Adaptation of the MacNew quality of life questionnaire after myocardial infarction in an Iranian population

BACKGROUND: Health-related quality of life (HRQL) assessment is an important measure of the impact of a wide range of disease process on an individual. To date, no HRQL tool has been evaluated in an Iranian population with cardiovascular disorders, specifically myocardial infarction, a major cause of mortality and morbidity. The MacNew Heart Disease Health-related Quality of Life instrument is a disease-specific HRQL questionnaire with satisfactory validity and reliability when applied cross-culturally. METHOD: A Persian version of MacNew was prepared by both forward and backward translation by bilinguals after which a feasibility test was performed. Consecutive patients (n = 51) admitted to a coronary care unit with acute myocardial infarction were recruited for measurement of their HRQL with retest one month after discharge in the follow-up clinic. Principal components analysis, intra-class correlation reliability, internal consistency, and test-retest reliability were assessed. RESULTS: Trivial rates of missing data confirmed the acceptability of the tool. Principal component analysis revealed that the three domains, emotional, social and physical, performed as well as in the original studies. Internal consistency was high and comparable to other studies, ranging from 0.92 for the emotional and physical domains, to 0.94 for the social domain, and to 0.95 for the Global score. Domain means of 5, 5.3 and 4.9 for emotional, physical and social respectively indicate that our Iranian population has similar emotional and physical but worse social HRQL scores. Test-retest analysis showed significant correlation in emotional and physical domains (P < 0.05). CONCLUSION: The Persian version of the MacNew questionnaire is comparable to the English version. It has high internal consistency and reasonable reproducibility, making it an appropriate specific quality of life tool for population-based studies and clinical practice in Iran in patients who have survived an acute myocardial infraction. Further studies are needed to confirm its validity in larger populations with cardiovascular disease

Electronic Publishing : the evolution and economics of a hybrid journal.

The technical, social and economic issues of electronic publishing are examined by using as a case study the evolution of the journal Electronic Publishing Origination, Dissemination and Design (EP-odd) which is published by John Wiley Ltd. The journal is a `hybrid' one, in the sense that it appears in both electronic and paper form, and is now in its ninth year of publication. The author of this paper is the journal's Editor-in- Chief. The first eight volumes of EP-odd have been distributed via the conventional subscription method but a new method, from volume 9 onwards, is now under discussion whereby accepted papers will first be published on the EP-odd web site, with the printed version appearing later as a once-per-volume operation. Later sections of the paper lead on from the particular experiences with EP-odd into a more general discussion of peer review and the acceptability of e-journals in universities, the changing role of libraries, the sustainability of traditional subscription pricing and the prospects for `per paper' sales as micro-payment technologies become available.