Effects of Ayurvedic practices on quality of life of health professionals in Brazil: trends from a quasi experimental study.

Integral health encompasses the way individuals live, considering their quality of life. An inadequate lifestyle can harm human health, increasing the risk of developing chronic non-communicable diseases, which represent 71% of the causes of death worldwide and 54.7% in Brazil. The COVID-19 pandemic has led to impacts on quality of life, resulting from lifestyle changes, especially among health professionals. This constitutes an important factor in the health-disease relationship and the core of the healthcare approach embraced by Ayurveda. The present study evaluated the role of daily Ayurvedic practices in improving the quality of life of health professionals working in the Family Health Strategy of SUS in Paty do Alferes/RJ, Brazil. Ayurveda practices based on Trayopastamba were introduced to 30 health professionals through lectures and guided activities from July to October 2021, spanning three months. Quality of life was assessed using the WHOQOL-BREF questionnaire before and after the intervention. An improvement in perceived quality of life was observed in the physical, psychological, and environmental domains (p > 0.05), while the social domain did not show statistically significant results. The physical domain demonstrated the most substantial score increase (10.95). Conversely, the social domain displayed the smallest rise in scores (5.83). In conclusion, the daily Ayurvedic practices demonstrated the potential to enhance the quality of life in this group, contributing to health promotion in a practical and economically accessible manner.

Pico de Massa Óssea e Níveis de Exercício Físico em Estudantes Universitários / Peak Bone Mass and Exercise Levels: Comparison between Physical Education and Medical Students

Introdução: Promover um adequado pico de massa óssea (PMO) é uma estratégia de prevenção para a osteoporose. Os estudantes universitários estão em idade de aquisição de massa óssea suscetível à influência dos hábitos do estilo de vida, incluindo a prática de exercícios físicos. Assim sendo, este estudo objetivou avaliar a massa óssea em universitários com diferentes estilos de vida. Métodos: Foram avaliados 142 estudantes, sendo 74 de Medicina (MED) e 68 de Educação Física (EF), com idade média de 22 anos. As variáveis do estudo foram obtidas por meio de anamnese densitométrica. A densidade mineral óssea (DMO) da coluna lombar, corpo inteiro, colo do fêmur e fêmur total foi medida por absorciometria de dupla emissão de raios X. Resultados: Não houve diferenças em relação à idade, sexo, IMC e ingestão de cálcio entre os grupos. Os estudantes de EF praticam mais exercícios que os de MED (481 vs. 128 min/semana). A frequência de exercício físico suficiente (> 150 min/semana) foi maior no grupo EF (91,2% vs. 40,5%; p <0,01). Exercícios que influenciam a DMO foram mais frequentes entre os estudantes de EF (91,2% vs. 63,5%; p <0,01). Baixo PMO foi mais frequente no grupo MED (52,7 vs. 14,7; p<0,01). Observou-se correlação positiva entre a quantidade semanal de exercício físico e DMO. Conclusão: Maiores taxas de prática de exercícios físicos foram associadas com melhor PMO em estudantes do curso de Educação Física.

Introduction: Promoting adequate peak bone mass (PBM) is a prevention strategy for osteoporosis. College students are at the age of bone mass acquisition susceptible to the influence of lifestyle habits, including exercise. Therefore, this study aimed to evaluate bone mass in college students with different lifestyles. Methods: We evaluated 142 students, 74 from Medicine (MED) and 68 from Physical Education (PE), with a mean age of 22 years. The study variables were obtained by densitometric anamnesis. Bone mineral density (BMD) of the lumbar spine, whole body, femoral neck, and total femur was measured by dual emission X-ray absorptiometry. Results: There were no differences in age, gender, BMI, and calcium intake between the groups. PE students exercised more than MED students (481 vs. 128 min/week). The frequency of sufficient exercise (> 150 min/week) was higher in the EF group (91.2% vs. 40.5%; p <0.01). Exercise influencing BMD was more frequent among EF students (91.2% vs. 63.5%; p <0.01). Low PBM was more frequent in the MED group (52.7 vs. 14.7; p<0.01). The study showed a positive correlation between the weekly amount of exercise and BMD. Conclusion: Higher exercise rates were associated with better PBM in physical education students.

Introducing Plant-Based Mediterranean Diet as a Lifestyle Medicine Approach in Latin America: Opportunities Within the Chilean Context.

Latin America is experiencing a significant epidemiological and nutritional transition, with a trend toward higher incidence of food-related chronic diseases. In this context, Lifestyle Medicine (LM) is a growing field focused on assisting individuals in adopting healthy behaviors for the prevention and treatment of these chronic diseases, including, among other pillars, a great emphasis on healthy eating. There is also a growing interest worldwide in environmental sustainability of dietary patterns, with increasing concern about their effects on planetary health. In this context, whole-food, plant-based diets -such as the Mediterranean diet (MD)- have emerged as a solution for both healthier eating and lowering environmental impact. Yet in order to be effective at these goals and achieve a high adherence to any nutritional prescription, the sociocultural reality of the community or population where we aim to practice must also be taken into account. In this review, we specifically highlight the plant-based MD as a LM-contextualized dietary pattern that is adaptable, applicable, and sustainable within the Chilean context and has the potential to address the current trend of chronic diseases in our country.

Perfil clínico de pacientes atendidos con diabetes mellitus tipo 2 en un programa de reversión / Clinical Profile Trial Of Patients Cared With Diabetes Mellitus Type 2 In A Reversion Program

La diabetes es una enfermedad crónica que aparece cuando el páncreas no produce insulina suficiente o cuando el organismo no utiliza eficazmente la insulina que produce. La insulina es una hormona que regula el azúcar en la sangre. El efecto de la diabetes no controlada es la hiperglucemia (aumento del azúcar en la sangre), que con el tiempo daña gravemente muchos órganos y sistemas, especialmente los nervios y los vasos sanguíneos.

Diabetes is a chronic disease that appears when the pancreas does not produce enough insulin or when the body does not use the insulin it produces effectively. Insulin is a hormone that regulates blood sugar. The effect of uncontrolled diabetes is hyperglycemia (increased blood sugar), which over time severely damages many organs and systems, especially nerves and blood vessels.

Consumo de tabaco y Neoplasia Intraepitelial Cervical / Tobacco Use And Cervical Intraepithelial Neoplasia

Objetivo: Determinar el efecto del consumo de tabaco en el desarrollo de neoplasia intraepitelial cervical en mujeres. Métodos: Se realizó una revisión sistemática. Se realizó la búsqueda electrónica, utilizando la pregunta de investigación: ¿Cuál es la asociación entre el tabaquismo y el desarrollo de neoplasia intraepitelial cervical? cuya pregunta PEO fue: Población: Mujeres. Exposición: Uso de tabaco. Resultado: Neoplasia intraepitelial cervical. Se seleccionaron los artículos publicados desde el 1 de enero de 2014 hasta diciembre de 2019. Resultados: Se encontraron 71 artículos, de los cuales 55 fueron excluidos por no cumplir con los criterios de selección, quedando 16 artículos para el análisis de este artículo. Aquellas mujeres que consumían tabaco tenían una asociación significativa para el desarrollo de neoplasia intraepitelial de alto grado (OR = 1,43, IC del 95% = 1,14-1,80). Asimismo, se observó asociación entre el tabaquismo severo y el uso de anticonceptivos orales, con mayor riesgo de neoplasia intraepitelial grado II y III (OR = 11,5; IC 95%, 1,88-70,40). Conclusión: La evidencia disponible sugiere la asociación entre el consumo de tabaco y el desarrollo de neoplasia intraepitelial cervical, particularmente lesiones intraepiteliales cervicales de alto grado.

Objective: To determine the effect of tobacco consumption with the development in women of cervical intraepithelial neoplasia. Methods: A systematic review was conducted. The electronic search was carried out, using the research question: What is the association between smoking and the development of cervical intraepithelial neoplasia? whose PEO question was: Population: Women. Exposure: Tobacco use. Outcome: Cervical intraepithelial neoplasia. Articles published from January 1, 2014 to December 2019 were selected. Results: 71 articles were found, 55 being excluded because they did not meet the selection criteria, leaving 16 articles for this paper analysis. Those women who smoked tobacco had a significant association for the development of high-grade intraepithelial neoplasia (OR = 1.43, 95% CI = 1.14-1.80). Likewise, synergy was observed between severe smoking and the use of oral contraceptives, with a greater risk of grade II and III intraepithelial neoplasia (OR = 11.5; 95% CI, 1.88-70.40). Conclusion: The available evidence suggests the association between tobacco use and the development of cervical intraepithelial neoplasia, particularly high-grade cervical intraepithelial lesions.

Estudio de Factibilidad para Evaluar la Proporción de Cáncer Atribuible a Factores de Riesgo Modificables en el Perú y Latinoamérica / Feasibility Study To Evaluate The Proportion Of Cancer Attributable To Modifiable Factors Of Risk In Peru And Latin America

Objetivo: Evaluar la factibilidad y validar de la propuesta metodológica para estimar la incidencia y mortalidad por cáncer atribuible a factores de riesgo modificables para el Perú y Latinoamérica. Métodos: Estudio piloto, ecológico a partir de fuentes secundarias. Se buscó y seleccionó los factores de riesgo modificables, prevalencia de exposicion, los riesgos relativos de dichos factores (RR) o una aproximación mediante la razón de posibilidades (OR). La información fue consignada en una ficha de recolección de datos la cual fue validada mediante juicio de expertos. Para el cálculo de la Fracción Atribuible Poblacional (FAP) se ensayó la fórmula planteada por Parkin y se desarrolló un modelo de simulación estadística con el software R. Studio V. 3.6.1. Resultados: En el Perú se cuenta con estudios de prevalencia para la mayoría de factores de riesgo modificables; asimismo, se dispone en Latinoamérica de estudios con estimaciones de OR para varios de los factores; sin embargo hubo que utilizar estudios de los Estados Unidos para los factores restantes. No hallamos estudios nacionales de radiaciones ionizantes ni ultravioleta. Se ensayó la sintaxis del modelo de simulación estadística la cual mostró ser válida y consistente con los resultados de estudios internacionales de FAP encontrándose dentro de los rangos de los estudios publicados. Conclusión: Es factible y viable realizar estudios de FAP de factores de riesgo modificables para cáncer en países de Latinoamérica, particularmente en el Perú, donde se cuenta con la información requerida para su estimación.

Objective: To evaluate the feasibility of the methodological proposal to estimate the incidence and mortality due to cancer attributable to modifiable risk factors for Peru and Latin America. Methods: Pilot study, ecological from secondary sources. Modifiable risk factors, exposure prevalence, relative risks of these factors (RR) or an approximation by means of possibilities ratio (OR) were searched and selected. The information was recorded in a data collection form which was validated by expert judgment. For the calculation of the Population Attributable Fraction (FAP), the formula proposed by Parkin was tested and a statistical simulation model was developed with R. Studio V. 3.6.1 software. Results: In Peru there are prevalence studies for the majority of modifiable risk factors; Likewise, studies with OR estimates for several of the factors are available in Latin America; however, studies from the United States had to be used for the remaining factors. No national studies of ionizing or ultraviolet radiation were found. The syntax of the statistical simulation model was tested, which proved to be valid and consistent with the results of international FAP studies within the ranges of published studies. Conclusion: It is feasible and viable to carry out PAF studies of modifiable risk factors for cancer in Latin American countries, particularly in Peru, where the information required for its estimation is available.

Consumo de alcohol como factor asociado a la depresión en estudiantes varones de medicina humana de la universidad Ricardo Palma del año 2018 / Alcohol consumption as a factor associated with depression in students of human medicine of the Ricardo Palma university of the year 2018

Objetivo: Determinar si el consumo de alcohol es un factor asociado a la depresión en estudiantes de medicina varones de la Universidad Privada Ricardo Palma del Ciclo II (agosto-diciembre) del año 2018. Métodos: Estudio de tipo no experimental, analítico, transversal, descriptivo, correlacional en la Facultad de Medicina Humana de la Universidad Ricardo Palma, durante el año académico 2018. Una encuesta y un Test validado realizaron a 200 estudiantes varones luego de su consentimiento informado: El Test validado de auto-evaluación de rasgos depresivos de Zung. que consta de 20 preguntas que nos ayudan a determinar el estado depresivo según los criterios diagnósticos CIE-10 y DSM IV. Resultados: Se encuestaron a 200 estudiantes varones. El 67.5% de los estudiantes tienen entre 18 a 22 años. El 70% de los estudiantes rara vez consume alcohol, y el 9% de los estudiantes consume alcohol 2 a 6 veces por semana, el 48.5% de los estudiantes presenta depresión leve y el 3% de los estudiantes presenta depresión grave , en el grupo de estudiantes que tienen depresión grave el 50% consume alcohol 2 veces a la semana, en la prueba de Chi Cuadrado el valor p (p= 0.000), que permiten establecer que existe relación significativa entre el consumo de alcohol y la depresión en los estudiantes varones, Finalmente se encontró que el Odd Ratio (OR=9.4) para el Consumo de Alcohol establece que los estudiantes varones que consumen más de 1 vez por semana alcohol tienen 9.444 mayor riesgo de presentar Depresión que los estudiantes varones que consumen alcohol 1 vez a la semana o menos. Conclusión: El consumo de alcohol es un factor de riesgo asociado a la depresión en los estudiantes varones de la Facultad de Medicina de la Universidad Ricardo Palma.

Objective: To determine whether alcohol consumption is a factor associated with depression in male medicine students at the Ricardo Palma del Ciclo II Private University (August-December) in 2018. Methods: Non-experimental, analytical, transversal, descriptive, correlational in the Faculty of Human Medicine of the Ricardo Palma University, during the academic year 2018. A survey and a validated test carried out 200 male students after their informed consent: The validated test of self-evaluation of depressive features of Zung. which consists of 20 questions that help us determine the depressive state according to the diagnostic criteria ICD-10 and DSM IV. Results: 200 male students were surveyed. 67.5% of students are between 18 and 22 years old. 70% of students rarely consume alcohol, and 9% of students consume alcohol 2 to 6 times a week, 48.5% of students have mild depression and 3% of students have severe depression, in the group of students who have severe depression, 50% consume alcohol twice a week, in the Chi-square test the p-value (p = 0.000), which allows establishing that there is a significant relationship between alcohol consumption and depression in students Finally, it was found that the Odd Ratio (OR = 9.4) for Alcohol Consumption establishes that male students who consume alcohol more than once a week have 9,444 higher risk of developing depression than male students who consume alcohol 1 time a the week or less. Conclusion: Alcohol consumption is a risk factor associated with depression in male students of the Faculty of Medicine of the Ricardo Palma University.

UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

Evaluating the effectiveness of physician counseling to promote physical activity in Mexico: an effectiveness-implementation hybrid study.

Integrating physical activity (PA) counseling in routine clinical practice remains a challenge. The purpose of this study was to evaluate the implementation and effectiveness of a pragmatic strategy aimed to improve physician PA counseling and patient PA. An effectiveness-implementation type-2 hybrid design was used to evaluate a 3-h training (i.e., implementation strategy-IS) to increase physician use of the 5-As (assess, advise, agree, assist, arrange) for PA counseling (i.e., clinical intervention-CI) and to determine if the CI improved patient PA. Patients of trained and untrained physicians reported on PA and quality of life pre-post intervention. Medical charts (N = 1700) were examined to assess the proportion of trained physicians that used the 5-As. The RE-AIM framework informed our evaluation. 305/322 of eligible physicians participated in the IS (M age = 40 years, 52% women) and 683/730 of eligible patients in the CI (M age = 49 years, 77% women). The IS was adopted by all state regions and cost ~ $20 Mexican pesos (US$1) per provider trained. Physician adoption of any of the 5-As improved from pre- to post-training (43 vs. 52%, p < .01), with significant increases in the use of assessment (43 vs. 52%), advising (25 vs. 39%), and assisting with barrier resolution (7 vs. 15%), but not in collaborative goal setting (13 vs. 17%) or arranging for follow-up (1 vs. 1%). Patient PA and quality of life did not improve. The IS intervention was delivered with high fidelity at a low cost, but appears to be insufficient to lead to broad adoption of the CI.

One-day workshop-based training improves physical activity prescription knowledge in Latin American physicians: a pre-test post-test study.

BACKGROUND: The physical inactivity pandemic and related non-communicable diseases have made it imperative for medical doctors (MDs) to effectively provide lifestyle counseling as part of prevention and treatment plans for patients. A one-day certification workshop was designed to improve MDs PA prescription knowledge, as part of the Exercise is Medicine® (EIM®) global health initiative. The objective was to determine knowledge gain of MDs participating in a standardized, one-day PA prescription workshop performed throughout Latin America (LA). METHODS: A 20-question multiple-choice test on PA topics, based on international guidelines, was completed before and after the workshop. Pre and post-test analyses, without a control group, were performed on 1044 MDs after the 8-h workshop that was delivered 41 times across 12 LA countries, from January 2014 to January 2015. Knowledge improvement was determined using the class-average normalized gain and individual relative gain. T-tests with 95% confidence interval levels were conducted to analyze differences between MD specialties. RESULTS: Test scores improved on average from 67 to 82% after the workshop (p <0.001). The average total individual relative gain was 29% [CI: 26 to 32%]. Relative gain by country ranged from 9.3% [CI: 2 to 16%; Nicaragua] to 73% [CI: 47 to 98%; Dominican Republic]. The mean of the 41 workshops' class-average normalized gain was 46% [CI: 42 to 51%]. The largest groups of participants were general practitioners (GPs) (33%; n = 348), internal medicine (19%; n = 194), and family medicine (9%n = 92) specialists. Relative gain for GPs was not different than for all grouped primary care specialties (30% vs. 27%, p =0.48). The knowledge gain was higher for the workshop modules on screening/risk stratification and prescription (43% [CI: 39-48%] and 38% [CI: 34-42%], than for the module on PA benefits and risks (26% [CI: 23-28%]). CONCLUSION: This one-day workshop had a positive impact on the knowledge gain of MD's on the topic of PA prescription. Although all groups of specialties increased knowledge, GPs and family medicine MDs benefited the most. This short course is an effective continuing education strategy for teaching PA assessment, counseling and prescription to MDs in Latin America, a topic rarely included in the training of MD's in the region and the world. Further follow-up is needed to ascertain impact on PA counseling practices.