Browsing by Author "Riquelme Pérez, Arnoldo Javier"
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- ItemDesigning feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review(2024) Fuentes Cimma, Javiera Carolina; Sluijsmans, Dominique; Riquelme Pérez, Arnoldo Javier; Villagrán Gutiérrez, Ignacio Andrés; Isbej Espósito, Lorena Pilar; Olivares Labbé, María Teresa; Heeneman, SylviaBackground: Feedback processes are crucial for learning, guiding improvement, and enhancing performance. In workplace-based learning settings, diverse teaching and assessment activities are advocated to be designed and implemented, generating feedback that students use, with proper guidance, to close the gap between current and desired performance levels. Since productive feedback processes rely on observed information regarding a student's performance, it is imperative to establish structured feedback activities within undergraduate workplace-based learning settings. However, these settings are characterized by their unpredictable nature, which can either promote learning or present challenges in offering structured learning opportunities for students. This scoping review maps literature on how feedback processes are organised in undergraduate clinical workplace-based learning settings, providing insight into the design and use of feedback. Methods: A scoping review was conducted. Studies were identified from seven databases and ten relevant journals in medical education. The screening process was performed independently in duplicate with the support of the StArt program. Data were organized in a data chart and analyzed using thematic analysis. The feedback loop with a sociocultural perspective was used as a theoretical framework. Results: The search yielded 4,877 papers, and 61 were included in the review. Two themes were identified in the qualitative analysis: (1) The organization of the feedback processes in workplace-based learning settings, and (2) Sociocultural factors influencing the organization of feedback processes. The literature describes multiple teaching and assessment activities that generate feedback information. Most papers described experiences and perceptions of diverse teaching and assessment feedback activities. Few studies described how feedback processes improve performance. Sociocultural factors such as establishing a feedback culture, enabling stable and trustworthy relationships, and enhancing student feedback agency are crucial for productive feedback processes. Conclusions: this review identified concrete ideas regarding how feedback could be organized within the clinical workplace to promote feedback processes. The feedback encounter should be organized to allow follow-up of the feedback, i.e., working on required learning and performance goals at the next occasion. The educational programs should design feedback processes by appropriately planning subsequent tasks and activities. More insight is needed in designing a full-loop feedback process, in which specific attention is needed in effective feedforward practices.
- ItemEstrategias para la prevención primaria y secundaria del cáncer gástrico: Consenso chileno de panel de expertos con técnica Delfi(2024) Corsi Sotelo, Oscar Felipe; Pizarro Rojas, Margarita Alicia; Rollán Rodríguez, Antonio; Silva Figueroa, Verónica; Araya Jofré, Raúl; Bufadel Godoy, María Ester; Cortés González, Pablo; González Donoso, Robinson; Fuentes López, Eduardo; Latorre Selvat, Gonzalo Ignacio; Medel Jara, Patricio Andrés; Reyes Placencia, Diego Armando; Pizarro Véliz, Mauricio; Garchitorena Marqués, María Jesus; Zegers Vial, María Trinidad; Crispi Galleguillos, Francisca; Espinoza, Manuel A.; Riquelme Pérez, Arnoldo JavierIntroducción: El cáncer gástrico (CG) es la primera causa de muerte oncológica en Chile y la sexta en América Latina y el Caribe (LAC). Helicobacter pylori (H. pylori) es el principal carcinógeno gástrico y su tratamiento reduce la incidencia y mortalidad por CG. La endoscopia digestiva alta (EDA) permite la detección de condiciones premalignas y CG incipiente. No existen programas de búsqueda masiva de la infección por H. pylori ni cribado de las condiciones premalignas ni CG incipiente en LAC. El objetivo de este estudio es establecer recomendaciones para la prevención primaria y secundaria de CG en población asintomática de riesgo estándar en Chile. Métodos: Se realizaron dos talleres y un seminario sincrónicos con modalidad a distancia, con expertos chilenos. Se realizó un consenso por panel Delfi de 2 rondas hasta lograr>80% de acuerdo respecto a las estrategias de prevención primaria y secundaria propuestas para la población estratificada según grupos etarios. Resultados: Se realizaron 2 talleres y un seminario con participación de 10, 12 y 12 expertos, respectivamente. En el panel Delfi respondieron 25 de 37 (77,14%) y 28 de 52 expertos (53,85%). Para la población de 16-34 años no hubo consenso sobre testear y tratar de forma no invasiva para H. pylori y se descartó el uso de EDA. Entre 35-44 años se recomienda testear y tratar de forma no invasiva para H. pylori y evaluar posteriormente su erradicación con pruebas no invasivas (antígeno en deposiciones de H. pylori o prueba de aire espirado). En el grupo ≥45 años se recomienda una estrategia combinada mediante testear y tratar para H. pylori sumado a biomarcadores no invasivos (serología IgG contra H. pylori y pepsinógenos I y II séricos); luego un grupo seleccionado de sujetos, será derivado a EDA con biopsias gástricas (Protocolo Sydney), que serán utilizadas para estratificar riesgo según clasificación Operative Link for Gastritis Assessment (OLGA); cada 3 años en OLGA III-IV y cada 5 años en OLGA I-II.ConclusiónSe propone una estrategia de testear y tratar la infección por H. pylori (prevención primaria) en base a estudios no invasivos en la población de 35-44 años y una estrategia combinada (serología y EDA) en población ≥45 años (prevención primaria y secundaria). Estas estrategias son potencialmente aplicables por otros países de LAC.
- ItemHypoadiponectinemia and its Association with Liver Fibrosis in Morbidly Obese Patients(2010) Nazal Ortiz, Leyla María; Riquelme Pérez, Arnoldo Javier; Solís López, Nancy De Las Mercedes; Pizarro Rojas, Margarita Alicia; Escalona Pérez, Alex Gamaliel; Burotto Pichun, Mauricio Emanuel; Méndez, Juan Ignacio; Saint-Jean, Catalina; Concha Bustos, María José; Giovanni, Stefano; Awruch Diego Ariel; Morales Soto, Arturo Javier; Baudrand Biggs, Rene Felipe; Carrasco Avino, Gonzalo; Domínguez De Landa, María Angelica; Padilla Pérez, Oslando; Espinoza, Manuel; Miquel, Juan Francisco; Nervi Oddone, Flavio; Arrese Jiménez, Marco AntonioReduced serum levels of adiponectin have been associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD). However, the relationship between serum adiponectin levels and hepatic histology in NAFLD is controversial. The aim of this study was to explore associations between plasma adiponectin concentrations and liver histology in morbidly obese patients.", "We conducted a case-control study including obese patients undergoing bariatric surgery and normal controls. Anthropometric, standard biochemical variables as well as plasma adiponectin and leptin levels were determined. Liver biopsy was performed in all patients at the time of surgery.", "Seventy morbidly obese patients (mean BMI, 40.6 +/- 5.6 kg/m(2)) met the inclusion criteria and were compared with 69 controls (mean BMI, 22.8 +/- 1.6 kg/m(2), p = 0.0001). Thirty patients (43%) had NAFLD and 20 (28%) of them fulfilled the histological criteria for steatohepatitis. Obesity was associated with increased leptin and decreased adiponectin levels. NAFLD patients exhibited decreased levels of serum adiponectin compared with matched controls [median (Q1-Q3), 3.9 (3.2-4.3) vs. 8.6 (6.5-9.2) mu g/mL, p < 0.0001]. In univariate analysis, age, gender, type 2 diabetes mellitus, BMI, HOMA-IR, aspartate aminotransferase (AST), alanine aminotransferase, serum glucose, and adiponectin levels were independently associated with hepatic fibrosis. In multivariate analysis, AST [OR = 1.082 (1.000-1.170)], age [OR = 1.119 (1.023-1.225)], and serum adiponectin levels [OR = 0.529 (0.299-0.936)] were significantly associated with the presence of liver fibrosis.", "NAFLD patients have lower plasma adiponectin concentrations than control subjects. Low adiponectin levels are associated with more severe liver histology. Serum adiponectin may be useful to estimate the severity of liver damage in obese patients with NAFLD.
- ItemLong-lasting neutralizing antibody responses in SARS-CoV-2 seropositive individuals are robustly boosted by immunization with the CoronaVac and BNT162b2 vaccines(2021) Muena, Nicolás A.; García Salum, Tamara Cristal; Pardo Roa, Catalina; Serrano García, Eileen Francisca; Levicán Asenjo, Jorge Enrique; Avendaño, María José; Almonacid Cárdenas, Leonardo Iván; Valenzuela Galaz, Gonzalo Hernán; Poblete Cárdenas, Estefany Aracely; Strohmeier, Shirin; Salinas Ortíz, Erick David; Haslwanter, Denise; Dieterle, Maria Eugenia; Jangra, Rohit K.; Chandran, Kartik; González, Claudia; Riquelme Pérez, Arnoldo Javier; Krammer, Florian; Tischler, Nicole D.; Medina, RafaelThe durability of circulating neutralizing antibody (nAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their boosting by vaccination remains to be defined. We show that outpatient and hospitalized SARS-CoV-2 seropositive individuals mount a robust neutralizing antibody (nAb) response that peaks at days 23 and 27 post-symptom onset, respectively. Although nAb titers remained higher in hospitalized patients, both study groups showed long-lasting nAb responses that can persist for up to 12 months after natural infection. These nAb responses in previously seropositive individuals can be significantly boosted through immunization with two doses of the CoronaVac (Sinovac) or one dose of the BNT162b2 (BioNTech/Pfizer) vaccines, suggesting a substantial induction of B cell memory responses. Noteworthy, three obese previously seropositive individuals failed to mount a booster response upon vaccination, warranting further studies in this population. Immunization of naïve individuals with two doses of the CoronaVac vaccine or one dose of the BNT162b2 vaccine elicited similar levels of nAbs compared to seropositive individuals 4.2 to 13.3 months post-infection with SARS-CoV-2. Thus, this preliminary evidence suggests that both, seropositive and naïve individuals, require two doses of CoronaVac to ensure the induction of robust nAb titers.
- ItemUtility analysis of an adapted Mini-CEX WebApp for clinical practice assessment in physiotherapy undergraduate students(2023) Fuentes Cimma, Javiera Carolina; Fuentes López, Eduardo; Isbej Esposito, Lorena Pilar; De La Fuente, Cancino Carlos Ignacio; Riquelme Pérez, Arnoldo Javier; Clausdorff Fiedler, Hans Jurgen; Torres Riveros, Gustavo Andrés; Villagrán Gutiérrez, Ignacio AndrésClinical workplace-based learning is essential for undergraduate health professions, requiring adequate training and timely feedback. While the Mini-CEX is a well-known tool for workplace-based learning, its written paper assessment can be cumbersome in a clinical setting. We conducted a utility analysis to assess the effectiveness of an adapted Mini-CEX implemented as a mobile device WebApp for clinical practice assessment. We included 24 clinical teachers from 11 different clinical placements and 95 undergraduate physical therapy students. The adapted Mini-CEX was tailored to align with the learning outcomes of clinical practice requirements and made accessible through a WebApp for mobile devices. To ensure the validity of the content, we conducted a Delphi panel. Throughout the semester, the students were assessed four times while interacting with patients. We evaluated the utility of the adapted Mini-CEX based on validity, reliability, acceptability, cost, and educational impact. We performed factor analysis and assessed the psychometric properties of the adapted tool. Additionally, we conducted two focus groups and analyzed the themes from the discussions to explore acceptability and educational impact. The adapted Mini-CEX consisted of eight validated items. Our analysis revealed that the tool was unidimensional and exhibited acceptable reliability (0.78). The focus groups highlighted two main themes: improving learning assessment and the perceived impact on learning. Overall, the eight-item Mini-CEX WebApp proved to be a valid, acceptable, and reliable instrument for clinical practice assessment in workplace-based learning settings for undergraduate physiotherapy students. We anticipate that our adapted Mini-CEX WebApp can be easily implemented across various clinical courses and disciplines.