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The new incremental step test (IST) is a field test that was developed for people with chronic obstructive pulmonary disease (COPD), based on the characteristics of the incremental shuttle walk test (ISWT); however, its measurement properties still need to be determined. We aimed, first, to assess the construct validity (through the comparison with the ISWT), within-day reliability and measurement error of the IST in people with COPD; and, second, to identify whether the participants have a learning effect in the IST.
Cross-sectional study, conducted according to COnsensus-based Standards for the selection of health status Measurement INstruments guidelines.
A family health unit in Portugal, April 2022 to June 2023.
63 participants (67.5±10.5 years) attended two sessions to perform two IST and two ISWT, separately. Spearman’s correlations were used to compare the best performances between the IST and the ISWT. Intraclass correlation coefficient (ICC2,1) was used for reliability, and the SE of measurement (SEM), minimal detectable change at 95% CI (MDC95) and Bland and Altman 95% limits of agreement (LoA) were used for measurement error. The learning effect was explored with the Wilcoxon signed-rank test.
The IST was significant and strongly correlated with the ISWT (0.722,1 of 0.95 (95% CI 0.92 to 0.97), SEM=11.7 (18.9%), MDC95=32.4 (52.2%) and the LoA were –33.61 to 31.48 for the number of steps. No difference was observed between the number of steps of the two attempts of the IST (p>0.05).
The IST can be suggested as a valid and reliable test to assess exercise capacity in people with COPD, with no learning effect when two IST are performed on the same day. The measurement error of the IST is considered indeterminate.
by Adam G. Clause, Roberto Luna-Reyes, Oscar M. Mendoza-Velázquez, Adrián Nieto-Montes de Oca, Israel Solano-Zavaleta
The mountain forests of Middle America are renowned for their endemic biodiversity, and arboreal alligator lizards (genus Abronia) are high-profile vertebrates endemic to this region. In this work, we describe a new species of arboreal Abronia that is known only from the type locality in the Northern Highlands of Chiapas, Mexico. The new species is diagnosed from all other members of the genus Abronia by the following combination of characters: lack of protuberant or spine-like supra-auricular scales, lack of protuberant or casque-like posterolateral head scales, dorsum of head pale yellow with distinct dark markings, 35–39 transverse dorsal scale rows, lateralmost row of ventral scales enlarged relative to adjacent medial row, and dorsum brown with darker crossbands that are sometimes reduced to rows of spots. We provisionally include the new species in the subgenus Lissabronia based on genomic and morphological evidence, but our results also suggest a close relationship to the subgenus Abaculabronia. The new species is geographically separated from the nearest Lissabronia and Abaculabronia species by the lowland Central Depression of Chiapas. Ongoing habitat loss and other factors imperil the new species, leading us to propose its listing under multiple threatened species frameworks. Because the Northern Highlands have poor coverage of protected areas, we briefly comment on the potential of this new species for stimulating conservation in the region.This study aims to estimate the levels of COVID-19 vaccine hesitancy in 53 low-income and middle-income countries, differences across population groups in hesitancy, and self-reported reasons for being hesitant to take the COVID-19 vaccine.
This paper presents new evidence on levels and trends of vaccine hesitancy in low-income and middle-income countries based on harmonised high-frequency phone surveys from more than 120 000 respondents in 53 low-income and middle-income countries collected between October 2020 and August 2021. These countries represent a combined 53% of the population of low-income and middle-income countries excluding India and China.
On average across countries, one in five adults reported being hesitant to take the COVID-19 vaccine, with the most cited reasons for hesitancy being concerns about the safety of the vaccine, followed by concerns about its efficacy. Between late 2020 and the first half of 2021, there tended to be little change in hesitancy rates in 11 of the 14 countries with available data, while hesitancy increased in Iraq, Malawi and Uzbekistan. COVID-19 vaccine hesitancy was higher among female, younger adults and less educated respondents, after controlling for selected observable characteristics.
Country estimates of vaccine hesitancy from the high-frequency phone surveys are correlated with but lower than those from earlier studies, which often relied on less representative survey samples. The results suggest that vaccine hesitancy in low-income and middle-income countries, while less prevalent than previously thought, will be an important and enduring obstacle to recovery from the pandemic.
Objetivo principal: Determinar el conocimiento y las actitudes con relación a la resistencia a los antibióticos de los estudiantes de Enfermería. Metodología: Se envió una encuesta a los estudiantes de Enfermería de la Facultad de Ciencias de la Salud en la que se recogía información sobre frecuencia de uso de antibióticos en el último año, conocimientos sobre antibióticos, posibles reacciones adversas, la resistencia y actitudes relacionadas con el uso de estos. Resultados principales: 167 estudiantes respondieron al cuestionario, 75 (45,7%) indicaron que habían tomado antibióticos en el último año y 159 (97%) habían oído hablar de la resistencia antimicrobiana. Los estudiantes demostraron una buena actitud con más del 90% de respuestas correctas a la mayoría de los ítems. Conclusión principal: Los estudiantes de enfermería tenían un conocimiento adecuado de los antibióticos y hacían un buen uso de ellos. Sin embargo, hubo un uso excesivo de antibióticos por parte de los estudiantes. Se proponen charlas y/o talleres, entre otros, para mejorar los resultados.
Objetivo principal: Con este trabajo nos marcamos el objetivo de evaluar la utilidad del uso de la técnica de canalización de la vía venosa bajo con-trol ecográfico en aquellos pacientes que fracasó la técnica habitual de canalización periférica y analizamos las causas que determinaron el motivo del fracaso. Metodología: Realizamos un estudio prospectivo, observacional y descriptivo donde se analizaron las variables que presentaban los casos del estudio y las variables de la técnica de punción venosa ecográfica; obesidad, fragilidad capilar, adicción a drogas, tratamiento de larga duración asociado, punciones fallidas, localización venosa, calibre del catéter, tiempo empleado, escala analógica visual del dolor (E.V.A.) y éxito/fracaso en la punción venosa bajo ecografía. Resultados principales: La tasa de canalización resultó del 86.5% con un porcentaje de intentos a la 1ª, del 78,4% y a la 2ª del 21,6%. Se canalizó la V. Basílica en un 64,9%, con catéteres de 18G en un 81,1%, empleando entre 1 y 3 minutos en el 62,1%, con una E.V.A. ≤3 puntos en el 75,6% de los casos. La obesidad en el 29,7% y la fragilidad de los vasos en el 56,8% de los pacientes dificultó el acceso normal a la vía periférica y fue un factor que llevó a utilizar de modo preferente la ecografía. Conclusión principal: La ecografía es una técnica útil, reproducible y exitosa en pacientes con dificultades de acceso venoso resultando especialmente valiosa en enfermos obesos y con fragilidad de vasos. Debemos ampliar la muestra a toda la población para estudiar si estas dos características son determinantes a la hora de canalizar la vía venosa.
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