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A survey of beliefs, attitudes, knowledge, and behaviors about evidence-based practice in physical therapists of Latin America : a cross-sectional study
No full textPublisher Copyright: © The Author(s) 2024.Evidence-based practice (EBP) refers to the integration of scientific evidence into the clinical setting. This study aimed to determine whether Latin American physiotherapists use EBP, analyze the associated factors, barriers, and facilitators, and examine the relationships between these elements in clinical practice. To conduct this cross-sectional study, the web-based questionnaire survey method was chosen. Survey was self-administered questionnaires to assess understanding of various EBP-related terms and determine their knowledge and ability to apply these concepts in clinical practice. The association between attitudes, awareness, and knowledge scores and the demographic data such as age group, years of experience, professional membership registry, and self-reported education was assessed. The questionnaire was distributed to a total of 5000 physical therapists, of which 4099 (82%) responded from seven Latin American countries (Argentina, Bolivia, Chile, Colombia, México, Perú, and Venezuela), between June 1, 2020, and May 31, 2024. Overall, the physical therapists had positive attitudes, beliefs, and interests in EBP. Their educational background, knowledge, and skills related to assessing and interpreting information were associated to the use of EBP. In addition, 53% of respondents indicated that lack of time was the main obstacle to the use of EBP. The top 3 barriers included insufficient time (53%), lack of information resources (20.8%), and lack of research tools (13.6%). Among Latin American physical therapists, individual characteristics workplace, clinical experience, educational background, and demographic characteristics, may behave as facilitators or barriers when performing an EBP. Thus, identifying methods and strategies to support physical therapists in adopting EBP in the Latin American is necessary. The academization of physiotherapy training might change this in the future
Análisis de la distribución espacial de pudús (pudu puda) ingresados a CEREFAS-USS en el período 2013-2021 según la causa de ingreso y tipo de egreso
No full textA home hospitalization assignment and routing problem with multiple time windows, mandatory returns and perishable biological samples : A Chilean case study
No full textPublisher Copyright: © 2024 Elsevier LtdThe increase in life expectancy and formal care has fostered the demand for home care services, including home hospitalization. For this service, decision-makers must allocate the staff and route the visits as efficiently as possible. To tackle this problem, in this paper, we devise a new mixed-integer programming formulation that incorporates several industry-specific features, including matching patients to medical specialties and synchronized visits of multiple specialists. Moreover, the proposed formulation also includes three features that have not been tackled simultaneously in the previous literature: multiple time windows, mandatory lunch breaks at the hospital, and fast delivery of perishable biological samples. The proposed model can be reduced to a vehicle routing problem with multiple times windows, known as NP-hard. Therefore, for solving large instances, we design a heuristic procedure composed of a constructive heuristic coupled with an improvement heuristic, which builds on a local branching scheme. To test the applicability of our approach, we conduct a case study focusing on the actual operations of Hospital Padre Hurtado of Santiago, Chile. Our computational experiments show that the model provides fully implementable solutions. Moreover, the heuristic procedure provides high-quality routes (regarding quality and solution times), making it a promising alternative to experience-based scheduling methods and state-of-the-art solvers
Urban Meteorology, Pollutants, Geomorphology, Fractality, and Anomalous Diffusion
No full textPublisher Copyright: © 2024 by the authors.The measurements, recorded as time series (TS), of urban meteorology, including temperature (T), relative humidity (RH), wind speed (WS), and pollutants (PM10, PM2.5, and CO), in three different geographical morphologies (basin, mountain range, and coast) are analyzed through chaos theory. The parameters calculated at TS, including the Lyapunov exponent (λ > 0), the correlation dimension (DC 0), the Hurst exponent (0.5 0), the loss of information ( < 0), and the fractal dimension (D), show that they are chaotic. For the different locations of data recording, CK is constructed, which is a proportion between the sum of the Kolmogorov entropies of urban meteorology and the sum of the Kolmogorov entropies of the pollutants. It is shown that, for the three morphologies studied, the numerical value of the CK quotient is compatible with the values of the exponent α of time t in the expression of anomalous diffusion applied to the diffusive behavior of atmospheric pollutants in basins, mountain ranges, and coasts. Through the Fréchet heavy tail study, it is possible to define, in each morphology, whether urban meteorology or pollutants exert the greatest influence on the diffusion processes
Impact of dietary fiber fraction of chia seed supplementation on hepatic steatosis and other metabolic disturbances in a high-fat diet model
No full textPublisher Copyright: © 2024 The AuthorsMetabolic dysfunction-associated steatotic liver disease (MASLD), characterized by hepatic triglyceride elevation is prevalent globally and often leads to significant consequences such as steatosis and hepatocarcinoma. In association with insulin resistance, oxidative stress, and inflammation, effective interventions are essential. Dietary fiber plays a crucial role in regulating these metabolic parameters. Chia (Salvia hispanica L.), a fiber-rich oilseed, is known for its high fiber content. This study assessed the impact of the fiber-rich fraction of partially defatted chia seeds (FFC) on hepatic steatosis and metabolic disturbances induced by a high-fat diet (HFD) in mice. Male C57BL/6J mice were fed either a control diet (CD) or HFD for 10 weeks, followed by FFC or oatmeal supplementation for an additional 4 weeks. FFC intake significantly reduced hepatic steatosis, lowered triglyceride and cholesterol levels, normalized plasma triglycerides, decreased oxidative stress, and attenuated inflammation. FFC has emerged as a promising candidate for managing hepatic steatosis
Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations
No full textPublisher Copyright: © The Author(s) 2024.Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging
Mejora de la calidad registro de evolución para profesionales de enfermería, Unidad de Cuidados Intensivos Hospital Luis Tisne Brousse, Santiago, Chile
No full textIntroducción: El registro clínico de enfermería es una actividad necesaria que permite plasmar el trabajo realizado para los pacientes, que abarca desde la valoración hasta la evaluación de las intervenciones. Es el documento que provee fuente de conocimiento, permite el crecimiento y desarrollo profesional además de ser un respaldo legal al momento de ejercer la profesión. Objetivos: Mejorar la calidad de los registros de las evoluciones de enfermería del paciente hospitalizado en la UCI. Metodología: Implementar un check list que permita orientar el registro de la evolución de enfermería. Resultados: el 55% de los datos relevantes en el registro de la evolución de enfermería mejoro su presencia, 27% se mantuvo y el 18% de ellos, disminuyó. Conclusiones: Tras la intervención se pudo objetivar una mejora en la calidad de los datos, aunque aun existen brechas considerables en caso que se pretenda implementar como un indicador de calidad en la unidad.Introduction: The clinical nursing record is a necessary activity that allows the work carried out for patients to be captured, ranging from assessment to evaluation of interventions. It is the document that provides a source of knowledge, allows professional growth and development in addition to being legal support when practicing the profession. Objetives: Improve the quality of records of nursing progress of patients hospitalized in the ICU. Methodology: Implement a check list that allows guiding the recording of nursing evolution. RESULTS: 55% of the relevant data in the nursing evolution record improved its presence, 27% was maintained and 18% of them decreased. Conclusions: After the intervention, an improvement in the quality of the data could be observed, although there are still considerable gaps if it is intended to be implemented as a quality indicator in the unit
Evaluation of energy and lighting in schools considering solar protections
No full textPublisher Copyright: © 2024 The AuthorsThe implementation of the solar protections laid out in the regulations and certification systems decreases cooling demands, although it has an uncontrolled and even unforeseen effect on daylighting. Achieving a balance between both requirements is a challenge for facade design, energy behavior, and lighting performance since restricting solar radiation contributions decreases daylight's contribution. This research aims to define a methodology that allows, in the early design stage, the evaluation of solar protection solutions that consider the optimal performance of daylight using annual dynamic indicators while maintaining adequate energy-saving levels. For this purpose, cooling energy consumption and dynamic indicators have been considered as the primary indicators, namely Spatial daylight autonomy (sDA), Annual Sunlight Exposure (ASE), and useful daylight illuminance (UDI) with variations of the Modified Solar Factor (MSF). Thermal and light performance assessments were made using energy modeling for two types of solar protection. The case study is a school classroom located in the city of Talca, in central Chile, considering window-to-wall ratios (WWR) of 40 %, 50 %, and 60 %. The premise's thermal and light behavior were obtained with both types of solar protection. The sDA and UDI results allowed making an approximation of optimal solutions, however, the ASE values in all cases, were classified as unsuitable for classroom use. The analysis suggests that better limit values for both requirements are obtained by organizing the results by WWR instead of by the MSF that each solution identifies. This methodology compared solar protection options at an early design stage, reaching recommended light performance levels and energy savings of 70 % or more, for the two types of solar protection. It is concluded that to achieve minimum acceptable daylighting levels, in balance with cooling energy consumption, it is necessary to consider annual dynamic assessments with sDA and UDI as relevant indicators
Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations
No full textPublisher Copyright: © The Author(s) 2024.Patients recovering from COVID-19 commonly exhibit cognitive and brain alterations, yet the specific neuropathological mechanisms and risk factors underlying these alterations remain elusive. Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing brain alterations is crucial for prioritizing follow-up care. Here, we report findings from a sample of patients consisting of 73 adults with a mild to moderate SARS-CoV-2 infection without signs of respiratory failure and 27 with infections attributed to other agents and no history of COVID-19. The participants underwent cognitive screening, a decision-making task, and MRI evaluations. We assessed for the presence of anosmia and the requirement for hospitalization. Groups did not differ in age or cognitive performance. Patients who presented with anosmia exhibited more impulsive alternative changes after a shift in probabilities (r = − 0.26, p = 0.001), while patients who required hospitalization showed more perseverative choices (r = 0.25, p = 0.003). Anosmia correlated with brain measures, including decreased functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss of white matter integrity. Hence, anosmia could be a factor to be considered when identifying at-risk populations for follow-up
Uso de ecografía doppler para determinar presencia embrionaria en yeguas pura raza chilena donantes previo a recuperación por flushing
Get PDFLa transferencia de embriones en yeguas ha sido ampliamente utilizada durante los últimos años, posicionándose actualmente como una de las biotecnologías más empleadas en reproducción equina. Sin embargo, luego de la monta o inseminación artificial, todavía es difícil tener certeza de que la yegua esté efectivamente preñada tan precozmente como al día 7-9 post ovulación. Esa confirmación, actualmente solo puede comprobar con la recuperación efectiva del embrión mediante flushing uterino, con algunos falsos positivos. Estudios previos han sugerido fenómenos de vasculogénesis y angiogénesis uterinas asociados a gestación tan temprana como menos de 10 días, así como aquellos coligados al posterior reconocimiento materno de la gestación. La ultrasonografía Doppler es una técnica de imagen que hipotéticamente podría evaluar cambios vasculares uterinos como vasculogénesis y angiogénesis en yeguas presuntamente gestantes, donantes, y confirmar diagnóstico de preñez tan temprana como al día 7-9 de gestación. Esta detección temprana de la gestación permitiría insistir en la recuperación embrionaria por flushing uterino, evitando equivocadamente abandonar este proceso al tener la idea de que la yegua está seca , promoviendo en ella la inducción de un nuevo ciclo estral. Es por esto, que surge la siguiente pregunta ¿existen cambios vasculares en el endometrio de yeguas donantes durante los días 7-9 de gestación asociados a la misma? Este estudio tuvo como objetivo caracterizar mediante ecografía Doppler color la vasculogénesis y angiogénesis durante la gestación temprana de 7-9 días en yeguas Pura Raza Chilena, confirmada por recuperación embrionaria. Se realizaron ecografías Doppler color a 30 yeguas donantes entre los días 7-9 post servicio, registrándose las características del flujo vascular uterino en imágenes por ecografía Doppler color, relacionándolas con la presencia o no del embrión. En las imágenes se observó aumento del flujo sanguíneo en el 93,3% de los animales, obteniéndose una recuperación embrionaria del 83,3%. El Doppler color tuvo un 96% de sensibilidad, 20% de especificidad, un 83% de exactitud y un valor predictivo positivo de 86%, lo cual indicaría que es una prueba fiable para poder detectar gestación de manera precoz.Embryo transfer in mares has been widely used during the last years and is currently one of the most used biotechnologies in equine reproduction. However, after mating or artificial insemination, it is still difficult to be certain that the mare is actually pregnant as early as 7-9 days post ovulation. Currently this confirmation can only be verified with the effective recovery of the embryo by uterine flushing, with some false positives. Previous studies have suggested phenomena of uterine vasculogenesis and angiogenesis associated with early gestation of 10 days, as well as those associated with subsequent maternal recognition of gestation. Doppler ultrasonography is an imaging technique that hypothetically could be used to evaluate uterine vascular changes such as vasculogenesis and angiogenesis in presumed pregnant mares, donors, and to confirm pregnancy diagnosis as early as day 7-9 of gestation. This early detection of pregnancy certainty would allow insisting on embryo recovery by uterine flushing, avoiding mistakenly abandoning this process with the idea that the mare is dry , promoting the induction of a new estrous cycle. Therefore, the following question arises: Are there vascular changes in the endometrium of donor mares during days 7-9 associated with gestation? The aim of this study was to characterize vasculogenesis and angiogenesis during early gestation of 7-9 days in Chilean Purebred mares, confirmed by embryo recovery, by means of color Doppler ultrasound. Color Doppler ultrasonography was performed on 30 donor mares between days 7-9 post service, recording the characteristics of uterine vascular flow in color Doppler images, relating them to the presence or not of embryo. The images showed an increase in blood flow in 93.3% of the animals, obtaining an embryo recovery of 83.3%. Color Doppler had 96% sensitivity, 20% specificity, 83% accuracy, and a positive predictive value of 86%, which would indicate that it is a reliable test for early detection of pregnancy