X-ray-free ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a comparative study with historical control

International Urology and Nephrology - To compare the outcomes and complications of supine X-ray-free ultrasound-guided percutaneous nephrolithotomy (XG-PCNL) with fluoroscopy-guided (FG)-PCNL in...     

Validity and Test-Retest Reliability of a Thai Stroke Physical Activity Questionnaire

Background and objectivesThis study evaluated the validity and reliability of the Stroke Physical Activity Questionnaire (SPAQ), a Thai self-report questionnaire for assessing physical activity (PA) in participants with chronic stroke.MethodsThe validity of the SPAQ was tested by correlating PA data from the SPAQ with data obtained from a waist worn accelerometer which participants wore for seven days. The participants completed the SPAQ twice, one week apart and test-retest reliability was calculated using intraclass correlation coefficient.ResultsForty-one participants, at least 3 months post-stroke (24 men and 17 women) were enrolled. The average age was 55.3 years (SD 11.9). Correlation coefficients of 0.58 and 0.57 were found between SPAQ and the accelerometer data for moderate PA and moderate to vigorous PA (MVPA), respectively. There was no significant correlation between light PA determined from SPAQ and accelerometer. The intraclass correlation coefficients were 0.56, 0.91 and 0.90 for light, moderate PA and MVPA, respectively.ConclusionsThe validity of the SPAQ for moderate and MVPA was acceptable and the test-retest reliability of the SPAQ was excellent. This suggests the SPAQ is a useful tool for assessing moderate PA and MVPA among chronic stroke participants. However, it cannot be used to quantify light PA.     

The costs of seeking healthcare: Illness,treatment seeking and out of pocket expenditures among the urban poor in Delhi,India

The poor often experience illness and the treatment costs are high and even catastrophic for the poor. This paper reports the extent of illness, treatment‐seeking behaviour and out of pocket healthcare expenditures and the determinants of treatment‐seeking behaviour and healthcare expenditures among the urban poor living in Delhi. A total of 2,998 households participated in the study. Socio‐demographic details, illness experiences (episodic illness in the past 3 months, hospitalisation in the past 1 year and any chronic illness), treatment seeking and healthcare expenditures were collected for all household members through a pretested, interviewer‐administered questionnaire. Logistic regressions were carried out for factors associated with treatment‐seeking choices. Multiple linear regressions were carried for factors associated with out of pocket expenditures (OOPE). Of the total 15,218 household members (of the 2,998 households), 4,052 (26.6%) experienced episodic illness (mainly fever, respiratory illnesses, food‐ and waterborne diseases and eye infections) in the past 3 months, 230 (1.5%) were hospitalised and 976 (6.4%) have chronic illness (mainly hypertension, diabetes, arthritis and respiratory problems). Of the 2,998 households, 2,225 (74.2%) households reported at least one event of illness. Unqualified practitioners were the main source of care for episodic illnesses. Perceived seriousness of the illness, having Employees State Insurance Scheme (ESIS) benefit, higher educational status of the head of the household, higher monthly household incomes, belonging other backward castes and settled‐migrant status led to seeking formal care. Dengue was the main reason for hospitalisation. Government including ESIS hospitals were mainly utilised for hospitalisation. Healthcare expenditures were higher for private healthcare. Possession of mandatory health insurance was protective against OOPEs. OOPEs were more for the men/boys and for the young. Improving access to government healthcare services is important. Extending the ESIS to the unorganised workers including urban poor migrants should be considered so as to bring them under mandatory social protection.