Mapping of the network connection between sleep quality symptoms, depression, generalized anxiety, and burnout in the general population of Peru and El Salvador.

BACKGROUND: A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. OBJECTIVE: The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. METHODS: A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. RESULTS: The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. CONCLUSION: The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.

Estimación de brechas de geriatras en Chile / Estimation of geriatrician gaps in Chile

Antecedentes: el envejecimiento de la población chilena y la transición epidemiológica que atraviesa el país, ha incrementado la necesidad de formar, entre otros especialistas, a médicos geriatras. Objetivo: estimar la brecha de geriatras en Chile de acuerdo con necesidades epidemiológicas de la población de 65 años y más. Método: se realizó una estimación de brecha de horas de geriatra para la red de salud, a partir de una consulta a 57 geriatras de laboralmente activos de un total de 156 geriatras registrados a enero del 2021. En dicha consulta se indagó sobre tiempo de duración de consulta y frecuencia de consultas ideales de acuerdo con la capacidad funcional de las personas mayores a nivel nacional y por región obtenida de la encuesta Casen 2017. Resultados: a febrero del 2022 existe un total de 162 geriatras en Chile, cifra que equivale a un geriatra por cada 15.806 personas de 65 años y más. De acuerdo con la estimación realizada, se requeriría en Chile, un total de 1.244.689 horas de geriatra anual, equivalentes a la existencia de 589 geriatras a nivel nacional. Conclusión: según los resultados del estudio, a nivel nacional se necesitarían de un total de 589 geriatras para cubrir las necesidades de atención de las personas mayores con algún nivel de dependencia. De acuerdo con estas cifras, al primer trimestre del 2022 el país presentaría una brecha de 427 geriatras. Ante lo elevada de esta brecha, se cree necesario avanzar en estrategias de formación general en geriatría y gerontología en los equipos de salud y socio-sanitarios.

Background:The ageing between the Chilean population and the epidemiological transition that the country is going through has increased the need to train, among other specialists, geriatric doctors.Objective: To estimate the gap between geriatricians in Chile according to the epidemiological needs of the population aged 65 years and over. Method:An estimate of the gap in geriatrician hours was made for the health network based on a consultation of 57 active geriatricians out of 156 registered as of January 2021. In this consultation, the duration and frequency of ideal consultations were inquired according to the functional capacity of the elderly at the national level and by region obtained from the Casen 2017 survey.Results: as of February 2022, there are 162 geriatricians in Chile, equivalent to one geriatrician for every 15,806 people aged 65 years and over. According to the estimate, a total of 1,244,689 hours of annual geriatrician would be required in Chile, equivalent to 589 geriatricians nationwide. Conclusion:According to the study's results, at the national level, a total of 589 geriatricians would be needed to cover the care needs of older people with some level of dependen-ce. According to these figures, in the first quarter of 2022, the country would present a gap of 427 geriatricians. Given the highness of this gap, it is believed necessary to advance general training strategies in geriatrics and gerontology in health and socio-health teams

COVID-19 y personas mayores en Chile: lecciones de dos años de pandemia / The impact of COVID-19 on the health status of older people in Chile

The article presents the main impact of COVID-19 pandemic on the health status of older people, systematizing the information about the direct impact of the pandemic in terms of number of cases, hospitalizations, deaths, the policies implemented for the prevention and management of COVID-19 in older people and the indirect impact of the two years of pandemic. Adopting a broad definition of health, the need to monitor and recover health care of older people is highlighted. The recovery of their functionality and mental health must be emphasized. The policies towards institutionalized older people must be revised. These areas should be the focus of health care policies for older people in Chile.

Bienestar subjetivo, estado de salud, funcionalidad y participación social en personas mayores de Chile / Subjective well-being, health status, functional capacity and social participation in Chilean older people

BACKGROUND: Chile is currently updating the Comprehensive Policy on Positive Aging, which establishes a positive association between Subjective Well-being, Self-perceived Health, Functional status, and Social Participation in older people. Aim: To study the relationship between Subjective Well-being, General Health, Functional status, and Social Participation in older people in Chile. MATERIAL AND METHODS: In a cross-sectional observational study, 2.031 people aged 60 years and over were included in the National Health Survey 2016-2017 (ENS). The study included analysis of correlations between the relevant variables, in addition to binomial logistic regression with Subjective Well-being as a response variable, as well as the application of structural equation techniques (SEM). Results: Subjective Well-being had a positive association with Self-perceived Health (Rho = 0.370), functional status (Rho = 0.360), and Social Participation (Rho = 0.290). However, in the logistic regression analysis only Self-perceived Health (OR = 0.293) and Functional status (OR = 0.932) had predictive capacity for Subjective Well-being. CONCLUSIONS: The relevance of Self-perceived Health and Functionality in the sensation of Well-being among older people, reinforces the need to improve health care within a framework of a comprehensive policy for this age group.

Identificación de roles y satisfacción en el desempeño en personas mayores participantes de programas municipales de la comuna de Puente Alto­Chile / Identification of occupational role and performance satisfaction of older people participating in community programs at the commune of Puente Alto­Chile

Objetivo: El contexto sociodemográfico del país ha desafiado a la sociedad un estudio cada vez más acabado de las personas mayores del país. Desde la Terapia Ocupacional surge la necesidad de conocer cuáles son los roles que desempeñan las personas mayores y su satisfacción e interés por involucrarse en éstos, dada la escasa evidencia local en la materia. Material y método: Diseño de corte transversal de tipo cuantitativo. El presente estudio se realiza en la comuna de Puente Alto a 322 personas mayores participantes de programas municipales a quienes se les aplica el Listado de Roles v3 (C) Forma 1. Resultados: Hombres y mujeres tienen la misma jerarquía y similar frecuencia en el desempeño de roles a excepción de los roles de amigo(a), aficionado(a) y participante de organizaciones. Los roles más desempeñados son amo(a) de casa y miembro de familia. Los menos desempeñados son de estudiante, voluntario y trabajador. En ambos géneros se ven altos niveles de satisfacción por los roles desempeñados y existe interés actual por ser amo de casa, amigo y aficionado en el caso de hombres, así como interés por ama de casa, miembro de familia y amiga en mujeres. Conclusión: Las personas mayores participantes mantienen una participación activa a través del desempeño de roles significativos que proveen de alta satisfacción, y tienen interés por desempeñar ciertos roles que como sociedad se podrían fomentar mayormente.

Objective: The actual social and demographic context has challenged society to study elderly people. From occupational therapy, the need arises to know which are the roles that older people play, their satisfaction and interest in getting involved in them, given the scant local evidence on the matter. Method: Quantitative type cross-sectional design. This study is carried out in the Commune of Puente Alto, with 322 older people participating in community programs, to whom the Role Cheklist v3 © Form 1 was applied. Results: Men and women have the same hierarchy and similar frequency in the performance of roles, with exception of the roles of friend, fan and participant in organizations. The most performed roles are housewife and family member. The least performed are student, volunteer and worker. In both genders, high levels of satisfaction are seen for the roles performed and there is current interest in being a housewife, friend and fan in the case of men, as well as interest in being a housewife, family member and friend in women. Conclusion: Older people maintain an active participation in the community through the performance of significant roles, which confirms their motivation to contribute and contribute to society, contradicting the theoretical proposals associated with that old age is a passive and inactive stage.

[The impact of COVID-19 on the health status of older people in Chile]. / COVID-19 y personas mayores en Chile: lecciones de dos años de pandemia.

The article presents the main impact of COVID-19 pandemic on the health status of older people, systematizing the information about the direct impact of the pandemic in terms of number of cases, hospitalizations, deaths, the policies implemented for the prevention and management of COVID-19 in older people and the indirect impact of the two years of pandemic. Adopting a broad definition of health, the need to monitor and recover health care of older people is highlighted. The recovery of their functionality and mental health must be emphasized. The policies towards institutionalized older people must be revised. These areas should be the focus of health care policies for older people in Chile.

[Subjective well-being, health status, functional capacity and social participation in Chilean older people]. / Bienestar subjetivo, estado de salud, funcionalidad y participación social en personas mayores de Chile.

BACKGROUND: Chile is currently updating the Comprehensive Policy on Positive Aging, which establishes a positive association between Subjective Well-being, Self-perceived Health, Functional status, and Social Participation in older people. AIM: To study the relationship between Subjective Well-being, General Health, Functional status, and Social Participation in older people in Chile. MATERIAL AND METHODS: In a cross-sectional observational study, 2.031 people aged 60 years and over were included in the National Health Survey 2016-2017 (ENS). The study included analysis of correlations between the relevant variables, in addition to binomial logistic regression with Subjective Well-being as a response variable, as well as the application of structural equation techniques (SEM). RESULTS: Subjective Well-being had a positive association with Self-perceived Health (Rho = 0.370), functional status (Rho = 0.360), and Social Participation (Rho = 0.290). However, in the logistic regression analysis only Self-perceived Health (OR = 0.293) and Functional status (OR = 0.932) had predictive capacity for Subjective Well-being. CONCLUSIONS: The relevance of Self-perceived Health and Functionality in the sensation of Well-being among older people, reinforces the need to improve health care within a framework of a comprehensive policy for this age group.

Health-related quality of life in older people with functional independence or mild dependence.

BACKGROUND: The concept of Health-Related Quality of Life (HRQOL) has grown in importance in the elderly population (PM), which is due to the increase in life expectancy of contemporary societies and the desire of people to live the most advanced years in good condition. OBJECTIVE: To know the effect of the epidemiological dimensions, functional capacity, social and psychological well-being on the HRQL of a group of senior people from the Borough of Puente Alto intervened by the multidimensional model of the Integral Center for Happy Aging, CIEF, Universidad de los Andes. RESULTS: Correlation was observed between the dimensions mentioned above, as well as the improvement in the predictive models of HRQL in the extent to which social and psychological variables are incorporated into the morbidity and functional capacity dimension, the latter strongly related to HRQL according to the scientific literature. CONCLUSION: The study shows the relevance of incorporating measures of social and psychological well-being in the evaluation of HRQL, especially with a view to the design of multidimensional interventions that encompass individual content and the environment in which seniors develop.

Assessing 3 Outbreak Detection Algorithms in an Electronic Syndromic Surveillance System in a Resource-Limited Setting.

We evaluated the performance of X-bar chart, exponentially weighted moving average, and C3 cumulative sums aberration detection algorithms for acute diarrheal disease syndromic surveillance at naval sites in Peru during 2007-2011. The 3 algorithms' detection sensitivity was 100%, specificity was 97%-99%, and positive predictive value was 27%-46%.

Pólipo fibrovascular gigante y ulcerado de esófago ­ reporte de caso y revisión de la literatura / Giant and ulcered fibrovascular polyp of the esophagus - case report and literature review

Introducción: Los pólipos fibrovasculares son neoplasias benignas muy raras del esófago, originadas generalmente por debajo del cricoides; son poco sintomáticos por largo tiempo, pudiendo debutar el paciente con regurgitación del pólipo y asfixia, o más frecuentemente con disfagia. Reporte de caso: paciente varón, 43 años, con historia de 3 meses de disfagia progresiva, baja ponderal y sensación de cuerpo extraño en esófago; al realizarle exámenes se diagnostica pólipo fibrovascular benigno gigante ulcerado en esófago que requirió remoción quirúrgica por esofagotomia cervical, con evolución post operatoria favorable y diagnóstico patológico final de Pólipo fibrovascular benigno gigante, ulcerado, de esófago. Interpretación: El pronóstico de estos pólipos una vez resecados es excelente, siendo la recurrencia muy rara. Los casos reportados de recidivas, mayoritariamente al ser reevaluados, son considerados como secundarios a remoción incompleta del pólipo en la primera intervención quirúrgica.

Introduction. Fibrovascular polyps are very rare benign neoplasms of the esophagus, usually originating below the cricoid; Are not very symptomatic for a long time, being able to debut the patient with regurgitation of the polyp and asphyxia, or more frequently with dysphagia. Case report: male patient, 43 years old, with a history of 3 months of progressive dysphagia, low weight and sensation of foreign body in the esophagus; The diagnosis of benign fibrotic polyp ulcerated ulcerated in the esophagus that required surgical removal by cervical esophagotomy, with favorable post-operative evolution and final pathological diagnosis of benign, ulcerated benign fibrotic polyp of the esophagus was diagnosed. Interpretation: The prognosis of these polyps once resected is excellent, with recurrence very rare. The reported cases of relapses, mostly when reevaluated, are considered secondary to incomplete removal of the polyp in the first surgical procedure.

[Outbreak of norovirus Group II in a military training center, Peru 2013]. / Brote de infección por norovirus del Grupo II en un centro de entrenamiento militar, Perú 2013.

We report an outbreak of norovirus(NoV) which occurred at a military training center in Peru. Thirteenstool samples that were taken from initial cases turned out positive for NoV GII by RT-PCR. A case-control study was performedto determine factorsassociated with infection.164 probable cases (45.2%clinical attack rate) were identified. The only factor associatedwith infection was "having shared room with a case" (ORa = 1.7; 95% CI 1.1 to 2.7).Epidemiological findings suggestthat the virus was spread person to person. Future investigations of outbreaks of diarrhea in Peru should consider the NoV as an etiologicagent.

Brote de infección por norovirus del grupo II en un Centro de Entrenamiento Militar, Perú 2013 / Outbreak of norovirus group II in a military training center, Peru 2013

Reportamos un brote de norovirus (NoV) ocurrido en un centro de entrenamiento militar peruano. Trece muestras de heces tomadas de casos iniciales resultaron positivas a NoV GII por RT-PCR. Se realizó un estudio caso-control para determinar factores asociados a la infección. Se identificó 164 casos probables (tasa de ataque clínica: 45,2%). El único factor asociado a la infección fue el ôhaber compartido habitación con un casoõ (ORa=1,7; IC95% 1,1 a 2,7). Los hallazgos epidemiológicos sugieren que el virus fue propagado persona a persona. Futuras investigaciones de brotes de diarrea en el Perú deberían considerar al NoV como un agente etiológico.

We report an outbreak of norovirus (NoV) which occurred at a military training center in Peru. Thirteen stool samples that were taken from initial cases turned out positive for NoV GII by RT-PCR. A case-control study was performed to determine factors associated with infection.164 probable cases (45.2% clinical attack rate) were identified. The only factor associated with infection was ôhaving shared room with a caseõ (ORa = 1.7; 95% CI 1.1 to 2.7).Epidemiological findings suggest that the virus was spread person to person. Future investigations of outbreaks of diarrhea in Peru should consider the NoV as an etiologic agent.

Assessing the impact of public health interventions on the transmission of pandemic H1N1 influenza a virus aboard a Peruvian navy ship.

BACKGROUND: Limited data exist on transmission dynamics and effectiveness of control measures for influenza in confined settings. OBJECTIVES: To investigate the transmission dynamics of a 2009 pandemic H1N1 influenza A outbreak aboard a Peruvian Navy ship and quantify the effectiveness of the implemented control measures. METHODS: We used surveillance data and a simple stochastic epidemic model to characterize and evaluate the effectiveness of control interventions implemented during an outbreak of 2009 pandemic H1N1 influenza A aboard a Peruvian Navy ship. RESULTS: The serological attack rate for the outbreak was 49·1%, with younger cadets and low-ranking officers at greater risk of infection than older, higher-ranking officers. Our transmission model yielded a good fit to the daily time series of new influenza cases by date of symptom onset. We estimated a reduction of 54·4% in the reproduction number during the period of intense control interventions. CONCLUSION: Our results indicate that the patient isolation strategy and other control measures put in place during the outbreak reduced the infectiousness of isolated individuals by 86·7%. Our findings support that early implementation of control interventions can limit the spread of influenza epidemics in confined settings.

Outbreak of Group A beta hemolytic Streptococcus pharyngitis in a Peruvian military facility, April 2012.

Group A Streptococcus (GAS), or Streptococcus pyogenes, is a common cause of acute pharyngitis as well as other diseases. Closed populations such as those living on military bases, nursing homes, and prisons are particularly vulnerable to GAS outbreaks due to crowding that facilitates person-to-person transmission. This report details a large outbreak of GAS pharyngitis at a Peruvian military training facility near Lima, Peru, in April 2012. Initial findings showed 145 cases. However, as the investigation continued it was revealed that some trainees may have concealed their illness to avoid real or perceived negative consequences of seeking medical care. A subsequent anonymous survey of all trainees revealed at least 383 cases of pharyngitis among the facility's 1,549 trainees and an attack rate of 34 percent among the 1,137 respondents. The epidemic curve revealed a pattern consistent with routine person-to-person transmission, although a point-source initiating event could not be excluded. Laboratory results showed GAS emm type 80.1 to be the culprit pathogen, an organism not commonly implicated in outbreaks of GAS in the Americas. Barious unique and illustrative features of outbreak investigation in military facilities and populations are discussed.

Fundaciones anulares y circulares en estructuras de revolucion

El proposito de este trabajo, es presentar un metodo racional para el calculo de zapatas de las estructras que presentan un eje de revolucion, como ser: chimeneas, silos, torres de television, tanques de agua, etc. los que estan frecuentemente fundados sobre zapatas circulares llenas de huecas(anulares). Se propone que el calculo de las zapatas anulares que tiene una rigidez finita, situadas en medios elasticos y que estan solicitadas por un momento de vuelco engendrado por las fuerzas horizontales que actuan sobre la estrcuctura y la determinacion de los momentos de flexion y torsion en las secciones rectas del anillo, tambien se refiere a las zapatas anulares fundadas sobre pilotes. Las zapatas llenas, presentan ventajas si el suelo es heterogeneo, gracias a su rigidez ellas pueden resistir mas eficazmente a las reacciones no uniformes del suelo, sin embargo las presiones en los bordes aumentan fuertemente bajo el empuje del viento de manera que en un terreno comprensible y en regiones con viento predominante, es posible que al cabo de un tiempo, la cimentacion se haya inclinado y si ademas se presentan cargas alternativas, pueden existir fuertes presiones deborde, pudiendo producirse el denominado "apoyo en silla de montar". Por el contrario si el suelo de fundacion es de buena calidad (caso de zapatas sobre grava, roca calcarea, roca y en caso de zapatas sobre pilotes) las zapatas anulares, pueden presentar cierto interes economico, por lo menos en lo que concierne a zapatas de gran diametro, encontrados con bastante frecuencia, en las cuales se aumenta la presion debida al peso propio, de manera que el maximo aumento por empuje de viento supone solamente un 50 de la tension debida al anterior efecto.