Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy

Goals of work: The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment between the patient and his partner.Materials and methods: Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3). Results: Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners' functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners' social functioning were positively related at T2. Conclusions: According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Computational and experimental studies on the thermolysis mechanism of zirconium and hafnium tetraalkyl complexes. Difference between titanium and zirconium complexes

The first reaction step in the thermolysis of zirconium and hafnium tetraalkyl complexes has been studied with ab initio molecular orbital calculations in comparison with that of the titanium tetraalkyl complexes (Wu, Y.-D.; Peng Z.-H.; Xue, Z. J. Am. Chem. Sec. 1996, 118, 9772). Several clear differences in geometry and reactivity between TiR4 and ZrR4 (HfR4) are predicted: (1) While TiMe4 is in a staggered conformation, ZrMe4 and HfMe4 are predicted to be in an eclipsed conformation; (2) the activation energy for the unimolecular methane elimination through intramolecular hydrogen abstraction is in the order TiMe4 much less than ZrMe4 < HfMe4; (3) the activation energy for the bimolecular methane elimination through intermolecular hydrogen abstraction for the three systems is much lower than that of the unimolecular mechanism and is in the order ZrMe4 < HfPMe4 < TiMe4; (4) unimolecular alpha-hydrogen abstraction for Ti(n-Pr)Me-3 and Ti(CH2CMe3)(4) is more favorable than gamma-hydrogen abstraction. However, the opposite is predicted for the Zr and Hf complexes. Chemical vapor deposition of ZrC from Zr(CH2CMe3)(4) and Zr(CD2CMe3)(4) has been studied. The major volatile products are neopentane and isobutene, which are in a ratio of about 2.3 in both reactions. Zn the case of Zr(CD2CMe3)(4), the molar ratios of neopentane-d(2)/neopentane-d(3) and isobutene-d2/isobutene-d(0) are about 4.9 and 1.52, respectively. These support a mechanism in which gamma-hydrogen abstraction is the first step of thermolysis

Reactions of d(0) alkylidene and amide complexes with silanes

Reactions of silanes with d(o) Ta alkylidene and Group 4 amide complexes were found to involve the initial attack on silicon atoms in the silanes by nucleophilic alkylidene carbon or amide nitrogen atoms. The reaction of (Me3SiCH2)(3)Ta(PMe3)[=CHSiMe3] (1) with H2SiR'Ph (R' = Me, Ph) gave (Me3SiCH2)(3)Ta[=C(SiMe3)SiHR'Ph] (2a-b). Similar reactions of these two silanes and (H2PhSi)(2)CH2 with (Me3SiCH2)Ta(PMe3)(2)[=CHR](2) (R = SiMe3, 3; CMe3, 4) yielded novel metallasilacyclobutadienes and a metalladisilacyclohexadiene, respectively. In comparison, the reactions between M(NMe2)(4) (M = Ti, Zr, Hf) and silanes were found to give aminosilanes and metal amide hydride species which were perhaps involved in the formation of titanium-silicon-nitride (Ti-Si-N) ternary materials

Assessing time use in long-term institutional care: development, validity and inter-rater reliability of the Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC)

BACKGROUND: Limited research has examined what is actually done in the process of care by nursing staff in long-term institutional care. The applied instruments employed different terminologies, and psychometric properties were inadequately described. This study aimed to develop and test an observational instrument to identify and examine the amount of time spent on nursing interventions in long-term institutional care using a standardized language. METHODS: The Groningen Observational instrument for Long-Term Institutional Care (GO-LTIC) is based on the conceptual framework of the Nursing Interventions Classification. Developmental, validation, and reliability stages of the GO-LTIC included: 1) item generation to identify potential setting-specific interventions; 2) examining content validity with a Delphi panel resulting in relevant interventions by calculating the item content validity index; 3) testing feasibility with trained observers observing nursing assistants; and 4) calculating inter-rater reliability using (non) agreement and Cohen’s kappa for the identification of interventions and an intraclass correlation coefficient for the amount of time spent on interventions. Bland-Altman plots were applied to visualize the agreement between observers. A one-sample student T-test verified if the difference between observers differed significantly from zero. RESULTS: The final version of the GO-LTIC comprised 116 nursing interventions categorized into six domains. Substantial to almost perfect kappa’s were found for interventions in the domains basic (0.67–0.92) and complex (0.70–0.94) physiological care. For the domains of behavioral, family, and health system interventions, the kappa’s ranged from fair to almost perfect (0.30–1.00). Intraclass correlation coefficients for the amount of time spent on interventions ranged from fair to excellent for the physiological domains (0.48–0.99) and poor to excellent for the other domains (0.00–1.00). Bland Altman plots indicated that the clinical magnitude of differences in minutes was small. No statistical significant differences between observers (p > 0.05) were found. CONCLUSIONS: The GO-LTIC shows good content validity and acceptable inter-rater reliability to examine the amount of time spent on nursing interventions by nursing staff. This may provide managers with valuable information to make decisions about resource allocation, task allocation of nursing staff, and the examination of the costs of nursing services