RESUMEN
The discovery of aerobic denitrifiers is the enrichment and breakthrough of traditional denitrification theory. Owing to their unique superiority in denitrogenation, aerobic denitrifiers have become a hotspot in the study of bio-denitrogenation of waste water. Under aerobic conditions, the aerobic denitrifiers can utilize organic carbon sources for their growth, and produce N2 from nitrate and nitrite. Most of the denitrifiers can also proceed with heterotrophic nitrification simultaneously, transforming NH4(+)-N to gaseous nitrogen. In this paper, the denitrogenation characteristics and action mechanisms of some isolated aerobic denitrifiers were discussed from the aspects of electron theory and denitrifying enzyme system. The effects of the environmental factors DO, carbon sources, and C/N on the denitrogenation process of aerobic denitrifiers were analyzed, and the screening methods as well as the present and potential applications of aerobic denitrifiers in wastewater treatment were described and discussed.
Asunto(s)
Bacterias Aerobias/metabolismo , Desnitrificación , Nitrógeno/metabolismo , Compuestos de Amonio Cuaternario/metabolismo , Eliminación de Residuos Líquidos/métodos , Bacterias Aerobias/aislamiento & purificación , Biodegradación Ambiental , Nitratos/metabolismo , Nitritos/metabolismo , Nitrógeno/químicaRESUMEN
OBJECTIVE: To undertake cost-utility analysis for endoscopic sinus surgery (ESS) in order to analyze the cost-effectiveness of different chronic sinusitis severity groups. METHODS: One hundred ninety-two patients with chronic sinusitis were evaluated with a Chronic Sinusitis Survey (CSS) before and 1-year after ESS. Direct health care cost data during the first year after operation were retrieved. The utility gain is defined as change in the CSS total score. The cost-utility ratio was defined as cost per utility gain. Patients are stratified by disease severity using the Harvard Staging System. RESULTS: The average total direct cost attributable to ESS is 40,829 NT dollars in the first postoperative year and the average cost-utility ratio is 2194.42 NT dollars. The high cost-utility ratio of 3246.45 NT dollars for pansinusitis cases is due to the higher cost and limited utility gain. CONCLUSIONS: Treating mild and moderate chronic sinusitis are most cost-effective because of their favorable utility gain and relatively reasonable cost. However, there is no proportional linear relationship between disease severity and cost-utility ratio.
Asunto(s)
Endoscopía/economía , Procedimientos Quirúrgicos Otorrinolaringológicos/economía , Sinusitis/cirugía , Adolescente , Adulto , Anciano , Enfermedad Crónica , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Sinusitis/economía , TaiwánRESUMEN
OBJECTIVE: Continuous quality improvement (CQI) is an effort by health care providers to improve the quality of service by continuously exceeding patients' expectations. Patient satisfaction is one of the measures of the quality of care. The aims of this study were to report the patients' evaluation of endoscopic sinus surgery (ESS) and to explore the feasibility in using patient satisfaction data in the CQI program for ESS. METHODS: Eighty-three patients completed a validated patient satisfaction survey (PSS) 1 month after undergoing ESS. Logistic regression models were applied to determine the confounders of patient satisfaction. RESULTS: In general, 72% of patients were very satisfied with the services. Education level and milder disease correlated with higher overall satisfaction levels (P
Asunto(s)
Endoscopía/métodos , Endoscopía/normas , Satisfacción del Paciente , Calidad de la Atención de Salud , Sinusitis/cirugía , Adolescente , Adulto , Anciano , Enfermedad Crónica , Femenino , Humanos , Tiempo de Internación , Modelos Logísticos , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios , Cuidados Preoperatorios , Competencia Profesional , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
BACKGROUND AND PURPOSE: Chronic rhino-sinusitis (CRS) is a disease in prevalence. This study evaluates the impact of this disorder to Taiwanese patients' general and sinus-related health status among Taiwanese patients with CRS. METHODS: A total of 201 consecutive CRS patients (male:female: 107:94, mean age: 40.1 +/- 14.6 years) seeking otolaryngological care at a tertiary referral medical center were recruited. Quality of life was measured by a Taiwan Standard Version of the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) and a Chinese version Chronic Sinusitis Survey (CCSS). Patients were administered with the SF-36 and CCSS preoperatively. RESULTS: CRS has a significant impact on patients in seven of the eight domains of SF-36: role-physical (88.9 +/- 24.7), bodily pain (70.3 +/- 22.6), general health (56.1 +/- 11.6), social functioning (79.3 +/- 21.6), vitality (56.4 +/- 19.1), role-emotional (57.7 +/- 42.1), and mental health (48.4 +/- 17.2) subscores of CRS patients are all in significant decrement (p < 0.05) as compared with the data derived from Taiwanese general population. Physical functioning is the only domain without impact. Significant decrements (p < 0.05) are also observed in symptom subscale (43.3 +/- 27.8), medication subscale (80.3 +/- 26.4), and total survey score (63 +/- 20.3) of the CCSS as compared to the healthy subjects. The severity of CRS is significantly predictive (p < 0.05, R2 = 0.34) of CCSS. CONCLUSIONS: CRS has considerable impacts on a patient's sinus-related quality of life, as well as on their general health status.
Asunto(s)
Estado de Salud , Calidad de Vida , Rinitis , Perfil de Impacto de Enfermedad , Sinusitis , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rinitis/fisiopatología , Rinitis/psicología , Sinusitis/fisiopatología , Sinusitis/psicología , TaiwánRESUMEN
The Chronic Ear Survey (CES) is a valid, disease-specific measure for the evaluation of health status and treatment effectiveness for adults with chronic suppurative otitis media (CSOM). This study compares the validation properties of the English and Chinese versions of the CES. The CES was translated into Mandarin Chinese by means of a parallel model. The Chinese version of the CES (CCES) was administered to 103 patients in a prospective manner, then was validated according to established criteria for reliability, validity, and longitudinal sensitivity. The CCES demonstrated good test-retest reliability and internal consistency (Cronbach's a = 0.81). The CCES significantly correlated with the Mandarin Chinese (Taiwan) version of the generic 36-Item Short-Form Health Survey (TSF-36). The standardized response mean for the CCES total score was 2.1, indicating excellent sensitivity to clinical change. This validation study demonstrated that the performance characteristics of the CCES were equivalent to those of the English-version CES. The CCES is a valid tool for evaluation of adults with CSOM among the Chinese-speaking population.
Asunto(s)
Estado de Salud , Otitis Media Supurativa , Evaluación de Resultado en la Atención de Salud , Encuestas y Cuestionarios , Actividades Cotidianas , Adolescente , Adulto , Anciano , Audiometría , Enfermedad Crónica , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Otitis Media Supurativa/diagnóstico , Otitis Media Supurativa/terapia , Calidad de Vida , Traducciones , Resultado del TratamientoRESUMEN
Epworth sleepiness scale (ESS) is widely used to evaluate degree of somnolence among Chinese patients with sleep-disordered breathing. Yet no Mandarin-Chinese translation has ever reported its validation data. In this study we translated and validated the ESS into Mandarin Chinese (CESS). We found, in 31 bilingual patients' responses to the CESS and the English ESS obtained 1-2 weeks apart did not differ significantly (10.5 +/- 3.7 vs. 9.6 +/- 3.9, p = 0.32, Wilcoxon's signed rank test) and were significantly correlated (Spearman's p = 0.67, p = 0.0004). A total of 359 sleep-disordered breathing subjects were enrolled into the validation study in a prospective manner. The CESS showed acceptable internal consistency (Cronbach's alpha = 0.81). Thirty out of these patients answered CESS twice at an interval of 2-4 weeks, to yield an acceptable level of test-retest reliability (p = 0.74, p = 0.001). The respiratory disturbance indices obtained from 251 out of 359 subjects were significantly correlated with their CESS scores (p = 0.22, p < 0.001). The standard response mean of CESS was 0.86 as obtained from 94 out of 359 subjects who had initial control of their symptoms at 3 months after radio-frequency palate surgery. We conclude that the CESS is reliable in both a linguistic and a test-retest sense, and appears to be valid and sensitive to clinical change. The CESS could be used to advantage among other Mandarin-speaking subjects as a standardised screening test of sleepiness in daily life.
Asunto(s)
Perfil de Impacto de Enfermedad , Síndromes de la Apnea del Sueño/fisiopatología , Trastornos del Sueño-Vigilia/fisiopatología , Encuestas y Cuestionarios , Traducción , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Síndromes de la Apnea del Sueño/clasificación , Trastornos del Sueño-Vigilia/clasificación , TaiwánRESUMEN
The aim of this study was to use a parallel model to translate the Snore Outcomes Survey (SOS) into Mandarin Chinese language by comparing performing characteristics and statistical properties of the original and Chinese versions SOS. The Chinese version SOS (CSOS) was validated in a prospective, non-randomized manner. A total of 359 patients with sleep-disordered breathing (SDB) aged 18 years and older diagnosed as having SDB participated in the study at entry. Reliability, validity, and longitudinal sensitivity data for CSOS were obtained. CSOS demonstrated good test-retest reliability (Intra-class correlation coefficient = 0.751). The Cronbach's alpha coefficient was 0.86. The item-total correlation coefficients varied from 0.30 to 0.99. The CSOS correlated well with polysomnogram (PSG) parameters including respiratory distress index (RDI), lowest arterial O2 saturation (LAST). CSOS also yielded significant correlations with vitality subscale of Chinese Taiwan version SF-36 (r = 0.4, p = 0.0011). The standard response mean (SRM) for CSOS was 1.33. The validation demonstrated only minor effects of language; the statistical properties of the CSOS were equivalent to the English version. The CSOS is a valid tool to evaluate adults with SDB among Chinese-speaking population.
Asunto(s)
Indicadores de Salud , Calidad de Vida , Síndromes de la Apnea del Sueño/psicología , Ronquido/psicología , Encuestas y Cuestionarios/normas , Adulto , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Síndromes de la Apnea del Sueño/fisiopatología , Ronquido/fisiopatologíaRESUMEN
BACKGROUND: The Chronic Sinusitis Survey (CSS) is a valid, disease-specific measure for evaluating the health status and treatment effectiveness of adults with chronic rhinosinusitis (CRS). In this study, we developed a Chinese version of the CSS (CCSS) which provides the psychometric properties of the Chinese CSS. METHODS: The CSS was translated into Chinese using a parallel model. The CCSS was administered to 198 patients in a prospective manner, and was validated in order to establish its reliability and validity. RESULTS: The CCSS demonstrated good test-retest reliability (correlation coefficient = 0.6-0.89, p=0.0001) and internal consistency (Cronbach's alpha =0.76). The CCSS results were significantly correlated with bodily pain (BP), general health (GH), role-emotional (RE), and mental health (MH) subscales of the Chinese (Taiwan) version of the generic 36-item Short-Form Health Survey (TSF-36). The standardized response mean for the CCSS total score was 0.75, indicating good sensitivity to clinical change. CONCLUSIONS: This validation study demonstrates that the performance characteristics of the CCSS meet the criteria for a valid measure. The CCSS is a valid tool to evaluate adults with CRS among Mandarin-speaking populations.
Asunto(s)
Sinusitis/psicología , Enfermedad Crónica , Humanos , Psicometría , Calidad de VidaRESUMEN
OBJECTIVE: The outcomes management of endoscopic sinus surgery (ESS) is a major effort to improve the quality of chronic sinusitis treatment. The objective of this study was to investigate the factors that may predict a variety of outcomes of ESS. STUDY DESIGN AND SETTING: Two hundred and thirty consecutive patients who underwent ESS were prospectively evaluated by computerized axial tomography scan of the sinus and a validated chronic sinusitis survey (CSS) before surgery. The effects of prognostic factors were then investigated. RESULTS: Extent of disease was a consistent predictor (P < 0.05) for bleeding, complication occurrence, medical resource utilization, subjective sinus-specific health status, and physicians' objective evaluation of surgical outcomes. The preoperative CSS total score and extent of disease significantly (P < 0.05) predicted the postoperative CSS total score. Subjective and objective outcomes were significantly correlated (r = 0.58, P = 0.0001). These findings suggested the necessity of disease severity stratification when reporting ESS outcomes. CONCLUSION: Operation-related events, medical resource utilization, physician evaluation, and sinus-specific health status of patients are all integral parts of reporting outcomes of ESS. We have concluded that computerized axial tomography scan of the sinuses and CSS are efficient ways of providing reliable baseline information before ESS.