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The COVID-19 pandemic affected the health of children and adolescents (CA). Isolation-related conditions could have impacted not only the functionality of children and adolescents with cerebral palsy (CP) but also their social and emotional well-being, affecting their health-related quality of life (HRQoL)., Objective: To analyze perceptions of impairment during the pandemic and differences in HRQoL dimensions compared with a previous registry in Argentinean children and adolescents diagnosed with CP from the perspective of their caregivers., Subjects and Method: Cross-sectional observational study at two time points (2019 and 2021) where 98 caregivers participated. We used the KIDSCREEN-27 and CP-QOL questionnaires for the assessment of HRQoL and an open-ended question regarding the impact of the pandemic on the health of children and adolescents, including in 2021. We compared mean scores of the dimensions of the questionnaires in both stages (significant differences: Cohen's d≥0.3). Responses to the open-ended question were analyzed via "open" and "axial" coding., Results: The scores of the dimensions Participation, Emotional well-being, Social well-being, and School environment (CP-QOL) and Psychological well-being, Friends, School environment, and General HRQoL index (KIDSCREEN-27) were lower during the pandemic (2021) compared with 2019 (d>0.3). Regarding perceived affectation during the pandemic, we identified three main recurrences: "impairment due to interruption of therapies and treatments", "deterioration of peer bonding", and "increased and positive appraisal of self-care"., Conclusions: The pandemic affected the psychosocial dimensions of health. Qualitative data highlight the positive assessment of self-care.

Introduction: The impact of cerebral palsy (CP) on quality of life requires the incorporation of subjective assessments of health, functional status, and well-being. A specific health-related quality of life (HRQoL) measure for CP is the Australian CP-QOL questionnaire, whose version for caregivers (PCQ) was adapted in Argentina. This study aimed to achieve the final structure and evaluate the reliability and validity of the CP-QOL-PCQ for the Argentine child and adolescent population., Methods: 100 caregivers of people from 3 to 24 years old with a diagnosis of CP from Argentina participated. In addition to the CP-QOL-PCQ, the KIDSCREEN-27 questionnaire was applied. Analysis of response distributions of all items, inter-item correlations, and internal consistency of the scales were performed using Cronbach's alpha. The convergent validity of the instrument was tested through the correlation with scales of similar content from the KIDSCREEN and through a priori hypotheses in groups of different ages and functional impairment., Results: A final structure of the CP-QOL-PCQ was achieved with 8 multidimensional scales, with satisfactory inter-item correlations (>0.30) and internal consistency (>0.70). Moderate and high correlations (r>0.30) were obtained between similar dimensions of the CP-QOL-PCQ and the KIDSCREEN with similar concepts. Higher HRQoL scores were confirmed at a younger age and at a lower level of functional impairment (Cohen's d >0.20)., Conclusion: This provides evidence of reliability and validity to be expected for a HRQoL measurement instrument that can be implemented in the Argentine child and adolescent population with CP., (Universidad Nacional de Córdoba)

The use of questionnaires as measuring tools involves the use of language. Spanish intralinguistic variation entails differences in the ways of perceiving the world, analyzing events and behaving, which must be taken into account when designing and adapting questionnaires. The IA-PCAT (Primary Care Assessment Tools for Iberomerica) harmonization process differs from the cross-cultural adaptation scenarios described in the scientific literature, since it intends to obtain a single Spanish product suitable for multiple target populations, that emanates from questionnaires previously adapted in several populations. Hence, this work requires the use of new analysis categories. The aim of this methodological note is to propose discriminant definitions of conceptual equivalence, practical equivalence and linguistic acceptability as analysis categories of the data collected during cognitive interviews to assess the questionnaires' comprehension, carried out with health professionals and users of healthcare services., (Copyright © 2020 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To evaluate the measurement characteristics of the Spanish and Catalan versions of the 10-Item Primary Care Assessment Tool for adults (PCAT-A10), shortened from the original Primary Care Assessment Tool (PCAT), with a new mental health item., Design: Cross-sectional observational study., Location: The city of Barcelona., Participants: Of the 3,496 people over 14 years of age from the representative random sample of the Barcelona population, from the 2016-17 Barcelona Health Survey, those who declared they had a family doctor, and had visited a specialist at some time in their lives, and had answered more than 50% of PCAT-A10 items were selected (n=3,107)., Main Measurements: Item descriptive analysis, analysis of internal consistency, corrected item - total correlation, of the PCAT-A10 index and the 10 items that make it up. Three scenarios for non-response to treatment were analysed: substitution by 0, by the intermediate value, and excluding people who did not answer any item., Results: The PCAT-A10 index obtained Cronbach alphas of 0.73, 0.79, and 0.85 in the three mentioned scenarios, correlation item total corrected between 0.41 and 0.66, and 20.8% non-responses to the mental health item., Conclusions: The new version of PCAT-A10 has a high reliability with a higher response in the mental health item compared to the previous version., (Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Prior studies conducted in Argentina found variable prevalence rates of high blood pressure (HBP) among children using different measurement methods. The objective of this study was to know the prevalence of HBP among schoolchildren from the city of Córdoba and its relation to sex, nutritional status, socioeconomic status (SES), and level of maternal education., Population and Methods: Blood pressure measurements and information on SES, level of maternal education, and body mass index of schoolchildren from the city of Córdoba, Argentina, were obtained. HBP was defined as systolic or diastolic blood pressure levels that are greater than or equal to the 95th percentile for a given age, sex, and height percentile at three consecutive measurements on separate days., Results: A total of 1531 boys and girls participated; their average age was 10.6 years. Fifty-five children had HBP. Systolic and diastolic blood pressure levels showed a significant association with obesity (p= 0.001), but not with age (p= 0.87), sex (systolic: p= 0.48; diastolic: p= 0.71) or SES (systolic: p= 0.07; diastolic: p= 0.09)., Conclusions: The prevalence of HBP in a sample of schoolchildren from Argentina was 3.7%. It showed a significant association with obesity, but not with SES., (Sociedad Argentina de Pediatría.)

Introduction: The assessment of health-related quality of life (HRQoL) during childhood favors the identification of factors that affect growth and development. The objectives of this study were: a) to describe the HRQoL in children between 8.0 and 11.9 years old living in the Province of Tucuman; and b) to assess whether the HRQoL varies in relation to macrosocial (quality of life in the department, urban/rural household, socioeconomic status) and individual (age and sex) factors., Population and Methods: Quantitative and cross-sectional study among students from the departments of Yerba Buena and Simoca. The KIDSCREEN-52 questionnaire was administered to measure the HRQoL dimensions, and Student" s t tests, analysis of variance and multivariate logistic regression analysis to evaluate the data according to macrosocial and individual factors., Results: A total of 1647 surveys were analyzed. Younger students and of male sex, in general, had a better perception of their health. Yerba Buena residents had mean scores that were significantly lower in the financial resources dimension, as compared to residents of Simoca (45.3 vs. 46.7, p: 0.01). There was no association between the socioeconomic status and the HRQoL. Children from rural areas had the lowest scores in most dimensions, with significant differences in selfperception (51.3 vs. 53.0, p: 0.01) and mood (43.2 vs. 44.5, p: 0.03)., Conclusions: Perceived health of children from Yerba Buena and Simoca varied in relation to macrosocial and individual factors. In Yerba Buena, the perception of financial resources was worse than in Simoca. In general, the opinion of children from urban areas was more favorable than that of children from rural areas. Younger students and of male sex had a better perception of their health status., (Sociedad Argentina de Pediatría)

Objective: To obtain versions adapted to the Colombian context of the Primary Care Assessment Tools Child Edition and Adult Edition questionnaires (PCAT-CE and PCAT-AE, respectively) to assess the functions of primary care with equivalence to their original versions., Methods: Transcultural adaptation process based on the adapted versions in Spanish validated in Argentina, Uruguay and Spain, in agreement with the Ibero-American Collaboration IA-PCAT., Results: Eighteen out of 99 PCAT-CE items and 31 out of 112 PCAT-AE items were suitable for Colombia according to the Latin American versions. Of them, 76 and 73, respectively, required minimal idiomatic changes, 2 and 4 required major changes, and 1 and 4 items were removed. Interviews confirmed understanding and allowed improvements., Conclusions: Versions tailored to the Colombian health system were obtained. The methodology used capitalized on the results of other countries and can contribute to achieving greater equivalence between instruments from different countries.

Objective: To validate the Brazilian short version of the PCAT for adult patients in Spanish., Design: Analysis of secondary data from studies made to validate the extended version of the PCAT questionnaire., Location: City of Córdoba, Argentina. Primary health care., Participants: The sample consisted of 46% of parents, whose children were enrolled in secondary education in three institutes in the city of Cordoba, and the remaining 54% were adult users of the National University of Cordoba Health Insurance., Main Measures: Pearson's correlation coefficient comparing the extended and short versions. Goodness-of-fit indices in confirmatory factor analysis, composite reliability, average variance extracted, and Cronbach's alpha values, in order to assess the construct validity and the reliability of the short version., Results: The values of Pearson's correlation coefficient between this short version and the long version were high .818 (P<.001), implying a very good criterion validity. The indicators of good global adjustment to the confirmatory factor analysis were good. The value of composite reliability was good (.802), but under the variance media extracted: .3306, since 3 variables had weak factorials loads. The Cronbach's alpha was acceptable (.85)., Conclusions: The short version of the PCAT-users developed in Brazil showed an acceptable psychometric performance in Spanish as a quick assessment tool, in a comparative study with the extended version., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)

Introduction: During adolescence, school performance may be related to health, and academic achievements at this age can have an impact on the future. Our objective was to assess the relationship between academic performance and perceived health among adolescents, considering sociodemographic characteristics of their families., Population and Methods: Cross-sectional pilot study conducted in a sample of adolescents attending common basic courses of three public secondary schools in the city of Córdoba (Argentina). Academic performance was calculated as the average grade in all subjects; performance was considered satisfactory if equal to or higher than 6. Perceived health was assessed using the KIDSCREEN-52 questionnaire, which scores ten dimensions. In addition, age, sex, maternal education level, socioeconomic level and household composition were also recorded. Univariate and bivariate analyses and multivariate logistic regression models were conducted., Results: Five hundred fifty-four adolescents participated, 52% of them were girls. Unsatisfactory academic performance (27.6%) was more common among adolescents who evidenced a worse relationship with parents (OR: 2.68, 95% CI: 1.22-5.85) and a better relationship with peers (OR: 0.46, 95% CI: 0.26-0.82). Stratification by socioeconomic level showed differences: among those with a high socioeconomic level, an unsatisfactory performance was more common among adolescents who perceived themselves as having a low autonomy, while it was more common among those who perceived a worse school environment in the middle-low socioeconomic level., Conclusion: Academic performance was associated with psychosocial dimensions of health, such as relationship with family members, peers, autonomy and school environment.

Introduction: Chronic conditions (CCs) in the early stages of life may have an impact on various dimensions of health-related quality of life (HRQoL) in children., Objective: To compare HRQoL in children with confirmed CCs, reported CCs, and without CC., Population and Method: Cross-sectional study conducted in 2012 in the context of a larger research study carried out at schools in Córdoba and Bahía Blanca, and at Hospital Italiano of Buenos Aires and Hospital Prof. Dr. Juan P. Garrahan at Buenos Aires. The presence of a chronic condition was established by medical diagnosis at the hospital or as reported by schoolchildren's caregivers. Eight-to-twelve year-old children completed the KIDSCREEN-52 questionnaire on HRQoL, a pubertal development scale, and a family financial resource scale. The association between CCs and HRQoL adjusted by sex, age, pubertal development, maternal education level, and socioeconomic level was estimated., Results: Six hundred and seventy children/ caregiver dyads participated; 13.3% (n= 89) had confirmed CCs, 14.5% (n= 97) were schoolchildren with reported CCs, and the rest corresponded to healthy schoolchildren. Their average age was 10.2 years old (standard deviation= 1.01); 54.8% were girls. Having a confirmed CC was associated with a higher frequency of low physical wellbeing (odds ratio |-OR-|: 2.61; 95% confidence interval |-95% CI-|:1.43-4.76), while the presence of a reported CC was associated with a low score in psychological well-being (OR: 1.96; 95% CI: 1.06-3.63), self-perception (OR: 2.22; 95% CI: 1.28-3.87), and parent relations (OR: 2.04; 95% CI: 1.21-3.44)., Conclusions: Children with confirmed CCs showed a higher frequency of physical discomfort, and those with reported CCs showed discomfort in psychosocial areas compared to children without CCs.

The way neighborhoods are designed can have enormous potential for encouraging physical activity. The aim of this study was to explore the recreational spaces available in peripheral neighborhoods of the city of Cordoba, Argentina, and determine the frequency with which children attending local public primary schools use them for physical activity. In 2011, parents answered self-administered questionnaires in which they reported their proximity to those spaces, the frequency with which children use them for physical activity, the sex of their child and the educational level of the mother. We found that places closer to the home were used more frequently by children for physical activity. Differences by the child's sex and the mother's educational level were observed. The results show the importance of these areas as resources for children's physical activity as well as the social inequalities that exist in access to these spaces.

Introduction: The KIDSCREEN questionnaire is an instrument to measure health-related quality of life (HRQoL). It allows to differentiate health levels or to assess the efficacy of interventions. The objective was to evaluate the reliability and validity of the Argentine version of the questionnaire in the population aged 8-18 years-old in the city of Bahía Blanca., Population and Methods: Cross sectional study conducted in public and private schools in 2008 using a district-stratified sampling. The questionnaire was self-administered and included the KIDSCREEN questionnaire (52 items) and questions about age, gender and family socioeconomic level (SEL). Reliability was analyzed using standard psychometric analysis techniques and the item response theory. The analysis of the factorial structure was performed using a confirmatory factor analysis (CFA), and that of the construct validity was conducted comparing dimension mean scores by age, gender and SEL., Results: Most dimensions had a Cronbach's alpha of >0.7 and 80% of items, and sufficient infit or outfit values (<0.8). The CFA showed an adequate data adjustment to the ten-dimension structure. The mean values of the dimensions confirmed lower scores in adolescents than in children, and lower scores in females than in males, as expected in several of the HRQoL dimensions., Conclusions: The reliability and validity of the Argentinean version of the KIDSCREEN-52 questionnaire were acceptable; therefore its use can be recommended for the 8-18 year-old Argentinean population.

Objective: To determine the validity and reliability of the version of the Primary Care Assessment Tool for adult users, adapted for Argentina (known as AR-PCAT-AE)., Methods: Two cross-sectional pilot studies were conducted among people over age 17, largely through self-administered questionnaires. Items that were equivalent to the original version of the PCAT and 13 others proposed for the instruments were analyzed. The factorial validity and reliability of the scores for each dimension were studied. The validity indicators were: factors that had three or more items with a factorial load of > 0.35, item-total correlation > 0.30, and interpretation of the solution according to the theoretical model., Results: The factorial analysis yielded nine factors that explained 57.4% of the variability. Considering the pre-established criteria for validity, two items were excluded from the dimensions of continuity and comprehensiveness and six were added to comprehensiveness and cultural competency. In the dimensions, the percentage of questions with an item-total correlation of greater than 0.30 ranged from 67% to 100% and the Chronbach's (alpha) coefficient of internal consistency ranged from 0.44 to 0.90., Conclusions: The validity and reliability of the AR-PCAT-AE questionnaire are adequate, maintaining high equivalence with the original version. The process presented could be adopted in other contexts to advance the evaluation of primary health care functions with quality tools.

Evaluation of Primary Care (PC) must include different perspectives. The objective of the study was to know the assessment of the PC in Catalonia and detecting whether or not a pattern of social inequality exists, through user's experience. A cross-sectional study was conducted, in a representative sample (n = 13,292) of the Catalonia population (aged 15), who identify a reference professional. It was studied an index of experience with PC by personal variables and variables about the reference professional. Negative binomial regression models (bivariate and multivariate) were adjusted to obtain the prevalence ratios and confidence intervals of 95%. The index gained an average of 71 (scale 0-100). A rating above 70 was associated with higher age, greater number of visits in the last year, more time with the same professional and living in an area of lower population density. Items with lower scores: telephone attention and availability of mental health services. We concluded that factors associated with a better experience are associated with more frequent visits to professionals. We did not detect social inequalities., (Copyright © 2011 Elsevier España S.L. All rights reserved.)

This study aimed to assess the available scientific evidence on the effectiveness or cost-effectiveness of interventions to prevent obesity, carried out in child and adolescent population. We conducted a systematic review, searching 10 databases and other resource directories for the period January 1998-July 2008. We assessed study quality and extracted and summarized information that met the established criteria. Results included 40 studies that evaluated interventions showing mostly components of physical activity, nutrition and education. We found no evaluations of cost-effectiveness. Thirteen studies resulted in a significant reduction in favor of intervention in some of the anthropometric measurements. In conclusion, some interventions showed an impact in preventing weight gain. However, it is weak, since most studies have not had the expected result, were heterogeneous and of short duration., (Copyright © 2009 Elsevier España, S.L. All rights reserved.)

Background: Health related quality of life (HRQOL) measures are increasingly used in research and clinical practice. The KIDSCREEN is a questionnaire developed in Europe for an 8 to 18 year-old population., Objective: To cross-culturally adapt this questionnaire for the Argentinean population, and to evaluate its cultural adequacy and semantic equivalence against the original version., Methods: Forward and backward translation according to international recommendations for cross-cultural adaptation of questionnaires, including the translation by professional linguists, cognitive interviews with people of different ages, gender and socioeconomic status to analyze cultural adequacy, and comparison of the Argentinean with the original versions to establish semantic equivalence., Results: The language required adaptation in the use of pronouns and verb tenses. Most of the items were considered to have low translation difficulty and high semantic equivalence. Boys and girls 8-11 years (n= 7), 12-15 years (n= 7), and 16-18 years (n= 2) participated in the interviews, as well as 6 mothers. There were no major difficulties in understanding, but younger children being in the lower socioeconomic status had some difficulties to answer the questionnaire. Eight questions were modified to achieve greater semantic equivalence., Conclusions: The Argentinean version of the KIDSCREEN questionnaire obtained through cross-cultural adaptation process, was equivalent to the European version. Future studies should establish its reliability and validity. It provides a useful measure of HRQOL for studies in clinical, school or community settings, with the possibility to establish international comparisons.

The aim was to develop a tool for the critical appraisal of epidemiological cross-sectional studies. Several recommendations or guidelines for assessing the strength of scientific evidence provided by observational studies were reviewed, like those from the Agency for Healthcare Research and Quality, the Scottish Intercollegiate Guidelines Group, the Osteba (Basque Office for Health Technology Assessment), and the STROBE Initiative. The tool has 27 items to assess: study question or objective, participants, comparability between groups, definition and measure of main variables; analysis and confusion, results, conclusions, external validity and applicability, and conflict of interest. This tool can be used to critically appraise research papers or to rate evidence during the elaboration of systematic reviews.

Background and Objective: This study assesses the reliability and validity of the KIDSCREEN-52, a new questionnaire of health-related quality of life (HRQoL), cross-culturally developed for children and adolescents in 13 European countries., Subjects and Method: The KIDSCREEN-52 was sent by post to a representative sample of the Spanish population aged 8-18 years old. Sociodemographic characteristics and other measures of HRQoL were collected. A health needs instrument was collected from parents. Psychome tric properties were assessed using the classical test theory, and item response theory approaches. Test-retest reliability was assessed in 10% of the sample 2-4 weeks later., Results: Response rate was 47% (n = 876). Cronbach's alpha values ranged from 0.74 to 0.86, and the intraclass correlation coefficient ranged between 0.55-0.79. Rasch analysis showed a good item-fit in each dimension (infit msq = 0.7-1.2). Confirmatory factor analysis confirms underlying structure of the 10 dimensions model (root mean square error of approximation [REMSEA] = 0.025; comparative fit index [CFI] = 0.94). KIDSCREEN scores were better in boys, in younger children, in those who did not report health care needs, and in those in the high socioeconomic level., Conclusions: The KIDSCREEN-52 questionnaire has acceptable levels of reliability and validity for the Spanish population aged 8-18. Further work is needed to assess sensitivity to change and its applicability in clinical settings.

Objective: To reduce, translate, and adapt transculturally, the short version of the PCAT questionnaire for users (PCAT Customer client version), in order to achieve an abbreviated version of the original instrument in Catalan and Castilian that is conceptually similar to the English original, culturally adequate and viable for use among the Spanish population, and useful for inclusion in the health surveys., Design: Translation and adaptation of one questionnaire. Three steps were followed: a) question selection; b) transcultural adaptation of the selected questions, by means of direct translations to Castilian and Catalan with subsequent re-translation to English; c) clarity, acceptability, and familiarity with content of the 2 pretest questionnaire versions were evaluated through cognitive interviews of persons with different profiles in the targeted population., Results: Fifteen questions were selected for the adult version and 24 for the <15 year-old version. These facilitated the identification of a primary health care provider and the collection of information on the dimensions of first contact, continuity of care, comprehensiveness of care and coordination., Conclusions: It is hoped that these instruments will be useful when included in the questionnaires of health surveys throughout Spain. The items selected facilitate evaluation of the degree to which primary health care succeeds as the first user contact with health services, maintains continuity of attention, coordinates and provides services, making them available when necessary. Furthermore, cultural competence will be evaluated.

Introduction: The Multiple Sclerosis Quality of Life 54 (MSQOL-54) is a health-related quality of life specific questionnaire for multiple sclerosis (MS) patients. The objective of this study was to develop the Spanish version of the MSQOL-54 and to obtain a conceptually equivalent version to the original one for its use in patients with MS in the first phase of the project., Methods: A transcultural adaptation procedure was designed according to the following phases: a) two independent translations made by bilingual native Spanish speaking translators (forward translation); b) a revision of the items by an expert panel; c) a back translation by a bilingual native English speaking person; d) comparison with the original version (expert panel and advise by the original authors), and e) cognitive debriefing (interviews with subjects with MS) to test the comprehension and feasibility of the instrument., Results: Ten interviews were carried out with 5 men and 5 women with MS, aged 21 to 54 years, with different education levels and EDSS scores ranging from 1,0 to 8,0. Most of the patients found the questionnaire easy to fill out and the understanding favorable. Only one item (item 51) was modified after the cognitive debriefing to improve its comprehension. Finally, a final pretest version was obtained., Conclusions: The procedure carried out maximizes the conceptual equivalence between the original MSQOL-54 and the translated version and shows that the Spanish pre-test version is comprehensible and its administration feasible in patients with MS. The psychometric properties must be evaluated in the next phase of the project.

Objective: To assess the psychometric properties of the Spanish version of the Vecú et Santé Perçue de l'Adolescent (VSP-A) in terms of reliability and validity., Design: Cross-sectional study., Setting: Pilot study parallel to the European Kidscreen project. Two secondary schools, one public and one private, were selected for their suitability in Barcelona and Gerona (Catalonia, Spain). The sample unit was the classroom., Participants: A sample of 354 adolescents aged 12 to 18 years old was selected., Main Measurements: The Spanish VSP-A questionnaire was administered, and again a week later to check its test-retest stability. The KINDL questionnaire was administered in parallel., Results: The response rate was 82% (n=291). The Spanish version of the VSP-A showed good internal consistency and acceptable test-retest reliability (Cronbach's alpha: 0.69-0.92, intraclass correlation coefficient [ICC]: 0.69-0.74) in most domains. Domains measuring a similar concept in the VSP-A and KINDL had closer correlation coefficients than those measuring different constructs (P<.05), which demonstrates its convergent validity. Girls had worse self-perceived health than boys (lower vitality, physical and emotional well-being and self-esteem, and a lower general score on the VSP-A; p<.01). These differences were more obvious in older teens (16-18 years old)., Conclusions: The Spanish VSP-A showed good psychometric properties and results were consistent with the original French version. The results mean we have an adequate HRQL instrument for teens and for use in primary care and public health.

Aims: To describe the cross-cultural development and psychometric properties of the Spanish version of the KIDSCREEN questionnaire, a health related quality of life instrument (HRQL) for use in children and adolescents aged 8-18 years old. The questionnaire was cross-culturally developed in 13 European countries., Methods: A literature review and Delphi study were performed, allowing consensus to be reached on the instrument's contents and structure. More specific items and dimensions were generated in focus groups. Forward and back translation and cultural adaptation were carried out, together with a pre-test (cognitive debriefing) to select items that were acceptable in all the countries involved. A pilot study was performed to obtain the definitive version of the KIDSCREEN through Rasch analysis and preliminary information on the questionnaire's psychometric properties., Results: The focus groups generated 1642 possible items, which were reduced during the stages of translation-adaptation and pilot study. The definitive version of the questionnaire contains 52 items and 10 dimensions. In the Spanish version, there was less than 5% nonequivalence (acceptability) in any of the dimensions, floor and ceiling effects were acceptable, and all dimensions had Cronbach's alpha values of > 0.70 (internal consistency)., Conclusions: The KIDSCREEN is the first HRQL instrument for children and adolescents to be developed simultaneously in several countries. The preliminary psychometric properties of the Spanish version were acceptable.

Objectives: To analyze the reliability and validity of the domains of the Child Health and Illness Profile-Child Edition Parent Report Form (CHIP-CE/PRF) included in the Barcelona Health Survey conducted in 2000 and to obtain population-based reference values., Methods: Data were obtained from proxy-respondent interviews of children aged 5-14 years old (n = 836) participating in the Barcelona Health Survey 2000. The 4 subdomains of the parent version of the CHIP-PRF included in the health survey were: satisfaction with health, and physical discomfort, emotional discomfort, and limitation of activities of the discomfort domain. Internal consistency was assessed using Cronbach's alpha coefficients. An exploratory factor analysis was carried out and analysis of covariance was performed to assess the construct validity of the subdomains., Results: In all the subdomains assessed, Cronbach's alpha was above 0.70 (range, 0.76-0.98). In the factorial analysis, almost all the items (31/35) presented the highest load in their corresponding subdomain. Most of the expected mean differences among groups were confirmed. Girls aged 10-14 years old scored the lowest, both in satisfaction with health (48.93; 95% confidence interval [CI 95%], 47.40-50.47) and in discomfort (48.87; CI 95%, 47.51-50.22). No differences were found according to the social class of the head of the family., Conclusions: The present study provides a useful measure of perceived health status in a child health survey.

Objectives: To obtain a Spanish version of the Kindl semantically and culturally equivalent to the original German version and to test its psychometric properties., Material and Methods: The methodology used in the adaptation process was based on the forward-backward translation method. To assess the psychometric properties of the Spanish Kindl, the pilot test of the project "Screening for and promotion of HRQL in children and adolescents: a European Public Health perspective (Kidscreen)" it was include in. A classroom was selected for each educational level (8-16 years old) from three schools in Gerona and Barcelona. The Spanish Kindl was administered twice, one week apart. Internal consistency was assessed by computing Cronbach alpha and test-retest stability was assessed using intraclass correlation coefficients (ICC). Analysis of variance was performed according to age, sex, type of school, and self-perceived health status., Results: Half of the items (12/24) required minor changes during the adaptation process. The response rate was 91 % (n = 447). Internal consistency was acceptable for most domains (alpha range = 0.40-0.88), as was test-retest stability (ICC range = 0.52-0.80). Girls and older teenagers scored worse in most domains (p < 0.01). No differences were found by type of school., Conclusions: The Spanish version of the Kindl showed adequate reliability and validity coefficients and represents a new HRQL instrument that can be applied in pediatric clinical practice and public health.

Studies done in various countries show important differences in the growth of breastfed and bottle-fed children. In addition, it has been found that breast-fed children grow more slowly beginning at the age of 2 or 3 months in comparison with the reference pattern of the U.S. National Center for Health Statistics (NCHS) and the World Health Organization (WHO). These results cast doubt on whether maximum growth is the same as optimal growth. The objective of this study was to compare the growth in weight and length, from birth to 24 months, for a group of children who were breast-fed with that of a group who were bottle-fed. The study was also intended to describe the growth of the breastfed group in relation to the NCHS/WHO norms and a WHO "12-month breast-fed pooled data set." For this research, data were analyzed from the "Cordoba: lactation, feeding, growth, and development" study (or CLACYD study, for its Spanish-language acronym). That study looked at a representative cohort, stratified by social class, of children born in 1993 in the city of Cordoba, Argentina. The researchers analyzed anthropometric data on 74 children who were breast-fed during the first year of life and on 108 bottle-fed children. The data had been recorded, using standardized techniques, at birth and at 6, 12, and 24 months of age. Both groups were homogenous with respect to the age and schooling of the parents, social stratum, birth order, maternal height, and child's weight and length at birth. The living conditions (housing construction and availability of water and sewer services) were better among the group that was bottle-fed (P = 0.04). The breast-fed children had a lower weight and a shorter length at 6, 12, and 24 months than did the bottle-fed children. The breast-fed children also showed a slowing in growth with respect to the NCHS/WHO guidelines beginning in the second semester. This indicates that the NCHS/WHO norms are not totally adequate for evaluating the growth of breast-fed children in Cordoba, Argentina. In the high and middle social strata, the values for the breast-fed group resembled those for the WHO "pooled data set," both in weight and length. In the low and very low social strata, weight values were satisfactory, but the figures for length were less than those of the "pooled data set." The gap in length found among the low and very low social strata does not reduce the validity of the WHO "pooled data set" reference, but rather indicates the influence of living conditions on linear growth.