Coordinated elimination of bacterial taxa optimally attenuates alloimmunity and prolongs allograft survival.

This study aimed to dissect the relationship between specific gut commensal bacterial subgroups, their functional metabolic pathways, and their impact on skin allograft outcome and alloimmunity. We previously showed that oral broad-spectrum antibiotic (Abx) pretreatment in mice delayed skin, heart, and lung allograft rejection and dampened alloimmune responses. Here, rationally designed Abx combinations targeting major bacterial groups were used to elucidate their individual contribution to modulating alloimmune responses. Abx cocktails targeting intestinal gram-negative, gram-positive, or anaerobic/gram-positive bacteria by oral gavage, all delayed skin allograft rejection, and reduced alloreactive T cell priming to different extents. Notably, the most pronounced extension of skin allograft survival and attenuation of alloimmunity were achieved when all gut bacterial groups were simultaneously targeted. These results suggest a model in which the strength of the alloimmune response is additively tuned up by gut microbial diversity. Shotgun metagenomic sequencing enabled strain-level resolution and identified a shared commensal, Parabacteroides distasonis, as the most enriched following all Abx treatments. Oral administration of P.distasonis to mice harboring a diverse microbiota significantly prolonged skin allograft survival, identifying a probiotic with therapeutic benefit in transplantation.

Characteristics Associated With Elevated Time Below Range in Elderly Patients With Type 1 Diabetes Using an Automated Insulin Delivery System.

BACKGROUND: This study investigated the characteristics associated with an increased risk of hypoglycemia, in elderly patients with type 1 diabetes mellitus (T1D) using automated insulin delivery (AID) systems. METHODS: Cross-sectional observational study including patients >60 years, using sensor-augmented insulin pump therapy with predictive low-glucose management (SAPT-PLGM), hybrid closed-loop (HCL), and advanced hybrid closed-loop (AHCL), for more than three months. A geriatric assessment was performed, and body composition was determined to investigate its association with achieving time below range (TBR) <70 mg/dL goals. RESULTS: The study included 59 patients (47.5% of men, mean age of 67.6 years, glycated hemoglobin [HbA1c] of 7.5 ± 0.6%, time in range (TIR) 77.8 ± 9.9%). Time below range <70 and <54 mg/dL were 2.2 ± 2.3% and 0.4 ± 0.81%, respectively. Patients with elevated TBR <70 mg/dL (>1%) had higher HbA1c levels, lower TIR, elevated time above range (TAR), and high glycemic variability. Regarding body composition, greater muscle mass, grip strength, and visceral fat were associated with a lower TBR <70 mg/dL. These factors were independent of the type of technology used, but TIR was higher when using AHCL systems compared with SAPT-PLGM and HCL systems. CONCLUSIONS: In elderly patients treated with AID systems with good functional status, lower lean mass, lower grip strength, and lower visceral fat percentage were associated with TBR greater than 1%, regardless of the device used. A similar finding along was found with CGM indicators such as higher HbA1c levels, lower TIR, higher TAR, and higher CV. Geriatric assessment is crucial for personalizing patient management.

Results From a Virtual Clinic for the Follow-up of Patients Using the Advanced Hybrid Closed-Loop System.

BACKGROUND: Evidence regarding the implementation of medium-term strategies in advanced hybrid closed-loop (AHCL) system users is limited. Therefore, this study aimed to describe the efficacy and safety of the AHCL system in patients with type 1 diabetes (T1D) on a six-month follow-up in a virtual diabetes clinic (VDC). METHOD: A prospective cohort of adult patients with T1D treated using the AHCL system (Mini Med 780G; Medtronic, Northridge, California) in a VDC follow-up. Standardized training and follow-up were conducted virtually. Clinical data and metabolic control outcomes were reported at baseline, and at three and six months. RESULTS: Sixty-four patients (mean age = 42 ± 14.6 years, 65% men, 54% with graduate education) were included. Percentage time in range (%TIR) increased significantly regardless of prior therapy with intermittently scanned continuous glucose monitoring + multiple daily injections and sensor-augmented pump therapy with predictive low-glucose management after starting AHCL and persisted during the follow-up period with no hypoglycemic events. The %TIR 70 to 180 mg/dL according to socioeconomic strata was 73.4% ± 5.3%, 78.1% ± 8.1%, and 84.2% ± 7.5% for the lower, middle, and upper strata, respectively. The sensor was used more frequently in the population with a higher education level. Adherence to sensor use and SmartGuard retention were higher in patients who underwent the VDC follow-up. CONCLUSIONS: Medium-term follow-up of users of AHCL systems in a VDC contributes to safely achieving %TIR goals. Virtual diabetes clinic follow-up favored adherence to sensor use and continuous SmartGuard use. Socioeconomic strata were associated with a better glycemic profile and education level was associated with better adherence to sensor use.

Role and Value of the Corporate Medical Director.

ABSTRACT: The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; addressing mental health; collaborating on employer benefits design; developing programs for global health, travel medicine, and remote/extreme environments; overseeing on- and near-site clinics; incorporating digital technology, artificial intelligence, and telehealth in health programs; supporting critical incident preparedness and business continuity planning; addressing workplace hazards; and overseeing periodic executive health examinations.

Methods to Study TLRs in Transplantation.

Toll-like receptors (TLRs) are key regulators of immune responses, including alloimmune responses. In this chapter, we present protocols to study whether and/or how TLRs can contribute to solid-organ transplant rejection. We describe methods to reduce heterogeneity in microbiome variations between animals before beginning experiments to limit confounding factors, protocols using TLR agonists to prevent anti-CD154/donor splenocyte transfer-mediated tolerance, and recipes to heat-kill microbes or use hosts genetically deficient in TLR-dependent pathways to distinguish between TLR-dependent and live bacteria-dependent effects.

Microbiota-dependent and -independent effects of obesity on transplant rejection and hyperglycemia.

Obesity is associated with dysbiosis and a state of chronic inflammation that contributes to the pathogenesis of metabolic diseases, including diabetes. We have previously shown that obese mice develop glucose intolerance, increased alloreactivity, and accelerated transplant rejection. In the present study, we investigated the influence of the microbiota on diet-induced obesity (DIO)-associated transplant rejection and hyperglycemia. Antibiotic treatment prolonged graft survival and reduced fasting glycemia in high-fat diet (HFD)-fed specific-pathogen-free (SPF) mice, supporting a role for the microbiota in promoting accelerated graft rejection and hyperglycemia induced by DIO. Further supporting a microbiota-dependent effect, fecal microbiota transfer from DIO SPF mice into germ-free mice also accelerated graft rejection when compared with lean mice-fecal microbiota transfer. Notably, HFD could be also detrimental to the graft independently from microbiota, obesity, and hyperglycemia. Thus, whereas HFD-associated hyperglycemia was exclusively microbiota-dependent, HFD affected transplant outcomes via both microbiota-dependent and -independent mechanisms. Importantly, hyperglycemia in DIO SPF mice could be reduced by the addition of the gut commensal Alistipes onderdonkii, which alleviated both HFD-induced inflammation and glucose intolerance. Thus, microbial dysbiosis can be manipulated via antibiotics or select probiotics to counter some of the pathogenic effects of obesity in transplantation.

Sleep Quality, Insomnia, and Perceived Stress among Colombian Healthcare Workers during the COVID-19 Pandemic.

Objective The COVID-19 pandemic has imposed a great burden on healthcare workers worldwide. The aim of the present study was to assess sleep quality, insomnia, and perceived stress in healthcare workers of a high complexity hospital located in Bogota, Colombia. Methods Cross-sectional study in which 1,155 healthcare workers at the Hospital Universitario San Ignacio in Bogotá, Colombia were included, between September and October 2020. Using an online-based survey, self-reported variables were assessed including demographics, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and 10 item Perceived Stress Scale (PSS-10). Associations between these variables were evaluated. Results Fifty percent of the respondents were between 31 and 45 years old, and 76 percent were women. Most of the surveyed were the nursing staff. Poor sleep quality, insomnia, and high perceived stress was found in 74.9, 12.4, and 13.2%, respectively. Poor sleep quality was predominantly found in females, in the 31 to 45 years old group and in married personnel. Also, poor sleep quality was found in relation to a moderate to high perceived risk of COVID-19 infection by the family of the workers surveyed. Discussion Poor sleep quality, moderate rates of insomnia, and perceived stress were found among healthcare workers committed to COVID-19 infected patients in Colombia. The identification of workers at greater risk and the implementation of targeted interventions are called upon as the results.

Numerical and clinical precision in hypoglycemia of the intermittent FreeStyle Libre glucose monitoring through an NFC-Bluetooth transmitter associated with the xDrip+ algorithm in diabetic patients under insulin therapy.

INTRODUCTION: There are data capture devices that attach to the FreeStyle Libre sensor and convert its communication from NFC (Near-field communication) to Bluetooth technology, generating real-time continuous glucose monitoring. The accuracy of hypoglycemia measurements displayed by smartphone apps using this device has not been established. METHODS: Study of diagnostic tests. Numerical accuracy was evaluated, utilizing the absolute difference with respect to capillary glucometry (ISO 15197:2015 standard) and clinical accuracy, using the Clarke and Parkes (Consensus) error grids, for glucose measurements less than 70mg/dL performed with the FreeStyle Libre system and with the digital estimation xDrip+ app, in diabetic patients managed with insulin therapy. RESULTS: Twenty-seven patients were included (TIR 73.4%, TBR70 5.6%), who contributed 83 hypoglycemic events. Numerical accuracy was adequate in similar proportions with the FreeStyle Libre system compared to the xDrip+ app (81.92% vs. 68.67%, p=0.0630). The clinical accuracy evaluation showed that 92.8% of the measurements for xDrip+ and 98.8% for FreeStyle libre met the criteria according to the Parkes (Consensus) grid (p=0.0535); and 79.5% and 91.6% of the measurements met the criteria according to the Clarke grid (p=0.0273), being higher with FreeStyle libre. CONCLUSIONS: The use of the NFC-Bluetooth transmitter (Miao-Miao) associated with the xDrip+ app does not improve numerical or clinical accuracy for detecting hypoglycemic events in diabetic patients managed with insulin therapy, compared to the FreeStyle Libre device.

Oral administration of the commensal Alistipes onderdonkii prolongs allograft survival.

Intestinal commensals can exert immunomodulatory effects on the host, with beneficial or detrimental consequences depending on underlying diseases. We have previously correlated longer survival of minor mismatched skin grafts in mice with the presence of an intestinal commensal bacterium, Alistipes onderdonkii. In this study, we investigated its sufficiency and mechanism of action. Oral administration of A onderdonkii strain DSM19147 but not DSM108265 was sufficient to prolong minor mismatched skin graft survival through inhibition of tumor necrosis factor production. Through metabolomic and metagenomic comparisons between DSM19147 and DSM108265, we identified candidate gene products associated with the anti-inflammatory effect of DSM19147. A onderdonkii DSM19147 can lower inflammation both at a steady state and after transplantation and may serve as an anti-inflammatory probiotic beneficial for transplant recipients.

Re-envisioning, Retooling, and Rebuilding Prevention Science Methods to Address Structural and Systemic Racism and Promote Health Equity.

The historic momentum from national conversations on the roots and current impacts of racism in the USA presents an incredible window of opportunity for prevention scientists to revisit how common theories, measurement tools, methodologies, and interventions can be radically re-envisioned, retooled, and rebuilt to dismantle racism and promote equitable health for minoritized communities. Recognizing this opportunity, the NIH-funded Prevention Science and Methodology Group (PSMG) launched a series of presentations focused on the role of Prevention Science to address racism and discrimination guided by a commitment to social justice and health equity. The current manuscript aims to advance the field of Prevention Science by summarizing key issues raised during the series' presentations and proposing concrete research priorities and steps that hold promise for promoting health equity by addressing systemic racism. Being anti-racist is an active practice for all of us, whether we identify as methodologists, interventionists, practitioners, funders, community members, or an intersection of these identities. We implore prevention scientists and methodologists to take on these conversations with us to promote science and practice that offers every life the right to live in a just and equitable world.

Sleep problems in low income, urban pediatric populations living at different altitudes in Colombia.

OBJECTIVE: To determine the frequency of sleep problems in low-income, urban pediatric populations in cities at different altitudes in Colombia. METHODS: A descriptive, cross-sectional population-based observational study was conducted in children aged between 2 and 12 years in the low income, urban areas of three cities in Colombia (Santa Marta, Bucaramanga, and Bogotá) located at 15, 959, and 2640 m above sea level, respectively. Sociodemographic data were collected, and the Spanish version of the Pediatric Sleep Questionnaire was used. RESULTS: 1989 children were surveyed, distributed as follows: Santa Marta (32.0%), Bucaramanga (33.4%), and Bogotá (34.6%). The overall prevalence of sleep problems was 39.0%. Children from Santa Marta had the highest frequency of parasomnias (58.0%); those from Bucaramanga had the highest frequency of attention deficit symptoms (4.0%) and apneic pauses witnessed by parents or caregivers (5.7%). Finally, Bogotá, the only high-altitude location, had the highest frequency of sleep disordered breathing (17.2%). CONCLUSIONS: The study found a high frequency of sleep problems in the pediatric population, especially at higher altitudes when compared to lower altitude settings. Sleep disorders warrant early detection and timely therapeutic intervention.

Host-versus-commensal immune responses participate in the rejection of colonized solid organ transplants.

Solid organ transplantation is the preferred treatment for end-stage organ failure. Although transplant recipients take life-long immunosuppressive drugs, a substantial percentage of them still reject their allografts. Strikingly, barrier organs colonized with microbiota have significantly shorter half-lives than non-barrier transplanted organs, even in immunosuppressed hosts. We previously demonstrated that skin allografts monocolonized with the common human commensal Staphylococcus epidermidis (S.epi) are rejected faster than germ-free (GF) allografts in mice because the presence of S.epi augments the effector alloimmune response locally in the graft. Here, we tested whether host immune responses against graft-resident commensal microbes, including S.epi, can damage colonized grafts independently from the alloresponse. Naive hosts mounted an anticommensal T cell response to colonized, but not GF, syngeneic skin grafts. Whereas naive antigraft commensal T cells modestly damaged colonized syngeneic skin grafts, hosts with prior anticommensal T cell memory mounted a post-transplant immune response against graft-resident commensals that significantly damaged colonized, syngeneic skin grafts. Importantly, allograft recipients harboring this host-versus-commensal immune response resisted immunosuppression. The dual effects of host-versus-commensal and host-versus-allograft responses may partially explain why colonized organs have poorer outcomes than sterile organs in the clinic.

[Association between sleep disorders and academic performance: Finding of health survey and academic performance in the Bio-Bio province 2018]. / Asociación entre problemas de sueño y rendimiento escolar: Resultados de la encuesta de salud y rendimiento escolar de la provincia del Biobío 2018.

OBJECTIVE: To analyze the association between sleep disorders, behaviors associated with cognition, and academic performance in elementary school students. SUBJECTS AND METHOD: Analytical and cross-sectional research including 733 students from 5th and 8th grades from public schools par ticipating in the study "Health survey and academic performance in the Bio-Bio Province 2018". The sleep disorders were reported through a sleep self-report questionnaire, and the academic per formance was measured through the grade point average (GPA) in subjects language, mathematics, physical education, general point averages, and perception of cognitive functions in a school context. RESULTS: 81.9% of the schoolchildren indicated problems with bedtime routines. The students with sleep disorders of both sexes presented higher memory problems, are slower in resolving math pro blems, have higher difficulties to maintain attention in classes, have more problems solving complex tasks, and more nervousness during a test than the student classified as not having sleep disorders. Additionally, the students with sleep disorders presented lower grades in their GPA and the subjects mathematics, language, and physical education than those students without sleep disorders. Con clusion: A high prevalence of bedtime routine problems was detected as well as an association bet ween sleep disorders and lower academic performance together with a worse perception of cognitive functions in schoolchildren. Implementing health promotion strategies, focused on sleep hygiene in educational centers could improve academic performance.

Calidad de vida en personas según tipo de confinamiento de estudiantes universitarios chilenos en pandemia por COVID-19 / Quality of life according to type of confinement of Chilean university students during COVID-19 pandemic

BACKGROUND: COVID-19 confinement measures in the population affected the quality of life and sleep. AIMS: To determine if confinement is associated with a lower quality of life and sleep. SUBJECTS AND METHODS: A self-reported survey including questions about type of confinement, time spent in front of a screen, the international physical activity questionnaire (IPAQ), the Sleep Self Report questionnaire and the SF-36 quality of life survey, was answered by 621 Chilean university students. RESULTS: Confined and not confined respondents spent a great amount of time in front of a screen, in sedentary activities and sleeping > 8 or < 6 hours per day. Those who were in confinement reported having a poorer quality of sleep and quality of life compared to those who were not in confinement. Those who required mandatory confinement for suspected COVID-19 had the worst quality of sleep and quality of life. CONCLUSIONS: University students had sedentary lifestyles regardless of the type of confinement. Those who were in confinement, especially for suspected COVID-19 infection, had the worst quality of sleep and quality of life.

Actividad física durante una jornada escolar con y sin clase de educación física y salud en estudiantes chilenos

Sepúlveda Martin, S., Martínez González, L., Cigarroa, I., y Zapata Lamana, R.E. (2022). Actividad física durante una jornada escolar con y sin clase de educación física y salud en estudiantes chilenos. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-18. Los altos índices de obesidad y el aumento del tiempo sedentario en los escolares tienen consecuencias directas en la prevalencia de enfermedades no transmisibles en edad adulta. El entorno escolar es una oportunidad para combatir estos factores de riesgo y la importancia de la clase de educación física es relevante. El objetivo del estudio fue comparar el nivel de actividad física, gasto energético y tiempo sedentario entre una jornada con y sin clases de educación física en niños y niñas de primer ciclo básico. Es un estudio no experimental, analítico transversal con una muestra intencionada de 46 escolares de primer ciclo básico. Se midió índice de masa corporal (IMC), actividad física, gasto energético y tiempo sedentario con acelerometría en jornada escolar con y sin clase de educación física. Se utilizó la prueba no paramétrica de Wilcoxon para determinar diferencias entre las jornadas escolares (p < .05). Los resultados muestran que, durante la jornada con clases de educación física, los escolares presentaron un nivel de actividad física moderada (3.03 MET) y, en la jornada sin clases de educación física, un nivel ligero (2.32 MET). Los estudiantes en la jornada escolar con educación física tuvieron mayores niveles de actividad física moderada (Z = -4.430; p < .0001), vigorosa (Z = -5.403; p < .0001), muy vigorosa (Z = -3.940; p < .0001) y disminuyeron el tiempo sedentario (Z = -4.149; p < .0001) con respecto a la jornada sin clase de educación física. Se concluye que aun cuando durante la jornada con educación física, los escolares tienen mayor actividad física, mayor gasto energético y menor tiempo sedentario, este rendimiento resulta insuficiente de acuerdo con las recomendaciones internacionales para la salud.

Sepúlveda Martin, S., Martínez González, L., Cigarroa, I., & Zapata Lamana, R.E. (2022). Physical activity indicators during a school day with and without physical education class and health among chilean students. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-18. High obesity rates and the increase in sedentary time among schoolchildren have direct consequences on the prevalence of non-communicable diseases in adulthood. The school environment is an opportunity to deal with these risk factors, and the importance of physical education classes is critical. The object of this study was to compare the level of physical activity, energy expenditure and sedentary time between a day with physical education class and one without, among first- to third-grade children. This is a non-experimental, analytic, cross-cutting study with a deliberate sample of 46 schoolchildren. Body Mass Index (BMI), physical activity, energy expenditure and sedentary time were measured with accelerometry on school days with and without physical education class. Wilcoxon's non-parametric test was used to determine differences between school days (p < .05). The results show that schoolchildren had a moderate level of physical activity (3.03 MET) during a day with physical education class, and a light level (2.32 MET) during a school day without physical education class. Students in a school day with physical education class had higher levels of moderate ( Z = -4.430; p < .0001), energetic (Z = -5.403; p < .0001) and highly energetic (Z = -3.940; p < .0001) physical activity, and their sedentary time was lower ( Z = -4.149; p < .0001) as compared to a day without physical education time. The conclusion is that, even though schoolchildren have higher physical activity, higher energy expenditure and lower sedentary time during a day with physical education class, this performance proves insufficient as compared to international recommendations for health.

Sepúlveda Martin, S., Martínez González, L., Cigarroa, I., e Zapata Lamana, R.E. (2022). Atividade física durante um dia letivo com e sem aula de educação física e saúde em estudantes chilenos. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20(1), 1-18. As altas taxas de obesidade e o aumento do tempo sedentário em estudantes têm consequências diretas sobre a prevalência de doenças não transmissíveis na idade adulta. O ambiente escolar é uma oportunidade de combater esses fatores de risco e a importância da aula de educação física é relevante. O objetivo do estudo foi comparar o nível de atividade física, gasto energético e tempo sedentário entre um dia letivo com e sem aulas de educação física em crianças do primeiro ciclo da educação fundamental. Trata-se de um estudo não experimental, analítico transversal com amostra intencional de 46 estudantes do primeiro ciclo da educação fundamental. O índice de massa corporal (IMC), a atividade física, o gasto energético e o tempo sedentário foram medidos com a acelerometria no dia letivo com e sem aula de educação física. O teste não paramétrico de Wilcoxon foi utilizado para determinar diferenças entre os dias letivos (p < 0,05). Os resultados mostram que, durante o dia com aulas de educação física, os escolares apresentaram nível moderado de atividade física (3,03 MET) e, no dia sem aulas de educação física, nível leve (2,32 MET). Os alunos no dia letivo com educação física apresentaram níveis mais elevados de atividade física moderada (Z = -4,430; p < 0,0001), vigorosa (Z = -5,403; p < 0,0001), muito vigorosa (Z = -3,940; p < 0,0001) e diminuição do tempo sedentário (Z = -4,149; p < 0,0001) em relação ao dia letivo sem aula de educação física. Conclui-se que, embora durante o dia letivo com educação física os escolares tenham maior atividade física, maior gasto energético e menos tempo sedentário, esse desempenho é insuficiente de acordo com as recomendações internacionais para a saúde.

Funcionalidad de las personas mayores en Chile: Resultados basados en el REM-P5 (2012-2016)

Antecedentes: En Chile la población de personas mayores se ha incrementado en las últimas décadas. Se han establecido durante los años políticas integrales de envejecimiento positivo con el fin de proteger la salud funcional de las personas mayores. No obstante, existe escasa evidencia sobre las características poblaciones de la funcionalidad de este grupo etario. Objetivos: Caracterizar la funcionalidad de personas mayores chilenas basadas en reportes del REM-P5 entre 2012-2016 según sexo, edad y zona geográfica y describir los ingresos y egresos del programa Más Adultos Mayores Autovalentes. Materiales y métodos: Estudio de diseño no experimental, de alcance descriptivo y de corte retrospectivo. Se tomaron registros nacionales y por región de los años 2012-2016 del REM-P5 Sección A, así como los registros de ingreso y egreso del programa Mas Adultos Mayores Autovalentes. Resultados: Se evidenció una disminución de funcionalidad entre 2012-2016 (1,4 %). Durante este periodo se observó un mayor porcentaje de funcionalidad en hombres que en mujeres y un descenso de la funcionalidad a medida que envejecían. Las zona norte y extremo sur concentraron el mayor porcentaje de personas mayores con altos niveles de funcionalidad y dependencia total. En el Programa Más Adultos Mayores Autovalentes, aumentaron las personas mayores que mantuvieron autovalencia sobre quienes mejoraron su autovalencia (Δ=7% de diferencia) entre 2015-2016. Conclusión: La funcionalidad de las personas mayores en Chile ha disminuido con los años, existiendo diferencias por sexo y región. Estos hallazgos podrían ayudar a enfocar las políticas sanitarias de intervención y monitorización orientadas a la funcionalidad de personas mayores.

Background: In Chile the older people increasing in the last decades. Have settled comprehensive policies of positive anging whit the objective of protect de functional health oh older people. However, there's a little bit evidence on the current situation functionality of this age group population. Objetive: To characterize the functionality of Chilean older people based in reports to REM-P5 between 2012 -2016 years. Materials and methods: Study with quantitative approach whit no experimental design, of descriptive scope and retrospective cut. National and regional records were taken from the years 2012-2016 of REM-P5 Section A, as well as the entry and exit records of the Mas Self-Employed Seniors program were recorded. Results: A decrease in functionality was evidenced between 2012-2016 (1.4%). Highlighting. During this period, a higher percentage of functionality was observed in men than in women and a decrease in functionality as they aged. The northern and extreme south areas concentrated the highest percentage of older people with high levels of functionality and total dependence. Related to the "Más Adultos Mayores Autovalentes" Program, the number of people who maintained self-valence increased over those who improved their self-valence (7% difference) between years 2015-2016. Conclusion: The functionality of older people in Chile has been decreasing, with differences by sex and region. These findings could help focus intervention and monitoring health policies aimed at the functionality of older people.

Ejercicio y educación mejoran equilibrio y la calidad de vida en mujeres con incontinencia urinaria de esfuerzo / Exercise and education improve balance and quality of life in women with stress urinary incontinence

Introducción: La incontinencia urinaria por esfuerzo (IUE) tiene una alta prevalencia en mujeres adultas, afectando variables psicológicas, sociales y funcionales como la disminución de capacidad de equilibrio, debido a una escasa contribución en los movimientos del tronco hacia una corrección postural. Objetivo: Determinar los efectos de un programa basado en ejercicio muscular de piso pélvico y educación sobre el equilibrio estático y la calidad de vida en mujeres con IUE. Materiales y métodos: Participaron 18 mujeres con IUE durante 12 semanas en 10 sesiones de ejercicio muscular de piso pélvico y educación (hábitos de higiene, micción, ingesta de líquidos). Pre y post-intervención se evaluó equilibrio estático mediante oscilografía postural y calidad de vida mediante el International Consultation on Incontinence Questionnaire Short-Form (ICQ-SF). Los datos fueron analizados con la prueba no paramétrica de Wilcoxon. Resultados: Se encontró una disminución significativa en el área de desplazamiento del centro de presión en el subtest ojos abiertos (p=0,027) y en el Subtest ojos cerrados (p=0,006). Disminuyó la sintomatología asociada a IUE (p=0,0001). Conclusiones: Pos-intervención mejora equilibrio estático y calidad de vida, confirmando los efectos positivos de este programa que pueden servir de orientación a profesionales de la salud que trabajan con mujeres con IUE.

Introduction: Stress urinary incontinence (SUI) has high prevalence in adult women, affecting psychological, social and functional variables, including decreased balance capacity, due to a lack of trunk movements that contribute to postural correction. Objective: To determine how a program based on pelvic floor muscle exercises and education affects static balance and quality of life of women with SUI. Materials and methods: 18 SUI female patients participated in a 12 week/10 sessions program that included pelvic floor muscle exercises and education (hygiene habits, urination, fluid intake). Static balance and quality of life were assessed before and after the intervention using postural oscillography and the International Consultation on Incontinence Questionnaire Short Form(ICQ-SF), respectively. Data were analyzed with the non-parametric Wilcoxon test. Results: The displacement area of the center of pressure in the open (p=0.027) and closed (p=0.006) subtests showed a significant reduction. Likewise, the amount of symptoms associated with SUI decreased (p=0.0001). Conclusions: Intervention improves static balance and quality of life, confirming the positive effects of this program, which can serve as a guide for health professionals who work with women with SUI.

[Quality of life according to type of confinement of Chilean university students during COVID-19 pandemic]. / Calidad de vida en personas según tipo de confinamiento de estudiantes universitarios chilenos en pandemia por COVID-19.

BACKGROUND: COVID-19 confinement measures in the population affected the quality of life and sleep. AIMS: To determine if confinement is associated with a lower quality of life and sleep. SUBJECTS AND METHODS: A self-reported survey including questions about type of confinement, time spent in front of a screen, the international physical activity questionnaire (IPAQ), the Sleep Self Report questionnaire and the SF-36 quality of life survey, was answered by 621 Chilean university students. RESULTS: Confined and not confined respondents spent a great amount of time in front of a screen, in sedentary activities and sleeping > 8 or < 6 hours per day. Those who were in confinement reported having a poorer quality of sleep and quality of life compared to those who were not in confinement. Those who required mandatory confinement for suspected COVID-19 had the worst quality of sleep and quality of life. CONCLUSIONS: University students had sedentary lifestyles regardless of the type of confinement. Those who were in confinement, especially for suspected COVID-19 infection, had the worst quality of sleep and quality of life.

Lifespan of peripheral intravenous short catheters in hospitalized children: A prospective study.

OBJECTIVE: To estimate the recommended lifespan of 223 peripheral intravenous accesses in pediatric services. METHOD: In this cohort study, we monitored the time of intravenous catheter between insertion and removal in children aged up to 15 years old in a Hospital from Bogotá-Colombia. The routine catheter observations was registered in questionnaires during nursing shifts. Survival analyses were performed to analyze the lifespan of the catheter free of complications. RESULTS: The median lifespan of peripheral intravenous catheters without complications was 129 h (IQR 73.6-393.4 h). This median time free from complications was much lower for children ⩽1 year 98.3 h (IQR 63-141 h), than for participants aged >1 year 207.4 h (IQR 100-393 h). Catheters of 24 G (gauge) caliber had a median complication free time of 128 h (IQR 69-207 h) and 22 G calibers 144 h (IQR 103-393 h). CONCLUSIONS: In this study, 75% of peripheral indwell catheters remained free from complications for 74 h, the other extreme 25% of these patients could remain up to 393 h.