Assessment of activities and participation of people by rehabilitation-focused clinical registries: a systematic scoping review.

INTRODUCTION: Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect information to assess specific outcomes in a defined population, can contribute to assessing the impact of the rehabilitation intervention. This review aims to identify and describe rehabilitation-specific registry systems with an emphasis on identifying outcomes that enable the assessment of vital areas and activities of daily living. EVIDENCE ACQUISITION: A systematic scoping review was conducted. A systematic search was conducted up to August 2022 in MEDLINE/PubMed, Embase, Cochrane Library, Epistemonikos, and other search resources. Studies related to rehabilitation registries presented data on people with health problems that could limit their functioning were selected. The inclusion of studies/clinical registries was not limited by methodological design, year of publication, country, or language. The unit of analysis was rehabilitation registries. The measurement instruments used to assess the outcomes were explored to estimate the domain assessed from the vital areas related to functioning and disability as described by the International Classification of Functioning, Disability and Health (ICF). The vital areas were classified according to activities of daily living (ADLs). EVIDENCE SYNTHESIS: Seventy-one registries in rehabilitation were identified. The registries included a median of 3 (IQR 2-5) assessment instruments designed to assess the impact of different rehabilitation programs. In total, 137 different assessment scales or instruments were identified. Each rehabilitation registry assessed 6 (IQR 2-8) domains of the ICF, and 15.4% of registries assessed all domains. The most assessed domain was "Mobility" (89.7%), and the least assessed was "General Tasks and Demands" (25.6%). In addition, 92.3% of rehabilitation registries assessed basic ADLs, 76.9% advanced ADLs, and 71.8% instrumental ADLs. CONCLUSIONS: Although clinical registries do not claim to directly assess the impact of rehabilitation programs on people's functioning according to the ICF framework, it was identified that a low percentage of them assessed the nine vital areas through different outcome assessment instruments. However, most rehabilitation registries directly or indirectly assess some basic, instrumental, and advanced ADLs. The findings of this review highlight the need to improve the design of clinical registries focused on assessing the impact of rehabilitation programs to assess people in all areas of their lives.

Voluntary Biosurveillance of Streptococcus equi Subsp. equi in Nasal Secretions of 9409 Equids with Upper Airway Infection in the USA.

This study aimed to describe selected epidemiological aspects of horses with acute onset of fever and respiratory signs testing qPCR-positive for S. equi and to determine the effect of vaccination against S. equi on qPCR status. Horses with acute onset of fever and respiratory signs from all regions of the United States were included in a voluntary biosurveillance program from 2008 to 2020 and nasal secretions were tested via qPCR for S. equi and common respiratory viruses. A total of 715/9409 equids (7.6%) tested qPCR-positive for S. equi, with 226 horses showing coinfections with EIV, EHV-1, EHV-4, and ERBV. The median age for the S. equi qPCR-positive horses was 8 ± 4 years and there was significant difference when compared to the median age of the S. equi qPCR-negative horses (6 ± 2 years; p = 0.004). Quarter Horse, Warmblood, and Thoroughbred were the more frequent breed in this horse population, and these breeds were more likely to test qPCR-positive for S. equi compared to other breeds. There was not statistical difference for sex between S. equi qPCR-positive and qPCR-negative horses. Horses used for competition and ranch/farm use were more likely to test qPCR-positive for S. equi (p = 0.006). Horses that tested S. equi qPCR-positive were more likely to display nasal discharge, fever, lethargy, anorexia, and ocular discharge compared to horses that tested S. equi qPCR-negative (p = 0.001). Vaccination against S. equi was associated with a lower frequency of S. equi qPCR-positive status.

Structural validity and reliability of the "Oral Health Assessment Tool" applied by speech-language therapists in a population of older Chilean people.

BACKGROUND: A good state of oral health allows people to communicate and eat. This topic is relevant in older people given its close relationship with their general health. At present, health challenges are directed at detecting and preventing oral disorders and are seen to exclusively by dentists, because the existing instruments can only be applied by them. However, speech-language therapists undergo similar training, which would allow them to collaborate in these processes. In this context, the Oral Health Assessment Tool (OHAT) is a detection instrument with good psychometric properties that is currently available for non-dental use. The objective of this study is the translation into Chilean Spanish of the OHAT and a structural validation of that version for application by these professionals. MATERIALS AND METHODS: A mixed qualitative-quantitative study was carried out. The OHAT instrument was adapted to Chilean Spanish and subsequently subject to structural validity and evaluation of internal consistency reliability, as well as a valuation of its reproducibility in 286 older people (166 female, 120 male) from different health contexts. RESULTS: The cultural adaptation of the instrument proved to be semantically consistent with the original instrument. Its application was considered to be speedy and simple in the pre-test. The confirmatory factor analysis evidenced the unidimensionality of the OHAT. In addition, the instrument shows good internal consistency and test-retest reliability. CONCLUSIONS: The OHAT instrument was considered to possess adequate structural validity and test-retest reliability properties. Its usefulness in the context of oral health disorders of this population in Chile is discussed.

Presence of Helicobacter spp. in dental tartar and gastric mucosa, and its relationship with EGUS in horses from a public slaughterhouse

Background: Despite the fact that Helicobacter spp. has been detected in equine gastric mucosa, no evidence exists about this infection in Colombian horses affected by equine ulcerative gastric syndrome (EGUS), nor in dental tartar. Objective: To detect Helicobacter spp. DNA in equine gastric mucosa and dental tartar and determine the relationship between the presence of Helicobacter spp. and gastric lesions. Methods: Samples of glandular gastric mucosa and dental tartar were collected from 30 equine slaughterhouses. Macroscopic lesions of the stomachs were classified and the total DNA in all samples was extracted using a commercial extraction kit. A final-point PCR was performed using primers for amplification of a segment of 251 bp of the gene encoding the 16s rRNA region; the amplified fragments were subjected to a second PCR to determine the presence of H. pylori, the VacA gene was typified. The resulting amplicons were sequenced. Results: It was possible to amplify 16s rRNA in several samples but there was no amplification of VacA. Fragments of the sequences were compatible with H. heilmannii. The 23.3 and 10% of gastric and tartar samples were positive for 16s rRNA of Helicobacter spp., respectively. Conclusion: Although genetic material of Helicobacter spp. was found in some animals, there was no relationship with gastric lesions. It is possible that helicobacteriosis has no bearing in EGUS etiology.

Antecedentes: A pesar de que se ha detectado Helicobacter spp. en mucosa gástrica equina, no existe evidencia de esta infección en caballos criollos colombianos afectados por síndrome ulcerativo gástrico (SUGE), ni tampoco reportes en sarro dental. Objetivo: Detectar ADN de Helicobacter spp. en sarro dental y mucosa gástrica de equinos, y determinar la relación entre la presencia de la bacteria y lesiones gástricas. Métodos: Las muestras de mucosa glandular gástrica y sarro dental fueron colectadas de 30 equinos que se encontraban en planta de beneficio. Las lesiones macroscópicas fueron clasificadas y el ADN total de las muestras fue extraído utilizando un kit comercial. Se desarrolló PCR convencional usando cebadores específicos para la amplificación de un segmento de 251 pb de un gen que codifica la región 16S del ARNr; los fragmentos amplificados fueron sometidos a una segunda PCR para determinar la presencia de H. pylori mediante la amplificación del gen VacA. Los amplificados resultantes fueron secuenciados. Resultados: Fue posible amplificar 16s ARNr en varias muestras, pero no hubo amplificación de VacA. Los fragmentos de las secuencias fueron compatibles con H. heilmannii. El 23,3 y 10% de las muestras gástricas y sarro fueron positivas para 16s ARNr de Helicobacter spp., respectivamente. Conclusión: Aunque el material genético de Helicobacter spp. se encontró en algunos animales, no hubo relación con las lesiones gástricas. Es posible que la helicobacteriosis no tenga incidencia en la etiología del EGUS.

Antecedentes: Apesar do Helicobacter spp. ter sido detectado na mucosa gástrica de equinos, não há evidências dessa infecção em cavalos crioulos colombianos afetados pela síndrome ulcerativa gástrica (SUGE), ou no sarro. Objetivo: Detectar ADN de Helicobacter spp. na mucosa gástrica e do sarro dental de equinos, e determinar a relação entre a presença de Helicobacter spp. e lesões gástricas. Métodos: Amostras de mucosa gástrica glandular e sarro dental foram coletadas de 30 equinos de abatedouro, as lesões macroscópicas dos estômagos foram classificadas. Se realizou extração de ADN total em todas as amostras através de kit comercial. Realizou-se PCR ponto final, amplificando o segmento de 251 pb do gene que codifica para a região 16s ARNr; os fragmentos amplificados foram sometidos novamente a PCR para determinar a presença de H. pylori, ao tipificar o gene VacA, e seguidamente foram sequenciados. Resultados: O houve amplificação do 16s ARNr em várias amostras, mas não amplificação de VacA. Fragmentos das sequencias foram compatíveis com H. heilmannii. O 23,3 e 10% das amostras gástricas e do sarro foram positivas para 16s ARNr de Helicobacter, respectivamente. Conclusão: Embora material genético de Helicobacter spp. encontrou-se em algumos animais não houve relação com lesões gástricas. Possivelmente a helicobacterioses não tem papel relevante na etiologia da SUGE.

Streptococcus equi culture prevalence, associated risk factors and antimicrobial susceptibility in a horse population from Colombia.

The objectives of this study were to determine the prevalence of S. equi in a horse population in Colombia, to determine the risk factors associated with its detection in the guttural pouches and to report the antimicrobial susceptibility of the isolates. Fifteen farms and 137 horses >6 months of age were enrolled. Sampling was randomly, stratified and proportional to the population size of each farm. The guttural pouch (GP) was swabbed via endoscopic guidance and culture was performed. DNA extraction and conventional PCR were performed in colonies compatibles with S. equi, the PCR products were sequenced and subjected to BLAST analysis. Antimicrobial drug sensitivity was assessed using an antimicrobial disc diffusion assay including penicillin, ceftiofur, trimethoprim-sulfamethoxasole (TMS), enrofloxacin and oxytetracycline. A mixed logistic regression model was constructed to evaluate risk factors associated with the presence of S. equi. The S. equi culture prevalence in the GP was 15%; 13.5 % for S. equi subsp. equi and 1.5% for S. equi subsp. zooepidemicus. History of travel was associated with the presence of S. equi, whereas every 1-year increase in age decreased the risk for S. equi detection in the GP. All isolates were susceptible to TMS, ceftiofur and penicillin, but resistant to enrofloxacin and oxytetracycline. S. equi is present in horses in Colombia, with a high prevalence and appear to be endemic in the tested population. Younger horses and horses with recent history of travelling had higher odds of testing positive for S. equi in swabs of the GP.

Chilean dentists' knowledge of hearing loss generated by occupational noise exposure / Conocimiento de odontólogos chilenos sobre la pérdida auditiva generada por exposición ocupacional al ruido

Abstract Introduction: Dentists are a population at high risk of hearing loss due to their constant exposure to instruments that can generate noise of up to 100 dB during their practice. Objective: To determine the level of knowledge of dentists working in Chile regarding hearing loss caused by exposure to noise generated by dental instruments. Materials and methods: A cross-sectional study was conducted in 114 dentists, who completed a virtual survey of 22 questions regarding the perception and level of knowledge about hearing loss due to exposure to loud noises and about national regulations on occupational noise exposure. Differences between perception and knowledge levels were evaluated taking into account the years of professional practice and the average weekly workload in dental treatment rooms. Descriptive and inferential statistics (Chi-squared test) were used for data analysis. Results: Most participants were Chilean (99.1%); 58.8% were women, and 72.8% had less than 10 years of professional experience. In addition, 97.4% were unaware of national regulations on occupational noise exposure and 50% of the sample reported having experienced hearing loss; of these, 57.9% (n = 32) associated it with their practice. Conclusions: A very low percentage of participants knew that there are regulations regarding occupational noise exposure. For this reason, it is important that, both during their training and their professional practice, dentists in Chile have greater access to information about these regulations and hearing protection measures.

Resumen Introducción. Los odontólogos son una población con un alto riesgo de desarrollar pérdida auditiva debido a la constante exposición a instrumentales que deben usar en su práctica profesional y que pueden generar ruidos de hasta 100 dB. Objetivo. Determinar el nivel de conocimiento de odontólogos laboralmente activos en Chile respecto a la pérdida auditiva causada por la exposición al ruido generado por maquinarias dentales. Materiales y métodos. Estudio transversal realizado en 114 odontólogos, quienes diligenciaron una encuesta virtual de 22 preguntas relativas a la percepción y el nivel de conocimiento sobre pérdida auditiva por exposición a ruidos fuertes y sobre la normativa nacional respecto a exposición ocupacional al ruido. Se evaluaron las diferencias entre percepción y niveles de conocimiento según los años de ejercicio profesional y la carga promedio de trabajo semanal en boxes de atención. Para el análisis de los datos se utilizó estadística descriptiva e inferencial (prueba de chi-cuadrado). Resultados. La mayoría de participantes eran chilenos (99.1%); el 58.8% fueron mujeres, y el 72.8% tenía menos de 10 años de ejercicio profesional. Además, el 97.4% desconocía las regulaciones nacionales sobre exposición ocupacional al ruido y el 50% reportó haber experimentado pérdida auditiva; de estos, 57.9% (n=32) lo asoció a su profesión. Conclusiones. Un muy bajo porcentaje de los participantes sabe que hay disposiciones sobre exposición ocupacional al ruido, por lo que es importante que, tanto en su formación, como durante su ejercicio profesional, los odontólogos en Chile tengan un mayor acceso a información relativa a estas normativas y a medidas ocupacionales de protección auditiva.

Assessment of mandibular kinematics values and its relevance for the diagnosis of temporomandibular joint disorders.

BACKGROUND/PURPOSE: Temporomandibular disorders (TMD) are common conditions that involve the temporomandibular joints (TMJs), jaw muscles, or both, and can cause alteration in the mandibular kinematics. The aim of this study was to assess the relationship between mandibular kinematics and temporomandibular joint disorders (TMJD) as a clinical tool for evaluation and diagnosis of these patients. MATERIALS AND METHODS: A retrospective study based on the analysis of the clinical findings from patients' charts was carried out, with a sample size of 476 patients. Statistical analysis was made with chi-square test for qualitative variables and student t-test for quantitative variables. Then, odds ratio with its confidence interval were calculated. A p value < 0.05 was considered statistically significant. RESULTS: Most patients were female (80.7%) and between 16 and 25 years old. Disc displacement with reduction (DDwR) and subluxation were associated with increased kinematic parameters, while disc displacement without reduction (DDwoR) and retrodiscitis were associated with decreased kinematic values. A soft end feel was related to osteoarthritis (OA). Structural incompatibility was most prevalent in older patients. CONCLUSION: Mandibular kinematic values are associated with specific temporomandibular joint disorders and could be considered as a useful clinical tool to perform the right diagnosis of TMJD.

Manejo deglutorio del adulto mayor institucionalizado por parte de técnicos en enfermería: un estudio cualitativo / Swallowing Management of Institutionalized Older Adults by Nursing Technicians: A Qualitative Study / Manejo deglutório do idoso institucionalizado por parte de técnicos em enfermagem: um estudo qualitativo

Resumen Introducción: se busca profundizar acerca del manejo cotidiano de las complicaciones de la deglución en centros del adulto mayor, las cuales generalmente asume el técnico o auxiliar de enfermería (TENS), quienes son los encargados de su alimentación. Materiales y métodos: se llevó a cabo un estudio con enfoque cualitativo basado en la teoría fundamentada. Se realizaron grupos de discusión y entrevistas en profundidad a dieciocho TENS de tres establecimientos de larga estadía en la Araucanía (Chile). Se analizaron los datos a través de codificación abierta y axial, con los cuales se obtuvieron seis categorías analíticas sobre esta situación. Resultados: los TENS y los auxiliares de la alimentación reportaron desconocimiento del uso y pertinencia de estas; además, comentaron que dichas maniobras las aprendieron mediante la observación a otros profesionales itinerantes dentro del centro, y no producto de la formación o trabajo interdisciplinario. Conclusión: dado el contexto y las limitaciones derivadas de la formación de los TENS, surge la necesidad de incrementar sus conocimientos y mejorar sus prácticas relacionadas con la deglución y alimentación, con el objetivo de disminuir el riesgo de ocurrencia de situaciones que agraven la salud de los adultos mayores. Se discute, así mismo, la pertinencia de que estos centros cuenten con profesionales capacitados en cuanto al abordaje de los trastornos de la deglución, pues ello contribuirá a mejorar este aspecto, en función del trabajo coordinado con el resto del equipo.

Abstract Introduction: This study examines the daily management of swallowing complications of older adults in centers, which generally assumes that the technician or auxiliary nurses (TENS) are the ones in charge of their feeding. Materials and Methods: A study was conducted with a qualitative approach based on the grounded theory. A focus group and in-depth interviews were performed with 18 nursing technicians and assistants from 3 long-stay facilities in Araucanía, Chile. Data were analyzed through open and axial coding, obtaining 6 analytical categories on this situation. Results: The TENS and auxiliary feeding reported to have no knowledge of the use and relevance of these maneuvers and reported that these were learned via the observation of other traveling professionals within the center and were not a product of interdisciplinary training. Conclusion: Given the context and the limitations derived from the formation of TENS, there is the need to increase their knowledge and improve their practices related to swallowing and feeding, with the aim of reducing the risk of occurrence of situations that aggravate the health of older adults. The relevance of these centers incorporating qualified professionals in the management of swallowing disorders, who would also contribute to improving these aspects, based on coordinated work with the rest of the team was also discussed.

Resumo Introdução: se busca aprofundar acerca do manejo cotidiano das complicações da deglução em centros do idoso, os quais geralmente os assume o técnico ou auxiliar de enfermagem (TENS) os quais são os encarregados de sua alimentação. Materiais e métodos: levou-se a cabo um estudo com enfoque qualitativo baseado na teoria fundamentada. Se realizaram focus group e entrevistas em profundidade a 18 TENS de 3 estabelecimentos de longa estadia em Auracanía, Chile. Se analisaram os dados através de codificação aberta e axial, obtendo-se 6 categorias analíticas sobre esta situação. Resultados: os TENS e auxiliares da alimentação reportaram desconhecimento do uso e pertinência destas, comentando para além de ditas manobras foram aprendidas através da observação a outros profissionais itinerantes dentro do centro, e não produto da formação ou trabalho interdisciplinar. Conclusão: devido ao contexto e às limitações derivadas da formação dos TENS, surge a necessidade de incrementar seus conhecimentos e melhorar suas práticas relacionadas à deglução e alimentação, com o objetivo de diminuir o risco de ocorrência de situações que agravem a saúde dos idosos. Se discute para além da pertinência de que estes centros contem com profissionais idóneos em quanto à abordagem dos transtornos da deglução, que contribuíram também a melhorar estes aspectos, em função do trabalho coordenado com o resto da equipe.

Recomendaciones para Resolución de Urgencias Odontológicas en Atención Primaria de Salud Durante la Pandemia de SARS-CoV-2 / Recommendations for the Resolution of Dentistry Emergencies in Primary Health During the SARS-CoV-2 Pandemic

RESUMEN: La enfermedad originada por el nuevo tipo de coronavirus, SARS-CoV-2, se ha convertido en un problema de Salud Pública a nivel mundial. Esto ha llevado a posponer las atenciones clínicas electivas de pacientes, exceptuando las atenciones de urgencia o emergencia. Las urgencias odontológicas han continuado con alta demanda en el Sistema Público de Salud durante la pandemia COVID-19, e incluso han aumentado en severidad de los cuadros. Las restricciones de horario y las medidas implementadas a nivel país, llevan a que los pacientes consulten en el Centro de Salud más cercano a su domicilio, es decir, Centro de Salud Familiar (CESFAM) o en los Servicios de Atención Primaria de Urgencia (SAPU). Como Cirujanos Dentistas somos parte de un equipo multidisciplinario de salud, por lo que debemos conocer la enfermedad de COVID-19, sus principales signo s, síntomas y riesgos asociados. El Cirujano Dentista es indispensable en el diagnóstico, tratamiento y derivación oportuna de enfermedades buco-maxilofaciales, las cuales pueden afectar de forma física y psicológica a los pacientes, llegando a producir complicaciones sistémicas graves si no son tratadas oportunamente. La atención odontológica actual debe incluir el manejo previo, durante y posterior al tratamiento del paciente de APS. Debemos considerar que el personal odontológico tiene un elevado riesgo de transmisión viral, debido a la cercanía con fluidos desde la cavidad oral del paciente. En este artículo se entregaran recomendaciones, basadas en la mejor evidencia disponible y la experiencia clínica actual para la atención odontológica de urgencias enfocadas en la Atención Primaria de Salud.

ABSTRACT: The disease caused by the new coronavirus, SARS-CoV-2 has become a world wide public health problem. This has lead to pospone elective clinical care, maintaining urgent and emergency care. Dental emergency maintains high demand, even more severe clinical situations, at the public health system during the pandemic COVID-19. The local restrictions implemented makes patients to consult at the closest health center, like the Family health centers (CESFAM) or at primary health urgency centers (SAPU). As dental surgeons, part of the multidisciplinary health team, it is a duty to know the COVID-19, signs, simptoms and associated risks. The dental surgeon it is essential in the diagnosis, traetment and timely referral of maxilofacial diseases, wich can affect patients physically and psychologically, even leading to serious systemic complications if not treated promptly. Dental care should have previous, during and posterior considerations in pandemic situations. Dental staff has high viral transmisión risk, due to closeness with oral cavity fluids. This article will provide evidence based recommendations and current clinical experience for dental emergency care at primary health centers.

Attitudes towards ageing of Speech-language Pathology students in a Chilean University. / Actitudes hacia el envejecimiento por parte de los estudiantes de Fonoaudiología de una Universidad Chilena.

PURPOSE: Describe the attitudes towards ageing of senior undergraduate Speech-language Pathology students in a Chilean University. METHODS: This is a cross-sectional study in which the validated Spanish version of the Kogan's Attitudes Toward Old People Scale (KAOP) was applied to 43 students in the aforementioned course. The average scores were compared for the variables gender and interaction with the elderly. RESULTS: A trend towards a positive attitude was observed. No differences were found for the variables described. An analysis was carried out with the items in which trends towards negative attitude were reported, and the implications were discussed. CONCLUSION: Although a positive attitude was reported, aspects of student academic training should be more comprehensively studied with a view to improving the quality of assistance provided to the elderly.

OBJETIVO: Describir las actitudes hacia el envejecimiento por parte de los estudiantes de último año de estudios pertenecientes a la Carrera de Fonoaudiología de una Universidad Chilena. MÉTODO: Se llevó a cabo un estudio de Corte Transversal, mediante el cual se aplicó la validación al español de la Escala de Actitudes Hacia el Envejecimiento de Kogan (KAOP) a 43 estudiantes de esta carrera. Se compararon los promedios de puntuación según variable género, y aquellas relacionadas a la interacción con adultos mayores. RESULTADOS: Hubo una tendencia hacia la actitud positiva. No se encontraron diferencias según las variables mencionadas. Se llevó a cabo un análisis de aquellos ítems donde se reportaron tendencias hacia actitud negativa, discutiendo sus implicancias. CONCLUSIÓN: Si bien hubo reporte de actitud positiva, resulta necesario continuar profundizando en aspectos de la formación académica de los estudiantes, con miras a mejorar la calidad de la atención de los adultos mayores.

Actitudes hacia el envejecimiento por parte de los estudiantes de Fonoaudiología de una Universidad Chilena / Attitudes towards ageing of Speech-language Pathology students in a Chilean University

RESUMEN Objetivo Describir las actitudes hacia el envejecimiento por parte de los estudiantes de último año de estudios pertenecientes a la Carrera de Fonoaudiología de una Universidad Chilena. Método Se llevó a cabo un estudio de Corte Transversal, mediante el cual se aplicó la validación al español de la Escala de Actitudes Hacia el Envejecimiento de Kogan (KAOP) a 43 estudiantes de esta carrera. Se compararon los promedios de puntuación según variable género, y aquellas relacionadas a la interacción con adultos mayores. Resultados Hubo una tendencia hacia la actitud positiva. No se encontraron diferencias según las variables mencionadas. Se llevó a cabo un análisis de aquellos ítems donde se reportaron tendencias hacia actitud negativa, discutiendo sus implicancias. Conclusión Si bien hubo reporte de actitud positiva, resulta necesario continuar profundizando en aspectos de la formación académica de los estudiantes, con miras a mejorar la calidad de la atención de los adultos mayores.

ABSTRACT Purpose Describe the attitudes towards ageing of senior undergraduate Speech-language Pathology students in a Chilean University. Methods This is a cross-sectional study in which the validated Spanish version of the Kogan's Attitudes Toward Old People Scale (KAOP) was applied to 43 students in the aforementioned course. The average scores were compared for the variables gender and interaction with the elderly. Results A trend towards a positive attitude was observed. No differences were found for the variables described. An analysis was carried out with the items in which trends towards negative attitude were reported, and the implications were discussed. Conclusion Although a positive attitude was reported, aspects of student academic training should be more comprehensively studied with a view to improving the quality of assistance provided to the elderly.

Estrategias profilácticas para disfagia orofaríngea en pacientes con cáncer de cabeza y cuello: revisión narrativa / Prophylactic strategies for oropharyngeal dysphagia in patients with head and neck cancer: a narrative review

El cáncer de cabeza y cuello es una patología prevalente a nivel mundial. Su abordaje consiste, en buena parte de los casos, de quimiorradioterapia, la cual, dentro de sus múltiples consecuencias, compromete la anatomía y el funcionamiento de órganos relacionadas a la deglución, generando disfagia orofaríngea. En ese sentido, el manejo fonoaudiológico predominantemente se lleva a cabo con ejercicios implementados posterior a la manifestación de la disfagia, con creciente interés sobre el manejo profiláctico del cuadro, existiendo variados estudios sobre la utilidad de ejercicios y maniobras relacionadas. En consecuencia, el objetivo de la presente revisión es presentar recursos terapéuticos basados en evidencia de calidad para el manejo proactivo de esta alteración, orientando la decisión clínica sobre su uso.

Head and neck cancer is a worldwide prevalent pathology. Its approach consists, in most cases, on chemoradiotherapy. Within its multiple consequences, compromises anatomy and functioning of structures related to swallowing, generating oropharyngeal dysphagia. In this context, Speech and Language Pathologist management is predominantly carried out with exercises implemented after the manifestation of dysphagia, existing increasing interest in prophylactic management of the condition, with several studies on the usefulness of exercises and related available maneuvers. Consequently, the objective of the present review is to present therapeutic resources based on good quality evidence for the proactive management of this alteration, guiding the clinical decision on its use.

Caracterización del uso de fuentes de información para el acceso a criterios diagnósticos por parte de fonoaudiólogas y fonoaudiólogos en Chile / Characterizing the use of information sources for accessing diagnostic criteria by speech and language therapists in Chile

En el modelo de la Práctica Basada en la Evidencia el fonoaudiólogo debe conocer los criterios diagnósticos y el nivel de evidencia de los procedimientos de intervención para ofrecer un tratamiento adecuado. En la literatura se describe un bajo grado de formación académica y un escaso uso de la Práctica Basada en la Evidencia como fuente de acceso a diagnósticos y tratamientos. Este estudio investigó las dificultades de los fonoaudiólogos para acceder a los criterios para el diagnóstico fonoaudiológico. Se realizó una encuesta masiva online a 384 fonoaudiólogos, usando un método cuantitativo, descriptivo y transeccional. Los resultados indican que, independiente de los años de ejercicio laboral, un 79,7% de los encuestados utiliza fuentes secundarias para el acceso a criterios para el diagnóstico fonoaudiológico, un 46% no conoce fuentes de información fiables para acceder a diagnósticos y un 73,4% afirma haber tenido dificultades para acceder a criterios diagnósticos. Los sujetos encuestados no utilizan fuentes primarias que les permitan acceder a criterios que apoyen los diagnósticos fonoaudiológicos. Por lo anterior, se considera relevante educar sobre Práctica Basada en la Evidencia en el contexto universitario.

In the Evidence-Based Practice model, the speech and language therapist must know the diagnostic criteria and be aware of the evidence supporting the intervention procedures, to provide an effective treatment. However, the literature describes both low levels of academic training and scarce use of evidence-based practices as a base of speech and language diagnosis and treatments. This study probes into the difficulties speech and language therapists face to access the diagnostic criteria and their bibliographic references. A massive online survey was conducted with 384 speech therapists, using a quantitative, descriptive and transectional method. Results show that 79.7% of respondents use secondary sources to access criteria on which subsequently base their speech and language diagnoses, 46% do not know reliable sources of information to access criteria for diagnoses and 73.4% maintain that they had difficulties in accessing diagnostic criteria. These difficulties do not recede with years of practice. Based on these results it is possible to conclude that surveyed therapists presented difficulty to find information on which to establish their diagnostic criteria and they do not use primary sources for access information. All of this supports training students on Evidence Based Practice when in their University programs.

Use of TEVI-R to describe passive vocabulary in children belonging to a Mapuche community. / Uso del TEVI-R para describir el vocabulario pasivo en niños de la etnia Mapuche.

PURPOSE: To describe the level of passive vocabulary in boys and girls belonging to the Mapuche ethnic group, using the Vocabulary Test in Images Revised version (TEVI-R). METHODS: A cross-sectional study was carried out. Twenty-six children, both gender, between 4 to 7 years old participated in the study. The performance of passive vocabulary was measured through the application of the TEVI-R, analyzing the variables age and gender, as well as performing an analysis of the items and the number of errors. RESULTS: The performance of these children is not influenced by gender or age. There are potential sources of error in the items of the instruments related to the cultural, geographical relevance and graphic quality of them. CONCLUSION: No association was observed by gender or differences by age in the study population. The possibility of developing new instruments or revising the available ones is discussed, given the characteristics of their native language, obtaining reliable results and respecting the elements that are part of their culture.

OBJETIVO: Describir el nivel de vocabulario pasivo en niños y niñas pertenecientes a la etnia mapuche, utilizando el Test de Vocabulario en Imágenes versión Revisada (TEVI-R). MÉTODO: Se llevó a cabo un estudio de corte transversal. Participaron 26 niños, de ambos géneros cuyas edades fluctuaron entre 4 y 7 años de edad. Se midió el desempeño de vocabulario pasivo mediante la aplicación del TEVI-R, analizando las variables edad y género, además de realizar un análisis de los ítems con mayor cantidad de errores. RESULTADOS: El rendimiento de estos niños no se ve influenciado ni por género, ni por edad. Existen potenciales fuentes de error en los ítems de los instrumentos relacionados a la pertinencia cultural, geográfica y a la calidad gráfica de los mismos. CONCLUSIÓN: No se observó asociación por género ni diferencias por edad en la población estudiada. Se discute la posibilidad de elaborar nuevos instrumentos o revisar los disponibles, dadas las características de su lengua materna, con la finalidad de recabar resultados fiables y respetar los elementos que forman parte de los marcadores propios de su cultura.

Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia / Foot mycosis: clinical and epidemiological characterization in one referal center in Bogota, Colombia

Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.

Uso del TEVI-R para describir el vocabulario pasivo en niños de la etnia Mapuche / Use of TEVI-R to describe passive vocabulary in children belonging to a Mapuche community

RESUMEN Objetivo Describir el nivel de vocabulario pasivo en niños y niñas pertenecientes a la etnia mapuche, utilizando el Test de Vocabulario en Imágenes versión Revisada (TEVI-R). Método Se llevó a cabo un estudio de corte transversal. Participaron 26 niños, de ambos géneros cuyas edades fluctuaron entre 4 y 7 años de edad. Se midió el desempeño de vocabulario pasivo mediante la aplicación del TEVI-R, analizando las variables edad y género, además de realizar un análisis de los ítems con mayor cantidad de errores. Resultados El rendimiento de estos niños no se ve influenciado ni por género, ni por edad. Existen potenciales fuentes de error en los ítems de los instrumentos relacionados a la pertinencia cultural, geográfica y a la calidad gráfica de los mismos. Conclusión No se observó asociación por género ni diferencias por edad en la población estudiada. Se discute la posibilidad de elaborar nuevos instrumentos o revisar los disponibles, dadas las características de su lengua materna, con la finalidad de recabar resultados fiables y respetar los elementos que forman parte de los marcadores propios de su cultura.

ABSTRACT Purpose To describe the level of passive vocabulary in boys and girls belonging to the Mapuche ethnic group, using the Vocabulary Test in Images Revised version (TEVI-R). Methods A cross-sectional study was carried out. Twenty-six children, both gender, between 4 to 7 years old participated in the study. The performance of passive vocabulary was measured through the application of the TEVI-R, analyzing the variables age and gender, as well as performing an analysis of the items and the number of errors. Results The performance of these children is not influenced by gender or age. There are potential sources of error in the items of the instruments related to the cultural, geographical relevance and graphic quality of them. Conclusion No association was observed by gender or differences by age in the study population. The possibility of developing new instruments or revising the available ones is discussed, given the characteristics of their native language, obtaining reliable results and respecting the elements that are part of their culture.

Elderly who refuse to use hearing aids: an analysis of the causes. / Adultos mayores que rehúsan usar audífonos: analizando las causas.

PURPOSE: The present research sought to describe the elements that interfere with the use of hearing aids in the elderly beneficiaries of a hearing aid delivery from Chile in a Family Health Center. METHODS: A descriptive, cross-sectional study was conducted with 24 beneficiary users, with application of a closed-question questionnaire prepared by the researchers. RESULTS: A 75% adherence to the use of hearing aids is reported. There was a difference of 3.8 h in the use between adherents and non-adherents and in the frequency of use. The main reasons for not using the hearing aids are discomfort due to mold and noise. CONCLUSION: It is necessary to provide quality education during the implementation process, as well as to address the technical difficulties related to atrial adjustment and calibration of the hearing aid in order to increase adherence.

OBJETIVO: Describir los elementos que interfieren en el uso de audífonos en adultos mayores beneficiarios del operativo de entrega de audífonos de un Centro de Salud en Chile. MÉTODO: Estudio descriptivo con diseño de corte transversal en 24 usuarios beneficiarios, con un cuestionario de preguntas cerradas de elaboración propia. RESULTADOS: Se reporta un 75% de adherencia al uso de audífonos. Hubo una diferencia de 3.8 horas en el uso entre adherentes y no adherentes y en la frecuencia de utilización. Los principales motivos de no uso corresponden con incomodidad por molde y ruidos del audífono. CONCLUSIÓN: Es necesario entregar educación de calidad durante el proceso de implementación, así como también abordar dificultades técnicas relacionadas al ajuste auricular y calibración del audífono, ya que esto podría aumentar la adherencia a su uso.

IP3 receptor blockade restores autophagy and mitochondrial function in skeletal muscle fibers of dystrophic mice.

Duchenne muscular dystrophy (DMD) is characterized by a severe and progressive destruction of muscle fibers associated with altered Ca2+ homeostasis. We have previously shown that the IP3 receptor (IP3R) plays a role in elevating basal cytoplasmic Ca2+ and that pharmacological blockade of IP3R restores muscle function. Moreover, we have shown that the IP3R pathway negatively regulates autophagy by controlling mitochondrial Ca2+ levels. Nevertheless, it remains unclear whether IP3R is involved in abnormal mitochondrial Ca2+ levels, mitochondrial dynamics, or autophagy and mitophagy observed in adult DMD skeletal muscle. Here, we show that the elevated basal autophagy and autophagic flux levels were normalized when IP3R was downregulated in mdx fibers. Pharmacological blockade of IP3R in mdx fibers restored both increased mitochondrial Ca2+ levels and mitochondrial membrane potential under resting conditions. Interestingly, mdx mitochondria changed from a fission to an elongated state after IP3R knockdown, and the elevated mitophagy levels in mdx fibers were normalized. To our knowledge, this is the first study associating IP3R1 activity with changes in autophagy, mitochondrial Ca2+ levels, mitochondrial membrane potential, mitochondrial dynamics, and mitophagy in adult mouse skeletal muscle. Moreover, these results suggest that increased IP3R activity in mdx fibers plays an important role in the pathophysiology of DMD. Overall, these results lead us to propose the use of specific IP3R blockers as a new pharmacological treatment for DMD, given their ability to restore both autophagy/mitophagy and mitochondrial function.

Early molecular response and microanatomical changes in the masseter muscle and mandibular head after botulinum toxin intervention in adult mice.

BACKGROUND: Masseter muscle paralysis induced by botulinum toxin type A (BoNTA) evokes subchondral bone loss in mandibular heads of adult rats and growing mice after 4 weeks. However, the primary cellular and molecular events leading to altered bone remodeling remain unexplored. Thus, the aim of the current work has been to assess the molecular response that precedes the early microanatomical changes in the masseter muscle and subchondral bone of the mandibular head in adult mice after BoNTA intervention. METHODS: A pre-clinical in vivo study was performed by a single intramuscular injection of 0.2 U BoNTA in the right masseter (experimental) of adult BALB/c mice. The contralateral masseter was injected with vehicle (control). Changes in mRNA levels of molecular markers of bone loss or muscle atrophy/regeneration were addressed by qPCR at day 2 or 7, respectively. mRNA levels of receptor activator of nuclear factor-κB ligand (RANKL) was assessed in mandibular heads, whilst mRNA levels of Atrogin-1/MAFbx, MuRF-1 and Myogenin were addressed in masseter muscles. In order to identify the early microanatomical changes at day 14, fiber diameters in transversal sections of masseter muscles were quantified, and histomorphometric analysis was used to determine the bone per tissue area and the trabecular thickness of subchondral bone of the mandibular heads. RESULTS: An increase of up to 4-fold in RANKL mRNA levels were detected in mandibular heads of the BoNTA-injected sides as early as 2 days after intervention. Moreover, a 4-6 fold increase in Atrogin-1/MAFbx and MuRF-1 and an up to 25 fold increase in Myogenin mRNA level were detected in masseter muscles 7 days after BoNTA injections. Masseter muscle mass, as well as individual muscle fiber diameter, were significantly reduced in BoNTA-injected side after 14 days post-intervention. At the same time, in the mandibular heads from the treated side, the subchondral bone loss was evinced by a significant reduction in bone per tissue area (-40%) and trabecular thickness (-55%). CONCLUSIONS: Our results show that masseter muscle paralysis induced by BoNTA leads to significant microanatomical changes by day 14, preceded by molecular changes as early as 2 days in bone, and 7 days in muscle. Therefore, masseter muscle atrophy and subchondral bone loss detected at 14 days are preceded by molecular responses that occur during the first week after BoNTA intervention.

Calidad de vida relacionada a la deglución: conceptos y aplicabilidad en salud / Swallowing-related quality of Life: concepts and applicability in health

La disfagia o trastorno de la deglución es una complicación clínica prevalente con impacto en la salud y calidad de vida de las personas, entendiéndose esta última como la percepción del individuo sobre su salud en variadas dimensiones, cuya medición permite captar impacto de la enfermedad o progresos terapéuticos. Su utilidad clínica en la valoración de la disfagia implica además captar la perspectiva de la persona en relacion a sus propias complicaciones. El objetivo del presente estudio es establecer una revisión teórica del concepto calidad de vida y sus variaciones, además de ofrecer y describir instrumentos genéricos y específicos de utilidad para la medición del constructo, especificando en los trastornos deglutorios. Para tal fin, se llevó a cabo una revisión de literatura en bases de datos para la identificación y descripción de los principales instrumentos utilizados. Se discute la utilidad clínica, en investigación y elementos a considerar para aplicar dichos instrumentos en diferentes contextos.

Dysphagia or swallowing disorder is a prevalent clinical complication, with an impact on the health and people's quality of life. The later being understood as the individual's perception of their health in various dimensions, whose measurement allows to describe the impact of the disease or therapeutic progress. Its clinical utility in the assessment of dysphagia also involves capturing the person's perspective of their own complications. The objective of this study is to establish a theoretical review of the concept of quality of life and its variations, in addition to offering and describing generic and specific instruments of utility for the measurement of the construct, specifying in swallowing disorders. For this purpose, a literature review was carried out in databases to identify and describe the main instruments used. The clinical or research utility and elements to consider in order to apply those instruments in different contexts are discussed.