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Clinical practice guidelines are a set of recommendations developed systematically and based on the best available evidence. Their purpose is to enable healthcare providers and patients to make the best decisions regarding healthcare interventions associated with a particular clinical condition, considering each patient's specific circumstances. One element that has gained importance recently is considering patient preferences when developing healthcare recommendations to increase adherence to therapeutic measures and patient satisfaction. One way to incorporate these preferences is by including patients or their representatives in developing these tools. Patient participation can take place through their inclusion as members of the development panel and/or at different stages of the guideline development process. This can be achieved through various methods like discussion groups, semi-structured interviews, or surveys. However, challenges still need to be addressed to optimally incorporate patients' perspectives, which, among other reasons, are related to socioeconomic barriers, educational gaps, and the persistence of a paternalistic view of healthcare. This article has been developed in the context of a methodological series on clinical epidemiology, biostatistics, and research methodology carried out by the departments of Research Methodology and Evidence-Based Medicine at the School of Medicine of the University of Valparaíso, Chile.

Introduction: The impact of confinement on eating habits has been associated with mental health, gender, and socioeconomic status. This study examined the consumption of sugar-sweetened beverages and fast food during the COVID-19 confinement period in Chile, a country with a history of high consumption of processed foods.

Methods: A cross-sectional design was done from responses obtained through an online survey between May and August 2020. Data were collected and managed using the SurveyMonkey® electronic tool (hosted at the Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol i Gurina, Barcelona, Spain). We recruited through online platforms and social networks using convenience and snowball sampling. People aged 18 years and older were included. The consumption of sugar-sweetened beverages and fast food was analyzed in relation to socioeconomic and sociodemographic variables. Logistic and log-binomial regression models were evaluated using Stata v18. P<0.05 was considered statistically significant.

Results: 6971 (93%) people completed the questionnaire. The participants were predominantly born in Chile (94.6%), with a majority being women (63.5%) and under 50 years old (74%). The prevalence of consumption of sugary drinks and fast food was 15.4% (men, 14.6%; women, 15.9%) and 19.6% (men, 17.2%; women, 21%), respectively. Age 40 years and older was a protective factor for both women and men. Factors associated with the consumption of sugar-sweetened beverages included a change in employment status (prevalence ratio 1.26; 95% confidence interval 1.02 to 1.45) and, for fast food consumption, being female (1.18; 1.06 to 1.32).

Conclusions: Sex, age, and change in income were associated with increased consumption of sugar-sweetened beverages and fast food during the COVID-19 pandemic. These results reaffirm the importance of implementing social and communicational strategies that promote healthy eating, especially during health emergency scenarios.

Event-based surveillance is an important strategy for the early detection of outbreaks of all types of diseases, especially in low- and middle-income countries. This research focuses on an evidence map, which systematizes and graphically represents the information gathered on the effectiveness of various interventions in these contexts. Key interventions include data quality, training, communication, multisectoral collaboration, timeliness, mortality and morbidity reduction, cost-effectiveness, early response to events, sensitivity, signals, and usefulness for real events. In this study, a review and evaluation of the literature was conducted on a total of 22 systematic reviews; 15 met the inclusion criteria, containing a total of 82 open-access primary articles. The quality of the evidence was assessed using the AMSTAR tool, identifying reviews with high, medium, and low reliability. The results show that event-based surveillance has been successfully implemented in countries such as the United States, Brazil, China, Australia, Canada, India, Japan, New Zealand, Taiwan, the Netherlands, the United Arab Emirates, and others. From the evidence gathered in these countries, it is clear that event-based surveillance improves early outbreak detection, alert response, and minimizes the spread of diseases. Further research and improvement of these strategies are needed for effective early detection and response to public health events.

Introduction: Primary dysmenorrhea is defined as pain during the menstrual cycle, recurrent cramping type in the absence of an identifiable cause. It can negatively affect the quality of life of those who suffer from it. The objective is to determine the association between pain intensity in primary dysmenorrhea and the impact on quality of life related to menstrual health, presenteeism, and sexual function in adult Chilean women.

Methods: Cross-sectional observational study. A sample of 392 women with painful menstruation in the last six months. A self-reported survey was distributed on social media between January and June 2024, consisting of sociodemographic questions, pain intensity and perception, the EQ5D-3L quality of life questionnaire, the Stanford Presenteeism Scale, and the Women's Sexual Function Questionnaire adapted to the study.

Results: The mean age was 29.2 +/- 8.2 years, and the mean pain intensity was 6.7 +/- 2.04 points. High pain intensity was associated with greater impairment. Those with severe or extreme pain experienced a significant impact on their quality of life related to menstrual health. Among the compromised aspects, the most notable were the performance of usual activities (OR 9.99), lower work performance (lack of concentration), and decreased social activities. The most common mitigation measures used were local heat (96.7%), herbal teas (63.5%), and medication (90%).

Conclusions: Dysmenorrhea impacts different dimensions of quality of life. Despite its high prevalence, it is often underestimated, and women often normalize pain by employing various methods to mitigate it. The concept of menstrual health is a subjective and multidimensional experience. The results suggest the importance of comprehensively updating the management of dysmenorrhea and incorporating new studies on economic evaluation, prevalence, and self-image to delve deeper into the subject.

Introduction: The five repetitions sit-to-stand test is commonly used to evaluate physical function, mainly to determine the risk of falls, and is also included as a component in other evaluations, such as the Short Physical Performance Battery. However, reference values are currently unavailable for populations living at high altitudes. This study aimed to establish normative values for the five repetitions sit-to-stand test in the population living 2500 meters above sea level.

Methods: A multicenter, cross-sectional research was carried out, collecting data from two high-altitude cities in Ecuador. Healthy adults aged 18 to 80 were recruited. Anthropometric measurements, physical activity levels, and tobacco use were registered. Reference equations were determined using multiple linear regression separately for men and women. The predictive model was generated using stepwise method.

Results: 400 healthy subjects (58% women) were recruited in the study. The participants had a median (P25 to P75) height of 1.62 (1.56 to 1.68) m, weight of 63.0 (57.8 to 70.1) kg, and Body Mass Index of 24.2 (22.5 to 26.0) kg/m. For men aged 18 to 29 years, the results for the five repetitions sit-to-stand test ranged from (P25 to P75) 5.1 to 9.3 seconds and between 8.2 to 12.2 seconds for people aged 70 to 80 years. For women aged 18 to 29 years, the results for five repetitions sit-to-stand test ranged from (P25 to P75) 5.0 to 7.9 seconds and between 8.2 to 14.3 seconds in the range 70 to 80 years.

Conclusions: Reference values were established for the five repetitions sit-to-stand test in the healthy population living at high altitudes, between 18 and 80 years old.

Introduction: There is a need for a validated instrument that assesses the perception of competencies and the level of preparedness of professionals and technicians who perform telehealth care in Chile.

Objective: To develop and evaluate the reliability and validity of an instrument designed to measure the perception of competencies and the level of preparedness in telehealth.

Methods: An instrument on telehealth competencies and level of preparedness was designed, obtaining content validity through expert judgement. The instrument was then administered in 2023 to a total of 83 healthcare professionals and technicians with telehealth experience. To determine construct validity, exploratory factor analysis was conducted, extracting factors using Principal Axes and estimating the number of factors by combining Horn's Parallel Analysis and scree plot. Rotation was performed using the Oblimin method. To estimate reliability, Cronbach's Alpha statistic was calculated.

Results: The factor analysis identified items with loadings over 0.6, resulting in a final scale of two factors with a total of 31 items. This factorial model explained 75.5% of the total variance. The first factor brings together items assessing perceptions of telehealth competencies, and the second factor assesses perceptions of the level of telehealth preparedness. Both factors show adequate reliability indicators, with Cronbach's Alpha of 0.98 and 0.97 respectively, and present correlations considered adequate.

Conclusions: The instrument has adequate psychometric indicators, even considering the sample size, to measure the perception of competencies and level of preparation in telehealth in health professionals and technicians in the Biobío region. The two factors that make up the instrument help identify training and education needs. It is suggested to extend the validation to samples from other regions and to increase the diversity of clinical disciplines.

Introduction: Multicomponent exercise programs have demonstrated benefits for both cognitive and physical function. However, their effects on brain-derived neurotrophic factor (BDNF) levels remain inconsistent, particularly in protocols incorporating functional exercises. This study aimed to evaluate the impact of two distinct multicomponent exercise protocols on BDNF levels and physical fitness in older women.

Methods: Ninety physically active. community-dwelling older women (70.4 ± 7.2 years) were allocated to three different groups: 1) Multicomponent program 1: Circuit-based functional training; 2) Multicomponent program 2: Pilates Method; and 3) control group that received only health education. Both multicomponent programs were conducted over a 12-week period, with 50-minute sessions held three times per week. The control group participated in 12-week Health Education intervention with 90-minute sessions once a week. Brain-derived neurotrophic factor levels, short physical performance battery, agility, six-minute walk, and handgrip tests were measured.

Results: Brain-derived neurotrophic factor levels increased significantly in both the functional training group (p<0.001) and Pilates group (p=0.005), with a more pronounced increase observed in the functional training group. The distance covered in the six-minute walk test also increased significantly in the functional training group (p=0.001) and was greater compared to both the Pilates (p<0.001) and control (p<0.001) groups.

Conclusions: Both multicomponent exercise programs led to increased BDNF levels after 12-week intervention. However, functional training yielded superior results compared to the Pilates method, possibly mediated by improvement in physical function.

Introduction: Advances in treatment have improved the survival rates of patients diagnosed with breast cancer. However, the number of women experiencing long-term consequences has also increased, affecting their quality of life, including sexual function.

Objectives: To evaluate the prevalence of sexual dysfunction as measured by the Female Sexual Function Index, its association with treatment modalities in Uruguayan breast cancer survivors, and to compare the questionnaire scores by age group (50 years or older versus under 50 years).

Methods: This ambispective observational study included patients diagnosed with early-stage breast cancer (I to III) who had completed surgery, chemotherapy, and radiotherapy treatments at least 12 months before inclusion. Patients completed the Female Sexual Function Index questionnaire, and the data were analyzed using simple and multiple binary logistic models to assess the relationship between treatment modalities and sexual dysfunction. Additionally, differences in Female Sexual Function Index scores between age groups were analyzed.

Results: A total of 149 patients were included; 67.1% underwent breast-conserving surgery, 68.5% received chemotherapy, 92.6% radiotherapy, and 95.3% hormone therapy. Sexual dysfunction, defined as a score ≤ 26.55 on the questionnaire, was present in 58.3% of patients. Multivariate analysis indicated a higher risk of sexual dysfunction in patients who underwent total mastectomy, were treated with chemotherapy, or used gonadotropin-releasing hormone agonists.

Conclusions: Although this study highlights the impact of certain treatment modalities on sexual function, the results should be interpreted considering the characteristics of the population and potential biases. These findings can guide clinicians in planning treatments to improve the quality of life of sexually active breast cancer patients.

Introduction: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection are major public health problems in Latin America and Africa. The province of Guayas in Ecuador has a high proportion of cases but there is limited information on their sociodemographic characteristics and spatial distribution. The aim of this study was to analyze the sociodemographic and spatiotemporal characteristics of TB/HIV coinfection patients in three cantons of the Guayas province, Ecuador, in 2018.

Methods: A cross-sectional study was conducted using secondary data from the Ministry of Public Health of Ecuador. The study population was all adult patients with a diagnosis of TB/HIV co-infection residing in the three cantons of the three cantons. Data were analyzed to determine prevalence, incidence and mortality, as well as socio-demographic variables such as age, sex, educational level and housing conditions. Spatial distribution was assessed using QGIS software version 3.24 to identify high-prevalence areas.

Results: A total of 379 cases of TB/HIV coinfection were identified, with a predominance of males (80.74%) and a mean age of 35 years. The prevalence was 1.24 per 100 000 inhabitants, with a case fatality rate of 15.57%. Individuals below the poverty line showed a stronger association with co-infection (PR=6.773, 95% CI: 4.985 to 9.202). Spatially, cases were concentrated in socioeconomically disadvantaged municipalities of Guayaquil.

Conclusions: TB/HIV co-infection shows a clear association with social determinants, especially poverty and educational level. The heterogeneous spatial distribution among the three cantons and the high case fatality rate suggests the need to strengthen epidemiological surveillance and implement targeted interventions addressing social determinants in the most vulnerable areas.

Introduction: Telehealth and telemedicine have proven to be useful in complementing face-to-face care, especially when long distances exist or when it is difficult to access specialists. New competencies are required to implement telehealth and telemedicine, not only in the use of technologies, but also in areas such as communication and ethics.

Objective: To identify the dimensions associated with competencies in telemedicine and telehealth from the perspective of professionals in the area based on research developed in the last ten years.

Methods: A Scoping Review was carried out by reviewing the WoS, Scopus, PubMed, and Scielo databases. The selection of publications included only original articles in both Spanish and English available under Open Access between the years 2013 and 2023.

Results: The review identified twelve key dimensions in telemedicine and telehealth, highlighting "Technological knowledge in general and in telehealth technologies", present in 25 papers. Seventeen papers addressed the dimensions of "coordination, cooperation and management", highlighting the effective integration of multidisciplinary teams. Ethical competencies, professionalism and legal aspects, essential to guarantee privacy, informed consent and safety in telehealth, were also highlighted. Professionalism includes effective communication, technical skills and clinical reasoning, while safety encompasses data protection, promoting ethical and patient-centered care.

Interpretation: The dimensions identified can guide researchers to better understand the competencies needed in the field of telehealth. Moreover, they can provide key elements for the development of a contextualized training framework leading to quality, flexible and more equitable remote care, responding to the needs of a society that is changing and adapting daily.