Browsing by Author "González, Francisca"
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Item Creencias frente a la utilización de métodos anticonceptivos reversibles de larga duración (LARCS) en mujeres entre 18 y 25 años, usuarias del CESFAM Gabriela Mistral, entre agosto y noviembre del año 2019(Universidad del Desarrollo. Facultad de Medicina. Escuela de Enfermería, 2019) Carrasco, Daniela; González, Francisca; Martini, Javiera; Otaíza, Macarena; Rivera, Marcela; Carrasco, Daniela; González, Francisca; Martini, Javiera; Otaíza, Macarena; Rivera, Marcela; Riquelme, Giselle; Riquelme, GiselleExisten creencias que generan un entorno restrictivo para la utilización de anticonceptivos de larga duración (LARCs), provocando su no uso, pese a ser los más eficaces. El objetivo general es describir las creencias frente a la utilización de LARCs en mujeres entre 18 y 25 años, usuarias del CESFAM Gabriela Mistral, de agosto a noviembre del año 2019. El estudio es cualitativo colectivo y la muestra fue dirigida y por conveniencia. Se realizó entrevistas, las que se analizaron de forma temática descriptiva. Pese a la alta efectividad y beneficios reconocidos por las participantes; existen barreras de falta de conocimiento, experiencias de terceros y mitos; los que generan inseguridad y llevan al no uso de LARCs. Los hallazgos coinciden con la evidencia, entrevistadas destacan eficacia de los LARCs; literatura muestra que proporcionan bajas tasa de embarazo y mujeres los prefieren por la poca manipulación usuaria. Sin embargo, experiencias negativas, falta de conocimiento y los mitos generan malentendidos que llevan al no uso. Entrevistadas destacan que a falta de conocimiento y mitos, son una barrera para el uso de LARCs. La enfermera desempeña un rol en la promoción y prevención, puede realizar derivaciones a expertos.Item Head Position in the Early Phase of Acute Ischemic Stroke: An International Survey of Current Practice(National Stroke Association. Published by Elsevier Inc., 2015) Muñoz, Paula; Olavarría, Verónica; González, Francisca; Brunser, Alejandro; Lavados, Pablo; Arima, Hisatomi; Anderson, CraigBACKGROUND: Evidence to recommend a specific head position for patients in the early phase of acute ischemic stroke (AIS) is scarce. The aim of this study was to assess current head position practice for AIS patients among physicians from hospitals in different countries. METHODS: A cross-sectional survey research design was used; physicians who are part of a stroke research network were invited to participate by e-mail. Descriptive statistics were used. RESULTS: An invitation to participate was delivered to 298 doctors from 16 countries and 42.9% completed all survey questions. Participant responses were evenly divided in sitting up and lying flat position as the most usual at their hospital: 52.8% (95% confidence interval [CI], 43.7-61.0) of respondents preferred sitting up, whereas 47.2% (95% CI, 38.2-55.5) preferred lying flat; 53.9% (95% CI, 45.3-62.5) of participants answered that no written protocol specifying the indicated head position for stroke patients was available at their hospital or department, and 71% (95% CI, 63.2-78.9) recognized being uncertain about the best position for AIS patients. CONCLUSIONS: Common practice differs between physicians, and there is a lack of consensus about the best strategy regarding head position for AIS patients in many countries. An opportunity exists for a randomized trial to resolve this uncertainty and develop evidence-based consensus protocols to improve patient management and outcomes.Publication Recommendations for Implementing the INTERACT3 CareBundle for Intracerebral Hemorrhagein Latin America: Results of a Delphi Method(2024) Allende, María Ignacia; Munoz Venturelli, Paula; González, Francisca; Bascur, Francisca; Craig S., Anderson; Ouyang, Menglu; Cabieses, Báltica; Obach, Alexandra; Cano-Nigenda, Vanessa; Arauz, Antonio; LATAM INTERACT3 Consensus Statement PanelIntroduction: The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT3) showed that the implementation of a care bundle improves outcomes after acute intracerebral hemorrhage (ICH). We aimed to establish consensus-based recommendations for the broader integration of the care bundle across Latin American countries (LAC). Methods: A 3-phase Delphi study allowed a panel of 32 healthcare workers from 14 LAC to sequentially rank statements relevant to 7 domains (training, resources/infrastructure, patient education, blood pressure, temperature, glycemic control, and anticoagulation reversal). The pre-defined consensus threshold was 75%. Results: A total of 43 statements reached consensus by the third round, with 12 new statements emerging through rounds. The highest-ranked statements in each domain emphasized critical aspects, but successful implementation requires appropriate resourcing. Key priorities were continuous training of all healthcare workers in ICH management, establishing protocols aligned with available resources, and collaborative interdisciplinary care supported by institutional networks. Statements related to anticoagulation reversal had the highest priority. Conclusions: Consensus statements are provided to facilitate integration of the INTERACT3 care bundle to reduce disparities in ICH outcomes in LAC.Item Reliability of hand-held transcranial doppler with M-mode ultrasound in middle cerebral artery measurement(Elsevier, 2017) Muñoz, Paula; Gaete, Javier; Illanes, Sergio; López, Javiera; Olavarría, Verónica; Reccius, Andrés; Brinck, Pablo; González, Francisca; Cavada, Gabriel; Lavados, Pablo; Brunser, AlejandroPurpose: To determine the intra- and interrater agreement of mean flow velocity (MFV) and pulsatility index (PI) measurement in middle cerebral arteries, assessed by transcranial Doppler (TCD) with M-mode. Methods: Masked experienced neurosonologists performed TCD with M-mode using handheld probe in healthy adult volunteers. The Bland–Altman method for concordance and intraclass correlation coefficient were used. Results: Seventy-seven healthy volunteers and seven raters participated (3 on regular TCD shift and 4 off-shift). The intrarater absolute mean difference between measurements was 5.5 cm/s [95% confidence interval (CI), 4.7–6.3] for MVF and 0.073 (95% CI, 0.063–0.083) for PI. The difference between MFV measurements was significantly higher in off-shift raters (p = 0.015). The interrater absolute mean difference between measurements was 6.5 cm/s (95% CI, 5.5–7.5) for MVF and 0.065 (95% CI, 0.059–0.071) for PI. No influence was found for the middle cerebral artery side, volunteer's sex, or age, and there was no significant difference between raters. The intraclass correlation coefficient was 82.2% (95% CI 77.8–85.6) and 72.9% (95% CI 67.4–77.6) for MFV and PI, respectively. Conclusions: There exists good intra- and interrater agreement in MFV and PI measurements using M-mode TCD. These results support the use of this noninvasive tool and are important for clinical and investigational purposes.Item Stroke care and collaborative academic research in Latin America(2022) Muñoz, Paula; González, Francisca; Urrutia, Francisca; Mazzon, Enrico; Navia, Víctor; Brunser, Alejandro; Lavados, Pablo; Olavarría, Verónica; Almeida, Juan; Guerrero, Rodrigo; Rojo, Alexis; Gigoux, Juan; Vallejos, José; Conejan, Nathalie; Esparza, Tomas; Escobar, Arturo; Soto, Álvaro; Pontes, Octavio; Arauz, Antonio; Abanto, Carlos; Carce, Cheryl; Zafra, Jessica; Liu, Hueiming; Song, Lili; Miranda, Jaime; Anderson, CraigObjective: A narrative overview of regional academic research collaborations to address the increasing burden and gaps in care for patients at risk of, and who suffer from, stroke in Latin America (LA). Materials and methods: A summary of experiences and knowledge of the local situation is presented. No systematic literature review was performed. Results: The rapidly increasing burden of stroke poses immense challenges in LA, where prevention and manage-ment strategies are highly uneven and inadequate. Clinical research is increasing through various academic consortia and networks formed to overcome structural, funding and skill barriers. However, strengthening the ability to generate, analyze and interpret randomized evidence is central to further develop effective therapies and healthcare systems in LA. Conclusions: Regional networks foster the conduct of multicenter studies -particularly randomized controlled trials-, even in resource-poor regions. They also contribute to the external validity of international studies and strengthen systems of care, clinical skills, critical thinking, and international knowledge exchange.Publication Stroke in Latin America: Systematic review of incidence, prevalence, and case-fatality in 1997–2021(2022) Delfino, Carlos; Nuñez, Marilaura; Asenjo, Claudia; González, Francisca; Riviotta, Amy; Urrutia, Francisca; Lavados, Pablo; Anderson, Craig; Muñoz Venturelli, PaulaBackground: Stroke is a major global cause of death and disability. Most strokes occur in populations of low-middle-income country (LMIC); therefore, the subsequent disease burden is greater than in populations of high-income countries. Few epidemiological data exist for stroke in Latin America, composed primarily of LMIC. Aims: To determine epidemiological measures of incidence, prevalence, and 1-month case-fatality for stroke in Latin America/Caribbean (LAC) during 1997-2021. Summary of review: A structured search was conducted to identify relevant references from MEDLINE, WOS, and LILACS databases for prospective observational and cross-sectional studies in LAC populations from January 1997 to December 2021. A total of 9242 records were screened and 12 selected for analysis, seven incidence studies and five prevalence studies. Case-fatality was reported in six articles. Sub-group analysis by age, sex, and income countries was performed. A narrative synthesis of the findings was performed. Meta-analysis was performed using random-effect model to obtain pooled estimates with 95% confidence intervals (CIs). Studies quality was assessed according to the risk of bias criteria described in the Joanna Briggs Institute's guide. The overall crude annual incidence rate of first-ever stroke in LAC was 119.0 (95% CI = 95.9-142.1)/100,000 people (with high heterogeneity between studies (I2 = 98.1%)). The overall crude prevalence was 3060 (95% CI: 95.9-142.1)/100,000 people (with high heterogeneity between studies (I2 = 98.8%)). The overall case-fatality at 1 month after the first stroke was 21.1% (95% CI = 18.6-23.7) (I2 = 49.40%). Conclusion: This review contributes to our understanding regarding the burden caused by stroke in LAC. More studies with comparable designs are needed to generate reliable data and should include both standardized criteria, such as the World Health Organization clinical criteria and updated standard methods of case assurance, data collection, and reporting.