Conocimiento y consumo de edulcorantes no calóricos en estudiantes universitarios peruanos

The objective of the present investigation was to evaluate the level of knowledge and consumption of non-caloric sweeteners in university students of the Faculty of Agriculture and Nutrition at the National University of Education "Enrique Guzmán y Valle". Likewise, associate the level of knowledge according to sociodemographic characteristics such as gender, academic cycle and study program. The research was of a quantitative, non-experimental or observational, cross-sectional approach. The sample consisted of 123 students from the different cycles of the Food Industries and Nutrition, Human Nutrition, Agricultural and Environmental Development programs. The level of knowledge and consumption of sweeteners was evaluated through a questionnaire prepared by the researchers, content validity was performed through expert judgment (94.1) and internal consistency through reliability analysis (0.820). . The data was presented at a descriptive and inferential level, the statistical analysis obtained a confidence level of 95% and an error level of 5%. The results showed that the level of knowledge about non-caloric sweeteners is low (71.6%) and at a medium level (27.6%). The sweetener that students know the most is stevia (43.5%), followed by sucrose (21.7%). One (60.2%) consumes sweeteners daily. In the logistic regression between the level of knowledge with the program and gender, it was higher in men (marginal p) and with the program, the association between consumption of non-caloric sweeteners with knowledge and demographic characteristics, a reduction in consumption was found. of sweeteners that was associated with knowledge and the program. No relationship was observed with age, sex and cycle of studies.El objetivo de la presente investigación fue evaluar el nivel de conocimiento y consumo de edulcorantes no calóricos en estudiantes universitarios de la Facultad de Agropecuaria y Nutrición en la Universidad Nacional de Educación “Enrique Guzmán y Valle”. Asimismo, asociar, el nivel de conocimiento según las características sociodemográficas como sexo, ciclo académico y programa de estudio. La investigación fue de enfoque cuantitativo, no experimental u observacional, de corte transversal. La muestra estuvo conformada por 123 estudiantes de los diferentes ciclos de los programas de Industrias Alimentarias y Nutrición, Nutrición Humana, Agropecuaria y Desarrollo Ambiental. El nivel de conocimientos y consumo de edulcorantes, se evaluó a través de un cuestionario elaborado por los investigadores, la validez de contenido fue realizado a través del juicio de expertos (94.1) y la coherencia interna a través del análisis de la confiabilidad (0.820). Los datos fueron presentados a nivel descriptivo e inferencial, el análisis estadístico obtuvo un nivel de confianza del 95% y un nivel de error 5%. Los resultados demostraron que el nivel de conocimientos sobre los edulcorantes no calóricos es bajo (71.6%) y en un nivel medio (27.6%). El edulcorante que más conocen los estudiantes es la estevia (43.5%), seguida de la sacarosa (21,7%). Un (60.2%) consume a diario edulcorantes. En la regresión logística entre el nivel de conocimiento con el programa y sexo, fue mayor en los varones (p marginal) y con el programa, la asociación entre consumo de edulcorantes no calóricos con conocimiento y características demográficas, se encontró una reducción en el consumo de edulcorantes que fue asociado al conocimiento y el programa. No se observó relación con edad, sexo y ciclo de estudios.&nbsp

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P<0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P<0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this