Factors associated with basic scientific-academic capacity in medical students from Latin America

"Introducción: existe evidencia limitada en cuanto al entrenamiento estudiantil en capacidades científicas y académicas esenciales para la formación médica. Objetivo: identificar los factores asociados a la capacidad científica-académica básica en estudiantes de medicina de 11 países de Latinoamérica. Métodos: se hizo un estudio transversal de análisis de datos secundarios a través de un cuestionario autoadministrado en estudiantes de medicina de 11 países latinoamericanos. La variable dependiente fue la presencia de capacidad básica, definida como el autorreporte de capacitación y uso de al menos una de tres bases de datos (PubMed, SCOPUS, UpToDate), capacitación en búsqueda bibliográfica y lectura crítica, uso académico de al menos una de tres tecnologías de información (laptop, smartphone, tablet) y consulta a revistas científicas. Se estimaron razones de prevalencia (RP) utilizando modelos lineales generalizados multinivel de efectos mixtos (MEGLM). Se realizó un modelo anidado para evaluar la inclusión de covariables en el modelo parsimónico utilizando LRTest. Resultados: de 11.587 estudiantes, solo el 1,4 % presentó capacidad básica científica-académica. Los factores asociados de forma positiva fueron la procedencia de universidad privada (RP: 4,85, p < 0,001), estar afiliado a una sociedad científica estudiantil (SOCEM) (RP: 3,20, p < 0,001), pertenecer a grupos de investigación (RP: 2,97, p < 0,001) y ser parte de más de un grupo extracurricular (RP: 4,29, p = 0,012). Los factores asociados de forma negativa fueron proceder de Bolivia (RP: 0,05, p = 0,005), Argentina (RP: 0,06, p = 0,011) y Perú (RP: 0,14, p < 0,001). Conclusión: existe un pobre entrenamiento en capacidades científicas-académicas básicas en estudiantes de medicina. Proceder de universidad privada y estar afiliado a sociedades científicas o grupos afines se asoció a una mayor frecuencia de adquirir dichas herramientas.

Association between Family Dysfunction and Post-Traumatic Stress Disorder in School Students during the Second COVID-19 Epidemic Wave in Peru

"Although the effect of the COVID-19 pandemic on children and adolescents’ mental health has been studied, there is still scarce evidence of the influence of nuclear family on the development of post-traumatic stress disorder (PTSD). This study aimed to determine the association between family dysfunction and PTSD in Peruvian high-school students during the COVID-19 pandemic. A cross-sectional study was conducted using a virtual survey administered to 562 high-school students in three schools in Chiclayo, Peru. The dependent variable was PTSD, which was measured with the Child PTSD Symptom Scale. Family dysfunction was the main independent variable, measured with the Family APGAR Questionnaire. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated with generalized linear models. Most of the students were female (88.3%) and the average age was 14.4 years. We found that 21.4% showed severe family dysfunction and 60.3% had PTSD. Students with mild and moderate family dysfunction had 37% (PR: 1.37; 95% CI: 1.14–1.65) and 26% (PR: 1.26; 95% CI: 1.04–1.54) higher PTSD prevalence, respectively. In conclusion, family dysfunction may influence the development of PTSD in adolescents. This study suggests the importance to develop a healthy family environment to help adolescents face critical situations experienced during the pandemic.

Validez de la prueba de riesgo de la Asociación Americana de Diabetes como cribado para prediabetes en una muestra de trabajadores peruanos: Validity of the American Diabetes association Diabetes risk test as screening for Prediabetes in a sample of peruvian workers.

Objective:&nbsp;To evaluate the validity of the risk test of the American Diabetes Association (ADA Test) as a screening for hyperglycemia in a sample of workers in Lima, Peru.&nbsp;Methods:&nbsp;Cross-sectional study of diagnostic tests. Secondary analysis of the data generated by the electronic health record of an occupational polyclinic, carried out in January and February 2020. The sample was made up of workers from different areas who attended for their occupational medical evaluation. Prediabetes was considered with a fasting glucose ≥ 100 mg / dl but less than 126 mg / dl.&nbsp;Results:&nbsp;397 subjects were evaluated. The prevalence of hyperglycemia was 29% (115/397). With a cutoff ≥ 3 points, the ADA Test presented an area under the curve of 0.868, a sensitivity of 94.8%, and a specificity of 51.8%. The PPV was 44.5% and the NPV was 96.1%. Finally, the positive likelihood coefficient calculated was 1.96, and the negative was 0.101.&nbsp;Conclusion:&nbsp;The ADA test, with a 3-point cutoff, proves to be a simple pragmatic screening tool for undiagnosed cases of prediabetes. If current results are confirmed in future research, due to its simplicity, it can facilitate various initiatives aimed at introducing and expanding early prevention and management strategies based on this trial.Objetivo:&nbsp;Evaluar la validez de la prueba de riesgo de la Asociación Americana de Diabetes (Prueba ADA) como cribado para prediabetes en una muestra de trabajadores peruanos.&nbsp;Métodos:&nbsp;Estudio transversal de pruebas diagnósticas. Análisis secundario de los datos generados por el registro electrónico en salud de un policlínico ocupacional, realizado en los meses enero y febrero del año 2020. La muestra estuvo conformada por trabajadores de diferentes áreas que asistieron para su evaluación médica ocupacional. Se consideró prediabetes con una glucosa en ayunas ≥ 100 mg/dl pero menor a 126 mg/dl.&nbsp;Resultados:&nbsp;Se evaluaron 397 sujetos. La prevalencia de prediabetes fue 29% (115/397). Con un corte ≥ 3 puntos, la Prueba ADA presentó un área bajo la curva de 0.868, una sensibilidad del 94,8% y una especificidad del 51,8%. El valor predictivo positio fue de 44,5% y negativo fue de 96,1%. Por último, el coeficiente de verosimilitud positivo calculado fue de 1,96, y el negativo fue de 0,101.&nbsp;Conclusión:&nbsp;La prueba ADA, con un corte de 3 puntos, demuestra ser una herramienta de detección pragmática simple para casos no diagnosticados de prediabetes. Si los resultados actuales se confirman en investigaciones futuras, debido a su simplicidad, puede facilitar diversas iniciativas orientadas a introducir y ampliar estrategias de gestión y prevención temprana a partir de esta prueba

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

Factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic

"Introduction: Sanitary control mechanisms differ greatly from country to country. Therefore, it is important to know citizens' perception of different realities. We aimed to determine the factors associated with the perception of inadequate sanitary control in 12 Latin American countries during the COVID-19 pandemic. Methods: This is an analytical cross-sectional study. We asked about six perceptions in regard to different situations experienced by inhabitants of 12 Latin American countries during the pandemic. Frequencies according to country were described and associations vs. other important variables were obtained. Results: Out of 8,489 participants, 68% stated that there were moments of collective hysteria. Honduras was the country that most perceived inadequate control mechanisms established by the government. Multivariate analysis showed that there were statistically significant differences among many of the countries according to the six evaluated items. The higher the level of education, the greater the perception of poor control in five of the aspects. Additionally, men had a lower perception of inadequate control. The older the age, the lower the perception of inadequate control regarding whether there was collective hysteria and shortages of basic essentials. Those with COVID-19 had a lower perception of medicine shortages. Conclusion: The population of multiple realities in Latin America have perceived a bad management of the pandemic. Citizens' perception is an important indicator of the performance of each government during the COVID-19 pandemic. This study may provide valuable information on the relationship between the effectiveness of government sanitary control and people's mental health, which ultimately helps to create objective prevention programs against post-traumatic stress disorder, depression, fear of contagion, and collective hysteria. In addition, governments could use this information to design effective mitigation plans for future unavoidable pandemic events based on the six criteria discussed here.

Factores asociados al dominio docencia e investigación en facultades de medicina

Introducción: La investigación en pregrado se ha convertido en una parte integral de la formación médica, la cual ha transformado a la educación en salud y ha seguido históricamente un modelo estático con una orientación hospitalaria. Objetivo: Determinar los factores asociados al dominio correspondiente a docencia e investigación, en las mallas curriculares de las facultades de medicina humana de universidades peruanas. Métodos: Estudio de corte transversal en el cual se analizaron las mallas curriculares de las facultades de medicina humana existentes en Perú en el año 2022. Se seleccionaron asignaturas que cumplieron las características correspondientes al dominio Docencia e Investigación según lo establecido en el Documento Técnico del Ministerio de Salud. Asimismo, se evaluaron las variables tipo de universidad, ubicación, año de creación; también se recopilaron variables relacionadas con investigación: Ranking SIR IBER 2022, número de publicaciones generales en Scopus, número de publicaciones en medicina en Scopus, índice H Scopus y número de investigadores. Resultados: De 40 facultades de medicina humana, la media de cursos del dominio Docencia e Investigación fue de 6,5. Se encontró que el tipo de universidad tuvo asociación significativa con la frecuencia de cursos correspondientes al dominio Docencia e Investigación, con una media de cursos en universidades privadas superior a la media reportada en universidades públicas (?= 7,5 vs. ?= 5,5; p= 0,023). Conclusiones: El factor asociado al dominio correspondiente Docencia e Investigación es el tipo de universidad, se encuentra una media de cursos en universidades privadas superior a lo reportado en universidades públicas

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

Factores asociados a la no adherencia al tratamiento antihipertensivo en un hospital del seguro social de Chiclayo durante el período de emergencia sanitaria por COVID-19

Background: Previous studies indicate poor therapeutic adherence in hypertensive patients, however, evidence on factors is limited. Objective: To determine the factors associated with non-adherence to antihypertensive treatment in a Social Health Security hospital in Chiclayo, Peru during November-December 2020. Material and Methods: Analytical cross-sectional study in adult patients with chronic diseases at Hospital I Naylamp, to whom the Morisky-Green questionnaire was applied to measure therapeutic adherence and the Bonilla and Gutiérrez instrument to evaluate factors that influence adherence to pharmacological treatment. Results: Of 234 participants, the non-adherence frequency was 52,7%, of these 68,7% were women and the main age was 71,82 + 9,15 years. In the simple regression, disease time was positively associated with non-adherence to treatment (RP: 1.02, 95%CI. Additionally, socio-economic factors related to the provider, therapy and patient were associated with a lower frequency of non-adherence to treatment. In multiple regression, people at risk of not developing treatment adherence behaviors due to socio-economic factors (RP: 0.67, 95%CI: 0,50-0,91) and to factors related to provider (RP: 0.71, 95%CI:0,54-0,92) have lower frequency of non-adherence to treatment compared to those that haver adherence. Conclusion: 5 to 6 out of 10 patients presented non-adherence to their antihypertensive treatment. Socio-economic factors, provider-related factors and patient-related factors were associated with a lower frequency of not developing adherence behaviors to their treatment.Introducción: Estudios previos señalan la escasa adherencia terapéutica en pacientes hipertensos, sin embargo, es limitada la evidencia sobre los factores influyen en la misma. Objetivo: Determinar los factores asociados a la no adherencia al tratamiento antihipertensivo en un hospital del Seguro Social de Salud en Chiclayo, Perú durante Noviembre-Diciembre 2020. Material y Métodos: Estudio transversal analítico en pacientes del programa del adulto con enfermedades crónicas del Hospital I Naylamp, a quienes se les aplicó el cuestionario de Morisky-Green para medir adherencia terapéutica y el instrumento de Bonilla y Gutiérrez para evaluar factores que influyen en adherencia al tratamiento farmacológico. Resultados: De 234 participantes, la frecuencia de no adherencia fue 52,7%, de estos 68,7% fueron mujeres y la media de edad fue 71,82 ± 9,15 años. En la regresión simple, se encontró que el tiempo de enfermedad está asociado positivamente a la no adherencia al tratamiento (RP: 1.02, IC95%: 0,99 – 1,02). Adicionalmente, factores socioeconómicos, relacionados con el proveedor, terapia y el paciente resultaron asociados a menor frecuencia de no adherencia terapéutica. En la regresión múltiple, se observó que las personas con riesgo de no desarrollar comportamientos de adherencia al tratamiento por factores socioeconómicos (RP: 0.67, IC95%: 0,50 – 0,91) y factores relacionados al proveedor (RP: 0.71, IC95%: 0,54 – 0,92) tienen menor frecuencia de no adherencia al tratamiento en comparación con las personas que tienen adherencia. Conclusión: De cada 10 personas, 5 – 6 resultaron no adherentes a su tratamiento antihipertensivo. Los factores socioeconómicos, factores relacionados al proveedor y al paciente se asociaron a una menor frecuencia de desarrollar comportamientos de no adherencia a su tratamiento

Toxoplasma gondii Infection and Threatened Abortion in Women from Northern Peru

Introduction. Toxoplasma gondii infection can cause important complications during pregnancy. Threatened abortion may be a late indicator for infection in settings with high prevalence of toxoplasmosis. We aimed to determine the association between T. gondii infection and threatened abortion in women from northern Peru. Methods. We conducted a secondary analysis of a cross-sectional study in pregnant women from a hospital and a rural community in Lambayeque, Peru. Exposure variable was serological diagnosis of toxoplasmosis, defined as the demonstration of either IgM or IgG antibodies against T. gondii. Outcome variable was threatened abortion, defined as the diagnosis of bloody vaginal discharge or bleeding during the first half of pregnancy. Prevalence ratios were estimated in simple and multiple regression analyses. Results. Of 218 pregnant women, 35.8% presented positive serology for T. gondii and 14.7% had threatened abortion in their current pregnancy. Pregnant women with positive T. gondii infection had 2.45-fold higher frequency of threatened abortion (PR: 2.45, 95% CI: 1.15-5.21). In addition, the frequency of threatened abortion decreased by 9% for each additional year of age (PR: 0.91, 95% CI: 0.86-0.97). A previous history of threatened abortion also showed a higher frequency of threatened abortion (PR: 5.22, 95% CI: 2.45-11.12). Conclusions. T. gondii infection is associated with threatened abortion. An early age of pregnancy and a previous history of abortion are also associated with this condition