Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study

Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon’s index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative powerThis work was financially supported by the EuroQol Research Foundation. EuroQol Research Foundation by 1226-RA project. (The EuroQoL Research Foundation is a non-profit organization) : Regional Association of Parents of Children with Cancer (ANDEX), Spai

Fat–Fit Patterns, Drug Consumption, and Polypharmacy in Older Adults: The EXERNET Multi-Center Study

Background: Physical fitness levels and the amount of accumulated adipose tissue (fatness) relate to current and future individuals’ heath status. Nevertheless, the interrelationships of their combined patterns with polypharmacy and the types of medications consumed have not been sufficiently investigated. Methods: This cross-sectional study was carried out in six Spanish regions between 2008 and 2009 with a sample of older community-dwelling adults (≥65 years old) without dementia or cancer. Fitness was measured with one-leg balance and senior fitness tests, as well as by measuring weight and fat mass with a bioelectrical impedance analyzer. Polypharmacy was defined as the use of five or more medications. An analysis of variance was performed for comparisons between the physical fitness and fatness patterns and the medication consumed. Results: A total of 1709 elders were included in the study (72.1 ± 5.2 years). The two unfit patterns were those with the highest drug consumption. The High-Fat–Unfit pattern was the one that had the most significant consumption and had the highest percentage of polymedicated subjects. The Low-Fat–Fit pattern had a significantly lower percentage of people that did not consume any medications. The highest percentages of drug consumption in 7 of the 10 groups that were included were concentrated in the two unfit patterns. Conclusions: This study highlights the importance of fitness in older adults, as it is at least as important as the avoidance of accumulation of excess fat with respect to the consumption of a smaller number of medicines.This research was funded by the Ministerio de Trabajo y Asuntos Sociales—IMSERSO (104/07), University of Zaragoza (UZ 2008-BIO-01), Ministerio de Sanidad, Servicios Sociales e Igualdad—IMSERSO (147/11), Centro Universitario de la Defensa de Zaragoza (UZCUD2016-BIO 01 and UZCUD2017-BIO-01), Ministerio de Educación y Ciencia (Red EXERNET DEP2005-00046), Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Biomedical Research Networking Center on Pathophysiology of Obesity and Nutrition (CIBEROBN), FEDER funds from the European Union (CB16/10/00477), and the 4IE+ project (0499_4IE_PLUS_4_E) funded by the Interreg V-A España-Portugal (POCTEP) 2014–2020 program. In addition, D. N. received a grant from “Gobierno de Aragón” (DGAIIU/1/20)

Estimation of Pubertal Growth Spurt Parameters in Children and Adolescents Living at Moderate Altitude in Colombia

Objective: Knowledge of the biological parameters of pubertal growth spurt allows verification of secular changes and exploration of the timing of puberty. The aim of the study was to estimate final height, age at peak height velocity (APHV), and peak height velocity PHV (cm/y) in children and adolescents living at moderate altitude in Colombia. Methods: A cross-sectional study was designed in 2.295 schoolchildren from Bogotá (Colombia) with an age range from 5.0 to 18.9 years. Height (cm) was assessed. Preece–Baines model 1 (1PB) was used to make inferences about mathematical and biological parameters. Results: The five mathematical parameters estimated in general have reflected quality in the fit to the model, reflecting a small residual error. Final height was reached in boys at 170.8 ± 0.4 cm and in girls at 157.9 ± 0.2 cm. APHV was estimated at 12.71 ± 0.1 years in boys and 10.4 ± 0.2 years in girls. Girls reached APHV 2.2 years earlier than boys. In relation to PHV (cm/y), boys reached higher growth speed in height (7.4 ± 0.4 cm/y), and in girls it was (7.0 ± 0.2 cm/y). Conclusion: It was determined that final height was reached at 170.8 ± 0.4 cm in boys and 157.9 ± 0.2 cm in girls, and APHV (years) and PHV (cm/ye) were reached relatively early and with average peak velocity similar to Asian and Western populations. A large-scale longitudinal study is needed to confirm these findings

Parent-child discrepancy in the assessment of health-related quality of life using the EQ-5D-Y questionnaire

Introducción. La evaluación de la calidad de vida relacionada con la salud (CVRS) permite detectar cambios en el tiempo en la salud de pacientes y posibilita realizar un análisis de coste-efectividad de tratamientos. En niños con características especiales de salud que no pueden autoevaluarse, existe la posibilidad de evaluar su CVRS a través de padres o cuidadores. Hasta la fecha, no se ha analizado la discrepancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y entre niños con parálisis cerebral (PC) y sus padres. El objetivo del presente estudio fue analizar el grado de concordancia en la evaluación de la CVRS a través del cuestionario EQ-5D-Y y su versión Proxy entre niños con PC y sus padres o cuidadores. Población y métodos. Participaron, en el estudio, niños y adolescentes con PC, así como sus padres y madres, procedentes de un centro de educación especial de la región de Extremadura (España). Se utilizó el cuestionario EQ-5D-Y para los niños y el EQ-5D-Y Proxy para los padres. Las entrevistas fueron llevabas a cabo durante el primer trimestre de 2015. Se analizó la concordancia en las respuestas mediante el nivel de acuerdo con kappa de Cohen para las 5 dimensiones que componen el EQ-5D-Y y el coeficiente de correlación intraclase para la escala visual analógica. Resultados. Participaron 62 niños con PC con afectación leve y/o moderada de su capacidad funcional, sus padres y madres. Hubo una pobre concordancia en la evaluación de la CVRS entre niños y padres en todas las dimensiones del cuestionario (< 0,20) y justo o pobre (< 0,60) en la escala visual analógica. Conclusiones. Existe un alto desacuerdo en la evaluación de la CVRS entre padres e hijos en población con PC a través del cuestionario EQ-5D-Y.ntroduction . The assessment of health-related quality of life (HRQoL) serves to detect changes over time in patients’ health status and allows to do a cost-effectiveness analysis of treatments. When children with special health features cannot perform a self-assessment, it is possible to assess their HRQoL through their parents or caregivers. To date, the discrepancy in the assessment of HRQoL using the EQ-5D-Y questionnaire among children with cerebral palsy (CP) and their parents has not been analyzed. The objective of this study was to analyze the level of agreement in the HRQoL assessment using the EQ-5D-Y questionnaire and its proxy version among children with CP and their parents or caregivers. Population and methods . Children and adolescents with CP, and their parents, from a special education school in the region of Extremadura (Spain) participated in the study. The EQ-5D-Y questionnaire was used for children and the EQ-5D-Y proxy version, for parents. Interviews were conducted in the first quarter of 2015. The level of agreement in the responses was analyzed using the Cohen’s kappa coefficient for the five domains of the EQ-5D-Y and the intraclass correlation coefficient for the visual analogue scale. Results . Sixty-two children with CP and mild and/or moderate functional capacity impairment, and their parents, participated in the study. The level of agreement was poor in the HRQoL assessment between children and parents in all the questionnaire domains (<0.20) and fair or poor (<0.60) in the visual analogue scale. Conclusions . A high level of parent-child disagreement was observed in the HRQoL assessment in the population with CP using the EQ-5D-Y questionnaire.peerReviewe

Stair negotiation in women with fibromyalgia: a descriptive correlational study

Subir y bajar escaleras es una actividad común e importante de la vida diaria. Las mujeres con fibromialgia a menudo muestran una capacidad reducida para realizar esta tarea. El objetivo de este estudio fue evaluar la confiabilidad de las tareas de negociación de la escalera y la prueba de reevaluación y evaluar el impacto de los síntomas de la fibromialgia en la capacidad de negociar las escaleras. Cuarenta y dos mujeres con fibromialgia participaron en este estudio descriptivo correlacional. La relevancia de la negociación de la escalera (tanto subir y bajar) se evaluó al evaluar su asociación con la versión revisada del cuestionario de impacto de la fibromialgia (FIQ-R) y otras variables relacionadas con la salud. También se analizó la fiabilidad test-retest. Las principales medidas de resultado fueron el tiempo que se pasó subiendo y bajando escaleras y el impacto de la fibromialgia, la calidad de vida, el número de caídas, el peso y la resistencia y resistencia de las extremidades inferiores. El coeficiente de correlación intraclase (ICC) para el descenso de la escalera fue de 0.929 mientras que para el ascenso fue de 0.972. La puntuación en estas pruebas se correlacionó significativamente con la puntuación total para el FIQ-R y la puntuación para muchas de las dimensiones y síntomas: es decir, la función física, el impacto general de la fibromialgia, el dolor, la energía, la rigidez, el sueño reparador, la sensibilidad y la autoestima. Problemas de equilibrio percibido, y sensibilidad. Dada la importancia de la negociación de la escalera como actividad de la vida diaria y la alta confiabilidad, las tareas de ascenso y descenso de la escalera pueden ser útiles como medidas de resultado en estudios en pacientes con fibromialgia.Walking up and down stairs is a common and important activity of daily living. Women with fibromyalgia often show a reduced ability to perform this task. The objective of this study was to evaluate the test–retest reliability of stair negotiation tasks and to assess the impact of fibromyalgia symptoms on the ability to negotiate stairs. Forty-two women with fibromyalgia participated in this descriptive correlational study. The relevance of the stair negotiation (both walking up and down) was evaluated by assessing its association with the revised version of the fibromyalgia impact questionnaire (FIQ-R) and other health-related variables. Test–retest reliability was also analyzed. The main outcome measures were time spent walking up and down stairs and impact of fibromyalgia, quality of life, number of falls, weight, and lower limb strength and endurance. The intraclass correlation coefficient (ICC) for stair descent was 0.929 whereas that for ascent was 0.972. The score in these tests correlated significantly with the total score for the FIQ-R and the score for many of dimensions and symptoms: that is, physical function, overall impact of fibromyalgia, pain, energy, stiffness, restorative sleep, tenderness, self-perceived balance problems, and sensitivity.• Ministerio de Economía y Competitividad. Becas DEP2012-39828 y DEP2015-70356 • Ministerio de Educación, Cultura y Deportes. Beca FPU14/01283, para Daniel Collado MateopeerReviewe

Fitness, physical functionality and quality of life in elderly: a mediation analysis

El estudio tiene como objetivo analizar la relación entre la condición física y la calidad de vida relacionada con la salud (CVRS), midiendo el efecto mediador de la funcionalidad física. Se realizaron diferentes pruebas de condición física a adultos mayores. El cuestionario composite physical function se utilizó para medir la funcionalidad física y el EQ-5D-5L para valorar la CVRS. El análisis de mediación confirma el papel de mediador de la funcionalidad física entre la condición física y la CVRS (B = .051; CI = .036 a .067). La asociación directa de la condición física y CVRS tuvo un efecto B = .0314, t = 3.313. p = .001. Se concluye que la relación entre la condición física y la CVRS está parcialmente mediada por la función física en mayores.The aim of this work was to analyze the association between fitness and health related quality of life, assessing the physical functionality impact as a mediator. Different tests of physical condition were carried. The composite physical function (CPF) questionnaire was used to measure the physical functionality and the EQ-5D-5L to quantify the HRQoL. The mediation analysis confirms the physical functionality mediator role between fitness and HRQoL (B=.051; CI= .036 to .067). The direct association of fitness and HRQoL had an effect of B=.0314, t=3.313. p=.001. It is concluded that the fitness, regardless its impact on physical functioning, is related to HRQoL

Health-related quality of life in Chilean patients with chronic obstructive pulmonary disease

ANTECEDENTES: La enfermedad pulmonar obstructiva crónica (EPOC) tiene un impacto relevante en la calidad de vida relacionada con la salud (CVRS). La herramienta de calidad de vida de dimensiones cortas de Forma 6 (SF-6D) permite a los investigadores calcular utilidades basadas en preferencias utilizando datos de los cuestionarios SF-12 o SF-36. OBJETIVO: Proporcionar valores normativos de SF-6D derivados de SF-12 para pacientes chilenos con EPOC. MATERIAL Y MÉTODOS: El índice de utilidad SF-6D se calculó utilizando datos de la Encuesta Nacional de Salud de Chile 2009/2010. Sesenta y nueve hombres y 120 pacientes con EPOC participaron en la encuesta. Los datos se estratificaron por género, edad, región, estado civil, estado de fumador, ingresos mensuales, nivel educativo y área. Resultados: La media (± SD) del índice de utilidad SF-6D para pacientes chilenos con EPOC fue de 0,65 ± 0,15. Las puntuaciones para hombres y mujeres fueron de 0,68 ± 0,15 y 0,64 ± 0,15, respectivamente. Los pacientes con altos ingresos y nivel educativo informaron puntuaciones más altas de SF-6D. El efecto techo no fue una limitación cuando se utilizó SF-6D en estos pacientes chilenos. CONCLUSIONES: El estudio actual proporciona valores normativos de SF-6D derivados de SF-12 para pacientes chilenos con EPOC.BACKGROUND: Chronic obstructive pulmonary disease (COPD) has a relevant impact on health-related quality of life (HRQoL). Short Form 6 dimensions (SF-6D) quality of life tool allows researchers to calculate preference-based utilities using data from SF-12 or SF-36 questionnaires. AIM: To provide normative values of SF-6D derived from SF-12 for Chilean patients with COPD. MATERIAL AND METHODS: SF-6D utility index was calculated using data from the 2009/2010 Chilean National Health Survey. Sixty-nine male and 120 female patients with COPD participated in the survey. Data was stratified by gender, age, region, marital status, smoking status, monthly incomes, educational level and area. Results: The mean (± SD) SF-6D utility index for Chilean patients with COPD was 0.65 ± 0.15. The scores for men and women were 0.68 ± 0.15 and 0.64 ± 0.15, respectively. Patients with high incomes and educational level reported higher SF-6D scores. Ceiling effect was not a limitation when SF-6D was used in these Chilean patients. CONCLUSIONS: The current study provides normative values of SF-6D derived from SF-12 for Chilean patients with COPD.• Ministerio de Educación, Cultura y Deporte. Beca FPU14/01283, para Daniel Collado Mateo • Fundación Tatiana Pérez de Guzmán el Bueno. Beca predoctoral para Daniel Collado MateopeerReviewe

Fitness as mediator between weight status and dimensions of health-related quality of life

FUNDAMENTOS: Hay pruebas de que el sobrepeso y la obesidad en los niños se asocia con una mala condición física y, por consiguiente, con una menor calidad de vida relacionada con la salud (HRQoL). Sin embargo, esta relación lineal-causal entre el Estado de Peso → Aptitud Física → CVRS no es suficiente para comprender plenamente este fenómeno. Por lo tanto, es necesario saber, a través de un análisis de mediación, cómo funciona la Aptitud Física entre el estado de peso y las dimensiones de la CVRS. PROPÓSITO: El objetivo de este estudio fue determinar qué dimensiones de CVRS están mediadas por la Aptitud Física en niños obesos (incluyendo el sobrepeso) y de peso normal. El estudio también examinó la asociación entre la Aptitud Física, el Índice de Masa Corporal (IMC) y la CVRS. MÉTODOS: Un total de 233 niños obesos o con sobrepeso y 105 niños con peso normal participaron en el estudio. Los niños fueron reclutados en centros educativos públicos y en un programa público de pérdida de peso. Se midió el IMC, la aptitud física (fuerza de las extremidades superiores, centrales e inferiores; agilidad y rango de movimiento) y la CVRS (PedsQL y VAS). Se realizaron análisis simples de mediación por género, a través de la macro de PROCESO desarrollada por Predicador y Hayes, para analizar si la Aptitud Física computada como z-score, es un mediador en la relación entre el estado de peso (peso normal o sobrepeso/obesidad) y las dimensiones de CVRS. \N - Tradicionalmente, las estadísticas de desigual-varianzas t se ejecutaron para conocer las diferencias en el IMC, los componentes de Aptitud Física y las dimensiones de CVRS entre los grupos, y las correlaciones para conocer las asociaciones entre el estado de peso, el puntaje z de Aptitud Física y la CVRS. RESULTADOS: Nuestros resultados, indicaron la asociación entre el puntaje z de Aptitud Física y las dimensiones de CVRS en niños con sobrepeso/obesos. Con respecto al análisis de mediación, los resultados mostraron que la asociación negativa entre el sobrepeso/obesidad y la CVRS se suaviza por el nivel de Aptitud Física. Por lo tanto, la aptitud física es un mediador en la relación entre los niños con sobrepeso y obesidad y la mayoría de las dimensiones de la CVRS, excepto el funcionamiento de la escuela en los niños y el funcionamiento de la escuela y las emociones en las niñas. CONCLUSIONES: El efecto negativo del sobrepeso u obesidad en la CVRS de los niños, es mitigado por la Condición Física. Por consiguiente, la Aptitud Física es un mediador de la CVRS en la mayoría de las dimensiones, especialmente en la vida diaria, en los escolares.BACKGROUND: There is evidence that overweight and obesity in children is associated with poor Physical Fitness and consequently lower Health-related Quality of Life (HRQoL). However, this linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Therefore, need to know, through mediation analysis, how operate the Physical Fitness between weight status and HRQoL dimensions. PURPOSE: The aim of this study was to determine which HRQoL dimensions are mediated through Physical Fitness in obese (including overweight) and normal weight children. The study also examined the association between Physical Fitness, Body Mass Index (BMI) and HRQoL. METHODS: A total of 233 overweight/obese children and 105 normal-weight children participated in the study. Children were recruited from public educational centers and a public weight loss program. BMI, Physical Fitness (upper limb, central body and lower limb strength; agility and range of motion) and HRQoL (PedsQL and VAS) were measured. Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status (normal weight or overweight/obesity) and HRQoL dimensions. \itionally, unequal-variances t statistics were executed to know differences in BMI, Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL. RESULTS: Our results, indicated association between the Physical Fitness z-score and HRQoL dimensions in overweight/obese children. Regarding to mediation analysis, the results showed that the negative association between overweight/obesity and HRQoL is softened by the level of Physical Fitness. Therefore Physical Fitness is a mediator in the relationship between overweight/obesity children and the most of dimensions of HRQoL, except the School functioning in boys and the School and Emotional functioning in girls. CONCLUSIONS: The negative effect of overweight or obesity on HRQoL inn children, is mitigated by Physical Fitness. Consequently, the Physical Fitness is a mediator on HRQoL in most dimensions, especially daily living, in schoolchildren.• Junta de Junta de Extremadura. Beca de Salud y Dependencia ref. 118/06peerReviewe

Acute effects of block jumps in female volleyball players: the role of performance level

Aunque el papel de la capacidad de salto en las jugadoras de voleibol es bien conocido, el efecto de la fatiga en esta habilidad no es bien conocido. El objetivo del presente estudio fue examinar el efecto de una serie de saltos en bloque (BJ) en la capacidad de salto y si varía según el nivel de rendimiento. Diez jugadores de voleibol femenino de élite (EG) y 11 aficionados (AG) realizaron una intervención de fatiga que consistió en 45 BJ, que se probaron para el salto de sentadilla (SJ), el salto de contramovimiento (CMJ) y BJ antes y después de la intervención. Índice de elasticidad (EI): (100 x (CMJ - SJ) / SJ) e índice de coordinación de las extremidades superiores (ULCI): se calcularon (100 x (BJ - CMJ) / CMJ). Después de la intervención, EG mostró una disminución de 4.40% en la altura de BJ (p = 0.04; ES = 0.40), mientras que AG presentó un aumento de 1.27%, que no fue significativo (p = 0.57; ES = 0.07). Sin embargo, EG y AG no presentaron diferencias significativas en SJ (p = 0.965 y p = 0.655) y CMJ (p = 0.742 yp = 0.211) cuando se compararon los valores iniciales con la intervención posterior. Aunque EI y ULCI no mostraron diferencias significativas después de la intervención en ningún grupo (AG: p = 0.989 y p = 0.114; EG: p = 0.242 yp = 0.205, respectivamente), AG presentó un tamaño de efecto medio (ES = 0.50) en EI y una pequeña en ULCI (ES = 0.37), también EG mostró un efecto medio-grande en ULCI (ES = 0.75). Estos hallazgos sugieren que el rendimiento de EG en BJ tiende a disminuir al final de una práctica específica de entrenamiento de salto. Por lo tanto, los entrenadores y preparadores físicos que trabajan con jugadores de voleibol de élite deben concentrarse en los ejercicios para mantener la capacidad de salto durante un partido.Although the role of jumping ability in female volleyball players is well recognised, the effect of fatigue on this ability is not well known. The aim of the present study was to examine the effect of a series of block jumps (BJ) on jumping ability and whether it varies by performance level. Ten elite (EG) and 11 amateur (AG) female volleyball players performed a fatigue intervention consisting of 45 BJ, being tested for squat jump (SJ), countermovement jump (CMJ) and BJ before and after the intervention. Elasticity index (EI): (100 x (CMJ - SJ)/SJ) and upper limbs coordination index (ULCI): (100 x (BJ - CMJ)/CMJ) were calculated. After the intervention, EG showed a decrease of 4.40% in BJ height (p = 0.04; ES = 0.40), whereas AG presented an increase of 1.27%, which was not significant (p = 0.57; ES = 0.07). However, EG and AG presented no significant differences in SJ (p = 0.965 and p = 0.655) and CMJ (p = 0.742 and p = 0.211) when comparing baseline with post-intervention. Although EI and ULCI showed no significant differences after intervention in any group (AG: p = 0.989 and p = 0.114; EG: p = 0.242 and p = 0.205, respectively), AG presented a medium effect size (ES = 0.50) in EI and a small one in ULCI (ES = 0.37), also EG showed a medium-large effect in ULCI (ES = 0.75). These findings suggest that EG performance in BJ tends to decrease at the end of a specific jump training practice. Therefore, coaches and fitness trainers working with elite volleyball players should focus on exercises to maintain jumping ability during a match.• Junta de Extremadura. Ayuda GR15020peerReviewe

The validity and reliability of a novel mobile app to measure agility performance in the physically active youth population

Agility is a key component of physical fitness in adolescents. However, the measurement of this variable is usually complex, requiring high cost instruments and complex software. To test the validity and reliabilityof a novel iPhone app (Lap Tracker Auto-timer) to measure agility performance among adolescents.Twenty-four physically active adolescents (15.7 ± 2.3 years old) participated in two testing sessions (separated by 7 days). They performed three 4 x 10 m agility test trials measured by Photocell or the iPhone app.The correlation analysis revealed high validity (r = .92; 95% confidence interval [CI] = .88 –.95), with a standard error of the estimate of 0.56 s (p < 0.001). The coefficient of variation (CV; 0.09) and intraclass correlation coefficient (ICC; .93; 95% CI = .85 –.97) showed an acceptable reliability.This study demonstrated that the iPhone App Lap Tracker Auto-timer could be a valid, reliable and low-cost tool to evaluate agility performance in adolescents. However, more studies are required to guarantee the utility of this app