Depresión, Ansiedad y Estrés en población adulta de 20 a 40 años de Centla, municipio de Frontera Tabasco de México

Objetivo: Identificar el grado de depresión, ansiedad y estrés en la población adulta de 20 a 40 años en Centla, municipio de Frontera Tabasco, México. Método: Investigación cuantitativa de tipo transversal descriptivo realizada en 222 sujetos de 20 a 40 años a través de un muestreo no probabilístico por conveniencia. Se utilizó la Escala de DASS-21, que fue diseñada para medir estados emocionales negativos como depresión, ansiedad y estrés, los datos fueron procesados a través del programa estadístico SPSS V23. Resultados principales: Se identificó que predomina la sintomatología relacionada a la ansiedad (56,3%), seguido de los síntomas depresivos (54,1%) y por último los síntomas de estrés (48,2%). Al considerar sólo los participantes que manifestaron síntomas, se logró identificar que predomina la categoría moderada en el 32,5% de los participantes con síntomas depresivos y el 32,0% con síntomas de ansiedad, además que el 34,4% se ubica con síntomas de estrés leve. Conclusión: El estudio demuestra que existe una alteración en los estados emocionales de los individuos, lo que pudiera limitar su desarrollo individual, familiar y social, además de representar un área de oportunidad para los profesionales de la salud en el fomento y cuidado de la salud mental

Inserción laboral de los Egresados de la Licenciatura en Fisioterapia. Debilidades vs fortalezas

The objective of the present investigation is to know the status of labor insertion and to analyze the strengths and weaknesses of the educational program of the Degree in Physiotherapy from the perspective of the graduates in the year 2021. The present research work has a quantitative approach, descriptive scope, cross-section, the population was made up of graduates of the educational program of the Bachelor of Physiotherapy in 2021. The sampling was non-probabilistic at convenience consisting of 17 study subjects. The percentage of graduates of the Degree in Physiotherapy from the Autonomous University of Carmen that enters the labor field of the corresponding disciplinary area is 76.47%, carrying out activities according to the graduation profile of the same. The strengths that were identified with the highest prevalence were those of laboratory practices 35.29% followed by teamwork with 29.41%. The weaknesses indicated were the lack of teaching staff with 47.05% followed by the lack of external practice venues with 41.17%. In conclusion, we can say that the findings of the present study are the basis for the identification of the strengths and weaknesses of the study plan of the Degree in Physiotherapy in operation, from the perspective of the graduates, these indicators help the continuous improvement of the curricular structure embodied and the search for strategies to master the competencies of the profession, it is worth mentioning that the search for identity depends closely on what is learned in the classroom and in field practices. Currently the physiotherapy profession is relatively new in the clinical and social context, however, work is underway to strengthen the evidence-based clinical profession.El objetivo de la presente investigación es conocer el estatus de inserción laboral y analizar las fortalezas y debilidades del programa educativo de la Licenciatura en Fisioterapia desde la perspectiva de los egresados en el año 2021. El presente trabajo de investigación es de enfoque cuantitativo, alcance descriptivo, corte transversal, la población estuvo conformado por los egresados del programa educativo de la Licenciatura en Fisioterapia del año 2021. El muestreo fue no probabilística a conveniencia constituido por 17 sujetos de estudio. El porcentaje de egresados de la Licenciatura en Fisioterapia de la Universidad Autónoma del Carmen que se inserta al campo laboral del área disciplinar correspondiente es del 76.47%, realizando actividades acordes al perfil de egreso de la misma.  Las fortalezas que se identificaron con mayor prevalencia fueron las de prácticas del laboratorio 35.29% seguido de trabajo en equipo con el 29.41%. Las debilidades señaladas fueron la falta de personal docente con 47.05% seguida de falta de sedes externas de práctica con el 41.17%. En conclusión, podemos decir que los hallazgos del presente estudio, son la base para la identificación de las fortalezas y debilidades del plan de estudio de la Licenciatura en Fisioterapia en operación, desde una perspectiva de los egresados, estos indicadores ayudan a la mejora continua de la estructura curricular plasmado y a la búsqueda de estrategias para el domino de las competencias propias de la profesión, cabe mencionar que la búsqueda de la identidad depende estrechamente de lo que se aprende en el aula y en la prácticas de campo. Actualmente la profesión de fisioterapia es relativamente nueva en el contexto clínico y social, sin embargo, se está trabajando para fortalecer la profesión clínica basada en evidencia

Prevalencia de lesiones musculoesqueléticas en estudiantes del área de la salud

Determinar la prevalencia del riesgo ergonómico que ocasionan las lesiones musculoesqueléticas en los estudiantes de prácticas clínicas, que se encontraron realizando estancia en el laboratorio de simulación clínica de una Universidad del sureste mexicano, durante el periodo de agosto a diciembre del 2018. El tipo de estudio que se utilizó en esta investigación fue de tipo cuantitativo, de cohorte transversal; para su análisis se trabajó con una muestra de 25 alumnos y los métodos que se emplearon fueron el cuestionario nórdico estandarizado y el método ergonómico de evaluación postural de OWAS. El 84% de la muestra fue de sexo femenino y el 16% masculino; el promedio de edad de +22.44 (DE=±22.44), promedio de horas de prácticas en el laboratorio +5.12 horas, una confiabilidad del instrumento del cuestionario nórdico estandarizado con alfa de Cronbach basados en elementos estandarizados de 0.761 y la confiabilidad del método de OWAS con un alfa de Cronbach de 0.747; se determinó que el 92.8% de los estudiantes presentaron problemas musculoesqueléticos, principalmente en la zona de cuello (72%), hombros (52%), espalda baja (84%), rodillas (52%) y en los últimos siete días dolor en caderas (32.5%); una sobrecarga de peso se encontró en el nivel 3 de riesgo ergonómico, lo que representó el 32.2%. Estas evaluaciones identificaron la sintomatología inicial de lesiones musculoesqueléticas en los alumnos durante su formación profesional, que repercuten en la edad productiva, lo que genera absentismo y baja producción laboral, constituyéndose en un problema de Salud Pública. PALABRAS CLAVE: Ergonómico; OWAS; Cuestionario Nórdico Estandarizado; estudiantes; Fisioterapia. Teaching factors and their association with the failure rate in higher-level students ABSTRACT The type of study that was used in this research was quantitative, cross-sectional cohort; For its analysis, a sample of 25 students was used and the methods used were the standardized Nordic questionnaire and the ergonomic method of postural evaluation of OWAS. 84% of the sample was female and 16% male; the average age of +22.44 (SD = ± 22.44), average hours of laboratory practice +5.12 hours, a reliability of the standardized Nordic questionnaire instrument with Cronbach's alpha based on standardized elements of 0.761 and the reliability of the method of OWAS with a Cronbach's alpha of 0.747; It was determined that 92.8% of the students presented musculoskeletal problems, mainly in the neck area (72%), shoulders (52%), lower back (84%), knees (52%) and in the last seven days pain in hips (32.5%); a weight overload was found in ergonomic risk level 3, which represented 32.2%. These evaluations identified the initial symptoms of musculoskeletal injuries in students during their professional training, which affect their productive age, which generates absenteeism and low labor production, becoming a Public Health problem. KEYWORDS: Ergonomic; OWAS; Standardized Nordic Questionnaire; students; Physiotherapy

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

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

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