The 6-min walk distance (6MWD) predicted values have been derived from small cohorts mostly from single countries. The aim of the present study was to investigate differences between countries and ...identify new reference values to improve 6MWD interpretation. We studied 444 subjects (238 males) from seven countries (10 centres) ranging 40-80 yrs of age. We measured 6MWD, height, weight, spirometry, heart rate (HR), maximum HR (HR(max)) during the 6-min walk test/the predicted maximum HR (HR(max) % pred), Borg dyspnoea score and oxygen saturation. The mean ± sd 6MWD was 571 ± 90 m (range 380-782 m). Males walked 30 m more than females (p < 0.001). A multiple regression model for the 6MWD included age, sex, height, weight and HR(max) % pred (adjusted r² = 0.38; p < 0.001), but there was variability across centres (adjusted r² = 0.09-0.73) and its routine use is not recommended. Age had a great impact in 6MWD independent of the centres, declining significantly in the older population (p < 0.001). Age-specific reference standards of 6MWD were constructed for male and female adults. In healthy subjects, there were geographic variations in 6MWD and caution must be taken when using existing predictive equations. The present study provides new 6MWD standard curves that could be useful in the care of adult patients with chronic diseases.
Objective. From my experience as a member of the editorial board of the journal Investigación y Educación en Enfermería, the implications and scope of participating in this entity and the mutual and ...reciprocal benefits of this academic interaction between members of the editorial board and the journal are explained.
Content synthesis. The key elements on operation, integration, tasks, and responsibilities of editorial boards to disseminate scientific research in different disciplines are analyzed and described, highlighting the rigor and commitment to academic ethics that allows guaranteeing the credibility of the contents published and topics addressed by a journal within a context of high competitiveness and risk of breaches of academic and scientific probity and ethics.
Conclusion. Integrating an editorial board requires developing a fundamental role that implies a series of commitments and challenges that must be addressed with professionalism and ethics to guarantee the quality and prestige of the academic publication. In this task, achievements and goals are reached for the journal, as well as academic benefits for the editorial board members.
Objective. Within the context of evidence-based practice, this article exposes the reflection on the understanding and usefulness of the information provided by the research findings shared in ...reports and research publications, exposing differences based on the interpretation of statistical significance and clinical significance.
Content synthesis. Basic aspects of the meaning and use of the information reported by research on p value (statistical significance) and the value and usefulness of these results are analyzed and exemplified, contrasting the value for the practice of an additional judgment on clinical significance. In addition to establishing conceptual differences, the need is highlighted for nurses to have the competencies to differentiate and apply each of them according to the clinical contexts of their potential implementation.
Conclusion. The real usefulness of research about interventions within the context of nursing care is given by its real application and reach for the practice and benefit for patients. For this to occur, nurses must interpret adequately the information provided by scientific publications and other research reports.
Foot drop is a gait disturbance characterized by difficulty in performing ankle dorsiflexion during the swing phase of the gait cycle. Current available evidence shows that functional electrical ...stimulation (FES) on the musculature responsible for dorsal ankle flexion during gait can have positive effects on walking ability. This study aims to present a proof of concept for a novel easy-to-use FES system and evaluates the biomechanical effects during gait in stroke patients, compared to unassisted walking. Gait was quantitatively evaluated in a movement analysis laboratory for five subjects with chronic stroke, in basal condition without assistance and in gait assisted with FES. Improvements were found in all temporospatial parameters during FES-assisted gait, evidenced by statistically significant differences only in gait speed (\boldsymbol{p}=\mathbf{0.02}) . Joint kinematics showed positive changes in hip abduction and ankle dorsiflexion variables during the swing phase of the gait cycle. No significant differences were found in the Gait Deviation Index. In conclusion, the present pilot study demonstrates that the use of this FES system in the tibialis anterior muscle can cause gait functional improvements in subjects with foot drop due to chronic stroke.
Table grape production requires large amount of water, which can be problematic in semi-arid Mediterranean regions, where climate change projections anticipated reductions in water availability ...associated to decreases in precipitation and increases in temperature. In this context, this study aims to evaluate the effect of contrasting irrigation strategies and climate change scenarios on key water balance variables using a Chilean Table grape crop as case study. A standard and an improved irrigation management treatments were implemented in situ during the 2015/2016 and the 2016/2017–2017/2018 observed growing seasons, respectively. Then, the HYDRUS-1D water transfer model was run to simulate the three observed growing seasons and 27 near future growing seasons (2019/2020–2044/2015) under climate change conditions. Satisfactory calibration and validation results against soil moisture and water storage measurements were obtained within the first and the second observed growing seasons respectively (RRMSE values below 5%). Results during the observed seasons showed that by changing the standard irrigation by the improved irrigation management, the water use efficiency (WUEi) increases from 49.5% to 55.7%. For the near future, the calibrated model shows that under all the tested climate change scenarios, irrigation strategies based on supplying 80% and 50% of the crop evapotranspiration (ETc) (deficit irrigation scenarios) have larger efficiencies compared to the standard irrigation management (presenting a higher actual basal crop coefficient and lower percolation). Similar results were obtained under future extreme climate change years, defined as the ratio between model-based projections of reference evapotranspiration (ET0) and precipitation, with the deficit irrigation scenarios having larger efficiencies than the standard irrigation management. Based on these results, it is concluded that by mid- century, the irrigation management has more relevance than climate change impacts for tables grapes growing under a Mediterranean climate in central Chile.
•Satisfactory simulations of water transfers were done on an irrigated table grape.•80% of ETc was the better irrigation strategy under current climate conditions.•Irrigation management has more relevance than climate change for tables grapes.
Objective. Within the context of evidence-based practice, this article exposes the reflection on the understanding and usefulness of the information provided by the research findings shared in ...reports and research publications, exposing differences based on the interpretation of statistical significance and clinical significance. Content synthesis. Basic aspects of the meaning and use of the information reported by research on p value (statistical significance) and the value and usefulness of these results are analyzed and exemplified, contrasting the value for the practice of an additional judgment on clinical significance. In addition to establishing conceptual differences, the need is highlighted for nurses to have the competencies to differentiate and apply each of them according to the clinical contexts of their potential implementation. Conclusion. The real usefulness of research about interventions within the context of nursing care is given by its real application and reach for the practice and benefit for patients. For this to occur, nurses must interpret adequately the information provided by scientific publications and other research reports. Descriptors: nursing research; data interpretation, statistical; clinical relevance; nursing, practical; evidence-based practice Objetivo. En el contexto de una practica basada en evidencia, este articulo expone la reflexion sobre la comprension y utilidad de la informacion que proveen los hallazgos de investigacion reportados en informes y publicaciones de investigacion, exponiendo las diferencias a partir de la interpretacion de la significancia estadistica y significancia clinica. Sintesis del contenido. Se analizan y ejemplifican aspectos basicos sobre el significado y uso de la informacion que reportan las investigaciones sobre valor p (significancia estadistica) y el valor y utilidad de estos resultados contrastando el valor para la practica de un juicio adicional sobre significancia clinica. Ademas de establecer diferencias conceptuales, se resalta la necesidad de que las enfermeras tengan las competencias para diferenciar y aplicar cada uno de ellos segun los contextos clinicos de su potencial implementacion. Conclusion. La real utilidad de la investigacion sobre intervenciones en el contexto del cuidado de enfermeria esta dada por su real aplicacion y alcance para la practica y el beneficio para los pacientes. Para que ello ocurra, las enfermeras deben interpretar adecuadamente la informacion que proveen las publicaciones cientificas y otros reportes de investigacion. Descriptores: investigacion en enfermeria; interpretacion estadistica de datos; relevancia clinica; enfermeria practica; practica clinica basada en la evidencia. Objetivo. No contexto de uma pratica baseada em evidencias, este artigo apresenta a reflexao sobre a compreensao e utilidade da informacao fornecida pelos resultados da investigacao relatados em relatorios de investigacao e publicacoes, expondo as diferencas com base na interpretacao da significancia estatistica e da significancia clinica. Sintese de conteudo. Aspectos basicos sobre o significado e uso das informacoes relatadas pelas pesquisas sobre valor p (significancia estatistica) e o valor e utilidade desses resultados sao analisados e exemplificados, contrastando o valor para a pratica de um julgamento adicional sobre significancia clinica. Alem de estabelecer diferencas conceituais, destaca-se a necessidade de o enfermeiro ter competencias para diferenciar e aplicar cada uma delas de acordo com os contextos clinicos de seu potencial implementacao. Conclusao. A real utilidade da investigacao sobre intervencoes no contexto dos cuidados de enfermagem e dada pela sua real aplicacao e ambito de pratica e beneficio para os pacientes. Para que isso ocorra, os enfermeiros devem interpretar adequadamente as informacoes fornecidas pelas publicacoes cientificas e outros relatorios de pesquisa. Descritores: pesquisa em enfermagem; interpretacao estatistica de dados; relevancia clinica; enfermagem pratica; pratica clinica baseada em evidencias.
In this work, we propose a new approach to diagnose if a water allocation scheme is compatible with long-term water security at the catchment scale, and suggest steps to achieve such compatibility. ...We argue that when the remaining flow of a river after upstream withdrawals is not sufficient to safeguarding ecological river functions, the basin is at extreme risk of water scarcity, which indicates that the water management is failing. To test this, we analysed the water scarcity risks and the safeguarded environmental flows (e-flows) in 277 basins across a wide range of hydro-climatic conditions in Chile (17–55°S). For each basin, water scarcity risks were assessed based on water stress indices (WSIs, computed as the ratio of withdrawals to water availability), considering two water-use scenarios: (i) WSImax, where total withdrawals correspond to the maximum consumptive water allowed by the law, i.e., where only the e-flows protected by law remain in the river, and (ii) WSIalloc, where total withdrawals correspond to the actual allocated consumptive water uses within the basins. Further, we evaluated the adequacy of the water management system to protect ecological river functions by contrasting the e-flows protected in Chile with those safeguarded in six other countries.
The water allocation system in Chile incorporated the protection of minimum e-flows in 2005 and established that these do not exceed 20% of the mean annual streamflow, except in some exceptional cases. This upper limit is consistently lower than the e-flows safeguarded in other countries, where 20%–80% of the mean annual streamflow are protected. This turns out in WSImax values between 80% and 100% in all basins, well above the threshold associated with over-committed basins under extreme risk of water scarcity (70% typically). When moving from the legally allowed to the actually allocated water use scenario, we found contrasting results: about 70% of the basins show low water scarcity risk (WSIalloc <40%), while an 18% have WSIalloc above 100%, indicating the allocation is going beyond current law limits and even beyond physical limits.
Our results reveal that the link between e-flows, water allocation and water security has not been adequately incorporated in the current law. E-flows stipulated by law are insufficient to fulfil environmental requirements, while placing the basins under extreme risk of water scarcity if the total allowed withdrawals were exerted. To move towards a system that can effectively achieve long-term water security, we recommend: (i) To define tolerable water scarcity risks for basins, considering environmental requirements. (ii) To translate those risks into measurable basin indices to measure water security, such as the WSI. (iii) To set maximum water use limits (or minimum e-flows) within the basins that are compatible to the water security goals. If, under current and projected water availability conditions, the existing withdrawals exceed these limits, water managers should be able to adapt total consumption to the required limits.
•We diagnose if a water allocation scheme is compatible with long-term water security.•We compute water stress indices (WSIs) and e-flows for 277 basins in Chile.•We assign water scarcity risks to the WSIs and contrast e-flows with other countries.•E-flows protected in Chile place all basins under extreme risk of water scarcity.•Allocated withdrawals go beyond current law limits and even beyond physical limits.
On 12 May 2020, the world commemorated thebicentennial of the birth of Florence Nightingale,and to date, multiple publications in press media,social networks, and journal articles have relatedher ...biography and accounted for her contributionand legacy, not only to nursing, but to publichealth. It is precisely within this context of healthcontingency due to the COVID-19 pandemic thatthe relevance of Nightingale gains greater senseon aspects as simple, but as necessary, likehandwashing and measures of basic health.