Community Emergency Response Teams and disaster volunteerism in Latin America.

While it may be more common to think of a disaster volunteer as someone from outside the community who comes to assist during times of need, it is important not to forget those members of the community who are well poised to build grassroots resilience when provided with the necessary training and tools. This paper examines the state of disaster volunteerism in Latin America and Spanish-speaking communities in the USA who have been exposed to the Community Emergency Response Team (CERT) programme, with an emphasis on the perceptions of and motivations for grassroots volunteerism from the perspective of both local emergency managers and CERT volunteers. The research team developed an online survey and shared it with active Spanish-speaking emergency management groups throughout the USA, Mexico, Central and South America. Conducted over nine days in October 2022, the survey collected 40 responses from the target demographic. The results show that enthusiasm for disaster volunteerism is high throughout the communities surveyed. Established disaster volunteer training programmes like CERT and LISTOS have already been successfully exported from the USA to Chile, Honduras and Mexico. An international community of emergency managers should consider how else to support grassroots preparedness activities in Latin America to ensure that local communities are empowered to direct their own resilience-building initiatives.

Retrospective Evaluation of Deep Transcranial Magnetic Stimulation as Add-On Treatment for Parkinson's Disease.

OBJECTIVE: To evaluate the safety and assess the different symptom improvements found after a combined low-frequency primary motor cortex and high-frequency prefrontal cortex (PFC) stimulation using the deep TMS (dTMS) H-coil, as an add-on treatment for Parkinson's disease (PD). METHODS: Forty-five PD patients underwent 14 dTMS sessions; each consisting of 1 Hz stimulation of the primary motor cortex for 15 min, followed by 10 Hz stimulation of the PFC for 15 min. Clinical assessments were performed, BEFORE, at the MIDDLE, and END of therapy as well as at FOLLOW-UP after 30 days, using Movement Disorder Society-Unified Parkinson's Disease Rating Scale, TINETTI, UP&GO, SCOPA, HDRS21, Beck Depression Inventory, and self-applied daily motor assessment scales. RESULTS: Treatment was well-tolerated, without serious adverse effects. dTMS-induced significant PD symptom improvements at END and at FOLLOW-UP, in all subscales of the UPDRS, gait speed, depressive symptoms, balance, autonomic symptoms, and a 73% increase in daily ON time. CONCLUSION: In the cohort of PD patients treated, dTMS was well-tolerated with only minor adverse effects. The dTMS-induced significant improvements in motor, postural, and motivational symptoms of PD patients and may potentiate concurrent levodopa treatment. SIGNIFICANCE: The present study demonstrates that dTMS may have a much wider spectrum of beneficial effects than previously reported for TMS, including enhancement of levodopa effects, suggesting that future clinical trials with dTMS should include a broader range of symptom measurements.

Análisis criminal, proactividad y desarrollo de estrategias policiales basadas en la evidencia / Criminal analysis, proactivity and development of evidence-based police strategies / Análise criminal, proatividade e desenvolvimento das estratégias policiais baseadas na evidência

Se examina cómo los analistas pueden ayudar a responder a los retos emergentes que enfrentan las instituciones policiales y de persecución en la región: la necesidad de proactividad y mayor eficacia. El Método que se sigue es la descripción de la función y las tareas "tradicionales" del analista criminal, y la revisión de las tendencias y requisitos asociados al diseño y ejecución de políticas criminales eficaces. La búsqueda de determinantes de mejores resultados y la incursión en evaluaciones de las acciones policiales y de persecución penal representan desafíos "nuevos", que deberían abordar los analistas, con un uso intensivo del Método científico, en especial en la observación, testeo y comprobación de qué realmente funciona o no. Se advierte, entonces, una transición que interpela el papel del analista y del análisis: desde la "gestión de información" a la "gestión de conocimiento" en las organizaciones.

This article examines how analysts can assist police and prosecution institutions in the region to meet emerging challenges, thus the need for proactivity, enhanced efficiency and improved efficacy. The method used is the description of the criminal analyst's relevant function and "traditional" tasks, along with a trend review and the revision of requisites associated to design and enforcement of effective criminal policies. The search for determinants of better results along with an incursion into police and criminal prosecution actions represent "new provocations" to be addressed with an intensive use of the scientific method, particularly in dealing with observation, testing and verification of what actually works or does not work. Then, a transition that questions the role of the analyst and the analysis itself is observed from "information management" to "knowledge management" in the organizations.

Examina-se como os analistas podem ajudar a responder aos desafios emergentes que enfrentam as instituições policiais e da persecução na região: a necessidade da proatividade e da maior eficácia. O Método seguido é a descrição da função e as tarefas "tradicionais" do analista criminal, e a revisão das tendências e das exigências associadas ao projeto e execução de políticas criminais eficazes. A busca das determinantes de melhores resultados e da incursão nas avaliações das ações policiais e da persecução penal representa desafios "novos", que deveriam ser abordados pelos analistas, com um uso intensivo do Método científico, em especial na observação, nos testes e na verificação de aquilo que funciona realmente. Apercebe-se, então, uma transição que interpela o papel do analista e da análise: desde a "gestão da informação" à "gestão do conhecimento" nas organizações.

La evaluación del desempeño de la policía: explorando relaciones entre opinión pública y labor policial en Chile / A avaliação do desempenho da polícia: Explorando relações entre a opinião pública e o trabalho da polícia no Chile / Police performance evaluation: exploring the relationships between public opinion and police work in Chile

El desempeño policial es un aspecto fundamental en la ejecución de políticas de seguridad. Sin embargo, en la región las fuentes de datos y herramientas de análisis son escasas. Emplear y explotar encuestas de opinión y aplicar un instrumento ad hoc, “índice de percepción del desempeño policial”, como ocurre en Chile, es útil para mejorar la relación de la policía con las personas. Se propone abordar el estudio de la eficacia policial no solo desde una perspectiva econométrica, sino también psicosocial y sociopolítica. Se presentan los resultados de la aplicación de este instrumento y se introducen reflexiones para su comprensión dentro de dinámicas de mejoramiento de la labor policial y políticas públicas de seguridad.

Police performance is an essential factor in the achievement of security policies. However, in the region, both data sources and analysis tools are scarce. Using and taking advantage of opinion surveys and applying an ad hoc instrument like the “perception of police performance index” in Chile is useful to improve the relationship between the Police and people. This article is intended to deal with the study of police efficiency, not only from an econometrical perspective but also in psychosocial and sociopolitical terms.The results of the application of this instrument are presented, and reflections for understanding them are offered within police work improvement dynamics, and public security policies.

O desempenho policial constitui um aspecto essencial na implementação de políticas de segurança. No entanto, as fontes de dados e análise de ferramentas são escassas na região. Empregar e explorar as sondagens de opinião e aplicar um instrumento ad hoc, "índice de percepção do desempenho policial", como no Chile, é útil para melhorar as relações da polícia com as pessoas. O objetivo é discorrer o estudo da eficácia policial não só numa perspectiva econométrica, mas também psicossocial e sócio-política. Os resultados da aplicação do presente instrumento são apresentados e as reflexões para sua compreensão na dinâmica para melhorar o trabalho da polícia e políticas de segurança pública são introduzidas.

La edad es un factor predictor independiente para recurrencia tumoral en el cáncer de vejiga no músculo invasor: resultados de una serie local / Age is an independent predictor for tumoral recurrence in non muscle-invasive bladder cancer: results of a local series

Introducción: El cáncer de vejiga es en su mayoría una enfermedad de pacientes de edad avanzada. El objetivo del estudio fue evaluar la edad como factor pronóstico en una cohorte de pacientes chilenos con cáncer de vejiga no músculo invasor. Material y métodos: Se revisaron retrospectivamente los registros clínicos de 107 pacientes tratados por un cáncer no-músculo invasor de vejiga confirmado histológicamente. Se determinaron asociaciones de la edad con parámetros clínicos e histopatológicos, así como con recurrencia y progresión tumoral. Finalmente se realizó un análisis multivariado para identificar factores predictores de los desenlaces mencionados. Resultados: La mediana de edad fue 65 años (rango 29-94). Se observó una significativa asociación de unos pacientes jóvenes con el tabaquismo activo. Por otro lado, los pacientes mayores a 65 años mostraron una asociación significativa con la presencia de recurrencia y progresión tumoral en el análisis univariado. Finalmente, una edad por sobre los 65 años fue el predictor independiente más importante para la recurrencia en el análisis multivariado, por sobre el estadío pT. Conclusiones: Existen varios factores clínicos y psicosociales que contribuyen al significativo poder predictor de una edad > 65 años en el pronóstico de un paciente con un cáncer de vejiga no músculo invasor. Por lo mismo, cada paciente debe ser evaluado en forma integral, tomando en cuenta las distintas dimensiones involucradas. En un escenario de progresivo envejecimiento de la población, el urólogo debe estar preparado para resolver adecuadamente esta situación.

Introduction: Bladder cancer is most frequently a disease of the elderly. The aim of the study was to evaluate the impact of age on prognosis in a cohort of Chilean patients with non muscle-invasive bladder cancer. Methods: The medical records of 107 patients treated for non muscle-invasive bladder cancer at our institution were retrospectively reviewed. Associations of age with clinical and histopathological parameters were assessed, as well as with tumoral recurrence and progression. Finally, a multivariate analysis was performed in order to identify predictive factors for the mentioned outcomes. Results: The median age was 65 years (range 29-94). Younger patients showed a significant association with an active smoking status. On the other hand, a significant association of age > 65 years with tumoral recurrence and progression was observed on univariate analysis. Age was also the most important predictive factor for recurrence on the multivariate analysis, even more than the pT stage. Conclusions: There are several clinical and psychosocial factors related to the significant predictive power of a higher age on the prognosis of patients with non muscle-invasive bladder cancer. Therefore, every patient should be assessed integrally, taking into account all the different dimensions involved. In an era of an aging population, the urologist must be prepared to handle with this situation.