Access to infertility care in Brazil: validation of a questionnaire for a bioethical discussion.

BACKGROUND: The World Health Organization characterizes infertility as a disease since 2009; however, in many countries, reproductive health is not prioritized. Characterizing a target population and knowing the barriers to accessing reproductive care may allow for a broadening of the discussion on how to provide equal opportunities. The objective of this study was to develop and validate a questionnaire that seeks to identify socioeconomic and cultural characteristics of Brazilian infertile couples to open the discussion on the principle of fair access to health. METHODS: (1) literature review in the main databases, (2) questionnaire elaboration by researchers within the areas of human reproduction and bioethics, concerned with content adequacy and comprehension, using the Google Forms online platform, (3) pilot study - the questionnaire was applied to 54 couples, over 18 years of age, that were seeking treatment for infertility and accepted to participate in the study and (4) statistical analysis - for continuous numerical variables, mean, standard deviation and 95% CI of the means were presented. For discrete numerical variables, median, interquartile range, minimum and maximum were presented. RESULTS: Forty-four questionnaires were fully completed and with adequate answers. The questionnaire proved to be objective and easy to understand. It was possible to obtain information on education, race of the couple, the impact of infertility on the couple's life, socioeconomic conditions, and the main difficulties in accessing medical care for treatment of infertility. CONCLUSION: The questionnaire proved to be feasible in collecting appropriate information to characterize a target population and the only limitation was that there was no academic expert evaluation prior to the pilot test.

[Transcultural adaptation and validation of the DASH questionnaire in Mexican healthy volunteers and patients with neurogenic disorders of the upper extremity]. / Adaptación transcultural y validación de la versión mexicana del cuestionario DASH en individuos sanos y pacientes con trastornos neurogénicos del miembro superior.

Background: The Disability of the Arm, Shoulder and Hand (DASH) questionnaire assesses the impact of upper extremity disorders on quality of life. However, its use in the Mexican population has not been formally validated. Objective: To conduct a cultural adaptation and validation of the DASH questionnaire to evaluate the perspective of patients with neurogenic disorders of the upper extremity regarding the impact on their quality of life. Method: We performed an adaptation of the Spanish version of the DASH questionnaire to the Mexican vocabulary and applied it to 478 volunteers. Ceiling effect, floor effect, item-total correlation, descriptive statistics of items and total score, internal consistency, precision, cross-sectional and longitudinal validity were estimated by comparing healthy controls and affected individuals with different disability levels. Results: Our DASH questionnaire version was equivalent to those previously approved and showed homogeneity of the items with respect to the total value of the questionnaire (Cronbach's alpha > 0.96). In addition, it showed an accuracy of 7.25 points and the crosssectional and longitudinal validity was documented with significant differences between groups and subgroups with distinct disability levels. Conclusions: The DASH questionnaire can be used with a high level of confidence in the Mexican population.

Antecedentes: El cuestionario de discapacidad de brazo, hombro y mano (DASH, Disabilities of the Arm, Shoulder and Hand) mide el impacto de patologías del miembro superior en la calidad de vida. Sin embargo, su uso en la población mexicana no ha sido formalmente validado. Objetivo: Realizar la adaptación cultural y validación del cuestionario DASH para conocer la perspectiva de pacientes con trastornos neurogénicos del miembro superior respecto al impacto en su calidad de vida. Método: Se realizó una adaptación al vocabulario mexicano de la versión española del cuestionario DASH y se aplicó en 478 voluntarios. Se estimaron el efecto techo, el efecto suelo, la correlación ítem-total, las medidas de tendencia central de ítems y el puntaje total, la consistencia interna, la precisión y la validez transversal y longitudinal mediante la comparación de individuos sanos y enfermos con diferente nivel de discapacidad. Resultados: Nuestra versión del cuestionario DASH resultó equivalente a las previamente aprobadas y mostró homogeneidad de los ítems respecto al valor total del cuestionario (alfa de Cronbach > 0.96). Además, tuvo una precisión de 7.25 puntos y se documentó la validez transversal y longitudinal con diferencias significativas entre grupos y subgrupos con diferente nivel de discapacidad. Conclusiones: El cuestionario DASH puede ser empleado con un nivel de confianza alto en la población mexicana.

Validação de questionário sobre a assistência do enfermeiro de práticas avançadas à idosos / Validation of questionnaire on advanced practice nurse assistance for elderly / Validación de cuestionario de prácticas avanzadas asistencia de enfermería para ancianos

Objetivo: Construir e validar instrumento para avaliar o grau de satisfação dos usuários idosos no modelo de atuação do enfermeiro navegador, clínico e de práticas avançadas em serviços de oncologia. Métodos: Estudo metodológico embasado no processo de construção e validação de instrumento que contemplou a estrutura conceitual; definição dos objetivos e população; construção dos itens e escala de resposta; seleção e organização dos itens; estruturação do instrumento; opinião de especialistas; pré-teste e validação de conteúdo. Resultados: Construiu-se instrumento com 13 itens, distribuídos em dois blocos temáticos: aspectos socioeconômicos, composto por oito itens, e cinco perguntas fechadas. Evidenciado por dois métodos estatísticos: correlação não paramétrica e coeficiente de concordância. Conclusão: Conclui-se que o instrumento de avaliação sobre o grau de satisfação de usuários idosos com um modelo de atuação do enfermeiro navegador, enfermeiro clínico e enfermeiro de práticas avançadas tem validade de conteúdo e aparência. (AU)

Objective: To construct and validate an instrument to evaluate the degree of satisfaction of elderly users in the nurse navigator, clinical and advanced practice models in oncology services. Methods: Methodological study based on the process of construction and validation of an instrument that included the conceptual structure; definition of objectives and population; construction of items and response scale; selection and organization of items; structuring of the instrument; expert opinion; pre-test and content validation. Results: An instrument with 13 items was constructed, distributed in two thematic blocks: socioeconomic aspects composed of eight items, and five closed questions. Evidenced by two statistical methods: non-parametric correlation and agreement coefficient. Conclusion: It is concluded that the assessment instrument on the degree of satisfaction of elderly users with a nurse navigator, nurse practitioner and advanced practice nurse performance model has content and appearance validity. (AU)

Objetivo: Construir y validar un instrumento para evaluar el grado de satisfacción de los usuarios mayores en los modelos de enfermera navegante, clínica y de práctica avanzada en los servicios de oncología. Métodos: Estudio metodológico basado en el proceso de construcción y validación de un instrumento que incluyó la estructura conceptual; la definición de los objetivos y la población; la construcción de los ítems y la escala de respuesta; la selección y organización de los ítems; la estructuración del instrumento; la opinión de expertos; el pre-test y la validación del contenido. Resultados: Instrumento construido con 13 ítems, distribuidos en dos bloques temáticos: aspectos socioeconómicos compuestos por ocho ítems, y cinco preguntas cerradas. Lo demuestran dos métodos estadísticos: la correlación no paramétrica y el coeficiente de acuerdo. Conclusión: Se concluye que el instrumento de aval sobre el grado de satisfacción de los usuarios idosos con un modelo de actuación del enfermero navegador, enfermero clínico y enfermero de prácticas avanzadas tiene validez de contenido y apariencia. (AU)

Cross-Cultural Adaptation and Validation of the Methotrexate Intolerance Severity Score Questionnaire in Portuguese (Brazil) for Children and Adolescents with Juvenile Idiopathic Arthritis.

The Methotrexate (MTX) Intolerance Severity Score (MISS) questionnaire has been developed to identify MTX adverse events in juvenile idiopathic arthritis (JIA). The objective of this study was to translate and validate MISS into Brazilian Portuguese for children and adolescents. The MISS was translated into Portuguese following the standardized guidelines. We analyzed the following psychometric properties: acceptability, internal consistency, test-retest reproducibility, relative-child reliability, and external criterion and discriminant validity. We included 138 JIA patients (age: 8-18 years) and 108 relatives who took less than 5 min to answer MISS. Reproducibility tested after 15 days was good, with a kappa > 0.76. We observed good internal consistency (Cronbach's coefficient 0.75-0.87 (patients) and 0.75-0.79 (relatives)). Reliability between patients and relatives was good except for stomachache and restlessness. Cut-off points of 5 and 6 had good sensitivity (84 and 71, respectively) and specificity (80 and 87, respectively). Using a cut-off value of 6, we observed 86 (62.3%) MTX-intolerant patients. In conclusion, MISS is a viable and practical tool for routine clinical care to identify MTX intolerance in JIA. Parents do not easily identify stomachache and restlessness as adverse MTX events.

Development of an online food frequency questionnaire and estimation of misreporting of energy intake during the COVID-19 pandemic among young adults in Peru.

Background: The Young Lives longitudinal study switched to remote data collection methods including the adaptation of dietary intake assessment to online modes due to the physical contact restrictions imposed by the COVID-19 pandemic. This study aimed to describe the adaptation process and validation of an online quantitative food frequency questionnaire (FFQ) for Peruvian young adults. Methods: A previously validated face-to-face FFQ for the adult Peruvian population was adapted to be administered through an online self-administered questionnaire using a multi-stage process. Questionnaire development was informed by experts' opinions and pilot surveys. FFQ validity was assessed by estimating misreporting of energy intake (EI) using the McCrory method, and the FFQ reliability with Cronbach alpha. Logistic regressions were used to examine associations of misreporting with sociodemographic, body mass index (BMI), and physical activity covariates. Results: The FFQ was completed by 426 Peruvian young adults from urban and rural areas, among whom 31% were classified as misreporters, with most of them (16.2%) overreporting daily EI. Men had a lower risk of under-reporting and a higher risk of over-reporting (OR = 0.28 and 1.89). Participants without a higher education degree had a lower risk of under-reporting and a higher risk of over-reporting (OR = 2.18 and 0.36, respectively). No major difference in misreporting was found across age groups, areas, studying as the main activity, being physically active or sedentary, or BMI. Results showed good internal reliability for the overall FFQ (Cronbach alpha = 0.82). Conclusion: Misreporting of EI was mostly explained by education level and sex across participants. Other sociodemographic characteristics, physical activity, sedentary behavior, and BMI did not explain the differences in EI misreporting. The adapted online FFQ proved to be reliable and valid for assessing dietary intakes among Peruvian young adults during the COVID pandemic. Further studies should aim at using and validating innovative dietary intake data collection methods, such as those described, for informing public health policies targeting malnutrition in different contexts after the COVID-19 pandemic.

Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders.

This cross-sectional study aims to assess eating competence (EC­an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who "never/almost never" felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

Validation of the severe respiratory insufficiency questionnaire for Chile.

BACKGROUND: Long-term home non-invasive ventilation (LTH-NIV) has an impact on the health-related quality of life of patients with chronic hypercapnic respiratory failure (CRF) of different causes. There are generic and specific questionnaires for respiratory diseases. In 2003 a specific questionnaire was developed for patients with CRF in LTH-NIV, called the Severe Respiratory Insufficiency (SRI) questionnaire, which has been shown to be reproducible and reliable and has been validated in several languages. The aim of the study was to translate and culturally adapt the SRI questionnaire for adult Chilean patients under LTH-NIV, and to assess its psychometric properties. METHODS: The Chilean version of the SRI was obtained using the translation-back translation method, which was then applied by cross-sectional study to a non-probabilistic convenience sample of stable patients from five regions of Chile. The validated Chilean version of the SRI questionnaire and SF-36 (gold standard) questionnaire were applied, demographic and ventilatory data were collected. Reliability was analysed using Cronbach's alpha and intraclass correlation (test-retest). Construct validity was tested using exploratory factor analysis (principal component extraction and equimax orthogonal rotation) and hypothesis testing (Mann-Whitney test). Convergent criterion validity was tested using Spearman's rho. RESULTS: The sample comprised 248 patients, 132 women (53.2%), median age (IQR) was 62 years (51-75), 146 patients (58.9%) were 60 years or older, 40% had a low education level. The mean ± SD completion time of the questionnaire was 18.8 ± 9.1 min, and 100% of the items were answered. The questionnaire was self-applied by 46.8% of the sample. The validated Chilean version of the SRI questionnaire showed very good overall reliability (0.95) and by scales (> 0.7). It showed a good correlation with the SF-36, with equivalent scales, a rotated matrix with 8 factors and hypotheses that explain the underlying constructs. CONCLUSIONS: The validated Chilean version of the SRI questionnaire has good psychometric properties. It is feasible, valid, and reliable for application to evaluate patients with CRF in LTH-NIV. It was found to be sensitive to assess the characteristics of the local population.

Adaptación y validación al español de la Escala de Empoderamiento Psicológico / Spanish adaptation and validation of the Psychological Empowerment Scale

Resumen El empoderamiento psicológico es un constructo de gran importancia en Psicología. Aunque existen diversos instrumentos de medida, el Psychological Empowerment Instrument de Spreitzer (PEI, 1995) ha sido tradicionalmente el más utilizado en el área de la Psicología Organizacional. Originalmente, este instrumento constaba de 16 ítems organizados en cuatro factores. Por ello, el objetivo del presente artículo fue la adaptación y validación al español del PEI, así como el análisis de su estructura factorial. Para ello, se llevaron a cabo dos estudios independientes. El objetivo del primero fue su traducción al español y su adaptación cultural en una muestra de 242 estudiantes universitarios para analizar la estructura factorial de los ítems y su fiabilidad. En el segundo estudio, se aplicó el nuevo instrumento traducido a una muestra de 317 trabajadores de una empresa de servicios con el fin de validarlo y comprobar la bondad del modelo, así como la validez concurrente con otras variables, tales como el empoderamiento estructural, el compromiso afectivo y la rotación, de la que se conoce su relación por estudios previos. El nuevo cuestionario resultante confirmó la estructura factorial original en cuatro dimensiones (competencia, significado, autonomía e impacto), aunque redujo el número de ítems (de los 16 originales a 13). El cuestionario adaptado al español obtenido tuvo, además, buenos parámetros psicométricos y de bondad de ajuste. El trabajo finaliza discutiendo sobre la relevancia del instrumento adaptado y sus posibles aplicaciones.

Abstract Psychological empowerment is a construct with a multifaceted character composed of four basic cognitions (impact, competence, meaning, and self-determination), which goes beyond a simple delegation of power. The impact of empowerment in different fields of Psychology has been important due to the proven relations maintained with other well-founded psychological variables in the scientific literature, and because of the positive consequences on the results and well-being of people. Although there are different instruments for the measurement of this construct, the Psychological Empowerment Instrument (PEI) by Spreitzer (1995) has been traditionally the one most employed to measure the psychological empowerment in the area of Organizational Psychology, counting with more than one thousand publications, and articles as well as translations and adaptations to different languages. The original questionnaire elaborated by Spreitzer consists of 16 items organised in four factors following the four basic cognitions that were described above. Therefore, the aim of this article is the adaptation to Spanish, validation of the PEI, and to analyse its factor structure. In order to do so, two independent studies were carried out. The specific objective of the first study was to translate into Spanish and to adapt culturally such questionnaire. In the second study, the objective was to validate the resulting questionnaire and to analyse the factor structure and its goodness and with other psychological and organisational variables as well as the external validity in a sample of workers. In order to do so, in the first study it was carried out an inverse translation and adaptation to Spanish with a sample of 242 university students to subsequently analyse the factorial structure of the items and its reliability. The resulting translated questionnaire confirmed the factor structure in four dimensions (Competence, Meaning, Self-determination, and Impact), although the number of items was reduced from the original 16 to 13, which would explain the 74.08 % of the sampling variance. To confirm the psychometric characteristics of this new questionnaire, we performed a second study with 317 workers of a Spanish service company in order to analyse through confirmative procedures the internal structure of this new instrument, verify its adequacy and goodness of fit of the resulting factors as well as assessing the relation and external validity in a sample of workers and concurrency with other variables (structural empowerment, affective commitment and intention to leave), which are known to have a relation with psychological empowerment from previous research. From the application of this new questionnaire translated to Spanish into this sample of workers, we confirmed again the structure of 13 items in four factors from the first study. Furthermore, we obtained good fit indexes (GFI, AGF, and NNFI), with values between .90 and .96. Additionally, through regression analysis we obtained positive and statistically significant results between psychological empowerment and other variables included in the study (structural empowerment, affective commitment, and intention to leave), testing the interrelations among them. Therefore, those people with a greater cognition on their empowerment developed a greater engagement and attachment towards the organisation, and consequently, their wish to leave was lower. Our study concludes with a discussion about the importance of the adapted instrument and its possible applications.

Comparison of conventional and wide field direct ophthalmoscopy on medical students' self-confidence for fundus examination: a 1-year follow-up.

BACKGROUND: Fundus examination is an easy, quick and effective way to diagnose sight- and life-threatening diseases. However, medical students and physicians report lack of proficiency and self-confidence in perform fundoscopy. The aim of this study was to compare students' self-confidence in fundus examination, using two different direct ophthalmoscopes, 1 month and 1 year after practical training. METHODS: In this prospective cohort, medical students (MS) of the same class were divided in small groups for PanOptic (PO) or conventional (CO) direct ophthalmoscope training. The intervention group encompassed MS of the 4th -year (class of 2019), and the control group encompassed MS of year behind (class of 2020). A questionnaire to measure self-confidence in fundoscopy technique assessing optic nerve, cup-to-disc ratio and macula was translated and validated to Portuguese, and applied 1-month and 1-year after practical training. RESULTS: One-hundred and sixty-seven MS were enrolled (35 PO group, 38 CO group, and 94 control group). PO group had a significantly higher overall self-confidence comparing either control or CO groups, respectively (3.57 ± 0.65 vs. 2.97 ± 1.03 vs. 2.46 ± 0.87, p < 0.01) as well as in evaluate cup-to-disc ratio (3.09 ± 0.75 vs. 2.32 ± 0.87 vs. 1.46 ± 0.81, p < 0.01), optic disc margins (3.26 ± 0.85 vs. 2.71 ± 0.96 vs. 2.01 ± 0.97, p < 0.01) and macula (3.43 ± 1.12 vs. 2.89 ± 1.08 vs. 2.02 ± 0.89, p < 0.01) 1-month after practical training. One-year after intervention, CO group showed a significantly higher score compared to PO group in overall self-confidence (3.31 ± 0.69 vs. 3.18 ± 0.73, p = 0.03) and in optic disc margins assessing (3.16 ± 0.85 vs. 2.95 ± 0.78, p = 0.03), but not significant in the evaluation of cup-to-disc ratio (2.78 ± 0.97 vs. 2.68 ± 0.94, p = 0.08), and macula (3.34 ± 0.79 vs. 3.27 ± 0.98, p = 0.07). CONCLUSIONS: Students were more confident in use PO as an instrument to perform direct ophthalmoscopy immediately after practical training, but confidence level of CO was higher compared to PO one year after practical training. These findings would help medical schools decide which ophthalmoscope to choose to teach fundus examination.

COVID-19 Vaccine Intention among Rural Residents in Mexico: Validation of a Questionnaire.

The COVID-19 pandemic forced the scientific community and the pharmaceutical industry to develop new vaccines, in an attempt to reach herd immunity and stop the SARS-CoV-2 from spreading. However, to ensure vaccination among the general population, COVID-19 vaccine intention must be measured. So far, no studies have focused on rural residents in Latin America, which represent approximately 20% of the population of this geographical region. In this study, we present the validation of a self-developed questionnaire, which was validated in a pilot study with 40 Spanish-speaking Mexican rural residents in the state of Guerrero, Mexico. In this study, we describe the chronological validation of the questionnaire, including the assessment of its internal consistency and temporal reliability, which we measured with the Cronbach's alpha and Spearman's rank correlation coefficient, respectively. After the psychometrical analysis, we were able to validate a 20-item questionnaire, which intends to assess vaccine intention among the rural population. Aiming to develop a comprehensive policy and vaccination strategies, we hope this instrument provides valuable insight regarding COVID-19 vaccination willingness across rural communities in Mexico and Latin America. Finally, if we want to reach worldwide herd immunity, it is important to understand rural residents' position towards COVID-19 vaccination.

Diseño y validación de cuestionario de conocimientos, actitudes y prácticas de la enfermedad de Chagas / Design and validation of the survey of knowledge, attitudes and practices of Chagas disease

La enfermedad de Chagas es considerada una afección desatendida a nivel mundial que afecta principalmente a la población de escasos recursos en Latinoamérica, con aproximadamente 10 millones de personas afectadas. Se estima que en Ecuador más de 200000 personas son seropositivas para T. cruzi y 4.400 adquieren la infección anualmente. Se han realizado estudios en zonas endémicas como Loja, Manabí, Guayas y El Oro, las cuales constituyen el hábitat de cinco especies de triatómicos, responsables de la transmisión vectorial de la enfermedad, no obstante, se requiere información epidemiológica actualizada en áreas consideradas prioritarias. Es por ello, que se realizó un estudio descriptivo transversal para diseñar y validar un cuestionario de conocimientos, actitudes y prácticas de la enfermedad de Chagas en las 5 áreas prioritarias en Ecuador. Se diseñó un cuestionario inicial de 36 ítems, empleado para un estudio piloto con 5 expertos claves que validaron dicho instrumento, Para evaluar la validez de contenido se empleó la V de Aiken (0,82) y la validez del constructo fue evaluada a través del análisis factorial exploratorio, del cual se obtuvieron 3 dimensiones; ´ mientras que la prueba de alfa de Cronbach (>0,7) demostró la consistencia interna del instrumento. La versión final del cuestionario contentiva de 31 ítems fue aplicada a 20 participantes con características epidemiológicas diferentes de cada área prioritaria, demostrando que el mismo reúne todas las condiciones de validación y confiabilidad y puede ser aplicado en otros estudios epidemiológicos relacionados con la enfermedad de Chagas(AU)

Chagas disease is considered a neglected condition worldwide which mainly affects the poor population in Latin America, with approximately 10 million people affected. It is estimated that in Ecuador more than 200,000 people are seropositive for T. cruzi and 4,400 acquire the infection annually. Studies have been carried out in endemic areas such as Loja, Manabí, Guayas and El Oro, which constitute the habitat of five species of triatomics, responsible for the vector transmission of the disease, however, updated epidemiological information is required in areas considered priority. For this reason, a cross-sectional descriptive study was carried out to design and validate a questionnaire on knowledge, attitudes and practices of Chagas disease in the 5 priority areas in Ecuador. An initial questionnaire of 36 items was designed, used for a pilot study with 5 key experts who validated said instrument. To evaluate the content validity, Aiken's V (0.82) was used and the validity of the construct was evaluated through the exploratory factor analysis, from which 3 dimensions were obtained; While the Cronbach's alpha test (> 0.7) demonstrated the internal consistency of the instrument. The final version of the questionnaire containing 31 items was applied to 20 participants with different epidemiological characteristics from each priority area, showing that it meets all the validation and reliability conditions and can be applied in other epidemiological studies related to Chagas disease(AU)

Diseño y validación de un instrumento sobre las capacidades cognitivo-prácticas para el tratamiento con mínima intervención de la caries dental en la carrera de Estomatología / Design and validation of a tool about cognitive-practical capacities for the minimal intervention treatment of dental caries in undergraduate dental training

Introducción : El desarrollo científico-tecnológico en el tratamiento de la caries dental hace necesario la sistematización del proceso de enseñanza-aprendizaje y una didáctica apropiada que permita que los educandos adquieran conocimientos y habilidades para su ejercicio. Objetivo : Diseñar y validar un instrumento para la medición de la correspondencia del plan de estudios y de la estrategia didáctica con las capacidades cognitivo-prácticas necesarias para el tratamiento de mínima intervención de la caries dental en la carrera de Estomatología. Métodos : Estudio de desarrollo tecnológico en el que participaron 28 expertos seleccionados sobre la base de su trayectoria docente, científica y experiencia en el tema. Los mismos ofrecieron sus opiniones a través de cuestionarios autogestionados respecto a la claridad, coherencia, precisión, relevancia y presentación del instrumento mencionado. Se empleó la Razón de validez de contenido, por el método de Tristán y el índice de validación de contenido. Resultados : La totalidad de los ítems fueron válidos en los 4 criterios medidos, por lo que coincidieron los índices de validación de contenido global y aceptable. El instrumento mostró coherencia, precisión y relevancia la claridad con cifras de índice de validación de contenido de 0,90; 0,93; 0,92; y 0,94, respectivamente. Conclusiones : Se diseñó y validó un instrumento efectivo en contenido y presentación, por lo que está disponible para continuar con la siguiente etapa para su aprobación final(AU)

Introduction: Scientific and technological development in the treatment of dental caries requires systematization of the teaching-learning process and an appropriate methodology fostering the acquisition of knowledge and skills necessary for professional practice. Objective: Design and validate a tool to measure the correspondence of the curriculum and the didactic strategy to the cognitive-practical capacities required for the minimal intervention treatment of dental caries in undergraduate dental training. Methods: A technological development study was conducted with 28 experts selected for their teaching experience, their scientific background and their knowledge about the topic. The experts contributed their opinions through self-administered questionnaires about the clarity, coherence, accuracy, relevance and layout of the tool. Use was made of content validity ratio by the Tristan method and the content validation index. Results: All the items were found to be valid in terms of the four criteria measured, showing agreement between global and acceptable content validation indices. The tool exhibited coherence, accuracy, relevance and clarity, with content validation index values of 0.90, 0.93, 0.92 and 0.94, respectively. Conclusions: A tool was designed and validated which is effective for its content and presentation. It is therefore available for final validation(AU)

Validation of the Spanish-Mexican Version of the Australian Breastfeeding Attitude Questionnaire in Higher Education Health Students.

Positive attitudes towards breastfeeding in health professionals/students have been associated with increasing their confidence to provide support and accompaniment to mothers. In Mexico, there is no valid/reliable tool to assess attitudes towards breastfeeding in this population. The Australian Breastfeeding Attitudes (and Knowledge) Questionnaire (ABAQ) measures attitudes in the Australian population. We aimed to adapt and validate the ABAQ in Mexican health students. We included 264 health students (nursing, nutrition, and medicine) from the University of Guadalajara. Bilingual translators carried out the Spanish adaptation with a reverse translation into English. Experts evaluated the content validity. Reliability was evaluated through an internal consistency analysis (Cronbach's alpha) and construct validity through convergent-divergent validation, item-total correlation, exploratory factor analysis (by principal components), and confirmatory factor analysis. According to the exploratory factor analysis, only one component was identified. Seven items were removed (low correlation between items ≤0.2 and low factor load ≤0.3). The Cronbach's alpha was 0.78. According to the confirmatory factor analysis, the one-factor solution of the ABAQ-13Mx showed a good model fit (X2 = 98.41, G = 62, p = 0.02, CFI = 0.940, and RMSEA = 0.048). The ABAQ-13Mx is a reliable and valid instrument for evaluating attitudes towards breastfeeding in Mexican health degree students.

Validez y fiabilidad de un cuestionario que evalúa competencias investigativas e innovativas / Validity and reliability of a questionnaire evaluating innovative and research competences

RESUMEN Introducción: el desarrollo de competencias investigativas e innovativas en los profesionales, es esencial para la aplicación de resultados generados por la investigación y por la innovación. Objetivos: evaluar la validez y fiabilidad de un cuestionario destinado a cuantificar el nivel de desarrollo de competencias investigativas e innovativas de profesores de la Universidad de Ciencias Médicas de Matanzas. Materiales y métodos: se realizó un estudio de tipo evaluativo, de enero a mayo del 2019. La validación del contenido se realizó aplicando los postulados de Moriyama. Su consistencia interna por el coeficiente alfa de Cronbach y la validez de construcción lógica por análisis factorial de los componentes principales. Resultados: el Alfa de Cronbach obtenido fue de ,930. La validación de contenido permitió considerar que la formulación de los ítems, es razonable, justifican su presencia en el cuestionario. Las categorías propuestas para ser incluidas en la construcción del instrumento son adecuadas. Los resultados sugirieron la presencia de cuatro factores que explicaron el 71,16 % de la varianza acumulada por todos los factores. Conclusiones: los resultados de validez fueron favorables. Está disponible un instrumento con condiciones adecuadas y criterios válidos que justifican su uso y aplicación en el terreno investigativo (AU).

ABSTRACT Introduction: the development of research and innovative competences in the professionals is essential for the application of results generated by research and innovation. Objective: to assess the validity and reliability of a questionnaire designed to quantify the development level of research and innovative competences of professors of the University Of Medical Sciences Of Matanzas. Materials and methods: an evaluative-kind study was carried out from January to May 2019; the content validation was made applying Moriyama´s postulates, its internal consistence applying Chronbach´s alpha coefficient, and its logical construction validity applying the factorial analysis of the main components. Results: the obtained Chronbach´s alpha was ,930. The content validation allowed considering that items formulation is reasonable, justifying their presence in the questionnaire. The categories proposed to be included in the instrument construction are adequate. The results suggest the presence of four factors explaining 71.16 % of the variance accumulated by all the factors. Conclusions: the validity results are favorable. An instrument is available with adequate conditions and valid criteria justifying its use and application in the research field (AU).

Validation of the Multi-INdependence Dimensions (MIND) questionnaire for prolonged mechanically ventilated subjects.

BACKGROUND: Evaluating severity of illness of patients with prolonged mechanical ventilation (PMV) is important to adopt the best appropriate care management for each individual. Yet, no severity-of-illness scoring system has been specifically designed for this type of patients. The aim of this study was to develop and validate a new instrument, the Multi-INdependence Dimensions (MIND) questionnaire designed to comprehensively measure the severity of illness of patients under PMV. METHODS: The validation of the MIND questionnaire was performed during a longitudinal observational study conducted with PMV subjects in weaning facilities in three countries (Argentina, Colombia and Germany). The questionnaire validity was tested in 3 stages: 1) Specification of components, with description of item responses, inter-item and Cronbach alpha correlations; 2) Creation of the composite scores; 3) Measurement properties determination including test-retest reliability after 30 days, clinical validity (Medical Research Council (MRC) muscle strength score, Sepsis-related Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), Dependence Nursing Scale and EuroQol-5 Dimension evaluated at inclusion), and ability to detect change. RESULTS: A total of 128 subjects participated in the validation study. Eleven component scores and four composite scores were created. MIND scores significantly correlated with MRC muscle strength, SOFA, DNS, GCS and EQ-5D, supporting the validity of the new scores. Intraclass Correlation Coefficient greater than 0.82 were observed for all composite scores, indicating good test-retest reliability. MIND scores were able to detect improvement in subject severity of illness. CONCLUSION: The MIND questionnaire is a valid and reliable instrument for measuring comprehensively the multiple dimensions characterizing the severity of illness of PMV patients. TRIAL REGISTRATION: NCT02255058 .

Self-Reported Non-Celiac Gluten Sensitivity in Brazil: Translation, Cultural Adaptation, and Validation of Italian Questionnaire.

This study aimed to translate, culturally adapt, validate, and apply a questionnaire to the Brazilian non-celiac gluten sensitive (NCGS) population. We also aimed to estimate the prevalence of symptoms which affect Brazilian NCGS. The Brazilian Portuguese version of the NCGS questionnaire was developed according to revised international guidelines. Five-hundred-and-fourty-three participants responded the NCGS questionnaire. We evaluated the reproducibility and validity of the questionnaire which presents valid measures of reproducibility. This is the first specific self-reported validated questionnaire for NCGS patients in Brazilian Portuguese, and the first nationwide characterization of self-reported NCGS in Brazilian adults. Most respondents were female (92.3%), and the main intestinal symptoms reported were bloating and abdominal pain. The most frequent extraintestinal symptoms were lack of wellbeing, tiredness, and depression. We expect that the present study will provide a picture of Brazilian individuals with suspected NCGS, which could help health professionals and governmental institutions in developing effective strategies to improve the treatment and diagnosis of Brazilian NCGS.

Validación del cuestionario pediátrico de sueño en la población colombiana / Validation of the pediatric sleep questionnaire in colombian population

Introducción: El síndrome de apnea e hipopnea obstructiva del sueño es una patología frecuente en la población pediátrica que genera un alto impacto en la calidad de vida tanto de los pacientes como de sus familias. Objetivo: Realizar la validación del Cuestionario Pediátrico de Sueño a la población pediátrica colombiana a grandes alturas y determinar si existe asociación entre los hallazgos en el cuestionario y los hallazgos polisomnográficos. Diseño: Observacional analítico prospectivo. Materiales y métodos: Este estudio fue realizado a 2,600 metros sobre el nivel del mar. Se incluyeron 121 pacientes entre 2 y 18 años, candidatos a adeno/amigdalectomía a los que se les aplicó el cuestionario pediátrico de sueño, y fue sometido a un proceso de validación específico para la población colombiana. Resultados: No se obtuvo una correlación de los resultados del cuestionario con los resultados de severidad de la enfermedad en el polisomnograma. Discusión: El cuestionario pediátrico de sueño (PSQ) fue sometido a un proceso de validación específico para la población colombiana a grandes alturas. Sin embargo, dado que los ítems A24, A25, B7, B9, y B22 se determinaron como redundantes, se podría proponer una escala condensada específica para la población colombiana, omitiendo estas preguntas. Conclusiones: El cuestionario pediátrico de sueño (PSQ) fue validado satisfactoriamente a la población colombiana habitante de grandes alturas. Sin embargo, se propone una modificación, eliminando las preguntas A24, A25, B7, B9, y B22, logrando un cuestionario más corto y simplificado, sin tener efectos sobre la validez del mismo.

Introduction: The obstructive sleep apnea and hypopnea syndrome is a frequent pathology in the pediatric population that generates a high impact on the quality of both patients and their families. Objective: To validate the Pediatric Sleep Questionnaire to the Colombian pediatric population. Design: Prospective analytical observational. Methods: This study was conducted at 2,600 meters above sea level. We included 121 patients between 2 and 18 years old, who were candidates for adeno/tonsillectomy to whom the Pediatric Sleep Questionnaire was applied; this questionnaire was underwent to a specific validation process for the Colombian population. Results: The results of the questionnaire was not correlated with disease severity determined by polysomnogram. Discussion: The pediatric sleep questionnaire (PSQ) was underwent to a specific validation process for the Colombian population at high altitudes. However, due to that articles A24, A25, B7, B9 and B22 were determined as redundant, a specific escalation could be proposed for the Colombian population, omitting these questions. Conclusions: The pediatric sleep questionnaire (PSQ) was validated satisfactorily in the Colombian population living at high altitudes. However, a modification is proposed, eliminating the questions A24, A25, B7, B9 and B22, obtaining a shorter and simplified questionnaire, without having effects on the duration of the same.

Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR-Br): cross-cultural validation, reliability, and construct and structural validation.

PURPOSE: This study aimed to culturally adapt and validate the Revised Fibromyalgia Impact Questionnaire (FIQR) to Brazilian Portuguese, by the use of analysis of internal consistency, reliability, and construct and structural validity. METHOD: A total of 100 female patients with fibromyalgia participated in the validation process of the Brazilian Portuguese version of the FIQR (FIQR-Br).The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Pearson's rank correlation for construct validity, and confirmatory factor analysis (CFA) for structural validity. RESULTS: It was verified excellent levels of reliability, with ICC greater than 0.75 for all questions and domains of the FIQR-Br. For internal consistency, alpha values greater than 0.70 for the items and domains of the questionnaire were observed. Moderate (0.40 < r < 0.70) and strong (r > 0.70) correlations were observed for the scores of domains and total score between the FIQR-Br and FIQ-Br. The structure of the three domains of the FIQR-Br was confirmed by CFA. CONCLUSIONS: The results of this study suggest that that the FIQR-Br is a reliable and valid instrument for assessing fibromyalgia-related impact, and supports its use in clinical settings and research. The structure of the three domains of the FIQR-Br was also confirmed. Implications for Rehabilitation Fibromyalgia is a chronic musculoskeletal disorder characterized by widespread and diffuse pain, fatigue, sleep disturbances, and depression. The disease significantly impairs patients' quality of life and can be highly disabling. To be used in multicenter research efforts, the Revised Fibromyalgia Impact Questionnaire (FIQR) must be cross-culturally validated and psychometrically tested. This paper will make available a new version of the FIQR-Br since another version already exists, but there are concerns about its measurement properties. The availability of an instrument adapted to and validated for Brazilian Portuguese may make it possible to reliably verify the effects of rehabilitation programs on disability from fibromyalgia. The FIQR-Br showed results comparable with other versions of the FIQR in other languages, thereby enabling comparison of effects of rehabilitation interventions on disability from fibromyalgia conducted in Brazil with results of studies carried out in other parts of the world.

Validación de una propuesta de encuesta sobre regulación de servicios farmacéuticos en México / Validation of a proposal of survey on the regulation of pharmaceutical services in Mexico

Introducción: la situación actual de los servicios farmacéuticos básicos y su regulación en México están más dirigidas para el aumento en la competencia comercial que para la participación de los farmacéuticos hacia la resolución de la problemática comunitaria, por lo que documentar cuáles son los servicios que actualmente se brindan y que no se regulan, resultaría interesante. Objetivo: desarrollar un instrumento de medición que permita conocer la opinión de los protagonistas de los sistemas farmacéuticos acerca de los servicios que se brindan. Métodos: se elaboró un cuestionario dirigido a la comunidad farmacéutica, que aborda diferentes tipos de actuaciones a desarrollar en los servicios farmacéuticos, englobados por dimensiones, con preguntas cerradas, se consideran los servicios que se relacionan con la disponibilidad y acceso, información, vigilancia, atención clínica y farmacéutica, educación, promoción para la salud y de los medicamentos, investigación científica y algunos otros servicios a desempeñar. Resultados: el cuestionario se envió para su validación, mediante correo electrónico a 75 expertos procedentes de áreas académicas de farmacia de las universidades públicas y privadas, miembros de asociaciones del área farmacéutica comercial en México y a colaboradores de la Drug Utilization Research Group Latinoamérica de siete países, solo 20 lo responden. Los resultados se agrupan en 10 Dimensiones y 56 preguntas. Se calificaron 67 respuestas relacionadas con los servicios que se brindan y sus regulaciones como poco conocidas y 120 respuestas relacionadas con las consideraciones de lo que se debe regular o las necesidades de enseñanza en las universidades y programas académicos idóneos calificadas como de acuerdo; ningún experto dejó de responder. Conclusiones: se califica el cuestionario como instrumento de medición adecuado para conocer la situación de los servicios que se brindan en los establecimientos farmacéuticos en México, lo que permitirá posteriormente extenderla a América Latina(AU)

Introduction: the current situation of basic pharmaceutical services and their regulation in Mexico are more oriented to increase market competition than to encourage the participation of pharmacists in solving community-based problems, so it will be interesting to document those services that are rendered but not regulated. Objective: to develop a measuring instrument that allows learning about the opinions of the leading players in the pharmaceutical systems on the services that are offered. Methods: a questionnaire aimed at the pharmaceutical community was drafted to deal with different types of performances in the pharmaceutical services, encompassed by dimensions and with close questions; it takes into account the services that relate to availability and access, information, surveillance, clinical and pharmaceutical care, education, health promotion and drug promotion, scientific research and some other services to be rendered. Results: the questionnaire was e-mailed for validation to 75 experts from academic areas of pharmacy from public and private universities, members of associations in the commercial pharmaceutical area in Mexico and collaborators of Drug Utilization Research Group Latin America from 7 countries; just 20 of them answered the questionnaire. The results were grouped into 10 dimensions and 56 questions. Sixty seven answers related to services that are given and their regulations were rated as barely known and 120 answers related to analysis of what to be regulated or the learning requirements in universities and the ideal academic programs were rated as agreed upon. All experts sent their answers. Conclusions: this questionnaire is regarded as adequate measuring instrument to find out the situation of rendered services in the pharmacies of Mexico, which will allow further extend this survey to Latin America(AU)

¿Qué tan capaces son los padres de niños con síndrome de Down en el cuidado de infecciones de vías respiratorias altas y la detección de complicaciones? / Are parents of children with Down's syndrome capable of general care and detection of complications of upper airway infections?

Introducción. Las infecciones de vías respiratorias altas son frecuentes en pediatría. En los niños con síndrome de Down se pueden presentar complicaciones cardiorrespiratorias con mayor frecuencia. Material y métodos. Se diseñó un cuestionario para revisar las principales áreas de atención general en el cuidado de infecciones respiratorias. Se validó por expertos. Se aplicó a los padres o cuidadores de pacientes que acudieron a la consulta externa de genética, durante el período comprendido entre octubre y noviembre del año 2004. Resultados. Se aplicaron 29 cuestionarios. La confiabilidad del cuestionario fue de 0.75. El área de cuidado con mejor rendimiento fue la detección de complicaciones respiratorias, seguido de hidratación y manejo de la fiebre. El área que obtuvo el menor rendimiento fue la de alimentación. En general se encontró poca habilidad en el cuidado de infecciones respiratorias. Conclusiones. Los padres de niños con síndrome de Down tienen poca habilidad para el cuidado general y la detección de complicaciones en sus hijos.

Introduction. Upper airways infections are frequent in children. Down's syndrome patients frequently present cardiorespiratory complications. Material and methods. A specific questionnaire was constructed including the recommendations on general care of upper airway infection, and was validated through experts. It was then answered by the parents or care-givers of children who assisted to Genetics during October and November 2004. Results. Twenty nine persons participated. Confidence of the questionnaire was 0.75. Parents were most likely to identify respiratory complications, followed by hydration and fever management.The area with less correct answers was nutrition. Overall knowledge was considered low. Conclusions. Down's syndrome parents have scarce knowledge with respect to the general treatment and respiratory complications detection of respiratory tract diseases of their children.