Cross-cultural adaptation and validation of the RhinAsthma Patient Perspective (RAPP) in Spanish

OBJECTIVE: the RhinAsthma Patient Perspective (RAPP) is the only available tool to assess HRQoL in daily practice. The aim of this study is to cross-culturally validate the RAPP in Spanish. METHODS: The RAPP was translated into Spanish. Adult patients receiving usual care for asthma and allergic rhinitis (AR) were recruited consecutively and assessed twice with a four-week interval between visits to test the psychometric properties of the questionnaire. RESULTS: 149 patients (62.8% female) with a mean age of 37.7 years completed the study. Exploratory and confirmatory factor analysis confirmed the uni-dimensional structure of the questionnaire. Internal consistency (0.73 at visit 1; 0.87 at visit 2), convergent and discriminant validity (p < .05 at both visits) were satisfactory. Reliability was confirmed by an ICC of 0.69 and a CCC of 0.74. Responsiveness was supported by a significant association with VAS (r = 0.28, p < 0.003) and ACT (r = -0.35, p < 0.01). The minimal clinical difference (MID) value in the analyzed population was 2. CONCLUSIONS: The Spanish version of RAPP was demonstrated to have satisfactory psychometric properties and is a valid, reliable and responsive tool for the assessment of asthma and AR HRQoL in clinical practice

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Cross-cultural adaptation and validation of the RhinAsthma Patient Perspective (RAPP) in Spanish.

OBJECTIVE: the RhinAsthma Patient Perspective (RAPP) is the only available tool to assess HRQoL in daily practice. The aim of this study is to cross-culturally validate the RAPP in Spanish. METHODS: The RAPP was translated into Spanish. Adult patients receiving usual care for asthma and allergic rhinitis (AR) were recruited consecutively and assessed twice with a four-week interval between visits to test the psychometric properties of the questionnaire. RESULTS: 149 patients (62.8% female) with a mean age of 37.7 years completed the study. Exploratory and confirmatory factor analysis confirmed the uni-dimensional structure of the questionnaire. Internal consistency (0.73 at visit 1; 0.87 at visit 2), convergent and discriminant validity (p<.05 at both visits) were satisfactory. Reliability was confirmed by an ICC of 0.69 and a CCC of 0.74. Responsiveness was supported by a significant association with VAS (r=0.28, p<0.003) and ACT (r=-0.35, p<0.01). The minimal clinical difference (MID) value in the analyzed population was 2. CONCLUSIONS: The Spanish version of RAPP was demonstrated to have satisfactory psychometric properties and is a valid, reliable and responsive tool for the assessment of asthma and AR HRQoL in clinical practice.

Anaerobic treatment of organic chemical wastewater using packed bed reactors.

The studied organic chemical wastewater had a high COD, 20-45g/L, and low TSS, less than 200 mg/L, making anaerobic bio-filtration a suitable treatment method. The organic matter consisted of alcohols, amines, ketones and aromatic compounds, such as toluene and phenol. Granulated activated carbon (GAC) and a porous stone called tezontle, widely available in Mexico, were used as a bio-film support. Once inoculated, the mesophilic reactors with granulated activated carbon (GAC-BFs) reached stability with 80% COD removal in 40 days, while the reactors with tezontle material (tezontle-BF) required 145 days. Biodegradation of more than 95% was obtained with both support media: at organic loads less than 1.7 kg m(-3) d (-1) in tezontle-BF and with loads of up to 13.3 kg m(-3) d(-1) in GAC-BFs. The bio-filters with GAC allowed COD removal efficiency of 80% at a load as high as 26.3 kg m (-3) d(-1), while the same efficiency with tezontle was obtained at loads up to 4.45 kgm (-3d) (-1). The use of GAC as support material allows greater biodegradation rates than tezontle and it makes the bio-filters more resistant to organic increases, inhibition effects and toxicity. Methanogenic activity was inhibited at loads higher than 1.7 kg m(-3) d(-1) in bio-filters with tezontle and 22.8 kg m(-3) d(-1 ) in bio-filters with GAC. At loads lower than the previously mentioned, high methane production yield was obtained, 0.32-0.35 m(3) CH4/kg COD removed. The biomass growth rates were low in the bio-filters with both kinds of material; however, a sufficiently high biomass holdup was obtained.

Treatment of chemical-pharmaceutical wastewater in packed bed anaerobic reactors.

Biological degradation in packed bed anaerobic mesophilic reactors with five different support materials was studied for the treatment of chemical-pharmaceutical wastewater with high COD (23-31 g/L), which contains toxic organic compounds. Experimental up-flow bio-filters were operated at different organic loads for a two-year period. Removals of 80-98% were obtained in the reactors with sand, anthracite and black tezontle, but at relatively low organic loads, less than 3.6 kg m(-3)d(-1). The reactor with granular activated carbon (GAC) had a better performance; efficiencies higher than 95% were obtained at loads up to 17 kg m(-3)d(-1) and higher than 80% with loads up to 26 kg m(-3)d(-1). Second in performance was the reactor with red tezontle which allows COD removals higher than 80% with loads up to 6 kg m(-3)d(-1). The use of GAC as support material allows greater biodegradation rates than the rest of the materials and it makes the process more resistant to organic load increases, inhibition effects and toxicity. Methanogenic activity was inhibited at loads higher than 21.9 kg m(-3)d(-1) in the GAC-reactor and at loads higher than 3.6 kg m(-3)d(-1) in the rest of the reactors. At loads lower than the previously mentioned, high methane production yield was obtained, 0.32-0.35 m3CH4/kg CODremoved.