Introduction. Given the potential influence of biomechanical demands imposed by beach tennis (BT) on athletes’ scapular movement patterns, it is essential to ascertain the reliability of clinical tests for scapular dyskinesis (SD) in this particular population. Objective. To investigate the intra- and inter-rater reliability of a clinical test for SD in BT athletes. Method. Two blinded raters (a novice and an expert) independently evaluated SD in 58 BT athletes using the same video recordings to determine inter‑rater reliability. Furthermore, intra-rater reliability was assessed by examining the consistency of SD classifications made by the novice rater across two trials. Each scapula was independently classified as normal, subtle, or obvious dyskinesis. The intra- and inter-rater reliability was determined by use of linear weighted Kappa (κw). Results. For the dominant extremity, the expert rater classified approximately 32.5% [95%CI: 17.3 to 55.6] of right-handed athletes and 16.7% [95%CI: 3.4 to 48.7] of left-handed athletes as presenting SD. The novice rater identified approximately 25.0% [95%CI: 12.0 to 46.0] of right-handed athletes and 22.2% [95%CI: 6.1 to 56.9] of left-handed athletes with SD. Inter-rater reliability was low for the left upper extremity (κw = 0.132 [95%CI: −0.15 to 0.42]) and moderate for the right upper extremity (κw = 0.601 [95%CI: 0.39 to 0.81]). Intra-rater reliability demonstrated substantial agreement for both the left (κw= 0.594 [95%CI: 0.33 to 0.86]) and right (κw = 0.693 [95%CI: 0.51 to 0.88]) upper extremity. Conclusion. The clinical test for SD demonstrated substantial intra-rater reliability, but variable inter-rater reliability among BT athletes.
Introduction. The quality of clinical mentorship is a determining factor in the training of future nursing professionals. However, various organizational and personal factors can limit the involvement, motivation, and commitment of clinical preceptors. Objective. To evaluate the impact of a training program on the perceive involvement, motivation, satisfaction, and commitment among health professionals who mentor nursing students in a clinical setting. Method. A quasi-experimental, prospective, pre-post intervention study was conducted in a tertiary hospital in Spain. The IMSOC questionnaire was administered to 239 professionals. Mean scores for the dimensions of involvement, motivation, satisfaction, obstacles, and commitment were compared. Results. Satisfaction was the only dimension that showed a statistically significant improvement after the training (with the mean score increasing from 22.96 to 25.41; p = 0.029). No significant changes were observed in involvement (p = 0.491), motivation (p = 0.304), or commitment (p = 0.230). In fact, commitment showed a slight non-significant decrease. Conclusion. Training alone is insufficient to improve most key dimensions of the mentoring experience, except for satisfaction. It is imperative for healthcare institutions to implement complementary strategies, such as formal recognition and the creation of a supportive culture, to comprehensively strengthen the commitment, involvement, and motivation of clinical preceptors.
Introduction. Work-related injuries (WRIs) generate substantial functional and economic burdens, yet evidence on their duration and direct costs remains scarce in middle-income countries. Objective. This study aimed to characterize the duration and direct salary-related costs of WRIs and to identify predictors of return to work (RTW) in the financial and insurance sector of the Metropolitan District of Quito (DMQ), Ecuador. Method. An analytical cross-sectional study was conducted using secondary administrative microdata from the General Insurance for Work Risks (SGRT) of the Ecuadorian Social Security Institute, covering 409 certified non-fatal WRIs with at least one day of temporary work incapacity (TWI) recorded between 2023 and 2024. TWI duration was compared across sociodemographic, occupational, and place of occurrence categories using the Mann–Whitney U and Kruskal–Wallis H tests. Time to RTW was estimated using Kaplan–Meier methods and compared using the log-rank test; observations exceeding 90 days of TWI were right-censored. Unadjusted and adjusted Cox proportional hazards regression models were used to identify independent predictors of time to RTW. Direct salary-related costs were estimated using the human capital method, disaggregated by responsible payer. Results. Of the 409 WRIs analysed, 256 (62.6%) resulted in ≥4 days of TWI. Commuting accidents represented 67.7% of all injuries and were significantly associated with longer TWI duration (median: 44.0 vs. 6.0 days for workplace accidents; p < 0.001). Place of occurrence was the only statistically significant independent predictor of time to RTW, with workers injured at the workplace having a 6.6 times higher probability of RTW at any given time compared to those involved in commuting accidents (AHR = 6.589, 95% CI: 4.520–9.607; p < 0.001). The SGRT bore 97.0% of total direct salary-related costs (US$479,617 out of US$494,379), with commuting accidents generating the highest mean cost per case (US$2,421 vs. US$264 for workplace accidents). Conclusion. Commuting accidents are the primary driver of prolonged TWI and the dominant source of direct salary-related costs in the financial and insurance sector of the DMQ. The current workers' compensation framework, which limits employer liability to the first three days of TWI, is associated with a marked structural asymmetry in the financial burden between employers and the social security system. Occupational health and safety strategies should be broadened to include commuting risk reduction measures, and potential reforms to the workers' compensation framework warrant further evaluation.
Introduction. Informal caregiver burden is a multidimensional phenomenon that may influence the well-being of dependent older adults. However, evidence regarding its relationship with quality of life in Andean community settings remains limited. Objective. To evaluate the association between caregiver burden and quality of life among older adults receiving home care in a high-Andean community in Peru, while recognizing that this relationship may be influenced by clinical, functional, nutritional, and contextual factors. Methods. A quantitative, correlational, nonexperimental, cross-sectional study was conducted. A total of 281 older adult-caregiver dyads were evaluated, selected through simple random sampling. Quality of life was measured with the WHOQOL-AGE, and caregiver burden with the Zarit Scale. Due to the non-normal distribution of the data, medians and interquartile ranges were reported. Bivariate analyses were performed using Spearman correlation and the Mann-Whitney U and Kruskal-Wallis tests, with statistical significance set at p < 0.05. In addition, an exploratory binary logistic regression model was fitted to evaluate the adjusted association between caregiver burden and inadequate quality of life. Results. Quality of life was inadequate in three-quarters of the sample, and more than half of the caregivers had some degree of burden. Quality-of-life scores differed significantly according to nutritional status and functional status (p < 0.05), whereas caregiver burden scores did not differ across the characteristics examined. No significant correlation was observed between older adults' quality of life and caregiver burden (ρ = −0.079; p = 0.189). However, in an exploratory adjusted logistic regression model, caregiver burden was associated with higher odds of inadequate quality of life (adjusted OR = 1.868; 95% CI: 1.035–3.370; p = 0.038). Conclusion. In this population, the bivariate correlation between caregiver burden and quality-of-life scores was not statistically significant. Nevertheless, an exploratory adjusted logistic regression model suggested that caregiver burden may be associated with higher odds of inadequate quality of life. Given the cross-sectional design and the possibility of residual confounding, this finding should be interpreted cautiously and viewed as hypothesis-generating.
Introduction. Understanding Body Mass Index (BMI) trends over time is essential for addressing the global overweight and obesity pandemic and its associated health risks. However, evidence from low- and middle-income countries remains limited. This study analyzed long-term BMI trends in Argentina (2005-2018), examining variations by age, sex, and socioeconomic status (SES), and comparing patterns according to the presence of obesity-related chronic diseases in adults. Method. Data were obtained from repeated cross-sectional, population-based Argentine surveys: the National Risk Factors Survey (2005, 2009, 2013 and 2018; n = 126,590). Age specific BMI trends were estimated using three-age moving medians. Polynomial curves were fitted to estimate the age at maximum BMI (maxBMI) and its corresponding value in the general population according to sex, SES, and chronic conditions (hypertension and type 2 diabetes mellitus). Results. A steady increase in mean BMI was observed across survey waves. Overall, maxBMI was reached between approximately 58–61 years of age, and its value was similar for men and women; however, women reached maxBMI at slightly older ages. The low SES group showed both a higher maxBMI and an earlier age at maxBMI than the high SES group. Additionally, individuals with hypertension or type 2 diabetes exhibited a higher maxBMI, which occurred at earlier ages than in participants without these conditions. Conclusions. BMI increased steadily in Argentina during the study period, with differences according to sex, SES, and health status. Unlike conventional approaches based on average BMI values, age-specific BMI curves allow for a life-course perspective on obesity dynamics. This approach highlights the importance of considering these factors when monitoring BMI as population health indicator, especially among socially disadvantaged groups.
