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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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Independent Reliability Analysis of a New Classification for Pyogenic Spondylodiscitis
(2020)
Gaston Camino Willhuber
;
Alfredo Guiroy
;
ZAMORANO PÉREZ, JUAN JOSÉ
;
Nelson Astur
;
Marcelo Valacco
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Diagnostic study, level of evidence III. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> Pyogenic spondylodiscitis can cause deformity, neurological compromise, disability, and death. Recently, a new classification of spondylodiscitis based on magnetic resonance imaging was published. The objective of this study is to perform an independent reliability analysis of this new classification. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> We selected 35 cases from our database of different spine centers in Latin America and from the literature; 8 observers evaluated the classification and graded the scenarios according to the methodological grading of the classification developed by Pola et al. Cases were sent to the observers in a random sequence after 3 weeks to assess intraobserver reliability. The interobserver and intraobserver reliabilities were performed with Fleiss and Cohen statistics, respectively. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The overall Fleiss κ value for interobserver agreement was substantial, with 0.67 (95% CI = 0.43-0.91) in the first reading and 0.67 (95% CI = 0.45-0.89) in second reading for the main types of classification. The Cohen κ value for intraobserver agreement was also substantial, with 0.68 (95% CI = 0.45-0.92). The interobserver agreement analysis for the subtypes of this classification was overall substantial, with 0.60 (95% CI = 0.37-0.83) in the first reading and 0.61 (95% CI = 0.41-0.81) in the second reading. The overall intraobserver agreement for subtypes of the classification was also substantial, with 0.63 (95% CI = 0.34-0.93). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice. </jats:p></jats:sec>
Scopus© Citations 14 7
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Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys
(2023)
Andrea Ramírez Varela
;
Pedro C. Hallal
;
Juliana Mejía Grueso
;
Željko Pedišić
;
Deborah Salvo
<jats:p><jats:italic><jats:bold>Background</jats:bold>:</jats:italic> Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. <jats:italic><jats:bold>Methods</jats:bold>:</jats:italic> We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. <jats:italic><jats:bold>Results</jats:bold>:</jats:italic> The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. <jats:italic><jats:bold>Conclusion</jats:bold>:</jats:italic> Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.</jats:p>
1 2Scopus© Citations 46

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