Nivel de información médica sobre diabetes, actitud de los pacientes hacia la enfermedad y su asociación con el nivel de control glucémico

ObjetivoDeterminar el nivel de información y de actitud que sobre su enfermedad tienen pacientes con diabetes tipo 2 (DM2) y su asociación con el nivel de control glucémico.DiseñoEncuesta transversal survey.EmplazamientoDos unidades de medicina familiar.PacientesDoscientos sujetos con DM2.IntervencionesSe aplicaron 2 instrumentos validados para valorar nivel de conocimientos y actitud, y se midió el promedio de las últimas 6 glucemias.Mediciones y resultadosLa calificación global del instrumento de conocimientos fue 58,6 ± 17,9 (escala 0-100). Para el instrumento de actitud fue de 18,9 ± 2,1 (escala 0-35). La calificación de conocimientos del grupo controlado fue de 55,48 ± 16,8, y la del grupo descontrolado de 59,2 ± 18,1. La calificación sobre actitud del grupo controlado fue de 17,8 ± 2,3, y la del grupo descontrolado de 19,1 ± 2 (p = 0,001). El nivel de información proporcionado por el médico familiar fue del 42,9%, por el equipo de salud del 10,2% y por otras fuentes del 6,3%. En cuanto al análisis del grado de actitud y el nivel de información, hubo una mejor actitud cuando la información fue proporcionada por otras fuentes (p < 0,05). Por lo que respecta al porcentaje de información y el control glucémico, el nivel de control fue mejor cuando la información fue proporcionada por el equipo de salud (p < 0,01).ConclusionesEl nivel de información médica sobre diabetes proporcionada por el médico familiar y el equipo de salud es bajo, y sólo en este último caso se asocia a un mejor control glucémico. La actitud es mejor cuando se recibe información sobre diabetes de otras fuentes.ObjectiveTo determine the level of information and attitude that it has more than enough their illness has patient with diabetes type 2 (DM2), and their association with level of glucemic control.DesignCross-sectional.SettingTwo units of family medicine.Patient200 subject with DM2.InterventionsTwo instruments were applied validated to measure, level of knowledge and attitude was measured the average of the last 6 glucaemias.Measurements and resultsThe qualification average of the instrument of knowledge was 58.6 ± 17.9 (it scale 0–100). For the instrument of attitude it was of 18.9 ± 2.1 (it scale 0 at 35). The qualification of knowledge of the controlled group was of 55.48 ± 16.8, and of the uncontrolled group it was of 59.2 ± 18.1. The qualification has more than enough attitude of the controlled group it was of 17.8 ± 2.3, and of the uncontrolled group of 19.1 ± 2, p = 0.001. The proportionate level of information the family doctor was of 42.9%, of the team of health of 10.2% and of other sources of 6.3%. At the analysis of the degree of attitude and the level of information, there was a better attitude when the information was provided by other sources p < 0.05. In the percentage of information and the level of glucemic control, the control level was better when the information was for the team of health p < 0.01.ConclusionsThe level of medical information on diabetes provided by the family doctor and the team of health is low and it doesn't and only this last are associate to better glucemic control. The attitude is better when one receives information of other sources

Summing Feynman diagrams in the worldline formalism

The worldline formalism shares with string theory the property that it allows one to write down master integrals that effectively combine the contributions of many Feynman diagrams. While at the one-loop level these diagrams differ only by the position of the external legs along a fixed line or loop, at multiloop they generally involve different topologies. Here we summarize various efforts that have been made over the years to exploit this property in a computationally meaningful way. As a first example, we show how to generalize the Landau-Khalatnikov-Fradkin formula for the non-perturbative gauge transformation of the fermion propagator in QED to the general 2n - point case by pure manipulations at the path-integral level. At the parameter-integral level, we show how to integrate out individual photons in the low-energy expansion, and then sketch a recently introduced general framework for the analytical evaluation of such worldline integrals involving a reduction to quantum mechanics on the circle and the relation between inverse derivatives and Bernoulli polynomials

“Everything…Fell Apart Once COVID-19 Hit”—Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study

COVID-19 caused widespread disruption of activities for Ending the HIV Epidemic (EHE). In this study we assessed public health perspectives on leveraging the COVID-19 response to advance the goals of EHE. We conducted a qualitative study with 33 public health partners in the Midwestern and Southern United States from October 2020 to February 2022. Participants were asked how the strategies developed for COVID-19 could be applied to the HIV epidemic. Interviews were recorded, transcribed, and examined using rapid qualitative analysis. Four themes emerged: (1) Rebuilding teams and adapting culture for success in EHE activities; (2) Recognizing and modernizing the role of disease intervention specialists (DIS); (3) Enhanced community awareness of the public health role in disease response and prevention; and (4) Leveraging COVID-19 data systems and infrastructure for EHE activities. The COVID-19 pandemic called attention to the dearth of public health funding and outdated information technology (IT) infrastructure used for HIV activities. It also led to greater public health knowledge, including increased familiarity with partner services and molecular epidemiology of HIV, and opportunities to develop new data systems for surveillance that can be applied to efforts for EHE

Aprender a aprender en la universidad: perspectivas del profesorado y de los estudiantes

The aim of this study was to explain the perceptions of university students and professors regarding the “learning to learn” approach. We set up focus groups with both collectives, using the GIPU-EA model as it was operative and integrative enough to permit systematization of the coding. We analyzed maturity and density and computed an intra-dimensional coherence score. The results showed two different profi les in perceiving “learning to learn”; one matching the professors and the other the students. The implications for university teaching were discussed at the end of the paper, together with the limitations of the results we found.El objetivo de este estudio fue interpretar las perspectivas del profesorado y de los estudiantes universitarios acerca de la competencia “aprender a aprender”. Llevamos a cabo grupos de discusión con ambos colectivos y nos apoyamos en el Modelo GIPU-EA, ya que era lo suficientemente operativo e integrador como para sistematizar las codificaciones. Analizamos el enraizamiento y la densidad, y calculamos un puntaje de coherencia intradimensional. Los resultados mostraron dos perfiles diferentes en la percepción de la competencia. Uno se ajustó al profesorado y otro a los estudiantes. Las implicaciones para la docencia universitaria se discuten al final del documento, junto con las limitaciones del estudio

Looking for Crumbs in the Obesity Forest: Anti-obesity Interventions and Obesity-Associated Cardiometabolic Traits in the Mexican Population. History and Systematic Review With Meta-Analyses

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthesizes the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without an inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, covering alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting metabolism-associated traits such as BMI, weight, waist circumference, triglycerides, glucose, among others. Only the studies with at least 3 months of treatment were included in the meta-analyses in order to reduce placebo effects. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43 national, and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and the implemented strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium-to-high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like pure water instead of sweet beverages decrease triglycerides and systolic blood pressure. Dark chocolate showed the highest effect for BMI and high blood pressure, and treatment with insulin increased weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different cardiometabolic associated traits, which should be analyzed in detail in the population living near the Mexico-U.S. border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population\u27s treatment response

Randomized Clinical Trials of obesity treatments in Mexican population. Systematic Review and Meta-Analysis

Background: Mexicans and Mexican Americans share similar culture, genetic background, and predisposition for obesity and diabetes. Randomized clinical trials (RCT) assessing obesity treatments (ObT) are reliable to assess efficacy. To date, there is no systematic review to investigate ObT tested by RCT in Mexican adults. Methods: We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve ObT RCT from 1990 to 2019. The ObT included alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions. The analyzed RCT were at least three months of duration, and reported: BMI, weight, waist circumference, triglycerides, glucose and blood pressure. Results: We found 634 entries; after removal of duplicates and exclusions based on eligibility criteria, we analyzed 43 and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and did not have replications from other studies. The nutrition/behavioral interventions were difficult to blind, and most studies had medium to high risk of bias. Random effects meta-analysis of nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decreased triglycerides and systolic blood pressure. Participants with obesity and hypertension had beneficial effects with antioxidants, and the treatment with insulin increased weight in those with T2D. Conclusions: The RCT’s in Mexico reported effects on metabolic components despite small sample sizes and lack of replication. In the future we should analyze ObT in population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle cultural effects on ObT response