Factor structure of psychosis screening questionnaire in Ugandan adults.

BACKGROUND: Psychotic disorders are common and contribute significantly to morbidity and mortality of people with psychiatric diseases. Therefore, early screening and detection may facilitate early intervention and reduce adverse outcomes. Screening tools that lay persons can administer are particularly beneficial in low resource settings. However, there is limited research evaluating the validity of psychosis screening instruments in Uganda. We aimed to assess the construct validity and psychometric properties of the Psychosis Screening Questionnaire (PSQ) in Uganda in a population with no history of a psychotic disorder. METHODS: The sample consisted of 2101 Ugandan adults participating as controls in a larger multi-country case-control study on psychiatric genetics who were recruited between February 2018 and March 2020. Participants were individuals seeking outpatient general medical care, caretakers of individuals seeking care, and staff or students recruited from five medical facilities that were age 18 years or older and able to provide consent. Individuals were excluded who had acute levels of alcohol or substance use, including being under inpatient hospitalization or acute medical care for one of these conditions. We used confirmatory factor analysis (CFA) and item response theory (IRT) to evaluate the factor structure and item properties of the PSQ. RESULTS: The overall prevalence screening positive for psychotic symptoms was 13.9% 95% CI (12.4,15.4). "Strange experiences" were the most endorsed symptoms 6.6% 95% CI (5.6,7.8). A unidimensional model seemed to be a good model or well-fitting based on fit indices including the root mean square error of approximation (RMSEA of 0.00), comparative fit index (CFI of 1.000), and Tucker-Lewis Index (TLI of 1.000). The most discriminating items along the latent construct of psychosis were items assessing thought disturbance followed by items assessing paranoia, with a parameter (discrimination) value of 2.53 and 2.40, respectively. CONCLUSION: The PSQ works well in Uganda as an initial screening tool for moderate to high-level of psychotic symptoms.

Effect of Obesity on the Respiratory Parameters in Children with Obstructive Sleep Apnea Syndrome.

The aim of the study was to investigate how obesity can influence sleep respiratory parameters in obstructive sleep apnea syndrome (OSAS) in children. METHODS: The study analyzes 56 Caucasian children and adolescents aged 11 ± 2.79 years with a BMI > 5th percentiles and a PSQ value ≥ 0.33. Children were divided into Obesity Group (OG) with BMI ≥ 95th and Control Group (CG) with 5th < BMI > 95th percentile. All selected children underwent PG. Respiratory parameters AHI (Apnea-Hypopnea Index), SaO2 (Saturation of Oxygen), ODI (Oxygen Desaturation Index), and Nadir (the lowest value of SaO2 registered during PG) were extracted from the PG. AHI was used to divide the severity of OSAS into four levels: snoring (AHI ≤ 1), mild (AHI > 1 and ≤5), moderate (AHI > 5 and <10), and severe (AHI ≥ 10). RESULTS: The comparison analysis between the OG and CG showed a statistical significance only for ODI (p = 0.02). A statistically significant correlation between BMI and AHI (r = 0.02), SaO2 (r = 0.01), and Nadir O2 (r = 0.02) was found. CONCLUSIONS: There was no strong correlation between obesity and OSAS, but a positive association was found between BMI and AHI severity.

Enhancing Self-Reported Assessment of Working Conditions in Policing: Revisiting the Psychometric Properties and Applications of the Police Stress Questionnaire.

OBJECTIVES: Policing is recognized as a highly stressful occupation, encompassing stressors not commonly encountered in other fields. In response, police-specific stress scales have been developed and used when studying police work. Despite changes in the composition of police personnel, most studies examining police working conditions focus on sworn police officers (SPO), excluding employees without police education (EWPE). To advance research and practice on stress in the police, align results, and increase the possibilities for comparisons across studies using police-specific measures (PSMs) we conducted a psychometric evaluation of the two scales in the Police Stress Questionnaire (PSQ). We examined whether adding "Not Applicable" to the response scales would reduce vulnerability and make the PSQ more robust. METHOD: Based on a survey with a randomised sample (N = 560) of SPO and EWPE in the Norwegian Police, we tested the original factor structures of the PSQ through Confirmatory Factor Analysis including tests of factor structures from previous studies. RESULTS: For all models, the indicators of fit indicated a poor fit with either our whole or stratified sample. The response choice 'Not Applicable' provided extended information for SPOs and EWPEs on the PSQ. CONCLUSIONS: To promote aligning results and enabling comparisons across studies using the PSQ, we suggest treating the PSQ scales as formative indexes, rather than reflective scales. Adding "Not Applicable" to the response scale offers an influential elaboration of the PSQ with beneficial and extended information. Generalised studies of stress in the police should include the entire population working there.

Validation and Psychometric Properties of the German Operational and Organizational Police Stress Questionnaires.

CONTEXT: Working in the police force is an operationally and organizationally stressful job. Suitable psychometric tools are needed to detect and study the psychosocial risks of these professionals. The original version contains 40 items, which may be too long for clinical use or as a research control measure. The main aim of this study is to validate the Police Stress Questionnaire (PSQ) in German. The secondary objective is to validate a shorter version. METHOD: After translation and counter translation of the PSQ-G by a committee of experts, 10 participants pre-tested the comprehension of an intermediate version, allowing the development of a final version that was submitted to a psychometric validation plan with 2314 German-speaking officers. Structure, reliability, and convergent, divergent, and discriminant validities were tested for each sample. RESULTS: The German version of the PSQ performed well psychometrically. We have created a short version of 14 items with good psychometric properties, 7 items for each subscale: operational stressors and organizational stressors. CONCLUSION: This study validated a German version of the PSQ and provides a reliable measure of stress processes in the police force. A short version is now available.

Musculoskeletal complaints, postural patterns and psychosocial workplace predictors in police officers from an organizational unit of a German federal state police force - a study protocol.

BACKGROUND: Police officers are exposed to a particularly high risk of musculoskeletal disorders (MSDs) and psychosocial stress due to their working conditions. Therefore, the aim of this project will be to assess the occupational physical and mental health of police officers from an organizational unit of the police force of a German federal state. METHODS: The aim is to analyze at least 200 active police officers of a state police force in Germany between the age of 18 and 65 years. In a mixed-methods design, a video raster stereography-based measurement of the upper body posture and a modified version of the Nordic Questionnaire (NQ) will be used for investigating their physical health, while the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Operational Police Stress Questionnaire (PSQ-Op) will be used to analyze their mental health. In addition, job-specific psychosocial factors at the workplace will be assessed (using self-designed questions that were previously evaluated in an expert interview). DISCUSSION: To date, there is a lack of current questionnaire-based data on the prevalence of MSDs in police officers, or of MSDs associated with injuries or psychosocial workplace factors. Thus, in this study, these MSDs will be correlated with quantitative upper body posture data. If these results prove an increased physical and/or psychosocial stress, then the existing workplace health promotion measures should be analyzed and modified if necessary.

Translation and validation of the Arabic version of the sleep-related breathing disorder scale of the pediatric sleep questionnaire (PSQ-SRBD).

BACKGROUND/OBJECTIVES: The incidence of sleep-related breathing disorders is underestimated because polysomnography is required to confirm its diagnosis. The pediatric sleep questionnaire-sleep-related breathing disorder (PSQ-SRBD) scale is a self-reported questionnaire completed by a patient's guardian. There is no validated Arabic version of the PSQ-SRBD that can be used in the Arabic-speaking population. Therefore, we aimed to translate, validate, and culturally adapt the PSQ-SRBD scale. We also aimed to evaluate its psychometric properties for the diagnosis of obstructive sleep apnea (OSA). METHODS: The cross-cultural adaptation method consisted of the following steps: forward-backward translation, appraisal of a sample of 72 children (aged between 2 and 16 years) by an expert group, and performing Cronbach's alpha coefficient testing, Spearman's rank correlation coefficient testing, Wilcoxon signed-rank testing, and sign testing. The reliability of the Arabic version of the PSQ-SRBD scale was assessed using a test-retest comparison, and a factor analysis of the items was used to verify construct validity. For statistical purposes, p-values <0.05 were considered to indicate significance. RESULTS: All subscales had adequate internal consistency: 0.799 for snoring and breathing, 0.69 for sleepiness, 0.711 for behavioral problems, and 0.805 for the entire questionnaire. Comparing questionnaire responses administered 2 weeks apart revealed no statistically significant difference in total scores between the two groups (p-values >0.05 by Spearman's rank correlation coefficient test for all domains) and also no statistical difference among 20 out of 22 questions independently (p-value >0.05 by sign test). A factor analysis conducted to assess the structure of the Arabic-SRBD scale revealed good correlational patterns. The mean score before surgery was 0.464 ± 0.166, and this changed to 0.185 ± 0.142 after surgery with a reduction of 0.278 ± 0.184 which was statistically significant (p < 0.001). CONCLUSION: The Arabic version of the PSQ-SRBD scale is a valid tool for the assessment of pediatric OSA patients and can be used to follow-up patients after surgery. Future research will determine this translated questionnaire's applicability.

Construct Validity of the Psychosis Screening Questionnaire in Ugandan Adults.

Background: Psychotic disorders are common and contribute significantly to morbidity and mortality of people with psychiatric diseases. Therefore, early screening and detection may facilitate early intervention and reduce adverse outcomes. Screening tools that lay persons can administer are particularly beneficial in low resource settings. However, there is limited research evaluating the validity of psychosis screening instruments in Uganda. We aimed to assess the construct validity and psychometric properties of the Psychosis Screening Questionnaire (PSQ) in Uganda in a population with no history of a psychotic disorder. Methods: The sample consisted of 2101 Ugandan adults participating as controls in a larger multi-country case-control study on psychiatric genetics. We used confirmatory factor analysis (CFA) and item response theory (IRT) to evaluate the factor structure and item properties of the PSQ. Results: The overall prevalence screening positive for psychotic symptoms was 13.9%. "Strange experiences" were the most endorsed symptoms (6.6%). A unidimensional factor was the best fitting model based on the fit indices including the root mean square error of approximation (RMSEA of 0.00), comparative fit index (CFI of 1.000), and Tucker-Lewis Index (TLI of 1.000). The most discriminating items along the latent construct of psychosis were items assessing thought disturbance followed by items assessing paranoia, with a parameter (discrimination) value of 2.53 and 2.40, respectively. Conclusion: The PSQ works well in Uganda as an initial screening tool for moderate to high-level of psychotic symptoms.

The validity and reliability of the Arabic translation of the Pediatric Sleep Questionnaire.

OBJECTIVE/BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder in childhood. Polysomnography is the gold standard for the diagnosis of OSA. However, it is expensive and time-consuming, and it may be unavailable. The self-administered Pediatric Sleep Questionnaire (PSQ) is a reliable and validated screening test featuring high sensitivity (0.85) and specificity (0.87). It has been translated into multiple languages and is widely used to screen for OSA in children. This study translated the PSQ into Saudi Arabian Arabic and validated it. PATIENTS/METHODS: The Arabic-PSQ was translated using forward-backward translation, following established guidelines. A review committee monitored the process and approved the final version. The reliability of the scale was measured using Cronbach's alpha and kappa statistics. The validity of the Arabic-PSQ was evaluated using confirmatory factor analysis (CFA). RESULTS: Our study recruited 220 Saudi children with potential adenoid hypertrophy from King Abdulaziz University hospital clinics. The Arabic-PSQ had excellent internal consistency (Cronbach's α 0.946). Additionally, all subscales had excellent reliability, with Cronbach's α of 0.924 for snoring, 0.762 for sleepiness, and 0.820 for behavior. Test-retest reliability showed excellent agreement of >80% in all items (p < 0.0001). CFA for the Arabic-PSQ confirmed a significant correlation between the items of each subscale. CONCLUSIONS: The Arabic-PSQ is reliable, validated, and culturally adapted. It can be safely used to screen for OSA in children. However, given this study's limitations, the diagnostic efficacy of the Arabic-PSQ should be assessed in future studies.

Telemedicine as an environmental ally - The social, financial, and environmental impact of virtual care in the otolaryngology clinic.

PURPOSE: Synchronous virtual care rapidly expanded worldwide amid the COVID-19 pandemic to provide remote medical assessment, minimizing contact and disease transmission risk. Despite its benefits, such an abrupt expansion has shed light on the need to address patients' level of satisfaction with this service delivery. The purpose of this study was to investigate patients' satisfaction, travel cost, productivity loss, and CO2 emissions involved with synchronous virtual care and in-person assessments in rhinology and sleep apnea clinics. MATERIALS AND METHODS: This prospective comparative study included patients managed via virtual care, or in-person clinic visit at St. Joseph Hospital, London, Canada, from December/2020 to April/2021, with rhinology pathologies or sleep apnoea. Patient satisfaction questionnaire (PSQ-18) scores were assessed. The overall scores of respondents were recorded including cost implications. RESULTS: A total of 329 patients were invited, 28.5 % responded (n = 93). 33 virtual care (age 48 ± 6), and 60 in-person (age 51 ± 19). There was no statistical significance in PSQ-18 scores. However, under a diagnosis-based subgroup analysis, allergic rhinitis patients on virtual care presented a significantly lower PSQ-18 scores on the general satisfaction (3.28 vs. 4.25, p = 0.04). The time spent with the doctor was directly correlated with age for patients seen in-person (r = 0.27; p = 0.037). The estimated loss of productivity for the Virtual care group was CAD 12, patients assessed in-person presented an average loss of productivity about six times higher (CAD 74 ± 40). CONCLUSIONS: Overall patients' satisfaction did not depend on whether they were seen virtually or in-person. However, time spent with the doctor contributed to higher satisfaction levels, but only among older patients who were seen in person. Nonetheless, allergic rhinitis patients seemed less satisfied with the virtual care option. Virtual care demonstrates economic benefits.

Assessing medical students' perceived stress levels by comparing a chatbot-based approach to the Perceived Stress Questionnaire (PSQ20) in a mixed-methods study.

Objective: Digital transformation in higher education has presented medical students with new challenges, which has increased the difficulty of organising their own studies. The main objective of this study is to evaluate the effectiveness of a chatbot in assessing the stress levels of medical students in everyday conversations and to identify the main condition for accepting a chatbot as a conversational partner based on validated stress instruments, such as the Perceived Stress Questionnaire (PSQ20). Methods: In this mixed-methods research design, medical-student stress level was assessed using a quantitative (digital- and paper-based versions of PSQ20) and qualitative (chatbot conversation) study design. PSQ20 items were also shortened to investigate whether medical students' stress levels can be measured in everyday conversations. Therefore, items were integrated into the chat between medical students and a chatbot named Melinda. Results: PSQ20 revealed increased stress levels in 43.4% of medical students who participated (N = 136). The integrated PSQ20 items in the conversations with Melinda obtained similar subjective stress degree results in the statistical analysis of both PSQ20 versions. Qualitative analysis revealed that certain functional and technical requirements have a significant impact on the expected use and success of the chatbot. Conclusion: The results suggest that chatbots are promising as personal digital assistants for medical students; they can detect students' stress factors during the conversation. Increasing the chatbot's technical and social capabilities could have a positive impact on user acceptance.

Satisfaction of psychologically impaired patients with health-care services: A Saudi Arabian perspective.

Psychological problems affect a sizable portion of the population, and they require special care. In the current study, we aimed to assess patient satisfaction with the healthcare system at one of the multispecialty hospitals in Riyadh, Saudi Arabia, as well as to identify potential factors that can have an impact on patient satisfaction. A validated pre-tested questionnaire including features to evaluate general hospital services (HS-6 items), nursing services (NS-3 items), pharmacy services (PS-7 items), and a standard patient satisfaction questionnaire (PSQ-18 item) was administered to patients who had been receiving therapy for their psychological disease for the past 3 months. Using binary and multiple regression analysis, the strengths of the associations between sociodemographic factors and patient satisfaction measures were evaluated. The results were expressed as adjusted odds ratios (AOR), which were deemed significant when the P value was < 0.05. Sixty-six percent of the 258 study participants were men, and sixty percent of them were between the ages of 18 and 35 years. The bulk of survey respondents (74%) were employed, married, and well-educated. Our research revealed that those who were employed (AOR, HS-2.5; NS-2.65, PS-2.32), have a higher education (AOR, HS-2.23, NS-2.63, PS-2.82), male gender (AOR, HS-1.12, NS-1.08, PS-1.86) and between the ages of 18 and 35 years (AOR, HS-1.48, NS-1.53, PS-1.67) were more likely to be satisfied with general hospital, nursing, and pharmacy services. Further, those who were married had 1.43 and 1.21 times more chance of satisfaction with the pharmacy and nursing services, respectively, compared to singles. Additionally, those with employment had odds of being satisfied that were 2.4 times higher, highly educated individuals had odds that were 2.1 times higher, participants between the ages of 18 and 35 had odds that were 1.51 times higher, and men had odds that were 1.41 times higher on the patient satisfaction questionnaire scale (PSQ-18). Overall, the study participants' satisfaction with general hospital, nursing, and pharmacy services was 70, 76.3, and 83.3%, respectively, compared to only 61.2% on the PSQ-18. Participants in the survey awarded the hospital amenities, pharmacy services, and nursing care high ratings. The medical care, however, fell short of expectations. The study's findings suggest that action needs to be taken to enhance healthcare system services, particularly in the psychological departments of the medical organization.

Factors Associated with patient satisfaction towards a prison detention Clinic Care among male drug-using inmates.

This study assessed patient satisfaction and its associated factors among male drug-using inmates utilizing a prison detention clinic in Taiwan. A cross-sectional design and structured questionnaire were employed to recruit 580 drug-using inmates into the study. The Patient Satisfaction Questionnaire Short Form (PSQ-18), developed by the RAND Corporation, was used as the basis for the short scale of patient satisfaction, and the research data were analyzed using the SPSS for Windows 20.0 statistical software package. The results showed that the research subjects had low patient satisfaction in all the factors assessed compared with the scale's general norms. Among the original seven satisfaction subscales in this study, the highest score was for the financial aspects, and the lowest was for the amount of time spent with doctors. This study also investigated satisfaction with medical lab exams and the pharmacy at the prison's clinic, and the satisfaction scores were higher than the original seven subscales. In multiple logistic regression analyses, the final model indicated that the inmates undergoing observed rehabilitation (OR = 13.837, 95% CI = 2.736-69.983) were more likely satisfied with prison detention clinic c than those serving prison sentences. Those inmates with custodial deposits (high vs. low; OR = 1.813, 95% CI = 1.038-3.168), and meet their physical health needs (met vs. unmet; OR = 4.872, 95% CI = 2.054-11.560) had significant correlated with detention clinic care satisfactory level. Although there is only one study setting cannot give a generalizability for people who are incarcerated in Taiwan, this study highlights that the prison authorities should scrutinize factors associated with detention clinic care satisfaction, such as the type of inmate, economic status in the prison, self-reported health status, and their physical health needs, to increase the level of patient satisfaction.

Sleep-Related Breathing Disorders in Children-Red Flags in Pediatric Care.

OBJECTIVES: In recent years, we have witnessed a growing interest in pediatric sleep-related breathing disorders (SRBD). Although a Pediatric Sleep Questionnaire (PSQ) exists and was found reliable in screening SRBD in children, many of the children remain underdiagnosed. The aim of the present study was to define anamnestic and clinical findings that can serve as red flags indicating the presence of SRBD in children. METHODS: 227 children aged 4-12 years old were evaluated with regard to the following parameters: (i) anamnestic variables (e.g., general state of health, oral habits, bruxism, esophageal reflux, sleep continuity, snoring); (ii) clinical parameters (e.g., oral mucosa, palate, tonsils, tongue, floor of the mouth, angle classification, gingival health, caries risk) and (iii) presence of SRBD (through the PSQ). RESULTS: Significant differences between children with and without SRBD were observed regarding continuous sleep, developmental delay, mouth breathing, and snoring. Taking medications for ADHD increased the odds of SRBD in children by over seven times, non-continuous sleep increased the odds of SRBD by six times, mouth breathing increased the odds by almost five times, and snoring increased the odds by over three times. CONCLUSIONS: Child caregivers from various fields (dentists, orthodontists, pediatric physicians, school nurses) should actively inquire about disturbed sleep, medications for ADHD, snoring, and mouth breathing among their young patients. Initial screening through a few simple questions may help raise red flags that can assist in the early detection of SRBD in children and lead to proper diagnosis and treatment.

Recruitment to Chromatin of (GA)n-Associated Factors GAF and Psq in the Transgenic Model System Depends on the Presence of Architectural Protein Binding Sites.

Polycomb group (PcG) repressors and Trithorax group (TrxG) activators of transcription are essential for the proper development and maintenance of gene expression profiles in multicellular organisms. In Drosophila, PcG/TrxG proteins interact with DNA elements called PRE (Polycomb response elements). We have previously shown that the repressive activity of inactive PRE in transgenes can be induced by architectural protein-binding sites. It was shown that the induction of repression is associated with the recruitment of PcG/TrxG proteins, including the DNA-binding factors Pho and Combgap. In the present study, we tested the association of the two other PRE DNA-binding factors, GAF and Psq, with bxdPRE in the presence and absence of sites for architectural proteins. As a result, it was shown that both factors can be efficiently recruited to the bxdPRE only in the presence of adjacent binding sites for architectural proteins Su(Hw), CTCF, or Pita.

Squaramide-Immobilized Carbon Nanoparticles for Rapid and High-Efficiency Elimination of Anthropogenic Mercury Ions from Aquatic Systems.

Water pollution due to environmental remediation and poor waste administration in certain areas of the globe signifies a serious problem in acquiring safe and clean drinking water. This problem is especially critical in rural areas, where advanced water purification techniques are deficient, and it remains a daunting task for ecosystem and public health protection. This critical task can be addressed herein by developing scalable poly squaramide-phenyl methacrylamide (PSQ)-functionalized carbon nanoparticles (CNPs) (PSQ-CNPs) with densely populated chelating sites with strong Hg2+-binding capacity. The PSQ-CNPs have shown high efficiency in removing Hg2+ from aqueous solution, providing a Hg2+ capacity of 2840 mg g-1, surpassing all the amine and thiol-based adsorbents reported hitherto. More significantly, the adsorbent reveals the largest distribution coefficient value (Kd) of 9.09 × 1010 mL g-1, which allows it to reduce Hg2+ content from 10 ppm to less than 0.011 ppb, well below the United States Environmental Protection Agency (EPA) limits for drinking water standards (2 ppb). The adsorption measurements of the adsorbent followed the Langmuir isotherm model and pseudo-second order. The practical applicability of PSQ-CNPs was verified with the real samples (the lake, river, and industrial wastewater) and has been proven to be excellent. The adsorbent could still retain its Hg2+ removal efficacy even after 12 sorption cycles. It is attributed that the remarkable performance of PSQ-CNPs arises from the high-density chelating sites and pores on the surface of CNPs. The present work shows a new benchmark for Hg2+-removal adsorbents and presents a novel practical approach for decontaminating Hg2+ and other heavy metal ions from wastewater.

Patients' Satisfaction with Ophthalmology Clinic Services in a Public Teaching Hospital.

Purpose: To evaluate patients' satisfaction with ophthalmology health services in a teaching clinic of a tertiary public hospital. Patients and Methods: This was a cross-sectional study in ophthalmology clinic of Dr. Sardjito teaching hospital, Yogyakarta, Indonesia conducted in 2019. Patients were surveyed using the Patient Satisfaction Questionnaire-18 (PSQ-18). PSQ-18 subscale score was analyzed based on patients' characteristics. The main outcome was the odds of reaching top satisfaction score (TSS) of 4-5 from a Likert scale 1 to 5. Results: Our study recorded 269 participants who consisted of 138 males (51.3%) and 131 females (48.7%) with median age of 52 (18-87) years old. Variables with higher odds of reaching TSS on "patient overall satisfaction" was public health insurance (OR: 7.959 [95% CI: 1.989-31.852], p=0.003) while examination time (OR: 0.955 [95% CI: 0.923-0.988], p=0.008) had lower odds. Examination waiting time (OR: 0.992 [95% CI: 0.985-0.999], p=0.027) and examination time (OR: 0.941 [95% CI: 0.908-0.976], p=0.001) had lower odds of reaching TSS in "general satisfaction". Family monthly income (OR: 1.829 [95% CI: 1.038-3.223], p=0.037) had higher odds of reaching TSS in "technical quality" while examination time (OR: 0.961 [95% CI: 0.931-0.993], p=0.017) and education (OR: 0.549 [95% CI: 0.322-0.934], p=0.027) had lower odds. Comorbidities (OR: 0.533 [95% CI: 0.301-0.944], p=0.031) had lower odds of reaching TSS in "financial aspects". Retina subspecialty clinic (OR: 3.436 [95% CI: 1.154-10.232], p=0.027) had higher odds of reaching TSS in "time spent with doctor". Registrar as attending physician (OR: 0.427 [95% CI: 0.205-0.89], p=0.0230) and examination time (OR: 0.957 [95% CI: 0.924-0.991], p=0.013) had lower odds of reaching TSS in "accessibility-convenience". Conclusion: Examination time and examination waiting time should be shortened, specialist doctors should always see the patients whenever possible, and registrars' technical and communication skill should be improved. Alternative funding for patients without health insurance also should be provided to increase satisfaction.

Association of Symptoms of Sleep-Related Breathing Disorders with Asthma Control in Indian Children.

OBJECTIVE: To explore the association of symptoms of sleep-related breathing disorders (SRBD) with asthma control in Indian children. METHODS: This study was carried out in the pediatric chest clinic of a tertiary care center in western India. Children from 6 to 18 y of age with a physician-diagnosed case of asthma were included in the study. A validated pediatric sleep questionnaire, SRBD scale, was used to screen the symptoms of SRBD. At the same time, Asthma Control Questionnaire (ACQ) was administered to assess asthma control. RESULTS: A total of 207 (73% boys) children with asthma were enrolled; the median age was 10 (7, 13) y. Asthma symptoms were well controlled (ACQ ≤ 0.75) in 102 (49.3%) and partly or poorly controlled (ACQ > 0.75) in 105 (50.7%) children. Inattention and/or hyperactivity was the most common SRBD symptom observed in 125 (60.4%) children; daytime sleepiness, mouth breathing, snoring, and night-time breathing problems were observed in 92 (44.5%), 91 (44%), 77 (37.2%), and 68 (32.8%) children, respectively. SRBD score showed a near-linear correlation with ACQ score (r = 0.28, p < 0.001). The score was positive in 52 (25.1%) children. A positive SRBD score was statistically more common in partly or poorly controlled asthma (aOR 2.5; 95% CI: 1.2-5.0; p = 0.01). However, the positive score did not show a statistically significant association with gender, being underweight, obesity, allergic rhinitis, compliance to therapy, and inhalation technique. CONCLUSION: SRBD symptoms are common in children with asthma. They showed a statistically significant association with partly or poorly controlled asthma. Therefore, it would be interesting to look for SRBD symptoms in children with partly or poorly controlled asthma.

Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ*) into Brazilian Portuguese.

INTRODUCTION: Obstructive sleep apnea is a frequent entity in childhood that can lead to important consequences for the health and children's quality of live. Polysomnography is the gold-standard exam to diagnose obstructive sleep apnea, but it is expensive, complex, and poorly affordable in Brazil. The pediatric sleep questionnaire has shown to be a valuable screening test for obstructive sleep apnea. It is a simple questionnaire with good sensitivity and specificity compared to polysomnography in the countries where it has been validated. OBJECTIVE: Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ), into Brazilian Portuguese. METHODS: The translation of the PSQ into Brazilian Portuguese was carried out in accordance with good practices. The validated and adapted questionnaire was applied to parents/caregivers of 60 children (40 of them with obstructive sleep apnea and 20 controls) aged 2-18 years. Retest was applied to 30 children with obstructive sleep apnea. The following tests were performed: internal consistency, test-retest, validation of questionnaire (the latter by ROC curve). RESULTS: Brazilian PSQ has shown high internal consistency by Cronbach's alpha (0.86 for the total test, 0.83 for subscale "snoring", 0.64 for "sleepiness" and 0.65 for "behavior"). Test-retest presented a correlation of 0.89 for subscale "snoring", 0.93 for "sleepiness" and 0.86 for "behavior". Accuracy by ROC curve was 0.99. Nine was considered the optimal value to discriminate patients with obstructive sleep apnea from controls, with a sensitivity of 0.92 and specificity of 1.0. CONCLUSION: The translation and cross-cultural adaptation of the PSQ into Brazilian Portuguese proved to be successful. In places with difficult access to polysomnography, PSQ can be a useful tool in screening and follow-up of children with obstructive sleep apnea.

Satisfaction of patients with health care services in tertiary care facilities of Riyadh, Saudi Arabia: A cross-sectional approach.

As part of Saudi Vision 2030, the country's healthcare system is undergoing a significant makeover, with accessibility and effectiveness serving as the benchmarks for measuring patient care quality. This study's goal was to ascertain the degree of patient satisfaction with the medical care and services received in Riyadh's tertiary care facilities. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standardized validated questionnaire including areas of "overall satisfaction," "technical quality," "interpersonal aspect," "communication," "financial aspect," "time spent with the doctor," and "accessibility and convenience," was used in this cross-sectional study on 384 patients of two tertiary care facilities in Riyadh, Saudi Arabia, over a 6-month period. The degree to which sociodemographic characteristics and components of patient satisfaction are correlated was assessed using binary and multiple regression analysis. When the P-value was < 0.05, the results were considered significant and were presented as adjusted odds ratios (AOR). To ascertain how each PSQ-18 subscale affected other subscales, a Pearson Correlation analysis was conducted. The overall degree of satisfaction with all 18 items was 73.77%. The financial component received a rating of 81% compared to 77% for general satisfaction. Technical quality (75%) was followed by accessibility and convenience (73.5%), communication (73%), and interpersonal elements (72%). At 68%, the time spent in the doctor's domain received the lowest rating. The odds of satisfaction were increased by 3.87 times, 3.45 times, and 3.36 times among those who are employed, qualified by university education, and married compared to unemployed (P-value = 0.018), less qualified (P-value = 0.015) and singles (P-value = 0.026), respectively. The younger age group also made 1.78 times more of a difference in higher satisfaction ratings. The general satisfaction domain showed a positive association with other areas. Participants who were satisfied with the communication and accessibility and convenience domains of healthcare providers were the only ones who were typically satisfied with the domain of doctor time spent. The study's findings could act as a benchmark for Saudi Arabia's healthcare services as well as a starting point for quality assurance procedures.

Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ*) into Brazilian Portuguese / Tradução e adaptação transcultural do pediatric sleep questionnaire (PSQ*) para o português do Brasil

Abstract Introduction Obstructive sleep apnea is a frequent entity in childhood that can lead to important consequences for the health and children's quality of live. Polysomnography is the gold-standard exam to diagnose obstructive sleep apnea, but it is expensive, complex, and poorly affordable in Brazil. The pediatric sleep questionnaire has shown to be a valuable screening test for obstructive sleep apnea. It is a simple questionnaire with good sensitivity and specificity compared to polysomnography in the countries where it has been validated. Objective Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ), into Brazilian Portuguese. Methods The translation of the PSQ into Brazilian Portuguese was carried out in accordance with good practices. The validated and adapted questionnaire was applied to parents/caregivers of 60 children (40 of them with obstructive sleep apnea and 20 controls) aged 2-18 years. Retest was applied to 30 children with obstructive sleep apnea. The following tests were performed: internal consistency, test-retest, validation of questionnaire (the latter by ROC curve). Results Brazilian PSQ has shown high internal consistency by Cronbach's alpha (0.86 for the total test, 0.83 for subscale "snoring", 0.64 for "sleepiness" and 0.65 for "behavior"). Test-retest presented a correlation of 0.89 for subscale "snoring", 0.93 for "sleepiness" and 0.86 for "behavior". Accuracy by ROC curve was 0.99. Nine was considered the optimal value to discriminate patients with obstructive sleep apnea from controls, with a sensitivity of 0.92 and specificity of 1.0. Conclusion The translation and cross-cultural adaptation of the PSQ into Brazilian Portuguese proved to be successful. In places with difficult access to polysomnography, PSQ can be a useful tool in screening and follow-up of children with obstructive sleep apnea.

Resumo Introdução A apneia obstrutiva do sono é uma doença comum na infância que pode trazer consequências importantes para a saúde e qualidade de vida das crianças. O exame padrão‐ouro para o diagnóstico (polissonografia) é um exame caro, complexo e disponível em poucos centros. O pediatric sleep questionnaire, PSQ, tem demonstrado ser um bom teste de triagem para apneia obstrutiva do sono, por ser um questionário simples e com boa sensibilidade e especificidade quando comparado à polissonografia nos países em que foi validado. Objetivo Tradução e adaptação transcultural do PSQ para o português do Brasil. Método Foi feita a tradução do PSQ para o português do Brasil, de acordo com as boas práticas. O questionário validado e adaptado foi aplicado aos pais/responsáveis de 60 crianças com 2-18 anos, 40 com apneia obstrutiva do sono e 20 controles. O reteste foi feito em 30 crianças com apneia obstrutiva do sono. Foram avaliados: consistência interna, teste‐reteste, validação do conteúdo e acurácia do questionário, pela curva ROC (do inglês receiver operating characteristic curve). Resultados O PSQ‐Brasil apresentou alta consistência interna, pelo coeficiente Alfa de Cronbach (0,86 para o teste total; 0,83 para o subdomínio "ronco"; 0,64 para "sonolência" e 0,65 para "comportamento". O teste‐reteste teve concordância de 0,89 para o subdomínio "ronco"; 0,93 para sonolência" e 0,86 para "comportamento". A acurácia medida pela curva ROC foi de 0,99. O valor de 9,0 foi considerado ideal para diferenciar os pacientes com apneia obstrutiva do sono e controles, com sensibilidade de 0,92 e especificidade de 1,0. Conclusão A tradução e adaptação transcultural do PSQ para o português do Brasil mostrou‐se bem‐sucedida. Em locais com dificuldade de acesso à polissonografia, o PSQ pode ser uma ferramenta útil na suspeição diagnóstica e seguimento das crianças com apneia obstrutiva do sono.