Background: All definitions for diagnosing sarcopenia include the estimation of muscle mass. This can be made using bioelectrical impedance analysis (BIA) or dual x-ray absorptiometry (DXA). BIA is a portable and inexpensive method suitable for clinical settings, while DXA is cumbersome, more expensive and less available. Objectives: To evaluate the interchangeability of both techniques for skeletal muscle mass index (SMI) estimation, and assess whether the two methods are comparable for the diagnosis of sarcopenia. Approach: Prospective, cross-sectional study. Setting: Faculty for Health Sciences, Universidad de Caldas, Colombia. Participants: Seventy-two subjects aged 65–80 years were recruited. Measurements: BIA and DXA for SMI estimation and sarcopenia diagnoses using the definition of the European Working Group on Sarcopenia in Older People (EWGSOP). Of the 72 patients, 28 were diagnosed with sarcopenia by BIA and corroborated by DXA were included in the study. To establish the agreement between techniques, the intraclass correlation coefficient and the concordance correlation coefficient were calculated. A Bland–Altman plot evaluated the agreement. To evaluate agreement on the diagnosis of sarcopenia, a Cohen’s kappa test was performed. Main results: Agreement between SMI by BIA and DXA was good according to the intraclass correlation coefficient (ICC 0.7 95% CI 0.5 to 0.8) but poor when the concordance correlation coefficient was used (CCC 0.4 was calculated 95% CI 0.3 to 0.5). The Bland–Altman analysis showed a clinically unacceptable discrepancy between the methods; the confidence intervals were too wide; the difference between methods tends to get larger as the average increases and the scatter around the bias line get larger as the average gets higher. Cohen’s kappa test was 0.2 (SEE: 0.1). Significance: The agreement between BIA and DXA was weak. We concluded that, in this studied population, the methods were not interchangeable. Results may improve if a specific formula in a greater sample size is used.
BackgroundAs their availability grew exponentially in the last 20 years, the use of information and communication technologies (ICT) in health has been widely espoused, with many emphasizing their potential to decrease health inequities. Nonetheless, there is scarce availability of information regarding ICT as tools to further equity in health, specifically in Latin American and Caribbean settings.ObjectiveOur aim was to identify initiatives that used ICT to address the health needs of underserved populations in Latin America and Caribbean. Among these projects, explore the rationale behind the selection of ICT as a key component, probe perceptions regarding contributions to health equity, and describe the challenges faced during implementation.MethodsWe conducted an exploratory qualitative study. Interviews were completed via Skype or face-to-face meetings using a semistructured interview guide. Following participant consent, interviews were audio recorded and verbatim transcriptions were developed. All transcriptions were coded using ATLASti7 software. The text was analyzed for patterns, shared themes, and diverging opinions. Emerging findings were reviewed by all interviewers and shared with participants for feedback.ResultsWe interviewed representatives from eight organizations in six Latin American and Caribbean countries that prominently employed ICT in health communication, advocacy, or surveillance projects. ICT expanded project's geographic coverage, increased their reach into marginalized or hard-to-reach groups, and allowed real-time data collection. Perceptions of contributions to health equity resided mainly in the provision of health information and linkage to health services to members of groups experiencing greater morbidity because of poverty, remote place of residence, lack of relevant public programs, and/or stigma and discrimination, and in more timely responses by authorities to the health needs of these groups as a result of the increased availability of strategic information on morbidity and its social determinants. Most projects faced initial resistance to implementation because of lack of precedents. Their financial and technical sustainability was threatened by reliance on external funding and weak transitional structures amidst key staff changes. Projects often experienced challenges in establishing meaningful communication with target audience members, mainly because of divergent motivations behind ICT use between projects and its target audience and the lack of access or familiarity with ICT among the most underserved members of such audiences.ConclusionsICT can benefit projects focusing on the health needs of underserved populations by expanding the breadth and depth of target audience coverage and improving data management. Most projects tended to be small, short-term pilot interventions with limited engagement with the formal health sector and did not include health equity as an explicit component. Collaborative projects with government institutions, particularly those with health ...
Although the evidence is fragmented and some of its real effects are contradictory, it is clear that fear, trust, love, and skepticism influence the behavior of individuals participating in social networks (1, 2). Given this dynamic, social networks provide unlimited opportunities to improve public health interventions (3). However, to harness the power of social networking, an effective online communications strategy requires an unambiguous ABSTRACT
OBJETIVO: Evaluar lla frecuencia de DPE en pacientes con ERC estadios III a IV. METODOS: Estudio descriptivo, de corte transversal. Evaluación de base de datos de pacientes con ERC, que contaran con variables sociodemográficas, bioquímicas, Valoración Global Subjetiva (VGS), y medidas antropométricas, para el diagnóstico de DPE de la Sociedad Internacional de Nutrición y Metabolismo Renal. RESULTADOS: De 200 pacientes revisados de la consulta externa de Nefrología, 60 cumplieron con los criterios de inclusión. El promedio de edad fue de 68,4 años, con una media de tasa de filtración glomerular (TFG) de 47,1ml/min. Con relación a la ERC, el 61,66% (37) de los pacientes fue clasificado en estadio IIIa, 31,6% (19) en estadio IIIb, y 6,66% (4) en estadio IV. Ninguno de los pacientes cumplío con los criterios para DPE. La evaluación de la VGS mostró que el 53,33% (32) de los pacientes estaban en categoría VGS A (bien nutridos), el 45% (27) VGS B (malnutrición moderada) y solo un paciente fue clasificado como VGS C (malnutrición grave). La mayor proporción de pacientes con bajos niveles de albúmina y colesterol estuvo en pacientes con ERC en estadio IIIb, y los pacientes con IMC menor a 23 en estadios IIIb y IV. CONCLUSION: Según los criterios de la Sociedad Internacional de Nutrición y Metabolismo Renal, ningún paciente presentaba DPE.
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