Design of a treatment satisfaction measure for patients undergoing varicose vein treatment: Venous Treatment Satisfaction Questionnaire (VenousTSQ).

BACKGROUND: Established condition-specific patient-reported outcome measures for varicose veins are limited to the measurement of health status and function. A treatment satisfaction measure is needed to understand patient satisfaction with different treatment options. The aim of this study was to design a Venous Treatment Satisfaction Questionnaire (VenousTSQ) that would be ready for large-scale data collection and psychometric evaluation. METHODS: Relevant items were selected from the -TSQ Item Library and new items were designed where necessary. A draft VenousTSQ was prepared using the existing AneurysmTSQ as a template. Fifteen interviews were conducted from 4 days to 16 months after the procedure. The interviews were designed to elicit important sources of satisfaction or dissatisfaction before completion of draft questionnaires. The VenousTSQ drafts were modified between sets of interviews until no further changes were required. RESULTS: The final VenousTSQ consists of two questionnaires: VenousTSQ early (VenousTSQe) and VenousTSQ status (VenousTSQs). Items that need be asked only once are in the VenousTSQe, whereas those that can usefully be asked more than once are in the VenousTSQs. Of the 16 unique items forming the VenousTSQ, 12 were from the -TSQ Item Library. Only 1 of these 12 required significant modification. CONCLUSIONS: The VenousTSQ represents a condition-specific psychological outcome measure for varicose veins, enabling patient satisfaction or dissatisfaction with such treatments to be measured. Large-scale data collection is under way to establish optimal scoring, quantitative validity, and reliability of the VenousTSQ.

Design of an individualised questionnaire to measure the impact of cancer on quality of life: The cancer dependent quality of life (CancerDQoL) questionnaire.

AIM: To design an individualised questionnaire to measure the impact of cancer and its treatments on quality of life (QoL). MATERIALS & METHODS: Design of the Cancer-Dependent Quality of Life (CancerDQoL) questionnaire was based on the Audit of Diabetes Dependent QoL (ADDQoL) questionnaire and related -DQoLs for other conditions. Item selection, face validity and content validity were established through clinician and patient ratings of the importance and relevance of 60 domains from the -DQoL Item Library, and semi-structured interviews with 25 English-speaking participants with a range of cancers attending a cancer centre in Zimbabwe (age range: 25-78 years; 16 women, 9 men). Ten interviews were subsequently conducted with UK English-speaking participants with a range of cancers attending Maggie's Centres in London and Dundee (age range: 40-76; 5 women, 5 men) to adapt the CancerDQoL for UK use. RESULTS: The first draft of the CancerDQoL contained 25 domain-specific items from the -DQoL Item Library plus four overview items. Zimbabwean participants indicated that cancer negatively impacted on all life domains included, except 'having children'. Weighted impact (impact ratings multiplied by importance) was most negative for 'sex life', 'depend on others' and 'physical capability'. The least negative weighted impact was found for 'having children', 'spiritual/religious life' and 'past medical/self-care'. UK interviews confirmed no new items were required. CONCLUSIONS: Face and content validity of the CancerDQoL is established for an adult sample of English-speaking cancer patients in Zimbabwe and confirmed in an adaptation following UK interviews.

The hyperexcitability of dentate granule neurons in organotypic hippocampal slice cultures is due to reorganization of synaptic inputs in vitro.

Organotypic hippocampal slice cultures (OHSCs) provide the experimental flexibility of cell culture while leaving much of the natural neuronal connectivity intact. Previously, it was shown that the functional and morphological features of CA1 pyramidal neurons in OHSCs resemble, to a surprising extent, those of CA1 neurons in the acute brain slice preparation. However, the extent to which the characteristics of other principle hippocampal neurons change or are preserved in cultured slices remains to be determined. In the present study, I initially sought to understand whether and how the synaptic inputs and morphology of cultured dentate granule neurons (GCs) differ from GCs that have developed in vivo. To this end, I compared GCs in OHSCs and GCs in acute slices at two equivalent developmental time points (P14 vs. DIV7 and P21 vs. DIV21). The findings suggest that there is considerable reorganization of synaptic input to the organotypic GCs, such that these cells are more susceptible to hyperexcitation than GCs in acute slices after 3 weeks. It appears that this hyperexcitability emerges through an increase in the proportion of mature synapses at proximal dendritic sites and is accompanied by an increase in inhibitory neuron activity. These alterations appear to arise in a coordinated manner such that the substantial increase in excitatory synaptic drive received by the DIV21 GCs in OHSCs remains local and is not translated into excessive output possibly leading to damage or major morphological alterations of downstream pyramidal neurons.