Psicometric properties of an instrument for measuring patient’s satisfaction with physical therapy (medrisk) in spanish population: cultural diversity

The Spanish-language versión of the MedRisk Insttrument for Mesauring Partient Satisfaction with Physical therapy Care was validated in a simple of 203 Spanish-speakers patients in New York City. The purpose of this investigation is to adapt this instrument to Spanish population (patients who assist to physical therapy services in Spain); to corroborate if exist a psychometric equivalence and to identify if Spanish patients consider relevant the same dimensions as the preliminary validation. Relevance: At time to used a measurement instrument that has been validated in another country, it is necessary to assure that it is not only reliable and valid to the country where was developed, but also it needs to be appropriated to the patients subjects of the current investigation. Participants: A total of 300 patients of the Hospital of San Juan de Dios del Aljarafe (in Sevilla, Spain) participated in this study (44% men and 56% women between 13 and 93 years old). Methods: It has been done a cross-sectional descriptive study. Data were collected between April 2008 and November 2009.To the patients involved in the research, it was applied the original 20-item version of the MRPS (18 items and two global measures) and not the validated 12-item MRPS (10 items and two global measures). The main investigator randomly selected days during which the data were collected. The sample was taken finally on by convenience: all patients, in these selected days, who assist to medical care once they were done with their prescribed physiotherapy treatment. Analysis: Like Spanish version in New York, factor structure was investigated using item-correlation and exploratory factor analysis. Group-level reliability for single test administration was assessed using the Cronbach alpha. Results: Factor structure: the inter-item correlation matrix revealed that 3 items were not significantly correlated to both of the global measures . These 3 items were not included in the subsequent analysis. Principal components analysis revealed 4 eigenvalues greater than 2.0 explaining 67.93% of the cumulative variance. This suggested a 4-factor solutions. Following varimax rotation, a total of 14 items loaded on four factors were retained. Reliability: The Cronbach alpha was .87 Conclusions: Spanish version of MRPS that was validated with Spanish-speakers patients in New York is similar but not identical to the validation obtained with Spanish Population. In both of them, 9 of the 12 and 14 items finally selected in each other, have a coincidence. In the first one, there is a conclusion of two factors, internal and external. And in our investigation there were obtained 4 dimensions, 2 of them refer to internal factors (respect of the healthcare team and professional behavior of the therapist) and 2 that does it to external factors (adaptation of the center and accessibility)Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Proteinuria Is Associated with Quality of Life and Depression in Adults with Primary Glomerulopathy and Preserved Renal Function

BACKGROUND: There is no information about HRQoL, depression and associated factors in adult with nephrotic syndrome-associated glomerulopathy. METHODOLOGY/PRINCIPAL FINDINGS: Patients with primary glomerulopathy where compared with age and sex-matched hemodialysis patients and healthy subjects. Laboratory data, medical history, comorbid conditions were collected to evaluate factors associated with HRQoL (SF-36) and Depression (Hamilton Depression Rating Scale-HAMD). Glomerulopathy patients had low HRQoL in all eight SF-36 domains and two composite scores (physical and mental) in comparison with healthy subjects. HAMD score also was elevated and there was high depression prevalence. Overall, these data were comparable between glomerulopathy and hemodialysis patients. Using multiple regression analysis, factors associated with low HRQoL physical composite score were: last 24 h-urine protein excretion (-0.183, 95%CI -0.223 to -0.710 for each gram of proteinuria, p = 0.01) and cyclosporine use (-15.315, 95%CI -25.913 to -2.717, p = 0.03). Low HRQoL mental composite score was associated with last 24 h-urine protein excretion (-0.157, 95%CI -0.278 to -0.310 for each gram of proteinuria, p = 0.03) and HMAD score was independently associated with age (0.155, 95%CI 0.318 to 0.988 for each year, p = 0.04), female sex (4.788, 95%CI 1.005 to 8.620, 0 = 0.03), disease duration (0.074, 95%CI 0.021 to 0.128 for each month, p = 0.01) and last 24 h-urine protein excretion (0.050, 95%CI 0.018 to 0.085 for each gram of proteinuria, p = 0.02). CONCLUSIONS/SIGNIFICANCE: Nephrotic-syndrome associated glomerulopathy patients have low HRQoL and high prevalence of depression symptoms, comparable with those of hemodialysis patients. Last 24 h-protein excretion rate is independently associated with physical and mental HRQoL domains in addition to depression

Oral mucosal lesions and their association with sociodemographic, behavioral, and health status factors

The aim of this study was to evaluate the frequency of oral mucosal lesions and their associations with sociodemographic, health, and behavioral factors in a southern Brazilian population. Information was collected from participants (n = 801) using a structured questionnaire during an oral cancer screening campaign held at an agribusiness show in southern Brazil in 2009. Data were described using frequency distributions or means and standard deviations. Associations between independent variables and outcomes were assessed using the Chi-squared test. A total of 465 lesions were detected (actinic cheilitis: n = 204, 25.5%; candidiasis: n = 50, 6.2%; fibrous inflammatory hyperplasia: n = 42, 5.2%; ulceration, n = 33, 4.1%; hemangioma: n = 14, 1.7%; leukoplakia: n = 11, 1.4%). Candidiasis, actinic cheilitis, and fibrous inflammatory hyperplasia were associated significantly with literacy. Actinic cheilitis was also associated significantly with sun exposure and hat use, and leukoplakia was associated with smoking. The high frequency of oral mucosal lesions observed highlights the importance of education about risk factors. Additionally, training of health professionals, mainly those from public health services, in the use of preventive and community education strategies is needed

Cytokine profile associated with chronic and acute human schistosomiasis mansoni

The production and regulation of interleukin (IL) IL-13, IL-4 and interferon-gamma (IFN-³) was evaluated in 43 schistosomiasis patients with different clinical forms. Whole-blood cultures cytokine production in response to soluble egg antigen (SEA), soluble worm adult preparation (SWAP), mitogens, neutralizing antibodies or recombinant IL-13 were measured by ELISA. After SWAP stimulation, chronic patients, particularly hepatointestinals, produced higher levels of IL-4 in comparison with acute patients, suggesting the presence of a type 2 cytokine profile in these patients. Following SEA and SWAP stimulation, hepatosplenic (HS) patients showed increased levels of IFN-³ when compared with acute patients, indicating that HS disease in humans is associated with a type 1 cytokine response. The mechanisms of immune regulation are apparently different between the clinical stages of the disease, some of which are antigen-specific