To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Pasture management that considers pasture growth dynamics remains an open question. Conceptually, such management must allow for grazing only after the recuperation of the pasture between two separate timely grazing periods when pasture reaches optimum recovery, as per the first law of Voisin’s rational grazing system. The optimum recovery period not only implies a pasture with better nutritional value and higher biomass yield but one that also reduces the production of enteric methane (CH4) to improve the grazing efficiency of cattle. Therefore, this study aimed to evaluate three different recovery periods (RP) of mixed grasses on the grazing behaviour of heifers, as well as herbage selectivity, herbage yield and nutritional value, in vitro degradability and CH4 production. Based on these criteria, three pasture RPs of 24 (RP24), 35 (RP3) and 46 (RP46) days were evaluated in six blocks using a randomized block design. At each predetermined RP, samples of the pasture were taken before the animals were allowed to graze. Right after collecting the pasture samples, heifers accessed the pasture during 4 h consecutively for grazing simulation and behavioural observations. We also measured the bite rate of each animal. The pasture growing for 24 days had the highest biomass production, best nutritional value, best efficiency of in vitro CH4 relative emission (ml) per DM degraded (g) and bite rate of the three RPs. Heifers all selected their herbage, irrespective of RP, but with different nutritional value and higher in vitro degradability. However, this did not change the production of in vitro CH4. Considering the growth conditions of the area where the study was performed, we recommend the shorter RP24 as the most suitable during the summer season. The study’s findings support the idea of management intervention to increase the quality of grazing systems.
Objective: To conduct a formative evaluation of a transitional intervention for family caregivers, with assessment of feasibility, acceptability, appropriateness, and potential benefits. Methods: The intervention aimed to provide emotional support, information on community resources, and information and support for development of coping skills for the caregivers of patients aged 65 and older who were to be discharged home from an acute medical hospital admission. We used a one-group, pre- and three-month post-test study design. Results: Ninety-one patient-caregiver dyads were recruited. Of these, 63 caregivers (69%) received all five planned intervention sessions, while 60 (66%) completed the post-test. There were significant reductions in caregiver anxiety and depression following the intervention, and high rates of satisfaction. Discussion: This transitional intervention should be further evaluated, preferably with a control group, either as a stand-alone intervention or as one component of a comprehensive transitional intervention for older patients and their caregivers.
A 4-year (2010–2013) plot study was undertaken to evaluate the effect of nitrogen (N) fertilizer rate (0, 60, 120, 196 and 240 kg N/ha/year) on seasonal responses and species persistency in frequently and tightly grazed (⩽4 cm) grass-only (GO) and grass white clover swards (GWc). Increasing N application rate increased herbage removed and pre-grazing sward height. Cows frequently grazed the GWc tighter than the GO. Increasing N rate reduced clover content, especially during the warmest months of the year, but less so up to 120 kg N/ha/year. The GWc had greater amounts of herbage removed than GO in the May–September period but the effect was less as N rate increased. Cumulative herbage removed from GWc was greater than GO swards receiving the same N rate and herbage quality was better in GWc than GO. Such effects were reduced as swards aged and with increasing N rate. It was concluded that under frequent and tight grazing management: (1) clover inclusion increased annual herbage removed; (2) herbage removed from GWc swards receiving no N was the same as the GO sward receiving 240 kg N/ha, and greater for the 240 GWc swards than the 240 GO swards; (3) clover inclusion benefits were mainly from summer onwards; (4) the management strategy applied in the current experiment may be capable of alleviating the detrimental effect of N fertilizer on clover, to a point between 60 and 120 kg N/ha.
Most studies selected euthymic patients with bipolar disorder in inter-episodic phase according to clinical remission criteria at least between 1 and 6 months. However, possible differences can exist in the course of clinical symptoms in bipolar patients related to the duration of clinical remission.
The main aim of this study was to evaluate the clinical status of bipolar patients after 6 months of clinical remission.
We performed a cross-sectional study of bipolar outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Young Mania Rating scale, Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment were used to assess residual symptomatology of patients. Multivariate analysis (MANCOVA) was conducted for analysing possible differences between 3 groups of patients according to their duration of clinical remission (< 6 months–1 year, < 1 year–3 years, < 3 years–5 years).
A total of 525 patients were included into the study. The multivariate analysis indicated a significant effect of the duration of clinical remission on the different residual symptoms (Pillai's trace: F 4.48, P < 0.001). The duration of clinical remission was associated with the significant improvement of the BDRS total score (P = 0.013), the PSQI total score (P < 0.001) and the cognitive VAS total score (P < 0.001)
These results support a possible improvement of residual symptoms according to the duration of clinical remission in bipolar patients. Any definition of euthymia should specify the duration criteria.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The SIMPLe project was designed with the aim of developing a smartphone application (i.e. app) to monitor and psychoeducate subjects with bipolar disorder through highly personalized messages from both passive and active data. The project was based on a face-to-face group program, which has an increasing scientific evidence of its efficacy and cost-effectiveness reducing bipolar disorder relapses.
An initial feasibility study was conducted to evaluate the usability and satisfaction of an Android version of the SIMPLe app 1.0.
The SIMPLe feasibility study was conducted from March 2015 to June 2015. The participation in the study was offered to a consecutive sample of adult patients diagnosed of bipolar disorder I, II or NOS (not otherwise specified) attending the outpatient mental health clinic of the Hospital Clinic of Barcelona, Spain.
The participation in the study was offered to 72 stable bipolar patients. Forty-three subjects were enrolled in the study. Since the day the patients were enrolled in the study, the rate of completed tests was 0.74 per day and 1.13 per week. Nine emergency alerts were received through the application and notified to the reference patients’ psychiatrists. Ninety-five percent of the initial participants remained actively using the app and no relapses were identified during the 3 months of the study.
These preliminary results suggest a high feasibility of the SIMPLE app based on the rates of tasks completed and retention.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The assessment and management of psychomotor agitation may result in the use of coercive or sedative treatments. In the absence of conclusive evidence, the consensus of experts can guide clinical decisions.
To seek consensus recommendations on the assessment and management of psychomotor agitation.
An international expert task force in this field developed consensus using the Delphi method. Twenty-seven experts were invited to participate and 91% of them agreed. Initial survey items were gathered from the content of literature search (systematic review). This included open-ended questions inviting participants to add suggestions by e-mail correspondence. After this initial first round, the Delphi study was conducted online using Google Forms. Survey items were rated on a 5-point scale. Items rated by at least 80% of experts as essential or important were included. Items rated as essential or important by 65–79% of experts were included in the next survey for re-rating. Items with consensus below to 65% were rejected and excluded.
The initial survey included 52 items. The second web-based survey included 33 items. The briefer third survey consisted of 6 items that needed rerating. Twenty-two of the initial 33 items were endorsed and formed the clinical recommendations on the assessment and management of the psychomotor agitation. The endorsed items were categorized into 5 domains forming the clinical recommendations.
The panel expert generated 22 recommendations on the assessment and management of agitation. The Delphi method is a suitable formal iterative process for reaching consensus on relevant and controversial issues.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Asenapine is the most recent compound that has been FDA- and EMA-approved for treatment of mania. Its efficacy and safety have been assessed in placebo-controlled trials, but little is known about its performance in routine clinical conditions. In this study, we compared features of patients treated with adjunctive asenapine or other adjunctive antipsychotics and the costs of the treatment.
A combined prospective and retrospective data collection and analysis was conducted from January 2011 to December 2013 following a clinical interview and assessment of manic and depressive symptoms (YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST), sexual dysfunction (PRSexDQ) and health resource costs associated with treatment with adjunctive asenapine versus other adjunctive antipsychotics.
Hundred and fifty-two patients from different university hospitals were included. Fifty-three patients received adjunctive asenapine and 99 received other adjunctive antipsychotics concomitantly to mood stabilizers. Considering inpatients, those treated with adjunctive asenapine presented a significantly less severe manic episode (P = 0.001), less psychotic symptoms (P = 0.030) and more comorbid personality disorder (P = 0.002). Regarding outpatients, those treated with adjunctive asenapine showed significantly less severe manic episode (P = 0.046), more previous mixed episodes (P = 0.013) and more sexual dysfunction at baseline (P = 0.036). No significant differences were found in mean total costs per day.
Clinicians tended to use adjunctive asenapine in patients with less severe manic symptoms but more complex clinical profile, including more mixed episodes in the past, concomitant personality disorder, and sexual problems. Treatment with adjunctive asenapine was not associated with higher costs when compared to other options.
Asenapine is the most recent compound that hasbeen FDA- and EMA-approved for treatment of mania. Its efficacy and safety havebeen assessed in placebo-controlled trials, but little is known about itsperformance in routine clinical conditions. The MANACOR study assessed costsassociated with treatment of mania in several hospital settings acrossCatalonia, Spain. As part of the protocol, we compared cost-effectiveness ofasenapine versus other treatment options.
A combined prospective and retrospective datacollection and analysis was conducted from January 2011 to December 2013following a clinical interview and assessment of manic and depressive symptoms(YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST),sexual dysfunction (PRSexDQ) and health resource costs associated withtreatment with asenapine versus other antipsychotics.
152 patients from different university hospitalswere included. 53 patients received asenapine and 99 received otherantipsychotics. Considering inpatients (N=117), those treated with asenapinepresented a significantly less severe manic episode (p=0.001), less psychoticsymptoms (p=0.030) and, more comorbid personality disorder (p=0.002). Regardingoutpatients, those treated with asenapine showed significantly less severemanic episode (p=0.046), more previous mixed episodes (p= 0.013) and, moresexual dysfunction at baseline (p=0.036). No significant differences were foundin mean total costs per day.
Non-randomized study design.
Clinicians tended to use asenapine in patientswith less severe manic symptoms but more complex clinical profile, includingmore mixed episodes in the past, concomitant personality disorder, and sexualproblems. Treatment with asenapine was not associated with higher costs when comparedto other options.
Bipolar disorder is characterized by relapsing and remitting mood phases, such as manic or depressive episodes as well as periods of subsyndromal symptoms. Among the treatment options for acute manic episodes, most antipsychotics have a good level of evidence of effectiveness . Asenapine is a new atypical antipsychotic which showed good effectiveness and tolerability  along with a reasonable cost-effectiveness  in placebo-controlled trials. However, few studies have tested this in real-world clinical settings so far.
The aim of this study was to evaluate the effectiveness and tolerability of asenapine in bipolar patients in a naturalistic clinical setting.
We retrospectively examined the clinical records of 94 systematically followed-up adult patients who received asenapine in four selected Spanish reference centers. We assessed sociodemographic variables, tolerability as well as clinical severity through routinely used evaluation scales.
Half of the patients reported at least one adverse effect related to the asenapine (51%), being somnolence the most frequent (30%). Although none of the side effects reported was a cause to discontinue it. Asenapine showed good levels of effectiveness with a 61% reduction of manic and 44% of the depressive symptoms. Concerning mixed states, there was reduction of 30% and 39%, for both manic and depressive symptoms respectively.
Though asenapine has an indication for acute manic episodes in bipolar disorder, the present study suggests that it can also have a role in treating depressive and mixed states in a real world setting. In addition, tolerability was consistent with clinical trial data.
Bipolar disorder is a frequent condition in the general population with a high morbimortality, which consists in dysfunctional temporal fluctuations between different mood phases during which frequently there is a lack of insight. Besides the pharmacological treatment, psychoeducational programs have proved to be a cost-effective approach to help patients recognize early signs and symptoms in order to prevent full-blown episodes, although its broad implementation is still difficult and costly .
Objectives and Aims
The main aim of this study is to develop and clinically validate a smartphone application to monitor symptoms and signs in stable bipolar patients along with customized embedded psycho-education contents and empower the self-management of their disorder to avoid relapses and hospitalizations.
The study will be carried out in three different but complementary phases in order to fully include patients and therapist's preferences: 1. Feasibility study using SIMPLe 1.0 app (subjective information only). 2. Feedback-based improvement process which will incorporate the objective information. 3. Randomized controlled trial with two arms of 74 patients each (SIMPLe 2.0+TAU vs. TAU).
After the collaborative development of clinical algorithms to ensure adequate sensibility and specificity to detect relapses and personalize psychoeducational messages, a technical pilot test of SIMPLE 1.0 app is underway and the first patients are being recruited to start the 1st phase of the study in Mid-October of 2014.
The possibility to deliver personalized psychoeducation contents based on monitoring signs and symptoms through a smartphone seems a promising cost-effective method, although a clinical validation is necessary.
This article contributes to a line of research in Business History that aims to determine the factors of family business longevity in the long term with the study of individual cases. The literature has identified family cohesion as one of the essential factors for survival. Cohesion may be reinforced or broken at the time of the intergenerational transfer. This study finds that a critical response on the part of the business family to the difficulties associated with intergenerational transfer of control, including modifications to the original plan, is usually based on trust between generations. Within the business family cohesion facilitates intergenerational transfers and, consequently, allows the family to evolve and transform itself into a business dynasty.
Bipolar disorder type II(BDII) has a prevalence of about 5% of the population according to different studies(1). There is evidence that the diagnosis of bipolar disorder patients may be delayed in 8 to 10 years, and this is especially relevant in BDII, where hypomania is often overlooked (2). The HCL-32 is a widely used and reliable instrument for the detection of previous hypomanic episodes and was validated in several languages, including Spanish (3). The massive use of internet and new technologies, may help to make this tool available to a greater extend of the population and could help detect even more cases. Accordingly, we evaluated the online version of the HCL-32.
To evaluate the validity and reliability of the HCL-32 online Spanish version.
We recruited 110 consecutive outpatients with different diagnosis, who agreed to participate and signed an informed consent. They were asked to complete a paper version(Pv)of HCL-32 in addition to an online version(Ov) sent by email within two weeks. The results were analyzed using SPSS v21.
The HCL32 Pv showed a high internal consistency as well as the Ov(Cronbach's α, 0,91 and 0,90 respectively). The total score correlation between both versions was high(0,94, p<0,001) and there were no mean score significant differences. All Item-scale's correlation were significant.
The online Spanish version of the HCL-32 for the screening of hypomanic episodes has the same good psychometric properties as the paper version, which makes it suitable to be available to more people through Internet.
Yerba mate(ilex paraguariensis(IP))is a plant widely consumed in South America as a hot(mate)or cold infusion beverage(tereré). During the last years, there was an increasing interest in its health properties supported by a growing scientific evidence. These studies showed that the IP could have hepatoprotective, hypocholesterolemic, diuretic and antioxidant properties. Furthermore it showed to be a nervous system stimulant and protectant(1). Recently, there were reports about its invitro potential to inhibit the Monoaminooxidase(MAO) which can have effects on mood state(2).
Exploratory research to study possible associations between the use of IP and mood symptoms.
An observational cross-sectional study was conducted by an online survey in paraguayan population through an invitation. The survey collected data information about sociodemographics conditions, substance use(including IP), Spielberg's State-Trait Anxiety Inventory and PHQ-9 scale for depressive symptoms. A descriptive and multiple lineal regression analysis of the data was performed.
300 subjects accepted the invitation and information was obtained of about 76% of them. The sample mean age(SD) was 27(7,4), most of them females(61,6%)and with universitary studies(66,1%). The 86% of the sample consumed IP regularly and 56% daily. Only a 3,5% reported previous psychiatric history. A significant relationship was observed between the use of IP and daily alcohol(p=0,022). No relevant associations were found concerning IP use and anxiety trait-state or depressive symptoms after adjusting for the use of coffee, tea, alcohol and others sociodemographic variables.
No significant associations were found in the sample studied between the use of IP and state-trait anxiety or depressive symptoms. Although, given the frequency of its use, the association with alcohol consumption and its potential clinical applications, more and bigger studies might be necessary.
The aim of this study was to determine the effect of single layer centrifugation (SLC) using Androcoll-E-Large on donkey sperm quality parameters after 24 h of cool-storage. Ejaculates were collected from Andalusian donkeys and then cooled at 5°C. SLC was carried out after 24 h of cool-storage using Androcoll-E-Large. In the first experiment, all sperm parameters assessed (total and progressive sperm motility, viability, sperm morphology and sperm kinematics VCL, VSL, VAP, LIN, STR, WOB, ALH and BCF) were statistically compared between semen samples processed or not with Androcoll-E-Large. Significant differences (P<0.05) were found between SLC-selected and unselected semen samples for all parameters assessed, obtaining better results after SLC. In the second experiment, semen samples were classified in two groups according to their sperm progressive motility (PM) before SLC. Then, the increments obtained in semen quality parameters after SLC were compared between groups. No significant differences were found between groups, indicating that SLC improved the sperm quality parameters of entire set of semen samples processed with independence to their original PM. In conclusion, SLC with Androcoll-E-Large can be used in donkeys, increasing the sperm quality of cooled-stored donkey semen doses after 24 h of cool storage.
The effects of precipitation regime on the size of soil carbon (C) pools were compared in mature tropical dry forests of the Yucatan Peninsula. Our study included three forest stands in each, a dry site (potential evapotranspiration ratio = 3.2 mm mm−1; mean annual precipitation = 537 mm), a wetter site (2.0 mm mm−1; 993 mm) and a site in which water was comparatively less limiting (1.3 mm mm−1; 1086 mm). At each site, soil C pools in dead fallen phytomass (includes leaves, flowers, fruits, small twigs and deadwood debris) deposited on the litter layer and in roots and organic matter of the mineral soil (from the upper 10 cm) were measured in samples collected during the dry season. A high proportion of the total C pool (93–95%) was in the top 10 cm of soil in all forest sites. The smallest C pool was in roots (1.8–2.4% of the total C), meanwhile the C in the litter layer represented 3–5% of the total pool. These patterns were observed irrespective of study site. However, distribution of C (i.e. wood debris vs. fine litter) varied across sites; the proportion of the forest-floor C pool in wood debris decreased from 80% in the driest site, to 51% and 42% in 993-mm and 1086-mm sites, respectively. Overall, we observed that three pools (wood debris, roots and soil organic C) provide evidence for the significant decrease in soil C storage with increase in mean annual precipitation in Yucatan Peninsula. A potential explanation for this unexpected pattern includes an increasing C turnover time with decreasing mean annual precipitation, resulting in higher C accumulation per unit of C input in the driest site.
To assess the feasibility and effectiveness of the International Nosocomial Infection Control Consortium (INICC) multi-dimensional hand hygiene approach in 19 limited-resource countries and to analyze predictors of poor hand hygiene compliance.
An observational, prospective, cohort, interventional, before-and-after study from April 1999 through December 2011. The study was divided into 2 periods: a 3-month baseline period and a 7-year follow-up period.
Ninety-nine intensive care unit (ICU) members of the INICC in Argentina, Brazil, China, Colombia, Costa Rica, Cuba, El Salvador, Greece, India, Lebanon, Lithuania, Macedonia, Mexico, Pakistan, Panama, Peru, Philippines, Poland, and Turkey.
Healthcare workers at 99 ICU members of the INICC.
A multidimensional hand hygiene approach was used, including (1) administrative support, (2) supplies availability, (3) education and training, (4) reminders in the workplace, (5) process surveillance, and (6) performance feedback. Observations were made for hand hygiene compliance in each ICU, during randomly selected 30-minute periods.
A total of 149,727 opportunities for hand hygiene were observed. Overall hand hygiene compliance increased from 48.3% to 71.4% (P < .01). Univariate analysis indicated that several variables were significantly associated with poor hand hygiene compliance, including males versus females (63% vs 70%; P<.001), physicians versus nurses (62% vs 72%; P<.001), and adult versus neonatal ICUs (67% vs 81%; P<.001), among others.
Adherence to hand hygiene increased by 48% with the INICC approach. Specific programs directed to improve hand hygiene for variables found to be predictors of poor hand hygiene compliance should be implemented.
The Day Hospital (DH) provides an intensive, multidisciplinary, coordinated, group and customized care for patients admitted for treatment. The therapeutic approach improve their clinical situation, their quality of life and facilitate their reintegration into everyday life. Our objective is to evaluate overall clinical improvement and perceived quality of life of patients admitted in a general hospital DH (2010–2012). Clinical diagnosis (DSM-IV-R) grouped (NSUD, SUD and DUAL), clinical variables, baseline/ high clinical situation (CGI-S), global impression of improvement (CGI-I) and related quality of life perceived (EQ5) at baseline / high were recorded. Data were analyzed using SPSS v15. 174 patients were evaluated, 58% women, mean age 47 years and schooling medium-high (76%). The average stay (DT) was 35 days. Patients came from 47%: acute hospitalization, 51%: Mental Health Center (MSC) or outpatient and 4%: other units. The reasons for admission were detoxification (34.5%), stabilization (33.3%), consolidation of detoxification (15.5%), decompensation (9.2%) and re-structuring of treatment (7.5%). The overall clinical improvement of the whole sample at the end of stay assessed by the CGI-I was: 35% = “much better” 38% = “moderately better”, 5% = “slightly better”, 21% = “no change” and only 1% “worse” (p = 0.001). An overall clinical improvement and quality of life perceived was observed in the three groups of patients. While it remains to know the persistence of these parameters in the long term, the Day Hospital proved to be an important therapeutic resource for overall clinical improvement of patients towards their incorporation into daily life.
ECT remains as one of the most effective and secure psychiatric treatments for a wide variety of disorders, like depression, bipolar disorder or schizophrenia. Although not fully known, several theories hypothesize about its mechanism of action. To be effective, it has to induce a generalized convulsion of at least 15 seconds.
To analyze and compare convulsion times regarding diagnosis and treatment phase (acute, continuation or maintenance) to discern whether these factors influence convulsion time.
1675 ECT sessions were performed on 117 patients during a year at a universitary hospital. Convulsion times were analyzed comparing them according to main diagnosis (bipolar disorder, major depressive disorder, schizophrenia, schizoaffective disorder), as well as according to treatment phase (acute, continuation, maintenance).
Schizophrenia mean convulsion time was 40,77 seconds (CI95% 39,25-42.28), for schizoaffective disorder it was 34,59 seconds (CI95% 32,74-36,44), for bipolar disorder 35,13 seconds (CI95% 33,83-36,43) and for major depressive disorder 34,90 seconds (CI95% 32,72- 37,07), with a statistical significance between groups of p < 0.001.
According to treatment phase, mean convulsion time in the acute phase was 34,94 seconds (CI95% 33,81-36,19), in the continuation phase it was 39,61 seconds (ICI95% 37,28-42,29), and in the maintenance phase it was 39,00 seconds (CI95% 37,92-40,18), with a statistical significance between groups of p < 0.001.
Although there exist statistically significant differences between groups according to diagnosis and treatment phase, they are not clinically relevant, thus concluding that neither diagnosis nor treatment phase seem to influence convulsion time to a relevant degree.
Standardized scales are a helpful and objective way to measure outcomes in clinical practice. However,previous surveys have revealed that only a small percentage of psychiatrists use them in clinical practice. Time-saving and cost-efficient tools are needed for daily clinical practice. A few successful experiences using online resources have been recently described and have been positively evaluated by patients. Still,it is an underdeveloped resource.
1. 1.Evaluate psychiatrist’s perception regarding use of scales in Spanish clinical practice facilities.
2. 2.Measure patient satisfaction using online tools.
Evaluate the need and potential use of online tools in routine clinical practice.
We conducted a survey among psychiatrists working in local clinical facilities to evaluate use of scales in daily clinical practice and their perception on the subject. We conducted a survey among patients who have used experimental online tools to evaluate their satisfaction with this method.
We wrote an email to 54 psychiatrists asking to answer an online-survey about the subject. 47 psychiatrists answered.Among them, only 40% use them always or frequently. 47% of them felt limited resources and time to administer as a difficulty to use scales. Furthermore, 34% suggested that online implementation could be helpful. 24 patients answered the satisfaction survey. 80% of them found online scales easier and more comfortable while 63% found them faster than traditional methods.
Scales are a useful and objective way to follow-up patients and evaluate clinical outcomes. However, psychiatrists find difficulties to use them in clinical practice, mainly by limited resources and time. Online implementation of scales is perceived as a potentially helpful and efficient tool for both psychiatrists and patients.
The aim of this study was to analyze the reliability and validity evidence of scores on the Spanish version of Self-Description Questionnaire II (SDQ-II). The instrument was administered in a sample of 2022 Spanish students (51.1% boys) from grades 7 to 10. Confirmatory factor analysis (CFA) was used to examine validity evidence based on internal structure drawn from the scores on the SDQ-II. CFA replicated the correlated 11 first-order factor structure. Furthermore, hierarchical confirmatory factor analysis (HCFA) was used to examine the hierarchical ordering of self-concept, as measured by scores on the Spanish version of the SDQ-II. Although a series of HCFA models were tested to assess academic and non-academic components organization, support for those hierarchical models was weaker than for the correlated 11 first-order factor structure. Results also indicated that scores on the Spanish version of the SDQ-II had internal consistency and test-retest reliability estimates within an acceptable range.