Preliminary validity testing of the eHealth Literacy Questionnaire (eHLQ): a Confirmatory Factor Analysis (CFA) in Norwegian hospitalized patients.

AIMS: To perform the first psychometric analysis of the Norwegian version of the eHLQ using confirmative factor analysis (CFA) procedures in a population of patients admitted to hospital using a cross-sectional design. The eHLQ consists of 35 items capturing the 7-dimensional eHealth Literacy Framework (eHLF) which describes users' attributes, user's interaction with technologies and user's experience with digital health systems. METHODS: The 7 independent scales of the eHLQ was translated from Danish and culturally adapted into the Norwegian language following a standardised protocol. Assessment of construct validity of the eHLQ was undertaken using data from a cross-sectional survey of 260 patients hospitalized at a Norwegian University Hospital in the Oslo area during a two-week period in June 2021. The analysis included using correlation analysis (Pearsons R), internal consistency (Cronbach's alpha) and confirmatory factor analysis (CFA). RESULTS: All factor loadings were high to acceptable (i.e. > 0.6), except for five items which had somewhat lower loadings. Regarding internal consistency, alpha ranged from 0.73 to 0.90. For optimal CFA fit for the different scale models, correlated residuals were required for five of the seven scales. Overall our analysis shows an intermediate fit of the orginal construct. Scale intercorrelations were all below 0.8, indicating an overall acceptable discriminant validity between the 7 dimensions. CONCLUSIONS: The results from the CFA analysis indicate that for almost all 7 eHLQ scales, an acceptable model fit was achieved. The 260 hospitalized patients included in this study represented a variety of diagnoses, recruited from a geographically limited area. Further studies on psychometric properties of the Norwegian version of eHLQ in larger samples, diverse settings and by using more comprehensive approaches are warranted.

Identification of genes associated with environmental persistence in Campylobacter jejuni and Campylobacter coli isolates from processing in a broiler abattoir.

The aim of this study was to determine the prevalence of the htrA, htrB and ppk1 genes -all of which are related to environmental persistence- in C. jejuni and C. coli isolates obtained from abattoir samples at the arrival of broilers (initial stage) and in meat products after processing (final stage). A total of 119 DNA extracts (55 C. jejuni and 64 C. coli) were included in the study. Identification of genes was performed by conventional PCR (one for each gene). The overall prevalence was 40.3%, 93.3% and 68.9% for the htrA, htrB and ppk1 genes, respectively. Statistically significant differences were found (p < 0.05) between prevalence of C. jejuni and C. coli for all three genes. In C. coli the prevalence was significantly higher for the htrA (p = 0.007) and htrB (p = 0.015) genes, while ppk1 gene prevalence was significantly higher in C. jejuni (p < 0.001). In addition, statistically significant increase in the frequency of htrA (p = 0.007) and htrB (p = 0.013) genes in the final product compared to broilers on arrival at the abattoir was observed in C. jejuni, but not in C. coli. These results suggest that htrA and htrB genes are involved in environmental persistence of Campylobacter jejuni.

Health literacy profiling in persons with psoriasis - A cluster analysis.

Objective: To explore health literacy (HL) profiles within a cohort of people with psoriasis. A cluster approach identifies groups of individuals that have similar HL profiles. The method unmasks sub-groups with particular HL strengths, or subgroups with limitations, which require tailored healthcare services to improve. Methods: A cross-sectional sample of 792 patients from the Norwegian Climate Helio Therapy Programme in Gran Canaria participated. The HL questionnaire assessed nine HL dimensions. Using Ward's Hierarchical Clustering Method (Stata version 16), we looked for subgroups of patients across the dimensions. We also explored whether these clusters had specific demographic features and associations to outcomes such as psoriasis knowledge, quality of life and self-management capacity. Result: The analysis revealed four unique clusters identifying clinically meaningful subgroups. Two groups stood out as especially interesting. One cluster representing 26.6% of the sample presented severe HL limitations associated with lower psoriasis knowledge, quality of life, self-management and self-efficacy. HL domains connected to cooperation with healthcare professionals showed deficient scores. The other cluster included a smaller percentage (7.7%) with high HL compared to the total sample. This cluster was associated with higher self-management, quality of life and better self-efficacy. Conclusion: The cluster analysis revealed substantial differences in HL profiles within the sample. These results support the importance of a holistic understanding of the HL needs and the vulnerabilities within a psoriasis cohort. Implementing one size fits all approaches, may not be sufficient in psoriasis context to target HL.

Survey of Aujeszky's Disease Virus in Hunting Dogs from Spain.

Direct contact with swine infected by Aujeszky's disease virus (ADV) represents a potential risk of transmission to carnivore species, in which the infection is normally fatal. We assessed exposure to ADV in hunting dogs in an area where the virus is highly endemic in wild boar populations. Two out of 466 (0.43%; 95% CI 0.00-1.02%) hunting dogs analyzed were positive by gE-bELISA, gB-bELISA and the virus neutralization test. The seroprevalence levels detected, as well as the absence of reports of clinical cases in the hunting dog groups tested, indicate limited contact of this species with ADV in the study area. Further studies are warranted to assess the pathogenicity of Aujeszky's disease virus strains infecting wild boar.

A systematic review of quality of life research in medicine and health sciences.

PURPOSE: Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to describe the country of origin, target groups, instruments, design, and conceptual issues. METHODS: A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor. RESULTS: QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items. CONCLUSION: QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges.

Health literacy: a new piece of the puzzle in psoriasis care? A cross-sectional study.

BACKGROUND: Health literacy (HL) - the ability to seek, understand and utilize health information - is important for good health. Suboptimal HL has been associated with poorer health outcomes in other chronic conditions, although this has not previously been studied in patients with psoriasis. OBJECTIVES: To investigate the HL strengths and weaknesses of a cohort of patients with moderate-to-severe psoriasis. Another aim was to examine possible associations between patients' quality of life, their demographic, clinical and self-management characteristics, and dimensions of HL. METHODS: A cross-sectional study was conducted. Data were collected from a cohort of patients with psoriasis who had received climate helio therapy from 2011 to 2016 (n = 825). HL was assessed by the Health Literacy Questionnaire (HLQ). The association between HL domains, demographic, clinical and self-management variables were analysed using bivariate correlation and a four-step linear multiple regression model. RESULTS: The scores on all HLQ dimensions indicated lower health literacy than other populations. The linear regression models showed a significant association between HL, quality of life and self-management variables, with higher HL predicting higher quality of life, self-efficacy and psoriasis knowledge. Sex, educational attainment, age and disease severity had less influence on health literacy. CONCLUSIONS: Improving HL may be a useful strategy for reducing disparities in self-management skills for patients with psoriasis. Interventions that aim to reduce disease severity and increase psoriasis knowledge, self-efficacy and quality of life may positively increase HL.

Seroprevalence and risk factors associated with Brucella seropositivity in dairy and mixed cattle herds from Ecuador.

An extensive cross-sectional study to determine the seroprevalence of and associated risk factors for Brucella infection was performed in dairy and mixed (dairy-beef) cattle herds in Ecuador. A total of 2666 serum samples from 386 farms were analyzed using Rose Bengal test and a blocking ELISA test. In addition, a questionnaire with 57 variables related to management, feeding, facilities, biosecurity, and animal health was filled in every cattle farm. A Generalized Estimating Equations model was used to determine the factors associated with Brucella seropositivity. The true prevalence of Brucella seropositivity in dairy and mixed cattle from Ecuador reached 17.0% (CI95% 15.6-18.4%). The herd prevalence was 45.1% (174/386) (CI95% 40.1-50.1%), and the within-herd prevalence ranged from 10 to 100% (mean 38.9%; Q1 14.3%, Q2 26.8%, Q3 52.5%). Seven factors were included in the GEE model for Brucella seropositivity: the nominal variables sex (OR 2.03; CI95% 1.32-3.13), herd type (dairy) (OR 1.79; CI95% 1.11-2.87), closed facilities in the farm (OR 1.80; CI95% 1.19-2.74), and ad libitum feeding (OR: 0.32; CI95%: 0.19-0.54), and the quantitative variables age (OR 1.005; CI95% 1.001-1.009), average slope in the farm (%) (OR 1.013; CI95% 1.002-1.024), and annual abortion rate (OR 1.016; CI95% 1.002-1.031). This study remarks the high spread of Brucella infection in cattle farms from Ecuador. In addition, it reports the risk factors associated to this infection in the predominant extensive system existent in this country.

Genetic diversity and antimicrobial resistance of Campylobacter and Salmonella strains isolated from decoys and raptors.

Infections caused by thermotolerant Campylobacter spp. and Salmonella spp. are the leading causes of human gastroenteritis worldwide. Wild birds can act as reservoirs of both pathogens. A survey was carried out to determine the prevalence, genetic diversity and antimicrobial resistance of thermotolerant Campylobacter and Salmonella in waterfowl used as decoys and wild raptors in Andalusia (Southern Spain). The overall prevalence detected for Campylobacter was 5.9% (18/306; CI95%: 3.25-8.52) in decoys and 2.3% (9/387; CI95%: 0.82-3.83) in wild raptors. Isolates were identified as C. jejuni, C. coli and C. lari in both bird groups. Salmonella was isolated in 3.3% (10/306; CI95%: 2.3-4.3) and 4.6% (18/394; CI95%: 3.5-5.6) of the decoys and raptors, respectively. Salmonella Enteritidis and Typhimurium were the most frequently identified serovars, although Salmonella serovars Anatum, Bredeney, London and Mikawasima were also isolated. Pulsed-field gel electrophoresis analysis of isolates showed higher genetic diversity within Campylobacter species compared to Salmonella serovars. Campylobacter isolates showed resistance to gentamicin, ciprofloxacin and tetracycline, while resistance to erythromycin and tetracycline was found in Salmonella isolates. The results indicate that both decoys and raptors can act as natural carriers of Campylobacter and Salmonella in Spain, which may have important implications for public and animal health.

Campylobacter infection in wild artiodactyl species from southern Spain: occurrence, risk factors and antimicrobial susceptibility.

A cross-sectional study was performed to assess the occurrence of Campylobacter species and to identify potential associated risk factors for wild artiodactyl species in southern Spain. Campylobacter species were isolated in 55 of 363 (15.2%) faecal samples. Campylobacter was identified in faeces from wild boar (49/126; 38.9%), red deer (5/179; 2.8%) and mouflon (1/13; 7.7%) but not from fallow deer (0/45). The isolated Campylobacter species were identified as C. jejuni (2 isolates; 3.6%), C. coli (11 isolates; 20.0%) and C. lanienae (37 isolates; 67.3%). Five isolates (9.1%) could not be identified at the species level. This report is the first to describe C. lanienae infection in wild ruminant species. Resistance to erythromycin (4.8%), ciprofloxacin (37.5%), tetracycline (52.9%) and streptomycin (55%) were detected. C. lanienae presented a significantly higher number of susceptible isolates to ciprofloxacin and tetracycline than C. coli. Due to the low number of positive wild ruminants, a Generalised Estimating Equations model was only carried out for wild boar. The model indicated that the risk factors associated with Campylobacter infection were the density of wild boar (>10/100ha) (OR: 3.05; CI95%: 2.2-4.3), the presence of artificial waterholes (OR: 3.67; CI95%: 1.3-10.5) and the winter season (OR: 3.30; CI95%: 1.9-5.8). Campylobacter infection is widespread in wild boar populations in southern Spain. These findings suggest that wild artiodactyls, particularly wild boar, constitute a reservoir of Campylobacter species, including resistant and multi-resistant strains, which may be of public health concern.

Campylobacter spp., C. jejuni and C. upsaliensis infection-associated factors in healthy and ill dogs from clinics in Cordoba, Spain. Screening tests for antimicrobial susceptibility.

A microbiological and epidemiological survey examining Campylobacter species-related infection in dogs from clinics in Cordoba (Southern Spain) was performed from May 2007 to March 2008. Three-hundred and six rectal swabs were taken from both ill and healthy dogs, and an epidemiological questionnaire was filled out. The isolated bacterial strains were identified by means of multiplex polymerase chain reaction (PCR). The prevalence factors for Campylobacter spp., C. jejuni and C. upsaliensis infection were determined by logistic regression. An antimicrobial susceptibility screening test was performed using the agar disk diffusion method. Campylobacter species were isolated from 102 samples. Forty strains (35.2%) were identified as Campylobacter jejuni, 60 strains (58.8%) as Campylobacter upsaliensis and two strains (2%) as Campylobacter spp. The sampling season was a prevalence factor for C. jejuni infection, while the age of the dog was a prevalence factor for Campylobacter spp. and C. upsaliensis infection. Enteric disease was a prevalence factor for Campylobacter spp., C. jejuni and C. upsaliensis infection. The antimicrobial susceptibility test indicated that gentamicin and erythromycin were the most effective antibiotics, with 97.8% and 88% strains sensitive to the antibiotics, respectively.

Abortion associated with Chlamydia abortus in extensively reared Iberian sows.

Reproductive disease was investigated in Iberian pigs on an extensive farrow-to-finish farm in the southwest of Spain. Chlamydia abortus was isolated in cell culture and C. abortus-specific PCR products were detected in placental and fetal tissues. In one batch of 14 sows, the percentage of sera positive for C. abortus specific antibodies increased from 35.7% to 85.7% in the period of 2 weeks following abortion. C. abortus may play a role in abortion in extensively reared Iberian sows.

Seroprevalence and risk factors associated to Bovine Herpesvirus 1 (BHV-1) infection in non-vaccinated dairy and dual purpose cattle herds in Ecuador.

A cross-sectional study was carried out to determine the seroprevalence and risk factors associated to Bovine Herpesvirus 1 (BHV-1) infection in non-vaccinated dairy and dual purpose cattle herds from Ecuador. A total of 2367 serum samples from 346 herds were collected from June 2008 through February 2009. A questionnaire, which included variables related to cattle, health, management measures and environment was filled out in each herd. A commercial indirect ELISA test was used to determine the seropositivity against BHV-1. Generalized Estimating Equations (GEE) model was used to determine risk factors at individual level, including herd as random effect. The individual seroprevalence to BHV-1 in Ecuador was 43.2% (1023/2367; CI(95%): 41.2-45.2%). The herd prevalence was 82.1%; (284/346; CI(95%): 78.1-86.1%) and the intra-herd prevalence ranged from 12.5 to 100% (mean=64.1%). The GEE model showed that animal age (>4 years) (OR: 1.44; CI(95%): 1.18-1.75), BRSV infection (OR: 1.45; CI(95%): 1.09-1.92), altitude over the sea level (≤ 1800 m) (OR: 2.97; CI(95%): 2.1-4.22) and average slope (> 11%) (OR: 1.45; CI(95%): 1.07-1.95) are risk factors associated with BHV-1 infection, while a good cleaning of the facilities (OR: 0.66; CI(95%): 0.44-0.99) was shown to be a protective factor.

Concurrent aspergillosis and ascites with high mortality in a farm of growing broiler chickens.

Two flocks of broiler chickens aged 15 to 30 days presented respiratory signs such as dyspnea and up to 25% mortality. These were the only two flocks in the farm where a bed of sunflower shells was used instead of the rice-hull bedding used in other flocks. At necropsy, severe ascites, right heart hypertrophy, pulmonary congestion, and extensive multifocal granulomatous pneumonia were recorded. Histopathologic examination revealed chronic multifocal mycotic granulomatous pneumonia. Aspergillus fumigatus was identified by microbiologic study from pulmonary specimens. After disinfecting the floor and changing the bedding, no clinical signs were recorded in the farm. Severe chronic granulomatous pneumonia caused by A. fumigatus in the chickens of the present study may have caused hypoxia, leading to pulmonary hypertension, heart failure, and ascites.

[Interaction of nurses and women caring informally for dependent persons]. / Interacción de enfermería y cuidadoras informales de personas dependientes.

OBJECTIVE: To find the attitudes that primary care nurses in Albacete have towards family carers. DESIGN: Qualitative research using discussion groups. SETTING: Primary care in Albacete: 5 health centres, 2 rural and 3 urban. PARTICIPANTS: Nurses following a primary care home visit programme, of both sexes, differing experience and training, and coming from both rural and urban areas took part. Exclusion criterion: nurses in management and administrative posts at time of recruitment. They were recruited by primary care nurses in line with the profiles of participants required. METHOD: Information was collected through discussion in the groups, which was recorded and later transcribed for analysis. RESULTS AND CONCLUSIONS: Those taking part in the 2 discussion groups had the following characteristics: 3 men and 8 women. 5 of them were from rural health centres (HC) and 6 from urban HC; 3 had under 2 years experience in the Home Visit Programme (HVP) and 8 had over 5 years experience in it; 5 completed their nursing studies before 1990, and 6 afterwards. In the chats it was clear that the broad experience of PC nurses made them aware of the health situation and quality of life of informal carers, of the loneliness of these and the inter-personal conflicts that occur in families when a situation of dependency arises. Nurses had their educational function towards the carers assumed despite the limitations. The view that the responsibility for the care of the dependent person is the family's was predominant, and a concern for lack of resources and support was appreciated. Nurses had a view of the carer as a resource and barely perceived her as a patient.

Epidemiological relationship of human and swine Streptococcus suis isolates.

Two cases of meningitis due to Streptococcus suis in humans are reported here. A butcher and an abattoir worker were referred to a health centre in Castellón (Spain) with fever and symptoms of meningitis. After adequate treatment, a slight hipoacusia persisted as sequelae in both cases. Colonies of S. suis group R, serotype 2 and phenotype MRP+EF+ were isolated from cerebroespinal fluid. Epidemiological studies showed that both workers had in common the handling of pork meat of slaughtered healthy pigs from three closed farms. A study of the tonsils from apparently healthy, slaughtered pigs was carried out. A total of 234 tonsillar samples were obtained and 81 strains of S. suis were isolated from them. Serotype 2 appeared to be the most frequent (50.6%), and the analysis for phenotype showed a high percentage of tonsillar strains with the phenotype MRP+EF+ (35.9%). The humans and 28 tonsillar swine strains showed a similar profile (S. suis group R, serotype 2 and phenotype MRP+EF+). A total of 26 of the swine isolates were analysed by ribotyping using EcoRI. The human strains showed the same six-band hybridization pattern that shared five bands with the pattern most frequently shown by most of the tonsillar N. suis group R, serotype 2 and phenotype MRP+EF+ strains, differing only in the lightest, faintest band which was slightly less anodical in human (> or = 1.8 kb) than in swine (approximately 1.8 kb). From these results, both groups of strains, humans and porcine, showed differences; how can these differences in the pattern of ribotyping be explained if they should have the same origin? Is it possible that they have undergone an adaptation to the new host or perhaps the modification is due to other unknown causes? Further studies in this area are required in order to answer these questions.