Sex-related differences in the associations between diurnal cortisol pattern and social and emotional loneliness in older adults.

Introduction: Loneliness is a distressful feeling that can affect mental and physical health, particularly among older adults. Cortisol, the primary hormone of the Hypothalamic-Pituitary-Adrenal axis (HPA-axis), may act as a biological transducer through which loneliness affects health. While most previous studies have evaluated the association between loneliness, as a unidimensional construct, and diurnal cortisol pattern, no research has examined this relationship discriminating between social and emotional loneliness in older adults. As sex differences in the negative mental health outcomes of loneliness have been reported, we also investigated whether diurnal cortisol indices and loneliness associations occur in a sex-specific manner. Methods: We analyzed the diurnal cortisol- pattern in 142 community-dwelling, non-depressed, Caucasian older adults (55,6% female) aged 60-90. Social and emotional (family and romantic) loneliness scores were assessed using the Spanish version of the Social and Emotional Loneliness Scale for Adults (SELSA). Five salivary cortisol samples were used to capture key features of the diurnal cortisol pattern, including: awakening and bedtime cortisol levels, awakening response (CAR), post-awakening cortisol output (post-awakening cortisol [i.e., the area under the curve with reference to the ground: AUCG]), total diurnal cortisol release (AUCG), and diurnal cortisol slope (DCS). Results: After controlling for sociodemographic variables, the hierarchical linear multiple regression analyses revealed that in male older adults, higher scores on social and family loneliness were associated with elevated awakening cortisol levels, total diurnal cortisol output, and a steeper diurnal cortisol slope (DCS). However, these associations were not observed in female older adults. In addition, feelings of romantic loneliness were positively associated with bedtime cortisol levels and AUCG in older males. Multilevel growth curve modeling showed that experiencing more social and emotional loneliness predicted higher diurnal cortisol output throughout the day in older male adults. Discussion: The presence of sex differences in the relationship between cortisol indices and loneliness among older adults holds particular significance for diagnostic and screening procedures. Combining loneliness scales as screening tools with diurnal cortisol measures has the potential to be an effective and cost-efficient approach in identifying higher-risk individuals at early stages.

Bioseguridad en ambientes quirúrgicos durante la COVID-19

Introducción: La COVID-19 significó un gran reto para los servicios de cirugía a nivel mundial, lo que trajo como consecuencia modificaciones, incluso la suspensión de la actividad quirúrgica en algunos casos con el objetivo de garantizar seguridad tanto para el paciente como para el personal de salud. Objetivo: Describir acciones que contribuyan a garantizar condiciones de bioseguridad en ambientes quirúrgicos durante la pandemia de COVID-19. Métodos: Se realizó una revisión bibliográfica para la cual se usaron 37 referencias bibliográficas en inglés y español. Se consultaron fuentes científicas como PubMed/Medline, SciELO, Scopus, ScienceDirect y fuentes oficiales como la Organización Mundial de la Salud. Desarrollo: Ante la reanudación de la cirugía electiva se crearon protocolos de actuación. Deben clasificarse los pacientes en 3 grupos según la posibilidad de padecer COVID-19: individuos sanos, portadores asintomáticos y pacientes con síntomas. Además, debe darse prioridad a los pacientes cuyos procedimientos fueron cancelados. Se preconiza crear circuitos independientes y separados para evitar el contacto de casos sospechosos o confirmados de COVID-19 con el resto de pacientes. Para garantizar mayor seguridad debe entrenarse al personal médico en la forma correcta de utilizar los medios de protección personal. La inducción anestésica de estos pacientes debe garantizar su seguridad y prevenir el contagio. Una vez concluida la cirugía, se llevará a cabo la recuperación inicial del paciente dentro del propio quirófano y este será higienizado estrictamente. Conclusiones: Los profesionales sanitarios deben estar adecuadamente entrenados y conocer las medidas de bioseguridad y protocolos sanitarios tanto del hospital como del país en que se encuentren.

Introduction: COVID-19 posed a great challenge to surgical services worldwide, resulting in modifications, including the suspension of surgical activity in some cases with the aim of ensuring safety for both the patient and the health personnel. Objective: To describe actions that contribute to guarantee biosafety conditions in surgical environments during the COVID-19 pandemic. Methods: A bibliographic review was carried out using 37 bibliographic references in English and Spanish. Scientific sources, such as PubMed/Medline, SciELO, Scopus and ScienceDirect, were consulted; as well as official sources, such as the World Health Organization. Development: When elective surgery was resumed, action protocols were created. Patients should be classified into 3 groups, according to the possibility of having COVID-19: healthy individuals, asymptomatic carriers, and patients with symptoms. In addition, priority should be given to patients whose procedures have been cancelled. Independent and isolated wards are recommended to be created in order to avoid contact between suspected or confirmed COVID-19 cases and the rest of the patients. To ensure greater safety, the medical personnel should be trained in the correct use of personal protective equipment. The anesthetic induction of these patients should ensure their safety and prevent contagion. Once the surgery is over, the initial recovery of the patient will be carried out inside the operating room itself, which shall be strictly sanitized. Conclusions: Healthcare professionals must be adequately trained and be aware of the biosecurity measures and healthcare protocols of both the hospital and the country where they are located.

Normative Data for Verbal Fluency, Trail Making, and Rey-Osterrieth Complex Figure Tests on Monolingual Spanish-Speaking Older Adults.

OBJECTIVE: This study aimed to generate updated normative data for commonly used tests in neuropsychological assessment applied to older monolingual Spanish-speaking adults: Verbal fluency tests, the Trail Making Test (TMT), and the Rey-Osterrieth complex figure test (ROCF). METHOD: To obtain normative data, 382 cognitively healthy 60- to 90-year-old Spanish monolingual participants from the Autonomous Community of Madrid (Spain) with 0-22 years education were assessed using an overlapping interval strategy that involved cell and midpoint techniques, and that assessed the influence of age, education, and sex. RESULTS: Age and education were associated with the scores in the verbal fluency tests, TMT, and ROCF, whereas sex only significantly affected the TMT results. Age-adjusted scaled scores (SSA) based on percentile ranks were also converted into age-education scaled scores (SSAE) using a linear regression model. In addition, tables with the relevant adjustments for sex are provided for TMT-A and TMT-B. CONCLUSIONS: Thus, this study provides updated, uniform normative data for widely used neuropsychological tests on older Spanish adults. The normative procedure followed helps to make consistent comparisons when using these neuropsychological tests, which will improve the interpretation of the data obtained when these tools are employed, reducing the risk of misdiagnosing cognitive impairment in older adults.

Normative data for the Spanish version of the California Verbal Learning Test (TAVEC) from older adults.

The aim of this study was to establish normative data for the Spanish version of the California Verbal Learning Test, the Test de Aprendizaje Verbal España-Complutense (TAVEC). Through different subtests, the TAVEC allows verbal learning and episodic memory to be evaluated, an assessment that was carried out on a sample of 382 cognitive healthy Spanish individuals aged 60-90 years old. Unlike the participant's educational level, their age and sex significantly influenced performance in the TAVEC. We provide tables that allow the scaled scores obtained with this test to be adjusted for age and other tables with the relevant adjustments for sex. The normative data obtained in this study will help more precisely interpret the performance of older Spanish adults in the TAVEC, enhancing the utility of this neuropsychological test to evaluate verbal learning and episodic memory in clinical settings and in relation to healthy aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparación de resultados de la Cirugía Torácica Convencional y la Uniportal en el Instituto Nacional de Oncología y Radiobiología / Comparison of results of Conventional and Uniportal Video-Assisted Thoracic Surgery in the National Institute of Oncology and Radiobiology

Introducción: La cirugía torácica videoasistida por un solo puerto (Uniportal VATS) se ha convertido hoy en uno de los abordajes más utilizados para resecciones pulmonares en muchos centros de cirugía torácica del mundo, en Cuba su introducción es bastante reciente y todavía se encuentra en fase inicial. Objetivo: Comparar los resultados obtenidos por cirugía torácica abierta y Uniportal VATS en pacientes intervenidos en el Instituto Nacional de Oncología y Radiobiología de La Habana (INOR) durante enero de 2016 a abril de 2017. Material y Métodos: Estudio observacional descriptivo de corte longitudinal retrospectivo con 60 pacientes atendidos en el INOR durante enero de 2016 a abril de 2017 a los cuales se les realizó cirugía torácica. Resultados: Veinticuatro pacientes fueron operados por Uniportal VATS y 36 a través de la toracotomía, primaron las lesiones del lado derecho, el procedimiento más realizado fue lobectomía. Los estadíos predominantes fueron IA y IB, la mayoría de los procedimientos fue realizada en tres horas o menos, 8 casos se convirtieron, 13 sufrieron complicaciones. La estadía media de los pacientes tratados con Uniportal VATS fue menor que los que recibieron la toracotomía abierta. Conclusiones: El abordaje Uniportal se caracterizó por ser seguro, tener una gran versatilidad, pocas complicaciones y por mejorar la recuperación postquirúrgica del paciente y acelerar su reincorporación a las actividades de la vida cotidiana(AU)

Introduction: Single-port Video Assisted Thoracic Surgery (Uniportal VATS) has currently become one of the most commonly used approaches for lung resections in many Thoracic Surgery Centers around the world. In Cuba, its introduction is quite recent and it is still in its initial phase. Objective: To compare the results obtained by open thoracic surgery and Uniportal VATS in patients who underwent surgery in the National Institute of Oncology and Radiobiology of Havana (INOR) from January 2016 to April 2017. Material and Methods: An observational descriptive longitudinal retrospective study was conducted in 60 patients who underwent Thoracic Surgery in the INOR during 2016 - April 2017. Results: A total of 24 patients were operated through Uniportal VATS and 36 underwent thoracotomy. The lesions predominantly affected the right side and lobectomy was the most performed surgical procedure. Stages IA and IB predominated. Most of the procedures were carried out in 3 hours or less, 8 cases were converted and 13 suffered from complications. The average postoperative length of stay in hospital for patients who underwent Uniportal VATS was reduced compared to those who underwent open thoracotomy. Conclusions: Uniportal VATS is characterized by being a safe procedure with few complications and great versatility. It improves postoperative recovery of patients and accelerates their return to daily life activities(AU)

Características y tratamiento del paciente oncológico en el marco de la actual pandemia de la COVID-19 / Characteristics and treatment of the oncologic patient in the midst of the current COVID-19 pandemic

Introducción: El cáncer constituye una de las principales causas de morbimortalidad en todo el mundo. Múltiples reportes indican lo peligroso que puede llegar a ser la COVID-19 en pacientes oncológicos. Objetivo: Caracterizar al paciente oncológico y su tratamiento en el marco de la actual pandemia de COVID-19. Material y Métodos: Se realizó una revisión bibliográfica para la cual se usaron 37 referencias bibliográficas en inglés y español para la cual se utilizó Pubmed/Medline, ScIELO, Scopus, ScienceDirect, así como fuentes oficiales como OMS y CDC. Desarrollo: Los pacientes oncológicos presentan un sistema inmune comprometido. La polipnea se presentó más en pacientes con cáncer con diagnostico de la COVID-19 que en aquellos sin antecedentes oncológicos. No se hallaron diferencias en relación con otros síntomas; sin embargo se detectaron lesiones de mayor severidad en la Tomografía Axial Computarizada. En estos pacientes deben reforzarse medidas preventivas y se plantea la posibilidad de retrasar los tratamientos quimioterapéutico y quirúrgico mientras sea posible, aunque debe tenerse en cuenta el riesgo que esto constituye. Todos los pacientes con cáncer deben clasificarse como de alto riesgo y los que contraigan el SARS-CoV-2, recibirán el mismo tratamiento que los pacientes no oncológicos. Conclusiones: Los pacientes oncológicos tienen un mayor riesgo que la población general de padecer formas graves de la COVID-19; de ahí que sea importante adoptar medidas preventivas adecuadas que no se opongan a la aplicación de un tratamiento oncológicamente adecuado; por tanto se hace necesario adaptar los esquemas previamente establecidos a la situación que vive el mundo actualmente(AU)

Introduction: Cancer is one of the main causes of morbidity and mortality around the world. Numerous reports indicate how dangerous COVID-19 can be for oncologic patients. Objective: To characterize the oncologic patient and the treatment to follow in the midst of the COVID-19 pandemic. Material and Methods: A bibliographic review, which included 37 bibliographic references in Spanish and English languages, was carried out. Pubmed/Medline, SciELO, Scopus, and ScienceDirect databases as well as other official sources such as WHO and CDC were used for the search. Development: Oncologic patients have a compromised immune system. Polypnea was more common in oncologic patients with COVID-19 than in patients without cancer. There were no differences in relation to other symptoms; however, more severe lesions were found in CT-Scans. In oncologic patients, preventive measures must be reinforced and both chemotherapeutic and surgical treatment should be delayed as long as possible; however, the risk must be considered. All patients with cancer must be classified as high risk patients and those infected with SARS-CoV-2 will receive the same treatment than non-oncologic patients. Conclusions: Oncologic patients have a higher risk of suffering from severe forms of COVID-19 than the general population; therefore, it is very important to take preventive measures that are not opposed to the administration of an adequate oncological treatment. Because of that, it is necessary to adapt the previously established protocols to the current situation the world is living(AU)

Penn State Worry Questionnaire-11 validity in Colombia and factorial equivalence across gender and nonclinical and clinical samples / Validez del Penn State Worry Questionnaire-11 en Colombia y equivalencia factorial a través de género y muestras clínicas y no clínicas

The Penn State Worry Questionnaire (PSWQ) is the gold standard measure of the unspecific worry that characterizes generalized anxiety disorder. This study aims to explore the validity of the PSWQ in Colombia and its measurement invariance across gender and clinical and nonclinical participants. An abbreviated, 11-item version of the PSWQ by Sandín, Chorot, Valiente, and Lostao (2009) was used because the negatively worded items have shown to be problematic for Spanish speakers. Additionally, research has suggested that the negatively worded items of the PSWQ lack of practical utility. The PSWQ-11 was administered to a total of 1045 participants, including a sample of nonclinical participants (N = 710) and a sample of clinical participants (N = 335). The internal consistency of the PSWQ-11 across samples was excellent. The one-factor model showed an acceptable fit to the data. Metric and scalar invariance were observed across gender and clinical and nonclinical samples. In conclusion, the PSWQ-11 seems to be a valid measure of GAD-related worry in Colombia, whereas data on factorial equivalence data warrant the comparison of scores across gender and clinical and nonclinical samples

El Penn State Worry Questionnaire (PSWQ) es la medida principal de la preocupación inespecífica que caracteriza al trastorno de ansiedad generalizada (TAG). Este estudio explora la validez del PSWQ en Colombia y su invarianza de medida entre género y participantes clínicos y no clínicos. Se utilizó la versión abreviada de 11 ítems de PSWQ propuesta por Sandín, Chorot, Valiente y Lostao (2009) porque los ítems redactados negativamente han mostrado ser problemáticos para los hispanohablantes. Adicionalmente, la investigación ha sugerido que los ítems redactados en negativa carecen de utilidad práctica. El PSWQ-11 se administró a un total de 1045 participantes, incluyendo una muestra de participantes no clínicos (N = 710) y una muestra de participantes clínicos (N = 335). La consistencia interna del PSWQ-11 a través de muestras fue excelente. El modelo de un factor mostró un ajuste aceptable a los datos. Se observó invarianza métrica y escalar a través de género y muestras clínicas y no clínicas. En conclusión, el PSWQ-11 parece ser una medida válida de la preocupación tipo TAG, mientras que los datos sobre equivalencia factorial permiten la comparación de puntuaciones a través de género y participantes clínicos y no clínicos

Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery / Sutura transeptal - uma alternativa custo-benefício para tamponamento nasal em cirurgia do septo

ABSTRACT INTRODUCTION: Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. OBJECTIVE: To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. METHODS: This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. RESULTS: In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. CONCLUSIONS: Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs.

Resumo Introdução: O tamponamento nasal é usado rotineiramente na cirurgia septal para evitar sangramentos no pós-operatório. Objetivo: Demonstrar a possibilidade de se realizar uma sutura transeptal como alternativa eficaz e segura ao tamponamento nasal, com melhora na eficiência da intervenção. Método: Este é um estudo prospectivo, descritivo e de custo inferencial, compreendendo 92 pacientes. Dois grupos aleatórios foram estudados: um com tamponamento nasal e o outro com sutura transeptal. Resultado: No grupo de sutura transeptal, nenhum paciente experimentou sangramento no pós-operatório, tendo sido estatisticamente demonstrada uma significante redução de cefaléia e dor. Ao mesmo tempo, houve melhora na eficiência da intervenção, com economia no custo de material. Conclusões: A sutura transeptal é uma alternativa eficaz e segura ao tamponamento nasal clássico. Além do mais, melhora a eficiência da intervenção, economizando no custo de material.

Factor structure and psychometric properties of the Dysfunctional Attitude Scale Revised in Colombian undergraduates / Estructura factorial y propiedades psicométricas de la Escala de Actitudes Disfuncionales Revisada en universitarios colombianos

The Dysfunctional Attitude Scale (DAS) is a classic, 40-item measure of dysfunctional schema - a key construct of the cognitive model of depression. However, some controversy exists regarding the factorial structure of the DAS. Accordingly, a revised version of the DAS (hereafter, the DAS-R) has been recently proposed using confirmatory factor analysis and consisting of 17 items. The DAS-R contains two correlated factors: Perfectionism/Performance evaluation and Dependency. In a previous study with a Spanish sample, a hierarchical factor model with these two first-order factors and a general factor showed the best fit of the data. This study analyses the factorial structure and psychometric properties of the DAS-R in a sample of 762 Colombian undergraduates. The results were very similar to the ones obtained in the Spanish sample. The hierarchical factor structure showed the best fit of the data, and the DAS-R showed good internal consistency and discriminant and convergent validity. In conclusion, the DAS-R seems a good option to measure dysfunctional schema in Colombia. Furthermore, the replication of the hierarchical factor structure indicates that the DAS-R provides general and specific measures of dysfunctional schema that are theoretically meaningful.

La Escala de Actitudes Disfuncionales (DAS) es una medida clásica de 40 items de los esquemas disfuncionales, un constructo central en el modelo cognitivo de la depresión. Sinembargo, existe alguna controversia en torno a su estructura factorial. Recientemente se ha Análisis factorial propuesto una versión revisada del DAS (de aquí en adelante DAS-R), consistente en 17 items, usando un análisis factorial confirmatorio. El DAS-R contiene 2 factores correlacionados: perfeccionismo/evaluación del rendimiento y dependencia. En un estudio previo con una muestra española, una estructura jerárquica con estos 2 factores de primer orden y un factor general mostró el mejor ajuste a los datos. Este estudio analiza la estructura factorial y las propiedades psicométricas del DAS-R en una muestra de 762 estudiantes universitarios colombianos. Los resultados fueron muy similares a los obtenidos en la muestra española. La estructura factorial jerárquica mostró el mejor ajuste a los datos y el DAS-R mostró buena consistencia interna y validez discriminante y convergente. En conclusión, el DAS-R parece una buena opción para medir los esquemas disfuncionales en Colombia. Además, la replicación de la estructura factorial jerárquica indica que el DAS-R provee medidas generales y específicas de los esquemas disfuncionales que son teóricamente significativas.

Psychometric properties of the Mindful Attention Awareness Scale in Colombian undergraduates / Propiedades psicométricas de la Mindful Attention Awareness Scale en universitarios colombianos

The Mindfulness Attention Awareness Scale is one of the most popular instruments to measure mindfulness, and this construct is conceived as unidimensional, emphasizing attention/awareness as its essential aspect. This study aimed to analyze the factor structure and psychometric properties of the Spanish version of the MAAS in a Colombian sample of 762 undergraduates. Data were very similar to those obtained in other validation studies of the MAAS. A confirmatory factor analysis found that the expected one-factor structure showed a good fit to the data. The MAAS had excellent internal consistency, and showed theoretically coherent correlations with emotional symptoms, automatic negative thoughts, psychological inflexibility, and life satisfaction. Participants who could have a psychopathological problem because they exceeded the cut-off of the General Health Questionnaire, 12 scored lower on the MAAS than participants who scored below this cut-off. In conclusion, the MAAS seems to be a reliable and valid measure of mindfulness in Colombian undergraduates.

La Mindfulness Attention Awareness Scale es uno de los instrumentos más populares para medir mindfulness, concibe este constructo como unidimensional y subraya el aspecto esencial de la atención/conciencia. Este estudio pretende analizar la estructura factorial y las propiedades psicométricas de la versión en español de la MAAS en una muestra de 762 universitarios colombianos. Los resultados fueron muy similares a los obtenidos en otros estudios de validación. El análisis factorial confirmatorio encontró que la estructura unifactorial esperada mostró un buen ajuste a los datos. La MAAS tuvo una consistencia interna excelente y mostró correlaciones teóricamente coherentes con síntomas emocionales, pensamientos automáticos negativos, inflexibilidad psicológica y satisfacción vital. Los participantes que podían tener algún problema psicopatológico por exceder el punto de corte del General Health Questionnaire - 12, puntuaron más bajo en la MAAS que los participantes que puntuaron por debajo de este punto de corte. En conclusión, la MAAS parece ser una medida fiable y válida de mindfulness en universitarios colombianos.

Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery.

INTRODUCTION: Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. OBJECTIVE: To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. METHODS: This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. RESULTS: In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. CONCLUSIONS: Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs.

Craniofacial pain and disability inventory (CF-PDI): development and psychometric validation of a new questionnaire.

BACKGROUND: Orofacial pain, headaches, and neck pain are very common pain conditions in the general population and might be associated in their pathophysiology, although this is not yet clarified. The development and validation of a prediction inventory is important to minimize risks. Most recent questionnaires have not focused on pain, but pain is the common symptom in temporomandibular disorders, headaches, and neck pain. It is necessary to provide tools for these conditions. OBJECTIVES: The purpose of this study is to present the development and analysis of the factorial structure and psychometric properties of a new self-administered questionnaire (Craniofacial Pain and Disability Inventory [CF-PDI]) designed to measure pain, disability, and functional status of the mandibular and craniofacial regions. STUDY DESIGN: Multicenter, prospective, cross-sectional, descriptive survey design. A secondary analysis of the reliability of the measures was a longitudinal, observational study. SETTING: A convenience sample was recruited from a hospital and 2 specialty clinics in Madrid, Spain. METHODS: The study sample consisted of 192 heterogeneous chronic craniofacial pain patients. A sub-sample of 106 patients was asked to answer the questionnaire a second time, to assess the test-retest reliability. The development and validation of the CF-PDI were conducted using the standard methodology, which included item development, cognitive debriefing, and psychometric validation. The questionnaire was assessed for the following psychometric properties: internal consistency (Cronbach's α); floor and ceiling effects; test-retest reliability (Intraclass Correlation Coefficient [ICC]; Bland and Altman method); construct validity (exploratory factor analysis); responsiveness (standard error of measurement [SEM] and minimal detectable change [MDC]); and convergent validity (Pearson correlation coefficient), by comparing visual analog scale (VAS), the Tampa Scale for Kinesiophobia (TSK-11), the Pain Catastrophizing Scale (PCS), the Neck Disability Index (NDI), and the Headache Impact Test-6 (HIT-6). Multiple linear regression analysis was used to estimate the strength of the associations with theoretically similar constructs. RESULTS: The final version of the CF-PDI consists of 21 items. Exploratory factor analysis revealed 2 factors ("pain and disability" and "jaw functional status"), both with an eigenvalue greater than one, explaining 44.77% of the variance. Floor or ceiling effects were not observed. High internal consistency of the CF-PDI (Cronbach's α: 0.88) and also of the 2 subscales (Cronbach's α: 0.80 - 0.86) was confirmed. ICC was found to be 0.90 (95% confidence interval [CI] 0.86 - 0.93), which was considered to be excellent test-retest reliability. The SEM and MDC were 2.4 and 7 points, respectively. The total CF-PDI score showed a moderate correlation with most of the assessed questionnaires (r = 0.36 - 0.52) and a strong correlation with the NDI (r = 0.65; P < 0.001). The NDI, VAS, and TSK-11 were predictors of CF-PDI. LIMITATIONS: Only self-reported measures were considered for convergent validity. Future research should use physical tests to explore the clinical signs relating to pain and disability. CONCLUSION: The CF-PDI showed good psychometric properties. Based on the findings of this study, the CF-PDI can be used in research and clinical practice for the assessment of patients with craniofacial pain.

Cochlear implants in adults over 60: a study of communicative benefits and the impact on quality of life.

OBJECTIVES: Quantifying the improvement in quality of life (QoL) of cochlear implant (CI) patients over 60, its relation to audiometric benefits and the subjective impact on specific areas of life. METHODS: An observational retrospective study was conducted on 26 individuals (17 male and 9 female) older than 60, all implanted in our unit between 1 January 1999 and 31 January 2009. And 10 patients (5 male and 5 female) aged between 40 and 60 were the control group. A full postoperative audiological evaluation was completed. Sociodemographic characteristics and history of hearing loss were collected. To evaluate QoL benefits, the Glasgow Benefit Inventory test and the Specific Questionnaire were filled in. RESULTS: Patients in the test and control groups had similar preoperative speech recognition levels. Preoperative audiometric thresholds were significantly worse in patients from 40 to 60 years of age although they scored better in speech recognition after implantation. Patients experienced significant improvement in their QoL in all areas, especially in general health, while they experienced a smaller improvement in social interaction. Age, duration of deafness, and years wearing the processor were statistically related to QoL regardless of audiometric benefit. Unilateral CI users and patients without tinnitus obtain better QoL although no statistical relation was found. CONCLUSIONS: Cochlear implantation improves QoL of patients over 60 by the mere fact of having been implanted, regardless of poorer audiological benefits. Older patients, with long-term deafness experience a greater improvement in QoL after implantation. The results of this study should aid other centers when counseling patients on the expected, daily functional benefits of cochlear implantation.

Use of telemedicine in the remote programming of cochlear implants.

CONCLUSION: Remote cochlear implant (CI) programming is a viable, safe, user-friendly and cost-effective procedure, equivalent to standard programming in terms of efficacy and user's perception, which can complement the standard procedures. The potential benefits of this technique are outlined. OBJECTIVES: We assessed the technical viability, risks and difficulties of remote CI programming; and evaluated the benefits for the user comparing the standard on-site CI programming versus the remote CI programming. SUBJECTS AND METHODS: The Remote Programming System (RPS) basically consists of completing the habitual programming protocol in a regular CI centre, assisted by local staff, although guided by a remote expert, who programs the CI device using a remote programming station that takes control of the local station through the Internet. A randomized prospective study has been designed with the appropriate controls comparing RPS to the standard on-site CI programming. Study subjects were implanted adults with a HiRes 90K(R) CI with post-lingual onset of profound deafness and 4-12 weeks of device use. Subjects underwent two daily CI programming sessions either remote or standard, on 4 programming days separated by 3 month intervals. A total of 12 remote and 12 standard sessions were completed. To compare both CI programming modes we analysed: program parameters, subjects' auditory progress, subjects' perceptions of the CI programming sessions, and technical aspects, risks and difficulties of remote CI programming. RESULTS: Control of the local station from the remote station was carried out successfully and remote programming sessions were achieved completely and without incidents. Remote and standard program parameters were compared and no significant differences were found between the groups. The performance evaluated in subjects who had been using either standard or remote programs for 3 months showed no significant difference. Subjects were satisfied with both the remote and standard sessions. Safety was proven by checking emergency stops in different conditions. A very small delay was noticed that did not affect the ease of the fitting. The oral and video communication between the local and the remote equipment was established without difficulties and was of high quality.

Relaciones empíricas entre los estadísticos de la teoría clásica de los tests y los de la teoría de respuesta a los ítems / Empirical relationhips between classical test theory and item response theory statistics

En este trabajo se analiza empíricamente las relaciones entre las estimaciones de los parámetros de los ítems de la Teoría de la Respuesta al Ítem (TRI) y de la Teoría Clásica de los TEST (TCT). Asimismo, se analiza el grado de invarianza que presentan los parámetros de ambos marcos teóricos. Para ello se llevó a cabo un estudio de simulación Monte Carlo en el que se generaron las muestras a partir del modelo logístico de tres parámetros. A partir de estas muestras se formaron tres submuestras en función de nivel de aptitud: baja, media y alta aptitud, respectivamente. A continuación se estimaron los parámetros de los ítems en cada submuestra y en la muestra total con los modelos de uno, dos y tres parámetros de la TRI, así como con el modelo de la TCT. Los resultados mostraron, en general, correlaciones muy altas entre las estimaciones de la TRI y de la TCT en el parámetro de habilidad de los sujetos y la dificultad de los ítems, especialmente en los grupos aptitud media. Correlaciones más bajas se encontraron entre las estimaciones de la discriminación de los ítems en todos los grupos. Por último, en relación al segundo objetivo de este trabajo, los resultados no son todo lo buenos que cabría esperar salvo en lo referente al índice de dificultad (AU)

The purpose of this paper was examine empirically: (1) the relationships between the item and person statistics from Item Response Theory (IRT) and Classical Test Theory (CTT) and, (2) the invariance of parameters in both measurement frameworks. In order to achieve these objectives, a simulation study was carry out where 30 samples with 500 subjects and 50 items were generated from the 3-PL model; 10 of these samples with low level of ability, 10 with medium and 10 with high level of ability. The items were calibrated by the 1-, 2-, and 3-PL models. Likewise, the person and item statistics in CTT was calculated in each sample. The findings indicate that the relationships between the statistics from both, IRT and CTT, were very strongs, with very high correlation indices, except in the discrimination parameters. The degree of invariance of parameters across the samples wasn’t very high in both measurement frameworks (AU)