Quality of Life of Patients with Oral Squamous Cell Carcinoma.

Background: Oral squamous cell carcinoma (OSCC) has numerous physical, psychosocial and financial implications, which significantly affect patients' quality of life. We aimed to determine the health-related quality of life (HRQoL) and identify quality of life (QoL) predictors in patients with OSCC. Methods: We included 64 consecutive patients aged 40 to 80 yr treated for OSCC from Jan to Dec 2021. Health-related QoL was evaluated using the 30-item Cancer Quality of Life Questionnaire (QLQ-C30) and the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-H&N35). The demographic questionnaire and clinical parameters were also presented. Results: The functioning scale in the QLQ-C30 questionnaire with the lowest average score was Global health status. The mean QLQ-C30 summary score (80.92 ± 10.4) was higher than the Global health status score (50.5 ± 22.2). In the QLQ-H&N35 questionnaire, the symptoms with highest scores were weight loss, dry mouth, and social eating. Linear regression analysis demonstrated that Global health status score was associated with education level [ß-coefficient = 19.33 (95% CI: 10.7-24.9, P=0.004], alcohol consumption [ß-coefficient=10.04 (95% CI: 4.5-14.8), P=0.023] and invasive surgical procedure [ß-coefficient=22.75 (95% CI: 15.0-30.5), P=0.002]. The QLQ-C30 summary score was associated with living alone [ß-coefficient= -20.05 (95% CI: -29.91-(-10.21), P=0.018], smoking status [ß-coefficient=4.35 (95% CI: 1.8-6.91), P=0.043] and alcohol consumption [ß-coefficient =4.59 (95% CI: 1.99-7.19), P=0.037]. Conclusion: We found several significant predictors of worse perception of HRQoL among patients with OSCC, which may be useful for specific prevention and treatment in order to achieve better QoL.

Psychometric validation of the short version of the Information Needs in Cardiac Rehabilitation scale through a first global assessment.

AIMS: Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally. METHODS AND RESULTS: In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine. CONCLUSION: Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe.

Patients need information to manage their heart diseases, such as what to do if they have chest pain, what a heart attack is, and how to take their medicine to lower the chances they will have another one, so a study of the information needs of over 1600 heart patients from around the globe was undertaken for the first time. Using the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale­which was shown to be a good measurement tool through the study and hence may improve patient education­patients reported they most wanted information about heart events, heart-healthy eating, exercise benefits, their pills, symptom response, risk factor control, and cardiac rehabilitation­but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ratings for each item ranged from 30.0 to 67.4%, also varying by region and income class; perceived knowledge sufficiency ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine.

Characteristics Associated with Relationship-Centred and Task-Focused Mealtime Practices in Older Adult Care Settings.

Purpose: To assess care home and staff characteristics associated with task-focused (TF) and relationship-centred care (RCC) mealtime practices prior to the COVID-19 pandemic.Methods: Staff working in Canadian and American care homes were invited to complete a 23-item online survey assessing their perceptions of mealtime care, with one item assessing 26 potential care practices from the Mealtime Relational Care Checklist (relationship-centred = 15; task-focused = 11) reported to occur in the home prior to the pandemic. Multivariate linear regression evaluated staff and care home characteristics associated with mealtime practices.Results: Six hundred and eighty-six respondents completed all questions used in this analysis. Mean TF and RCC mealtime practices were 4.89 ± 1.99 and 9.69 ± 2.96, respectively. Staff age was associated with TF and RCC practices with those 40-55 years reporting fewer TF and those 18-39 years reporting fewer RCC practices. Those providing direct care were more likely to report TF practices. Dissatisfaction with mealtimes was associated with more TF and fewer RCC practices. Homes that were not making changes to promote RCC pre-pandemic had more TF and fewer RCC practices. Newer care homes were associated with more RCC, while small homes (≤49 beds) had more TF practices.Conclusions: Mealtime practices are associated with staff and home factors. These factors should be considered in efforts to improve RCC practices in Canadian homes.

Discrepancies between self- and informant-ratings of functional abilities and objective cognition: predictors of bias in mild cognitive impairment.

OBJECTIVE: Self- and informant-ratings of functional abilities are used to diagnose mild cognitive impairment (MCI) and are commonly measured in clinical trials. Ratings are assumed to be accurate, yet they are subject to biases. Biases in self-ratings have been found in individuals with dementia who are older and more depressed and in caregivers with higher distress, burden, and education. This study aimed to extend prior findings using an objective approach to identify determinants of bias in ratings. METHOD: Participants were 118 individuals with MCI and their informants. Three discrepancy variables were generated including the discrepancies between (1) self- and informant-rated functional status, (2) informant-rated functional status and objective cognition (in those with MCI), and (3) self-rated functional status and objective cognition. These variables served as dependent variables in forward linear regression models, with demographics, stress, burden, depression, and self-efficacy as predictors. RESULTS: Informants with higher stress rated individuals with MCI as having worse functional abilities relative to objective cognition. Individuals with MCI with worse self-efficacy rated their functional abilities as being worse compared to objective cognition. Informant-ratings were worse than self-ratings for informants with higher stress and individuals with MCI with higher self-efficacy. CONCLUSION: This study highlights biases in subjective ratings of functional abilities in MCI. The risk for relative underreporting of functional abilities by individuals with higher stress levels aligns with previous research. Bias in individuals with MCI with higher self-efficacy may be due to anosognosia. Findings have implications for the use of subjective ratings for diagnostic purposes and as outcome measures.

Translation, cultural adaptation and psychometric validation of the Arabic short version of the coronary artery disease education questionnaire (CADE-Q SV) in Saudi Arabia.

Objective: To translate, culturally adapt, and psychometrically validate the Arabic Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV). Methods: The CADE-Q SV was translated to Arabic by two independent translators, followed by back-translation. Then, an expert panel of 10 healthcare providers and 10 patients reviewed the survey and provided input for content validity (CV) and clarity of items. For the psychometric analysis, 202 cardiac patients from Saudi Arabia completed the questionnaire, of which factor structure, internal consistency, construct, and criterion validity were assessed. Results: Items were translated, and CV was confirmed. Items were rated based on relevance and understandability. The scale was finalized after changes in 5 items. Confirmatory factor analysis revealed 5 factors, all internally consistent: medical condition, risk factors, exercise, nutrition, and psychosocial health. Overall alpha was 0.84. Construct validity was established by significant associations between scores and occupation, educational level, family income, having a diagnosis of acute coronary syndrome or valve disorders and with a history of valve repair or replacement a coronary artery bypass graft procedure. Scores were significantly higher for those that participated in cardiac rehabilitation, confirming criterion validity. Conclusions: Results from this study confirm the validity and reliability of the CADE-Q SV in Arabic-speaking patients. Innovation: The CADE-Q SV can be used as a knowledge measurement to support clinical work and development of education intervention for Arabic patients.

Evaluation of treatment and restoration preferences in deep carious teeth with various pulp exposure sizes: A questionnaire-based survey.

This study evaluated the management preferences in a deep carious vital tooth. A questionnaire was e-mailed to members of the Turkish Dental Association. The questionnaire included a photograph and radiographs of an extremely deep carious molar (#16) of a 30-year-old man suffering from cold and chewing sensitivity. The dentists were asked to choose treatments for pulp exposure of <1, 1-2, and ≥2 mm and a permanent restoration. Chi-squared test was used to analyse data (p < 0.05). 504 (4.84%) of 10 411 dentists responded. When the pulp exposure was <1 mm: direct pulp capping (84.9%); 1-2 mm: root canal treatment (49.6%); ≥2 mm: root canal treatment (85.7%) were the most preferred treatments. 69.6% of the respondents chose direct composite restorations. If the tooth would be an abutment, most respondents preferred root canal treatment, regardless of the perforation size. The extent of pulp exposure and the type of permanent restoration influenced the treatment decision-making process.

Sound psychometric properties of a short new screening tool for patient safety climate: applying a Rasch model analysis.

BACKGROUND: WHO recommends repeated measurement of patient safety climate in health care and to support monitoring an 11 item questionnaire on sustainable safety engagement (HSE) has been developed by the Swedish Association of Local Authorities and Regions. This study aimed to validate the psychometric properties of the HSE. METHODS: Survey responses (n = 761) from a specialist care provider organization in Sweden was used to evaluate psychometric properties of the HSE 11-item questionnaire. A Rasch model analysis was applied in a stepwise process to evaluate evidence of validity and precision/reliability in relation to rating scale functioning, internal structure, response processes, and precision in estimates. RESULTS: Rating scales met the criteria for monotonical advancement and fit. Local independence was demonstrated for all HSE items. The first latent variable explained 52.2% of the variance. The first ten items demonstrated good fit to the Rasch model and were included in the further analysis and calculation of an index measure based on the raw scores. Less than 5% of the respondents demonstrated low person goodness-of-fit. Person separation index > 2. The flooring effect was negligible and the ceiling effect 5.7%. No differential item functioning was shown regarding gender, time of employment, role within organization or employee net promotor scores. The correlation coefficient between the HSE mean value index and the Rasch-generated unidimensional measures of the HSE 10-item scale was r = .95 (p < .01). CONCLUSIONS: This study shows that an eleven-item questionnaire can be used to measure a common dimension of staff perceptions on patient safety. The responses can be used to calculate an index that enables benchmarking and identification of at least three different levels of patient safety climate. This study explores a single point in time, but further studies may support the use of the instrument to follow development of the patient safety climate over time by repeated measurement.

Measurement properties of the Spinal Appearance Questionnaire in adolescents with idiopathic scoliosis: a systematic review.

BACKGROUND: Scoliosis is defined as a three-dimensional deformity of the spine characterized by lateral tilt and axial rotation of the vertebrae. Its magnitude in the frontal plane is identified by a Cobb angle greater than 10o. The aim of the study was to systematically examine the clinimetric properties of the Spinal Appearance Questionnaire (SAQ) in its cross-cultural adaptations in different languages. METHODS: Medline (PubMed), CINAHL, EMBASE, Science Direct, PsycINFO and WorldWideScience.org databases were used for screening studies until July 16, 2022. In this study, records on the development, evaluation and translation of the SAQ instrument in adolescents with idiopathic scoliosis were included. In addition, two independent reviewers defined whether the studies were eligible and analyzed their psychometric properties of internal consistency, reliability, content validity, cross-cultural validity, construct validity and structural validity, according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The modified GRADE was applied for evidence synthesis. RESULTS: A total of 95 articles were selected by title and abstract. After removing duplicates and reading and searching the references, a total of 13 studies were included in this review. The original version of the SAQ was described in English, and the instrument was translated into Polish, Canadian French, Simplified Chinese, Spanish (Europe), Danish, Traditional Chinese, Portuguese (Brazil), Korean, German, Turkish and Persian. The evidence was moderate for construct validity, low for internal consistency, and very low for reliability and cross-cultural validity; the content and structural validity properties did not present minimum data for classification. CONCLUSION: The quality of the evidence regarding the clinimetric properties of the SAQ instrument in adolescents with idiopathic scoliosis was low due to the absence of clinimetric properties or dubious methodological quality. However, for clinical practice and research, we recommend the use of the instrument to assess the self-perception of the spine in adolescents. For future translations and adaptations, we recommend the use of the COSMIN guidelines.

Assessment of the psychological impact of dental aesthetics among undergraduate university students in Iraq.

AIM: This study aimed to assess Iraqi university students' oral health-related quality of life (OHRQoL) according to sociodemographic variables and compare dental and non-dental students. METHODS: A cross-sectional study was carried out for students in multiple Iraqi universities from June 15, 2022, to July 15, 2022. A total of 771 individuals participated in the study using an online questionnaire. A pre-tested and validated Arabic version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was adopted as an evaluation tool. A P value of less than 0.05 was considered statistically significant. Reliability analysis was conducted using Cronbach's alpha. RESULT: Cronbach's alpha score for the overall scales was 0.942, indicating excellent internal consistency. There were 69.8% (n = 538) dental students in the total sample. A significant difference was found between dental and non-dental students in the total PIDAQ scores and other subscale domains (P < 0.05). Statistically significant differences in means were also noted in the residency (P = 0.005) and household income of students (P = 0.000). CONCLUSIONS: This study shows the reliability of the PIDAQ scale for assessing the psychological impact of dental aesthetics on undergraduate Iraqis. It was found that the perception of OHRQoL varies between dental and non-dental university students, and according to socioeconomic status and residency.

Validation of the Chinese DeFeC questionnaire: a comprehensive screening tool for symptoms and causes of constipation and incontinence.

BACKGROUND: Currently, the diagnosis of defecation disorders in China is usually based on varied and ambiguous criteria. We aimed to translate the Groningen Defecation and Fecal Continence (DeFeC) questionnaire to Chinese and test its reproducibility and feasibility in the general Chinese population. METHODS: The Groningen Defecation Questionnaire was translated into Chinese according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). The feasibility and reproducibility were evaluated by performing a test-retest online survey and calculating the Cohen's kappa (κ) coefficient [or intraclass correlation coefficient (ICC)], with 0.01-0.20 considered slight agreement; 0.21-0.40, fair agreement; 0.41-0.60, moderate agreement; 0.61-0.80, substantial agreement; and 0.81-1.00, almost perfect agreement. RESULTS: In total, 130 respondents completed the questionnaire twice, with a mean age of 47.08±12.46 years. No remarks were made that indicted that the questions were difficult to understand. The median time to complete the questionnaire was 20.78 min [interquartile range (IQR), 14.83-29.20 min] for the first time. The κ coefficient of all defecation function-related domains ranged between 0.25 and 0.71, with an average value of 0.53. The constipation and fecal incontinence-related domains showed a substantial and moderate agreement level, as indicated by κ of 0.65 and 0.52, respectively. The Agachan constipation score and Wexner incontinence score showed perfect and substantial agreement, as indicated by an ICC of 0.88 and 0.74, respectively. CONCLUSIONS: The Chinese version of the Groningen DeFeC questionnaire is highly feasible and reproducible and can be applied in clinical and research activities for the Chinese population.

Translation, Cross-Cultural Adaptation and Psychometric Validation of the Arabic Version of the Cardiac Rehabilitation Barriers Scale (CRBS-A) with Strategies to Mitigate Barriers.

Cardiac rehabilitation (CR) utilization is low, particularly in Arabic-speaking countries. This study aimed to translate and psychometrically validate the CR Barriers Scale in Arabic (CRBS-A), as well as strategies to mitigate them. The CRBS was translated by two bilingual health professionals independently, followed by back-translation. Next, 19 healthcare providers, followed by 19 patients rated the face and content validity (CV) of the pre-final versions, providing input to improve cross-cultural applicability. Then, 207 patients from Saudi Arabia and Jordan completed the CRBS-A, and factor structure, internal consistency, construct, and criterion validity were assessed. Helpfulness of mitigation strategies was also assessed. For experts, item and scale CV indices were 0.8-1.0 and 0.9, respectively. For patients, item clarity and mitigation helpfulness scores were 4.5 ± 0.1 and 4.3 ± 0.1/5, respectively. Minor edits were made. For the test of structural validity, four factors were extracted: time conflicts/lack of perceived need and excuses; preference to self-manage; logistical problems; and health system issues and comorbidities. Total CRBS-A α was 0.90. Construct validity was supported by a trend for an association of total CRBS with financial insecurity regarding healthcare. Total CRBS-A scores were significantly lower in patients who were referred to CR (2.8 ± 0.6) vs. those who were not (3.6 ± 0.8), confirming criterion validity (p = 0.04). Mitigation strategies were considered very helpful (mean = 4.2 ± 0.8/5). The CRBS-A is reliable and valid. It can support identification of top barriers to CR participation at multiple levels, and then strategies for mitigating them can be implemented.

Pharmacist-directed Sputnik V (GAM-COVID-VAC) surveillance program: a prospective observational study in Southern India.

OBJECTIVES: The study underwent to evaluate the adverse events, the incidence of COVID-19 and the participant's attitude and perception towards the vaccine following Sputnik V administration through an active surveillance program. METHODS: The prospective observational study was conducted four months in the Sputnik V vaccination center that enrolled 700 participants. Sociodemographic details, medical histories, COVID-19 incidences and adverse events following immunization (AEFI) of each sample were collected through face-to-face interviews and a telephonic feedback system. A self-prepared and validated questionnaire addressed their acceptances and perceptions towards the vaccination drive. RESULTS: Our study reported 42.1% of AEFIs after the first dose and 9.1% after the second. Fever, pain at the injection site, body pain, headache and fatigue were predominant, while dizziness and diarrhoea were rare. However, AEFIs were not influenced by the presence of comorbidities (p > 0.05). On the other hand, there were limited post immunization (1.8%) COVID-19 patients and that too with minor severity (p < 0.01). Our participants were overall satisfied with the Sputnik V immunization. However, those presented with AEFIs on the consecutive three days depicted slightly declined gratification (p < 0.05). CONCLUSIONS: Our pharmacist-directed surveillance program on Sputnik V showed fewer events of AEFIs and negligible occurrence of COVID19 following immunization. Moreover, the population had appreciable attitude and positive perceptions towards Sputnik V vaccination.

Identifying Cognitive Impairment Among Older Participants in a Nationally Representative Internet Panel.

OBJECTIVES: The Health and Retirement Study Telephone Interview for Cognitive Status (HRS TICS) score and its associated Langa-Weir cutoffs are widely used as indicators of cognitive status for research purposes in population-based studies. The classification is based on in-person and phone interviews of older individuals. Our purpose was to develop a corresponding classification for web-based self-administered assessments. METHODS: Participants were 925 members of a nationally representative internet panel, all aged 50 and older. We conducted (a) a phone interview comprised of cognitive items used to construct the HRS TICS score, and (b) a web counterpart with self-administered cognitive items, while also considering (c) other already administered web-based cognitive tests and instrumental activities of daily living survey questions, all from the same respondents. RESULTS: The web-administered HRS TICS items have only modest correlations with the same phone items, although neither mode showed universally higher scores than the other. Using latent variable modeling, we created a probability of cognitive impairment score for the web-based battery that achieved good correspondence to the phone Langa-Weir classification. DISCUSSION: The results permit analyses of predictors, correlates, and consequences of cognitive impairment in web surveys where relevant cognitive test and functional abilities items are available. We discuss challenges and caveats that may affect the findings.

A Questionnaire to Assess Phonation and Problems in Daily Living for Provox® Voice Prosthesis Users in Japan.

The aim of this study was to investigate the problems in daily life of Provox® users in Japan with the use of a questionnaire survey and to consider future guidance methods for these patients. We mailed questionnaires to 190 members of a Japanese laryngectomized patient group. We received 118 questionnaires with valid responses. The total voice handicap index (VHI) score was 44.1. Patients were allocated to two groups based on the type of surgery they underwent-laryngectomy or jejunum reconstruction. The VHI score was significantly lower in the simple laryngectomy group than that in the free jejunum reconstruction group (p < 0.01). Only 55.9% of the patients reported having received voice rehabilitation therapy. For other problems of daily life, many patients answered "bad/very bad" for the "smelling," "eating/drinking hot foodstuffs," "blowing nose," and "quantity of sputum" categories. Based on our results, there is a requirement for an effective rehabilitation therapy and appropriate guidance for patients with the Provox® voice prosthesis.

Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19.

Background: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. Aim: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. Methods: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. Results: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. Conclusion: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified.

Corona Chronicles: A Cross-sectional Survey of Practices, Challenges, and Dermatological Impact of the COVID-19 Pandemic.

Objective: Mask usage and hand hygiene are the pillars of defense against the novel pathogen causing COVID-19. This study was conducted to compare these practices among healthcare workers (HCWs) and nonhealthcare workers (nonHCWs) and to examine the outlook toward the healthcare sector among the two. Methods: A cross-sectional online survey (via Google forms) using snowball sampling was conducted. Appropriate ethical clearance was taken from the Institutional Ethical Committee (IEC). HCWs and nonHCWs 18 years of age or older with basic literacy in English and with internet access were included. Results: There were 404 total respondents (M:F ratio: 0.87:1; mean age: 30.16±9.63 years). Among the respondents, 63.3 percent were HCWs while 35.6 percent were nonHCWs. Persons performing hand hygiene more than10 times/day were found to be almost three times more likely to develop skin dryness (odds ratio [OR]: 2.95, 95% confidence interval [CI]: 1.372, 6.362). Female participants were found to be 2.5 times more likely to develop dryness (odds ratio: 2.594, 95% CI: 1.590, 4.234). Use of gloves was found to be a protective factor against development of dryness (odds ratio: 0.485,95% CI: 0.287, 0.818). A statistically significant correlation was found between mask acne and female respondents (p-value=0.000), HCWs (p-value=0.000), and use of N95 mask in combination with surgical mask (p-value=0.04). Limitations: Being an online survey, responses could not be captured from people with limited internet access and of lower socio-economic strata. Conclusion: There is a considerable burden of preventive measures on HCWs and nonHCWs alike. Significant dermatological implications are seen with frequent hand hygiene and mask usage.

An evaluation of instruments measuring behavioural aspects of the nurse-patient relationship.

The Fundamentals of Care Framework is an evidence-based, theory-informed framework that conceptualises high-quality fundamental care. The Framework places the nurse-patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse-patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse-patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty-seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse-patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework.

Estimation of underreporting of energy intake using different methods in a subsample of the ELSA-Brasil study / Estimativa da subnotificação de ingestão energética através de diferentes métodos em uma subamostra do estudo ELSA-Brasil / Estimación de la infradeclaración de la ingesta de energía utilizando diferentes métodos en una submuestra del estudio del ELSA-Brasil

Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.

Os métodos existentes para avaliar consumo alimentar estão sujeitos a erros de medição, especialmente à subnotificação de ingestão calórica, que descreve a ingestão calórica abaixo do mínimo necessário para manter o peso corporal. Este estudo buscou comparar a identificação de subnotificações de ingestão calórica através de diferentes equações preditivas e instrumentos para coletar dados dietéticos. Este estudo foi realizado com 101 participantes selecionados na terceira onda do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) do Hospital Universitário da Universidade de São Paulo. A partir da avaliação dietética, aplicamos um questionário de frequência alimentar (QFA), dois recordatórios de 24 horas (24hR) pelo software GloboDiet e dois 24hR utilizando o software Brasil-Nutri. A subnotificação de ingestão calórica obtida pelo QFA foi de 13%, 16% e 1%, utilizando-se as equações propostas por Goldberg et al. (1991), Black (2000) e McCrory et al. (2002), respectivamente. Com essas mesmas equações, o 24hR achou uma subnotificação de 9,9%, 14,9% e 0,9%, respectivamente, com o software GloboDiet e de 14,7%, 15,8% e 1,1%, respectivamente, com o software Brasil-Nutri. Verificou-se baixa prevalência de ingestão calórica subnotificada entre os três métodos de captação de dados dietéticos por autorrelato (FFQ e 24hR com GloboDiet e Brasil-Nutri). As equações para cada método diferem entre si embora não tenhamos encontrado diferenças estatisticamente significativas entre os três métodos. A concordância de ingestão calórica entre os métodos foi muito semelhante, mas a melhor foi entre a GloboDiet e a Brasil-Nutri.

Los métodos existentes para evaluar el consumo de alimentos están sujetos a errores de medición, especialmente la infradeclaración de la ingesta de energía, caracterizada por la notificación de la ingesta de energía por debajo del mínimo necesario para mantener el peso corporal. El objetivo de este estudio era comparar la identificación de las infradeclaraciones de ingesta energética utilizando diferentes ecuaciones de predicción e instrumentos de recogida de datos dietéticos. El estudio se realizó con 101 participantes seleccionados en la tercera ola del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) en el Hospital Universitario de la Universidad de São Paulo. Para la evaluación de la dieta, se aplicó un cuestionario de frecuencia de alimentos (QFA), dos recordatorios de dieta de 24 horas (24hR) utilizando el software GloboDiet, y dos 24hR utilizando el software Brasil-Nutri. La infradeclaración de la ingesta energética obtenida del QFA fue del 13%, el 16% y el 1,0% utilizando las ecuaciones propuestas por Goldberg et al. (1991), Black (2000) y McCrory et al. (2002), respectivamente. Con estas mismas ecuaciones, el 24hR describió una infradeclaración del 9,9%, el 14,9% y el 0,9% respectivamente con el software GloboDiet y del 14,7%, el 15,8% y el 1,1% respectivamente con el software Brasil-Nutri. Se verificó una baja prevalencia de ingesta de energía subdeclarada entre los tres métodos de recogida de datos dietéticos basados en el autoinforme (QFA, 24hR con GloboDiet y Brasil-Nutri). Aunque no se encontraron diferencias estadísticamente significativas entre los tres métodos, las ecuaciones de cada uno de ellos diferían entre sí. La concordancia de la ingesta de energía entre los métodos fue muy similar, pero la mejor fue entre GloboDiet y Brasil-Nutri.

A Disclosure About Death Disclosure: Variability in Circulatory Death Determination.

INTRODUCTION: Circulatory-respiratory death declaration is a common duty of physicians, but little is known about the amount of education and physician practice patterns in completing this examination. METHODS: An online survey of physicians was conducted evaluating the rate of formal training and specific examination techniques used in the pronouncement of circulatory-respiratory death. Data, including the level of practice, training received in a formal death declaration, and examination components, were collected. RESULTS: Respondents were attending physicians (52.4%), residents (30.2%), fellows (10.7%), and interns (6.7%). Most respondents indicated they had received no formal training in death pronouncement; however, most reported self-perceived competence. When comparing examination components used by the study's cohort, 95 different examination combinations were used for death pronouncement. CONCLUSIONS: Formal training in death pronouncement was uncommon and clinical practice varied. Implementation of formal training and standardization of the examination are necessary to improve physician competence and reliability in death declarations.