Examinando por Autor "Seron, Pamela"

Mostrando 1 - 8 de 8
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    Assessing swallowing disorders in adults on high-flow nasal cannula in critical and non-critical care settings. A scoping review protocol
    (Public Library of Science, 2023-10) Gutierrez-Arias, Ruvistay; Salgado-Maldonado, Gabriel; Letelier Valdivia, Paola; Salinas-Barahona, Francisco; Echeverría-Valdebenito, Carmen; Seron, Pamela
    Introduction The high-flow nasal cannula (HFNC) has become a widely used respiratory support system, which has proven to be effective in different populations. The facilitation of oral communication and feeding have been described as advantages of this support. Nevertheless, swallowing disorders associated with the use of HFNC have been postulated. However, such evidence is scattered in the literature, not systematically searched, and needs to be adequately summarised. This review aimed to explore the literature, to identify and map the evidence, regarding the frequency and methods of assessment of swallowing disorders in adult HFNC users, in both critical and non-critical units. Materials and methods A scoping review will be conducted. A systematic search in MEDLINE (Ovid), Embase (Ovid), CENTRAL, CINAHL (EBSCOhost), and other resources will be conducted. Primary studies, in any language or publication status, assessing the incidence of swallowing disorders in adults with HFNC support will be included. Two reviewers will independently select studies and extract data. Disagreements will be resolved by consensus or a third reviewer. The results will be reported narratively, using tables and figures to support them. Discussion Positive end-expiratory pressure generated in the airway by HFNC could impair the proper swallowing performance. Knowing the methodological characteristics, the instruments or scales used to assess the presence of dysphagia, and the results of the studies may contribute to considering swallowing assessment in this population on a routine basis, as well as to guide the conduct of new studies that may respond to less researched areas in this topic.
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    Assessment of redundancy, methodological and reporting quality, and potential discrepancies of results of systematic reviews of early mobilisation of critically ill adults: A meta-research protocol
    (BMJ Publishing Group, 2023-07) Gutierrez-Arias, Ruvistay; Pieper, Dawid; Nydahl, Peter; González-Seguel, Felipe; Jalil, Yorschua; Oliveros, Maria-Jose; Torres-Castro, Rodrigo; Seron, Pamela
    Introduction Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilisation in critically ill adult patients. Methods and analysis A meta-research of early mobilisation SRs in critically ill adult patients will be conducted. A search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the 'Evidence-Based Research' framework. The methodological quality of the SRs will be assessed with the A MeaSurement Tool to Assess systematic Reviews 2 tool, and the quality of the reports through compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the potential reasons for discordance in the results of the SRs considering divergence in results and their interpretation. Ethics and dissemination As meta-research, this study does not involve the participation of people whose rights may be violated. However, this overview will be developed rigorously and systematically to achieve valid and reliable results. The findings of this meta-research study will be presented at conferences and published in a peer-reviewed journal related to rehabilitation, critical care or research methodology. Trial registration number osf.io/kxwq9. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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    Considerations for ensuring safety during telerehabilitation of people with stroke. A protocol for a scoping review
    (Public Library of Science, 2023-01) Gutierrez-Arias, Ruvistay; González-Mondaca, Camila; Marinkovic-Riffo, Vinka; Ortiz-Puebla, Marietta; Paillán-Reyes, Fernanda; Seron, Pamela
    Introduction Exercise interventions have a positive impact on people with stroke. However, access to exercise interventions is variable, and there may be a delay in the start of rehabilitation. Telerehabilitation has enabled the delivery of exercise interventions replacing the traditional face-to-face approach. Aspects related to the safety of people with stroke should be considered to avoid adverse events during the delivery of exercise interventions remotely. However, such information is scattered in the literature, and the detail with which measures taken during the implementation of exercise interventions for people with stroke are reported is unknown. Objective To summarise measures or aspects targeted at reducing the incidence of adverse events during the delivery of exercise interventions through telerehabilitation in patients after stroke. Materials and methods A scoping review will be conducted. A systematic search in MEDLINE-Ovid, Embase-Ovid CENTRAL, CINAHL Complete (EBSCOhost), and other resources will be carried out. We will include primary studies, published in full text in any language, involving people with stroke who undergo telerehabilitation where exercise is the main component. Two reviewers will independently select studies and extract data, and disagreements will be resolved by consensus or a third reviewer. The results will be reported in a narrative form, using tables and figures to support them. Discussion To implement this strategy within rehabilitation services, one of the first aspects to be solved is to ensure the safety of people. The results of this scoping review could contribute an information base for clinicians and decision-makers when designing remotely delivered exercise intervention programs. Copyright: © 2023 Gutierrez-Arias et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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    Effectiveness of physical exercise programmes in reducing complications associated with secondary lymphoedema to breast cancer: a protocol for an overview of systematic reviews
    (NLM (Medline), 2023-07) Aguilera-Eguía, Raúl Alberto; Gutiérrez-Arias, Ruvistay; Zaror, Carlos; Seron, Pamela
    INTRODUCTION: Breast cancer-related lymphoedema (BCRL) is one of the most underestimated and debilitating complications associated with the treatment that women with breast cancer receive. Several systematic reviews (SRs) of different physical exercise programmes have been published, presenting disperse and contradictory clinical results. Therefore, there is a need for access to the best available and summarised evidence to capture and evaluate all the physical exercise programmes that focus on reducing BCRL. OBJECTIVE: To evaluate the effectiveness of different physical exercise programmes in reducing the volume of lymphoedema, pain intensity and improving quality of life. METHOD AND ANALYSIS: The protocol of this overview is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and its methodology is based on Cochrane Handbook for Systematic Reviews of Interventions. Only those SRs involving physical exercise by patients with BCRL will be included, whether on its own or combined with other exercises or other physical therapy interventions.The outcomes of interest to be considered will be lymphoedema volume, quality of life, pain intensity, grip strength, range of motion, upper limb function and any adverse event. The MEDLINE/PubMed, Lilacs, Cochrane Library, PEDro and Embase databases will be searched for reports published from database inception to April 2023.Two researchers will perform study selection, data extraction and risk of bias assessment independently. Any discrepancy will be resolved by consensus, or ultimately, by a third-party reviewer. We will use Grading of Recommendations Assessment, Development and Evaluation System to assess the overall quality of the body of evidence. ETHICS AND DISSEMINATION: The results of this overview will be published in peer-reviewed scholarly journals and the scientific dissemination will take place in national or international conferences. This study does not require approval from an ethics committee, as it does not directly collect information from patients. PROSPERO REGISTRATION NUMBER: CRD42022334433. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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    Effectiveness of physical rehabilitation interventions in critically ill patients-A protocol for an overview of systematic reviews
    (Public Library of Science, 2023-04) Gutierrez-Arias, Ruvistay; Nydahl, Peter; Pieper, Dawid; González- Segue, Felipe; Jalil, Yorschua; Oliveros, Maria-Jose; Torres-Castro, Rodrigo; Seron, Pamela
    Introduction Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have been studied to evaluate their effectiveness in improving critically ill patients' outcomes. Given that many published systematic reviews (SRs) aims to determine the effectiveness of different types of physical rehabilitation interventions, it is necessary to group them systematically and assess the methodological quality of SRs to help clinicians make better evidence-based decisions. This overview of SRs (OoSRs) aims to map the existing evidence and to determine the effectiveness of physical rehabilitation interventions to improve neuromusculoskeletal function and other clinical outcomes in adult and pediatric critically ill patients. Methods An OoSRs of randomized and non-randomized clinical trials involving critically ill adult and pediatric patients receiving physical rehabilitation intervention will be conducted. A sensitive search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos, and other search resources will be conducted. Two independent reviewers will conduct study selection, data extraction, and methodological quality assessment. Discrepancies will be resolved by consensus or a third reviewer. The degree of overlap of studies will be calculated using the corrected covered area. The methodological quality of the SRs will be measured using the AMSTAR-2 tool. The GRADE framework will report the certainty of evidence by selecting the "best"SR for each physical rehabilitation intervention and outcome. Discussion The findings of this overview are expected to determine the effectiveness and safety of physical rehabilitation interventions to improve neuromusculoskeletal function in adult and pediatric critically ill patients based on a wide selection of the best available evidence and to determine the knowledge gaps in this topic by mapping and assessing the methodological quality of published SRs. © 2023 Gutierrez-Arias et al.
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    How a Developing Country Faces COVID-19 Rehabilitation: The Chilean Experience
    (Frontiers Media S.A., 2022-07) Torres-Castro, Rodrigo; Neculhueque-Zapata, Ximena; Hrzic-Miranda, Katherina; Gutiérrez-Arias, Ruvistay; Valenzuela-Suazo, Raúl; Castro-Acuña, Cristobal; Ríos-Quevedo, Marianela; Águila-Villanueva, Camilo; Seron, Pamela
    The coronavirus 19 (COVID-19) pandemic has been one of the most significant challenges to public health in recent decades. The heterogeneity of government responses and the varying preparedness of health systems has determined that the pandemic's impact differs from country to country. Chile is no stranger to the challenges posed by rehabilitation in a developing country. We aimed to describe the approach to rehabilitation during the pandemic in Chile in the public health system since rehabilitation is considered a relevant health strategy from the prevention to management of complications, mitigation of sequelae, or new complications associated with COVID-19. For this, a descriptive study was conducted on the rehabilitation strategies implemented by Chile to respond to the COVID-19 pandemic. The analysis includes the context of the Chilean health system and the matrix of access to rehabilitation services in COVID-19. The Health Ministry (MINSAL) rehabilitation strategy includes five central axes: approaches, specific lines, transversal lines, intervention, and funding. Additionally, the policies were based and supported by the WHO recommendations. Intensive care unit beds were increased approximately 68%, and the primary care response was the reconversion of function depending on the epidemiological context. During the 2021–2022 period, the estimated number of people diagnosed with a post-COVID-19 condition was 80,528. With this, we can conclude that a developing country has managed to coordinate a rehabilitation policy for people with COVID-19 by generating a structure of the different health system levels. However, the effectiveness of this policy will need to be evaluated in the future. Copyright © 2022 Torres-Castro, Neculhueque-Zapata, Hrzic-Miranda, Gutiérrez-Arias, Valenzuela-Suazo, Castro-Acuña, Ríos-Quevedo, Águila-Villanueva and Seron.
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    Strategies used to manage overlap of primary study data by exercise-related overviews: protocol for a systematic methodological review
    (BMJ Publishing Group, 2023-04) Gutierrez-Arias, Ruvistay; Pieper, Dawid; Lunny, Carole; Torres-Castro, Rodrigo; Aguilera-Eguía, Raúl; Seron, Pamela
    Introduction One of the most conflicting methodological issues when conducting an overview is the overlap of primary studies across systematic reviews (SRs). Overlap in the pooled effect estimates across SRs may lead to overly precise effect estimates in the overview. SRs that focus on exercise-related interventions are often included in overviews aimed at grouping and determining the effectiveness of various interventions for managing specific health conditions. The aim of this systematic methodological review is to describe the strategies used by authors of overviews focusing on exercise-related interventions to manage the overlap of primary studies. Methods and analysis A comprehensive search strategy has been developed for different databases and their platforms. The databases to be consulted will be MEDLINE (Ovid), Embase (Ovid), The Cochrane Database of Systematic Reviews (Cochrane Library) and Epistemonikos. Two reviewers will independently screen the records identified through the search strategy and extract the information from the included overviews. The frequency and the type of overlap management strategies of the primary studies included in the SRs will be considered as the main outcome. In addition, the recognition of the lack of use of any overlap management strategy and the congruence between planning and conducting the overview focusing on overlap management strategies will be assessed. A subgroup analysis will be carried out according to the journal impact factor, year of publication and compliance with the Preferred Reporting Items for Overviews of Reviews statement. Ethics and dissemination This study will not involve human subjects and therefore does not require ethics committee approval. However, the conduct and reporting of the findings of this review will be conducted in a rigorous, systematic and transparent manner, which relates to research ethics. The findings of this review will be presented at scientific conferences and published as one or more studies in peer-review scientific journals related to rehabilitation or research methods. © 2023 Author(s). Published by BMJ.
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    Which physical therapy intervention is most effective in reducing secondary lymphoedema associated with breast cancer? Protocol for a systematic review and network meta-analysis
    (BMJ Publishing Group, 2022-09) Aguilera-Eguía, Raúl Alberto; Seron, Pamela; Gutiérrez-Arias, Ruvistay; Zaror, Carlos
    Introduction Lymphoedema associated with breast cancer is caused by an interruption of the lymphatic system, together with factors such as total mastectomy, axillary dissection, positive lymph nodes, radiotherapy, use of taxanes and obesity. Physiotherapy treatment consists of complex decongestive therapy, manual lymphatic drainage and exercises, among other interventions. Currently, there are several systematic review and randomised controlled trials that evaluate the efficacy of these interventions. However, at present, there are no studies that compare the effectiveness of all these physical therapy interventions. The purpose of this study is to determine which physical therapy treatment is most effective in reducing breast cancer-related lymphoedema, improving quality of life and reducing pain. Methods and analysis MEDLINE, PEDro, CINAHL, EMBASE, LILACS and Cochrane Central Register of Controlled Trials will be searched for reports of randomised controlled trials published from database inception to June 2022. We will only include studies that are written in English, Spanish and Portuguese. We will also search grey literature, preprint servers and clinical trial registries. The primary outcomes are reduction of secondary lymphoedema associated with breast cancer, improvements in quality of life and pain reduction. The risk of bias of individual studies will be evaluated using the Cochrane Risk of Bias 2.0 Tool. A network meta-analysis will be performed using a random-effects model. First, pairs will be directly meta-analysed and indirect comparisons will be made between the different physical therapy treatments. The GRADE system will be used to assess the overall quality of the body of evidence associated with the main results.