Aplicación de tecnología móvil en el monitoreo biológico de calidad de agua: ciencia participativa en la Comunidad Campesina Cordillera Blanca

Universidad Nacional Agraria La Molina. Escuela de Posgrado. Maestría en Recursos HídricosLa presente investigación busca aplicar un modelo de ciencia participativa en la comunidad campesina Cordillera Blanca que permita generar información sobre la calidad de fuentes de agua naturales como una herramienta comunitaria para la adecuada gestión de los recursos hídricos. Para ello, se realizará la capacitación en el uso de la aplicación móvil “Aqua Biosmart”, basada en la presencia o ausencia de macroinvertebrados bentónicos, que permite identificar puntos de contaminación y transmitirlos de manera remota. Las comunidades en zonas altoandinas utilizan las fuentes de agua naturales de forma directa para su consumo y actividades productivas, por lo que es indispensable un monitoreo continuo de su calidad.Por ello, es importante proveer de herramientas que permitan conocer fácil y eficazmente, las condiciones de calidad del agua y poder tomar decisiones sobre su mejor uso. En este sentido, la participación y capacitación de la población local en el uso de estas herramientas de monitoreo es indispensable. El método más usado para evaluar la calidad del agua es el análisis fisicoquímico, que brinda información puntual de las condiciones ambientales en el momento del muestreo, pero no sobre los efectos de tales condiciones en el ecosistema acuático. Por eso, una forma de caracterizar la salud integral de los ecosistemas es mediante métodos biológicos, que permiten resumir los efectos de la contaminación u otros estresores ambientales a través de índices basados en la biodiversidad. A este respecto, el uso de macroinvertebrados bentónicos como indicadores de calidad de agua, ha demostrado gran eficiencia en detectar puntos de alteración ambiental y la integridad ecológica en diversos sistemas acuáticos. La ciencia participativa es una metodología que involucra a la población local en el monitoreo de variables ambientales mediante capacitaciones didácticas en el uso de diferentes estrategias, que traigan beneficios a su comunidad en el largo plazo.This research seeks to apply a participatory science model in the rural community of Cordillera Blanca to generate information on the quality of natural water sources as a community tool for the proper management of water resources. For this purpose, training will be provided in the use of the mobile application "Aqua Biosmart", based on the presence or absence of benthic macroinvertebrates, which allows identifying contamination points and transmitting them remotely. Communities in high Andean areas, use natural wáter sources directly for consumption and productive activities, so continuous monitoring of water quality is essential. Therefore, it is important to provide tools that make it possible to easily and effectively evaluate water quality conditions and make decisions on its best use. In this sense, the participation and training of the local population in the use of these monitoring tools is indispensable. The most commonly used method to assess water quality is physicochemical analysis, which provides timely information on environmental conditions at the time of sampling, but not on the effects of such conditions on the aquatic ecosystem. Therefore, one way to characterize the overall health of ecosystems is through biological methods, which allows to summarize the effects of pollution or other environmental stressors through biodiversity-based indices. In this regard, the use of benthic macroinvertebrates as indicators of water quality has shown great efficiency in detecting points of environmental alteration and ecological integrity in diverse aquatic systems. Participatory science is a methodology that involves the local population in the monitoring of environmental variables through didactic training in the use of different strategies that bring long-term benefits to the community

Surgical and rehabilitation treatment for patients with Muscular Dystrophies. Evidence-based recommendations for clinical practice guidelines in Colombia

ABSTRACT: Surgical and rehabilitation treatment for patients with Muscular Dystrophies. Evidence-based recommendations for clinical practice guidelines in Colombia Muscular dystrophies (MD) are genetic diseases that cause progressive weakness and degeneration of muscles. The Guide to clinical practice for early detection, comprehensive care, monitoring and rehabilitation of patients diagnosed with muscular dystrophy developed recommendations for the comprehensive care of patients diagnosed with the most common MD. The Methodological guide for the development of clinical practice guidelines with economic assessment in the general social security system in health of Colombia was used, which mainly includes the use of the GRADE methodology. This article includes recommendations related to the surgical and rehabilitation treatment of people with MD. In general, we recommend spinal fixation surgery, elongation of the Achilles tendon, scapular fixation and tendon elongation; also the use of positive pressure devices, respiratory therapy, exercises of submaximal strengthening and aerobics, avoid prolonged immobility, use of knee ankle foot orthotic, manual and motorized wheel chairs, previously examining the feasibility of prescribing them and the patient, psychological intervention, family therapy and the use of functional scales. Spinal orthoses, high resistance exercises and leisure and recreational therapies are not recommended.RESUMEN: Las distrofias musculares (DM) son enfermedades genéticas que causan debilidad y degeneración progresiva del músculo. La Guía de práctica clínica para la detección temprana, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de distrofia muscular desarrolló recomendaciones para la atención integral de pacientes con las DM más comunes. Se utilizó la Guía metodológica para la elaboración de guías de práctica clínica con evaluación económica en el sistema general de seguridad social en salud colombiano, que incluye principalmente el uso de la metodología GRADE. El siguiente artículo recoge las recomendaciones relacionadas con el tratamiento quirúrgico y de rehabilitación de las personas con DM. Se recomiendan, en general, la cirugía de fijación espinal, de alargamiento del tendón de Aquiles, de fijación escapular y de alargamiento tendinoso; los dispositivos de presión positiva, la terapia respiratoria, los ejercicios de fortalecimiento submáximos y aeróbicos, evitar la inmovilidad prolongada, el uso de órtesis rodilla tobillo pie, las sillas de ruedas manual y motorizadas, examinando previamente la factibilidad de la prescripción y al paciente, la intervención psicológica, la terapia familiar y el uso de escalas funcionales. No se recomiendan las órtesis espinales, los ejercicios de alta resistencia y las terapias lúdicas y recreativas

Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population:A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey

Background As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods Data from 6’635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.</p

Didactic Proposal with Ecological and Interdisciplinary Approach: a Commitment to Inclusive Higher Education

People with intellectual disabilities have had few opportunities to access higher education, for a long time it has been considered that they are not a potential group to be trained in the university environment. This article is derived from an investigation that was developed in the Colombian context, the purpose of which was to contribute to reducing the barriers of young people for their inclusion in the family, social, academic and occupational context, through the design and validation of a model of comprehensive care with an ecological and interdisciplinary approach. The study had a mixed methodological perspective, the ABAS II scale was used to evaluate the adaptive behavior index in 20 young people as a pretest and posttest. It was concluded that this experience contributed to the formation and quality of life of the young people; and it showed that all people can be taught, but that each one learns in their uniqueness.Las personas en situación de discapacidad intelectual han tenido pocas oportunidades para acceder a la educación superior; durante mucho tiempo se ha considerado que ellas no son un colectivo potencial para formarse en el ámbito universitario. Este artículo es derivado de una investigación que se desarrolló en el contexto colombiano, cuyo propósito consistió en contribuir a disminuir las barreras de los jóvenes para su inclusión en el contexto familiar, social, académico y ocupacional, mediante el diseño y validación de un modelo de atención integral con enfoque ecológico e interdisciplinar. El estudio tuvo una perspectiva metodológica mixta, se utilizó la escala ABAS II para evaluar el índice de conducta adaptativa en 20 jóvenes a modo de pretest y postest. Se concluyó que esta experiencia contribuyó a la formación y calidad de vida de los jóvenes; y mostró que a todas las personas se les puede enseñar, pero que cada una aprende en su singularidad

Advancing the World Health Assembly's landmark Resolution on Strengthening Rehabilitation in Health Systems: unlocking the Future of Rehabilitation

: In May 2023, the historic Resolution on Strengthening Rehabilitation in Health Systems was adopted unanimously by the 194 Member States of the World Health Assembly (WHA), the highest health policy-setting body. The resolution aims to scale up and integrate rehabilitation into health systems as part of Universal Health Coverage (UHC) to address the growing rehabilitation needs due to the global ageing population, the increasing prevalence of non-communicable diseases, and the emergence of new infectious diseases such as COVID-19. Globally, data extracted from the Global Burden of Disease Study in 2019 showed that one out of three people could benefit from rehabilitation, while more than half of the population in many countries is not receiving essential rehabilitation services. This special article highlights the global challenges in meeting rehabilitation needs and emphasizes the importance of affordable, accessible, and quality rehabilitation services for vulnerable populations. The resolution's path, which started in 2017 with the "Rehabilitation 2030: a Call for Action" initiative by the World Health Organization (WHO), is outlined. We summarize the key aspects of the WHA resolution, including its requests for Member States, international organizations, and the WHO Director-General. Finally, we discuss the way forward towards implementation, involving advocacy and concrete actions by all stakeholders, with the support of the newly established World Rehabilitation Alliance. The goal is to integrate rehabilitation into health systems worldwide, thus improving the well-being and socio-economic participation of those in need

Revisiting functioning recovery in persons with spinal cord injury undergoing first rehabilitation: Trajectory and network analysis of a Swiss cohort study.

Information about an individual's functioning and its longitudinal development is key to informing clinical rehabilitation. However, the description and understanding of the detailed longitudinal course of functioning, i.e., functioning trajectories, is rare in the current SCI literature. The aim of this study was to re-estimate previously identified functioning trajectories of individuals with spinal cord injury (SCI) undergoing initial rehabilitation in Switzerland using trajectory analysis, and to identify highly influential functioning domains that could become trajectory-specific targets for clinical interventions using network analysis. The study was based on data from the Swiss SCI Cohort Study and included individuals with SCI (N = 1099) who completed their rehabilitation in one of four collaborating centers between May 2013 and March 2022. For the trajectory analysis, functioning was operationalized using the total sum score of the Spinal Cord Independence Measure version III (SICM III), which was assessed at up to four time points (T1-T4) during rehabilitation. For the network analysis, individual SCIM III items were used to operationalize relevant functioning problems at T1 (admission) and T4 (discharge). The re-estimation of trajectory analysis confirmed the previously identified mean functioning trajectory classes of stable high functioning (N = 239; 21.75%), early (N = 33; 3.00%), moderate (N = 753; 68.52%), and slow (N = 74; 6.73%) functioning improvement. The network analysis revealed highly connected functioning problems at T1 for the moderate functioning improvement class, including "Feeding", "Dressing upper body", and "Dressing lower body", "Mobility in bed", and "Use of toilet". These functioning domains might indicate potential trajectory-specific targets for clinical interventions. This study has increased our knowledge about functioning trajectories of individuals with SCI undergoing initial rehabilitation in Switzerland and its findings may inform discussions about the application and use of functioning trajectories in clinical practice. Due to the exploratory nature of this study, further research is needed to confirm the findings presented

Mobile Health Self-management Support for Spinal Cord Injury: Systematic Literature Review

BackgroundSelf-management plays a critical role in maintaining and improving the health of persons with spinal cord injury (SCI). Despite their potential, existing mobile health (mHealth) self-management support (SMS) tools for SCI have not been comprehensively described in terms of their characteristics and approaches. It is important to have an overview of these tools to know how best to select, further develop, and improve them. ObjectiveThe objective of this systematic literature review was to identify mHealth SMS tools for SCI and summarize their characteristics and approaches to offering SMS. MethodsA systematic review of the literature published between January 2010 and March 2022 was conducted across 8 bibliographic databases. The data synthesis was guided by the self-management task taxonomy by Corbin and Strauss, the self-management skill taxonomy by Lorig and Holman, and the Practical Reviews in Self-Management Support taxonomy. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards guided the reporting. ResultsA total of 24 publications reporting on 19 mHealth SMS tools for SCI were included. These tools were introduced from 2015 onward and used various mHealth technologies and multimedia formats to provide SMS using 9 methods identified by the Practical Reviews in Self-Management Support taxonomy (eg, social support and lifestyle advice and support). The identified tools focused on common SCI self-management areas (eg, bowel, bladder, and pain management) and overlooked areas such as sexual dysfunction problems and environmental problems, including barriers in the built environment. Most tools (12/19, 63%) unexpectedly supported a single self-management task instead of all 3 tasks (ie, medical, role, and emotional management), and emotional management tasks had very little support. All self-management skills (eg, problem-solving, decision-making, and action planning) had coverage, but a single tool addressed resource use. The identified mHealth SMS tools were similar in terms of number, introduction period, geographical distribution, and technical sophistication compared with SMS tools for other chronic conditions. ConclusionsThis systematic literature review provides one of the first descriptions of mHealth SMS tools for SCI in terms of their characteristics and approaches to offering SMS. This study’s findings highlight a need for increased coverage of key SMS for SCI components; adopting comparable usability, user experience, and accessibility evaluation methods; and related research to provide more detailed reporting. Future research should consider other data sources such as app stores and technology-centric bibliographic databases to complement this compilation by identifying other possibly overlooked mHealth SMS tools. A consideration of this study’s findings is expected to support the selection, development, and improvement of mHealth SMS tools for SCI

Estimated parameters of the best-fitting latent process mixed model.

Estimated parameters of the best-fitting latent process mixed model.</p

Overview of study participant characteristics for the identified classes of functioning trajectories.

Overview of study participant characteristics for the identified classes of functioning trajectories.</p

Observed individual functioning trajectories according to Rasch-transformed SICM III total scores (N = 1099).

Abbreviations: SCIM III, Spinal Cord Independence Measure version III. (PDF)</p