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

Constitutive RB1 mutation in a child conceived by in vitro fertilization: implications for genetic counseling

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to identify mutations associated with bilateral retinoblastoma in a quadruplet conceived by in vitro fertilization, and to trace the parental origin of mutations in the four quadruplets and their father.</p> <p>Methods</p> <p>Mutational screening was carried out by sequencing. Genotyping was carried out for determining quadruplet zygosity.</p> <p>Results</p> <p>The proband was a carrier of a novel <it>RB1</it> constitutive mutation (g.2056C>G) which was not detected in her father or her unaffected sisters, and of two other mutations (g.39606 C>T and g.174351T>A) also present in two monozygotic sisters. The novel mutation probably occurred de novo while the others were of likely maternal origin. The novel mutation, affecting the Kozak consensus at the 5'UTR of <it>RB1</it> and g.174351T>A were likely associated to retinoblastoma in the proband.</p> <p>Conclusion</p> <p>Molecular diagnosis of retinoblastoma requires genotypic data of the family for determining hereditary transmission. In the case of children generated by IVF with oocytes from an anonymous donor which had been stored in a cell repository, this might not be successfully accomplished, making precise diagnosis impracticable for genetic counseling.</p

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis

BACKGROUND: Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. METHODS: Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. RESULTS: Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. CONCLUSIONS: Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services