Validity and reliability of the Spanish version of the Florida Patient Acceptance Survey

Antecedentes Para los sistemas de salud actuales, la medición y la generación de indicadores que permitan evaluar los resultados en salud, han tomado gran relevancia como parte de la calidad en la atención. En consecuencia, los procesos de adaptación y validación de los instrumentos, son importantes para tener herramientas de medición fiables. El instrumento Florida Patient Acceptance Survey, es una escala específica para medir la aceptación de las personas a los dispositivos cardiacos. Método estudio de tipo metodológico, en el cual se llevó a cabo la validez facial, de contenido y confiabilidad de la versión en español del instrumento Florida Patient Acceptance Survey. La validez facial y de contenido se realizó mediante el juicio de expertos, utilizando las pruebas estadísticas de Coeficiente Kappa de Fleiss e índice de Lawshe modificado. Para realizar la prueba de confiabilidad se utilizó la teoría del ítem; participaron 126 personas implante de un dispositivo de estimulación cardiaca. La fiabilidad se calculó mediante la prueba estadística de alfa de Cronbach. Resultados la validez facial evaluó tres categorías: claridad, precisión y comprensión, mostrando un acuerdo moderado entre los jueces para las categorías. La validez de contenido presentó un acuerdo substantivo entre los jueces, con un índice de Lawshe de 0,822. La confiabilidad fue determinada con un alfa de Cronbach de 0,724. Conclusiones la versión en español del Florida Patient Acceptance Survey, es un instrumento fiable para medir la aceptación de las personas con implante de dispositivo de estimulación cardiaca.Background For the current health services, the measurement and generation of indicators that enable health outcomes to be evaluated, is of great relevance as part of quality health care. As a result, the adaptation and validation processes of measurement tools are important to ensure that they are reliable to use. The Florida Patient Acceptance Survey is a specific scale for measuring the acceptance of cardiac devices by individuals. Method A methodological-type study was carried out, in which the face validity, content and reliability of the Spanish version of the Florida Patient Acceptance Survey. The face validity and content was performed by expert consensus, using the statistical tests, Fleiss Kappa Coefficient and the modified Lawshe index. The theory of the item was used to perform the reliability test, in which a total of 126 individuals implanted with a cardiac stimulation device took part. The reliability was calculated using the Cronbach alpha statistical test. Results The face validity evaluates three categories: clarity, precision, and comprehension, showing a moderate agreement between the experts for the categories. There was a substantial agreement in content validity among the experts, with a Lawshe index of 0.822. The reliability was determined with a Cronbach alpha of 0.724. Conclusions The Spanish version of the Florida Patient Acceptance Survey, is a reliable tool to measure the acceptance of individuals with cardiac stimulation device implant

Characterization of cassava ORANGE proteins and their capability to increase provitamin A carotenoids accumulation

Cassava (Manihot esculenta Crantz) biofortification with provitamin A carotenoids is an ongoing process that aims to alleviate vitamin A deficiency. The moderate content of provitamin A carotenoids achieved so far limits the contribution to providing adequate dietary vitamin A levels. Strategies to increase carotenoid content focused on genes from the carotenoids biosynthesis pathway. In recent years, special emphasis was given to ORANGE protein (OR), which promotes the accumulation of carotenoids and their stability in several plants. The aim of this work was to identify, characterize and investigate the role of OR in the biosynthesis and stabilization of carotenoids in cassava and its relationship with phytoene synthase (PSY), the rate-limiting enzyme of the carotenoids biosynthesis pathway. Gene and protein characterization of OR, expression levels, protein amounts and carotenoids levels were evaluated in roots of one white (60444) and two yellow cassava cultivars (GM5309-57 and GM3736-37). Four OR variants were found in yellow cassava roots. Although comparable expression was found for three variants, significantly higher OR protein amounts were observed in the yellow varieties. In contrast, cassava PSY1 expression was significantly higher in the yellow cultivars, but PSY protein amount did not vary. Furthermore, we evaluated whether expression of one of the variants, MeOR_X1, affected carotenoid accumulation in cassava Friable Embryogenic Callus (FEC). Overexpression of maize PSY1 alone resulted in carotenoids accumulation and induced crystal formation. Co-expression with MeOR_X1 led to greatly increase of carotenoids although PSY1 expression was high in the co-expressed FEC. Our data suggest that posttranslational mechanisms controlling OR and PSY protein stability contribute to higher carotenoid levels in yellow cassava. Moreover, we showed that cassava FEC can be used to study the efficiency of single and combinatorial gene expression in increasing the carotenoid content prior to its application for the generation of biofortified cassava with enhanced carotenoids levels

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Cross cultural adaptation of "Florida Patient Acceptance Survey" instrument that measures acceptance of patients of cardiac devices

Objective: Adaptar transculturalmente al contexto colombiano el instrumento "Florida Patient Acceptance Survey" que mide la aceptación de las personas implantadas con dispositivos de estimulación cardiaca.Materiales y métodos: Se ha seguido la metodología de traducción y retrotraducción, con equivalencia en semánticas culturales para llevar acabo la adaptación transcultural de la versión original del instrumento Florida Patient Acceptance Survey (FPAS). En el proceso participaron expertos en el área de: alteraciones del ritmo cardiaco, salud mental y validación de instrumentos de salud, así como, un profesional en lingüística y un profesional en estadística.Resultados: Se logra obtener una versión en español del instrumento FPAS adaptada culturalmente al contexto colombiano, con la realización de ajustes necesarios para la comprensión de la población objeto, a fin de conservar la equivalencia semántica y conceptual de la versión original.Conclusiones: La versión en español del FPAS es semántica y culturalmente equivalente a su versión original en inglés. A partir de los aportes de los expertos se realizaron ajustes que no modificaron la esencia del instrumento, posteriormente se realizarán las pruebas psicométricas para llevar a cabo el proceso de validez y fiabilidad

Validez y confiabilidad del cuestionario Florida versión en español

Resumen: Antecedentes: Para los sistemas de salud actuales, la medición y la generación de indicadores que permitan evaluar los resultados en salud, han tomado gran relevancia como parte de la calidad en la atención. En consecuencia, los procesos de adaptación y validación de los instrumentos, son importantes para tener herramientas de medición fiables. El instrumento Florida Patient Acceptance Survey, es una escala específica para medir la aceptación de las personas a los dispositivos cardiacos. Método: estudio de tipo metodológico, en el cual se llevó a cabo la validez facial, de contenido y confiabilidad de la versión en español del instrumento Florida Patient Acceptance Survey. La validez facial y de contenido se realizó mediante el juicio de expertos, utilizando las pruebas estadísticas de Coeficiente Kappa de Fleiss e índice de Lawshe modificado. Para realizar la prueba de confiabilidad se utilizó la teoría del ítem; participaron 126 personas implante de un dispositivo de estimulación cardiaca. La fiabilidad se calculó mediante la prueba estadística de alfa de Cronbach. Resultados: la validez facial evaluó tres categorías: claridad, precisión y comprensión, mostrando un acuerdo moderado entre los jueces para las categorías. La validez de contenido presentó un acuerdo substantivo entre los jueces, con un índice de Lawshe de 0,822. La confiabilidad fue determinada con un alfa de Cronbach de 0,724. Conclusiones: la versión en español del Florida Patient Acceptance Survey, es un instrumento fiable para medir la aceptación de las personas con implante de dispositivo de estimulación cardiaca. Abstract: Background: For the current health services, the measurement and generation of indicators that enable health outcomes to be evaluated, is of great relevance as part of quality health care. As a result, the adaptation and validation processes of measurement tools are important to ensure that they are reliable to use. The Florida Patient Acceptance Survey is a specific scale for measuring the acceptance of cardiac devices by individuals. Method: A methodological-type study was carried out, in which the face validity, content and reliability of the Spanish version of the Florida Patient Acceptance Survey. The face validity and content was performed by expert consensus, using the statistical tests, Fleiss Kappa Coefficient and the modified Lawshe index. The theory of the item was used to perform the reliability test, in which a total of 126 individuals implanted with a cardiac stimulation device took part. The reliability was calculated using the Cronbach alpha statistical test. Results: The face validity evaluates three categories: clarity, precision, and comprehension, showing a moderate agreement between the experts for the categories. There was a substantial agreement in content validity among the experts, with a Lawshe index of 0.822. The reliability was determined with a Cronbach alpha of 0.724. Conclusions: The Spanish version of the Florida Patient Acceptance Survey, is a reliable tool to measure the acceptance of individuals with cardiac stimulation device implant. Palabras clave: Estimulación eléctrica, Dispositivo, Estudios de validación, Aceptación de la atención en salud, Arritmias, Keywords: Electrical stimulation, Device, Validation studies, Health care acceptance, Arrhythmia

Validity-rationale of the FLORIDA for patient acceptance survey (FPAS) in spanish

Frente a los procedimientos alternativos sugeridos por Carranza Esteban, López-Gonzales y Caycho-Rodríguez, y en relación con los resultados de la validación del instrumento FPAS versión en Espanol ˜ pocos fiables sugeridos por Merino-Soto y Angulo-Ramos, es importante precisar que este estudio de validación que fue realizado en el ano˜ 2016 utilizando la mejor evidencia científica disponible para poder obtener un instrumento válido y fiable en el idioma espanol ˜ de la escala que mide la aceptación de las personas al dispositivo de estimulación cardiaca, se sustenta en la aplicación de la teoría clásica del test1 que aún permanece vigente y es ampliamente utilizada en el área de la validación de los instrumentos de las ciencias de la salud, así como en otras áreas, como las ciencias humanas y sociales

Periodontal disease in individuals with a genetic risk of developing arthritis and early rheumatoid arthritis: A cross-sectional study

Recent consensus emphasizes the importance of studying individuals at risk for rheumatoid arthritis (pre‐RA) and those with early RA (eRA). Periodontal tissues have been recently evaluated, but these studies are limited. To evaluate the periodontal condition, immunoglobulin (Ig)G subclasses against Porphyromonas gingivalis in individuals with pre‐RA and eRA were compared with controls to establish an association between periodontal infection markers and rheumatic activity. Rheumatologic and periodontal condition was evaluated in 119 individuals with pre‐RA, 48 patients with eRA, and matched controls. P. gingivalis IgG1 and IgG2 were analyzed. C‐reactive protein, erythrocyte sedimentation rate (ESR), rheumatoid factor, anticitrullinated protein antibodies (ACPAs), and RA activity were measured. The groups were compared with McNemar test and paired t‐test. Conditional logistic regression was performed for pre‐RA confounders, and χ2 test was used to evaluate periodontal variables and RA activity indices. Pre‐RA individuals showed significantly higher levels of plaque index (P = 0.01) and bleeding on probing (P = 0.03) and higher severity of periodontal disease (P = 0.02). Periodontitis was associated with pre‐RA (odds ratio, 3.39; 95% confidence interval, 1.64 to 7.01) but not with eRA. In pre‐RA, P. gingivalis–specific IgG2 was associated with ACPAs (P = 0.049) and disease severity visual analog scale (P = 0.03). In eRA, IgG2 against P. gingivalis was associated with ESR (P = 0.046) and ACPAs (P = 0.04). P. gingivalis was associated with ACPAs (P = 0.04). This study shows that individuals with pre‐RA have significant inflammatory periodontal involvement. There was a significant association between IgG against P. gingivalis and ACPAs in pre‐RA and markers of RA activity in individuals with eRA