Spanish and Catalan Versions of the eHealth Literacy Questionnaire: Translation, Cross-Cultural Adaptation, and Validation Study.

BACKGROUND: The rise of digital health services, especially following the outbreak of COVID-19, has led to a need for health literacy policies that respond to people's needs. Spain is a country with a highly developed digital health infrastructure, but there are currently no tools available to measure digital health literacy fully. A well-thought-through questionnaire with strong psychometric properties such as the eHealth Literacy Questionnaire (eHLQ) is important to assess people's eHealth literacy levels, especially in the context of a fast-growing field such as digital health. OBJECTIVE: This study aims to adapt the eHLQ and gather evidence of its psychometric quality in 2 of Spain's official languages: Spanish and Catalan. METHODS: A systematic cultural adaptation process was followed. Data from Spanish-speaking (n=400) and Catalan-speaking (n=400) people were collected. Confirmatory factor analysis was used to confirm the previously established factor structure. For reliability, the Cronbach α and categorical ω were obtained for every subscale. Evidence of convergent and discriminant validity was provided through the correlation with the total score of the eHealth Literacy Scale. Evidence based on relations to other variables was evaluated by examining extreme values for educational level, socioeconomic level, and use of technology variables. RESULTS: Regarding the confirmatory factor analysis, the 7-factor correlated model and the 7 one-factor models had adequate goodness-of-fit indexes for both Spanish and Catalan. Moreover, measurement invariance was established between the Spanish and Catalan versions. Reliability estimates were considered adequate as all the scales in both versions had values of >0.80. For convergent and discriminant validity evidence, the eHealth Literacy Scale showed moderate correlation with eHLQ scales in both versions (Spanish: range 0.57-0.76 and P<.001; Catalan: range 0.41-0.64 and P<.001). According to the relationship with external variables, all the eHLQ scales in both languages could discriminate between the maximum and minimum categories in level of education, socioeconomic level, and level of technology use. CONCLUSIONS: The Spanish and Catalan versions of the eHLQ appear to be psychometrically sound questionnaires for assessing digital health literacy. They could both be useful tools in Spain and Catalonia for researchers, policy makers, and health service managers to explore people's needs, skills, and competencies and provide interesting insights into their interactions and engagement regarding their own experiences with digital health services, especially in the context of digital health growth in Spain.

Exploring COVID-19 research credibility among Spanish scientists.

Amidst a worldwide vaccination campaign, trust in science plays a significant role when addressing the COVID-19 pandemic. Given current concerns regarding research standards, we were interested in how Spanish scholars perceived COVID-19 research and the extent to which questionable research practices and potentially problematic academic incentives are commonplace. We asked researchers to evaluate the expected quality of their COVID-19 projects and other peers' research and compared these assessments with those from scholars not involved in COVID-19 research. We investigated self-admitting and estimated rates of questionable research practices and attitudes towards current research status. Responses from 131 researchers suggested that COVID-19 evaluations followed partisan lines, with scholars being more pessimistic about others' colleagues' research than their own. Additionally,researchers not involved in COVID-19 projects were more negative than their participating peers. These differences were particularly notable for areas such as the expected theoretical foundations or overall quality of the research, among others. Most Spanish scholars expected questionable research practices and inadequate incentives to be widespread. In these two aspects, researchers tended to agree regardless of their involvement in COVID-19 research. We provide specific recommendations for improving future meta-science studies, such as redefining QRPs as inadequate research practices (IRP). This change could help avoid key controversies regarding QRPs' definition while highlighting their detrimental impact. Lastly, we join previous calls to improve transparency and academic career incentives as a cornerstone for generating trust in science. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-02797-6.

Efficacy of Ceftolozane-Tazobactam in Combination with Colistin against Extensively Drug-Resistant Pseudomonas aeruginosa, Including High-Risk Clones, in an In Vitro Pharmacodynamic Model.

Combination therapy is an attractive therapeutic option for extensively drug-resistant (XDR) Pseudomonas aeruginosa infections. Colistin has been the only treatment available for these infections for many years, but its results are suboptimal. Ceftolozane-tazobactam (C/T) is a newly available therapeutic option that has shown good antipseudomonal activity, even against a number of XDR P. aeruginosa strains. However, data about combinations containing C/T are scarce. The aim of this study was to analyze the activity of C/T and colistin alone and in combination against a collection of XDR P. aeruginosa strains containing 24 representative clinical isolates from a multicentre Spanish study. Twenty-four time-kill experiments performed over 24 h were conducted in duplicate to determine the effects of colistin and C/T alone and combined. An in vitro pharmacodynamic chemostat model then was used to validate this combination against three selected XDR P. aeruginosa ST175 isolates with different susceptibility levels to C/T. Static time-kill assays demonstrated superior synergistic or additive effect for C/T plus colistin against 21 of the 24 isolates studied. In the in vitro dynamic pharmacokinetic/pharmacodynamic (PK/PD) model, the C/T regimen of 2/1 g every 8 h with a steady-state concentration of 2 mg/liter colistin effectively suppressed the bacterial growth at 24 h. Additive or synergistic interactions were observed for C/T plus colistin against XDR P. aeruginosa strains and particularly against C/T-resistant strains. C/T plus colistin may be a useful treatment for XDR P. aeruginosa infections, including those caused by high risk-clones resistant to C/T.

Coefficient Alpha: The Resistance of a Classic.

BACKGROUND: During the 20th century the alpha coefficient (α) was widely used in the estimation of the internal consistency reliability of test scores. After misuses were identified in the early 21st century alternatives became widespread, especially the omega coefficient (ω). Nowadays, α is re-emerging as an acceptable option for reliability estimation. METHOD: A review of the recent academic contributions, journal publication habits and recommendations from normative texts was carried out to identify good practices in estimation of internal consistency reliability. RESULTS: To guide the analysis, we propose a three-phase decision diagram, which includes item description, fit of the measurement model for the test, and choice of the reliability coefficient for test score(s). We also provide recommendations on the use of R, Jamovi, JASP, Mplus, SPSS and Stata software to perform the analysis. CONCLUSIONS: Both α and ω are suitable for items with approximately normal distributions and approximately unidimensional and congeneric measures without extreme factor loadings. When items show non-normal distributions, strong specific components, or correlated errors, variants of ω are more appropriate. Some require specific data gathering designs. On a practical level we recommend a critical approach when using the software.

Attitudes towards Trans Men and Women in Spain: An Adaptation of the ATTMW Scale.

This article presents the results of the adaptation and validation of the Attitudes Toward Trans Men and Women (ATTMW) scale-a measure capable of detecting transphobic positions towards trans men and women-in the Spanish context. A total of 310 prospective teachers from different stages of education participated in the study on its adaptation. In order to provide quantitative evidence of validity, confirmatory factor analysis and regression analysis with different constructs and sociodemographic variables were carried out. Internal consistency reliability was adequate. The study demonstrated that the ATTMW is a psychometrically sound instrument for the assessment of attitudes towards trans people, especially with items that categorize trans women and men as second-class people.

The Adaptation and Validation of the Trans Attitudes and Beliefs Scale to the Spanish Context.

This article examines the reliability and validity of the adaptation of the Trans Attitudes and Beliefs Scale (TABS), an instrument capable of detecting transphobic positions, to the Spanish context. A total of 829 psychology students participated in the adaptation procedure. A confirmatory factor analysis was performed to study the fit of the new scale to the factor structure of the original scale (interpersonal comfort, gender identity beliefs, and human value). Convergent validity evidence showed significant correlations and predictive levels with different constructs and sociodemographic variables. The internal consistency of the mean scores was adequate at the global level. The study showed that the TABS is a psychometrically sound instrument for the assessment of attitudes toward trans people, particularly in the context of debates over access to rights and the lack of professional training in disciplines such as psychology.

Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method.

Acknowledgement of the prevalence of recreational opioid use (PROU) is key to the planning and evaluation of care services. However, in Spain, the prevalence of PROU in recent years is unknown. The objective of this study was to estimate the PROU between 2005 and 2019 in the general populations of six Spanish cities. A benchmark-multiplier methodology was used to estimate the PROU population size. The benchmark used was overdose deaths from recreational opioid use in Spain's six most populated cities. The multiplier was the overdose death rate in a cohort of heroin users. Linear regression was used to estimate the trend of the PROU estimate over the set period of years. In 2005, the PROU was 4.78 (95%CI 3.16-7.91) per 1000 people. The estimated trend decreased, with the two lowest values being 2.35 per 1000 in 2015 and 2.29 in 2018. In 2019 the PROU was 2.60 per 1000 (95%CI 1.72-4.31), 45% lower than in 2005. While the decline in the PROU continues, its deceleration over the last four years calls for increased vigilance, especially in light of the opioid crisis in North America that has occurred over the last few years.

Impact of ceftolozane/tazobactam concentrations in continuous infusion against extensively drug-resistant Pseudomonas aeruginosa isolates in a hollow-fiber infection model.

Ceftolozane/tazobactam (C/T) has emerged as a potential agent for the treatment of extensively drug-resistant (XDR) Pseudomonas aeruginosa infections. As it is a time-dependent antimicrobial, prolonged infusion may help achieve pharmacokinetic/pharmacodynamic (PK/PD) targets. To compare alternative steady-state concentrations (Css) of C/T in continuous infusion (CI) against three XDR P. aeruginosa ST175 isolates with C/T minimum inhibitory concentration (MIC) values of 2 to 16 mg/L in a hollow-fiber infection model (HFIM). Duplicate 10-day HFIM assays were performed to evaluate Css of C/T in CI: one compared 20 and 45 mg/L against the C/T-susceptible isolate while the other compared 45 and 80 mg/L against the two C/T-non-susceptible isolates. C/T resistance emerged when C/T-susceptible isolate was treated with C/T in CI at a Css of 20 mg/L; which showed a deletion in the gene encoding AmpC ß-lactamase. The higher dosing regimen (80 mg/L) showed a slight advantage in effectiveness. The higher dosing regimen has the greatest bactericidal effect, regardless of C/T MIC. Exposure to the suboptimal Css of 20 mg/L led to the emergence of C/T resistance in the susceptible isolate. Antimicrobial regimens should be optimized through C/T levels monitoring and dose adjustments to improve clinical management.

Time-Kill Evaluation of Antibiotic Combinations Containing Ceftazidime-Avibactam against Extensively Drug-Resistant Pseudomonas aeruginosa and Their Potential Role against Ceftazidime-Avibactam-Resistant Isolates.

Ceftazidime-avibactam (CZA) has emerged as a promising solution to the lack of new antibiotics against Pseudomonas aeruginosa infections. Data from in vitro assays of CZA combinations, however, are scarce. The objective of our study was to perform a time-kill analysis of the effectiveness of CZA alone and in combination with other antibiotics against a collection of extensively drug-resistant (XDR) P. aeruginosa isolates. Twenty-one previously characterized representative XDR P. aeruginosa isolates were selected. Antibiotic susceptibility was tested by broth microdilution, and results were interpreted using CLSI criteria. The time-kill experiments were performed in duplicate for each isolate. Antibiotics were tested at clinically achievable free-drug concentrations. Different treatment options, including CZA alone and combined with amikacin, aztreonam, meropenem, and colistin, were evaluated to identify the most effective combinations. Seven isolates were resistant to CZA (MIC ≥ 16/4 mg/liter), including four metallo-ß-lactamase (MBL)-carrying isolates and two class A carbapenemases. Five of them were resistant or intermediate to aztreonam (MIC ≥ 16 mg/liter). Three isolates were resistant to amikacin (MIC ≥ 64 mg/liter) and one to colistin (MIC ≥ 4 mg/liter). CZA monotherapy had a bactericidal effect in 100% (14/14) of the CZA-susceptible isolates. Combination therapies achieved a greater overall reduction in bacterial load than monotherapy for the CZA-resistant isolates. CZA plus colistin was additive or synergistic in 100% (7/7) of the CZA-resistant isolates, while CZA plus amikacin and CZA plus aztreonam were additive or synergistic in 85%. CZA combined with colistin, amikacin, or aztreonam was more effective than monotherapy against XDR P. aeruginosa isolates. A CZA combination could be useful for treating XDR P. aeruginosa infections, including those caused by CZA-resistant isolates. IMPORTANCE The emergence of resistance to antibiotics is a serious public health problem worldwide and can be a cause of mortality. For this reason, antibiotic treatment is compromised, and we have few therapeutic options to treat infections. The main goal of our study is to search for new treatment options for infections caused by difficult-to-treat resistant germs. Pseudomonas aeruginosa is a Gram-negative bacterium distributed throughout the world with the ability to become resistant to most available antibiotics. Ceftazidime-avibactam (CZA) emerged as a promising solution to the lack of new antibiotics against infections caused by P. aeruginosa strains. This study intended to analyze the effect of CZA alone or in combination with other available antibiotics against P. aeruginosa strains. The combination of CZA with other antibiotics could be more effective than monotherapy against extensively drug-resistant P. aeruginosa strains.

Can Multi-Item Measures and Single-Item Measures be Trusted to Assess Self-Determination Theory Constructs in the Elderly?

BACKGROUND: Measuring complex constructs, such as those from self-determination theory models, is challenging in the elderly due to the response process, particularly in collective data gathering. In order to examine this construct in physical activity settings we aimed at determining whether single-item measures were as good as pre-existing multi-item measures. For that reason, we developed seven single-item measures targeting perceived interpersonal styles, basic needs satisfaction, and well-being. METHOD: We gathered evidence of validity and reliability for multi-item measures and single-item measures based on a sample of 128 elderly adults. Another sample of 62 elderly adults provided test-retest reliability for the single-item measures. RESULTS: Favourable evidence of the expected internal structure, concurrent validity, and reliability was obtained for competence- and relatedness-supportive styles, and for satisfaction of the basic psychological need of relatedness, fairly good evidence was obtained for subjective vitality, whereas mixed evidence was obtained for autonomy-supportive style and the satisfaction of the basic psychological needs of autonomy and competence. CONCLUSIONS: Single-item measures proved to be psychometrically sound substitutes for their multi-item counterparts, but the autonomy constructs need to be reconsidered. Furthermore the response process and consequences of testing should play a prominent role when devising questionnaires for the elderly.