Uso de bebidas energizantes y síntomas de insomnio en estudiantes de medicina de una universidad peruana / Use of energy drinks and insomnia symptoms in medical students from a Peruvian university

OBJETIVO: Determinar la asociación entre el consumo de bebidas energizantes y síntomas de insomnio en estudiantes de medicina de una universidad en Lima, Perú. MATERIALES Y MÉTODO: El tipo de estudio realizado es transversal analítico. La población objetivo fueron los estudiantes de medicina de una universidad peruana ubicada en Lima sur de segundo y quinto año. Hubo 289 participantes en el estudio. Se utilizó una encuesta compuesta por un cuestionario sobre el consumo de bebidas energizantes y el Insomnia Severity Index, del cual se determinó un punto de corte de 15 para considerar la presencia de síntomas de insomnio. El análisis multivariado crudo y ajustado se realizó usando la regresión de Poisson con varianza robusta ajustado para sexo, edad, consumo de café, y antecedente de ansiedad y depresión, para obtener el PR (Razón de Prevalencias) con un intervalo de confianza de 95%. RESULTADOS Y DISCUSIÓN: La prevalencia de síntomas de insomnio en la muestra estudiada fue de 21,80%, mientras que la de consumo de bebidas energizantes fue de 39,45%. Se encontró asociación significativa (p=0,008) entre el consumo de este tipo de bebidas y la presencia de síntomas de insomnio. Además, se encontró que los estudiantes que consumen bebidas energizantes tuvieron 1,78 veces más probabilidad de presentar síntomas de insomnio (IC95%: 1,13-2,82), en comparación con los que no consumieron bebidas energizantes (p=0,013). CONCLUSIONES: Existe asociación entre el consumo de bebidas energizantes y síntomas de insomnio.

OBJECTIVE: To determine the association between the consumption of energy drinks and symptoms of insomnia in medical students of a university in Lima, Peru. Materials and METHODS: This study is cross-sectional analytical. The target population was the second-and fifth-year medical students of a private Peruvian university in southern Lima. There were 289 participants in this study. For this study, a survey composed of a questionnaire about the consumption of energy drinks and the Insomnia Severity Index were used, from which a cut-off point of 15 was determined to consider the presence of insomnia symptoms. The multivariate crude and adjusted analysis were done with Poisson regression with robust variance adjusted for sex, age, coffee consumption, previous diagnosis of depression and previous diagnosis of anxiety; to calculate the PR (Prevalence Ratio) with a 95% CI. RESULTS AND DISCUSSION: The prevalence of insomnia symptoms in the sample studied was 21,80%, while the consumption of energy drinks was 39,45%. A significant association was found (p = 0.008) between the consumption of this type of drinks and the presence of insomnia symptoms. In addition, it was found that students who consumed energy drinks were 1,78 times more likely to have symptoms of insomnia (95% CI: 1,13-2,82), compared to those who did not consume energy drinks (p=<0,013). CONCLUSIONS: There is an association between the consumption of energy drinks and symptoms of insomnia.

A Multi-Year Analysis of Fatal Farm and Agricultural Injuries in Pennsylvania.

Agriculture, forestry, fishing, and hunting comprise the most hazardous industry in the U.S., and production agriculture accounts for the majority of fatalities in the industry. Using Penn State's farm and agricultural injury database, data were coded according to ASABE's Farm and Agricultural Injury Classification (FAIC) code and the U.S. Bureau of Labor Statistics' Occupational Injury and Illness Classification System (OIICS) for source and event or exposure types. Occupational and non-occupational incidents were compared based on age groups, religious sect, source of injury, and the injury event or exposure. There were 355 farm and agricultural fatalities in Pennsylvania from 2000 through 2012, and 56% of these fatalities were occupational. The fatality rate was 33.4 per 100,000 farm household residents per year. Youth under 15 years old, seniors age 65 and older, Anabaptist youth, and young females were at high risk of fatal farm injury. Vehicles and transportation incidents were the most common injury source and event/exposure type, respectively. This research illustrates how state-level or national-level data can be collected, coded, and analyzed based on the FAIC and OIICS classification systems to better understand fatal injury causes and connections among important variables. This process can also help to target intervention programs and efforts.

Evaluation of the effectiveness of educational interventions in the Pennsylvania Central Region Farm Safety Pilot Project.

BACKGROUND: Evaluation of agricultural safety interventions has frequently been identified as an area requiring further research. This study prospectively evaluates the effectiveness of three specific educational safety interventions in reducing farm hazards. METHODS: Farm characteristics and hazard conditions at 216 farms in Pennsylvania were assessed through a questionnaire and objective audit, respectively, at both pre- and post-intervention time points. Counties were assigned to one of the following interventions: youth education, community coalition, self-audit, pre/post control, or post-only control group. Changes in hazard were analyzed through linear regression. RESULTS: Self-audit was the most effective intervention, leading to a 20% reduction in hazard scores. The community coalition and pre/post control group also showed reductions. CONCLUSIONS: Intervention effectiveness significantly differed depending on initial hazards, indicating the need to target specific interventions for more or less hazardous farms. Findings of this prospective evaluation differed from the initial cross-sectional results, thus underscoring the need for longitudinal investigations.

Evaluating the efficiency and effectiveness of approaches to nasogastric tube insertion during trauma care.

BACKGROUND: Numerous invasive, uncomfortable, and discomforting procedures are implemented almost routinely during trauma care. Previous research has shown that trauma care practitioners use comforting strategies during this care. Yet little is known of the effect of these comforting strategies on the effectiveness and efficiency of treatment. OBJECTIVES: To evaluate the effect of the caregiver's approach on the efficient and effective completion of a discomforting procedure (nasogastric tube insertion) on conscious patients during trauma care. METHODS: Ethology was used to analyze 32 attempts at nasogastric tube insertion from 193 videotaped trauma cases from 3 level I trauma centers in North America. Both qualitative and quantitative analytic techniques were used. RESULTS: The practitioner's approach was associated with the outcome of the treatment. Overall, practitioners who balanced the technical aspects of the procedure with use of comforting strategies to minimize the patient's discomfort (the blended approach) were most efficient and most effective in completing this procedure. Practitioners who were most attentive to procedural technique (with little respect to patients' discomfort) or who were overly attentive to comforting strategies (termed the technical and affective approaches, respectively) took longer and/or were less successful at completing the procedure. CONCLUSIONS: Four patterned, standardized approaches to care were found: technical, affective, blended, and mixed. This study has implications for further research into the effect of the practitioner's approach on the patient's behavioral state in trauma care.

Personal and social determinants of rural nurses' willingness to care for persons with AIDS.

The purpose of this study was to investigate the individual and social determinants of rural nurses' willingness to care for people with AIDS (PWAs). Willingness to care was viewed as a function of nurses' personal attitudes about AIDS care and PWAs; the influence of normative (significant others), comparative (the nursing profession), and generalized (the rural community) reference group norms on these attitudes; and how much importance respondents placed on membership in these reference groups. Responses to a mailed questionnaire from 615 rural nurses were analyzed. Individual determinants were nurses' feelings of preparedness and favorable attitudes about their personal safety when administering care. Social determinants were the degree of upset of respondents' significant others about their caring for AIDS patients and favorable attitudes of the respondents about professional and social concerns related to AIDS.

An assessment of the effectiveness of an intergenerational program for youth.

The purpose of this research was to assess the effectiveness of an intergenerational program for youth. Findings indicated that, after participating in the program, youth had more favorable attitudes toward the elderly and more knowledge of the aging process than youth in the control group. The program did not appear to have a direct effect on participants' willingness to volunteer, although results indicated that willingness to volunteer may increase indirectly through the improved attitudes of participants toward the elderly.

Cultural correlates of self perceived health status among Chinese elderly.

This study examines self-perceived physical and mental health among 213 Chinese elderly who visited the Geriatric Outpatient Clinic of Beijing Hospital, the People's Republic of China. The study hypothesizes that cultural factors, specified by family relations, along with demographic factors, number of diseases, economic well-being, and living conditions have a significant impact on subjects self-perceived health status. Pearson correlation, linear and logistic regression analyses are performed. Results indicate that age, number of diseases, perceived family respect, neighborhood relations, and percentage of income spent on rent are significant predictors of self-perceived physical health. These same factors plus preference to live with a son and personal monthly income are significant predictors of self-perceived mental health. Socio-cultural implications of these findings are examined.

Linkage strategies of rural hospitals--independent hospital, local health system, and/or externally linked facility.

Strategies associated with ownership or management of a range of health service facilities, service sharing, and other coordination activities are important to the viability of many rural hospitals. This article articulates a set of linkage strategies employed by rural hospitals. Such strategies and their environmental and organizational correlates are assessed in a sample of 46 rural Pennsylvania hospitals.

The influence of insurance status and income on health care use among the nonmetropolitan elderly.

The objective of this research is to examine the influence of income and type of insurance coverage on the use of health services among the nonmetropolitan elderly. A model of health services utilization is used as the foundation for examining this issue with data from a telephone survey of a randomly selected sample of residents from four nonmetropolitan counties in Pennsylvania. Results indicated that those elders with Medicaid coverage were less likely to visit a doctor than respondents with private insurance or Medicare only, even after controlling for income and other relevant factors. Further, lower income respondents with Medicare were less likely to visit the dentist than those with private insurance (Medicare does not cover dental care). In contrast, neither income nor insurance predicted hospital use. As such, the health and dental care needs of many lower income nonmetropolitan elders may potentially be going unmet. In general, findings highlight the continued relevance of economic barriers to the use of such services among the nonmetropolitan elderly.

Use of LISREL in scale validation.

A confirmatory factor analysis of items representing two dimensions of the locus of control construct was conducted with LISREL. In general, the analysis substantiated the hypothesized model by providing statistical tests of the loadings and the fit of the model to the data. Given the presence of several correlated error terms, a three-factor model was tested. While both the two-factor and three-factor models appeared to fit the data, the former provided a better fit. In addition, LISREL provided evidence of interfactor correlation; those with a stronger external expectation of control tend to be characterized by stronger powerful-others or fate orientations.

Caffeine reduces amphetamine-induced activity in asymmetrical interaction.

Caffeine-amphetamine interactions were studied to determine whether attenuation of amphetamine-induced activity by caffeine pretreatment (30 mg/kg) is the result of increased or decreased sensitivity to amphetamine. Caffeine pretreatment attenuated amphetamine activity in the rats without producing a horizontal shift in the dose-response curve. Results support a reduction in sensitivity to amphetamine. A cross-tolerance design revealed an asymmetrical interaction between caffeine and amphetamine. Multiple caffeine treatments (30 mg/kg) produced tolerance and attenuation of subsequent amphetamine activity (1.5 mg/kg). Amphetamine did not produce tolerance or affect subsequent caffeine-induced activity.