Bibiana Bouzon Martinez - Academia.edu (original) (raw)

Papers by Bibiana Bouzon Martinez

Resumo O século XXI vem sendo significativamente marcado pelo envelhecimento populacional. No Val... more Resumo O século XXI vem sendo significativamente marcado pelo envelhecimento populacional. No Vale do Taquari, o número de habitantes idosos já supera a média nacional, caracterizando 14% da população total, segundo o Censo de 2010. O Projeto Ações Sociais e de Saúde em Gerontologia, da Universidade do Vale do Taquari (Univates), trabalha com o público idoso desta região desde 2014. O objetivo deste trabalho foi avaliar o impacto social de tal projeto, junto aos participantes, no ano de 2016. Os idosos responderam sobre suas satisfações em relação ao retorno das avaliações de saúde realizadas, aos temas e informações prestadas durante as oficinas e em relação ao impacto do projeto na vida deles. A média das respostas apontam que os idosos consideraram as ações ótimas. Palavras-Chave: Envelhecimento. Extensão Universitária. Impacto Social. Idoso. THE IMPACT OF THE SOCIAL ACTIONS AND HEALTH IN GERONTOLOGY PROJECT/UNIVATES FOR ELDER PARTICIPANTS Abstrat This century has been significantly marked by populational aging. In Vale do Taquari, Brazil, the number of elderly inhabitant already surpasses the national average, characterizing over 14% of total population, according to the 2010 Census. The Social and Health Actions in Gerontology of Univates works with the elderly public of this region since 2014. This work's objective was to evaluate the social impact of said project, along with the participants in the year of 2016. The Elders answered about their satisfactions related to the return of the health evaluations ministered, the themes and information provided during the workshops and in relation to the impact of the project in their lives. The response average show that the elders considered the actions good and useful.

American Journal of Occupational Therapy, Jul 1, 2015

Date Presented 4/16/2015 The purpose of this randomized controlled trial was to test the feasibil... more Date Presented 4/16/2015 The purpose of this randomized controlled trial was to test the feasibility of an outpatient poststroke lifestyle intervention in a safety-net health care system to estimate and compare effect sizes for short-term changes in body mass index (BMI), diet, and physical activity.

Stroke, Feb 1, 2020

Background: Minority and socioeconomically disadvantaged individuals are underrepresented in seco... more Background: Minority and socioeconomically disadvantaged individuals are underrepresented in secondary stroke prevention trials. Little is known about factors associated with study retention in these populations. Objective: To evaluate the impact of sociodemographic characteristics on retention in the Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED) trial. Methods: 487 participants ≥40 years with stroke/TIA were recruited from 4 safety-net hospitals and 1 stroke center serving low income zip codes. Strategies for boosting retention included: having bilingual research assistants from similar cultures establish rapport and follow participants; culturally and linguistically tailoring materials; arranging visits around participants’ schedules; offering transportation, and conducting assessments in the home and community. We compared sociodemographic characteristics among those retained at 12 months (n=412) vs. those not retained (n=75) using t-test, Chi Square, and Fisher exact tests. Independent factors associated with retention were determined using logistic regression. Results: Average age was 57 years, 18% were black, 71% were Hispanic, 58% were Spanish-speaking, and 72% were born outside the US. 12-month retention was 85%. On bivariate analysis, factors associated with retention were: Spanish-speaking, Hispanic ethnicity, younger age, born outside the US, and married status (all p&amp;amp;lt;0.05). After multivariate analysis, study site, younger age (&amp;amp;lt;64 vs ≥65 years OR 2.2, 95% CI 1.1,4.4), married status (OR 2.0, 1.0,4.2), government insurance (vs uninsured OR 25.1, 1.2,5.1), private insurance (vs uninsured, OR 4.6, 1.3,16.4), and inability to afford medical care (OR 2.9, 1.3,6.7) were associated with retention. Discussion: In this secondary prevention trial of stroke survivors from predominantly minority backgrounds, younger age, marriage, and insurance were associated with retention, suggesting that addressing barriers in the elderly, and those without insurance or spousal support may be beneficial. Financial constraints were associated with retention suggesting that study participation appealed to more socioeconomically vulnerable individuals.

Extensio, Dec 20, 2017

The American Journal of Gastroenterology, Oct 1, 2016

Gastroenterology, May 1, 2018

Background: Previous studies reveal that many patients with gastrointestinal (GI) conditions beli... more Background: Previous studies reveal that many patients with gastrointestinal (GI) conditions believe their symptoms are related to food. There is an unmet need to develop a patientreported outcome (PRO) measure that accurately tracks the link between food and GI symptoms; such a measure could help diagnose presence and intensity of food intolerance, and evaluate the impact of dietary changes. Commonly used measures, such as the Gastrointestinal Symptom Rating Scale (GSRS) and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Scales are validated for aggregate weekly recall, thereby not permitting within-day symptom assessment necessary for evaluating relationships to diet. To address this gap, we developed the Food and Symptom Tracker (FAST) Score, allowing for high resolution within-day symptom assessment. The objective of this study was to determine the feasibility of a mobile application (app) in deploying FAST and validating the score against legacy measures. Methods: We developed FAST using themes derived from interviews with expert dieticians supplemented by insights from the literature. Then, we conducted initial construct validation in a cohort of adult patients (764 observations across 21 subjects) with GI symptoms who were referred to a GI dietician. Patients were recruited 7 days prior to their first appointment and completed a 14-day pre-post study to test FAST's ability to detect symptom changes before vs. after diet recommendations. Patients downloaded a smartphone app, recorded meals throughout the day, and answered FAST items 1-hour after each meal. At the end of each week, patients completed GSRS & PROMIS Global Health 10 questionnaires. Multilevel two-part log-gamma regressions were used to test the association between FAST and legacy measures. Results: Patients reported GI symptoms 42% of the time, with an average FAST score of 7.6 (range: 1.0, 53.5) when symptoms were present. An increase of 1 point on GSRS, indicating worsening symptoms, was associated with a 6% increase in the likelihood of GI symptoms as reported on FAST (p<0.001) and a 2% expected increase in the FAST score (p=0.03) among symptomatic individuals. A 1-point decrease on PROMIS-10, denoting declining overall health, was associated with a 5% increase in the likelihood of GI symptoms on FAST (p=0.04). Discussion: In this study, patients seeking dietician care reported having symptomatic discomfort approximately half of the time following a meal, suggesting a need for FAST to determine within-day variations in GI symptoms. FAST correlates significantly with established measures, indicating construct validity. These initial findings indicate utility of FAST as part of a digital health app for patients with food-specific GI symptoms. Additional validation, including the ability to detect change after a dietary intervention, are forthcoming. Patient Characteristics and Measure Descriptive Statistics *For asymptomatic and symptomatic individuals combined Mo1966

Anales De Pediatria, Dec 1, 2015

Método Delphi; Fórmulas infantiles; Suplementos; Consenso Resumen Introducción: La alimentación i... more Método Delphi; Fórmulas infantiles; Suplementos; Consenso Resumen Introducción: La alimentación infantil en los primeros meses/años de vida condiciona la salud a corto y largo plazo. La lactancia materna es la alimentación ideal por sus innumerables beneficios. Sin embargo, cuando no es posible la alimentación con leche materna, las fórmulas infantiles constituyen la mejor alternativa. El objetivo del estudio fue definir el papel de las fórmulas de inicio y continuación para lactantes mediante la opinión de un panel de expertos en gastroenterología y nutrición infantil. Material y métodos: Encuesta realizada mediante el método Delphi por 48 especialistas en pediatría y nutrición infantil. El cuestionario constaba de 62 ítems, estratificados en 5 bloques, sobre aspectos nutricionales de las fórmulas infantiles. Resultados: Se consensuó el 64,6% de los ítems, estableciéndose un acuerdo no unificado respecto a aspectos nutricionales y su impacto sobre el desarrollo corporal, cerebral y la maduración inmune. Conclusiones: Según los expertos encuestados, existe consenso sobre la adecuada composición en lípidos, lactosa, calcio, vitamina D y prebióticos, de las fórmulas infantiles, para el correcto desarrollo cerebral, inmunitario y somático. No hubo consenso en aspectos aún no bien definidos, como la calidad nutricional de las proteínas, la utilización de espesantes y la suplementación con taurina, probióticos y simbióticos. Son necesarios más estudios que determinen estos aspectos.

The Journal of Emergency Medicine

Innovation in Aging

Frequent 911 calls from older adults place a significant burden on emergency response systems. Dr... more Frequent 911 calls from older adults place a significant burden on emergency response systems. Drawing from key informant interviews, we explore factors implicated in repeated Emergency Medical Services (EMS) among older people in the City of Los Angeles and provide system and policy recommendations to mitigate overuse of EMS 911 calls. Los Angeles Fire Department (LAFD) dispatch call records documented 370,016 EMS encounters from 202,471 unique individuals over 50 from 2012 to 2016. Frequent 911 callers over the age of 50 (n=8), family members (n=6), Los Angeles Fire Department (LAFD) personnel (n=10), and community service providers (n=3) participated in in-depth, qualitative interviews to understand individual- and system-level factors that increase the likelihood of repeated calls. All interviews were audio recorded, transcribed, and analyzed thematically. Guided by Grounded Theory, two themes emerged across all interviewee groups pointing to factors that contributed to 911 call...

PLOS ONE, 2021

ABO blood groups have recently been related to COVID19 infection. In the present work, we perform... more ABO blood groups have recently been related to COVID19 infection. In the present work, we performed this analysis using data from 412 COVID19 patients and 17796 blood donors, all of them from Gipuzkoa, a region in Northern Spain. The results obtained confirmed this relation, in addition to showing a clear importance of group O as a protective factor in COVID19 disease, with an OR = 0.59 (CI95% 0.481–0.7177, p<0.0001) while A, B and AB are risk factors. ABO blood groups are slightly differently distributed in the populations and therefore these results should be replicated in the specific areas with a proper control population.

American Journal of Gastroenterology, 2015

Introduction: Studies have quantifi ed the annual cost of acute pancreatitis, but to date there i... more Introduction: Studies have quantifi ed the annual cost of acute pancreatitis, but to date there is limited data on the impact of comorbidities on the cost of hospitalizations among patients with acute pancreatitis Methods: An analysis of the 2005 to 2010 Nationwide Inpatient Sample (NIS) database was conducted. Using ICD9 code 577.0 we identifi ed adult (aged ≥ 18 years) patients with primary diagnosis of acute pancreatitis. We excluded patients with secondary diagnosis of chronic pancreatitis (ICD9 code 577.1). We also excluded those age 79 years. Th e most frequent comorbidities in those hospitalized for acute pancreatitis were obtained. Primary outcome was cost which was estimated by multiplying total charges with hospital-specifi c cost-to-charge ratios. All costs were adjusted for infl ation by converting to 2010 US dollars using appropriate consumer price index. Discharge level weights were applied to the data. Generalized linear models were used to estimate the mean cost of hospitalization by number of comorbidities. We subsequently estimated the added unadjusted and adjusted mean cost of hospitalization for the presence versus absence of each of the listed comorbidity. Our model adjusted for patient level factors, hospital factors, year of admission, and geographic price index. Results: Overall, 329,717 patients met all criteria. Th e most frequent comorbidities were hypertension 148,053 (45%), alcohol abuse 80,017 (24%), uncomplicated diabetes mellitus 66,627 (20%) and anemia 44,356(13%). Most patients had 3 or more comorbidities (n=133,104 (40%)), while 77,578 (24%), 69,986 (21%) and 49,049 (15%) patients had two, one, and no comorbidity, respectively. Th e mean adjusted hospitalization cost was signifi cantly higher for patients with three or more comorbidities $9568

American Journal of Gastroenterology, 2014

An Indirect Comparisons Analysis of Biologic Medications in the Induction of Response and Remissi... more An Indirect Comparisons Analysis of Biologic Medications in the Induction of Response and Remission in Crohn’s Disease Sandeep Dayanand, MD,1 Pradeep Dayanand, MBBS,3 Elie Donath, MD,1 Daniel Sussman, MD,2 Amar Deshpande, MD2. 1. JFK Medical Center/Regional Campus University of Miami Miller School of Medicine, West Palm Beach, FL; 2. University of Miami, Miami, FL; 3. Mamata Medical College, Khammam, India.

American Journal of Gastroenterology, 2016

JMIR mental health, Jan 29, 2017

Improvements in software and design and reduction in cost have made virtual reality (VR) a practi... more Improvements in software and design and reduction in cost have made virtual reality (VR) a practical tool for immersive, three-dimensional (3D), multisensory experiences that distract patients from painful stimuli. The objective of the study was to measure the impact of a onetime 3D VR intervention versus a two-dimensional (2D) distraction video for pain in hospitalized patients. We conducted a comparative cohort study in a large, urban teaching hospital in medical inpatients with an average pain score of ≥3/10 from any cause. Patients with nausea, vomiting, dementia, motion sickness, stroke, seizure, and epilepsy and those placed in isolation were excluded. Patients in the intervention cohort viewed a 3D VR experience designed to reduce pain using the Samsung Gear Oculus VR headset; control patients viewed a high-definition, 2D nature video on a 14-inch bedside screen. Pre- and postintervention pain scores were recorded. Difference-in-difference scores and the proportion achieving ...

BMC neurology, Jan 6, 2017

Recurrent strokes are preventable through awareness and control of risk factors such as hypertens... more Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diver...

The American journal of gastroenterology, Jan 2, 2016

The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Informa... more The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS) to allow efficient, online measurement of patient-reported outcomes (PROs), but it remains untested whether PROMIS improves outcomes. Here, we aimed to compare the impact of gastrointestinal (GI) PROMIS measures vs. usual care on patient outcomes. We performed a pragmatic clinical trial with an off-on study design alternating weekly between intervention (GI PROMIS) and control arms at one Veterans Affairs and three university-affiliated specialty clinics. Adults with GI symptoms were eligible. Intervention patients completed GI PROMIS symptom questionnaires on an e-portal 1 week before their visit; PROs were available for review by patients and their providers before and during the clinic visit. Usual care patients were managed according to customary practices. Our primary outcome was patient satisfaction as determined by the Consumer Assessment of Healthcare Provide...