31 research outputs found

    Atitude frente ao consumo e nao consumo de alcool em estudantes de nivel medio Mexico

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    The objective of this study was to identify differences in high school students’ attitudes towards the consumption or non-consumption of alcohol using the theory of planned behavior. This was a qualitative, descriptive, cross-sectional study that included a sample of 131 students. We found that 74% of students had consumed alcohol, and 18.3% exhibited a harmful level of consumption. We also found that behavioral beliefs towards consumption were higher among alcohol consumers (mean=29.32, median=27.50) than those who did not consume alcohol. Moreover, positive beliefs towards consumption were higher among alcohol consumers (mean=17.72, median=9.52) than non-consumers, which demonstrates a need for preventative programs to strengthen adolescents’ beliefs concerning alcohol as well as protective factors and healthy lifestyles.El objetivo del estudio fue identificar diferencias de actitud entre estudiantes de la educaciĂłn secundaria consumidores y no de alcohol a travĂ©s de la TeorĂ­a de la Conducta Planeada. Estudio descriptivo transversal con abordaje cuantitativo, con una muestra de 131 adolescentes. Se verifi cĂł que 74% ya habĂ­an consumido alcohol y 18.3% tienen consumo dañino. Se constatĂł que las creencias conductuales hacia el consumo eran mĂĄs altas en los consumidores de alcohol ( X =29.32, Mdn=27.50) que en los no consumidores, asĂ­ con la evaluaciĂłn de las creencias en sentido positivo son mĂĄs altas en los consumidores de alcohol ( X =17.72, Mdn=9.52) que en los no consumidores, haciĂ©ndose necesaria la implementaciĂłn de programas preventivos que fortalezcan las creencias de los adolescentes, asĂ­ como estimular las estrategias vinculadas con el fortalecimiento de factores protectores y estilos de vida saludables.O objetivo do trabalho foi identificar as diferenças de atitude entre estudantes de nĂ­vel mĂ©dio consumidores ou nĂŁo de ĂĄlcool, por meio da Teoria da Conduta Planejada. Estudo descritivo transversal com abordagem quantitativa, com uma amostra de 131 adolescentes. Verificou-se que 74% jĂĄ haviam consumido ĂĄlcool e 18.3% mantinham consumo nocivo, contatou-se que as crenças comportamentais em relação ao consumo eram mais altas nos consumidores de ĂĄlcool ( X =29.32, Mdn=27.50) que nos nĂŁo consumidores, assim como a avaliação das crenças positivas, igualmente mais altas nos consumidores de ĂĄlcool ( X =17.72, Mdn=9.52) que nos nĂŁo consumidores. Concluiu-se que Ă© necessĂĄrio a implementação de programas preventivos que fortaleçam as crenças dos adolescentes, assim como estimular estratĂ©gias de fortalecimento de fatores protetores e estilos de vida saudĂĄveis

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

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    Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

    COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

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    Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≀ 18 years: 69, 48, 23; 85%), older adults (≄ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

    Actitud ante el consumo y no consumo de alcohol en estudiantes de preparatoria Mexico

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    El objetivo del estudio fue identificar diferencias de actitud entre estudiantes de la educación secundaria consumidores y no de alcohol a través de la Teoría de la Conducta Planeada. Estudio descriptivo transversal con abordaje cuantitativo, con una muestra de 131 adolescentes. Se verifi có que 74% ya habían consumido alcohol y 18.3% tienen consumo dañino. Se constató que las creencias conductuales hacia el consumo eran mås altas en los consumidores de alcohol ( X =29.32, Mdn=27.50) que en los no consumidores, así con la evaluación de las creencias en sentido positivo son mås altas en los consumidores de alcohol ( X =17.72, Mdn=9.52) que en los no consumidores, haciéndose necesaria la implementación de programas preventivos que fortalezcan las creencias de los adolescentes, así como estimular las estrategias vinculadas con el fortalecimiento de factores protectores y estilos de vida saludables

    Differences in HCV viral decline between low and standard-dose pegylated-interferon-alpha-2a with ribavirin in HIV/HCV genotype 3 patients.

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    BACKGROUND: The aim of the study was to analyze the different impact of standard and low-dose Peg-IFN-α2a/RBV therapies on HCV viral decline in HIV/HCV genotype 3 co-infected patients during the first weeks of treatment. METHODS: Plasma HCV viral decline was analyzed between baseline and weeks 1, 2 and 4 in two groups of treatment-naïve HCV genotype 3 patients with HIV co-infection. The Standard Dose Group (SDG) included patients who received Peg-IFN at 180 ”g/per week with a weight-adjusted dose of ribavirin; Low-Dose Group (LDG) patients received Peg-IFN at 135 ”g/per week with 800 mg/day ribavirin. The effect of IL28B genotype on HCV viral decline was evaluated in both groups. HCV viral decline was analyzed using a multivariate linear regression model. RESULTS: One hundred and six patients were included: 48 patients in the SDG and 58 in the LDG. HCV viral decline for patients in the LDG was less than for those in the SDG (week 1:1.72±0.74 log(10) IU/mL versus 1.78±0.67 log(10) IU/mL, p = 0.827; week 2:2.3±0.89 log(10) IU/mL versus 3.01±1.02 log(10) IU/mL, p = 0.013; week 4:3.52±1.2 log(10) IU/mL versus 4.09±1.1 log(10) IU/mL, p = 0.005). The linear regression model identified the Peg-IFN/RBV dose as an independent factor for HCV viral decline at week 4. CONCLUSIONS: Our results showed that HCV viral decline was less for patients in the low-dose group compared to those receiving the standard dose. Until a randomized clinical trial is conducted, clinicians should be cautious about using lower doses of Peg-IFN/RBV in HIV/HCV genotype 3 co-infected patients

    Mean HCV viral decline by IL28B genotype for the standard dose group (SDG) (<b>Figure 2A</b>) and the low-dose group (LDG) (<b>Figure 2B</b>).

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    <p>Mean HCV viral decline by IL28B genotype for the standard dose group (SDG) (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0048959#pone-0048959-g002" target="_blank"><b>Figure 2A</b></a>) and the low-dose group (LDG) (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0048959#pone-0048959-g002" target="_blank"><b>Figure 2B</b></a>).</p
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