment of desirable sense of ethics values by analyzing the consciousness of biomedical ethics of freshmen nursing students. The subjects of the study were 420 freshmen nursing students. The period of data collection was from April 1 to 6, 2012 and collected data were analyzed on SPSS/PC 19.0 program. The results is followed; First, the mean score of the consciousness of biomedical ethics was <TEX>$2.39{\pm}0.25$</TEX>. While the mostly high ranked category of biomedical ethics was the right to life of newborn(<TEX>$2.76{\pm}0.39$</TEX>), the category with the lowest score was the artificial abortion(<TEX>$2.13{\pm}0.39$</TEX>). Second, with respect to the characteristics of participants there were statistically significant difference in total score according to age, religion, and participation in religious activity, experience of hearing for biomedical ethics, sources of information for biomedical ethics, ethical values for biomedical ethics, and in intention to attend biomedical ethics in subjects. As a result, an arbitration program that could promote either changeable or controllable ethical values must be considered with attention to the significant variables that can promote the consciousness of biomedical ethics of freshmen nursing students.

Changes in Clinical Management and Diagnosis following DaTscan™ SPECT Imaging in Patients with Clinically Uncertain Parkinsonian Syndromes: A 12-Week Follow-Up Study

Background: An accurate diagnosis is important for timely and adequate treatment in patients with clinically uncertain parkinsonian syndrome (CUPS). Objective: The objective of this study was to assess safety and changes in clinical management, diagnosis and quality of life (QoL) at 4 and 12 weeks following DaTscan™ (ioflupane [¹²³I] injection) imaging in patients with CUPS. Methods: This randomized, open-label, single-dose, multicenter trial was carried out in patients with CUPS who were randomized to either a DaTscan imaging group or to a control group without imaging. The main outcome measures were the proportions of patients with changes in clinical management and diagnosis from baseline through to 12 weeks after DaTscan. A total of 19 university hospital centers in Europe and the USA participated in the study. There were 267 patients enrolled and randomized (131 DaTscan, 136 control). Results: Significantly more DaTscan patients had changes in clinical management after 12 weeks (p = 0.004) compared to the control group, and significantly more DaTscan patients had changes in diagnosis at 4 weeks and at 12 weeks (both p < 0.001) compared to control patients. No significant difference in total score for QoL was observed between groups during the study duration. DaTscan was safe and well-tolerated. No deaths, serious adverse events (AEs) or withdrawals due to AEs occurred during the study. One patient had a headache following treatment with a suspected relationship to DaTscan. Conclusion: DaTscan imaging significantly affected the clinical management and diagnosis of patients with CUPS. DaTscan is safe and well-tolerated and is a useful adjunct to differential diagnosis of CUPS.

Impact of DaTscan SPECT imaging on clinical management, diagnosis, confidence of diagnosis, quality of life, health resource use and safety in patients with clinically uncertain parkinsonian syndromes: a prospective 1-year follow-up of an open-label controlled study

BackgroundThis study assessed the impact of DaTscan on clinical management, diagnosis, confidence of diagnosis (CoD), quality of life (QoL), health resource use (HRU) and safety during a 1-year follow-up in...

Desenvolvimento e validação da versão em português da Escala de Barreiras para Reabilitação Cardíaca

Cardiovascular diseases show high incidence and prevalence in Brazil; however, participation in Cardiac Rehabilitation (CR) is limited and has been poorly investigated in the country. The Cardiac Rehabilitation Barriers Scale (CRBS) was developed to assess the barriers to participation and adherence to CR. To translate, cross-culturally adapt and psychometrically validate CRBS to Brazilian Portuguese. Two independent initial translations were performed. After the reverse translation, both versions were reviewed by a committee. The new version was tested in 173 patients with coronary artery disease (48 women, mean age = 63 years). Of these, 139 (80.3%) participated in CR. Internal consistency was assessed by Cronbach's alpha, test-retest reliability by intraclass correlation coefficient (ICC) and construct validity by factor analysis. T-tests were used to assess criterion validity between participants and non-participants in CR. The applied test results were evaluated regarding patient characteristics (gender, age, health status and educational level). The Brazilian Portuguese version of the CRBS had Cronbach's alpha of 0.88, ICC of 0.68 and disclosed five factors, most of which showed to be internally consistent and all were defined by the items. The mean score for patients in CR was 1.29 (SD = 0.27) and 2.36 for ambulatory patients (SD = 0.50) (p <0.001). Criterion validity was also supported by significant differences in total scores by gender, age and educational level. The Brazilian Portuguese version of CRBS has shown adequate validity and reliability, which supports its use in future studies.

병원 간호사의 존엄사에 대한 태도

The purpose of this study was to identify attitude of hospital nurse's on death with dignity. The subjects of the study were 516 nurses. The data was analyzed by SPSS PC 19.0 program. 1) 82.8% participants agree to death with dignity, and they and their family will ask death with dignity in actual situations. 2) The average score of overall attitude on death with dignity was <TEX>$3.13{\pm}0.52$</TEX>. 3) With respect to the general characteristics of participants there were statistically significant difference in total score according to age, Marital Status, education level, religion, career, position, and existence of patients with incurable disease around. 4) With respect to the death with dignity related characteristics of participants there were statistically significant difference in total score according to agreement to death with dignity, request to my death with dignity, in case my family member requests death with dignity. Although many nurses had a positive concept of death with dignity, they still have ethical dilemmas in life-sustaining care. Therefore training programs on moral rights are necessary to provide guidelines foe end-of-life care.

Modified Sequential Therapy Regimen versus Conventional Triple Therapy forHelicobacter pyloriEradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

Objective. Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. To observe the effect of eradicating Helicobacter pylori (H. pylori) and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy. Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy and H. pylori positive confirmed by rapid urease test, serum anti-H. pylori antibody (ELASE), or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases) and group B (70 cases) were provided 10-day modified sequential therapy; group C (70 cases) was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily. H. pylori eradication rate was checked four to eight weeks after taking the medicine by using a 13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously. Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that the H. pylori eradication rate of each group was as follows: group A 92.5% (62/67), group B 86.8% (59/68), and group C 78.8% (52/66). The H. pylori eradication rate of group A was slightly higher than group B (P < 0.05) and both of them were obviously higher than group C (P < 0.05). Modified sequential therapy was significantly more effective in patients with clarithromycin-resistant strains (80%/67% versus 31%; P = 0.02). Symptoms improvement: all the three groups could improve the symptoms such as epigastric gnawing, burning pain, and acidity since the first day. There was no significant difference in total score descending of symptoms between each group (P > 0.05). Conclusions. All the three therapy schemes could alleviate symptoms of duodenal ulcer patients in China efficiently. But as far as eradicating H. pylori is concerned, the modified sequential therapy was better than standard triple therapy, especially the therapy scheme used in group A.