[Spanish translation, cross-cultural adaptation and validation of the ADTC scale (Atopic Dermatitis Control Tool)] / Traducción al español, adaptación transcultural y validación de la escala ADTC (Atopic Dermatitis Control Tool).

OBJETIVES: Obtain a version to validate it in a population of adults with AD. MATERIALS AND METHODS: 1) Translation into Spanish and cross-cultural adaptation of the questionnaire from the original version in English, through a seven-step process. 2) Evaluation of the unidimensionality of the resulting scale by means of an exploratory factor analysis (EFA), of its reliability by means of Cronbach's alpha coefficient, and of its validity by evaluating the correlation of its score with those of the POEM and DLQI questionnaires. (external reference criteria). RESULTS: The version resulting from the translation and cross-cultural adaptation process was well understood by the target population. The AFE of the 66 questionnaires documented the unidimensionality of the scale based on compliance with all the criteria used for its verification. Its reliability was excellent (Cronbach's Alpha: 0.917) and its score had a very high correlation with the external reference criteria (POEM: Spearman's Rho 0.85; p < 0.0001; DLQI Spearman's Rho = 0.81; p < 0 .0001). CONCLUSIONS: The version translated into Spanish and adapted for transculturation of the ADCT questionnaire has appropriate psychometric characteristics, which will contribute to optimizing the care processes of Spanish-speaking patients.

INTRODUCCIÓN: El cuestionario ADCT (Atopic Dermatitis Control Tool) permite objetivar en forma breve y autoadministrada la repercusión de la dermatitis atópica (DA) sobre la vida cotidiana de quien la padece. OBJETIVO: Obtener una versión validarla en una población de adultos con DA. MATERIALES Y METODOS: 1) Traducción al español y adaptación transcultural del cuestionario a partir de la versión original en inglés, a través de un proceso de siete pasos. 2) Evaluación de la unidimensionalidad de la escala resultante mediante un análisis factorial exploratorio (AFE), de su confiabilidad mediante el coeficiente alfa de Cronbach, y de su validez mediante la evaluación de la correlación de su puntaje con los de los cuestionarios POEM y DLQI (criterios externos de referencia). RESULTADOS: La versión resultante del proceso de traducción y adaptación transcultural fue bien comprendida por la población blanco. El AFE de los 66 cuestionarios documentó la unidimensionalidad de la escala a partir del cumplimiento de todos los criterios utilizados para su verificación. Su confiabilidad fue excelente (Alfa de Cronbach: 0,917) y su puntaje tuvo muy alta correlación con los criterios de referencia externos (POEM: Spearman's Rho 0,85; p < 0,0001; DLQI Spearman's Rho = 0,81; p < 0,0001). CONCLUSION: La versión traducida al español y adaptada transculturación del cuestionario ADCT tiene características psicométricas apropiadas, lo que contribuirá a optimizar los procesos de cuidado de pacientes de habla hispana.

Intraocular pressure changes under an atmospheric pressure spectrum in a multiplace hyperbaric chamber / Análise de alterações da pressão intraocular (PIO) sob o espectro da pressão atmosférica em uma câmara hiperbárica multi-lugar

ABSTRACT Purpose: To evaluate the influence of atmospheric pressure changes on the behavior of intraocular pressure of healthy military individuals-students and instructors of the National Navy's Diving & Rescue School at the "ARC BOLÍVAR" naval base-during a simulated immersion in the hyperbaric chamber of the Naval Hospital of Cartagena. Methods: A descriptive exploratory study was performed. The intraocular pressure was measured at different atmospheric pressures during 60-min sessions in the hyperbaric chamber while breathing compressed air. The maximum simulated depth was 60 feet. Participants were students and instructors of the Naval Base's Diving and Rescue Department. Results: A total of 48 eyes from 24 divers were studied, of which 22 (91.7%) were male. The mean age of the participants was 30.6 (SD=5.5) years, ranging from 23 to 40. No participant had a history of glaucoma or ocular hypertension. The mean base intraocular pressure at sea level was 14 mmHg, which decreased to 13.1 mmHg (decreased by 1.2 mmHg) at 60 feet deep (p=0.0012). However, during the safety stop at 30 feet, the mean IOP kept decreasing until reaching 11.9 mmHg (p<0.001). By the end of the session, the mean intraocular pressure reached 13.1 mmHg, which is inferior and statistically significant when compared with the intraocular pressure base mean (p=0.012). Conclusions: In healthy individuals, the intraocular pressure decreases when reaching a depth of 60 feet (2.8 absolute atmosphere pressure) and it decreases even more during ascension at 30 feet. Measurements at both points were significantly different when compared with base intraocular pressure. The final intraocular pressure was lower than the baseline intraocular pressure, suggesting a residual and prolonged effect of the atmospheric pressure on intraocular pressure.

RESUMO Objetivo: Avaliar a influência das alterações da pressão atmosférica no comportamento da pressão intraocular de indivíduos militares saudáveis-alunos e instrutores da Escola de Mergulho e Resgate da Marinha Nacional na base naval "ARC BOLÍVAR"-durante uma imersão simulada na câmara hiperbárica do Hospital da Marinha de Cartagena. Métodos: Realizamos um estudo exploratório descritivo. A pressão intraocular foi medida em diferentes pressões atmosféricas durante sessões de 60 minutos na câmara hiperbárica respirando ar comprimido. A profundidade máxima simulada foi de 60 pés. Os participantes eram alunos e instrutores do Departamento de Mergulho e Resgate da Base Naval. Resultados: Quarenta e oito olhos de 24 mergulhadores foram estudados. Vinte e dois participantes (91,7%) eram do sexo masculino. A média de idade dos participantes foi de 30,6 (DP=5,5) anos, variando de 23 a 40. Nenhum participante tinha histórico de glaucoma ou hipertensão ocular. A média de base da pressão intraocular ao nível do mar foi de 14 mmHg, diminuindo para 13,1 mmHg (queda de 1,2 mmHg) a 60 pés de profundidade (p=0,0012). Entretanto, durante a parada de segurança a 30 pés, a pressão intraocular média continuou diminuindo até atingir 11,9 mmHg (p<0,001). Ao final da sessão, a pressão intraocular média atingiu 13,1 mmHg, valor inferior e estatisticamente significativo quando comparada à média de base da pressão intraocular (p=0,012). Conclusões: Em indivíduos saudáveis, a pressão intraocular diminui ao atingir uma profundidade de 60 pés (2,8 de pressão atmosférica absoluta) e diminui ainda mais durante a ascensão a 30 pés. As medidas em ambos os pontos foram significativamente diferentes quando comparadas à pressão intraocular de base. A pressão intraocular final foi menor do que a pressão intraocular de base, sugerindo um efeito residual e prolongado da pressão atmosférica sobre a pressão intraocular.

Adaptación transcultural y validación de la versión en español del cuestionario de carga de tratamiento en personas con diabetes mellitus tipo 2 que concurren a centros de atención primaria del sector público de salud. San Juan / Transcultural adaptation and validation of the spanish version of the treatment burden questionnaire for people with diabetes mellitus type 2 that attend to primary health care centers within the public health care system. San Juan

Introducción: el Treatment Burden Questionnaire (TBQ) evalúa la carga que implica el autocuidado de personas con enfermedades crónicas y el impacto que la asistencia sanitaria genera en su calidad de vida. Objetivos: adaptar y validar psicométricamente la versión en español del cuestionario TBQ-esclerosis múltiple al contexto de la diabetes mellitus (DM) en pacientes atendidos en el sector público de Argentina. Materiales y métodos: estudio analítico de adaptación transcultural y validación psicométrica de un cuestionario. Se realizó un análisis factorial exploratorio (AFE) y un análisis factorial confirmatorio (AFC). La validez de criterio concurrente se evaluó a través de la correlación Pearson con tres escalas (OMS-5, PHQ-9 y test de Morisky-Green). La fiabilidad se analizó a través del coeficiente alfa de Cronbach, de la fiabilidad compuesta y la varianza media extractada. Resultados: participaron 256 personas. La versión adaptada fue adecuadamente comprendida por la población destinataria. El AFE (n=100) permitió hipotetizar cuatro dominios: 1) tratamiento farmacológico; 2) asistencia sanitaria/sistema de salud; 3) mantenimiento de un estilo de vida y su repercusión económica; 4) esfera psicosocial. En el AFC (n=156) las cargas factoriales del 87,5% (14/16) de los ítems fueron mayores a 0,5 con significancia estadística. Se documentó correlación inversa (-0,46; p=0,0002) con el puntaje OMS-5 y directa (0,36; p=0,0046) con PHQ-9. Los pacientes categorizados como "no adherentes" mediante la escala de Morisky-Green-Levine arrojaron un resultado de TBQ-DM de 16,99 (IC 95%: 0,95 a 33,03) puntos más que los pacientes categorizados como "adherentes" (p=0,0383). La consistencia interna del cuestionario fue muy buena (alfa de Cronbach: 0,87), su fiabilidad compuesta fue aceptable y su validez divergente, baja. Conclusiones: el TBQ en español adaptado a DM2 tiene aceptables propiedades psicométricas. Su implementación podría ofrecer cuidados basados en la persona.

Introduction: the Treatment Burden Questionnaire (TBQ) assess the load that implies the self-care for people with chronic diseases and the impact that medical assistance produce in their quality of life. Objectives: to adapt and psychometrically validate the spanish version of the TBQ-multiple sclerosis questionnaire to the diabetes mellitus (DM) context in patients treated in the Argentinian public health sector. Materials and methods: analytic study of transcultural adaptation and psychometric validation of a questionnaire. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were performed. Concurrent criterion validity was evaluated through Pearson correlation with three scales (WHO-5, PHQ-9, Morisky-Green Test). Reliability was evaluated through Cronbach's alpha coefficient, composite reliability, and average variance extracted. Results: 256 people participated. The adapted version was adequately understood by the target population. EFA (n=100) allowed for the hypothesis of four domains: 1) pharmacological treatment; 2) healthcare/health system; 3) maintenance of a lifestyle and its economic impact; 4) psychosocial sphere. In the CFA (n=156), the factor loadings of 87.5% (14/16) of the items were greater than 0.5 with statistical significance. An inverse correlation (-0.46; p=0.0002) with the WHO-5 index and a direct correlation (0.36; p=0.0046) with the PHQ-9 scale were documented. Patients categorized as "non-adherent" by the Morisky-Green-Levine scale had a TBQ-DM score of 16.99 (95% CI: 0.95 to 33.03) points higher than patients categorized as "adherent" (p=0.0383). The internal consistency of the questionnaire was very good (Cronbach's alpha: 0.87), its composite reliability was acceptable, and its divergent validity was low. Conclusions: the spanish TBQ adapted to DM2 has acceptable pyshcometric properties. Its implementation can help offer a person-centered care.

Intraocular pressure changes under an atmospheric pressure spectrum in a multiplace hyperbaric chamber.

PURPOSE: To evaluate the influence of atmospheric pressure changes on the behavior of intraocular pressure of healthy military individuals-students and instructors of the National Navy's Diving & Rescue School at the "ARC BOLÍVAR" naval base-during a simulated immersion in the hyperbaric chamber of the Naval Hospital of Cartagena. METHODS: A descriptive exploratory study was performed. The intraocular pressure was measured at different atmospheric pressures during 60-min sessions in the hyperbaric chamber while breathing compressed air. The maximum simulated depth was 60 feet. Participants were students and instructors of the Naval Base's Diving and Rescue Department. RESULTS: A total of 48 eyes from 24 divers were studied, of which 22 (91.7%) were male. The mean age of the participants was 30.6 (SD=5.5) years, ranging from 23 to 40. No participant had a history of glaucoma or ocular hypertension. The mean base intraocular pressure at sea level was 14 mmHg, which decreased to 13.1 mmHg (decreased by 1.2 mmHg) at 60 feet deep (p=0.0012). However, during the safety stop at 30 feet, the mean IOP kept decreasing until reaching 11.9 mmHg (p<0.001). By the end of the session, the mean intraocular pressure reached 13.1 mmHg, which is inferior and statistically significant when compared with the intraocular pressure base mean (p=0.012). CONCLUSIONS: In healthy individuals, the intraocular pressure decreases when reaching a depth of 60 feet (2.8 absolute atmosphere pressure) and it decreases even more during ascension at 30 feet. Measurements at both points were significantly different when compared with base intraocular pressure. The final intraocular pressure was lower than the baseline intraocular pressure, suggesting a residual and prolonged effect of the atmospheric pressure on intraocular pressure.

Validity and reliability of the Spanish version of the ACE tool for assessing competencies in evidence-based medicine in medical students.

OBJECTIVE: To translate and culturally adapt the tool 'Assessing Competency in evidence-based medicine (EBM)' (ACE) to Spanish and to implement it in a cohort of medical students for the evaluation of the instrument's psychometric properties. DESIGN: Bilingual translators produced a translation and backtranslation of the original instrument, with interim consensus in each stage with oversight and input by a group of experts. We then performed cognitive interviews to adapt the wording of the tool culturally. Finally, we implemented the final version in a cohort of medical students on a virtual general practice course with EBM modules. SETTING: Medical School in Buenos Aires, Argentina. Due to restrictions to in-person teaching during the COVID-19 pandemic, we conducted this study in the context of virtual learning. PARTICIPANTS: We included 125 fourth and fifth-year medical students. MAIN OUTCOME MEASURES: We measured internal consistency with the Kuder-Richardson coefficient (>0.6 as a threshold for reliability) and construct validity through a Pearson's correlation between the examinations carried out with the translated instrument and the results of the regular examinations of EBM in the same students (expected values of at least 0.3 to 0.7). We also compared the total score of the instrument of fifth-year students to fourth-year students. RESULTS: As for measurements for internal consistency, the coefficient Kuder-Richardson resulted in a value of 0.268, below our prespecified threshold. For construct validity, the Pearson correlation between the sum of the items and regular examinations was 0.139, also below our prespecified threshold. However, fifth-year students averaged 0.94 points more than fourth-year students (95% CI 0.24 more to 1.65 more). CONCLUSION: The translated and cross-culturally adapted version of the ACE tool into Spanish had low reliability and validity in an MBE course taught and evaluated in a virtual environment. TRIAL REGISTRATION: Not applicable.

[Telemedicine: validation of a questionnaire to evaluate the experience of health professionalsTelemedicina: validação de um questionário para avaliar a experiência dos profissionais de saúde]. / Telemedicina: validación de un cuestionario para evaluar la experiencia de los profesionales de la salud.

Objective: This objective of this work is to develop and validate a questionnaire to evaluate health professionals' experience with telemedicine systems. Methods: Based on an abbreviated, locally validated Spanish-language version of the patient questionnaire developed by Parmanto et al., a group of experts developed a version to evaluate the experience of health professionals who provide telemedicine services. The psychometric behavior of the items was tested in an initial sample of 129 professionals, using exploratory factor analysis. The comprehensibility of the items was then assessed through cognitive interviews. Finally, in a new sample of 329 professionals, the construct validity of the questionnaire was evaluated by means of confirmatory factor analysis (CFA); its criteria of external validity were assessed by comparing the score with that of a summary question. Results: A 12-item questionnaire was obtained, with a two-factor structure and acceptable adjustment indicators documented through CFA. Reliability, convergent validity, and discriminant validity were appropriate. The criteria of external validity showed optimal results. Conclusions: The instrument obtained has adequate psychometric properties and will contribute to the objective evaluation of the experience of health professionals who perform telemedicine.

Objetivo: Desenvolver e validar um questionário para avaliar a experiência dos profissionais de saúde com os sistemas de telemedicina. Métodos: Com base na versão abreviada em espanhol ­ e validada localmente ­ do questionário para pacientes desenvolvido por Parmanto et al., um grupo de especialistas gerou uma versão de consenso para avaliar a experiência de profissionais de saúde que prestam serviços de telemedicina. O comportamento psicométrico dos itens foi testado em uma primeira amostra de 129 profissionais, por meio de análise fatorial exploratória. Em seguida, sua compreensibilidade foi avaliada por meio de entrevistas cognitivas. Por fim, em uma nova amostra de 329 profissionais, avaliou-se a validade de construto do questionário por meio de uma análise fatorial confirmatória (AFC), e sua validade de critério externo, mediante a avaliação de sua pontuação com a de uma pergunta resumo. Resultados: Obteve-se um questionário de 12 itens com estrutura de dois fatores, com indicadores de ajuste aceitáveis, documentados pela AFC. A confiabilidade, a validade convergente e a validade discriminante foram adequadas. A validade de critério externo apresentou ótimos resultados. Conclusões: O instrumento obtido possui propriedades psicométricas adequadas e contribuirá para a avaliação objetiva da experiência dos profissionais que realizam telemedicina.

Telemedicina: validación de un cuestionario para evaluar la experiencia de los profesionales de la salud

[RESUMEN]. Objetivo. El siguiente trabajo tiene como objetivo desarrollar y validar un cuestionario para evaluar la experiencia de los profesionales de la salud con los sistemas de telemedicina. Métodos. A partir de la versión abreviada en español y validada localmente del cuestionario para pacientes desarrollado por Parmanto y col., un grupo de expertos consensuó una versión para evaluar la experiencia de profesionales de la salud que brindan servicios de telemedicina. El comportamiento psicométrico de los ítems se testeó en una primera muestra de 129 profesionales a través de un análisis factorial exploratorio. Luego, se evaluó su comprensibilidad a través de entrevistas cognitivas. Por último, en una nueva muestra de 329 profesionales, se evaluó la validez de constructo del cuestionario mediante un análisis factorial confirmatorio (AFC), y su validez de criterio externo, mediante la evaluación de su puntaje con el de una pregunta de resumen. Resultados. Se obtuvo un cuestionario de 12 ítems con una estructura de dos factores con indicadores de ajuste aceptables, documentada mediante AFC. La fiabilidad, la validez convergente y la validez discrimi- nante fueron apropiadas. La validez de criterio externo mostró resultados óptimos. Conclusiones. El instrumento obtenido cuenta con propiedades psicométricas adecuadas y contribuirá a la evaluación objetiva de la experiencia de los profesionales que realizan telemedicina.

[ABSTRACT]. Objective. This objective of this work is to develop and validate a questionnaire to evaluate health professionals' experience with telemedicine systems. Methods. Based on an abbreviated, locally validated Spanish-language version of the patient questionnaire developed by Parmanto et al., a group of experts developed a version to evaluate the experience of health professionals who provide telemedicine services. The psychometric behavior of the items was tested in an ini- tial sample of 129 professionals, using exploratory factor analysis. The comprehensibility of the items was then assessed through cognitive interviews. Finally, in a new sample of 329 professionals, the construct validity of the questionnaire was evaluated by means of confirmatory factor analysis (CFA); its criteria of external validity were assessed by comparing the score with that of a summary question. Results. A 12-item questionnaire was obtained, with a two-factor structure and acceptable adjustment indica- tors documented through CFA. Reliability, convergent validity, and discriminant validity were appropriate. The criteria of external validity showed optimal results. Conclusions. The instrument obtained has adequate psychometric properties and will contribute to the objec- tive evaluation of the experience of health professionals who perform telemedicine.

[RESUMO]. Objetivo. Desenvolver e validar um questionário para avaliar a experiência dos profissionais de saúde com os sistemas de telemedicina. Métodos. Com base na versão abreviada em espanhol e validada localmente do questionário para pacientes desenvolvido por Parmanto et al., um grupo de especialistas gerou uma versão de consenso para avaliar a experiência de profissionais de saúde que prestam serviços de telemedicina. O comportamento psicométrico dos itens foi testado em uma primeira amostra de 129 profissionais, por meio de análise fatorial exploratória. Em seguida, sua compreensibilidade foi avaliada por meio de entrevistas cognitivas. Por fim, em uma nova amostra de 329 profissionais, avaliouse a validade de construto do questionário por meio de uma análise fatorial confirmatória (AFC), e sua validade de critério externo, mediante a avaliação de sua pontuação com a de uma pergunta resumo. Resultados. Obteve-se um questionário de 12 itens com estrutura de dois fatores, com indicadores de ajuste aceitáveis, documentados pela AFC. A confiabilidade, a validade convergente e a validade discriminante foram adequadas. A validade de critério externo apresentou ótimos resultados. Conclusões. O instrumento obtido possui propriedades psicométricas adequadas e contribuirá para a ava- liação objetiva da experiência dos profissionais que realizam telemedicina.

Propuesta de una versión abreviada de un cuestionario internacional para pesquisar acoso escolar: adaptación al español de Argentina y análisis factorial exploratorio / Proposal for a short version of an international questionnaire to detect bullying: adaptation to Argentine Spanish language and exploratory factor analysis

Introducción. El acoso escolar (bullying) comprende conductas de intimidación, hostigamiento y acoso físico o psicológicoejercidas intencionalmente por un escolar(acosador) contra otro (víctima) en formareiterada. Incluye el maltrato físico y verbal, la exclusión social y el ciberacoso (ciberbullying). Las víctimas incrementan el ausentismo escolar y tienen más riesgo de desarrollar síntomassomáticos, ansiedad, depresión y suicidio. Si bien el cuestionario Adolescent Peer Relations Instrument (APRI) para la pesquisa de acoso escolar (19 ítems) fue validado en España en 2016, no se contaba con una herramienta validadaen Argentina. Objetivo. Obtener una versión abreviadaadaptada al español hablado en Argentina del cuestionario APRI. Población y método. Se realizó una adaptación transcultural al español hablado en Argentina del cuestionario APRI para la pesquisa deacoso escolar en adolescentes y, posteriormente, la reducción de ítems mediante un procesomatemático (análisis factorial exploratorio) y conceptual (comité de expertos). Participaron adolescentes de 13 a 17 años que cursabanestudios secundarios en dos escuelas estatales de la localidad Boulogne Sur Mer en San Isidro, provincia de Buenos Aires. Resultados. Se obtuvo una versión abreviada delcuestionario, conformada por 14 ítems divididosen dos dominios: maltrato físico y victimización verbal y social. Conclusiones. El cuestionario abreviado obtenidotiene equivalencia semántica con la versiónoriginal y cuenta, además, con una adecuada validez aparente y de contenido.

Introduction. Bullying encompasses intentional intimidation, abuse, and physical or psychological harassment behaviors by a student (bully) against another student (victim) repeatedly. It includes physical and verbal abuse, social exclusion, and cyberbullying. Victims miss school more often and have a higher risk for somatic symptoms, anxiety, depression, and suicide. Although the Adolescent Peer Relations Instrument (APRI) is a bullying screening questionnaire (19 items) validated in Spain in 2016, there was no validated instrument available in Argentina. Objective. To obtain a short version adapted to Argentine Spanish of the APRI. Population and method. The APRI, a questionnaire to screen for bullying among adolescents, was cross-culturally adapted to Argentine Spanish language and then questionnaire items were reduced by a mathematical process (exploratory factor analysis) and a conceptual process (expert committee). Participants were adolescents aged 13-17 years who were attending secondary public schools in the city of Boulogne Sur Mer, San Isidro, province of Buenos Aires. Results. A short questionnaire version made up of 14 items divided into 2 dimensions (physical abuse and social and verbal victimization) was obtained. Conclusions. The resulting short questionnaire is semantically equivalent to the original version and also has adequate apparent and content validity.

Proposal for a short version of an international questionnaire to detect bullying: adaptation to Argentine Spanish language and exploratory factor analysis. / Propuesta de una versión abreviada de un cuestionario internacional para pesquisar acoso escolar: adaptación al español de Argentina y análisis factorial exploratorio.

INTRODUCTION: Bullying encompasses intentional intimidation, abuse, and physical or psychological harassment behaviors by a student (bully) against another student (victim) repeatedly. It includes physical and verbal abuse, social exclusion, and cyberbullying. Victims miss school more often and have a higher risk for somatic symptoms, anxiety, depression, and suicide. Although the Adolescent Peer Relations Instrument (APRI) is a bullying screening questionnaire (19 items) validated in Spain in 2016, there was no validated instrument available in Argentina. OBJECTIVE: To obtain a short version adapted to Argentine Spanish of the APRI. POPULATION AND METHOD: The APRI, a questionnaire to screen for bullying among adolescents, was cross-culturally adapted to Argentine Spanish language and then questionnaire items were reduced by a mathematical process (exploratory factor analysis) and a conceptual process (expert committee). Participants were adolescents aged 13-17 years who were attending secondary public schools in the city of Boulogne Sur Mer, San Isidro, province of Buenos Aires. RESULTS: A short questionnaire version made up of 14 items divided into 2 dimensions (physical abuse and social and verbal victimization) was obtained. CONCLUSIONS: The resulting short questionnaire is semantically equivalent to the original version and also has adequate apparent and content validity.

Introducción. El acoso escolar (bullying) comprende conductas de intimidación, hostigamiento y acoso físico o psicológico ejercidas intencionalmente por un escolar (acosador) contra otro (víctima) en forma reiterada. Incluye el maltrato físico y verbal, la exclusión social y el ciberacoso (ciberbullying). Las víctimas incrementan el ausentismo escolar y tienen más riesgo de desarrollar síntomas somáticos, ansiedad, depresión y suicidio. Si bien el cuestionario Adolescent Peer Relations Instrument (APRI) para la pesquisa de acoso escolar (19 ítems) fue validado en España en 2016, no se contaba con una herramienta validada en Argentina. Objetivo. Obtener una versión abreviada adaptada al español hablado en Argentina del cuestionario APRI. Población y método. Se realizó una adaptación transcultural al español hablado en Argentina del cuestionario APRI para la pesquisa de acoso escolar en adolescentes y, posteriormente, la reducción de ítems mediante un proceso matemático (análisis factorial exploratorio) y conceptual (comité de expertos). Participaron adolescentes de 13 a 17 años que cursaban estudios secundarios en dos escuelas estatales de la localidad Boulogne Sur Mer en San Isidro, provincia de Buenos Aires. Resultados. Se obtuvo una versión abreviada del cuestionario, conformada por 14 ítems divididos en dos dominios: maltrato físico y victimización verbal y social. Conclusiones. El cuestionario abreviado obtenido tiene equivalencia semántica con la versión original y cuenta, además, con una adecuada validez aparente y de contenido. Palabras clave: acoso escolar, encuestas y cuestionarios, adolescente, Adolescent Peer Relations Instrument.

Validación en español de un cuestionario para la evaluación de la calidad de la mentoría en investigación en ciencias de la salud / Spanish validation of a questionnaire for the quality evaluation of research mentoring in health sciences

Introducción. Es relevante contar con un cuestionario breve y auto-administrado para evaluar la calidad de los procesos de mentoría en investigación en la comunidad científica hispanohablante. Objetivos. Validar una versión abreviada, auto-administrada y en español del cuestionario multidimensional Evaluación de las competencias de mentoría. Métodos.1) Traducción y adaptación transcultural; 2) Reducción de la versión traducida; 3) Validación de la versión abreviada en una muestra local de 159 participantes respecto de su validez de constructo (análisis factorial confirmatorio) y de criterio (correlación de su puntaje total con el de una pregunta agregada y con la versión extensa del cuestionario). Resultados. Obtuvimos un cuestionario abreviado, en español y auto-aministrado de 17 ítems divididos en cinco dimensiones: 1) Mantenimiento de una comunicación efectiva, 2) Alineación de expectativas, 3) Evaluación del conocimiento,4) Promoción de la independencia, 5) Promoción del desarrollo profesional. El modelo hipotetizado ajustó de manera aceptable a los datos de nuestra muestra de validación (RMSEA=0,045; CFI=0,992; TLI=0,99 y WRMR=0,564). Todos los parámetros estimados para los ítems individuales tuvieron significancia estadística, oscilando las cargas factoriales estandarizadas entre 0,571 y 0,936. La fiabilidad compuesta de los diferentes dominios estuvo comprendida entre 0,764 y0,865, y la varianza media extractada, entre 0,522 y 0,644, en concordancia con lo recomendado. La validez convergente fue adecuada ya que las cargas factoriales estandarizadas de 94 % de los ítems del modelo final fueron mayores a 0,6 y con significancia estadística (valor t>1,96). La correlación entre los cinco factores fue alta (0,740 a 0,944). En la mayoría de las comparaciones, el cuadrado de dichas correlaciones fue superior a la varianza media extractada, lo que refleja una validez divergente o discriminante baja. El puntaje de la versión abreviada tuvo una correlación positiva y alta (Coeficiente de Pearson 0,847; p<0,001) con la pregunta agregada como criterio externo concurrente de validación y muy alta correlación (coeficiente de Pearson: 0,988;p<0,001) con el puntaje de la versión original traducida de 26 ítems. Conclusiones. La versión abreviada en español del cuestionario Evaluación de las competencias de mentoría tiene adecuadas propiedades psicométricas y puede ser aplicada en forma auto-administrada, lo que la vuelve la primera herramienta en español para evaluar procesos de mentoría en investigación. (AU)

Introduction. It is relevant to have a short and self-administered questionnaire to assess research mentoring processquality in the Spanish-speaking scientific community. Objectives. To validate a short and self-administered version in Spanish of the multidimensional questionnaire Mentoring Competency Assessment. Methods.1) Translation and cross-cultural adaptation; 2) Reduction of the translated version; 3) Validation of the shortenedversion in a local sample of 159 participants regarding its construct validity (confirmatory factor analysis) and its criterion validity (correlation of its total score with that of an additional question and with the long version of the questionnaire). Results. We obtained an abbreviated (17 items) and self-administered questionnaire in Spanish, divided into five constructs: 1) Maintaining effective communication, 2) Aligning expectations, 3) Addressing knowledge, 4) Promoting independence, 5) Promoting professional development. The hypothesized model fit acceptably to the data from our validation sample (RMSEA=0.045; CFI=0.992; TLI=0.99 and WRMR=0.564).All the parameters estimated for the individual items were statistically significant, with their standardized factor loads ranging from 0.571 to 0.936. The composite reliability of the different domains ranged between 0.764 and 0.865, and the mean extracted variance, between 0.522 and 0.644, in accordance with the recommended range. Convergent validity was adequate since the standardized factor loads of 94 % of the items in the final model were greater than 0.6 and with statistical significance (t-value >1,96). The correlation between the five factors was high (0.740 to 0.944) and in most of the comparisons, the square of these correlations was higher than the average variance extracted, reflecting low divergent or discriminant validity. The score of the shortened version had a positive and high correlation (Pearson coefficient 0.847;p <0.001) with the additional question as a concurrent external validation criterion and a very high correlation (Pearson coefficient: 0.988; p <0.001) with the score of the original 26-item translated version. Conclusions. The shortened Spanish version of the Mentoring Competency Assessment questionnaire has adequate psychometric properties and can be applied in a self-administered way, which makes it the first tool in Spanish to assessresearch mentoring processes. (AU)

Telemedicina: validación de un cuestionario para evaluar la experiencia de los profesionales de la salud / Telemedicine: validation of a questionnaire to evaluate the experience of health professionals / Telemedicina: validação de um questionário para avaliar a experiência dos profissionais de saúde

RESUMEN Objetivo. El siguiente trabajo tiene como objetivo desarrollar y validar un cuestionario para evaluar la experiencia de los profesionales de la salud con los sistemas de telemedicina. Métodos. A partir de la versión abreviada en español y validada localmente del cuestionario para pacientes desarrollado por Parmanto y col., un grupo de expertos consensuó una versión para evaluar la experiencia de profesionales de la salud que brindan servicios de telemedicina. El comportamiento psicométrico de los ítems se testeó en una primera muestra de 129 profesionales a través de un análisis factorial exploratorio. Luego, se evaluó su comprensibilidad a través de entrevistas cognitivas. Por último, en una nueva muestra de 329 profesionales, se evaluó la validez de constructo del cuestionario mediante un análisis factorial confirmatorio (AFC), y su validez de criterio externo, mediante la evaluación de su puntaje con el de una pregunta de resumen. Resultados. Se obtuvo un cuestionario de 12 ítems con una estructura de dos factores con indicadores de ajuste aceptables, documentada mediante AFC. La fiabilidad, la validez convergente y la validez discriminante fueron apropiadas. La validez de criterio externo mostró resultados óptimos. Conclusiones. El instrumento obtenido cuenta con propiedades psicométricas adecuadas y contribuirá a la evaluación objetiva de la experiencia de los profesionales que realizan telemedicina.

ABSTRACT Objective. This objective of this work is to develop and validate a questionnaire to evaluate health professionals' experience with telemedicine systems. Methods. Based on an abbreviated, locally validated Spanish-language version of the patient questionnaire developed by Parmanto et al., a group of experts developed a version to evaluate the experience of health professionals who provide telemedicine services. The psychometric behavior of the items was tested in an initial sample of 129 professionals, using exploratory factor analysis. The comprehensibility of the items was then assessed through cognitive interviews. Finally, in a new sample of 329 professionals, the construct validity of the questionnaire was evaluated by means of confirmatory factor analysis (CFA); its criteria of external validity were assessed by comparing the score with that of a summary question. Results. A 12-item questionnaire was obtained, with a two-factor structure and acceptable adjustment indicators documented through CFA. Reliability, convergent validity, and discriminant validity were appropriate. The criteria of external validity showed optimal results. Conclusions. The instrument obtained has adequate psychometric properties and will contribute to the objective evaluation of the experience of health professionals who perform telemedicine.

RESUMO Objetivo. Desenvolver e validar um questionário para avaliar a experiência dos profissionais de saúde com os sistemas de telemedicina. Métodos. Com base na versão abreviada em espanhol - e validada localmente - do questionário para pacientes desenvolvido por Parmanto et al., um grupo de especialistas gerou uma versão de consenso para avaliar a experiência de profissionais de saúde que prestam serviços de telemedicina. O comportamento psicométrico dos itens foi testado em uma primeira amostra de 129 profissionais, por meio de análise fatorial exploratória. Em seguida, sua compreensibilidade foi avaliada por meio de entrevistas cognitivas. Por fim, em uma nova amostra de 329 profissionais, avaliou-se a validade de construto do questionário por meio de uma análise fatorial confirmatória (AFC), e sua validade de critério externo, mediante a avaliação de sua pontuação com a de uma pergunta resumo. Resultados. Obteve-se um questionário de 12 itens com estrutura de dois fatores, com indicadores de ajuste aceitáveis, documentados pela AFC. A confiabilidade, a validade convergente e a validade discriminante foram adequadas. A validade de critério externo apresentou ótimos resultados. Conclusões. O instrumento obtido possui propriedades psicométricas adequadas e contribuirá para a avaliação objetiva da experiência dos profissionais que realizam telemedicina.

[Food insecurity in the area of influence of the Center of Family and Community Medicine "San Pantaleón" (Province of Buenos Aires).] / Inseguridad alimentaria en el área de influencia del Centro de Medicina Familiar y Comunitaria "San Pantaleón" (Provincia de Buenos Aires).

Introduction: Last years, food insecurity is a raising problem in Argentina and is a key indicator of population health. The principal aim of this study was to determine food insecurity prevalence in a population of Buenos Aires suburbs, considering as secondary objectives: 1) to evaluate associated variables with food insecurity; 2) to perform provisional statistical validation of the Food Insecurity Experience Scale (FIES). Methods: It was conducted a descriptive, cross-sectional research study was conducted. Check the FIES survey in people over 15 years of age in the Barrio Santa María in Bajo Boulogne, San Isidro district, Buenos Aires. A probabilistic sampling was carried out. The data will be analyzed following the Rasch model proposed by the Food and Agriculture Organization of the United Nations. Results: 222 people were interviewed, finding a prevalence of moderate / severe food insecurity of 47.29% and severe of 6.57%. We found an independent association with a female head of household OR 2.22; (95%CI 1.27 to 3.87) and having more than 4 cohabitants in the home OR 2.24; (95%CI 1.25 to 4.02). The provisional validation of the FIES survey was carried out in our sample through the testing of the Rasch model assumptions. Conclusion: food insecurity is a problem present in our population. It was carried out the validation of an instrument to measure it, easy to apply and that allows valid comparisons between local and international measurements.

Introducción: La inseguridad alimentaria es una problemática en aumento en los últimos años en Argentina y resulta un indicador clave del estado de salud de la población. Este estudio se propuso determinar su prevalencia en una población del conurbano bonaerense planteándose como objetivos secundarios: 1) evaluar variables que se asocien con la inseguridad alimentaria; 2) realizar la validación estadística provisional de la Escala de la Inseguridad Alimentaria basada en la Experiencia (FIES). Materiales y métodos: Se realizó un estudio de investigación descriptivo, de corte transversal. Se utilizó la encuesta FIES en personas mayores de 15 años del Barrio Santa María en el Bajo Boulogne, partido de San Isidro, provincia de Buenos Aires. Se realizó un muestreo probabilístico. Se analizaron los datos siguiendo el modelo Rasch propuesto por la Organización de las Naciones Unidas para la Alimentación y la Agricultura. Resultados: Se entrevistaron 222 personas hallando una prevalencia de inseguridad alimentaria moderada/severa de 47,29% y severa de 6,57%. Se observó una asociación independiente con una jefatura de hogar femenina OR 2,22; (IC95% 1,27 a 3,87) y con tener más de 4 convivientes en el hogar OR 2,24; (IC95% 1,25 a 4,02). Se realizó la validación provisional de la encuesta FIES en nuestra muestra a través del testeo de las asunciones del modelo Rasch. Conclusión: la inseguridad alimentaria es un problema presente en nuestra población. Se realizó la validación de un instrumento para medirla, de sencilla aplicación y que permite realizar comparaciones válidas entre mediciones locales e internacionales.

Clinical application of Doppler ultrasound in the diagnosis of fertility problems in equines / Aplicações da ultrassonografia Doppler no diagnóstico de problemas de fertilidade em equinos

The use of different ultrasound modalities (color, power and pulsed Doppler) in clinical research has enhanced knowledge of reproductive pathophysiology in equine, in addition to improving the clinical diagnosis of reproductive disorders in both the stallion and the mare. In the stallion, color Doppler ultrasound has improved the diagnostic potential of conventional ultrasound, improving the differential diagnosis of pathologies such as testicular torsion (decrease or absence of blood flow in the cord) and orchitis (increased blood flow in the cord). The function of the testicle is highly dependent on the blood flow it receives; therefore, any vascular alterations can affect both the quality and production of sperm. In recent years there have been a greater number of studies in which Doppler ultrasound is used as a tool in the diagnosis of testicular dysfunction and in the monitoring of medical and surgical treatments. In the mare, ultrasound technology has allowed numerous advances in basic research regarding the vascular hemodynamics of the ovary and uterus. Moreover, it has become an indispensable tool in reproductive practice. Among the clinical applications of this technique in mares are the evaluation of CL (corpus luteum) functionality, being a useful tool in the selection of recipients in embryo transfer programs or the use of power Doppler in the diagnosis of pregnancy as early as 7 days postovulation prior to flushing. Finally, the incorporation of color and pulsed Doppler ultrasound into the examination improves the diagnosis of mares with endometritis due to a pathological increase in uterine blood flow.

[Validation of the Spanish version of the Lubben Social Network Scale-6]. / Validación de la versión en español de la Escala de Red Social Lubben-6.

Social support is an important determinant of health. The Lubben-6 Social Network Scale (LSNS-6) is one of the most used by the international community and its application is simple and brief. To date there are no works that have validated this scale in the Spanish language. Aim: Validate the spanish version of the LSNS-6. Methods: The Spanish version of the questionnaire was generated through the translation, back-translation and transcultural adaptation of the LSNS-6, made with native translators and adapted by a bilingual committee. The construct validity was evaluated using a Confirmatory Factor Analysis. We first considered a single factor (family or friends), and then two factors (family and friends). We compared results using Goodness-of-fit index (GFI). The validity of external criteria was evaluated by correlating the score of the questionnaire with that assigned by a professional counselor trained during an in-depth in-person interview conducted at the patient's home. Results: We interviewed 150 older adults, 54% men; mean age 76.3 years. The GFI presented adequate values ​​for the two-factor model (P Chi2 = 0.069; NFI = 0.97; NNFI = 0.99; RMR st. = 0.03; the RMSEA showed a marginal value, 0.085); While the Pearson correlation was 0.665 (p <0.001). Conclusion: The Spanish version of the LSNS-6 scale is valid and reliable.

Introducción: El apoyo social es un determinante importante de la salud. La Escala de Red Social de Lubben-6 (LSNS-6) es una de las más utilizadas por la comunidad internacional y su aplicación es sencilla y breve. No existen a la fecha trabajos que hayan validado esta escala en el idioma español. Objetivo: Validar al español la escala LSNS-6. Métodos: Fue generada una versión en Español del cuestionario a través de la traducción, retrotraducción y adaptación transcultural del LSNS-6. La ​vali​dez de constructo fue evaluada mediante un Análisis Factorial Confirmatorio, considerando inicialmente un factor y luego dos. Los resultados fueron comparados mediante indicadores de buen ajuste (IBA). La ​va​lidez de criterio externo fue evaluada mediante la correlación del puntaje del cuestionario con el asignado por una orientadora sociosanitaria profesional entrenada durante una entrevista presencial en profundidad realizada en el domicilio del paciente. Resultados: Entrevistamos 150 adultos mayores (54 % hombres; edad media 76,3 años). Los IBA presentaron valores adecuados para el modelo de dos factores; Chi Cuadrado / Grado de libertad 1,81; "p" ajustada al Chi Cuadrado: 0,069; error de aproximación cuadrático medio (RMSEA) 0,085; Indice de ajuste normado (NFI) 0,97; índice de ajuste no normado (NNFI) 0,99; residuo cuadrático medio estandarizado (RMR st) 0,03. La correlación Pearson del puntaje de la versión en español del LSNS-6 con el asignado por la orientadora sociosanitaria fue de 0.665 (p < 0.001). Conclusiones: La versión en español de la escala LSNS-6 es válida y confiable.

Validación de un cuestionario en español sobre la usabilidad de la telemedicina / Validation of a Spanish questionnaire on telemedicine usability

Resumen La telemedicina es la prestación de servicios de la salud mediante la utilización de tecnologías de la información y la comunicación. Su implementación se realiza a través de sistemas cuya usabilidad es variable. En 2016, Parmant y col., desarrollaron y validaron un cuestionario en inglés que mide su usabilidad y permite evaluar los factores que influyen en la misma. En 2019, tradujimos, adaptamos transculturalmente y publicamos este cuestionario en español. Con el objetivo de transformar el mismo en una herramienta confiable y accesible, cuya utilidad es indiscutible en el contexto actual, llevamos a cabo un trabajo de investigación que permitió su validación y simplificación.

Abstract Telemedicine is the provision of services by health professionals through the use of information and communication technologies. Its implementation is usually carried out through systems of variable usability. In 2016, Parmanto et al, developed and validated a questionnaire in English that measures its usability and allows to evaluate all factors that influence it. In 2019, we translated, adapted cross-culturally, and published this questionnaire in Spanish. With the aim of transforming it into a reliable and accessible tool, the utility of which is indisputable in the current context, we carried out a research work that allowed its validation and simplification.

[Validation of a Spanish questionnaire on telemedicine usability]. / Validación de un cuestionario en español sobre la usabilidad de la telemedicina.

Telemedicine is the provision of services by health professionals through the use of information and communication technologies. Its implementation is usually carried out through systems of va riable usability. In 2016, Parmanto et al, developed and validated a questionnaire in English that measures its usability and allows to evaluate all factors that influence it. In 2019, we translated, adapted cross-culturally, and published this questionnaire in Spanish. With the aim of transforming it into a reliable and accessible tool, the utility of which is indisputable in the current context, we carried out a research work that allowed its validation and simplification.

La telemedicina es la prestación de servicios de la salud mediante la utilización de tecnologías de la información y la comunicación. Su implementación se realiza a través de sistemas cuya usabilidad es variable. En 2016, Parmant y col., desarrollaron y validaron un cuestionario en inglés que mide su usabilidad y permite evaluar los factores que influyen en la misma. En 2019, tradujimos, adaptamos transculturalmente y publicamos este cuestionario en español. Con el objetivo de transformar el mismo en una herramienta confiable y accesible, cuya utilidad es indiscutible en el contexto actual, llevamos a cabo un trabajo de investigación que permitió su validación y simplificación.

Adaptación y validación de la versión argentina de un instrumento para evaluar actividades de desarrollo profesional continuo / Adaptation and validation of the Argentine version of an instrument to assess continuing professional development activities

Introducción. Investigadores canadienses desarrollaron un cuestionario autoadministrado para indagar sobre la intención de los participantes de actividades de desarrollo profesional continuo (DPC) de transferir los conocimientos adquiridos en ámbitos áulicos a la práctica clínica. Su uso podría facilitar los procesos de mejora de la calidad en dichas actividades de DPC.Objetivo. Realizar la traducción y adaptación transcultural y validación del cuestionario REACTION (A theoRy-basEd instrument to assess the impACT of continuing profesional development activities on profesional behavIOr chaNge) para su uso en la Argentina, a partir de la versión original en inglés.Población y métodos. Se realizó la traducción y adaptación transcultural de los 12 ítems del instrumento, con un proceso de cinco pasos. La validez de constructo se exploró mediante el análisis factorial exploratorio, y la confiabilidad, a través del coeficiente de Cronbach y el coeficiente G.Resultados. La versión final del cuestionario se aplicó a una muestra de 133 médicos asistentes a 9 actividades presenciales de DPC de un hospital universitario de la Ciudad de Buenos Aires (edad promedio: 38 años; el 23,3 %, hombres; el 76 %, médicos de familia). El análisis factorial exploratorio arrojó 3 factores (influencia social, confianza en las capacidades propias y criterio ético). El coeficiente de Cronbach fue 0,82 y el coeficiente G fue 0,72.Conclusiones. Se realizó la adaptación y validación de la versión argentina del instrumento REACTION para evaluar el impacto del DPC enfocado en el entrenamiento de habilidades clínicas en la intención de los médicos de implementarlo en su práctica.

Introduction. Canadian researchers developed a self-administered questionnaire to ask participants of continuing professional development (CPD) activities about their intention to translate the knowledge acquired in the classroom into clinical practice. The questionnaire may facilitate quality improvement processes in such CPD activities.Objective. To translate, cross-culturally adapt and validate the original English REACTION questionnaire (A theoRy-basEd instrument to assess the impACT of continuing professional development activities on professional behavIOr chaNge) for its use in Argentina.Population and methods. The 12 questionnaire items were translated and cross-culturally adapted using a five-step process. The construct validity was assessed using an exploratory factor analysis, whereas reliability, with Cronbach's coefficient and the G coefficient.Results. The final questionnaire version was administered to a sample of 133 physicians who attended 9 CPD activities at a teaching hospital in the Autonomous City of Buenos Aires (average age: 38 years; 23.3 %, men; 76 %, family physicians). The exploratory factor analysis showed 3 factors (social influence, confidence in one's abilities, and ethical judgment). Cronbach's coefficient was 0.82 and the G coefficient, 0.72.Conclusions. The Argentine version of the REACTION questionnaire was adapted and validated to assess the impact of CPD centered on clinical skills training on physicians' intention to implement it in their practice

Adaptation and validation of the Argentine version of an instrument to assess continuing professional development activities. / Adaptación y validación de la versión argentina de un instrumento para evaluar actividades de desarrollo profesional continuo.

INTRODUCTION: Canadian researchers developed a self-administered questionnaire to ask participants of continuing professional development (CPD) activities about their intention to translate the knowledge acquired in the classroom into clinical practice. The questionnaire may facilitate quality improvement processes in such CPD activities. OBJECTIVE: To translate, cross-culturally adapt and validate the original English REACTION questionnaire (A theoRy-basEd instrument to assess the impACT of continuing professional development activities on professional behavIOr chaNge) for its use in Argentina. POPULATION AND METHODS: The 12 questionnaire items were translated and cross-culturally adapted using a five-step process. The construct validity was assessed using an exploratory factor analysis, whereas reliability, with Cronbach's coefficient and the G coefficient. RESULTS: The final questionnaire version was administered to a sample of 133 physicians who attended 9 CPD activities at a teaching hospital in the Autonomous City of Buenos Aires (average age: 38 years; 23.3 %, men; 76 %, family physicians). The exploratory factor analysis showed 3 factors (social influence, confidence in one's abilities, and ethical judgment). Cronbach's coefficient was 0.82 and the G coefficient, 0.72. CONCLUSIONS: The Argentine version of the REACTION questionnaire was adapted and validated to assess the impact of CPD centered on clinical skills training on physicians' intention to implement it in their practice.

Introducción. Investigadores canadienses desarrollaron un cuestionario autoadministrado para indagar sobre la intención de los participantes de actividades de desarrollo profesional continuo (DPC) de transferir los conocimientos adquiridos en ámbitos áulicos a la práctica clínica. Su uso podría facilitar los procesos de mejora de la calidad en dichas actividades de DPC. Objetivo. Realizar la traducción y adaptación transcultural y validación del cuestionario REACTION (A theoRy-basEd instrument to assess the impACT of continuing profesional development activities on profesional behavIOr chaNge) para su uso en la Argentina, a partir de la versión original en inglés. Población y métodos. Se realizó la traducción y adaptación transcultural de los 12 ítems del instrumento, con un proceso de cinco pasos. La validez de constructo se exploró mediante el análisis factorial exploratorio, y la confiabilidad, a través del coeficiente de Cronbach y el coeficiente G. Resultados. La versión final del cuestionario se aplicó a una muestra de 133 médicos asistentes a 9 actividades presenciales de DPC de un hospital universitario de la Ciudad de Buenos Aires (edad promedio: 38 años; el 23,3 %, hombres; el 76 %, médicos de familia). El análisis factorial exploratorio arrojó 3 factores (influencia social, confianza en las capacidades propias y criterio ético). El coeficiente de Cronbach fue 0,82 y el coeficiente G fue 0,72. Conclusiones. Se realizó la adaptación y validación de la versión argentina del instrumento REACTION para evaluar el impacto del DPC enfocado en el entrenamiento de habilidades clínicas en la intención de los médicos de implementarlo en su práctica.

The KidscoreTM D5 algorithm as an additional tool to morphological assessment and PGT-A in embryo selection: a time-lapse study.

OBJECTIVE: To evaluate the use of implantation data algorithm KIDscoreTM D5 (Vitrolife®, Canada) as an additional tool for morphological assessment and preimplantation genetic testing for aneuploidies (PGT-A) to improve implantation and ongoing pregnancy rates. MATERIALS AND METHODS: This study looked into 912 embryos from 270 patients who underwent IVF at the INMATER Fertility Clinic in Lima, Peru, between October 2016 and June 2018. All embryos were cultured for up to five or six days in an Embryoscope® time-lapse incubator (Vitrolife®, Canada) and evaluated based on the KIDscoreTM D5 algorithm (KS5). Biopsies for PGT-A screening were performed in 778 (85.31%) embryos. A total of 184 single embryo transfers (68% of patients) were performed during the study period and the embryos transferred were divided into four groups: 1) euploid embryos transferred without consideration to their KS5 scores (n=86); 2) euploid embryos transferred considering their KS5 scores (n=48); 3) embryos transferred without consideration to their KS5 scores and that were not evaluated by PGT-A (n=40); and 4) embryos transferred considering their KS5 scores and that were not evaluated by PGT-A (n=10). Implantation and ongoing pregnancy rates were compared between the groups and between euploid embryos with the highest KS5 scores (KS5=6, n=25) and euploid embryos with the lowest KS5 scores (KS5=1, n=51). The correlations between KS5 scores and embryo euploidy rates were also evaluated. RESULTS: Euploid embryo transfers in which KS5 scores were considered in the selection process had significantly higher Implantation and ongoing pregnancy rates compared to euploid embryo transfers in which selection was based on morphology (75.00% vs. 50.00%; p=0.002 and 66.66% vs. 48.83%; p=0.037, respectively). Additionally, implantation rates were significantly higher for blastocysts with the highest KS5 score (KS5=6) compared to blastocysts with the lowest score (KS5=1) (80.00% vs. 49.02%; p=0.045). Ongoing pregnancy rates were not significantly different (72.00% vs. 47.06%; p=0.105). Euploidy rates were significantly higher in the group of embryos with KS5=6 than in the group of embryos with KS5=1 (61.88% vs. 48.33%; p=0.006). CONCLUSION: Embryo selection based on the KS5 algorithm score improved the implantation rates of single euploid blastocyst transfers. Furthermore, embryos with the highest KS5 score had a higher probability of being euploid and implanting.

Blastocyst contractions are strongly related with aneuploidy, lower implantation rates, and slow-cleaving embryos: a time lapse study.

OBJECTIVES: This study aimed to identify human blastocyst contraction patterns and their correlations with ploidy status (PGT-A analysis), the time it took for embryos to reach the blastocyst stage, and pregnancy rates. METHODS: The study included 912 embryos from 270 patients seen in our center. All embryos were cultivated in an Embryoscope incubator. An NGS platform was used to test 778 of the 912 embryos initially included in the study for aneuploidy at a reference laboratory. Blastocyst contractions were evaluated using the embryo drawing tool to compute percent contraction. A total of 182 single-embryo transfers were performed. The mean age of the included patients was 30.44 years (24-39 years). RESULTS: The embryos were divided into two groups, the first with embryos that contracted (CT group) and the second with embryos that did not contract, herein referred to as expanding-only embryos or solo expanding (SE group). In terms of ploidy status, 58.33% of the embryos in the SE group were euploid, while 53.58% of embryos in the CT group were aneuploid. The difference between the groups was statistically significant (p=0.029), showing that embryos that do not contract have a higher chance of being euploid than embryos that contract. Pregnancy rates were also significantly higher among embryos in the SE group than in the CT group (63.10% vs. 46.67%; p=0.012). Finally, we saw that embryos in the CT group took significantly longer to reach the blastocyst stage compared to embryos in the SE group (p=0.004). Patient age was not significantly different between the CT and SE groups, indicating that age might not be a factor in embryo contraction. CONCLUSION: Two of the traits for which the embryos included in this study were compared were statistically different. Embryos in the CT group had lower implantation rates, took longer to reach the blastocyst stage, and had a higher chance of being aneuploid, regardless of maternal age. Therefore, embryo contraction might be a useful parameter in the selection of embryos for transfer.