Processing and metabolism of beta-amyloid precursor protein (APP) and generation of a variety of beta-amyloid (Abeta) peptides in the human brain is essentially associated with pathophysiology of Alzheimer's disease (AD). APP degradation activity of the 68 kDa serine protease, which was originally prepared from familial AD lymphoblastoid cells and harbors beta-secretase-like activity, was analyzed by Western blot using anti Abeta 1/40 antibody and anti APP cytoplasmic domain (CT) antibody. Native lymphocyte APP (LAPP) prepared from normal or AD-derived lymphoblastoid cells was degraded by the protease, generating a 16 kDa Abeta-bearing C-terminal fragment of APP. N-terminal amino acid sequencing of the fragment indicated that the protease cleaves LAPP at the Abeta-N-terminus. When the LAPP was treated with chondroitinase ABC prior to proteolysis, the activity to generate the fragment was inhibited, but pretreatment with heparitinase resulted in no effect. Native hippocampal APP prepared from normal brain, however, did not generate the 16 kDa peptide by the protease treatment. These results suggest that the process of APP degradation and Abeta-peptides generation, including beta-secretase activity, is associated with tissue specificity of both APP substrate and proteases. They also indicate that sulfated glycoconjugates attached to a portion of APP isoforms may play a role as a molecular determinant in the proteolysis.
Goroji Nakagawa, a chief keeper of a trading house on Iturup Island, was brought unwillingly to Siberia by Russian vessels in 1807. In 1812, after about five years of hard life in Siberia, he was permitted to return to his homeland with two Russian books on vaccination. Sadayosi Baba, who stayed at Matsumae in 1813, happened to read one of the two books that had been published in 1803 in Peterburg and he translated it into Japanese. Within several months Baba finished his translation, however, he was clearly aware that the translation was far from perfect. Baba revised his draft in 1820 and titled it "Tonka Hiketu" or "The complete method for relieving small pox infection." But it remained unpublished until 1850, when Sen-an Tosimitsu obtained one of the manuscripts at Nagasaki and published it as "Rosia Gyuto Zensho" or "A Synopsis of Russian Vaccination." At present, sixteen manuscripts of "Tonka Hiketu" are extant in Japan and most of them are in public libraries. Bibliographical considerations of their contents, phonogramic descriptions of the original Russian title, comparisons of their illustrations with the originals and differences among Japanese translations reveal to us that the manuscript "Takeda A," among sixteen extant manuscripts, is the closest to the original manuscript of Sadayosi Baba, which remains lost.
To present the results of a pilot study of an innovative methodology for translating best evidence about spinal cord injury (SCI) for family practice.
Review of Canadian and international peer-reviewed literature to develop SCI Actionable Nuggets, and a mixed qualitative-quantitative evaluation to determine Nuggets' effect on physician knowledge of and attitudes toward patients with SCI, as well as practice accessibility.
Ontario, Newfoundland, and Australia.
Forty-nine primary care physicians.
Twenty Actionable Nuggets (pertaining to key health issues associated with long-term SCI) were developed. Nugget postcards were mailed weekly for 20 weeks to participating physicians. Prior knowledge of SCI was self-rated by participants; they also completed an online posttest to assess the information they gained from the Nugget postcards. Participants' opinions about practice accessibility and accommodations for patients with SCI, as well as the acceptability and usefulness of Nuggets, were assessed in interviews.
With Actionable Nuggets, participants' knowledge of the health needs of patients with SCI improved, as knowledge increased from a self-rating of fair (58%) to very good (75%) based on posttest quiz results. The mean overall score for accessibility and accommodations in physicians' practices was 72%. Participants' awareness of the need for screening and disease prevention among this population also increased. The usefulness and acceptability of SCI Nugget postcards were rated as excellent.
Actionable Nuggets are a knowledge translation tool designed to provide family physicians with concise, practical information about the most prevalent and pressing primary care needs of patients with SCI. This evidence-based resource has been shown to be an excellent fit with information consumption processes in primary care. They were updated and adapted for distribution by the Canadian Medical Association to approximately 50,000 primary care physicians in Canada, in both English and French.
The aim of this study was to adapt the instrument 'Good Nursing Care Scale for Patients' to Swedish conditions as a measure of patients' satisfaction, as well as estimating its reliability and validity. Following a pilot test, discussions in the author group, testing for readability among patients and judgement of content validity by a panel of experts, the final version was reduced to 72 items focusing on good caring. The refined instrument was assessed for internal consistency in 447 surgical in-patients, for 2 week test-retest reliability in 100 patients and subjected to orthogonal principal components factor analysis with varimax rotation, followed by second-order factor analysis. The internal consistency item-item correlation coefficient ranged from 0.15 to 0.91, correlation between each item and the total scale was >or=0.30 for 70 items, Cronbach's alpha coefficient for the final scale was 0.79 and test-retest reliability was 0.75. An orthogonal principal components factor analysis with varimax rotation was conducted on the final 71 items and the 15 first-order factors with eigenvalues >or=1 explained 66% of the total variance. A second-order factor analysis of these 15 factors as items resulted in a seven-factor solution. The total variance explained by the seven factors was 79%. Cronbach's alpha coefficient for the seven factors ranged between 0.32 and 0.95. The instrument seems reliable and valid to assess the patients' satisfaction with what happened during their hospital stay. To confirm the factor structure and improve factor consistency additional development and testing is suggested.
Shared learning activities aim to enhance the collaborative skills of health students and professionals in relation to both colleagues and patients. The Readiness for Interprofessional Learning Scale is used to assess such skills. The aim of this study was to validate a Danish four-subscale version of the RIPLS in a sample of 370 health-care students and 200 health professionals.
The questionnaire was translated following a two-step process, including forward and backward translations, and a pilot test. A test of internal consistency and a test-retest of reliability were performed using a web-based questionnaire.
The questionnaire was completed by 370 health care students and 200 health professionals (test) whereas the retest was completed by 203 health professionals. A full data set of first-time responses was generated from the 570 students and professionals at baseline (test). Good internal association was found between items in Positive Professional Identity (Q13-Q16), with factor loadings between 0.61 and 0.72. The confirmatory factor analyses revealed 11 items with factor loadings above 0.50, 18 below 0.50, and no items below 0.20. Weighted kappa values were between 0.20 and 0.40, 16 items with values between 0.40 and 0.60, and six items between 0.60 and 0.80; all showing p-values below 0.001.
Strong internal consistency was found for both populations. The Danish RIPLS proved a stable and reliable instrument for the Teamwork and Collaboration, Negative Professional Identity, and Positive Professional Identity subscales, while the Roles and Responsibility subscale showed some limitations. The reason behind these limitations is unclear.
The Cambridge pulmonary hypertension outcome review (CAMPHOR) is the first pulmonary hypertension-specific instrument for the assessment of the patient's perceived symptoms, activity limitations and quality of life (QoL).
To produce and validate a Swedish language version of the CAMPHOR.
Bilingual (n = 5) and lay panels (n = 5) were conducted to translate the CAMPHOR into Swedish. This new questionnaire was then field-tested with 14 patients and finally, it underwent psychometric evaluation by means of a postal validation study involving 38 patients with pulmonary hypertension (PH).
Few problems were experienced in translating the CAMPHOR into Swedish. The field-test participants found the scales relevant, comprehensible and easy to complete. Psychometric analyses showed that the Swedish adaptation was successful. The Swedish CAMPHOR scales had good internal consistency. Cronbach's alpha coefficients were 0.92 for the symptoms scale, 0.92 for activity limitations and 0.95 for the quality of life. Predicted correlations with the Nottingham Health Profile provided evidence of the construct validity of the scales. The Swedish scales also indicated known groups validity.
The Swedish version of the CAMPHOR is a reliable and valid measure of the impact of pulmonary hypertension on the lives of affected patients. It is recommended for use in clinical studies and routine practice in pulmonary hypertension patients.
Instruments for evaluating end-of-life care by voicing experiences of family members have previously been lacking in Sweden. The objective of this study was therefore to adapt and validate the VOICES (SF) questionnaire to evaluate quality of end-of-life care in Sweden. The VOICES (SF) [Views of Informal Carers - Evaluation of Services (Short form)] is a questionnaire about bereaved relatives' experiences of care in the last three months of life of a deceased family member.
This study was performed based on translation and back translation, cross-cultural adaptation and content validation through cognitive interviewing and feedback from professional experts. For the cognitive interviews, a purposeful sample of 35 bereaved family members was recruited from home care, hospital wards and nursing homes. The participants were 13 men and 22 women (age ranged between 20 and 90+, mean age 66), who were relatives of persons who died from life-limiting conditions. The bereaved family members' and the professional experts' concerns were summarised and analysed based on clarity, understanding, relevance, sensitivity and alternative response/wording.
The main concerns emerging from the content validation related to the understanding and clarity of some of the questionnaire items', and a few concerns regarding the relevance of different response alternatives or items. Only two of the family members found it emotional to complete the questionnaire, and they still deemed completing it to be important and manageable.
The VOICES (SF) can be considered as feasible in the Swedish context, provided that cultural adaptation has been achieved, that is translation alone is not enough. The Swedish version will be available for healthcare professionals to use for quality monitoring of the care provided over the last three months in life, and for research, it enables national and cross-national comparisons between different healthcare places and organisations.
OBJECTIVES: The study was designed to adapt the Stanford Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) for use in Denmark. METHOD: The instruments were translated into Danish and then field-tested with 10 RA patients for relevance, and face and content validity. Reliability and validity were assessed by administering the new measures and a comparator instrument (the Danish Nottingham Health Profile) to 80 RA patients on two occasions. RESULTS: Patients found both measures acceptable and easy to complete. They had good test-retest reliability (>0.90) and internal consistency and were both able to discriminate between groups with different levels of functional status and self-perceived severity. When compared with the NHP sections, both measures showed expected convergence and divergence. CONCLUSION: Given the excellent psychometric properties of the Danish versions of the RAQoL and HAQ, both are recommended for inclusion in clinical trials and studies.
Experiencing a false-positive screening mammography can cause considerable psychosocial distress. The Consequences of Screening - Breast Cancer questionnaire (COS-BC parts 1 and 2), recently developed in Denmark, is the only condition-specific questionnaire for measuring short- and long-term psychosocial consequences of false-positive mammographic screening. Additional studies are needed to further test the COS-BC before use across cultures. Furthermore, studies have suggested that the consequences of false-positive screening results are partly common across cancer screening settings, although this hypothesis remains largely untested.
This study (i) assesses content validity of a Swedish version of the COS-BC, (ii) tests whether items expressing long-term consequences of false-positive lung cancer screening results are relevant in a breast cancer screening context and (iii) explores the usefulness of taking results from Rasch analyses of the source version as an aid in questionnaire translation and adaptation.
Following dual-panel translation, content validity was assessed through qualitative interviews with representatives of the target population and the content validity index (CVI). Item locations and Rasch model fit of the source questionnaires were considered in the translation and assessment process.
The COS-BC items were generally found relevant and provided coverage of the target construct. Content validity was supported also for nine of 10 lung cancer screening items. Scale CVI values were =0.81. Previous Rasch data were useful in facilitating translation and assessing item content validity. The resulting Swedish version of the COS-BC parts 1 and 2 consists of 34 and 23 items, respectively.
This study illustrates the value of methodological triangulation and use of data from previous Rasch analyses in questionnaire translation and adaptation. We found support for the hypothesis that consequences of false-positive screening are common across cancer screening settings. Psychometric properties of the Swedish COS-BC remain to be established.
The Asthma Life Impact Scale (ALIS) is a disease-specific measure used to assess the quality-of-life of people with asthma. It was developed in the UK and US and has proven to be acceptable to patients, to have good psychometric properties, and to be unidimensional.
This paper reports on the adaptation and validation of the ALIS for use in representative Southern European (Italian) and Eastern European (Russian) languages.
The ALIS was translated for both cultures using the dual-panel process. The newly translated versions were then tested with asthma patients to ensure face and content validity. Psychometric properties of the new language versions were assessed via a test?re-test postal survey conducted in both countries.
It is possible that some cultural or language differences still exist between the different language versions. Further research should be undertaken to determine responsiveness. Further studies designed to determine the clinical validity of the Italian ALIS would be valuable.
Linguistic nuances were easily resolved during the translation process for both language adaptations. Cognitive debriefing interviews (Russia n=9, male=11.1%, age mean (SD)=55.4 (13.2); Italy n=15, male=66.7%, age mean (SD)=63.5 (11.2)) indicated that the ALIS was easy to read and acceptable to patients. Psychometric testing was conducted on the data (Russia n=61, age mean (SD)=40.7 (15.4); Italy n=71, male=42.6%, age mean (SD)=49.5 (14.1)). The results showed that the new versions of the ALIS were consistent (Russian and Italian Cronbach's alpha=0.92) and reproducible (Russian test-re-test=0.86; Italian test-re-test=0.94). The Italian adaptation showed the expected correlations with the NHP and the Russian adaptation showed strong correlations with the CASIS and CAFS and weak-to-moderate correlations with %FEV1 and %PEF. In both adaptations the ALIS was able to distinguish between participants based on self-reported general health, self-reported severity, and whether or not they were hospitalized in the previous week.