No abstract

Background-Fibrin sealants (also referred to as biological glue or fibrin tissue adhesives) have gained increasing popularity as interventions to improve peri-operative (intra-and post-operative) haemostasis and diminish the need for allogeneic red cell transfusion (blood from an unrelated donor).

Overall the results suggest that fibrin sealants are efficacious. Owing to lack of blinding, transfusion practices may have been influenced by knowledge of the patient's treatment status. This raises concern about blood transfusion practice as a response variable. Large methodologically rigorous trials of fibrin sealants with clinical outcomes are needed.

Background-Concerns regarding the safety of transfused blood have generated considerable enthusiasm for the use of technologies intended to reduce the use of allogeneic blood (blood from an unrelated donor). Platelet-rich plasmapheresis (PRP) offers an alternative approach to blood conservation.

Although the results suggest that PRP is effective in reducing allogeneic RBC transfusion in adult patients undergoing elective surgery, there was considerable heterogeneity of treatment effects and the trials were of poor methodological quality. The available studies provided inadequate data for firm conclusions to be drawn regarding the impact of PRP on clinically important endpoints.

No abstract

In 2000, the Newcastle Institute of Public Health (NIPH) undertook a project that aimed to review, identify and where necessary, develop a range of indicators of quality service provision in general practice. We describe the way in which quantitative and qualitative research methods (including a Delphi style survey) were combined to investigate consensus amongst stakeholders in defining quality indicators. Over 500 general practice stakeholders were consulted. They included general practitioners (GPs) and their representative groups, academics, policy makers, and consumers. Several important lessons were learnt from the process, including the importance of involving a broad representative group of stakeholders, informing workshop participants in advance, providing adequate response times for the Delphi surveys and using videoconferencing technologies.

Several quality of life instruments were considered for use in a Greek mental health environment. Subjective Quality of Life Profile was chosen as it was easy to complete and covered the issues raised by patients with schizophrenia through interviews. Confirmatory factor analysis gave credence to the four-dimensional structure identified by the original authors. Patients with schizophrenia were generally satisfied with their quality of life, found the items in the instrument important and were optimistic about expectations for change. Age, gender, education, marital status and years of sickness were not statistically significant in a general linear model with quality of life as the outcome for the 27 core questions. There were some statistically significant results for the three disease-specific questions; positive expectation was correlated positively with education and negatively with years of sickness.