Análisis bibliométrico de la producción científica peruana sobre la formación de profesionales de la salud

La investigación y la publicación científica son aspectos importantes dentro de la formación profesional en salud, pues permitirán practicar eficientemente una medicina basada en evidencias. El objetivo del trabajo fue describir a través de indicadores bibliométricos la producción científica relacionada con la formación de profesionales de la salud en Perú durante el periodo 2014-2018. Estudio bibliométrico sobre la totalidad de la producción científica peruana que trata de la formación de profesionales de la salud en el período 2014-2018, recuperada de la base de datos de Google Académico. Se calcularon los indicadores cienciométricos de 155 artículos filtrados por el software Harzing’s Publish or Perish v. 6. Las variables estudiadas fueron: total de artículos, citas, promedio de citas por año, por artículos, por autores y por autores por año, promedio de artículos por autor, promedio de autores por artículo, índices h, g, h contemporáneo (hc), h individual (hI), hI normalizado, AWCR, AW, AWCRpA, e, hm, hI anual, amplitud H, amplitud, cantidad de autores, índice de colaboración, artículos más citados y distribución anual de los artículos, así como su publicador.  Se obtuvo un total de 905 citas con un promedio de 181.00; 5.84 y 457.37 citas por año, artículos y autores respectivamente. Las publicaciones poseen un índice h de 16 y un índice g de 19. Destaca la producción anual del año 2015, con 41 publicaciones. La mayor cantidad de autores trabajan en parejas (48 artículos). Se totalizaron 458 autores en los 155 artículos, generando un índice de colaboración de 2.95.  La producción científica relacionada con la formación de profesionales de la salud en Perú fue escasa en los últimos 5 años. Los indicadores cienciométricos muestran una tendencia decreciente

La imaginación creativa de estudiantes universitarios de la especialidad de Psicología

The purpose of this study is to determine the predominant dimension in the creative imagination of students of psychology, with creative imagination understood as the ability to invent new situations, products or solutions beyond reproducing them from previous knowledge. This research study design is substantive, descriptive and explanatory. The study sample is composed of 85 students between 16 and 18 years of the Faculty of Psychology of the César Vallejo University. An instrument called PIC-J (Test of creative imagination for young people) was used, construct validity was performed through construct analysis and reliability through the Cronbach Alpha. The testing of the hypotheses was made through the logistic regression and these results show that the predominant dimension is narrative creativity and the relevant indicators are fluency and originality, which are fundamental for the students. El presente estudio tiene como finalidad determinar la dimensión predominante en la imaginación creativa de estudiantes de psicología, la imaginación creativa entendida como capacidad de inventar nuevas situaciones, productos o soluciones más allá de reproducirlas desde un conocimiento anterior. La investigación corresponde al tipo sustantivo, descriptivo explicativo, la muestra de estudio conformada por 85 estudiantes entre 16 a 18 años de la Facultad de Psicología de la Universidad César Vallejo, se utilizó un instrumento denominada PIC-J (Prueba de imaginación creativa para jóvenes), la validez de constructo se realizó a través del análisis de constructo y la confiabilidad a través del Alpha Cronbach. La contrastación de las hipótesis se realizó a través de la regresión logística y dichos resultados demuestran que la dimensión predominante es la creatividad narrativa y los indicadores relevantes la fluidez y originalidad, fundamental para los estudiantes

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Assessing support needs in children with intellectual disability and motor impairments: measurement invariance and group differences

Background This study assessed the equivalence of the measurement of support needs between children with intellectual disability (ID) and children with intellectual and motor disabilities (IMD) and compared both groups in the different domains of support. Method The Supports Intensity Scale-Children’s Version was used to assess the support needs of 713 children with ID and 286 children with IMD, mainly associated with cerebral palsy. Results The results supported measurement invariance between the group of ID and IMD, which allowed to conduct comparison between them. Children with IMD scored higher on support needs than did children without IMD, suggesting that children with IMD needed more support than their peers without motor impairments. Furthermore, the ID levels interacted with motor impairments: at the highest levels of ID, groups tended to be similar in support needs, with high scores and low variability. The greatest differences were found in the domains of Home and Community activities

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

A horizon scan exercise for aquatic invasive alien species in Iberian inland waters

As the number of introduced species keeps increasing unabatedly, identifying and prioritising current and potential Invasive Alien Species (IAS) has become essential to manage them. Horizon Scanning (HS), defined as an exploration of potential threats, is considered a fundamental component of IAS management. By combining scientific knowledge on taxa with expert opinion, we identified the most relevant aquatic IAS in the Iberian Peninsula, i.e., those with the greatest geographic extent (or probability of introduction), severe ecological, economic and human health impacts, greatest difficulty and acceptability of management. We highlighted the 126 most relevant IAS already present in Iberian inland waters (i.e., Concern list) and 89 with a high probability of being introduced in the near future (i.e., Alert list), of which 24 and 10 IAS, respectively, were considered as a management priority after receiving the highest scores in the expert assessment (i.e., top-ranked IAS). In both lists, aquatic IAS belonging to the four thematic groups (plants, freshwater invertebrates, estuarine invertebrates, and vertebrates) were identified as having been introduced through various pathways from different regions of the world and classified according to their main functional feeding groups. Also, the latest update of the list of IAS of Union concern pursuant to Regulation (EU) No 1143/2014 includes only 12 top-ranked IAS identified for the Iberian Peninsula, while the national lists incorporate the vast majority of them. This fact underlines the great importance of taxa prioritisation exercises at biogeographical scales as a step prior to risk analyses and their inclusion in national lists. This HS provides a robust assessment and a cost-effective strategy for decision-makers and stakeholders to prioritise the use of limited resources for IAS prevention and management. Although applied at a transnational level in a European biodiversity hotspot, this approach is designed for potential application at any geographical or administrative scale, including the continental one

Lista de especies exóticas acuáticas de la Península Ibérica (2020)

Se presenta una lista actualizada de las especies exóticas que se encuentran en etapa de establecimiento o de propagación de la invasión en aguas continentales de la península ibérica. La lista está basada en la evaluación sistemática de los datos en colaboración con un amplio equipo de expertos de España y Portugal. Esta lista de actualización es un instrumento de apoyo importante para la aplicación del Reglamento de la Unión Europea (UE) sobre las especies exóticas invasoras (EEI) y también proporciona una base objetiva para el examen de su aplicación. En última instancia, la información incluida puede utilizarse para supervisar el cumplimiento del objetivo de la Estrategia de la UE sobre diversidad biológica hasta 2030 para combatir las EEI, pero también para la aplicación de otras políticas de la UE con requisitos sobre especies exóticas, como las Directivas de Hábitats y Aves, la Directiva Marco sobre la Estrategia Marina (DMEM) y la Directiva Marco del Agua (DMA)

A horizon scan exercise for aquatic invasive alien species in Iberian inland waters

As the number of introduced species keeps increasing unabatedly, identifying and prioritising current and potential Invasive Alien Species (IAS) has become essential to manage them. Horizon Scanning (HS), defined as an exploration of potential threats, is considered a fundamental component of IAS management. By combining scientific knowledge on taxa with expert opinion, we identified the most relevant aquatic IAS in the Iberian Peninsula, i.e., those with the greatest geographic extent (or probability of introduction), severe ecological, economic and human health impacts, greatest difficulty and acceptability of management. We highlighted the 126 most relevant IAS already present in Iberian inland waters (i.e., Concern list) and 89 with a high probability of being introduced in the near future (i.e., Alert list), of which 24 and 10 IAS, respectively, were considered as a management priority after receiving the highest scores in the expert assessment (i.e., top-ranked IAS). In both lists, aquatic IAS belonging to the four thematic groups (plants, freshwater invertebrates, estuarine invertebrates, and vertebrates) were identified as having been introduced through various pathways from different regions of the world and classified according to their main functional feeding groups. Also, the latest update of the list of IAS of Union concern pursuant to Regulation (EU) No 1143/2014 includes only 12 top-ranked IAS identified for the Iberian Peninsula, while the national lists incorporate the vast majority of them. This fact underlines the great importance of taxa prioritisation exercises at biogeographical scales as a step prior to risk analyses and their inclusion in national lists. This HS provides a robust assessment and a cost-effective strategy for decision-makers and stakeholders to prioritise the use of limited resources for IAS prevention and management. Although applied at a transnational level in a European biodiversity hotspot, this approach is designed for potential application at any geographical or administrative scale, including the continental one