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Browsing by Author "Leppe, Jaime"

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Actividad física y conducta sedentaria de los trabajadores en Chile, según la encuesta nacional de salud de Chile 2016 - 2017
(Universidad del Desarrollo. Facultad de MedicinaL, 2020) Leppe Zamora, Marco; Leppe, Jaime
Introducción: La Encuesta Nacional de Salud tiene como objetivo medir los diferentes factores de riesgo, condiciones de salud y enfermedad que presenta la población chilena. La actividad física y la conducta sedentaria no han sido reportados según la ocupación de la población trabajadora. Objetivo: Determinar el nivel de actividad física y conducta sedentaria de la población trabajadora, según la Encuesta Nacional de Salud 2016-2017. Método: Análisis secundario de la encuesta 2016-2017. Se definió como población trabajadora aquellos sujetos que reportaron trabajar por ingresos los útimos 12 meses. Se agrupó en 28 subgrupos principales ocupacionales de acuerdo a la Clasificación Internacional Uniforme de Ocupaciones de la Organización Internacional del Trabajo. La actividad física y conducta sedentaria se obtuvo del Cuestionario Global de Actividad Física reportado en la Encuesta y se utilizó el criterio OMS para clasificar a los sujetos como suficientemente activos o insuficientemente activos. Para la conducta sedentaria se estableció como punto de corte ≥ a 4 horas/día. La actividad física y conducta sedentaria, se presentan en mediana y rango intercuartílico, las comparaciones según sexo para la variable tiempo se utilizó el test de wilcoxon, y para la comparación por subgrupos principales ocupacionales se utilizó el test de Kruskal Wallis. Para las comparaciones de variables dicotómicas se utilizó la prueba de pearson chi2. Resultados: De 1903 sujetos analizados, 49,9% son mujeres y 87,9% de zona urbana. El 71,1% de los trabajadores son suficientemente activos y el 25,6% tiene una conducta sedentaria ≥ a 4 horas/día. El tiempo de actividad física y conducta sedentaria en P50 (P25-P75) fue: Total de actividad física P50=102,8 (20-334,2) min/día, Traslado P50=17,8 (0-60) min/día, Trabajo P50=0 (0-240) min/día y Tiempo Libre P50=0 (0-12,8) min/día. Tiempo Conducta Sedentaria P50=120 (60- 300) min/día. Ocupaciones clasificadas en “otros profesionales científicos e intelectuales” reportan la menor actividad física y la mayor conducta sedentaria. Por el otro lado, se encuentran las ocupaciones asociadas al rol agropecuarios, industrias extractivas y de la construcción. Conclusión: Según el autoreporte, los trabajadores en Chile cumplirían en un alto porcentaje los criterios de suficiente actividad física y baja conducta sedentaria. La actividad física en el tiempo libre es el dominio más bajo a mejorar. Ocupaciones asociadas a trabajos intelectuales y en posición sentado son los grupos de intervención prioritarios para mejorar este comportamiento de estilo de vida saludable.
Actividad Física y Tabaquismo
(Sociedad Chilena de Enfermedades Respiratorias, 2017) Leppe, Jaime; Benitez, Angel; Campos, Alex; Villaroel, Raul
The Chilean National Health Survey 2009-10, evidences that 88.6% of the general population does not engage in sports or physical activity in their free time, and this behavior increases with age, low educational levels, and in women. According to evidence, using physical activity for smoking cessation has a weak. However, there is strong evidence that physical activity reduces withdrawal symptoms, craving, and weight gain during smoking cessation. Adults aged 18-64 need to spend at least 150 minutes a week on moderate intensity aerobic physical activity or 75 minutes of vigorous aerobic physical activity each week or an equivalent combination of moderate and vigorous activities to protect thenrselves against mortality from diverse causes.
Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS
(2021) González, Felipe; Pinto, Juan José; Aranis, Nadine; Leppe, Jaime
Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events (AEs) related to prone positioning in ARDS and, secondarily, to collect strategies and recommendations to mitigate these AEs. Methods: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from 6 relevant electronic databases and the websites of intensive care societies. Results: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 subjects and 994 prone maneuvers). We identified > 40 individual AEs, and the highest-pooled occurrence rates were those of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilation-associated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning included alternate face rotation (18 [43.9%]), repositioning every 2 h (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprised one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). Conclusions: We identified > 40 AEs reported in prone positioning ARDS studies, including additional AEs not yet reported by previous systematic reviews. The pooled AE proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate AEs could promote future consensus-based recommendations.
Adverse Events of Prone Positioning in Mechanically Ventilated AdultsWith ARDS
(2021) González, Felipe; Pinto, Juan José; Aranis, Nadine; Leppe, Jaime
Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events (AEs) related to prone positioning in ARDS and, secondarily, to collect strategies and recommendations to mitigate these AEs. Methods: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from 6 relevant electronic databases and the websites of intensive care societies. Results: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 subjects and 994 prone maneuvers). We identified > 40 individual AEs, and the highest-pooled occurrence rates were those of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilation-associated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning included alternate face rotation (18 [43.9%]), repositioning every 2 h (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprised one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). Conclusions: We identified > 40 AEs reported in prone positioning ARDS studies, including additional AEs not yet reported by previous systematic reviews. The pooled AE proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate AEs could promote future consensus-based recommendations.
Assistive Devices for Older Adults: A Longitudinal Study of Policy Effectiveness, Santiago, Chile, 2014–2016
(2019) Hirmas, Macarena; Olea, Andrea; Matute, Isabel; Delgado, Iris; Aguilera, Ximena; Poffald, Lucy; González, Claudia; Nájera, Manuel; Gómez, María Inés; Gallardo, Ligia; Abusleme, María Teresa; Leppe, Jaime; Mery, Hernán; Recabarren, Eladio; Massad, Cristián; Bustamante, Hernán
INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of five persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this figure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mobility or difficulty performing activities of daily living. To date, there have been no assessments of the program's effectiveness. OBJECTIVE Assess the effectiveness of an assistive devices policy in Chile on improving functional capacity of older adults aged ≥65 years, and beneficiaries' perceptions of the services received, including changes in their quality of life. METHODS This was a before-after longitudinal study. A cohort of 309 persons was recruited, consisting of patients who received care at a public hospital in Santiago, Chile during 2014-2015. They were assessed before delivery of assistive devices, then followed for seven months, with repeated evaluations made in their homes. The following indicators were measured: functional capacity (Tinetti scale and Barthel Index); changes in perceived quality of life related to use of assistive devices; and other sociodemographic, clinical and protocol-compliance variables. A longitudinal analysis of before-after progress was carried out, as well as a description of service delivery and medical followup. RESULTS Sixty-eight percent of those surveyed were women; median age was 74 years, average schooling was 6 years, and 93% had low income (monthly income
Autopercepción de aumento de volumen de extremidades superiores y cuatro criterios diagnósticos para linfedema en mujeres tratadas por cáncer de mama.
(Instituto Nacional de la Nutricion "Salvador Zubiran", 2017) Araya, Paulina; Leppe, Jaime; Ibañez, Gladys; Sacomori, Cinara;
Self-perception of upper limbs swelling can be an effective tool in diagnostic and early intervention of lymphedema. The aim of the present paper was to verify the association between self-perception of swelling of upper extremities and objective criteria commonly used for lymphedema diagnostic in women treated for breast cancer. We evaluated 112 women with breast cancer between 6- and 18-months post-surgery. Indirect calculation of the volume of upper extremities through four criteria commonly used was employed (≥2 cm, ≥ 200 mL, ≥10%, ≥20%). The self-perception of swelling was evaluated with a question. The chi square test was used for data analysis. The mean age was 56.3 years (DE=13.1). The prevalence of lymphedema according to limb volume difference ≥ 200 ml criterion was 13.4%; 17% for criterion ≥10 %; 6.25% for criterion ≥ 20%; and 33% for criterion ≥2 cm. Stemmer was positive in 51.8% and 17.9% women presented positive fovea. Self-perception of swelling was associated with the criteria ≥ 200 mL and ≥10 % and the presence of positive Stemmer and fovea (p <0.05). In conclusion, the information provided by the patient about her perception of swelling, is associated with objective diagnostic criteria and the Stemmer and fovea positive signs. Self-perception should be considered in the clinical evaluation.
Capacidad laboral, nivel de actividad física y fatiga en sobrevivientes de cáncer de mama en Chile: un estudio transversal
(Universidad del Desarrollo. Facultad de Medicina, 2024) Ortíz Orellana, Fernanda Andrea; Araya, Paulina; Leppe, Jaime
Propósito: Luego de los tratamientos oncológicos, muchas mujeres con cáncer de mama vuelven a sus trabajos con una baja capacidad laboral. El objetivo de este estudio es analizar la correlación entre la capacidad laboral, el nivel de actividad física (AF) y la fatiga relacionada al cáncer (FRC) en mujeres sobrevivientes de cáncer de mama que se encuentren en su primer año de retorno laboral. Método: Estudio analítico transversal. Se registraron datos sociodemográficos, se midió actividad física moderada a vigorosa (AFMV) con acelerometría (Actigraph WGT3X-BT) y se evaluó el cumplimiento de las recomendaciones de AF de la OMS (150 minutos de AFMV semanal). Se reportó la capacidad laboral (Work Ability Index) y la FRC (Brief Fatigue Inventory). Spearman Rho fue usada para correlacionar variables. Resultados: Se evaluaron 35 mujeres con una edad media de 46 (±8,5) años. El 77% reportó una capacidad laboral moderada-baja y el 43% una FRC severa. La mediana de AFMV semanal fue de 194,8 (133, 321) minutos/semana. El 68% cumplió con las recomendaciones de la OMS. Se encontró una correlación negativa entre capacidad laboral y FRC (rho=-0.564; p<0.001); no hubo correlación entre AFMV y capacidad laboral (rho=-0,067; p=0,704) ni entre AFMV y FRC (rho= 0,076; p=0,663). Conclusión: Existe un alto reporte de FRC severa en mujeres que regresaron al trabajo después de los tratamientos oncológicos, lo que se asoció con baja capacidad laboral. Aunque se observó un alto nivel de actividad física entre las participantes, no se encontró relación entre esto y las otras variables.
Characteristics of physiotherapy staffing levels and caseload: a cross-sectional survey of Chilean adult Intensive Care Units
(2019) Aranis, Nadine; Molina, Jorge; Leppe, Jaime; Castro, Ana; Fu, Carolina; Merino, Catalina
Introduction: The European Society of Intensive Care Medicine recommends the presence of a specialist physiotherapist, available every five beds, seven days a week in the high complexity Intensive Care Unit. However, in Chile the adherence of adult Intensive Care Units to this recommendation is unknown. Objective: To describe the organizational characteristics and the physiotherapist availability in adult Intensive Care Units in Chile, and according to the adherence to international recommendations, inform health decision-makers. Methods: Observational study based on a telephone survey. All adult Intensive Care Units institutions of high complexity, private hospitals and teaching health centers in Chile were eligible (n = 74). The primary outcome measures were the proportion of institutions with physiotherapist availability 24 hours a day and seven days a week (24/7 physiotherapist), a maximum caseload per physiotherapist of five patients and the presence of a specialist physiotherapist. Results: Response rate was 86.5%, with 59% of responding units being public and 83% offering level III care. 70% of the adult Intensive Care Units in Chile have 24/7 physiotherapist (87% of the public and 46% of the private sector). 41% of the centers had a maximum caseload per physiotherapist of five patients during the day on weekdays. This number decreased on weekends and during night shifts. 23% of the Intensive Care Units had a specialist physiotherapist, being more common in the private sector (31%). Conclusions: In Chilean adult ICU, 24/7 physiotherapist availability is high, the prevalence of physiotherapists with specialist training is low. Future efforts should focus on promoting the uptake of specialist training.
Chilean version of the Functional Status Score for the Intensive Care Unit: a translation and cross-cultural adaptation
(2019) González-Seguel, Felipe; Camus-Molina, Agustín; Leppe, Jaime; Hidalgo-Cabalín, Viviane; Gutiérrez-Panchana, Tania; Needham, Dale; Guimaraes, Fernando
Background: The Functional Status Score for the Intensive Care Unit (FSS-ICU) is a valid and reliable instrument to measure physical functioning in the intensive care unit setting. Translation and cross-cultural adaptation in Chile has not been published for the FSS-ICU. Aim: To translate and cross-culturally adapt all associated documents of the original FSS-ICU for Chile. Method: The Spanish version of FSS-ICU, available at www.ImproveLTO.com, was used as the starting point. This version was previously translated, with the original FSS-ICU developers, following established guidelines for this process. The Chilean pocket card version was newly developed based on the English version at www.ImproveLTO.com. Cognitive interviews were conducted for the adaptation of the FSS-ICU and pocket card version to assess understanding of relevant stakeholders (i.e., Chilean intensive care unit physiotherapists). Adaptations to the translation were made when agreement among the physiotherapists was less than 80%. Results: Cognitive interviews of the Chilean FSS-ICU (85 items) and pocket card version (18 items) were performed with 30 Chilean physiotherapists from 18 hospitals (14 public and 4 private). During the interviews, modest adaptations mainly made in the general guidelines and specific instructions for three items of the FSS-ICU and two items of the pocket card. Finally, the frequently asked questions, pocket card and full version of the FSS-ICU were developed. The original developers accepted all adaptations. Conclusions: The Chilean version of the FSS-ICU was easy to understand by the physiotherapists. The FSS-ICU is freely available for non-commercial clinical and research use by Chilean Spanish-speakers.
Co-diseño de estrategias de cambio de comportamiento para iniciar la práctica del running: un estudio cualitativo basado en el modelo de la rueda de cambio de comportamiento
(Universidad del Desarrollo. Facultad de Medicina, 2025) Poblete Soto, José Miguel; Besomi, Manuela; Leppe, Jaime
Antecedentes: En Chile, el 86,7% de la población tiene una conducta sedentaria y el 34,1% es físicamente inactiva. A pesar de los beneficios de la actividad física, existen barreras que dificultan su práctica. El running, o correr, es una alternativa accesible, pero enfrenta resistencias debido a creencias negativas relacionadas con su impacto en la salud articular. Este estudio tuvo como objetivo co-diseñar estrategias para facilitar la iniciación en el running en personas interesadas en comenzar a correr, utilizando el modelo de la Rueda de Cambio de Comportamiento (BCW). Método: Se seleccionaron 10 participantes de un estudio cualitativo previo donde se exploró los factores que influyen la decisión de comenzar a correr. Del total, 8 participantes (3 mujeres/4 hombres, 2 profesionales de la salud) participaron activamente en el proceso de co-diseño. Se llevaron a cabo cinco talleres de co-diseño entre agosto y diciembre de 2024 mediante reuniones en línea con pizarras virtuales interactivas. Siguiendo el modelo BCW, se realizaron tres etapas: (1) comprensión del comportamiento (2) identificación de intervenciones y la selección de categorías políticas, y (3) diseño y prototipado de estrategias de implementación. Resultados: Se identificaron influencias clave en el comportamiento, como la vergüenza, el desconocimiento sobre cómo empezar a correr y el miedo al dolor de rodilla. Se especificaron seis comportamientos objetivos y se seleccionaron cinco funciones de intervención (educación, incentivación, habilitación, entrenamiento y modelaje. Como estrategia principal, se propuso la creación del Centro Integral del Corredor, una comunidad de apoyo con grupos de entrenamiento guiados por mentores y asesoramiento de profesionales de la salud. Se realizó un análisis de viabilidad utilizando los criterios APEASE y se prototiparon las estrategias mediante collage. Conclusión: La aplicación del modelo BCW permitió el diseño estructurado y colaborativo de estrategias para promover el running en personas con interés en comenzar a correr. El apoyo social, la educación y la habilitación fueron aspectos clave en la propuesta de intervención. Las estrategias co-diseñadas requieren desarrollo e implementación para evaluar su efectividad en la promoción de la actividad física y el cambio de comportamiento.
Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive Care Unit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients
(2020) Camus-Molina, Agustín; Castro-Ávila, Ana Cristina; Leppe, Jaime
Objective: To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge. Design: The Chilean-Spanish version of the FSS-ICU was used in a prospective observational study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Setting: A 12-bed academic medical-surgical ICU. Participants: Mechanically ventilated patients (N=30), of 92 patients screened. Interventions: Not applicable. Main outcome measures: Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing 12 hypotheses, including the correlation with activity counts, activity time (>99 counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay, and duration of mechanical ventilation. Results: The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (ρ=-0.62, P<.001) and ICU discharge (ρ=-0.79, P<.001). Activity counts and activity time were not correlated as expected with the FSS-ICU. Conclusions: The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.
Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive CareUnit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients
(2021) Camus, Agustín; González, Felipe; Ana, Castro; Leppe, Jaime
Objective: To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge. Design: The Chilean-Spanish version of the FSS-ICU was used in a prospective observational study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Setting: A 12-bed academic medical-surgical ICU. Participants: Mechanically ventilated patients (NZ30), of 92 patients screened. Interventions: Not applicable. Main Outcome Measures: Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing 12 hypotheses, including the correlation with activity counts, activity time (>99 counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay, and duration of mechanical ventilation. Results: The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (rZ0.62, P<.001) and ICU discharge (rZ0.79, P<.001). Activity counts and activity time were not correlated as expected with the FSS-ICU. Conclusions: The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.Archives of Physical Medicine and Rehabilitation 2020;101:1914-21
Cross-cultural adaptation and evaluation of the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S)
(2022) Bunster, Josefina; Martínez, María; Mauri, Manuel; Leppe, Jaime; Nelson, Evan; Heiderscheit, Bryan; Besom, Manuela
Objective: To cross-culturally adapt and evaluate the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S) in Chilean runners with a running-related injury. Design: Cross-cultural adaptation and validation study, following the Consensus-based Standards for selecting health Measurement Instruments (COSMIN) recommendations. Setting: Outpatient sports medicine clinic and running clubs. Participants: UWRI was forward and backward translated, and culturally adapted. Thirty-one runners participated in the content validity of the UWRI-S; and fifty-seven in the assessment of psychometric properties. Main outcome measures: Runners seeking care from a physiotherapist completed the UWRI-S (baseline and after 48-72 h for reliability), Lower Extremity Functional Scale (LEFS), Patient Specific Functional Scale (PSFS), Global Rating of Change scale (GROC), and Numeric Pain Rating Scale (NPRS). Results: Suggestions about accuracy of wording and understanding of items were incorporated. UWRI-S showed a positive moderate correlation with LEFS (r = 0.6; p < 0.05), positive fair with GROC (r = 0.5, p < 0.05), negative fair with NPRS (r = -0.4; p < 0.05) and no correlation with PSFS (r = 0.3; p = 0.1). UWRI-S demonstrated acceptable internal consistency (α = 0.87) and test-retest reliability (ICC = 0.87). Conclusion: UWRI-S is a valid and reliable measure to evaluate running ability of Chilean runners during recovery from a running-related injury.
Cumplimiento diario del “Bundle” ABCDEF en una unidad de cuidados intensivos: un enfoque de mejora de la calidad de atención
(Universidad del Desarrollo. Facultad de Medicina, 2021) Muñoz Muñoz, Felipe; Leppe, Jaime
Objetivo: identificar el grado de cumplimiento diario del ABCDEF “bundle” en el registro clínico de los médicos, enfermeros y kinesiólogos de una UCI quirúrgica adulto. Diseño: estudio observacional retrospectivo de revisión de fichas desde marzo a agosto del 2019. Escenario: unidad de cuidados intensivos adulto quirúrgica de 8 camas de un hospital privado con afiliación académica. Pacientes: 133 pacientes cumplieron criterios de elegibilidad, de los cuales se obtuvieron 1134 días-paciente. Intervenciones: no aplica. Mediciones y resultados Principales: a través de los registros en la ficha clínica, se obtuvo el cumplimiento diario de la evaluación del dolor (elemento A), una prueba de interrupción de la sedación (elemento B1), una prueba de ventilación espontánea (elemento B2), elección de la sedación (elemento C), evaluación del delirium (elemento D), implementación de movilización temprana (elemento E) y la comunicación con la familia (elemento F). Se obtuvo un 22,3% de cumplimiento del ABCDEF “bundle”. Los elementos “E” (66.9%), “C” (40,4%) y “D” (24%) fueron identificados con mayor cumplimiento, mientras que los elementos “A” (13,9%) y “B2” (10,5%) fueron identificados con menor cumplimiento. Tanto el elemento “B1” como el “F” fueron identificados con un 0% de cumplimiento. Conclusiones: en este estudio el cumplimiento del ABCDEF “bundle” fue bajo, siendo los elementos “E” “C” y “D” los que se realizan con mayor frecuencia. Explorar que factores se asocian y explican este bajo cumplimiento, podrían ayudar a mejorar la implementación del “bundle” y los resultados a largo plazo de los pacientes.
Detecting sporting talents with-Z-Strategy- Cross sectional study
(2020) Souza-Lima, Josivaldo de; Leppe, Jaime; Yáñez-Sepúlveda, Rodrigo; Rodrigues Matsudo, Victor Keihan; Mahecha-Matsudo, Sandra
Introduction: Due to the relationship between early identification of physical and anthropometric characteristics above the population mean in children and adolescents, and success in sports, detecting potential sports talents should be broadly and systematically used as a strategy for the early identification of physical characteristics favorable to the sport in question. However, most studies do not use representative samples, or else they present talent detection without using valid scientific methods. This retrospective, comparative study therefore presents the identification of potential sports talents using the Z Strategy, calculated with anthropometric, neuromotor and physical fitness data. Objective: To identify physical abilities and anthropometric values above what are considered the normal ranges in a population of students in the 8th year of basic education, in Chile. Methods: The sample consisted of 9,429 students from public and private schools (50.9% boys). Data were obtained from a cross-sectional study conducted in 2013. Physical fitness and anthropometric data were recompiled through the Educational Quality Measurement System (Sistema de Medición de la Calidad de Educación – SIMCE) of physical education. The “Z Strategy” was used to detect sports talents by identifying values above the population mean. Results: In at least one variable, a total of 619 male and 623 female students with a standard deviation ≥2 (Z2) were detected. Conclusion: “Z Strategy” was able to detect sports talents of both sexes and of different ages. Level of evidence III; Retrospective comparative study.
Effects of 24-hours/day versus business hours physical therapy intervention in adult intensive care unit patients: a systematic review care unit patients
(2018) Merino, Catalina; Castro-Ávila, Ana Cristina; Gutiérrez-Arias, Ruvistay; Arriagada, María Jesús; Villanueva, Catalina; Leppe, Jaime; Fu, Carolina
Background: Some evidence suggests that higher doses of mobilization could have benefits on functional status. However, the impact of increasing the availability of Physical Therapist in the intensive care unit to provide critical care for these conditions is unclear. Objective: to determine the effect of physical therapy 24-hour/7days on the length of stay, index of respiratory system infection, days of mechanical ventilation, mortality and quality of life, in adult patients admitted to an intensive care unit. Methods and design: The databases EMBASE, MEDLINE, PUBMED, and reference lists of previous reviews were searched for clinical trials and observational studies, without restriction on language or publication date. Four reviewers independently screened articles for eligibility, and included studies were appraised using the ROBINS-I risk of bias tool for non-randomised studies. Results: 4509 records were screened. Two prospective cohorts were included in the review. Both studies reported significant improvements in length of intensive care unit stay and days of mechanical ventilation, while the index of respiratory system infection and mortality had unclear improvement. No studies reported quality of life in patients. Conclusion: There was insufficient robust data to conclude that increasing availability of physical therapy beyond business hours could shorten the length of ICU stay and days of mechanical ventilation. Further studies are required to increase certainty about the effectiveness of Physical Therapist intervention 24-hours/7 days in intensive care unit.
Encuesta sobre implementación de investigación en centros educacionales en Chile: cumplimientos de aspectos regulatorios éticos y legales
(Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2017) Merino, Catalina; Mattar, Gustavo; Leppe, Jaime; Bahamondes, Paz; Lecaros, Juan Alberto
Background: Research in educational centers is a frequent source of social and health related studies. Objective: To determine the knowledge and adherence to the current legal and ethical regulations to research performed on children at educational institutions. Methodology: Cross-sectional study online survey-type. The level of knowledge and adherence to the ethical regulation and legislation in Chile, to conduct research with minors was consulted. Results: 126 educational institutions responded the survey; 69% belonged to urban centers; 60% corresponded to those under the Municipality umbrella and 34% to charter schools. Research was performed in 31,8% of the consulted institutions, 41% of the research was on health issues and 30,8% on education. The 27,5% answered that they had the approval of ethical-scientific committee, 82% answered that they neither received nor had any awareness of regulatory aspects on research. Conclusion: There is low knowledge and adherence to ethical and legal regulation to research performed with children in educational centers. A journey for dissemination of results was performed and a flow chart was created by experts and proposed to the school directors to contribute to the adherence of ethical and regulatory aspects of research in educational centers.
Estandarización de los resultados de salto vertical en deportistas con aplicación móvil y alfombra de salto
(Universidad del Desarrollo. Facultad de Medicina. Escuela de Kinesiología, 2019) Altamirano Altamirano, Pía Consuelo; Leppe, Jaime
Introducción: El salto vertical (SV) es evaluado como parámetro de rendimiento deportivo y clínico. La estandarización de la altura de salto (AS) permite comparar el rendimiento intra e intergrupos y objetivar procesos de retorno deportivo. Objetivo: Estandarizar los resultados de Squat Jump (SJ), Contramovimiento (CMJ) y abalakov (ABK), determinando la concordancia de dos herramientas de medición y analizar los determinantes del SV. Método: Se evaluó la AS de 137 deportistas de forma simultánea con una aplicación móvil y alfombra de salto. Los resultados se estandarizaron con score Z, la comparación entre métodos se realizó mediante T-test y Bland- Altman. Se usó un modelo de regresión lineal univariado y multivariado para establecer las variables determinantes. Se propone una fórmula predictiva basada en el modelo. Resultados: El ABK registró la mayor AS (hombres= 39,13± 6,39 cm; mujeres= 27,40±4,89). La diferencia promedio entre sexos fue de 10,7 cm a favor de los hombres (p<0,001). La diferencia promedio entre la alfombra y la aplicación fue para SJ 0,087 cm (p=0,5), CMJ -0,44 cm (p=0,0014) y ABK -0,55 (p=0,0005). Según Bland Altman la ejecución de los saltos no es sesgada. En el modelo ajustado, la AS se explica en un 60% considerando las variables sexo, edad, sumatoria de pliegues y deporte. Conclusión: Se logró generar la estandarización de la AS. Usar la aplicación es útil para obtener el registro. El SV puede ser explicado por variables biológicas objetivas de fácil medición lo que permitiría obtener un modelo predictivo para este gesto deportivo.
Evidence-based strategies and interventions to promote the health of workers teleworking from home: Scoping review
(Universidad del Desarrollo. Facultad de Medicina, 2022) Fontecilla Galleguillos, Margarita Rocío; Leppe, Jaime
Background: In this "new era" numerous companies chose to continue in teleworking mode for non-COVID-19 reasons, since it proved to be a highly viable option, but that in turn, it could also provide more health risks. Evidence on interventions and strategies to promote health in teleworkers is limited and poorly understood. Objective: To examine the strategies and interventions that promote health during telework present in the literature. Methods: Through an exploratory review, scientific databases were searched to find articles that presented a strategy or an intervention that could improve the health of teleworkers. Two review authors independently applied the selection criteria and extracted information systematically. Data were extracted and synthesized in a narrative format. Results: The search produced 15 relevant articles. Interventions and strategies focused on promoting the physical and mental well-being and health security of teleworkers, mostly in the context of a pandemic. We found a large heterogeneity of types of interventions, strategies, and study designs, mainly were non-intervention studies. Deployment barriers and enablers include challenges in the respect workstation. Conclusion: Companies should aim to improve the experience of teleworking, considering the environment and organizational aspects, and then establish health promotion activities. However, there is a lack of studies that focus on other health matters, multicomponent interventions that include organizational strategies.
Factores de riesgo ambientales y biológicos de retraso del desarrollo psicomotor en Chile: Análisis secundario de datos.
(Universidad del Desarrollo. Facultad de Medicina, 2020) Astudillo Armijo, Daniela Alejandra; Leppe, Jaime
Objetivo: Determinar los factores de riesgo ambientales y biológicos asociados al déficit en el desarrollo psicomotor en una cohorte de niños chilenos al primer y tercer año de vida evaluados en la Encuesta Longitudinal de la Primera Infancia 2010 y 2012. Pacientes y método: Análisis secundario de datos de estudio de cohorte con muestra representativa a nivel nacional. Participaron 3219 niños menores de 18 meses de la Encuesta Longitudinal de la Primera Infancia realizada en Chile durante los años 2010 y 2012. Variables sociales, del cuidador principal y biológicas fueron recolectadas mediante cuestionario y evaluaciones. Se establecen los factores de riesgo que se asocian con déficit del desarrollo psicomotor para ambos años mediante regresión logística simple. Resultados: Al año de edad, el 22,8% de los niños presenta déficit del desarrollo y aumenta a 31,2% a los tres años, medido con el Inventario de Desarrollo Batelle. Factores de riesgo son bajo nivel socioeconómico, inteligencia del cuidador, extraversión y apertura a la experiencia, baja estimulación en el hogar y parto prematuro. Factores protectores son la asistencia a educación preescolar a los 3 años, mayor educación del cuidador, realizar actividades como leer, contar historias y compartir con el niño. Conclusión: Múltiples factores que afectan el desarrollo infantil fueron identificados en etapas tempranas de desarrollo. Se hace necesario estudiar la influencia en conjunto de los distintos factores de forma longitudinal para conocer las trayectorias de desarrollo.

Browsing by Author "Leppe, Jaime"

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