Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the norwegian HUNT study

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.OBJECTIVE: To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. RESEARCH DESIGN AND METHODS: A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trøndelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. RESULTS: Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). CONCLUSIONS: Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes.Revisión por pare

Association between time of residence and self-perception of distress, interpersonal relationships, and social role in Venezuelan immigrants in Lima, Peru 2018–19: mixed-methods study

Background: Immigrants arriving in a new country face changes that affect their social, employment, and migratory status. We carried out a mixed-methods study in the rapidly growing Venezuelan immigrant population in Lima, Peru. The objective was to determine whether there was an association between time in Peru and self-perception of symptom distress (SD), interpersonal relationships (IR), and social role (SR). Methods: The quantitative central component consisted of a cross-sectional study, surveying 152 participants using the Outcome Questionnaire 45.2 (OQ-45.2). The qualitative component, based on phenomenology, explored experiences and challenges during the migration process. Semi-structured in-depth interviews were conducted in 16 informants. Results: An association that was observed was the increase in the risk of clinically significant SR score with additional years of age. All informants mentioned having witnessed or experienced xenophobia in Peru. Every informant stated that significant labor differences existed between the countries. The most reported somatic symptoms were symptoms of anxiety and alterations of sleep. Additionally, no informant expressed a desire to remain in Peru long term. Conclusions: A minority of participants registered a clinically significant total score and in each of the three domains of SD, IR, and SR. No association between months in Lima and the self-perception of distress was found. However, this could be due to the short amount of time spent in Peru and any change in self-perception might only be perceived after years or decades spent in Peru. This study is one of the first to use mixed-methods to explore the mental health of the immigrant Venezuelan population.Revisión por pare

Comments on: "Family life stories in teenage mothers: Qualitative study conducted at the Engativá ESE Hospital in Bogotá, Colombia"

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Linfoma hepático primario no Hodgkin de células T y B asociado a VEB: un reporte de caso

El linfoma hepático primario (LHP) es una forma rara de linfoma no Hodgkin que suele manifestarse clínicamente con dolor abdominal, pérdida de peso, hepatomegalia e ictericia, sin presencia de adenomegalias o invasión extrahepática. De todos lo linfomas este presenta una prevalencia 0.016%. La etiología no se encuentra bien definida, sin embargo, el LHP se ha reportado estar asociado al virus Epstein-Barr (VEB), el cual posee la capacidad promover el crecimiento de los linfocitos, mediante los mecanismos de expresión del antígeno nuclear de Epstein-Barr 1 (EBNA1), la proteína de membrana latente 1 (LMP1) y LMP2 que producen la proliferación de células B. Mientras que, la activación de citocinas proinflamatorias y expresión de genes latentes, conducen a la proliferación de células T. Presentamos el caso de una paciente de 68 años que acude por presentar pérdida de peso de 10 kg en un periodo de 3 meses, malestar general, dolor abdominal tipo cólico localizado en epigastrio y sensación de llenura precoz asociado a fiebre no cuantificada, episodios de náuseas, diarrea en múltiples ocasiones e ictericia en escleras en los últimos 5 días. Mediante biopsia, se identifica Linfoma no Hodgkin inmunofenotipo T y B.Primary liver lymphoma (LHP) is a rare form of non-Hodgkin lymphoma that usually manifests clinically with abdominal pain, weight loss, hepatomegaly and jaundice, without the presence of adenomegalies or extrahepatic invasion. Of all lymphomas, this has a prevalence of 0.016%. The etiology is not well defined, however LHP has been reported to be associated with the Epstein-Barr virus (EBV), which has the ability to promote lymphocyte growth, by means of the Epstein-Barr nuclear antigen expression mechanisms. 1 (EBNA1), the latent membrane protein 1 (LMP1) and LMP2 that produce B-cell proliferation. While, the activation of proinflammatory cytokines and latent gene expression, lead to the proliferation of T-cells. We present the case of a 68-year-old patient who presented with a 10 kg weight loss over a period of 3 months, malaise, abdominal cramps in the epigastrium and a feeling of early fullness associated with unquantified fever, nausea episodes, multiple diarrhea occasions and jaundice in scleras in the last 5 days. By biopsy, non-Hodgkin lymphoma immunophenotype T and B is identified

Diarrheal disease and associations with water access and sanitation in Indigenous Shawi children along the Armanayacu River basin in Peru

Introduction: Diarrheal disease, particularly in children under 5 years old, remains a global health challenge due to its high prevalence and chronic health consequences. Public health interventions that reduce diarrheal disease risk include improving access to water, sanitation, and hygiene. Although Peru achieved the 2015 Millennium Development Goal (MDG) indicators for water access, less progress was achieved on sanitation. Furthermore, many Indigenous Peoples were overlooked in the MDG indicators, resulting in a prioritization of Indigenous Peoples in the 2030 Sustainable Development Goals (SDGs). This study aimed to estimate the prevalence of childhood diarrhea, characterize access to water and sanitation, and determine the association of childhood diarrhea with water access and sanitation indicators in 10 Shawi Indigenous communities along the Armanayacu River in the Peruvian Amazon. Methods: A cross-sectional survey (n=82) that captured data on diarrheal disease, sociodemographic variables, and water and sanitation exposures was conducted in 10 Shawi communities. Nutritional status of children under 5 was also assessed via physical examination. Descriptive and comparative statistics were conducted. Results: A small proportion (n=7; 8.54%) of participating children reported an episode of diarrhea in the previous month. Almost half (46.30%) of participating children had stunting, wasting, or both. Although not statistically significant, children living in households that used latrines were 4.29 times (95% confidence interval (CI) 1.01-18.19) more likely to report an episode of diarrhea than children living in households that practiced open defecation. Although not statistically significant, children living in households that used water treatment methods were 4.25 times (95%CI 0.54-33.71) more likely to report an episode of diarrhea than children living in households that did not. Conclusion: The prevalence of childhood diarrhea was lower for Shawi than for other Amazon areas. The higher prevalence of childhood diarrhea in households that used latrines and water treatments warrants further investigation into local risk and protective factors. These Shawi communities scored low for the WHO/UNICEF Joint Monitoring Programme indicators for water and sanitation, indicating that they should be prioritized in future water, sanitation, and hygiene initiatives. Research will be required to understand and incorporate local Indigenous values and cultural practices into water, sanitation, and hygiene initiatives to maximize intervention uptake and effectiveness

Globalización, el Proyecto Camisea y la salud de los Matsiguengas

Globalization has been the consequence of an important opening of the economies, achieved through the reduction in the obstacles to commerce, elimination of the capital controls and exchange restrictions. The impact of the Camisea Project in the Peruvian economy has aroused great interest and controversy with respect to the future social and economic national impact, and especially, in the Matsigenka population, located in the 88 and 56 lots, where gas extraction is being done. The area of Camisea gas exploitation offers the challenge of a complex sanitary problem, not only because of the impacts and risks produced by the hidrocarbon exploitation, but also due to a legacy of economical and sanitary precariousness that has accumulated from other times. At the same time, this area offers the opportunity to rethink the public health system according to the indigenous reality. It is necessary to take action in the social determinants of inequity and poverty in order to reach the positive effects the globalization can have in health, ensuring the interests of developing countries and vulnerable populations.La globalización ha sido consecuencia de una importante apertura de las economías, conseguida mediante la reducción de los obstáculos al comercio, y la eliminación de los controles de capital y de las restricciones cambiarias. El impacto del Proyecto Camisea en la economía peruana ha despertado gran interés y polémica con respecto al futuro impacto social y económico nacional y, especialmente, en la población Matsiguenga que se encuentra ubicada en los Lotes 88 y 56 donde se realiza la extracción de gas. La zona de explotación de gas de Camisea, ofrece el desafío de un problema sanitario complejo no solo por los impactos y riesgos producto de la explotación de hidrocarburos; sino también por una herencia de precariedad económica y sanitaria que se ha acumulado de otras épocas. Al mismo tiempo, esta zona ofrece la oportunidad para replantear el sistema de salud pública en función de la realidad indígena. Para que la globalización tenga efectos positivos sobre la salud es necesario tomar acción en los determinantes sociales de inequidad y pobreza; asegurando los intereses de los países en desarrollo y de las poblaciones vulnerables

Climatic Changes, Water Systems, and Adaptation Challenges in Shawi Communities in the Peruvian Amazon

Climate change impacts on water systems have consequences for Indigenous communities. We documented climatic changes on water systems observed by Indigenous Shawi and resultant impacts on health and livelihoods, and explored adaptation options and challenges in partnership with two Indigenous Shawi communities in the Peruvian Amazon. Qualitative data were collected via PhotoVoice, interviews, focus group discussions, and transect walks, and analyzed using a constant comparative method and thematic analysis. Quantitative data were collected via a household survey and analyzed descriptively. Households observed seasonal weather changes over time (n = 50; 78%), which had already impacted their family and community (n = 43; 86%), such as more intense rainfall resulting in flooding (n = 29; 58%). Interviewees also described deforestation impacts on the nearby river, which were exacerbated by climate-related changes, including increased water temperatures (warmer weather, exacerbated by fewer trees for shading) and increased erosion and turbidity (increased rainfall, exacerbated by riverbank instability due to deforestation). No households reported community-level response plans for extreme weather events, and most did not expect government assistance when such events occurred. This study documents how Indigenous peoples are experiencing climatic impacts on water systems, and highlights how non-climatic drivers, such as deforestation, exacerbate climate change impacts on water systems and community livelihoods in the Peruvian Amazon

Achieving the Sustainable Development Goals: A Mixed Methods Study of Health-Related Water, Sanitation, and Hygiene (WASH) for Indigenous Shawi in the Peruvian Amazon

Sustainable Development Goal 6 (SDG-6) addresses poor water quality, inadequate sanitation, and improper hygiene, all of which negatively impact health and disproportionately impact Indigenous Peoples’ health. Understanding and responding to local contexts is critical to effectively improve water, sanitation, and hygiene (WASH); however, in-depth understanding of local knowledge, practices, and perceptions are often overlooked. As such, this study described the knowledge, practices, and perceptions of WASH held by residents of two Indigenous Shawi communities in the Peruvian Amazon. Quantitative data were collected via a cross-sectional survey and analyzed using descriptive statistics. Qualitative data were collected via interviews, PhotoVoice, focus group discussions, and participatory transect walks, and analyzed using a constant comparative approach to thematic analysis. Emergent themes included characterizing water sources, collection methods, and consumption patterns; knowledge, perceptions, and practices related to WASH; and knowledge and perceptions of health issues related to WASH. This study provides insight into the ongoing challenges related to WASH in Indigenous communities in the Peruvian Amazon and highlights the need to prioritize interventions that will advance WASH-related SDGs

Structural Determinants of Indigenous Health: A Photovoice Study in the Peruvian Amazon

Indigenous populations in the Americas carry a disproportionate burden of disease. Common to populations affected by health inequities is the exposure to structural factors—social, political, environmental and economic—that shape the risks for disease. We conducted a photovoice study in three Shipibo-Konibo indigenous villages in the Peruvian Amazon. Twenty-four indigenous participants consented to take part. The study found that Shipibo-Konibo villagers are exposed to a series of structural factors such as malfunctioning latrines, lack of garbage disposal systems, lack of health services, migration, and mixing with outsiders which they see as important determinants of their health. While primary health care is urgently needed among indigenous communities in this region, any public health intervention must take into account the structural forces that affect indigenous people\u27s health

Proyecto de Tesis 2 - TF141 - 202101

Descripción: La investigación es parte esencial de la formación universitaria y particularmente de las carreras de las ciencias de la salud, por ello el requisito para que un estudiante de terapia física se gradúe en la Universidad Peruana de Ciencias Aplicadas es la sustentación de una tesis, que es un trabajo de investigación ejecutado por uno a dos alumnos. Para ello, los alumnos han llevado cursos previos que han dado herramientas para el desarrollo de su formación en investigación como Informática para Ciencias de la Salud, Bioestadística, Metodología de la Investigación y Epidemiología. En el curso de Proyecto de Tesis I los alumnos han desarrollado su protocolo de tesis, el cual será ejecutado, analizado y redactado durante el presente curso. Propósito: Proyecto de Tesis 2 es un curso específico del Programa de Terapia física, de carácter teórico-práctico, dirigido a los estudiantes del 9no ciclo. Se espera alcanzar un nivel 3 (avanzado) de las competencias comunicación escrita, razonamiento cuantitativo y manejo de la información; asimismo, se espera alcanzar un nivel 3 (avanzado) de la competencia específica investigación. 1Misión de la Carrera: Formar profesionales en terapia física líderes, íntegros e innovadores con visión global para que transformen el Perú. Visión de la Carrera: Ser reconocidos por formar profesionales en salud con las más altas competencias profesionales y su liderazgo en la transformación del Perú