[Diagnostic capacity of neck circumference to evaluate obesity in a young adult population. Data analysis from the second national health survey in Chile, 2009-2010]. / Capacidad diagnóstica de la circunferencia de cuello para evaluar la obesidad en la población adulta joven. Análisis de datos de la segunda Encuesta Nacional de Salud 2009-2010. Chile.

Introduction: Introduction: Chile is among the countries with the highest rate of excess malnutrition, for that reason it is important to have effective tools to evaluate the nutritional status; interest in neck circumference (NC) measurement as a potential prognostic tool that is easy to access and low-cost has increased. Objective: to evaluate the diagnostic capacity of neck circumference to predict obesity in the population aged 15-16 years, using data from the third National Health Survey 2009-2010. Materials and methods: Concurrent Criteria of Diagnostic Validation were used for the study. The sample consisted of 536 people of ages from 15 to 26 years, where BMI data where taken in order to classify obesity versus normality (gold standard), as was NC (measured in centimeters). People with hyperthyroidism were excluded. Indicators of diagnostic accuracy were obtained; the SPSS, version 25 was used for calculations. Results: according to age and gender ranks, the NC cut-off points to classify general obesity showed sensitivities and specificities above 0.85, with an area under the curve over 0.90, all with p < 0.001. Conclusion: there is evidence that supports that NC cutoff points are a suitable tool for diagnosing obesity in this age group.

Introducción: Introducción: Chile está dentro de los países con mayor tasa de malnutrición por exceso, lo que obliga a disponer de herramientas eficaces para evaluar el estado nutricional; así surge nuestro interés por explorar la posibilidad de utilizar la medición de la circunferencia del cuello (CCUE) como herramienta potencial de diagnóstico de fácil obtención y acceso, y bajo costo. Objetivo: evaluar la capacidad diagnóstica de la circunferencia del cuello como predictor de obesidad en la población de 15-26 años de edad. Materiales y métodos: dado que se encuentran disponibles, y son adecuados para nuestra investigación, se utilizarán datos extraídos de la Tercera Encuesta Nacional de Salud 2009-2010. Nuestro estudio se realizó aplicando el Método de Validación Diagnóstica por Criterio Concurrente. La muestra estuvo compuesta por 536 personas cuyas edades fluctuaban entre los 15 y 26 años, de quienes se tomaron los datos de IMC, para clasificarlas en las categorías de obesidad o normalidad (patrón oro), y la CCUE (en centímetros). Se excluyeron las personas con hipertiroidismo. Se obtuvieron indicadores de exactitud diagnóstica y valores predictivos. Se aplicó el SPSS, versión 25. Resultados: según los rangos de edad y el sexo, los puntos de corte de la CCUE para clasificar la obesidad general presentaron sensibilidades y especificidades superiores a 0,85 con una área bajo la curva superior a 0,90, todos con p < 0,001. Conclusión: existe evidencia a favor de que los puntos de corte de la CCUE presentan una adecuada capacidad de diagnosticar la obesidad en este grupo etario.

A Method to Estimate the Efficacy vs. Effectiveness in Meta-Analysis of Clinical Trials with Different Adherence Scenarios: A Monte Carlo Simulation Study in Nutrition.

Randomized clinical trials (RCTs) evaluating the effectiveness of interventions to promote fruit and vegetable (FV) consumption usually report intention-to-treat (ITT) analysis as the main outcome. These analyses compare the randomly assigned groups and accept that some individuals may not follow the recommendations received in their group. The ITT analysis is useful to quantify the global effect of promoting the consumption of FV in a population (effectiveness) but, if non-adherence is significant in the RCT, they cannot estimate the specific effect in the individuals that increased their FV consumption (efficacy). To calculate the efficacy of FV consumption, a per protocol analysis (PP) would have to be carried out, in which groups of individuals are compared according to their actual adherence to FV consumption, regardless of the group to which they were assigned; unfortunately, many RCTs do not report the PP analysis. The objective of this article is to apply a new method to estimate the efficacy of Meta-analysis (MA) PP which include RCTs of effectiveness by ITT, without estimates of adherence. The method is based on generating Monte Carlo simulations of percentages of adherence in each allocation group from prior distributions informed by expert knowledge. We illustrate the method reanalyzing a Cochrane Systematic Review (SR) of RCTs on increased FV consumption reported with ITT, simulating 1000 times the estimation of a PP meta-analyses, and obtaining means and ranges of the potential PP effects. In some cases, the range of estimated PP effects was clearly more favourable than the effect calculated with the original ITT assumption, and therefore this corrected analysis must be considered when estimating the true effect of the consumption of a certain food.

Effect of a Ketogenic Diet on the Nutritional Parameters of Obese Patients: A Systematic Review and Meta-Analysis.

The effect of a ketogenic diet (KD) on biochemical parameters and nutritional status has been the subject of debate over the years, as several randomized clinical trials (RCTs) obtained different results. METHOD: A systematic review and random-effects meta-analysis of RCTs comparing KD with a balanced diet was performed by means of a search of PubMed, Cochrane Library, Scopus, and Web of Science. Trials where the method for measuring the response variables was unclear, those that considered pathologies other than chronic non-communicable diseases and those with participants receiving pharmacological treatment for obesity were excluded from the comparison. RESULTS: Of the studies included in the meta-analysis, no statistically significant standardized mean differences were observed for body mass index (BMI) (d = -0.457, p = 0.359), total cholesterol, COL-T (d = 0.230, p = 0.591), high-density lipoprotein, HDL (d = -0.028, p = 0.934), low-density lipoprotein, LDL (d = 0.528, p = 0.173), or triglycerides, TG (d = -0.283, p = 0.222), with high values of heterogeneity. The percentage of women included in the studies is a significant moderating variable in terms of BMI ratio (z = -6.68, p < 0.001) and TG (z = -2.27, p = 0.023). CONCLUSION: A KD shows no more benefits on nutritional parameters than a balanced diet, and adverse effects of being on the diet are sometimes reported.

Transcultural adaptation of the Karen Personal instrument to measure the nurses' perception of healthcare quality in hospitals. / Adaptación transcultural del instrumento Karen Personal para medir la percepción de la calidad del cuidado en enfermeras de hospital.

OBJECTIVE: To adapt cross-culturally and validate the Karen Personal scale to measure the perception of the quality of care of hospital nurses of the public health care network in Chile. METHOD: For the transcultural adaptation to Spanish of the scale, the inverse method was applied with translation-back translation and the judgment of 41 nursing professionals from a medium complexity public hospital. Then in a sample of 290 nurses from three high complexity public hospitals, exploratory factor analysis (varimax rotation) and confirmatory (maximum likelihood) and structural equations were applied. The programmes Stata 13.0 and R 3.2.2 were used. RESULTS: A linguistically adapted version of the instrument was obtained and presented a factorial solution of four factors that together explain 63.8% of the variance, and the scale presented a good fit according to the indicators used: CFI (.961); TLI (.950); RMSEA (.65); SRMR (.67). CONCLUSIONS: The abbreviated version proposed in this study was adapted cross-culturally and shows adequate metrics and factorial analysis, it is necessary to continue evaluating its clinimetric properties in future studies.

Huella psicosocial del COVID-19 en enfermeras de 4 países de Latinoamérica, año 2021-2022: aprendizajes y desafíos / Psychosocial footprint of COVID-19 in nurses from 4 South American countries, year 2021-2022: learning and challenges / Pegada psicossocial da COVID-19 em enfermeiros de 4 países da América do Sul, ano 2021-2022: aprendizado e desafios

Objetivo: determinar la huella psicosocial de la pandemia por COVID-19 en enfermeras de 4 países de Sudamérica, año 2021-2022. Métodos: estudio de corte transversal, en una muestra de 279 enfermeras: colombianas (86), paraguayas (68), mexicanas (54) y chilenas (71), que cumplieron los criterios de inclusión.Se aplicaron las escalas de Duke-UNC para evaluar apoyo social recibido y confidencial; El cuestionario Medical Outcomes Study-Social Support Survey (MOS) para evaluar apoyo social y el cuestionario de variables de interacción psicosocial (VIP) Resultados: tanto el buen apoyo confidencial como afectivo, se asoció con las variables de vivir con dos o más personas, ser perteneciente a una religión, y trabajar en una unidad con pacientes. El consumo de medicamentos fue significativamente menor en el grupo con buen apoyo confidencial y afectivo, (p=0.012) Conclusiones:la ejecución del rol profesional de la enfermera es conocido como de alta calidad, y con una destacada responsabilidad, especialmente en pandemia por SAR COVID 19. Sin embargo, se aprecian huellas residuales físicas y emocionales en los profesionales de enfermería.

Objective: to determine the psychosocial footprint of the COVID-19 pandemic in nurses from 4 South American countries, 2021-2022. Methods: cross-sectional study, in a sample of 279 nurses: Colombian (86), Paraguayan (68), Mexican (54) and Chilean (71), who met the inclusion criteria. Duke-UNC scales were applied to assess received and confidential social support; The Medical Outcomes Study-Social Support Survey (MOS) questionnaire to assess social support and the psychosocial interaction variables (VIP) questionnaire. Results: both good confidential and affective support were associated with the variables of living with two or more people, belonging to a religion, and working in a unit with patients. Medication consumption was significantly lower in the group with good confidential and affective support, (p=0.012). Conclusions: the execution of the professional role of the nurse is known to be of high quality, and with outstanding responsibility, especially in the SAR pandemic. COVID 19. However, residual physical and emotional traces can be seen in nursing professionals.

Objetivo determinar a pegada psicossocial da pandemia de COVID-19 em enfermeiros de 4 países da América do Sul, 2021-2022. Métodos: estudo transversal, em uma amostra de 279 enfermeiras: colombianas (86), paraguaias (68), mexicanas (54) e chilenas (71), que atenderam aos critérios de inclusão. As escalas de Duke-UNC foram aplicadas para avaliar o suporte social recebido e confidencial; o questionário Medical Outcomes Study-Social Support Survey (MOS) para avaliar o apoio social e o questionário de variáveis de interação psicossocial (VIP). Resultados: tanto o bom apoio confidencial quanto o afetivo estiveram associados às variáveis morar com duas ou mais pessoas, pertencer a uma religião e trabalhar em unidade com pacientes. O consumo de medicamentos foi significativamente menor no grupo com bom apoio confidencial e afetivo, (p=0,012). Conclusões: sabe-se que o desempenho da função profissional do enfermeiro é de alta qualidade, e com destacada responsabilidade, principalmente na pandemia SAR COVID 19. No entanto, traços residuais físicos e emocionais podem ser observados nos profissionais de enfermagem.

Efecto de la cirugía bariátrica sobre calidad de vida en obesos: Una revisión sistemática global / Effect of bariatric surgery on quality of life in obese patients: A global systematic review

RESUMEN En situación de obesidad y cuando no se logra cumplir las metas del tratamiento, la cirugía bariátrica puede ser una alternativa prometedora, con efectos, a nivel físico y en el plano psicológico de la calidad de vida (CV). Este estudio tuvo como objetivo determinar el efecto de la cirugía bariátrica sobre la CV en hombres y mujeres obesas entre 20 y 60 años. Se realizó una revisión sistemática (RS) con metanálisis de RS aleatorizadas, que comparan la CV en los pacientes poscirugía bariátrica. Fueron consultadas las bases de datos electrónicas Ebsco, Scopus, Pubmed y Cochrane Library. Las variables de respuesta fueron las dimensiones función física, social, mental y emocional de la CV. Se sometieron a metanálisis con R 4.2.2. Se incluyeron tres RS, de las cuales se combinaron 25 ensayos clínicos con 3-6 y 12 meses de seguimiento poscirugía bariátrica. Se encontraron cambios estadísticamente significativos de los puntajes en función física (1,20; IC 95%: 0,80-1,61), social (0,95; IC 95%: 0,66-1,25), mental (0,35; IC 95%: -0,21- +0,90) y emocional (0,54; IC 95%: 0,03-1,06). Los ámbitos de la CV mejoran poscirugía bariátrica en pacientes obesos.

ABSTRACT In a situation of obesity and when treatment goals are not met, bariatric surgery can be a promising alternative; with effects at the physical level as well as at the psychological level of the quality of life. This study aims to determine the effect of bariatric surgery on the quality of life in obese men and women between 20 and 60 years of age. A systematic review (SR) was carried out with meta-analysis of randomized systematic reviews, which compare the quality of life in patients after bariatric surgery. Electronic databases were consulted: Ebsco, Scopus, Pubmed and Cochrane Library. The response variables were: physical, social, mental and emotional function. They were submitted to meta-analysis, with R 4.2.2. Three SR were included, of which 25 clinical trials were combined with 3-6 and 12-month follow-up after bariatric surgery, finding statistically significant changes in physical function scores (1.20; 95% CI: 0.80-1 .61), social (0.95; 95% CI: 0.66-1.25), mental (0.35; 95% CI: -0.21- +0.90) and emotional (0.54; 95% CI: 0.03-1.06). The surroundings of the quality of life improve post bariatric surgery in obese patients.

Conductas alimentarias de riesgo en jóvenes adultos de dos comunas de la región de Ñuble en Chile durante pandemia Covid-19

Objetivo: Analizar las conductas alimentarias de riesgo, en relación al estado nutricional y actividad física en jóvenes adultos durante la pandemia COVID-19 en las comunas de Chillán y Chillán Viejo. Método: Diseño observacional y transversal. Se obtuvo una muestra de 184 adultos jóvenes de ambos sexos, que residían en dos comunas de la región de Ñuble (Chile) durante el periodo de confinamiento por la pandemia COVID-19. Se les aplicó un cuestionario de antecedentes personales y la escala SCOFF que evalúa el riesgo de trastornos de la conducta alimentaria (TCA). Resultados: Se encontró un 37,16% de riesgo para TCA (IC 95%: 30,23 - 44,63%). El riesgo de trastornos de la conducta alimentaria tuvo relación con las variables: actividad física (p = 0,01 análisis bivariante) y estado nutricional (p = 0,03, análisis ajustado). Conclusión: Se logró identificar una proporción superior a la registrada en la literatura y los factores asociados a TCA eran los que se esperaban encontrar.

Objective: To analyze risky eating behaviors in relation to nutritional status and physical activity in young adults during the COVID-19 pandemic in the communes of Chillán and Chillán Viejo. Methods: Observational and cross-sectional design. A sample of 184 young adults of both sexes, who lived in two communes in the Ñuble region (Chile) during the period of confinement due to COVID-19 pandemic, was obtained. A personal history questionnaire and the SCOFF scale that assesses the risk of eating behavior disorders (EDs) were applied. Results: A 37.16% risk for ED was found (95% CI: 30.23 - 44.63%). The risk of eating behavior disorders was related to the variables: physical activity (p=0.01 bivariate analysis) and nutritional status (p=0.03, adjusted analysis). Conclusion: It was possible to identify a higher proportion than that recorded in the literature and the factors associated with eating disorders were those that were expected to be found.

Efectividad del ayuno intermitente en dos protocolos sobre perfil lipídico, composición corporal y presión arterial en adultos. Una revisión sistemática

El ayuno intermitente se ha popularizado como una estrategia alternativa para el control de peso y disminución de algunos parámetros bioquímicos. El propósito de esta revisión sistemática fue evaluar la efectividad del ayuno intermitente en dos protocolos: ayuno en días intermitentes (ADA) y ayuno restringido en el tiempo (ART), sobre el perfil lipídico, composición corporal y presión arterial en adultos. Método: Revisión sistemática basada en ensayos controlados aleatorios consultados en las bases de datos: Web of Science, Scopus, Cochrane Library, Clinical Trials, Proquest y PubMed. Se estudió a adultos mayores de 18 años con cualquier estado nutricional. La intervención correspondió a ayuno intermitente de al menos 16 horas. Se evaluaron riesgos de sesgos según la colaboración de Cochrane. Resultados: Se analizaron seis ensayos clínicos, encontrándose que el protocolo ADA, presente en cuatro de ellos, generó cambios en las variables: triglicéridos, c-HDL, c-LDL, colesterol total, peso, masa magra, masa grasa y presión arterial sistólica, mientras que el protocolo ART, presente en los dos restantes, provocó cambios en las variables: peso, masa grasa, masa magra, triglicéridos, colesterol total, c-LDL, c-HDL y glicemia. Conclusión: La evidencia disponible con ensayos clínicos nos permite sugerir que los protocolos ADA y ART pueden ser una dieta alternativa para adultos. Sin embargo, el ajuste calórico y una adecuada educación sobre estilos de vida saludable muestran resultados similares. Sin perjuicio a esto, el AI puede ser una alternativa para aquellos a quienes les es difícil seguir un patrón dietético con restricción calórica diaria.

Intermittent fasting has become popular as an alternative strategy for weight control and the reduction of some biochemical parameters. The purpose of this systematic review (SR) was to evaluate the effectiveness of intermittent fasting in two protocols: intermittent days fasting (ADA) and time-restricted fasting (ART), on lipid profile, body composition and blood pressure among adults. Methods: SR based on randomized controlled trials consulted in the following databases: Web of Science, Scopus, Library Cochrane, Clinical Trials, Proquest and PubMed. Adults over 18 years of age with any nutritional status were studied. The intervention corresponded to intermittent fasting of at least 16 hours. Risk of bias were assessed according to the Cochrane collaboration. Results: Six clinical trials were analyzed, finding that the ADA protocol, present in four of them, generated changes in the variables: triglycerides, c-HDL, c-LDL, total cholesterol, weight, lean mass, fat mass and systolic blood pressure, while the ART protocol, present in the remaining two, caused changes in the variables: weight, fat mass, lean mass, triglycerides, total cholesterol, c-LDL, c-HDL and glycemia. Conclusion: The available evidence with clinical trials allows us to suggest that the ADA and ART protocols can be an alternative diet for adults. However, caloric adjustment and adequate education on healthy lifestyles show similar results. Notwithstanding this, intermittent fasting may be an alternative for those who find it difficult to follow a dietary pattern with daily caloric restriction.

Validación de la encuesta de calidad y satisfacción de simulación clínica en estudiantes de enfermería / Validation of quality and satisfaction survey of clinical simulation in nursing students

RESUMEN La simulación clínica de alta fidelidad es considerada una metodología fundamental para la formación del estudiante. Una forma de evaluar la efectividad de esta metodología es por medio de la satisfacción de los estu diantes. Objetivo. Validar los constructos de la versión española de la escala "Encuesta de calidad y satisfacción de simulación clínica" de Durá Ros. Material y Método: Estudio transversal. La muestra fue de 216 estudiantes de 3° a 5° año de la carrera de Enfermería de la Universidad del Bío-Bío, Chillán-Chile. Se aplicó análisis de componentes principales con rotación Varimax. La consistencia interna se evaluó con a-Cronbach. Resulta dos: De los 216 estudiantes, el 37% cursaban el 3° año, el 36,6% 4° año y el 26,4% el 5° año de la carrera. El 87,5% ha obtenido una calificación promedio acumulada de 5,0-5,99 (escala de 1-7). Se obtuvo un coeficiente KMO=0,887, y la prueba de esfericidad de Bartlett fue estadísticamente significativa (x2=1014,977; 105 gl; p < 0,001), el análisis de componentes principales (ACP) resultó en tres componentes que visualizan los conceptos: aprendizaje significativo, estructura de la simulación clínica y relación interpersonal con la simulación clínica, los que en conjunto lograron explicar un 51,277% de la varianza total. El coeficiente alfa de Cronbach para los componentes fue a=0,865; 0,467 y 0,550 respectivamente. Conclusión. Emergieron tres componentes que caracterizan la satisfacción de los estudiantes con respecto a la simulación clínica. Se sugiere continuar con el trabajo exploratorio, hasta llegar a un análisis factorial confirmatorio que permita evaluar la bondad de ajuste del modelo con que se valida la escala.

ABSTRACT High-fidelity clinical simulations are considered a fundamental method of training for nursery students. One way of assessing the effectiveness of this method is through student's satisfaction. Objective: To validate the con structs of the Spanish version of the scale presented in "Survey of Quality and Satisfaction of clinical simulation" by Durá Ros. Method: A cross-sectional study was used, with a sample consisting of 216 undergraduate nursing students from third to fifth year from the University of Bío-Bío, in Chillán, Chile. A Principal Components Analysis (PCA) with Varimax rotation was used. Internal consistency was evaluated with a-Cronbach. Results: Of the 216 students, 37% were in the third year of the program, 36.6% in the fourth year and 26.4% in the fifth year. Using a grading scale of 1 to 7, 87.5% of students averaged grades between 5.0 and 5.99. A KMO=0.887 coefficient was obtained, and the Bartlett's sphericity test was statistically significant (/2=1014,977; 105 gl; p < 0.001). The Principal Components Analysis (PCA) resulted in three components: significant learning, structure of the clinical simulation and interpersonal relationship with the clinical simulation. Together, these compo nents managed to explain 51.227% of the total variance, with a values being 0.865, 0.467 and 0.550 respective ly. Conclusion: Three components emerged from the analysis, which help characterize student's satisfaction regarding clinical simulation. Exploratory work is suggested until a confirmatory factor analysis is reached to evaluate the goodness of fit of the model.