Program: Master in Science, Technology and Innovation Management. Universidad de Santander, Colombia
Thesis title: Current conditions of research in physiotherapy: analysis of scientific and technological capabilities at the Colombian level
Graduation year: 2021

Authors: Clemencia Pinilla Vásquez, José Ignacio Torres Hernández

Abstract

Physiotherapy in Colombia has been strengthened through evidence-based practice and has developed capacities to investigate formally, becoming an important focus in the health sciences.

This study seeks to analyze the current conditions of Physiotherapy research by evaluating scientific and technological capacities in Colombia, based on the information published by Minciencias on the ScienTi platform to measure and recognize researchers and research groups, technological development and innovation.

This analytical cross-sectional study included 421 physiotherapists linked to 91 research groups. Frequencies for categorical variables and measures of central tendency and dispersion for continuous variables were calculated. Adjusted prevalence ratios from simple and multiple Poisson regressions were utilized to determine the association between several independent variables and group classification (A, A1 vs B, C, recognized) and researcher classification (researcher vs non-researcher).

The groups and researchers’ scientific production focused on generating knowledge through articles, books and book chapters, which were not of high quality. Additionally, a low capability to generate technological products was evidenced. Factors such as group seniority, lines of research in basic sciences, and a greater number of researchers with a master’s degree increased the probability of achieving categories A and A1 (p <0.05). Physiotherapists researching physiotherapy interventions, having master’s or doctorate studies, and at least one published article were more likely to be classified as researchers (p <0.05).

Consequently, in Colombia, scientific and technological capabilities in Physiotherapy must be strengthened in order to promote research culture, development of discipline and its impact on society.

Key Words: Physical Therapy, Scientific and Technical Activities, Science, Technology and Innovation Indicators, Scientific Publication Indicators Research groups

Program: MSc. in Science, Technology and Innovation Management. Universidad de Santander, Colombia
Thesis title: Current conditions of research in physiotherapy: analysis of scientific and technological capabilities at the Colombian level
Graduation year: 2021

Authors: Clemencia Pinilla Vásquez, José Ignacio Torres Hernández

Abstract

Physiotherapy in Colombia has been strengthened through evidence-based practice and has developed capacities to investigate formally, becoming an important focus in the health sciences.

This study seeks to analyze the current conditions of Physiotherapy research by evaluating scientific and technological capacities in Colombia, based on the information published by Minciencias on the ScienTi platform to measure and recognize researchers and research groups, technological development and innovation.

This analytical cross-sectional study included 421 physiotherapists linked to 91 research groups. Frequencies for categorical variables and measures of central tendency and dispersion for continuous variables were calculated. Adjusted prevalence ratios from simple and multiple Poisson regressions were utilized to determine the association between several independent variables and group classification (A, A1 vs B, C, recognized) and researcher classification (researcher vs non-researcher).

The groups and researchers’ scientific production focused on generating knowledge through articles, books and book chapters, which were not of high quality. Additionally, a low capability to generate technological products was evidenced. Factors such as group seniority, lines of research in basic sciences, and a greater number of researchers with a master’s degree increased the probability of achieving categories A and A1 (p <0.05). Physiotherapists researching physiotherapy interventions, having master’s or doctorate studies, and at least one published article were more likely to be classified as researchers (p <0.05).

Consequently, in Colombia, scientific and technological capabilities in Physiotherapy must be strengthened in order to promote research culture, development of discipline and its impact on society.

Key Words: Physical Therapy, Scientific and Technical Activities, Science, Technology and Innovation Indicators, Scientific Publication Indicators Research groups

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis title: Determinants of access to prenatal control service among women who attended delivery care in health institutions of Floridablanca, Santander in 2017
Graduation year: 2021

Abstract

Objective: To determine the access to minimal prenatal care and associated factors in women who had delivery care in Floridablanca’s health institutions.
Methodology: A secondary analysis of cross-sectional data of live birth statistics from the Unified Registry of Affiliates, 2017 was carried out. The dependent variable was access to minimal prenatal care, defined as participating in at least 4 prenatal checkups. The sociodemographic and obstetric independent variables were classified according to the model of Aday and Andersen, 2013. The determinants of access to minimal prenatal care were evaluated using simple and multiple binary logistic regression models.
Results: In the multivariate analysis, the variables associated to access to minimal prenatal care of at least 4 prenatal checkups were the number of live births and health insurance scheme. The opportunity of meeting the recommendations of at least 4 prenatal checkups was 89% lower (OR = 0.11; 95% CI 0.02, 0.63; p = 0.013) in those women who reported between three and seven live births compared to those who had only one child born alive, and 0.73% (OR = 0.27; 95% CI 0.09; 0.75; p = 0.013) in uninsured women compared to those who belonged to the contributory or exception social insurance schemes.
Conclusion: It is recommended the implementation of a strategy that allows measuring access to prenatal care among pregnant women, to guarantee cost-effective interventions in this population of the municipality of Floridablanca.

Co-supervisors: Rocio del Pilar Martinez-Marin, Adriana Angarita-Fonseca

Program: MSc. in Early Childhood. Universidad de Santander, Colombia
Thesis title: Association between motor development and learning in children from 2 to 5 years from centres of children’s development of Bucaramanga. 2018 – 2019.
Graduation year: 2019

Abstract

Objective: To determine if there is an association between motor development and learning among children from 2 to 5 years old registered in child development centers in Bucaramanga, Colombia.
Methodology: A cross-sectional study was conducted in a sample of 297 children (152 boys and 145 girls) aged 2 to 5 years. The abbreviated scale of development for motor development and the qualitative scale of child development for learning were applied.
Results:  144 were living in the Provenza commune. 132 were studying pre-kinder, 109 kinder, and 56 Grade 1. 179 had obesity. 18 of the children were at alert level accordingly to their gross motor skills and 32 were in alert based on their adaptive fine motor skills. In global learning, 27 children were at risk. Those children classified in the alert level in the adaptive fine motor skills were more likely to be classified at-risk in learning.
Conclusion: The results confirm that delays in motor development can affect children’s relationship with themselves, with others and with the world. For this reason, the activities carried out with them must involve both gross and fine movement and the exploration of the world that leads to meaningful learning.
Co-supervisors: Camargo-Abello Marina, Adriana Angarita-Fonseca

Program: MSc. in Early Childhood. Universidad de Santander, Colombia
Thesis title: Association between motor development and learning in children from 2 to 5 years from centres of children’s development of Bucaramanga. 2018 – 2019.
Graduation year: 2019

Abstract

Objective: To determine if there is an association between motor development and learning among children from 2 to 5 years old registered in child development centers in Bucaramanga, Colombia.
Methodology: A cross-sectional study was conducted in a sample of 297 children (152 boys and 145 girls) aged 2 to 5 years. The abbreviated scale of development for motor development and the qualitative scale of child development for learning were applied.
Results:  144 were living in the Provenza commune. 132 were studying pre-kinder, 109 kinder, and 56 Grade 1. 179 had obesity. 18 of the children were at alert level accordingly to their gross motor skills and 32 were in alert based on their adaptive fine motor skills. In global learning, 27 children were at risk. Those children classified in the alert level in the adaptive fine motor skills were more likely to be classified at-risk in learning.
Conclusion: The results confirm that delays in motor development can affect children’s relationship with themselves, with others and with the world. For this reason, the activities carried out with them must involve both gross and fine movement and the exploration of the world that leads to meaningful learning.
Co-supervisors: Camargo-Abello Marina, Adriana Angarita-Fonseca

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis title: Effectiveness of Applied Behaviour Analysis (ABA) therapy in children from 5 to 16 years diagnosed with autism spectrum disorder (ASD) during 6-month in a health institution of Cucuta, 2015.
Graduation year: 2015

Abstract

Objective: To establish the effectiveness of Applied Behaviour Analysis ABA therapy among a population of 5 to 16 years diagnosed with autism spectrum disorder (ASD), applied for 6 months in the city of Cucuta IPS, 2015.
Methodology: A quasi-experimental design was used to compare the before and after of the ABA therapy. The Barthel scale was used to evaluate functionality. We included 9 boys and 3 girls diagnosed with ASD aged between 5 and 16 years attending a psychology and therapy Center.
Results: Although the sample was small, the median of the Barthel index increased after the intervention. Moreover, after the intervention, 100% of the participants had bowel control and 83.3% had urinary control. No participant was found with severe dependence, 25% had mild dependence, and 75% had a moderate dependency.
Conclusion: ABA therapy can be applied in patients with disruptive behavior, where the prevalence of age and the severity of the diagnosis does not play a major role.
Co-supervisors: Juan Carlos Uribe, Adriana Angarita-Fonsecca

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis Title: Levels of User Satisfaction in the Area of Ambulatory Surgery of the Fundación Oftalmológica de Santander (FOSCAL Internacional) Floridablanca, 2015″
Graduation year: 2015

Abstract

Objective: To determine the level of satisfaction of users of the area of ambulatory surgery of the FOSCAL international, Floridablanca, Santander in April 2015.
Methods: A cross-sectional study was conducted. The sample was comprised of 136 users of the services of ambulatory surgery of the FOSCAL international in Floridablanca, Santander. Patient satisfaction was assessed using the SERVQHOS questionnaire (“service quality” questionnaire). The SERVQHOS questionnaire items were divided into subjective quality (human assistance) and objective quality (organisational and facility issues).
Results: The type of surgery most conducted in the clinic were the general and orthopedic with 66.3%. Moreover, 63.5% had not had previous interventions. The percentage of users reporting better assistance than expected in the objective quality ranged between 68 and 91% and in the subjective quality ranged between 71.2% and 87.5%.
Conclusión: Users of the area of ambulatory surgery of the FOSCAL international are getting the assistance that they expected of the service.

Program: MSc. in Physical Activity and Sports Sciences. Universidad de Pamplona, Colombia.
Thesis Title: Effects of a functional core training program on strength, pain, health-related quality of life and physical activity level among women with fibromyalgia living in Bucaramanga
Graduation year: 2014

Abstract

Objective: To evaluate the effects of a program of functional muscle core training targeting women with fibromyalgia.
Materials and methods: A quasi-experimental type trial was conducted, before and after an intervention, for 20 days, often three days/week, 60 minutes each session. In a single-group of eight women, changes in muscle strength, pain, health-related quality of life, and physical activity were evaluated.
Results: An increase in repetitions of the test trunk flexion, time on the left and right bridge testing lateral and prone bridge the test were found. All features of pain decreased, and, according to the S-FIQ, a decrease in morning fatigue, stiffness, and anxiety was reported. Also Met’s/minute-weeks increased after the intervention.
Conclusion: These data suggest that functional program core muscle training is effective in increasing muscle strength, pain modulation, functional performance optimization, and increased levels of physical activity in women with fibromyalgia.
Co-supervisors: Edgar Correa-Perez, Adriana Angarita-Fonseca

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis Title: Socioeconomic determinants of access to primary prevention, outpatient care, and emergency services in Colombia: A secondary analysis of the National Survey of Quality of Life, 2013
Graduation year: 2014

Abstract

Objective: To establish the socioeconomic determinants of access to health services such as primary prevention, primary care consultation, and emergency consultation in the Colombian population.
Methods: It was made a secondary analysis of the National Survey on Quality of Life in Colombia during 2013. At first, people older than 15 years were included, and those who belonged to the special social security health regimes were excluded. The dependent variables were: Without being sick and to attend for prevention to primary care at least once a year to the physician, dentist, or both. In the second part of the analysis, people who had no health issues in the past 30 days were excluded. The dependent variable was: The formal health care provided in outpatient consultation and emergency caused by a health issue. To identify the determinants of real access was used generalized linear models for complex samples where the link function was logarithm ratio of the dependent variable and Poisson’s error distribution. The explanatory variables were categorized according to Andersen’s model (1995) in predisposing components by resources, capacity, and need.
Results: About the access to primary prevention, 50,532 individuals representing 31,968,124 Colombians were included. The results of the multivariate data analysis showed that being male, people who belong to an ethnic group, those who worked in the week prior to the survey, which inhabited housing deficit, which had no classification of socioeconomic status, which were affiliated to the subsidized regime, that did not know if were affiliated to the social security health and who had filed outa petition right for protection had the probability of access to primary prevention health services significantly lower than the rest of the population. On the other hand, people between 39 and 103 years, that had a life partner, with a secondary or higher level of education, middle or high socioeconomic status, in the urban area, with permanent restrictions, poor health status or even very poor, who received shares promotion and prevention of the secretariat or municipality, that have received contributions, and those who were in the top two quintiles of household income had a significantly higher probability of accessing prevention services. 5,758 individuals representing 3,348,977 Colombians were included in the analysis of access to emergency services or outpatient consultation. The prevalence of access to those was 74.3%. In multivariate data analysis, a significant and positive association was found between
access and poor or very poor health status; and a lower probability statistically significant of access to health services with the variable poverty perception and being part of subsidized regime or not knowing or not being affiliated to the social security health.
Conclusions: The characteristics of resource capacity and necessity Andersen’s model still continue influencing access to primary health services and tertiary prevention in Colombia.
Co-supervisors: Rocio del Pilar Martinez Marin, Adriana Angarita-Fonseca.

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis Title: Factors associated with access to physical therapy, speech therapy, or occupational therapy services in people with cerebral palsy from Bucaramanga and the metropolitan area.
Graduation year: 2013

Abstract

Objective: To describe the factors that influence access to physical rehabilitation services by the General Social Security Health System (GSSHS) among people with cerebral palsy (PCP) of Bucaramanga and its metropolitan area, 2013.
Methods: A case-control study was performed. Cases were those who were not cover by the GSSHS or those registered in the GSSS but who did not have access to physiotherapy, speech-language therapy, or occupational therapy services (hereafter rehabilitation services) in the last year. Controls were those covered by the SGSSS, who have had access to rehabilitation services at least once in the last year through the GSSHS; the expenses caused by these services should have been covered by the territorial entity. The sample included 89 cases and 91 controls aged between 0 to 60.
Results: The multivariable model showed an association between lack of access to rehabilitation services and being covered by the subsidized health-care scheme or being poor without social security, having filed a legal action for protection (acción de tutela), having received between 5 to 15 rehabilitation sessions in the last week, delaying in the appointment assignment, being independent (not requiring help). There was an interaction between income and transportation (OR= 0.31; IC95% 0.12, 0.77).
Conclusion: Our findings show the inequity in access to rehabilitation services that people with cerebral palsy face in Bucaramanga, Colombia.

Program: MSc. in Health Services Management. Universidad de Santander, Colombia
Thesis Title: Factors associated with access to physical therapy, speech therapy, or occupational therapy services in people with cerebral palsy from Bucaramanga and the metropolitan area.
Graduation year: 2013

Abstract

Objective: To describe the factors that influence access to physical rehabilitation services by the General Social Security Health System (GSSHS) among people with cerebral palsy (PCP) of Bucaramanga and its metropolitan area, 2013.
Methods: A case-control study was performed. Cases were those who were not cover by the GSSHS or those registered in the GSSS but who did not have access to physiotherapy, speech-language therapy, or occupational therapy services (hereafter rehabilitation services) in the last year. Controls were those covered by the SGSSS, who have had access to rehabilitation services at least once in the last year through the GSSHS; the expenses caused by these services should have been covered by the territorial entity. The sample included 89 cases and 91 controls aged between 0 to 60.
Results: The multivariable model showed an association between lack of access to rehabilitation services and being covered by the subsidized health-care scheme or being poor without social security, having filed a legal action for protection (acción de tutela), having received between 5 to 15 rehabilitation sessions in the last week, delaying in the appointment assignment, being independent (not requiring help). There was an interaction between income and transportation (OR= 0.31; IC95% 0.12, 0.77).
Conclusion: Our findings show the inequity in access to rehabilitation services that people with cerebral palsy face in Bucaramanga, Colombia.
Supervisor: Adriana Angarita-Fonseca

Program: Residency in Obstetrics and Gynaecology, Universidad Industrial de Santander, Colombia
Thesis Title: Prevalence of determinants of the perinatal morbidity and mortality in twin pregnancies in the University Hospital of Santander between 2008 and 2011.
Graduation year: 2012

Abstract

Objective: To determine the prevalence of risk factors associated with perinatal morbidity and mortality in twin pregnancy (TP).
Methodology: A retrospective study. It took 200 medical records of maternal, diagnosed with EG who visited the emergency department of obstetrics and gynecology at the Hospital Universitario de Santander (Level III) in the period 2008-2011. Related variables were collected from the mother (sociodemographic, gynecological and obstetric and risk factors). Prevalence was calculated (P) with confidence intervals of 95% (95%). The Stata statistical software used was 11.0.
Results: The prevalence of diagnosed TP chance was 78% (95% CI 71.6 to 83.5), the prevailing monocoronic-biamnotic placenta (P = 56% 95% CI 48.8 to 63.0) and presentation cephalic-breech (P = 41.5% 95% CI 34.6 to 48.7). Obstetric complications were more frequent preterm labor (P = 70.5% 95% CI 63.7 to 76.7), preeclampsia (P = 20.5% 95% CI 15.1 to 26.8) and premature rupture of membranes (P = 14.5% 95% CI 9.9 to 20.2). There were 21 TP per 1000 births between 2008 and 2011. The death of both babies was 2% and a 4.5% newborn. Most twins one (G1) (63.5%) and two (G2) (57%) had a weight between 1501 and 2499 gr. There were more G1 minute Apgar normal (63%) compared to G2 (49.0%).
Conclusion: The incidence of TP has remained relatively constant between 2008 and 2011. The twin mortality is low, most twins weigh less than 2500 grams and fetal distress is greater for twin two at one minute. Besides the twin pregnancy presents high levels of neonatal morbidity.
Supervisor: Carlos Becerra
Academic Advisor:Adriana Angarita-Fonseca