Prevalence and Factors Associated with Insomnia in Military Personnel: A Retrospective Study during the Second COVID-19 Epidemic Wave in Peru

Studies in military personnel are scarce and have reported increased rates of medical con-sultations and insomnia. The COVID-19 pandemic has been associated with a number of factors thatincrease the prevalence of insomnia, which has established consequences in the military. However,reported data are from different settings. We aimed to identify the prevalence and factors associatedwith insomnia during the second COVID-19 epidemic wave in Lambayeque, Peru. A retrospectivestudy in 566 participants was conducted face-to-face in November 2021. The dependent variable wasinsomnia, measured with the Insomnia Severity Index. The independent variables were socio-laborvariables, physical activity, food insecurity, eating behavior disorder, fear of COVID-19, and resilience.The prevalence of insomnia was 23% (95% CI: 19.6–26.7%). In multivariate analysis, insomnia wasassociated with a personal history of mental health (PR: 1.71, 95% CI: 1.01–2.93), food insecurity(PR: 1.43, 95% CI: 1.05–1.95), fear of COVID-19 (PR: 2.57, 95%CI: 1.87–3.54), and high resilience(PR: 0.60, 95%CI: 0.42–0.86). Overall, the Peruvian military population presents a high prevalenceof insomnia during the pandemic period. Special attention should be paid to factors that influenceinsomnia. Prevention and promotion programs should be established to reverse this negative trendin the military

Suicide Risk in Military Personnel during the COVID-19 Health Emergency in a Peruvian Region: A Cross-Sectional Study

": Military personnel represent a frontline group exposed to multiple stressors. These factors have increased during the COVID-19 pandemic, predisposing to the development of suicidal risk (SR). Given the few studies conducted in this population, we evaluated the prevalence of SR and its associated factors during the health emergency. A cross-sectional survey study was conducted in person among 514 participants in Lambayeque, Peru in 2021. The outcome was SR, and the exposures were depression (PHQ-9), anxiety (GAD-7), PTSD (PCL-C), and other sociodemographic variables. The prevalence of SR was 14.0% (95% CI: 11.12–17.31%) and was significantly higher in people with a family history of mental health (PR: 2.16; 95% CI: 1.13–4.15) and in those with moderate clinical insomnia (PR: 2.21; 95% CI: 1.19–4.12). Military personnel with high resilience had a lower prevalence of SR (PR: 0.54, CI: 0.31–0.95). Anxiety was associated with a higher prevalence of SR (PR: 3.27; 95% CI: 1.76–6.10). Our findings show that at least 1 out of 10 military personnel are at risk of suicide. Special attention should be paid to the associated factors to develop interventions and reverse their consequences. These results may be useful in policy implementation and general statistics of SR in the local and regional context.

A cross-sectional study to assess the level of satisfaction with virtual education in Peruvian medical students

"Objectives: Education has totally changed in the context of the pandemic. Therefore, the objective of the present study was to evaluate the factors associated with the level of satisfaction with virtual education in Peruvian medical students during COVID-19. Methods: Analytical and cross-sectional study, based on an online survey of students nationwide. We use previously validated instruments to measure the level of satisfaction and stress (EPP-10-c) of students with virtual education. For the associated factors, adjusted prevalence ratios (PR) were estimated using Poisson regression. Results: Of the 1,878 students surveyed, the median age was 21 years, 57.8% (1,086) were women, 34.8% (654) had a high level of satisfaction with virtual education and 10.7% (202) presented high levels of stress. The factors associated with a low level of satisfaction were attending the fifth year of study, the partial and non-virtual adaptation of the university to virtual education, and a high level of stress. On the other hand, the factors associated with a high level of satisfaction were the education platform used and the study method used. Conclusion: Seven out of 10 students presented a low level of satisfaction with virtual education, 1 out of 10 presented a high level of stress. The factors associated with the low level of satisfaction were attending the fifth year of study, the non-virtual and partial adaptation of the university to virtual education, and the high level of stress.

Mental Disorders and Level of Resilience in Eight High-Altitude Cities of Peru during the Second Pandemic Wave: A Multicenter Population-Based Study

COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study was conducted with 700 participants from eight cities. The dependent variables were depression, anxiety, and post-traumatic stress disorder (PTSD). The independent variable was resilience. Generalized logistic regressions were used to identify the associations between the variables. The population consisted mostly of university students (65.0%); the rest of the population was distributed among workers of public or private institutions, housewives, and others (35.0%). High prevalences of anxiety (72.7%), depression (64.1%), and PTSD (15.1%) were found, as well as a median (interquartile range) resilience score of 24 points was determined. Factors associated with a high prevalence of PTSD were having lost employment and having a family member who died from COVID-19. For depression, associated factors were severe food insecurity and hypersomnia. For anxiety, associated factors were were having a deceased family member with COVID-19 and mild food insecurity. Our results show that, during the pandemic, the general population had a higher prevalence of mental disorders. In addition, anxiety was the most prevalent of the dependent variables. Special attention should be paid to the factors influencing the development of mental disorders and mental health prevention and promotion programs should be established

Mental Health Disturbance after a Major Earthquake in Northern Peru: A Preliminary, Cross-Sectional Study

Little has been studied in Peru on the mental health repercussions after a major earthquake.We aimed to explore the factors associated with depressive and anxiety symptoms in people whoexperienced a 6.1 magnitude earthquake in Piura, Peru, on 30 July 2021. A preliminary cross-sectional study was conducted in the general population between August–September 2021. An onlinequestionnaire was provided using PHQ-9, GAD-7, and other relevant measures. Generalized linearmodels were applied. Of the 177 participants, the median age was 22 years, the majority were female(56%), and many experienced depressive (52%) or anxiety symptoms (52%). Presence of depressivesymptoms was associated with a personal history of mental disorder, moderate housing damage,social/material support from politicians, moderate food insecurity, and insomnia. Presence of anxietysymptoms was associated with physical injury caused by the earthquake, mild food insecurity, andinsomnia. The development of depressive and anxiety symptoms following the 2021 earthquakeexperienced in Piura depended on multiple individual and socioeconomic factors. Additional studiesshould reinforce the factors identified here given the methodological limitations, such as the studydesign, sampling method, and sample size. This would lead to effective intervention measures tomitigate the impact of earthquakes on mental health

Depression, anxiety, and stress in medical students in Peru: a cross-sectional study

ObjectiveTo determine the prevalence and factors associated with depressive, anxious, and stress symptoms in medical students in Peru, during the second pandemic wave of COVID-19.MethodsWe conducted an analytical cross-sectional study in 405 medical students from a university in northern Peru. The DASS-21 instrument was used to evaluate mental health outcomes (depression, anxiety, and stress), and to investigate their association with socio-educational characteristics.ResultsWe found a prevalence of depressive, anxious, and stress symptoms of 71.6% (95% CI: 66.94–75.95), 71.9% (95% CI: 67.2–76.2), and 62.7% (95% CI: 57.8–67.4); respectively. Students with eating behavior disorders had a higher prevalence of depressive symptoms (PR: 1.35), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.31). The prevalence of depressive symptoms (PR: 1.57), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.24) increased in students who did not report regular physical activity. In addition, having almost always academic exhaustion increased the prevalence of depressive symptoms (PR: 1.46), stress symptoms (PR: 1.72). On the contrary, the prevalence of depressive symptoms (PR: 0.79), anxious symptoms (PR: 0.73) and stress symptoms (PR: 0.82) decreased in male students. Students who reported sleeping 8 or more hours daily had a lower prevalence of stress symptoms (PR: 0.82).ConclusionSymptoms of depression and anxiety occurred in 7 out of 10 students, and stress in 6 out of 10. Among the factors associated with the presence of anxiety, depression, and stress were eating behavior disorder and not regularly exercising. Periodic evaluations of mental symptomatology are required and counseling should be promoted in medical schools

Abstract Number ‐ 131: Microsurgical Clipping and Endovascular Treatment of Paraclinoid Aneurysms: A Systematic Review and Meta‐Analysis

Introduction Paraclinoid aneurysms (PAs) have traditionally been treated with clipping. However, with the emergence of new techniques, endovascular treatment (EVT) has supplanted surgical treatment in recent years. We aimed to determine the safety and efficacy of EVT and microsurgical clipping for PAs. Methods A systematic review was performed in Scopus, Embase, Medline, Web of Science, and Cochrane from inception to March 2022 for all studies that tested the safety and efficacy of EVT or microsurgical clipping of PAs. Efficacy outcomes included complete aneurysm occlusion at last follow‐up, immediate complete occlusion, and an mRS 0–2 at last follow‐up. Safety outcomes included mortality, intraoperative and postoperative complications. We performed a random‐effects meta‐analysis of proportions and assessed the statistical heterogeneity across studies with I2 statistics. Results Eighty‐nine studies included 6496 patients, 3682 treated with EVT and 2814 with microsurgical clipping. Immediate complete occlusion rates were 92% (95% CI 88 – 96%; I2 = 60%) and 46% (95% CI 34 – 59%; I2 = 93%) for clipping and EVT, respectively. The rate of complete occlusion at last follow‐up was 94% (95% CI 91 – 96%; I2 = 0%) and 69% (95% CI 63 – 74%; I2 = 79%) for microsurgical clipping and EVT, respectively. Among EVT studies, the rate of complete occlusion was 54% (95% CI 48 – 59%; I2 = 50%), 52% (95% CI 39 – 64%; I2 = 73%), and 77% (95% CI 54 – 91%; I2 = 91%) for primary coiling, stent‐assisted coiling, and flow diversion, respectively. Among clipping studies, the rate of last follow‐up mRS 0–2 was 86% (95% CI 76 – 92%; I2 = 72%). Among EVT studies, the rate of last follow‐up mRS 0–2 was 94% (95% CI 86 – 98%; I2 = 93%). Mortality rate was 4% (95% CI 3 – 7%; I2 = 57%) and 1% (95% CI 0 – 3%; I2 = 0%) for clipping and EVT, respectively. Among EVT studies, the mortality rate was 3% (95% CI 1 – 6%; I2 = 0%) and 3% (95% CI 1 – 9%; I2 = 39%) for primary coiling and flow diversion, respectively. Intraoperative and postoperative complications were present in 9% (95% CI 6 – 14%; I2 = 68%) and 21% (95% CI 17 – 26%; I2 = 87%) among clipping studies, respectively. Intraoperative and postoperative complications were present in 6% (95% CI 4 – 9%; I2 = 64%) and 9% (95% CI 6 – 13%; I2 = 72%) among EVT studies, respectively. Conclusions In conclusion, microsurgical clipping and EVT for PAs are both safe and effective treatment modalities. Treatment via either approach should be determined on a case‐by‐case basis and according to institutional experience and resources

Mental Disorders and Level of Resilience in Eight High-Altitude Cities of Peru during the Second Pandemic Wave: A Multicenter Population-Based Study

COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study was conducted with 700 participants from eight cities. The dependent variables were depression, anxiety, and post-traumatic stress disorder (PTSD). The independent variable was resilience. Generalized logistic regressions were used to identify the associations between the variables. The population consisted mostly of university students (65.0%); the rest of the population was distributed among workers of public or private institutions, housewives, and others (35.0%). High prevalences of anxiety (72.7%), depression (64.1%), and PTSD (15.1%) were found, as well as a median (interquartile range) resilience score of 24 points was determined. Factors associated with a high prevalence of PTSD were having lost employment and having a family member who died from COVID-19. For depression, associated factors were severe food insecurity and hypersomnia. For anxiety, associated factors were were having a deceased family member with COVID-19 and mild food insecurity. Our results show that, during the pandemic, the general population had a higher prevalence of mental disorders. In addition, anxiety was the most prevalent of the dependent variables. Special attention should be paid to the factors influencing the development of mental disorders and mental health prevention and promotion programs should be established

Risk of bias of included studies using the Joanna Briggs Institute Critical Appraisal Tool for prevalence studies.

Risk of bias of included studies using the Joanna Briggs Institute Critical Appraisal Tool for prevalence studies.</p

Overall and subgroups prevalence of hypertension in the general population of the altitude.

Overall and subgroups prevalence of hypertension in the general population of the altitude.</p