Factors associated with frequent marijuana consumption in young people before admission to juvenile detention centers in Peru

Marijuana is the most widely used illicit drug in the world, especially among young people. This study is relevant to policy makers because it expands the knowledge regarding drug use in vulnerable youth, al-lowing health authorities to reduce marijuana consumption via educa-tional, family, and governmental strategies and policies. The objective of this study was to determine the prevalence of frequent marijuana consumption and its associated factors in young people before admission to juvenile detention centers in Peru. The data was taken from the 2016 National Population Census of the Youth Diagnostic and Rehabilitation Centers in Peru. The final sample was made up of 1,848 people with ages between 14 and 22 years old, with a median age of 17 (95.6% males). The variable frequent marijuana consumption was de-fined as the use of marijuana at least once a week, prior to entering the center. The main factors associated with frequent marijuana use were male sex, running away from home before the age of 15, physi-cal abuse during childhood, having a family member who consumed alcohol or drugs frequently, and the presence of criminal gangs in the housing area. Additionally, it was found that living with parents up to a specific critical age decreases the probability of frequent use of marijuana in young people. These results could aid the development of strategies and public policies that help prevent the consumption of marijuana and other drugs from an early age.Revisión por pare

Beliefs about medicines and adherence to preventive oral treatment for migraine

Introducción: El tratamiento oral preventivo para la migraña (TOPM) ha demostrado ser efectivo reduciendo la frecuencia e intensidad de los síntomas de migraña; no obstante, estudios evidencian que existe una baja adherencia a este. Dentro de los posibles factores asociados se plantean a las creencias de los pacientes sobre los medicamentos. Los estudios que relacionan creencias sobre los medicamentos con adherencia para otras enfermedades son vastos, pero aquellos que lo hacen para el TOPM son escasos. Objetivos: Conocer la asociación entre las creencias sobre los medicamentos y la adherencia al TOPM teniendo en cuenta otros factores que podrían estar relacionados con este comportamiento. Materiales y métodos: Estudio transversal analítico sobre una base de datos primaria de sujetos pertenecientes a comunidades virtuales de pacientes migrañosos. Para la medición de la adherencia se aplicó el cuestionario MARS-5 y para las creencias el BMQ-específico. Resultados: Se contó con una muestra de 102 participantes, de los cuales el 48.04% se consideraron como adherentes. Con respecto a las creencias en los medicamentos, el 46.08% de los participantes percibía más necesidades que preocupaciones al usar los medicamentos y la mayoría de los participantes se mostró con una actitud ambivalente con respecto al tratamiento. El estudio encontró que la edad, la conveniencia del medicamento y el consumo concomitante de otros medicamentos para otras enfermedades diferentes a la migraña, incrementan significativamente la probabilidad de que los pacientes sean adherentes al medicamento. Conclusión: La edad, la conveniencia percibida del medicamento y el consumo actual de otros medicamentos están asociados significativamente a la adherencia al TOPM. No se encontró asociación estadísticamente significativa entre las creencias sobre los medicamentos y la adherencia al TOPM.Introduction: Oral preventive medication for migraine (OPMM) has been shown to be effective in reducing the frequency and intensity of symptoms; however, studies show that there is low adherence to it. Among the possible associated factors, patient’s beliefs about medications are considered. Studies linking beliefs about medications with adherence in other diseases are vast, but those related to the OPMM are scarce. Objectives: Underline the association between beliefs about medications and adherence to the OPMM, considering other factors that could be related to this behavior. Materials and methods: Analytical cross-sectional study of a primary database of subjects belonging to virtual communities of migraineurs. For the measurement of adherence, the MARS-5 questionnaire was applied and the BMQ-specific for beliefs. Results: The sample consisted of 102 participants, of which 48.04% reported adherence. Regarding beliefs about medications, 46.08% of the participants perceived more needs than concerns when using the medication and most of the participants had an ambivalent attitude about treatment. The study found that age, the perceived convenience of the medication, and concomitant use of other drugs for conditions other than migraine significantly increase the likelihood that patients are adherent to the medication. Conclusion: Age, perceived convenience of the drug and current use of other medication are significantly associated with adherence to the OPMM. No association was found between beliefs about medications and adherence to the OPMM.Tesi

Well-being variations on students of health sciences related to their learning opportunities, resources, and daily activities in an online and on-crisis context: a survey-based study

Abstract Background Universities’ training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities. Method We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling. Results Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit. Conclusion Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study) : Does nutrition really affect ICU mortality?

The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. ClinicaTrials.gov NCT: 03634943