https://hdl.handle.net/10259/7328 Sun, 11 Oct 2026 12:33:35 GMT 2026-10-11T12:33:35Z https://hdl.handle.net/10259/12206 “They Don’t Know About Suffering”: Reasons from Physicians and Users for the Use of Coercion After a Suicide Attempt in Latin America Agudelo Hernández, Felipe; Plata Casas, Laura Ines; Delgado Reyes, Andrés Camilo The use of coercive practices worsens recovery processes in mental health. These practices have various forms of presentation that must be identified to incorporate a rights-based approach into care processes. The aim was to describe and analyze the reasons perceived by physicians who employed coercive practices and by the individuals on whom these practices were employed, following a suicide attempt in Caldas, Colombia, in 2023 and 2024. A qualitative, transversal, and descriptive research design was used. Data collection was conducted in two phases: in-depth interviews with individuals who had attempted suicide were carried out between January and December 2024, and interviews with healthcare professionals were conducted between November 2024 and January 2025. A total of 30 participants were included, all of whom had attempted suicide and for whom coercive measures had been taken at a clinical level. In addition, 22 medical professionals who treated one of the 30 participants during their suicide attempt were included. Through content analysis, the interviews were divided into two themes. The first, based on interviews with individuals who had attempted suicide, was titled Reasons perceived by people using health services after a suicide attempt and comprised three categories: Lack of knowledge, Lack of willingness to help, and Obligation. The second theme, Reasons perceived by medical professionals, comprised categories such as Coercion as a primary resource, Coercion in medical training, and Coercion as medical protocol. Coercive measures, even though they are protocolled by health professionals, cause great suffering and hinder the recovery of people who have experienced coercive practices in mental health. Fri, 01 May 2026 00:00:00 GMT https://hdl.handle.net/10259/12206 2026-05-01T00:00:00Z https://hdl.handle.net/10259/8859 Cómo estimar la composición corporal en la enfermedad de Huntington. Estudio transversal y observacional con bioimpedancia de múltiples frecuencias Rivadeneyra Posadas, Jéssica Jannett; Simón Vicente, Lucía; Castillo, Daniel; Raya-González, Javier; Soto Célix, María .; Rodríguez Fernández, Alejandro; García Bustillo, Álvaro; Saiz Rodríguez, Miriam; Vázquez Sánchez, Fernando; Aguado, Laura; Leyva-Hernández, Gonzalo Gámez; Cubo Delgado, Esther Introducción: La enfermedad de Huntington (EH) es un trastorno raro neurodegenerativo. La información fiable del estado nutricional, especialmente de la composición corporal, es crítica en clínica y en investigación. La facilidad de aplicación y portabilidad del análisis de la bioimpedancia de múltiples frecuencias (mfBIA) la convierten en una herramienta atractiva para medirla, pero se desconoce su precisión en la EH. Objetivo: Evaluar la precisión del mfBIA frente a la absorciometría dual de rayos X (DEXA) en la EH. Pacientes y métodos: Estudio transversal, observacional y unicéntrico. La EH se midió con la subescala motora de la escala unificada de valoración de la EH y con la capacidad funcional total. La composición corporal se valoró según la masa libre de grasa (MLG), la masa grasa (MG), el índice de masa libre de grasa (IMLG) y el índice de masa grasa (IMG). Se utilizó el coeficiente de correlación intraclase con intervalos de confianza al 95% y estimaciones de sesgo mediante gráficos de Bland-Altman. Resultados: Se incluyó a 16 pacientes, siete hombres y nueve mujeres, con edad media de 58,5 (32-68) años, capacidad funcional total de 10 (3-13) y escala unificada de valoración de la EH de 31 (7-85). La fiabilidad era alta entre el mfBIA y la DEXA para el IMLG en hombres, 0,88 (intervalo de confianza al 95%: 0,17-0,98), y mujeres, 0,9 (intervalo de confianza al 95%: 0,61-0,98); y para el IMG en hombres, 0,97 (intervalo de confianza al 95%: 0,83-0,99), y mujeres, 0,91 (intervalo de confianza al 95%: 0,68-0,98). El mfBIA sobreestimó ligeramente la MLG, la MG, el IMG y el IMLG en los hombres, pero subestimó el IMLG en las mujeres. Conclusiones: El mfBIA es un método fácil de usar, seguro, no invasivo y preciso para medir la composición corporal y el estado nutricional en pacientes con EH leve-moderada.; Introduction: Huntington´s disease (HD) is a rare neurodegenerative disorder. Reliable information about nutritional status, especially body composition from individuals with HD is critical for clinical care and research. The ease of application and portability of multiple frequencies bioelectrical impedance analysis (mfBIA) make it an attractive tool for measuring body composition, but its accuracy in HD is unknown. Aim: To evaluate the accuracy of mfBIA vs. Dual X-ray absorptiometry (DEXA) in HD. Patients and methods: Cross-sectional, observational, and single-center study. HD severity was measured using motor subscale of the unified Huntington´s disease rating scale (m-UHDRS) and the total functional capacity (TFC). Body composition was measured in terms of fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), and fat mass index (FMI). Using Bland-Altman plots, we analyzed reliability between DEXA and mfBIA using the Intraclass Correlation Coefficient with 95% confidence intervals (CI) and bias estimates for all. Results: We included 16 patients with HD, 7 men, and 9 women, median age of 58.5 (32;68) years, TFC: 10 (3;13), and m-UHDRS: 31 (7;85). The reliability between mfBIA and DEXA were high for FFMI in men: 0.88 (95% CI 0.17-0.98), and women: 0.90 (95% CI 0.61- 0.98); for FMI, men: 0.97 (95% CI 0.83-0.99), and women: 0.91 (95% CI 0.68-0.98). Compared to DEXA, mfBIA slightly overestimated FFM, FM, FMI and FFMI in men and underestimated FFMI in women. Conclusions: mfBIA is an easy-to-use, safe, non-invasive, accurate method for measuring body composition and nutritional status in patients with mild-moderate HD. Mon, 01 Jan 2024 00:00:00 GMT https://hdl.handle.net/10259/8859 2024-01-01T00:00:00Z https://hdl.handle.net/10259/8857 Validation of ActiGraph and Fitbit in the assessment of energy expenditure in Huntington's disease Simón Vicente, Lucía; Rodríguez Fernández, Alejandro; Rivadeneyra Posadas, Jéssica Jannett; Soto Célix, María .; Raya-González, Javier; Castillo, Daniel; Calvo Simal, Sara; Mariscal, Natividad; García Bustillo, Álvaro; Aguado, Laura; Cubo Delgado, Esther Background: Consumer and research activity monitors have become popular because of their ability to quantify energy expenditure (EE) in free-living conditions. However, the accuracy of activity trackers in determining EE in people with Huntington’s Disease (HD) is unknown. Research question: Can the ActiGraph wGT3X-B or the Fitbit Charge 4 accurately measure energy expenditure during physical activity, in people with HD compared to Indirect Calorimetry (IC) (Medisoft Ergo Card)? Methods: We conducted a cross-sectional, observational study with fourteen participants with mild-moderate HD (mean age 55.7 ± 11.4 years). All participants wore an ActiGraph and Fitbit during an incremental test, running on a treadmill at 3.2 km/h and 5.2 km/h for three minutes at each speed. We analysed and compared the accuracy of EE estimates obtained by Fitbit and ActiGraph against the EE estimates obtained by a metabolic cart, using with Intra-class correlation (ICC), Bland-Altman analysis and correlation tests. Results: A significant correlation and a moderate reliability was found between ActiGraph and IC for the incremental test (r = 0.667)(ICC=0.633). There was a significant correlation between Fitbit and IC during the incremental test (r = 0.701), but the reliability was poor at all tested speeds in the treadmill walk. Fitbit significantly overestimated EE, and ActiGraph underestimated EE compared to IC, but ActiGraph estimates were more accurate than Fitbit in all tests. Significance: Compared to IC, Fitbit Charge 4 and ActiGraph wGT3X-BT have reduced accuracy in estimating EE at slower walking speeds. These findings highlight the need for population-specific algorithms and validation of activity trackers. Fri, 01 Mar 2024 00:00:00 GMT https://hdl.handle.net/10259/8857 2024-03-01T00:00:00Z https://hdl.handle.net/10259/8838 Functionality and Quality of Life with Parkinson’s Disease after Use of a Dynamic Upper Limb Orthosis: A Pilot Study Jiménez Barrios, María; González Bernal, Jerónimo; Cubo Delgado, Esther; Gabriel Galán, José María; García López, Beatriz; Berardi, Anna; Tofani, Marco; Galeoto, Giovanni; Matthews, Martin J. A.; Santamaría Peláez, Mirian; González Santos, Josefa Parkinson’s disease (PD) is a chronic, neurodegenerative movement disorder, whose symptoms have a negative impact on quality of life and functionality. Although its main treatment is pharmacological, non-pharmacological aids such as the dynamic elastomeric fabric orthosis (DEFO) merit an evaluation. Our objective is to assess the DEFO in upper limb (UL) functional mobility and in the quality of life of PD patients. A total of 40 patients with PD participated in a randomized controlled crossover study, and were assigned to a control group (CG) and to an experimental group (EG). Both groups used the DEFO for two months, the experimental group the first two months of the study and the control group the last two. Motor variables were measured in the ON and OFF states at the baseline assessment and at two months. Differences from the baseline assessment were observed in some motor items of the Kinesia assessment, such as rest tremor, amplitude, rhythm or alternating movements in the ON and OFF states with and without orthosis. No differences were found in the unified Parkinson’s disease rating scale (UPDRS) or the PD quality-of-life questionnaire. The DEFO improves some motor aspects of the UL in PD patients but this does not translate to the amelioration of the standard of functional and quality-of-life scales. Wed, 01 Mar 2023 00:00:00 GMT https://hdl.handle.net/10259/8838 2023-03-01T00:00:00Z