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    Individualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses
    (Elsevier BV, 2025-01)
    Maite Romero-Expósito
    ;
    Beatriz Sánchez-Nieto
    ;
    Mercedes Riveira-Martin
    ;
    Mona Azizi
    ;
    Angeliki Gkavonatsiou
    Scopus© Citations 10  9
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    Scopus© Citations 221  1
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    Evaluating a Memory Clinic Using the RE-AIM Model. The Experience of the “Memory and Neuropsychiatry Clinic” in Hospital Del Salvador, Chile
    (2021)
    Tomas Leon
    ;
    Loreto Castro
    ;
    Franco Mascayano
    ;
    Brian Lawlor
    ;
    SLACHEVSKY CHONCHOL, ANDREA MARÍA  
    <jats:p>The development of healthcare services for dementia is key to improving access to care and post-diagnostic support for people living with dementia. Memory Units have emerged as a new healthcare service composed of multidisciplinary teams with the goal of improving diagnosis and/or management of dementia patients. The main objective of this study was to describe and evaluate the Reach and Effectiveness of a Memory Unit in a public hospital in Chile, using the RE-AIM model, a multi-component model that allows for the evaluation of the implementation of ongoing healthcare programs. Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed. Most patients came from primary care (51.9%) and from outpatient services at the Hospital Salvador (39.2%), particularly from the Neurology (63.3%) and Psychiatry (16.0%) departments. We estimated that our Memory Unit assessed 5.39% of all of the dementia patients living in the area of referral. With respect to “E” (Effectiveness): 419 patients are still being followed up at the Memory Unit. Ninety-one patients (18%) were discharged. Of these, 55 (66%) were referred to primary healthcare, 28 (31%) to other outpatient services, 9 (10%) to a specialized mental healthcare center, and 9 (10%) to a daycare center. Due to the short period of time that the Memory Unit has been operating, no other RE-AIM dimensions could be evaluated at this juncture. To our knowledge, this is the first implementation study of a Memory Unit in Latin America, and the first using the RE-AIM model. Although cultural differences worldwide might play a role in the lack of international guidelines, the publication of the experience of the first year of this unit in Chile could inform new countries about this process. Ongoing challenges include continuing to collect data to complement the RE-AIM evaluation and developing a protocol that can be adopted elsewhere in Chile and Latin America. Further studies are needed to assess the benefits of a Memory Unit in comparison to regular care and to develop a model that assures continuity and coordination of care for people with dementia.</jats:p>
    Scopus© Citations 8  2
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    Protocol for outpatient management in cleft lip and palate repair
    (2021)
    María Santos
    ;
    Jacqueline García
    ;
    Stephanie Graf
    ;
    Carlos Giugliano
      11Scopus© Citations 7
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    Endoscopic Findings Associated With Button Battery Ingestion in Children
    (2018)
    Gloria Ríos
    ;
    Lorena Rodríguez
    ;
    LUCERO, YALDA  
    ;
    Isabel Miquel
    ;
    María Eugenia Arancibia
      12  1Scopus© Citations 15
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    The Impact of an Interactive Guidance Intervention on Sustained Social Withdrawal in Preterm Infants in Chile: Randomized Controlled Trial
    (2022)
    Jorge Bustamante Loyola
    ;
    Marcela Pérez Retamal
    ;
    Andrés Mendiburo-Seguel
    ;
    Antoine Claude Guedeney
    ;
    Ricardo Salinas González
    <jats:sec><jats:title>Background</jats:title><jats:p>Sustained social withdrawal is a key indicator of child emotional distress and a risk factor for psychological development. Preterm infants have a higher probability of developing sustained social withdrawal than infants born full-term during their first year.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To compare the effect of a behavioral guidance intervention to that of routine pediatric care on sustained social withdrawal behavior in preterm infants.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Multicenter randomized clinical trial.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Ninety nine moderate and late preterm newborns and their parents were recruited and randomized into two groups, i.e., Intervention (<jats:italic>n</jats:italic> = 49) and Control (<jats:italic>n</jats:italic> = 50). Both groups attended medical check-ups at 2, 6 and 12 months and were assessed with the Alarm Distress Baby Scale. The intervention group received a standardized behavioral intervention if the neonatologist detected sustained social withdrawal. Also, parents filled out the Edinburgh Postnatal Depression Scale, the modified-Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale-revised.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>At baseline, the prevalence of withdrawal was 4.0% (95% CI: 0.03–14.2) for the control group and 22.4% (95% CI: 13.0–35.9) for the intervention group [OR = 0.22, <jats:italic>p</jats:italic> = 0.028 (95% CI =0.06–0.84)]. At 6 months, the prevalence was 10.0% (95% CI: 3.9–21.8) for the control group and 6.1% (95% CI: 2.1–16.5) for the intervention group [OR = 2.09, <jats:italic>p</jats:italic> = 0.318 (95% CI = 0.49–8.88)]. At 12 months, the prevalence was 22.0% (95% CI: 12.8–35.2) for the control group and 4.1% (95% CI: 1.1–13.7) for the intervention group [OR = 6.63, <jats:italic>p</jats:italic> = 0.018 (95% CI = 1.39–31.71)]. Logistic generalized estimating equation models were performed. The pooled crude OR (considering diagnosis at 6 and 12 months) was 3.54 [<jats:italic>p</jats:italic> = 0.022 (95% CI = 1.20–10.44); Cohen's d= 0.70]. In the case of pooled adjusted OR, the model considered diagnosis (0 = Withdrawal, 1 = Normal) as the dependent variable, time of evaluation (1= 6 months, 2 = 12 months) and group (0 = Control, 1 = Experimental) as factors. In this case, the pooled adjusted OR was 3.57 [<jats:italic>p</jats:italic> = 0.022 (95% CI = 1.20–10.65); Cohen's d = 0.70].</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Assessment and intervention of sustained social withdrawal in preterm infants via standardized instruments benefits families by reducing its prevalence, and possible associated negative outcomes.</jats:p></jats:sec><jats:sec><jats:title>Clinical Trial Registration</jats:title><jats:p>ClinicalTrials.gov; <jats:ext-link>https://clinicaltrials.gov/ct2/show/NCT03212547</jats:ext-link>, identifier: NCT03212547.</jats:p></jats:sec>
    Scopus© Citations 1  1
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      1  1
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    Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study
    (2021)
    CASTRO AVILA, ANA CRISTINA  
    ;
    Catalina Merino-Osorio
    ;
    Felipe González-Seguel
    ;
    CAMUS MOLINA, AGUSTIN  
    ;
    LEPPE ZAMORA, JAIME ESTEBAN  
    <jats:sec><jats:title>Introduction</jats:title><jats:p>The ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>Prospective, multicentre, mixed-methods cohort study in seven Chilean ICUs. Sample: 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation &gt;48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment–blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>The study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020–78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" specific-use="clinicaltrial pre-results" xlink:href="NCT04979897">NCT04979897</jats:ext-link>.</jats:p></jats:sec>
      1Scopus© Citations 4  2
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    Scopus© Citations 38  1
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    Determination of Brain Death/Death by Neurologic Criteria
    (2020)
    David M. Greer
    ;
    Sam D. Shemie
    ;
    Ariane Lewis
    ;
    Sylvia Torrance
    ;
    Panayiotis Varelas
    Scopus© Citations 328  3