Sleep quality and sleep deprivation: relationship with academic performance in university students during examination period.

The beginning of the university brings together maturational, psychosocial and academic changes that make university students more prone to suffer from insufficient or poor quality sleep, which can negatively influence their academic performance. The period of taking exams is a key part of the academic year. However, there are few studies that analyze sleep during this period of time. Our aim is to study the association of sleep quality and sleep deprivation with academic performance during the examination period. A descriptive, cross-sectional and correlational study was carried out with the participation of 640 subjects in the first three years of five faculties belonging to the Universidad Autónoma de Madrid. The instrument used consisted of a questionnaire that included sociodemographic and academic data, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and information about the academic performance. During the examination period, a positive association was found between sleep quality and academic performance. University students slept less than desired, both on weekdays and weekends, and the sleep debt during the week was associated with a worse students' perception of their academic performance. In total, 61.3% of the students believed that their performance would improve by getting more sleep. In addition, low drowsiness and napping were also found. In conclusion, during periods of greater academic demand, an insufficient sleep and poor quality is commonly observed, affecting negatively to their academic performance. Actually, about 2/3 of our subjects believed that their performance would improve by getting more sleep.

Predictive and criterion validity of the Cervantes-SF menopause quality of life questionnaire.

OBJECTIVES: To determine the predictive and criterion-based validity of the Cervantes-SF scale that measures the impact of menopause on Health-Related Quality of Life. METHODS: We recruited a noninstitutionalized sample of peri/postmenopausal women aged 40 to 65 years, who had their last menstrual cycle 12+ months prior to inclusion in the study of the psychometric validity of the Cervantes-SF scale. Predictive validity of the scale was confirmed for various health outcome measures administered concomitantly (years of disability-free life expectancy, work productivity and impact on daily activities, economic impact arising from loss of work productivity, hours of undisturbed sleep each day, and the utilization of healthcare facilities), whilst criterion validity was determined by the likelihood of identifying a moderate-to-severe vasomotor or genital syndrome requiring specific treatment. RESULTS: A sample of 308 peri/postmenopausal women with a mean age of 55.7 years (SD: 5.3 y) was analyzed in this study. A score >25 points on the dimension of vasomotor problems (or menopausal health) showed values of sensitivity and specificity > 80% for identifying women with moderate-severe vasomotor syndrome requiring pharmacological treatment. Predictive validity was confirmed for menopause-related health outcomes. A change of 6.7 points in the scale score, equivalent to the value of its minimal difference, is indicative of a significant increase in the degree of disability regarding work/day-to-day activities, greater economic loss due to decreased work productivity, fewer years of life expectancy without disability, fewer hours of undisturbed sleep, and more visits to the physician per year due to menopausal symptoms. CONCLUSIONS: These results confirm the criterion and predictive validity of the Cervantes-SF scale in peri/postmenopausal women.

Population-based norms for the Cervantes-SF short-form questionnaire assessing health-related quality of life in menopause.

OBJECTIVES: To develop the population-based norms for the Cervantes-SF scale, which measures the impact of menopause on the health-related quality of life (HRQOL) of women in Spain. METHODS: We used a sample obtained from representative studies of the Spanish population according to geographic density and autonomous community. This sample was composed of 5,237 non- institutionalized peri- and post-menopausal women, aged 40-75 years. Measures of central tendency, dispersion and percentiles were calculated for the total score and its dimensions, in 11 three-year age categories. Construct validity was analyzed based on a comparison with known groups to confirm the validity of the normative scales. RESULTS: The norms show a monotonic gradient, with an incremental impact on HRQOL as age increases, as shown by an increase in the total score and each of the dimensions. Fifty percent of women showed that peri-/post-menopausal symptomatology interfered with HRQOL > 39 %, ranging from 25 % (40-44 years) to 47 % (72-75 years). The population norms showed significant differences between groups according to generic HRQOL, number of comorbidities, history of osteoporotic fracture, educational level, and presence of obesity. CONCLUSIONS: These results support the validity of the population-based norms for the Cervantes-SF scale, a valid instrument for measuring the impact of menopause on HRQOL in Spain. The norms obtained facilitate the interpretation of these scores in clinical practice, research, and health management.

Mapping of the Gastrointestinal Short Form Questionnaire (GSF-Q) into EQ-5D-3L and SF-6D in patients with gastroesophageal reflux disease.

BACKGROUND: The short, self-administered Gastroesophageal Reflux Disease (GERD) Symptom Frequency Questionnaire (GSFQ) is a specific Quality of Life (QoL) instrument which measures the impact of GERD symptoms on QoL. This study aims to map the specific scores in GSFQ into two generic instruments: SF-6D and EQ-5D-3 L, in order to obtain utility estimates derived from the GERD condition. METHOD: A national representative sample of GERD patients was selected, stratified by gender, age (< 45, ≥45 years) and GERD severity (0-I, II-IV Savary-Miller score) for validation purposes. Age, gender, BMI, GERD diagnose, GERD severity, associated comorbidities and risk factors were recorded. GSFQ, SF-6D, EQ-5D-3 L, and the HRQoL Visual Analogue Scale (VAS) were answered by patients. Several mapping methods were estimated, regression using dummy variables, and linear, quadratic and cubic regression using optimal factor scores. The use of a GERD aggregated summary severity derived from the GSFQ was dimed the best predictor. Overall Mean Absolute Error (MAE), overall Mean Absolute Percentage Error (MAPE) were used as goodness-of-fit (GOF) indexes to compare models. RESULTS: A total of 3405 patients were recruited by 490 clinicians. Mean age was 49 (±14.4) years and 49.8% were women. Reported comorbidities were clustered in 6 antecedents and 15 concomitant pathologies. Aggregation of levels for the frequency of symptoms items was found more suitable for estimation. Regression weights were found to follow a monotonous progressive pattern. Overall MAE ranged from 0.092 to 0.094 for SF-6D utility prediction and from 0.008 to 0.08 for EQ-5D-3 L, while MAPE values ranged from 27.9 to 29% for SF-6D and from 36.8 to 38.4% for EQ-5D-3 L. Cubic regression GOF demonstrated a better fit. CONCLUSIONS: It is possible to translate specific GSFQ scores assessing GERD condition into generic SF-6D and EQ-5D-3 L utility values. Although regression using dummy variables is a suitable mapping procedure, other alternative mapping methods convey better fit, in particular cubic regression.

Mapping of the OAB-SF Questionnaire onto EQ-5D in Spanish Patients with Overactive Bladder.

BACKGROUND AND OBJECTIVE: Mapping disease-specific measures onto generic preference-based indexes allows estimating utility values in specific conditions to determine gain of quality-adjusted-life-years when the status of condition varies. The aim of this study was to map a disease specific scale, the Overactive Bladder Questionnaire 5-dimensional health classification system (OAB-5D) derived from the Overactive Bladder questionnaire-Short Form (OABq-SF), onto a preference-based scale, the EuroQol-5D (EQ-5D), in a sample of patients with overactive bladder (OAB) in a Spanish population. METHOD: A survey addressed to value the health states was conducted among 246 patients at 18 clinics of urology from Spain. A total of 43 out of 243 possible health states have been valued, using VAS (Visual Analog Scale) and TTO (time trade-off) techniques. In addition, ordinary least squares (OLS), generalized linear models (GLM) and Tobit models were estimated. Resulting models were compared and the best one was selected in terms of goodness of fit measures, attribute sign, coefficient magnitude, and statistical significance of regression coefficients. Finally, the internal validity of the best model was calculated by bootstrap resampling. RESULTS: The best model to map the OAB-5D onto EQ-5D could be estimated and the stability of parameter estimations was proved. The mentioned model estimated through OLS regression attained R (2) value of 0.892, with the aggregated data; with GLM (efficient maximum likelihood regression), Pearson χ (2) of 15.3 has been obtained; AIC (Akaike information criterion) = -550.9 and BIC (Bayesian information criterion) = -475.4. OLS model included the following OABq-SF items (and range of weights): A1 (0.102, 0.216); A3 (0.070, 0.171); B3 (0.071, 0.078); B1 (0.076, 0.136); B2 (-0.132, -0.028). CONCLUSION: It is possible to map the OAB-5D scores onto EQ-5D in the Spanish population, allowing estimating EQ-5D utility scores from OAB specific health conditions.

Prediction of diabetic nephropathy using urine proteomic profiling 10 years prior to development of nephropathy.

OBJECTIVE: We examined whether proteomic technologies identify novel urine proteins associated with subsequent development of diabetic nephropathy in subjects with type 2 diabetes before evidence of microalbuminuria. RESEARCH DESIGN AND METHODS: In a nested case-control study of Pima Indians with type 2 diabetes, baseline (serum creatinine <1.2 mg/dl and urine albumin excretion <30 mg/g) and 10-year urine samples were examined. Case subjects (n = 31) developed diabetic nephropathy (urinary albumin-to-creatinine ratio >300 mg/g) over 10 years. Control subjects (n = 31) were matched to case subjects (1:1) according to diabetes duration, age, sex, and BMI but remained normoalbuminuric (albumin-to-creatinine ratio <30 mg/g) over the same 10 years. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) was performed on baseline urine samples, and training (14 cases:14 controls) and validation (17:17) sets were tested. RESULTS: At baseline, A1C levels differed between case and control subjects. SELDI-TOF MS detected 714 unique urine protein peaks. Of these, a 12-peak proteomic signature correctly predicted 89% of cases of diabetic nephropathy (93% sensitivity, 86% specificity) in the training set. Applying this same signature to the independent validation set yielded an accuracy rate of 74% (71% sensitivity, 76% specificity). In multivariate analyses, the 12-peak signature was independently associated with subsequent diabetic nephropathy when applied to the validation set (odds ratio [OR] 7.9 [95% CI 1.5-43.5], P = 0.017) and the entire dataset (14.5 [3.7-55.6], P = 0.001), and A1C levels were no longer significant. CONCLUSIONS: Urine proteomic profiling identifies normoalbuminuric subjects with type 2 diabetes who subsequently develop diabetic nephropathy. Further studies are needed to characterize the specific proteins involved in this early prediction.

Ureteroscopía en el diagnóstico y tratamiento de litiasis urinaria

El presente estudio se centra en la experiencia obtenida en la Sección de Urología del Hospital General del I.G.S., en el diagnóstico y tratamiento de la Litiasis Urinaria durante el período transcurrido de diciembre de 1989 a diciembre de 1991. Aplicando técnicas urológicas de ureteroscopía y litotripsia, por ondas ultrasónicas y electrohidráulicas. Se presentan 34 casos manejados durante este tiempo tomando en cuenta el diagnóstico clínico y radiológico, indicadores para efectuar los procedimientos, estancia hospitalaria post-op, tiempo de inicio de labores y tiempo quirúrgico. Además se explican las técnicas utilizadas y se hace una evaluación de los resultados obtenidos