Validation of the Spanish version of the eating disorders quality of life instrument (EDQOL).

BACKGROUND: The Eating Disorders Quality of Life instrument (EDQOL) is a disease-specific health related quality of life self-report questionnaire designed for disordered eating patients. Although the EDQOL is one of the most suitable and widely used questionnaires in many countries, no prior research has addressed the psychometric properties of the Spanish adaptation of the EDQOL. Therefore, the aim of this study is to examine the psychometric properties of the Spanish version of the EDQOL among ED patients. METHODS: 141 female eating disorder patients, with a mean age of 18.06 years (SD = 6.31), completed the EDQL in addition to the Eating Disorder Examination Questionnaire (EDEQ), the Depression, Anxiety and Stress Scales (DASS-21), the Clinical Impairment Assessment (CIA 3.0) and the Health Survey (SF-12). We calculated item/scale characteristics, internal consistencies and bivariate correlations with other measures of quality of life and adjustments. We assessed the goodness-of-fit of the 4-factor model using confirmatory factors analysis and explored the sensitivity of change following skill-based interventions. RESULTS: The fit of the 4-factor model was acceptable (Root Mean Square Error of Approximation: 0.07, Standard Root Mean Square Residual: 0.07). Cronbach's alpha was excellent for the total (.91) and acceptable for all subscales (0.78-0.91). The construct validity was found with measures of psychological distress, depression, anxiety, quality of life and clinical impairment. The psychological and physical/cognitive scales and the EDQOL global scale were responsive to change. CONCLUSION: The Spanish EDQOL version is a useful instrument to assess quality of life in eating disorder patients and to evaluate outcomes of skills-based interventions.

Eating Disorders (EDs) have a severe impact on many domains of quality of life (QOL). Therefore QOL needs to be addressed in effectiveness research and clinical practice. Furthermore, QOL is a very relevant concept in the treatment of chronic diseases and its evaluation requires specific health-related questionnaires. One widely used self-report measure to assess the quality of life in eating disorders is the Eating Disorder Quality of Life (EDQOL). Despite its high clinical relevance, EDQOL has not been previously investigated in the Spanish context. To overcome this gap, the present study aimed to validate the Spanish version of the EDQOL in a sample of Spanish eating disorder patients. The findings showed that the Spanish version of the EDQOL is robust in terms of reliability, factor structure and construct validity. This questionnaire may be preferred by clinicians and researchers interested in ED-specific health related quality of life impairment and as an additional indicator of ED severity.

Facts and controversies regarding oral health in Parkinson's disease: A case-control study in Spanish patients

Background: Parkinson's disease (PD) is one of the leading neurological disorders, affecting more than 6 millionpeople worldwide. These patients present motor and non-motor symptoms, including oral pathology. The objective of this research is to determine the oral health of patients diagnosed with PD, in order to stablish a specificpreventive oral health programme.Material and Methods: Case-control study on 104 PD and 106 control patients. The pre-designed clinical protocolincluded a complete oral examination on general aspects, standardised epidemiological index for caries, periodontal disease and edentulism, analysis of oral hygiene, presence of mucous/ salivary/ functional disorder, anddental treatments.Results: A higher number of PD patients consumed daily sweets (p<0.004) and antidepressant drugs (p<0.004).Patients with PD practised less interdental hygiene (p<0.023). The mean plaque index was higher in PD (p<0.003).Drooling (p<0.001), xerostomia (p<0.001), hyposialia (p<0.001), dysphagia (p<0.001), hypogeusia/dysgeusia(p<0.025) and chewing difficulty (p<0.006) were more common in PD.Conclusions: Oral disorders are frequent in PD. A good knowledge of these alterations will allow us design a specific preventive protocol. Some oral alterations may be a sign of diagnostic alert or progression of PD. (AU)

Attitudes of Latin American Immigrants Resident in Florida (United States) Toward Related Living Kidney Donation.

INTRODUCTION: Latin American immigrants comprise an important population group in the United States. The purpose of this study was to analyze the attitude toward living kidney donation found among Latin American citizens who are residents in Florida and to identify the psychosocial variables affecting their attitude. MATERIAL AND METHODS: A sample of Latin American residents in the state of Florida was randomly obtained and stratified by nationality, age, and sex (n = 1524). Attitude was assessed through a validated questionnaire that was self-administered and completed anonymously. Descriptive, Student t test and the χ2 test were used to analyze findings. RESULTS: The questionnaire completion rate was 94% (N = 1433), with 59% (n = 845) in favor of related living donation, 40% (n = 571) were opposed to donation, with the remaining 1% (n = 17) undecided. The following variables were related to attitude toward living donation: country of origin (P < .001), marital status (P < .001), having descendants (P = .004), educational background (P < 0.001), having had previous experience of donation and transplantation (P < .001), attitude toward deceased donation (P < .001), considering the possibility of needing a transplant (P < .001), the respondent's partner's opinion (P < .001), having considered the subject with one's family (P < .001), having carried out prosocial type activities (P < .001), the respondent's religion (P < .001), knowing that one's religion is in favor of this therapy (P < .001), concern about mutilation after donation (P < .001), and considerations of the risks of living donation (P < .001). CONCLUSIONS: The attitude toward related living kidney donation of Latin American residents in Florida is not very favorable (only 59%).

The Knowledge of the Brain Death Concept Among Latin Americans Residing in Florida (USA).

OBJECTIVES: The knowledge of the concept of brain death is fundamental for being able to understand the organ donation process and helps to achieve its acceptance. Our aim was to analyze levels of understanding of the brain death concept among Latin Americans residing in Florida (USA) and to determine the factors affecting this understanding. MATERIALS AND METHODS: A sample of residents of Latin American origin in the state of Florida was randomized and stratified by nationality, age, and sex (N = 1524). Attitude was assessed using a validated questionnaire, which was self-administered and completed anonymously. For statistical analysis of descriptive data, we used t test, the chi-square test, and logistic regression analysis. RESULTS: The questionnaire completion rate was 95% (n = 1450). We found that 24% (n = 350) understood the concept of brain death, 54% (n = 777) did not understand it, and the remaining 22% (n = 323) believed it did not mean a person's death. The following variables were related to understanding this concept: (1) country of origin (P ⟨ .001), (2) sex (P = .001), (3) marital status (P ⟨ .001), (4) level of formal education (P < .001), (5) having spoken about the subject with one's family (P < .001), (6) a partner's attitude toward donation (P < .001), and (6) religion (P < .001). In the multivariate analysis, the following factors continued to be related: country of origin, level of formal education, and religion. A more positive attitude toward organ donation was found among those who understood the concept of brain death (29% vs 22%; P = .004). CONCLUSIONS: Knowledge of the concept of brain death among Latin American residents in Florida is limited, with marked differences depending on the respondent's country of origin, level of formal education, and religion.

Testing carer skill training programs in Spanish carers of patients with eating disorders / Aplicación de programas de entrenamiento en habilidades para cuidadores españoles de pacientes con un trastorno de la conducta alimentaria

BACKGROUND: The aim of this research was to conduct a pilot study to measure the effectiveness of the Collaborative Care Skills Training Workshops (CCSTW) on the outcomes of Spanish carers and to analyse the impact of this programme on the patient's wellbeing. We used psychoeducation as a comparison intervention in the study. METHOD: The study compared two forms of carer workshops. 64 carers and 37 eating disorder patients participated in this study. Carers were randomised to either the CCSTW or the Psycho-educational programme. This study used an experimental intervention design with evaluations before, after and at a 3-month follow-up. RESULTS: Carers receiving both intervention programmes showed an improvement in wellbeing indicating a benefi t from the training. The course of burden, psychological distress, expressed emotion and illness perception was similar in the two groups. In patients whose caregivers had participated in CCSTW programme the levels of anxiety, depression and psychological distress decreased. CONCLUSIONS: These fi ndings suggest that carer distress, burden, illness perception and expressed emotion can be alleviated if they are helped in this role. There appear to be secondary benefi ts of the CCSTW on patients' wellbeing

ANTECEDENTES: el objetivo de esta investigación fue llevar a cabo un estudio piloto para evaluar la efectividad de los Talleres de Cuidado Colaborativo (CCSTW) en cuidadores españoles de pacientes con un trastorno alimentario y analizar el impacto de este programa en el bienestar del paciente. MÉTODO: este estudio comparó dos programas para cuidadores. Los cuidadores fueron asignados aleatoriamente a un programa psicoeducativo o a CCSTW. Participaron 64 cuidadores y 37 pacientes con un trastorno alimentario. Este estudio utilizó un diseño experimental con medidas pre-post y a los 3 meses de seguimiento. RESULTADOS: los cuidadores de ambos programas mostraron una mejora en el bienestar que indica el benefi cio de ambas intervenciones. La evolución de la carga del cuidador, el malestar psicológico, la emoción expresada y la percepción de la enfermedad fueron similares en los dos grupos. En los pacientes, cuyos cuidadores habían participado en el programa CCSTW, los niveles de ansiedad, depresión y malestar psicológico disminuyeron. CONCLUSIÓN: estos resultados sugieren que el malestar del cuidador, la carga, la percepción de enfermedad y la emoción expresada pueden aliviarse si se les ayuda en este rol. Se encuentran benefi cios secundarios de los CCSTW en el bienestar de los pacientes

The attitude of Latin American immigrants in Florida (USA) towards deceased organ donation - a cross section cohort study.

The Latin American (LA) population resident in the USA is a growing subgroup of the population. To find out the structure of attitude towards organ donation in the LA population resident in Florida (USA). A sample was taken of LA residents in Florida, randomized and stratified by nationality, age and sex (n = 1524). Attitude was assessed using a validated questionnaire (PCID-DTO Rios) that was self-completed anonymously. The survey completion rate was 95% (n = 1450). Attitude was favourable in 33% of respondents (n = 485), against in 40% (n = 575) and undecided in 27% (n = 390). The following variables were associated with a favourable attitude: country of origin (Dominican Republic; P = 0.038); sex (female; P < 0.001); marital status (married; P < 0.001); level of education (university; P < 0.001); previous experience of the subject (P < 0.001); considering the need for a transplant in the future (P < 0.001); understanding the concept of brain death (P = 0.003); attitude towards donating a family member's organs (P < 0.001); having discussed organ donation and transplantation with one's family (P < 0.001) or with one's partner (P < 0.001); participation in pro-social type activities (P < 0.001); the respondent's religion (atheist-agnostic; P < 0.001); a respondent's knowledge of the attitude of his or her religion towards organ donation (P < 0.001); no concern about mutilation after donation (P < 0.001); acceptance of cremation (P < 0.001); burial (P < 0.001); and an autopsy if one were needed (P < 0.001). The attitude towards donation of LA in Florida is worse than that reported in the native population and is associated with certain psychosocial factors.

Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

BACKGROUND: The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. MATERIAL AND METHODS: Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. RESULTS: The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from 'plaque-like' lesions presented hyperkeratosis (p < 0.001) and epithelial dysplasia (p = 0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p = 0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. CONCLUSIONS: The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied

Metal Homeostasis Regulators Suppress FRDA Phenotypes in a Drosophila Model of the Disease.

Friedreich's ataxia (FRDA), the most commonly inherited ataxia in populations of European origin, is a neurodegenerative disorder caused by a decrease in frataxin levels. One of the hallmarks of the disease is the accumulation of iron in several tissues including the brain, and frataxin has been proposed to play a key role in iron homeostasis. We found that the levels of zinc, copper, manganese and aluminum were also increased in a Drosophila model of FRDA, and that copper and zinc chelation improve their impaired motor performance. By means of a candidate genetic screen, we identified that genes implicated in iron, zinc and copper transport and metal detoxification can restore frataxin deficiency-induced phenotypes. Taken together, these results demonstrate that the metal dysregulation in FRDA includes other metals besides iron, therefore providing a new set of potential therapeutic targets.

The Spanish Validation of the Accommodation and Enabling Scale for Eating Disorders Among Carers: A Pilot Study.

Literature suggests that families may accommodate patients' symptoms in attempts to alleviate family conflict and stress. These accommodating and enabling behaviours may have a negative impact on carers and those they care for. There are no self-report questionnaires validated in Spanish to measure accommodation among relatives of patients with an eating disorder. The aim of this study was to examine the psychometric properties of the Spanish version of the Accommodation and Enabling Scale for Eating Disorders (AESED-S) among relatives of eating disorder patients. A cross-sectional study of 90 relatives was carried out to explore the factor structure, reliability and validity of the AESED-S. The internal consistency of the Spanish version of the AESED subscales was good, ranging from .89 to .81. The correlation of the five subscales with conceptually related measures (negative caregiving experience and distress) supports the convergent validity of this instrument in this sample. Results indicated that the Spanish version of the AESED provides a reliable and valid tool for assessing family accommodation in the context of having a relative with an eating disorder.

TORC1 Inhibition by Rapamycin Promotes Antioxidant Defences in a Drosophila Model of Friedreich's Ataxia.

Friedreich's ataxia (FRDA), the most common inherited ataxia in the Caucasian population, is a multisystemic disease caused by a significant decrease in the frataxin level. To identify genes capable of modifying the severity of the symptoms of frataxin depletion, we performed a candidate genetic screen in a Drosophila RNAi-based model of FRDA. We found that genetic reduction in TOR Complex 1 (TORC1) signalling improves the impaired motor performance phenotype of FRDA model flies. Pharmacologic inhibition of TORC1 signalling by rapamycin also restored this phenotype and increased the lifespan and ATP levels. Furthermore, rapamycin reduced the altered levels of malondialdehyde + 4-hydroxyalkenals and total glutathione of the model flies. The rapamycin-mediated protection against oxidative stress is due in part to an increase in the transcription of antioxidant genes mediated by cap-n-collar (Drosophila ortholog of Nrf2). Our results suggest that autophagy is indeed necessary for the protective effect of rapamycin in hyperoxia. Rapamycin increased the survival and aconitase activity of model flies subjected to high oxidative insult, and this improvement was abolished by the autophagy inhibitor 3-methyladenine. These results point to the TORC1 pathway as a new potential therapeutic target for FRDA and as a guide to finding new promising molecules for disease treatment.

Estudio multicéntrico hospitalario en España, México y Cuba de actitud hacia la donación de vivo hepática / Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation

INTRODUCCIÓN: Dado el déficit de hígados para trasplante se está potenciando la donación de vivo hepática (DVH) en el ámbito de habla hispana. Para ello es fundamental que los profesionales de centros hospitalarios estén a favor de dicha donación, dado que son una pieza clave en este tratamiento y son un grupo generador de opinión ante la población. Objetivo Analizar la actitud hacia la donación de vivo hepática (DVH) entre el personal hospitalario de centros sanitarios de España y Latinoamérica MATERIAL Y MÉTODO: Del «Proyecto Colaborativo Internacional Donante» se seleccionaron 10 centros hospitalarios, 3 de España, 5 de México y 2 de Cuba. Muestra aleatoria y estratificada por tipo de servicio y categoría laboral. Se valora la actitud hacia la DVH a través de un cuestionario validado de aspectos psicosociales. El cuestionario fue anónimo y autoadministrado. Estadística: test de la t de Student, de la χ2 y análisis de regresión logística. RESULTADOS: De los 2.618 profesionales encuestados, el 85% (n = 2.231) está a favor de la DVH relacionada, y de ellos el 31% (n = 804) a favor de la DVH no relacionada. No se asocian con dicha actitud ni el país del encuestado, ni las variables sociopersonales ni las laborales. Los factores que se asocian a la actitud favorable hacia la DVH relacionada son haber tenido experiencia personal con la donación y el trasplante (p < 0,001), estar a favor de la donación de cadáver (p < 0,001), creer en la posibilidad de necesitar un trasplante para sí mismo (p < 0,001), estar a favor de la donación de vivo renal (p < 0,001), aceptar un hígado procedente de donante vivo si fuera necesario (p < 0,001), haber comentado con la familia sobre la donación y el trasplante (p < 0,001), la actitud favorable de la pareja hacia la donación y el trasplante (p < 0,001), realizar actividades de tipo prosocial (p < 0,001), ser católico (p = 0,040), creer el encuestado que su religión está a favor de la donación y el trasplante (p < 0,001), y no preocuparle la posible mutilación del cuerpo tras la donación (p < 0,001). CONCLUSIONES: La actitud hacia la DVH referida entre el personal hospitalario de España y Latinoamérica es favorable, y está asociada con factores relacionados directa e indirectamente con la donación y el trasplante, factores familiares, religiosos y de actitud hacia el cuerpo

INTRODUCTION: Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion. OBJECTIVE: To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America. MATERIAL AND METHOD: Ten hospitals were selected from the «International Donor Collaborative Project»: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis. RESULTS: Of the 2,618 employees surveyed, 85% (n = 2,231) were in favor of related LLD; of these, 31% (n = 804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P < .001); being in favor of deceased donation (P < .001); believing that one might need a possible transplant (P < .001); being in favor of living kidney donation (P < .001); being willing to accept a liver from a living donor (P < .001); having discussed the matter of donation and transplantation within the family (P < .001) and with one's partner (P < .001); carrying out pro-social type activities (P < .001); being Catholic (P = .040); believing that one's religion is in favor of donation and transplantation (P < .001); and not being concerned about the possible mutilation of the body after donation (P < .001). CONCLUSIONS: Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body

[Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation]. / Estudio multicéntrico hospitalario en España, México y Cuba de actitud hacia la donación de vivo hepática.

INTRODUCTION: Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion. OBJECTIVE: To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America. MATERIAL AND METHOD: Ten hospitals were selected from the «International Donor Collaborative Project¼: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis. RESULTS: Of the 2,618 employees surveyed, 85% (n=2,231) were in favor of related LLD; of these, 31% (n=804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P<.001); being in favor of deceased donation (P<.001); believing that one might need a possible transplant (P<.001); being in favor of living kidney donation (P<.001); being willing to accept a liver from a living donor (P<.001); having discussed the matter of donation and transplantation within the family (P<.001) and with one's partner (P<.001); carrying out pro-social type activities (P<.001); being Catholic (P=.040); believing that one's religion is in favor of donation and transplantation (P<.001); and not being concerned about the possible mutilation of the body after donation (P<.001). CONCLUSIONS: Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body.

Estudio multicéntrico hispano-latinoamericano de actitud hacia la donación de órganos entre profesionales de centros sanitarios hospitalarios / Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers

INTRODUCCIÓN: Los profesionales hospitalarios son un colectivo generador de opinión para el resto de la población en temas sanitarios. La actitud no favorable de dicho grupo es un obstáculo hacia el incremento de las tasas de donación de órganos propios de cadáver. OBJETIVO: Analizar la actitud de los profesionales hospitalarios hacia la donación de los órganos propios en centros sanitarios españoles y latinoamericanos y determinar los factores que condicionan dicha actitud. MATERIAL Y MÉTODO: Del «Proyecto Colaborativo Internacional Donante» se seleccionaron 11 centros hospitalarios, 3 de España, 5 de México, 2 de Cuba y uno de Costa Rica. Muestra aleatorizada y estratificada por tipo de servicio y categoría laboral. La actitud hacia la donación y el trasplante se valoró mediante una encuesta validada. El cuestionario fue anónimo y autoadministrado. Estadística: tests de la t de Student, de la χ2 y análisis de regresión logística. RESULTADOS: De los 2.785 profesionales encuestados, 822 son de España, 1.595 de México, 202 de Cuba y 166 de Costa Rica. El 79% (n = 2.191) está a favor de la donación de órganos de cadáver. Por país, están a favor el 94% (n = 189) de los cubanos, el 82% (n = 1.313) de los mexicanos, el 73% (n = 121) de los costarricenses y el 69% (n = 568) de los españoles (p < 0,001). En el análisis multivariante, las variables con más peso específico son: 1) país, siendo más favorable en Cuba (odds ratio= 8,196; p < 0,001); 2) ser médico (OR = 2,544; p < 0,001); 3) realizar una actividad laboral relacionada con el trasplante (OR = 1,610; p = 0,005); 4) haber comentado a nivel familiar el tema de la donación y el trasplante (OR = 3,690; p < 0,001); 5) la actitud a favor hacia la donación y el trasplante de la pareja (OR = 3,289; p < 0,001); 6) considerar el encuestado que su religión está a favor de la donación y el trasplante (OR= 3,021; p = 0,001); 7) no estar preocupado por la posible mutilación del cuerpo tras la donación (OR = 2,994; p < 0,001); 8) la preferencia de otras opciones distintas de la inhumación en el tratamiento del cuerpo tras el éxitus (OR = 2,770; p < 0,001) y 9) la aceptación de la realización de una autopsia si fuese necesaria (OR = 2,808; p < 0,001). CONCLUSIONES: La actitud hacia la donación entre el personal hospitalario de centros sanitarios españoles y latinoamericanos es favorable, aunque un 21% no está a favor de donar. Dicha actitud es más favorable entre los profesionales latinoamericanos, y está muy condicionada por factores laborales y psicosociales

INTRODUCTION: Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation. OBJECTIVE: To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude. MATERIAL AND METHOD: Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered. Statistical analysis: Student's t-test, the χ2 test and logistic regression analysis. RESULTS: Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n = 2,191) were in favor of deceased organ donation. According to country, 94% (n = 189) of Cubans were in favor, compared to 82% (n = 1,313) of the Mexicans, 73% (n = 121) of the Costa Ricans and 69% (n = 568) of the Spanish (P < .001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P < .001); 2) being a physician (OR = 2.544; P < .001); 3) performing a job related to transplantation (OR = 1.610; P = .005); 4) having discussed the subject of donation and transplantation within the family (OR = 3.690; P < .001); 5) having a partner with a favorable attitude toward donation and transplantation (OR = 3.289; P < .001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR = 3.021; P = .001); 7) not being concerned about the possible mutilation of the body after donation (OR = 2.994; P < .001); 8) the preference for other options apart from burial for treating the body after death (OR = 2.770; P < .001); and 9) acceptance of carrying out an autopsy if one were needed (OR = 2.808; P < .001). CONCLUSIONS: Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors

Knowledge of the brain death concept by personnel in Spanish and Latin-American healthcare centers.

BACKGROUND: The knowledge and acceptance of the concept of brain death (BD) among health care personnel is fundamental. OBJECTIVE: To analyze the level of understanding of the BD concept among personnel in Spanish and Latin American healthcare centers and to determine the factors affecting this attitude. MATERIAL AND METHODS: Data from 12 hospitals and 32 primary care centers in 4 countries within the International Collaborative Donor Project were selected (Spain, Mexico, Cuba and Costa Rica (n=4378)). RESULTS: 62% of the personnel (n=2714) understood BD and believed that this was the death of an individual. Of the rest, 30% (n=1333) did not understand it and the remaining 8% (n=331) believed it did not mean the death of a patient. 83% (n=931) of physicians understood BD, compared to 75% (n=895) of nurses, 55% (n=299) of healthcare assistants, 53% (n=108) of non-healthcare university-educated personnel and 36% (n=481) of those without a university education (p<0.001). 68% (n=1084) of Mexicans understood BD compared to 66% (n=134) of Cubans, 58% (n=1411) of Spaniards, and 52% (n=85) (p<0.001) of Costa Ricans. There were significant relationships between knowledge of the concept and the following: type of healthcare center (p<0.001), clinical service (p<0.001), having spoken about organ donation within the family (p<0.001) and one's partner's attitude to the subject (p<0.001). A direct relationship has been found between understanding the concept and attitude toward deceased donation (p<0.001). CONCLUSIONS: The understanding of BD by personnel from healthcare centers was not as good as expected. There were marked differences depending on job category.

A multicenter study in Spanish, Mexican, and Cuban hospitals of attitude toward living kidney donation.

BACKGROUND: Living kidney donation (LKD) is a treatment with good results, although it is not very widely used in Spanish-speaking countries. OBJECTIVE: To analyze the attitude toward LKD among hospital personnel in healthcare centers in Spain and Latin America. MATERIAL/METHODS: Ten hospitals within the "International Collaborative Donor Project" were selected, from Spain, Mexico, and Cuba. A random sample was taken, which was stratified according to type of service and job category. RESULTS: Of the 2618 workers surveyed, 90% were in favor of related LKD, 6% were against it, and the remaining 4% were undecided. If the LKD was not related, then 32% were in favor. Other factors associated with a favorable attitude toward related LKD were: Working in Latin American hospitals (p<0.001); Working in clinical services (p=0.030); Having job stability (p=0.013); Having had personal experience of donation and transplantation (p=0.002); Being in favor of deceased donation (p<0.001); Considering the possibility of needing a transplant (p<0.001); Being in favor of living liver donation (p<0.001); Accepting a kidney from a living donor (p<0.001); Having spoken about donation and transplantation within family and partner (p<0.001); Having carried out pro-social activities (p<0.001); and Having no concern about the possible mutilation of the body after donation (p<0.001). CONCLUSIONS: Hospital personnel had a favorable attitude toward LKD donation, both in Spain and Latin America. This attitude was related with factors of knowledge about and general attitude toward organ donation and transplantation, family factors, religious factors, and fear about mutilation remaining after the donation.

The attitude toward living kidney donation among personnel from units related to donation and transplantation in Spain, Mexico and Cuba.

BACKGROUND: Living kidney donation (LKD) is becoming increasingly necessary as a treatment option for reducing the deficit in transplant organs. Hospital personnel in services related to donation and transplantation play a key role in promoting this kind of donation. OBJECTIVE: To analyze the attitude toward LKD among hospital workers in services related to donation and transplantation in Spain and Latin America. METHODS: Eight hospitals in the "International Collaborative Donor Project" were selected (Spain-Mexico-Cuba). A random sample was taken which was stratified according to the type of service and job category, in transplant-related services. RESULTS: Of the 878 respondents, 90% were in favor of related LKD, and 28% were in favor if the LKD was not related. Attitude was more favorable among Latin Americans workers compared to the Spanish (p=0.014). Other factors associated to attitude included: age (p=0.004); an attitude in favor of deceased donation and living liver donation (p<0.001); and acceptance of a kidney from a donor (p<0.001). CONCLUSIONS: The attitude toward related LKD was very favorable among hospital personnel in units related to the donation and transplantation process in Spain and Latin America, which means that they could contribute to its promotion particularly at the current time when living kidney donation needs to be expanded.

Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers.

INTRODUCTION: Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation. OBJECTIVE: To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude. MATERIAL AND METHOD: Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered. STATISTICAL ANALYSIS: Student's t-test, the χ2 test and logistic regression analysis. RESULTS: Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001). CONCLUSIONS: Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors.

Actitud de los profesionales hospitalarios no sanitarios españoles y latinoamericanos hacia la donación de hígado de vivo / Attitudes among Spanish and Latin American non-medical health professionals to living donor liver transplantation

Introducción: Los profesionales hospitalarios son un grupo de opinión influyente sobre la población. Objetivo El objetivo de este trabajo ha sido analizar la actitud hacia la donación hepática de vivo (DVH) de los profesionales no sanitarios de hospitales españoles y latinoamericanos, y determinar las variables que influyen en dicha actitud. Material y método Del «Proyecto Colaborativo Internacional Donante» se selecciona una muestra aleatoria y estratificada por servicio entre el personal no sanitario: 3 en España, 5 en México y 2 en Cuba. La actitud se valoró mediante encuesta validada, anónima y autoadministrada. Resultados Se encuestan 951 profesionales no sanitarios, 277 de España, 632 de México y 42 de Cuba. El 86% (n = 818) está a favor de la DVH si fuera relacionada y el 31% (n = 299) si no es relacionada. Se asocia a dicha actitud: país (México 88%, Cuba 83%, España 81%) (p = 0,016), ser mujer (p = 0,026), tener experiencia con la donación y el trasplante (p = 0,001), tener una actitud a favor hacia la donación (p < 0,001), considerar la posibilidad de necesitar un trasplante (p < 0,001), estar a favor de la donación de vivo renal (p < 0,001), aceptar un hígado de DVH si fuera necesario (p < 0,001), comentar con la familia y la pareja sobre donación y trasplante (p < 0,001), realizar actividades prosociales (p < 0,001), considerar que su religión está a favor de donación y trasplante (p < 0,001), no preocuparse por la mutilación del cuerpo tras la donación (p < 0,001).Conclusiones La actitud hacia la DVH relacionada entre el personal no sanitario de varios hospitales españoles, mexicanos y cubanos es favorable. En el 86% de los encuestados dicha actitud no está condicionada por los factores psicosociales clásicos (AU)

Introduction: Hospital professionals are an opinion group that influences the general population. Objective: To analyze attitudes to living donor liver transplantation (LDLT) among non-medical professionals working in Spanish and Latin American hospitals and to determine the variables that influence these attitudes. Material and method: A random sample, stratified by department, was selected from nonmedical staff in the ‘‘International Donor Collaborative Project’’: there were three hospitals in Spain, five in Mexico and two in Cuba. Attitudes were evaluated through a validated, anonymous, self-administered questionnaire. Results: There were 951 non-medical professionals: 277 from Spain, 632 from Mexico and 42from Cuba. A total of 86% (n = 818) were in favor of related living donation and 31% (n = 299)were in favor of unrelated living donation. This attitude was associated with the following: country (Mexico 88%, Cuba 83%, Spain 81%) (p =0.016), female sex (p =0.026), having experience of donation and transplantation (p =0.001), having a favorable attitude to donation (P<0.001), considering the possibility of needing a transplant (P <0.001), being in favor of living kidney donation (P <0.001), being willing to accept a transplant from a living donor if necessary(P <0.001), discussing donation and transplantation with the family and partner (P <0.001),carrying out pro-social activities (P <0.001), believing that one’s religion was in favor of donation and transplantation (P<0.001), and not worrying about bodily mutilation after donation (P<0.001).Conclusions: Attitudes toward related LDLT among non-medical staff in various Spanish, Mexican and Cuban hospitals are favorable. In 86% of those surveyed, this attitude was not influenced by classical psychosocial factors (AU)

[Attitudes among Spanish and Latin American non-medical health professionals to living donor liver transplantation]. / Actitud de los profesionales hospitalarios no sanitarios españoles y latinoamericanos hacia la donación de hígado de vivo.

INTRODUCTION: Hospital professionals are an opinion group that influences the general population. OBJECTIVE: To analyze attitudes to living donor liver transplantation (LDLT) among non-medical professionals working in Spanish and Latin American hospitals and to determine the variables that influence these attitudes. MATERIAL AND METHOD: A random sample, stratified by department, was selected from non-medical staff in the "International Donor Collaborative Project": there were three hospitals in Spain, five in Mexico and two in Cuba. Attitudes were evaluated through a validated, anonymous, self-administered questionnaire. RESULTS: There were 951 non-medical professionals: 277 from Spain, 632 from Mexico and 42 from Cuba. A total of 86% (n = 818) were in favor of related living donation and 31% (n = 299) were in favor of unrelated living donation. This attitude was associated with the following: country (Mexico 88%, Cuba 83%, Spain 81%) (p =0.016), female sex (p =0.026), having experience of donation and transplantation (p =0.001), having a favorable attitude to donation (P <0.001), considering the possibility of needing a transplant (P <0.001), being in favor of living kidney donation (P <0.001), being willing to accept a transplant from a living donor if necessary (P <0.001), discussing donation and transplantation with the family and partner (P <0.001), carrying out pro-social activities (P <0.001), believing that one's religion was in favor of donation and transplantation (P<0.001), and not worrying about bodily mutilation after donation (P <0.001). CONCLUSIONS: Attitudes toward related LDLT among non-medical staff in various Spanish, Mexican and Cuban hospitals are favorable. In 86% of those surveyed, this attitude was not influenced by classical psychosocial factors.

Level of awareness of personnel in hospital services related to the donation process: A Spanish and Latin American multicenter study.

BACKGROUND: Services related to the donation and transplantation process are fundamental for developing solid organ transplantation and procuring organs from deceased donors. This study was conducted to analyze the attitude toward deceased organ donation among hospital personnel working in donation- and transplantation-related services in hospitals in Spain and Latin America. METHODS: Nine hospital centers within the "International Donor Collaborative Project" were selected (Spain, Mexico, Cuba, and Costa Rica). A random employee sample was taken and stratified according to the type of service and job category in transplant-related hospital services. RESULTS: Of the 925 employees surveyed, 78% were in favor of donation. By job category, attitude was more favorable among physicians (89%; p < 0.001). By type of service, attitude was more positive among personnel in transplant patient follow-up units (87%; p = 0.018). By country, the Cubans were most in favor (91%), followed by the Mexicans (81%), the Costa Ricans (77%), and the Spanish (70%; p < 0.001). Other factors were age (p < 0.001), sex (p = 0.005), considering the possibility of needing a transplant (p = 0.002), understanding the concept of brain death (p < 0.001), being in favor of living donation (p < 0.001), having discussed the subject of donation and transplantation within the family and the partner (p < 0.001), carrying out pro-social activities (p = 0.002), and concern about mutilation after donation (p = 0.002). CONCLUSIONS: Transplant-related personnel had a favorable attitude toward deceased donation, although it was not as positive as we would expect, especially among non-physicians. This attitude needs to be improved because of the negative effect that can result in organ donation. There were pronounced differences between countries, and the discordance between attitude and actual deceased donation rates in each country is notable.