Título del artículo:

Speaking Up About Patient Safety, Withholding Voice and Safety Climate in Clinical Settings: a Cross-Sectional Study Among Ibero-American Healthcare Students

Objectives: To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods: Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results: Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion: Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.

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International Journal of Public Health

Título del artículo:

Tectono-stratigraphic and sedimentological analysis of the Early to Middle Devonian Floresta Formation: Insights from the Floresta Massif, Northern Andes, Colombia

A comprehensive tectono-stratigraphic and sedimentological investigation of Early to Middle Devonian rocks was conducted in the southern Floresta Massif and adjacent regions in the Northern Andes of Colombia. A substantially reduced thickness of the Floresta Formation compared to prior studies is suggested here, attributable to pronounced stratal deformation and the prevalence of recumbent folds throughout the area. The deformation in the Floresta Formation manifests as atypical recumbent folds, diverging from the structural behavior observed in the underlying and overlying strata of the El Tibet and Cuche formations respectively, which exhibit minimal deformation. Our findings also reveal that the Floresta Formation accumulated under shallow-water platform conditions, subject to eustatic sea-level fluctuations. This resulted in distinct episodes of carbonate and siliciclastic deposition, with terrigenous sediments sourced from continental origins, potentially encompassing a combination of cratonic areas and uplifted blocks. The identification of a plausible stage of carbonate silicification signifies a post-diagenetic transformation. The sedimentary rocks of the Floresta Formation reached the upper epizone conditions, in proximity to the transition between the epizone and the upper anchizone, which suggests a maximum depth and temperature of ~5-7 km and ~300 °C, respectively. This contribution provides new insights into the geological history of the region, emphasizing the importance of scrutinizing Early to Middle Devonian rocks within the broader geological context of the Northern Andes.

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Andean Geology

Título del artículo:

Editorial: Global excellence in cardiovascular medicine: Central and South America

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Frontiers in Cardiovascular Medicine

Título del artículo:

Ankle mechanics during jump landings across different foot positions in professional ballet dancers

This study aimed to investigate the effect foot position on ankle joint mechanics and vertical ground reaction forces (vGRF) across jump landings in professional ballet dancers. Twenty-seven professional ballet dancers (men: 14; women: 13) attended one data collection session, completing five maximal countermovement jumps in parallel, first, second, fourth, and fifth positions. Three-dimensional ankle mechanics, landing vGRF variables, and jump height were recorded via a seven-camera motion capture system and one force platform. A repeated measures multivariate analysis of variance was used to assess the main effects foot position across all target variables. A linear discriminate analysis was conducted to investigate target variables across foot positions. Frontal and transverse plane ankle mechanics had the largest impact when discriminating between foot positions. Ankle power in the transverse plane during jump landing in fourth was double that of all other positions. Our findings suggest that ankle range of motion should be restored before returning to jumps in fourth and fifth positions following distal lower extremity injury. The multiplanar energy transfer observed indicates a need for specific exercises to develop multiplanar force and rate of force development of local structures around the ankle.

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Sports Biomechanics

Título del artículo:

Effectiveness of an interprofessional assessment and management approach for people with chronic low back disorders delivered via virtual care: A randomized controlled trial pilot intervention

Objective: Virtual care for chronic conditions has seen uptake due to COVID-19. Evaluation of virtual models is important to ensure evidence-based practice. There is a paucity of research in the use of virtual care for management of chronic back disorders. The objective of this study was to evaluate effectiveness of a team-based virtual care model for back disorder assessment where a physical therapist uses virtual care to join a nurse practitioner and patient in a rural Saskatchewan, Canada community. Methods: Sixty-four rural adults with chronic back disorders were randomly allocated to receive either: (1) team-based virtual care (n = 24); (2) care from an urban physical therapist travelling to community (n = 20); or (3) care from a rural nurse practitioner (n = 20). The team-based care group involved a nurse practitioner located with a rural patient, and a physical therapist joining using virtual care. The physical therapist alone and the nurse practitioner alone groups received in-person assessments. Groups with a physical therapist involved had follow-up treatments by in-person physical therapy. Outcomes over six months included pain, disability, back beliefs, satisfaction, quality-adjusted health status and management-related costs. Results: There were no significant differences for pain, disability, back beliefs and satisfaction between groups. The average cost per patient for implementing in-person physical therapist assessment ($135) was higher compared with the team over virtual care ($118) and NP care ($59). Conclusion: Primary outcomes were not different by group. Physical therapist alone was more costly than other groups. Future research should include more participants, longer follow-up time and refined cost parameters. Trial Registration: ClinicalTrials.gov NCT02225535; https://clinicaltrials.gov/ct2/show/NCT02225535 (Archived by WebCite at http://www.webcitation.org/6lqLTCNF7).

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Digital Health

Título del artículo:

Factors associated with non-communicable diseases in ex-combatants

Objective: Identification of factors associated with noncommunicable diseases in ex-com-batants of the FARC-EP resident in the Transitional Standardization Zone (ZVTN) in the department of Cesar(Colombia). Methodology: Cross-sectional analytical study in which 114 ex-combatants of the FARC-EP were evaluated, using sociodemographic questionnaire and STEP WISE application. Data were collected, analyzed and reported as mean ± standard deviation. Statistical comparisons were made between groups using SPSS 24 software. Results: Ex-combatants with more than 5 years of belonging to the group have 1.6 times the probability of presenting high levels of abdominal fat with an OR 1.62 (1.39-1.90), and 2.04 (1.38-3.01) times the probability of being overweight and obese. Conclusions: The data found suggests that exposure to armed conflict could affect the physical health of ex-combatants, related to a greater probability of developing noncommunicable diseases such as: hypertension, diabetes, lung cancer, among others.

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Salud Uninorte

Título del artículo:

A guane archaeological heritage: a strategy to bring the museum to young people

The appropriation of a culture by the society that succeeds it develops identity and creates a sense of belonging to its origins, in addition to forging its characteristic features linked to customs, beliefs and traditions. In the department of Santander, Colombia inhabited the guanes indigenous people who abandoned their legacy, remnants of culture contained in archaeological pieces that are found under institutions of the department. This collection presents a great responsibility when guarding them, but even more so, when it comes to disseminating and opening them up to the community. The interest of this research lies in determining appropriate mechanisms to bring representative cultural samples of a region to the young population, using digital and analog tools of the artifacts traditionally contained in museums and galleries for their appropriation, applied to the case study of the Ethnological, Archaeological and Historical Museum UDES. The strategy is validated through the development of creation workshops and a pilot test with a population sample, 170 high school students from the Promoción Social Norte school, where a 71.8% lack of knowledge towards the guanes was initially evidenced, achieving positive results through a trivia-type video game. and the interaction with the strategy.

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Revista del Museo de Antropologia

Título del artículo:

Dentists´ knowledge about common risk factors for cardiovascular diseases and periodontitis: An opportunity to be part of a multidisciplinary team

Background: Reducing the disease burden of cardiovascular diseases and periodontitis continues to be a priority and dentists are part of the primary care team. However, it is unclear whether Colombian dentists have the necessary knowledge to identify cardiovascular disease risk factors in clinical practice. The main aim of this study was to investigate Colombian dentists’ knowledge about common risk factors for cardiovascular disease and periodontitis. Material and Methods: A cross-sectional study was conducted. A self-administered electronic survey was validated by experts and completed by 232 dentists who practiced in Colombia. Descriptive and multivariate analyzes were performed, including hierarchical cluster analysis. Results: Regarding the identification of shared risk factors for the development of cardiovascular disease or periodontitis, 80.6% identified smoking and 72.8% diabetes. The correct identification of cardiovascular disease risk factors was between 34.9% in the case of eating practices and 78.0% for physical inactivity. Being a woman (79.8%), under 40 years of age (64.0%), not having completed a postgraduate degree (68.5%), and working in private institutions (88.8%) were the characteristics of dentists that best identified common risk factors for both cardiovascular disease and periodontitis. Conclusions: Colombian dentists had good knowledge of common risk factors for both cardiovascular diseases and periodontitis, but limited knowledge about cardiovascular disease risk factors. Younger dentists better identified risk factors. Conversely, older, more experience, and more specialized practitioners could benefit from more training about cardiovascular risk factors in order to truly be part of multidisciplinary teams in primary care.

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Journal of Clinical and Experimental Dentistry

Título del artículo:

Inclusive teaching of palaeontology for people with and without disabilities through didactic workshops

This work describes the didactic preparation and the result of carrying out palaeontological workshops designed for all students, based on strategies with a didactic approach proposed by the Universal Design for Learning in the methodologies used by teachers that allow students with and without disabilities to access knowledge regardless of their deficiency, removing context barriers and maximising learning opportunities. In this work, didactic workshops based not only on elements related to geosciences but also on interactivity with palaeontologists themselves are proposed, with which an exchange of ideas and information is established.

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International Journal of Inclusive Education

Título del artículo:

Doppler­ ultrasonography:­ early­ determination­ of­ pregnancy­ in­ dairy­ cows­ in­ Colombia

This study aimed to describe using Doppler ultrasonography to detect non-pregnant cows on day 19 post-AI in Chitagá, Norte de Santander, Colombia. A cross-sectional study was conducted, involving 46 multiparous Holstein cows. It was found that embryonic death for the period 19-35 post-AI was 15%. The reported Kappa value for Color Doppler and Power Mode Ultrasonography (USG) about the gold standard (B-Mode USG on day 35 post-AI) was 58% and 54%, respectively. The sensitivity and specificity of the Color Doppler test were 97.9% and 64.6%, respectively, while for Power Mode USG, the sensitivity and specificity were 94% and 62%, respectively. Finally, the area under the curve for the parallel combination of the diagnosis of B-Mode USG on day 35 post-AI as a cutoff point for the detection of pregnant cows on day 19 post-AI (Color Doppler and Power Mode) was 0.83 and 0.58, respectively. It is concluded that Color Doppler USG showed better sensitivity, specificity, Kappa index, and a higher area under the curve compared to Power Mode Doppler USG, and it could potentially be a valuable tool for the early detection of non-pregnant cows on day 19 post-AI.

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Taurus

Título del artículo:

What has been researched on systemic lupus erythematosus in Latin America? A historical bibliometric analysis since 1935

Introduction: Systemic lupus erythematosus (SLE) is a chronic and debilitating condition of significant interest in biomedical research. Historically, Latin American research on SLE has not been thoroughly explored. Aim: To analyze the evolution and characteristics of scientific research on SLE in Latin America. Materials and methods: Bibliometric cross-sectional study. Results: A total of 3 825 documents were included. Historically, a publication was found in 1935, establishing an analysis window of 88 years (1935-2023). It was observed that 83.5 % (n=3 192) of the production consisted of primary data articles, with 23.8 % international collaboration. Brazil, Mexico, and Argentina have been the most prolific countries, although the most prolific author is affiliated with Peru. There has been a significant transition in topics, from describing and discovering molecules, targets, and therapeutics to developing classifications and proposing clusters based on machine learning and novel immunological techniques. Conclusions: A sustained and marked growth in Latin American research on SLE has been identified since the 1970s, with the first publication in 1935, primarily driven by research with primary data. Brazil is the most prolific country, with some authors and institutions sharing the same characteristics, while Mexico has the greatest impact in the region. The most prominent theme has been the study of SLE linked to lupus nephritis, with a transition and inclusion of topics on machine learning, immunoturbidimetry, and evaluation of therapeutic outcomes in the last ten years.

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Gaceta Medica de Caracas

Título del artículo:

Cardiovascular risk assessment using three scales in a cohort of South American patients with COPD

Introduction: Chronic obstructive pulmonary disease (COPD) is expected to be the third cause of death worldwide by 2030, and the cardiovascular risk in these patients is considered high. Objective: The aim was to evaluate cardiovascular risk in a cohort of South American patients with COPD. Methods: A retrospective study was carried out by reviewing medical records from January 2015 to December 2018. The defined variables of metabolic syndrome were included. Quantitative variables are presented as mean ± standard deviation or median (interquartile range) according to their distribution, and qualitative variables are presented as percentages. Student\'s t-test was performed to evaluate differences between the two variables. It was used the statistical package SPSS for Windows v.20.1, Chicago, IL. Results: The male gender was 77 % compared to the female gender 23 %. The prevalence of smoking was 61 % distributed by gender (male 42 %, female 19 %). The Framingham equation classified a higher percentage of male COPD patients as having low cardiovascular risk compared to the PROCAM and SCORE equations. It was found that there was a greater cardiovascular risk in those patients with FEV1, less than 30 %, showing a statistical correlation of this alteration for the three stratification systems used. Conclusions: We encourage research groups in Latin America and other latitudes to estimate cardiovascular risk in populations diagnosed with COPD.

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Gaceta Medica de Caracas

Título del artículo:

Learning environments and school success in Latin America

This article finds the relationship that learning environments have on school success, in the Latin American countries participating in the International Program for Student Assessment (PISA), of the year 2018, estimating the Educational Production Function. Subsequently, the Shorrocks-Shapley decomposition is applied to determine which of the dimensions associated with learning has a greater weight in the heterogeneity of school success. It was found that the best school environments favor school success, while when the school climate in the classroom is “not the best”, performance drops. It was calculated, for the group of Latin American countries, that, on average, learning environments explain the variability of school success in 29.09 % for mathematics, 28.01 % for reading and 28.71 % for science, being the dimension that to a greater extent explains this heterogeneity.

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Lecturas de Economia

Título del artículo:

Didactic strategy for teaching Engineering Algebra - first iteration

The investigations related to Educational Technology are characterized by an acceleration in the emerging research themes and follow the current trends. This will lead to a lack of attention to the methodological rigor and the complete potential of the Technology in learning processes. The present work addresses the issues of the deficiencies in the specific competencies presented by the students in the engineering assignments related to Algebra by means of the DBR methodology as a general basis for the development of one of its stages, starting with the situation - diagnostic of the problem, taking into account the opinion of experts, the application of an evaluation tool with the main competencies related to Algebra required by the Engineering students and a technology appropriation survey. Then presents the first iteration of design and development of the didactic strategy, which is based on the didactic suitability of the Ontosemiotic Approach (EOS) and uses the NOOC as digital technology that conveys letter with the level Algebra area required by engineering students.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

Efficacy of a Hospital Discharge Transition Plan in the care competence of patients with chronic conditions and their family caregivers: a clinical trial

Objective: to assess the efficacy of a Hospital Discharge Transition Plan in the care competence and in adherence to the therapy of dyads comprised by patients with non-communicable chronic diseases and their caregivers. Method: a controlled and randomized clinical trial; the sample was comprised by 80 dyads of patients with chronic conditions and their caregivers, randomly allocated as follows: 40 to the control group and another 40 to the intervention group. The instruments to characterize the patient-caregiver dyad, the patients’ and caregivers’ care competence and the patients’ adherence to the treatment scale were applied. The “CUIDEMOS educational intervention” was applied to the intervention group; in turn, the control group was provided usual care with the aid of a booklet, with phone follow-up via at month 1. Results: 52.5% of the patients and 81.3% of the caregivers were women. The patients’ and caregivers’ mean ages were 69.5±12.6 and 47.5±13.1 years old, respectively. The Hospital Discharge Transition Plan increased the scores in the “knowledge”, “uniqueness”, “instrumental”, “enjoying”, “anticipation” and “social relations” dimensions, as well as the global care competence of the patients and family caregivers; in addition to the following factors: medications, diet, stimulants control, weight control, stress management, and global adherence to the therapy by the patient. There were no statistically significant differences between the control and intervention groups. Conclusion: the Hospital Discharge Transition Plan increased the patients’ and family caregivers’ care competence after the intervention, as well as the patients’ adherence to the treatment. However, there were no differences between the control and intervention groups, possibly due to the similarity of the activities.

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Revista Latino-Americana de Enfermagem

Título del artículo:

Pedagogical model for virtually mediated distance education with a transactional distance perspective

The starting point of the model was the recognition of dropout in distance education as a problematic situation. Analysing their possible causes, it was found that these were explained by the transactional distance theory. The study was carried out using design-based research, whose main characteristic is the introduction of a new element to transform a problematic situation. Initially, the literature was reviewed to identify possible causes of dropout in distance education. Subsequently, a pedagogical model was designed and validated based on the review of distance and virtual education models of a Mexican and Colombian universities. From this review, the main components of the pedagogical models were extracted and based on these elements, the pedagogical model was designed, like a system. It was then validated with a group of experts and tested with a group of students through a webinar. The results show that, by taking a course based on the fundamental ideas of the proposed pedagogical model, the perception of transactional distance decreases and, on the other hand, it is demonstrated that the intention to drop out shows a significant decrease.

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Revista de Educación a Distancia

Título del artículo:

Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study

Background: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering extrapolation of sociocultural and demographic factors of other regions. Objective: To evaluate sex differences in the prevalence of cardiovascular risk factors and the incidence of MACE and diabetes in Colombian adults. Methods: We performed a survival analysis from women and men aged 35–70 belonging to the Prospective Urban Rural Epidemiology-Colombia prospective study. Incidence rates for MACE composite (myocardial infarction, stroke, heart failure, death) and each outcome and diabetes were calculated. Kaplan-Meier curves and log-rank tests were performed. The association between demographic, behavioral, and metabolic variables with MACE and diabetes were evaluated with Cox proportional hazards models. Results: 7,552 participants (50±9.7 years) were included; 64% were women. Women had higher hypertension prevalence, body mass index, levels of total cholesterol, LDL-c, and HDL-c but lower triglycerides levels. Women were more sedentary but fewer smokers or active alcohol consumers and had higher educational levels. After 12-year mean follow-up (SD 2.3), the incidence rate of MACE composite was higher in men [4.2 (3.6–4.9) vs. 3.2 (2.8–3.7) cases per 1000 person-years]. Diabetes had the greatest association with MACE (HR = 2.63 95%CI:1.85;3.76), followed by hypertension (HR = 1.75 95%CI:1.30;2.35), low relative grip strength (HR = 1.53 95%CI:1.15;2.02), smoking (HR = 1.47 95%CI: 1.11;1.93), low physical activity (HR = 1.42 95%CI: 1.03;1.96). When evaluating risk factors by sex, only an increased waist-to-hip ratio was more strongly associated with MACE in men (p-interaction <0.05). Conclusions: The composite MACE outcome was higher in men despite having a lower overall burden of risk factors. The risk factors contribution was similar, leading us to reconsider the need to carrying out differentiated cardiovascular risk prevention and management campaigns, at least in our region.

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Global Heart

Título del artículo:

Tombstone cost and longevity: The San Pedro Cemetery Museum in Medellín in Colombia

Background Studies in the West suggest that tombstone cost is associated with longevity. The objective of this observational study was to investigate the association between tombstone cost and longevity in a large cemetery in Latin America. Methods Age at death was obtained from 2,273 consecutive death certificates held at the San Pedro Cemetery Museum in Medellín in Colombia. Subjects died in 2022, 2021, or 2020. Tombs are arranged in galleries in the cemetery and tombstone cost was based on the material from which the tombstone was made, its position in the gallery, and its ornamentation. Analysis of variance was used and the assumption of equal variance was not violated. Results Approximately 77% of tombstones were of low cost, 21% of medium cost, and 2% of high cost. Data from 1,751 subjects were used to investigate differences in longevity according to tombstone cost while adjusting for sex, civil status, violent death, and year of death. Longevity was similar in the low-cost group and medium-cost group: 64.3 years (63.2, 65.3) versus 63.3 years (61.3, 65.3) [estimated mean (95% confidence interval)]. Longevity was lower in the high-cost group: 47.0 years (40.1, 53.9). Conclusions The inverse association between tombstone cost and longevity would suggest that people in Medellín are inclined to spend more on tombstones when commemorating the tragic death of a young person.

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PLoS ONE

Título del artículo:

Rutting performance of asphalt mixtures containing treated RCA and reinforced with carbon fibers

This study examined the rutting performance of hot asphalt mixtures containing treated RCA and reinforced by carbon fibers. The methodology involved substituting RCA instead of coarse virgin aggregates in the several percentages (20, 40, 60, 80, and 100%) that were treated by being submerged for 24 hours in an acetic acid solution with a concentration of 0.1M. Carbon fibers were added in several percentages of 0.15, 0.25, and 0.35% by the entire weight of the mix to produce cylindrical specimens (4×2.5 inches) for evaluating the Marshall and volumetric properties, and rectangular slabs (30×40×5 cm) for evaluating rutting resistance. The study finds, that incorporating RCA and carbon fibers did not substantially affect the volumetric characteristics of asphalt mixtures, but Marshall\'s stability increased. The combination containing 60% RCA and 0.35% carbon fibers showed the greatest increase in Marshall stability, which was 35.81% over the control mixture. The addition of RCA led to a reduction in the rutting performance, whereas the addition of carbon fibers increased it, as seen by a decrease in rutting depth. The combination incorporating 40% RCA and 0.35% carbon fibers exhibited a minimum rutting depth of 40.64% lower than the control mixture. The combination incorporating 20% RCA and 0.35% carbon fibers exhibited the maximum level of dynamic stability, which was 1.64 times greater than the control mixture.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

Internal and external competitiveness of small industrial companies in COVID-19.

The industrial sector represents a priority activity for the economic development of the country. Sustaining its permanence in the market in the face of the difficult situation it has faced as a result of the Covid 19 pandemic is a challenge for businessmen and for the Mexican government. Given this complicated scenario, the objective of this research was to evaluate the internal and external competitiveness of small companies in the industrial sector in the context of the COVID-19 pandemic and the relationship between both types of competitiveness in Tabasco, Mexico. The study had a quantitative approach, non-experimental transactional, descriptive, and correlational design. Internal competitiveness was analyzed with the dimensions of strategic planning, production, quality assurance, marketing, accounting and finance, and human resources. External competitiveness was measured with the profitability dimension through a one-dimensional scale. The findings indicate less internal competitiveness in the areas of marketing and human resources and greater in strategic planning. In external competitiveness, the results of profitability after the pandemic are located at an unfavorable level. Pearson\'s correlation analysis indicated a positive and significant relationship between the two types of competitiveness. This research provides relevant information on the conditions in which the competitiveness of small companies in the industrial sector is found in the context of the pandemic, it is useful to identify areas of opportunity and make the right decisions to improve this economic sector, essential for the economic growth of the country.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

Service quality: a study in hotels with the SERQVUAL model.

The study aimed to analyze the quality of service hotels in Cúcuta offer tourists. The study is quantitative and has an exploratory and descriptive cross-sectional design. We worked with a non-probabilistic purposive sample of four three-star hotels in Cúcuta, Norte de Santander, Colombia. In this sense, the SERVQUAL model was applied to find the differences between the perceptions and expectations of customers in the dimensions of tangibility, reliability, responsibility, security, and empathy. The results revealed that service quality is of utmost importance nowadays as products and services offered by hotels with reliable characteristics are highly valued in the market and help to attract new customers. The changing economic, political, and social conditions make hotel companies create a service-oriented organizational culture; therefore, having a vision of quality is crucial for organizational prosperity. It was found that there is a small gap between the expectations and perceptions of customers in terms of service quality; however, it is evident that hotel companies are meeting customers\' needs in the different services offered to strengthen their loyalty.

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Aibi, Revista de Investigacion Administracion e Ingenierias

Título del artículo:

Innovating in physical rehabilitation models: properties of mobile applications as self-management tools in the execution of active kinesitherapy protocols in lower limb amputee patients

Active kinesitherapy rehabilitation protocols are a set of exercise routines that use strength, voluntarily or self-reflexively, controlled and corrected by a physiotherapist. Mobile ICT to support the execution of these protocols, mitigate difficulties of displacement in the rehabilitation process, favor personalization and adaptability to user needs. Objective: To present the results of the validity of a mobile application, proposed within the framework of a support model for the rehabilitation of lower limb amputee patients, based on the concept of self-management and the socio-medical model. Methods: Cross-sectional, descriptive and observational study of the properties exhibited by the mobile application applied to lower limb amputee patients and expert physiotherapists, by means of concordance evaluation - Kappa-Fleis on four usability criteria evaluated in 23 tasks performed with the mobile application in the execution of the protocol. Results: An acceptable concordance strength was found for each criterion. Comprehension\" and \"efficiency\" were those with the highest concordance in the patient; 0.269 and 0.290 respectively. Conclusions: Content Validity Index - CVI of 0.88 and 0.9 rated by patients and physiotherapists respectively. The mobile application exhibits acceptable properties to be used as a support tool for self-management and execution of active kinesitherapy protocols.

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Retos

Título del artículo:

The effect of El Niño and La Niña episodes on the existing niche and potential distribution of vector and host species of American Cutaneous Leishmaniasis

Leishmaniasis is a zoonotic disease transmitted to humans by a protozoan parasite through sandfly vectors and multiple vertebrate hosts. The Pan American Health Organization reported a declining trend in cases, with Brazil, Colombia, Peru, Nicaragua, and Bolivia having the most cases in 2020. There are still knowledge gaps in transmission and the parasite-host relationship. Ecological niche modeling has been used to study host-vector relationships, disease dynamics, and the impact of climate change. Understanding these aspects can aid in early surveillance and vector control strategies. The potential distribution of five host species associated with the transmission of cutaneous leishmaniasis (CL) was modeled. Occurrence data were collected for each host species, and environmental variables were used to build the models. Climatic data from El Niño, La Niña, and Neutral episodes were used to compare the predicted distributions. Additionally, the potential distributions of four vector species were compared to identify overlaps with host species. Niche analysis was conducted to evaluate changes in vector niches across episodes and to identify host-vector pairs based on niche overlap in geographic and environmental spaces. After spatial thinning, 467 records were obtained, and 1,190 candidate models were evaluated for each species. Results showed the distribution of occurrences in the environmental space, highlighting a high risk of extrapolation beyond the calibration areas. Movement-Oriented Parity analysis revealed distinct distribution patterns under different climate conditions, with areas of environmental similarity identified. Bradypus variegatus exhibited a broad potential distribution, while Dasypus novemcinctus and Didelphis marsupialis had more restricted ranges. Sylvilagus braziliensis covered most of the Neotropics. Our study provides valuable insights into ecological niches and geographic ranges of these species, contributing to the understanding of cutaneous leishmaniasis transmission dynamics.

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Acta Tropica

Título del artículo:

Letter to Our Colleagues Family Practitioners, Geriatricians, and Radiologists to Increase Awareness Regarding Idiopathic Normal Pressure Hydrocephalus

Objective: Idiopathic normal pressure hydrocephalus (iNPH) affects elderly individuals and is characterized by a progressive deterioration of gait, urinary continence, and cognition. In most cases, it is reversible with treatment. INPH is not uncommonly an unrecognized cause of dementia. We wish to raise awareness of iNPH among primary care providers who are seeing these patients first. Methods: We reviewed the current epidemiological data regarding iNPH as well as epidemiological data regarding Alzheimer disease. We searched for the most sensitive radiological screening test for iNPH. Results: Alzheimer disease comprises 60%–70% of all dementia cases, in 2023 is affecting 6.7 million Americans, about 10.7% of people 65 and older. Epidemiological data from the Scandinavian countries confirmed that 3.7% of people older than 65 have iNPH. Surgical studies confirmed the presence of early Alzheimer\'s pathology in about 25% of operated patients with iNPH. Useful radiological findings of iNPH include an Evans Index greater than 0.30, and a disproportionally enlarged subarachnoid space hydrocephalus (DESH). However, the callosal angle is thought to represent the best tool to discriminate iNPH from its mimics. Conclusions: According to the available epidemiological data iNPH is underdiagnosed. We strongly encourage the primary care physicians and geriatricians to ask the radiologist to measure the callosal angle on the initial brain computed tomography (or magnetic resonance) image. If the callosal angle is ≤71°, it is appropriate to refer the patient to neurosurgery for further diagnostic work-up.

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World Neurosurgery

Título del artículo:

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug-resistant tuberculosis in Brazil?

Objective: To evaluate the association between the availability of GeneXpert®MTB/RIF in municipalities and the proportion of people who have access to this diagnostic technology for tuberculosis (TB), as well as the resistance detected by the surveillance system in Brazil. Methods: We analysed 4998 Brazilian municipalities that reported 432,937 new TB cases between 2015 and 2020. We compared municipalities with and without the availability of GeneXpert®MTB/RIF regarding the effective access to GeneXpert®MTB/RIF diagnosis and the prevalence of detected resistance. Results: Municipalities with at least one GeneXpert®MTB/RIF system had three times (95% CI 2.9–3.0) the access to diagnostic tests and 80.4% (95% CI 70.6%–90.2%) higher detection of resistance, compared with municipalities without this technology. We estimated that there have been 1890 cases of undetected resistance during this period in the country. Conclusions: The availability of GeneXpert®MTB/RIF system in the municipality increased the sensitivity of the surveillance for detecting TB resistance. Public Health Implications: It is a priority to strengthen laboratory networks and narrow the gap in access to rapid diagnosis in remote areas to improve the detection and control of drug-resistant tuberculosis.

Acerca de la revista donde se publicó este artículo:

Tropical Medicine and International Health