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RESUMEN Objetivos : Determinar la relación entre años de estudio y síntomas depresivos y ansiosos durante los primeros meses de la pandemia por COVID-19, en una muestra de estudiantes de medicina de Lima, controlando en particular las covariables sexo y enfermedades médicas previas. Material y métodos : Se realizó una encuesta en línea, que recolectó información de 250 estudiantes de medicina incluyendo datos generales, historia médica previa, síntomas de depresión (PHQ-9) y de ansiedad (GAD-7). Los datos se manejaron mediante un análisis multivariado. Resultados : Se encontraron diferencias entre años de estudios y los valores combinados de PHQ-9 y GAD-7 (Lambda de Wilks = 0,86; p = 1,68 x 10-4; η2p = 0,08). La presencia de enfermedades médicas previas mostró diferencias significativas en relación a los valores combinados de PHQ-9 y GAD-7 (Lambda de Wilks = 0,94, p = 4,43 x 10-4, η2p = 0,06). Las muestras univariadas mostraron diferencias en años de estudios para PHQ-9 (F6,241 = 4,12, p = 0,001, η2p = 0,09) y GAD-7 (F6,241 = 2,81, p = 0,01, η2p = 0,07). El análisis post hoc mostró diferencias estadísticamente significativas en los primeros años de estudio. Conclusiones : Estos resultados sugieren que estudiantes de medicina de los primeros años muestran mayores niveles de síntomas depresivos y ansiosos que los participantes de años superiores. Asimismo, la ocurrencia de enfermedades médicas previas explica también los valores altos de depresión y ansiedad.
SUMMARY Objective : To determine the relationship between year levels of medical studies and depressive and anxious symptoms during the first months of the COVID-19 pandemic in a sample of medical students in Lima, controlling specifically the variables sex and presence of underlying medical conditions. Material and Methods : An online survey collected information from 250 medical students, covering general data, previous medical history and symptoms of depression (PHQ-9) and anxiety (GAD-7). Data were managed using multivariate analysis of covariance. Results : Differences were found between years of study and the combined values of PHQ-9 and GAD-7 (Wilks' Λ = 0.86; p = 1.68 x 10-4; η2p = 0.08). Underlying medical conditions also showed significant differences for the combined values of PHQ-9 and GAD-7 (Wilks' Λ = 0.94, p = 4.43 x 10-4, η2p = 0.06). The univariate test for year of study showed differences for PHQ-9 (F6.241 = 4.12, p = 0.001, η2p = 0.09) and GAD-7 (F6.241 = 2.81, p = 0.01, η2p = 0.07). The post hoc analysis showed statistically significant differences in the first years of study. Conclusions : These results suggest that medical students of the first years show higher levels of depression and anxiety symptoms than participants from more advanced years of the medical career. Likewise, the occurrence of previous medical conditions also explained high levels of depression and anxiety.
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Introduction: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education.Methods: Participants (n=484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively.Results: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954=5.78; Wilks' Λ=0.95; P<0.0005). The univariate tests showed differences for PHQ-9 (F2,478=8.70; P<0.0005) and GAD-7 (F2,478=11.16; P<0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD=1.82; 95%CI, 0.25-3.40; GAD-7: MD=1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD=3.10; 95%CI, 1.11-5.10; GAD-7: MD=2.46; 95%CI, 0.97-3.95).Conclusions: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.
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BACKGROUND: The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population. METHODS: 375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors. RESULTS: Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores. CONCLUSIONS: Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.
Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Health Personnel/psychology , Stress, Psychological/etiology , Students, Medical/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/prevention & control , Depression/diagnosis , Depression/epidemiology , Female , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Peru/epidemiology , Psychological Tests , Risk Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Young AdultABSTRACT
ABSTRACT Background: The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population. Methods: 375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors. Results: Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores. Conclusions: Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.
RESUMEN Introducción: El objetivo del estudio es comparar los efectos emocionales de la COVID-19 entre 3 grupos diferentes, a saber: personal de salud, estudiantes de Medicina y una muestra de la población general. Métodos: Se incluyó a 375 participantes en este estudio, de los que 125 eran estudiantes de Medicina (estudios preclínicos, 59; estudios clínicos, 66), 125 eran personal de salud (personal de primera línea contra la COVID-19, 59; personal no relacionado con la COVID-19, 66) y 125 pertenecían a la población general. Las escalas PHQ-9, GAD-7 y CPDI se utilizaron para evaluar el impacto emocional. Se realizó una regresión logística multinomial para medir las diferencias entre grupos, considerando posibles factores de confusión. Resultados: Con respecto a los valores del CPDI, todos los demás grupos mostraron valores reducidos en comparación con el personal de primera línea contra la COVID-19. Sin embargo, la población general y los estudiantes de Medicina preclínica y clínica mostraron un aumento de los valores del PHQ-9 en comparación con el personal en primera línea. Por último, los factores de confusión, sexo y edad se correlacionaron negativamente con puntuaciones más altas del CPDI y el PHQ-9. Conclusiones: Ser personal de primera línea se asocia con más estrés relacionado con la COVID-19. Sin embargo, la depresión está asociada con otros grupos que no están directamente involucrados en el tratamiento de los pacientes con COVID-19. Las mujeres y los participantes más jóvenes se correlacionaron con la depresión y el estrés relacionados con la COVID-19.
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In this study, changes in the electrochemical conditions of oil fields caused by biofilms with sulfate-reducing bacteria have been studied as they promote localized pitting damage, reservoir souring problems, and many other processes including well plugging that lead to increased production costs. Biofilm formation and its effects on 1020 carbon steel surfaces were evaluated in a discontinuous electrochemical reactor by using a bacterial consortium isolated from the injection water of a Colombian oil field. Sulfide concentration and pH values were observed to decrease, which was consistent with the exponential planktonic sulfate-reducing bacterial growth. The formation of a biofilm that adheres to a porous layer of corrosion products was identified using scanning electron microscopy and energy-dispersive X-ray spectroscopy. The morphology of the films revealed the presence of the biofilm and corrosion product crystals. Open circuit potential presented a negative shift in the potential during the first 24 h in a biotic cell. Electrochemical impedance spectroscopy showed a change in the behavior of the resistive zone for both systems, a charge transfer trend in the abiotic cell, and a transformation of the charge transfer process to a diffusive process in the biotic cell after 48 h. The polarization resistance showed its lowest resistivity 74.95 Ω·cm-2 during the first 48 h, while the corrosion rate was estimated as 3.37 mpy. This research contributes to the understanding of corrosion mechanisms in the metal-solution interface via detailed monitoring of biofilm growth.
Subject(s)
Biofilms , Carbon/chemistry , Electrochemical Techniques/methods , Microscopy, Electron, Scanning/methods , Steel/chemistry , Corrosion , Reproducibility of Results , Spectrometry, X-Ray Emission , WaterABSTRACT
Background: The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population. Methods: 375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors. Results: Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores. Conclusions: Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.
Introducción: El objetivo del estudio es comparar los efectos emocionales de la COVID-19 entre 3 grupos diferentes, a saber: personal de salud, estudiantes de Medicina y una muestra de la población general. Métodos: Se incluyó a 375 participantes en este estudio, de los que 125 eran estudiantes de Medicina (estudios preclínicos, 59; estudios clínicos, 66), 125 eran personal de salud (personal de primera línea contra la COVID-19, 59; personal no relacionado con la COVID-19, 66) y 125 pertenecían a la población general. Las escalas PHQ-9, GAD-7 y CPDI se utilizaron para evaluar el impacto emocional. Se realizó una regresión logística multinomial para medir las diferencias entre grupos, considerando posibles factores de confusión. Resultados: Con respecto a los valores del CPDI, todos los demás grupos mostraron valores reducidos en comparación con el personal de primera línea contra la COVID-19. Sin embargo, la población general y los estudiantes de Medicina preclínica y clínica mostraron un aumento de los valores del PHQ-9 en comparación con el personal en primera línea. Por último, los factores de confusión, sexo y edad se correlacionaron negativamente con puntuaciones más altas del CPDI y el PHQ-9. Conclusiones: Ser personal de primera línea se asocia con más estrés relacionado con la COVID-19. Sin embargo, la depresión está asociada con otros grupos que no están directamente involucrados en el tratamiento de los pacientes con COVID-19. Las mujeres y los participantes más jóvenes se correlacionaron con la depresión y el estrés relacionados con la COVID-19.
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En Cuba, el cáncer es la segunda causa de muerte con 24.902 defunciones en el 2018; de ellas, 795 fueron por tumores de laringe y 826 por tumores de labio, cavidad bucal y faringe. El anticuerpo monoclonal nimotuzumab (CIMAher®) está registrado como tratamiento combinado con radioterapia o quimioterapia para el cáncer de células escamosas de cabeza y cuello estadios avanzados. Del mismo se conoce su efectividad y perfil de seguridad, no así el impacto económico que acarrearía la incorporación del mismo al Sistema Nacional de Salud (SNS) cubano; de forma tal de asignar y reajustar presupuestos en la esfera de medicamentos. Por tanto, se hizo necesario realizar un análisis de impacto presupuestario, con el objetivo de estimar el impacto financiero de la incorporación del nimotuzumab (CIMAher®) al paquete de beneficios del SNS cubano. Se tomaron los datos de prevalencia e incidencia de la enfermedad en los estadios III/IV. Se estableció un escenario actual con la terapia radio/quimioterapia secuencial y una tasa de penetración de 100%. El escenario futuro fue radio/quimioterapia secuencial + nimotuzumab (CIMAher®) con tasa anual de penetración 20, 40, 60, 80 y 100 por ciento. La perspectiva fue desde el SNS y un horizonte temporal de 5 años (2019-2023). El análisis de impacto presupuestal mostró que, desde perspectiva, horizonte y tasa de penetración establecidos, el SNS debe invertir aproximadamente de 10 a 65 millones de pesos cubanos (CUP); cifras menores al presupuesto destinado a salud pública(AU)
In Cuba, cancer is the second cause of death with 24,902 deaths in 2018; 795 were due to laryngeal tumors and 826 due to tumors of the lip, oral cavity and pharynx. The monoclonal antibody nimotuzumab (CIMAher®) is registered as a combined treatment with radiotherapy or chemotherapy for advanced squamous cell carcinoma of the head and neck. Its effectiveness and safety profile are known, but not their economic impact into the Cuban National Health System (NHS); in order to allocate and readjust budgets in the field of medicines. Therefore, it was necessary to perform a budget impact analysis in order to estimate the financial impact of the incorporation of nimotuzumab (CIMAher®) into the benefits package of the Cuban NHS. Data on prevalence and incidence of the disease in stages III / IV were taken into account. The current scenario was with the therapy radio/sequential chemotherapy and penetration rate of 100 percent. The future scenario was radio/sequential chemotherapy + nimotuzumab (CIMAher®) and annual penetration rate of 20, 40, 60, 80 and 100 percent. The perspective was from the NHS and a time horizon of five years (2019-2023). The budget impact analysis showed that from an established perspective, horizon and penetration rate, the NHS must invest 10-65 million Cuban pesos (CUP) approximately; lower values than the budget allocated to Public Health(AU)
Subject(s)
Humans , Male , Female , Reference Drugs , Analysis of the Budgetary Impact of Therapeutic Advances , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/epidemiology , CubaABSTRACT
OBJECTIVES: Haemorrhage remains the leading cause of maternal mortality in Central America. The Salud Mesoamérica Initiative aims to reduce such mortality via performance indicators. Our objective was to assess the availability and administration of oxytocin, before and after applying Salud Mesoamérica Initiative interventions in the poorest health facilities across Central America. DESIGN: Pre-post study. SETTING: 166 basic-level and comprehensive-level health facilities in Belize, Guatemala, Honduras, Mexico, Nicaragua and Panama. PARTICIPANTS: A random sample of medical records for uncomplicated full-term deliveries (n=2470) per International Classification of Diseases coding at baseline (July 2011 to August 2013) and at first-phase follow-up (January 2014 to October 2014). INTERVENTIONS: A year of intervention implementation prior to first-phase follow-up data collection focused on improving access to oxytocin by strengthening supply chains, procurement, storage practices and pharmacy inventory monitoring, using a results-based financing model. PRIMARY AND SECONDARY OUTCOME MEASURES: Oxytocin availability (primary outcome) and administration (secondary outcome) for postpartum haemorrhage prevention. RESULTS: Availability of oxytocin increased from 82.9% to 97.6%. Oxytocin administration increased from 83.6% to 88.4%. Significant improvements were seen for availability of oxytocin (adjusted OR (aOR)=8.41, 95% CI 1.50 to 47.30). Administration of oxytocin was found to be significantly higher in Honduras (aOR=2.96; 95% CI 1.00 to 8.76) in reference to Guatemala at follow-up. CONCLUSION: After interventions to increase health facility supplies, the study showed a significant improvement in availability but not administration of oxytocin in poor communities within Mesoamerica. Efforts are needed to improve the use of oxytocin.
Subject(s)
Guideline Adherence/statistics & numerical data , Health Resources/supply & distribution , Health Services Accessibility/statistics & numerical data , Oxytocics/therapeutic use , Oxytocin/therapeutic use , Postpartum Hemorrhage/prevention & control , Practice Patterns, Physicians'/statistics & numerical data , Adult , Central America , Developing Countries , Female , Follow-Up Studies , Humans , Logistic Models , Practice Guidelines as Topic , PregnancyABSTRACT
El seguro social de Honduras tiene tres formas de organizar la provisión de serviciosde salud: i) a través de su red propia de hospitales y clínicas en las que se brindanatenciones de los tres niveles de atención; ii) por medio de proveedores privados -servicios sub rogados que ofrecen atenciones de primer y segundo nivel; y, iii) elservicio médico de empresas que otorga cuidados de primer nivel.El IHSS tiene las tasas de cotización más bajas de Centroamérica y un déficitfinanciero ya inoperable por lo bajo de dichas tasas; en cinco de los últimos ochoaños los flujos de recursos financieros para garantizar la entrega oportuna de lasprestaciones del REM, han venido presentando déficits en sus balances operativos,situación que podría agravarse en los próximos años, debido esencialmente (i) elestablecimiento de un techo máximo de cotización relativamente bajo, (ii) el cambioen la política cambiaria de estado, la que paso de un tipo de cambio fijo a uno dedeslizamiento reptante1, la que produce un encarecimiento relativo de los insumosimportados, sobre todo medicamentos y material de reposición periódica, (iii) la bajacobertura poblacional, y (iv) al potencial efecto de la desaceleración de la economía.En aras superar esta difícil situación financiera y operativa se propone diferentesmecanismos de solución potencial, para ello se simularon cuatro escenarios a fin deque las autoridades del IHSS tengan un abanico de opciones al respecto. En aras superar esta difícil situación financiera y operativa se propone diferentesmecanismos de solución potencial, para ello se simularon cuatro escenarios a fin deque las autoridades del IHSS tengan un abanico de opciones al respecto...
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Humans , Social Security/economics , Social Security , Economics, Medical , Social Security/trends , Academic Dissertations as Topic , Electronic ThesisABSTRACT
BACKGROUND: Whey protein isolate edible films with oregano or clove essential oils (EOs) incorporated as natural antimicrobials have been developed, with the aim of enhancing the microbial quality of poultry. The effectiveness of the films was determined against both the whole and selected microbiota developed during different periods of cold storage on the surface of skinless chicken breast. Tests were conducted by using both turbidimetric and agar disc diffusion methods. RESULTS: The antimicrobial edible films developed showed high effectiveness against the main spoilers developed on the surface of skinless chicken breasts cold-stored for 8 days. The films based on oregano EO showed greater effectiveness than those based on clove EO. Still, clove EO could be part of an effective antimicrobial edible film. Enterobacteriaceae was the most susceptible to the effect of the films when lower concentrations of EO were incorporated. The largest inhibition surfaces obtained were provoked by films with the highest concentration of oregano EO incorporated against lactic acid bacteria. CONCLUSION: The antimicrobial edible films developed in this study inhibited the growth of the microbial populations that developed through storage of the chicken breast and caused its spoilage. The results of this research have direct application in the food industry to enhance the control of the development of spoilers such as Pseudomonas spp. or lactic acid bacteria.
Subject(s)
Chickens/microbiology , Food Packaging , Food Preservation , Food Quality , Meat/microbiology , Milk Proteins/chemistry , Oils, Volatile/chemistry , Animals , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/metabolism , Anti-Bacterial Agents/pharmacology , Disk Diffusion Antimicrobial Tests , Enterobacteriaceae/drug effects , Enterobacteriaceae/growth & development , Enterobacteriaceae/isolation & purification , Food Handling , Lactobacillales/drug effects , Lactobacillales/growth & development , Lactobacillales/isolation & purification , Microbial Viability/drug effects , Milk Proteins/metabolism , Oils, Volatile/metabolism , Oils, Volatile/pharmacology , Origanum/chemistry , Pectoralis Muscles/microbiology , Pseudomonas/drug effects , Pseudomonas/growth & development , Pseudomonas/isolation & purification , Refrigeration , Spain , Surface Properties , Syzygium/chemistry , Whey ProteinsABSTRACT
Se presenta un estudio en el cual se recolectaron los datos para determinar la edad de aparición de la menarquia por observación quincenal y por recordatorio. El objetivo fue hacer notar la importancia de validar una técnica y comprobar que se está midiendo precisamente lo que se desea conocer. La fecha de aparición de la menarquia por observación se documentó en un estudio longitudinal de crecimiento y desarrollo de 85 jóvenes del medio rural. Cuatro años después de transcurrido el evento se llevó a cabo una encuesta para emplear el método por recordatorio. El porcentaje de varianza explicado para la edad por observación de la menarquia en función de edad recordada de la menarquia fue de 37%. El dato de ganancia en talla post-menarquia, se utilizó en esta investigación únicamente para ilustrar uno de los efectos que resultan cuando no se tiene una variable fundamental, adecuadamente recolectada, mostrando una significativa diferencia para una y otra edad de la menarquia. En investigaciones que no requieren exactitud en la edad de acuerdo a la naturaleza de las hipótesis planteadas, la diferencia en la técnica de recolección pudiera carecer de importancia
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Humans , Female , Menarche , Mental Recall , Rural Population , MexicoABSTRACT
Se presenta el análisis del comportamiento de la talla en función de la edad, hasta el séptimo año de vida, de dos grupos de niños rurales, uno con pérdida de peso corporal en los primeros quince días de vida extrauterina y el otro con pérdida neonatal. Los grupos fueron apareados, caso por caso al nacer, para peso, talla, edad gestacional, perímetros cefálico, torácico y del brazo, y grosor de panículo adiposo tricipital. A los siete años de edad, la talla en función de ambos grupos no fue significativamente diferente. La velocidad clínica no fue distinta entre grupos, pero la velocidad instantánea o matemática si acusó una diferencial significativa, favoreciendo a los niños con pérdida inicial de peso. La aceleración de la talla fue la diferencial más importante entre los dos grupos. Los datos demuestran la recuperación del déficit inicial del crecimiento longitudinal y señalan claramente la forma diferente de alcanzar la misma talla, según se trate de los niños con o sin pérdida de peso. Se sugieren áreas de estudio, que pudieran llevar a explicar el significado biológico de esta forma distinta de crecer
