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1.
Am J Orthopsychiatry ; 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38602793

RESUMO

Emerging research provides insights into migration-related cultural stress experiences and mental health among Venezuelan migrants; however, prior studies have not considered the critical distinction between online xenophobia and in-person discrimination. To address this gap, we assess the psychometric properties of an abbreviated version of the Perceived Online Racism Scale (PORS) with Venezuelan migrant youth and examine the interplay between online xenophobia, in-person discrimination, and mental health. Survey data were collected from Venezuelan migrant youth (N = 319; ages 13-17, 49.5% female) in Colombia in April-July 2023. Confirmatory factor analysis (CFA) was used to examine the PORS, and multiple regression was conducted to examine key associations. The CFA showed excellent model fit: χ²(7) = 13.498, p = .061; comparative fit index = .989; Tucker-Lewis index = .977; root-mean-square error of approximation = .055; standardized root-mean-square residual = .026. Controlling for demographic factors, online xenophobia was associated with depressive symptoms (ß = .253, p < .001) and anxiety (ß = .200, p = .001). The online xenophobia-mental health association weakened when controlling for in-person discrimination but remained nevertheless significant (depression: ß = .181, p = .002, anxiety: ß = .135, p = .026). Interaction effects (Online × In-Person) revealed a pattern in which greater exposure to online xenophobia was associated with greater distress, but only at relatively low levels of in-person discrimination. Findings provide new insights regarding (a) the properties of an increasingly relevant measure of cultural stress, (b) how online xenophobia relates to mental health, and (c) the interplay of online and in-person cultural stressors vis-à-vis mental health among Venezuelan migrant youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

2.
Pathogens ; 11(10)2022 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-36297148

RESUMO

Acute febrile illness (AFI) is a morbid condition with a sudden onset of fever with at least seven days of evolution, where no signs or symptoms related to an apparent infection have been identified. In Latin America, a high proportion of disease is typically due to malaria and arboviruses. However, among the infectious etiologies, tick-borne diseases (TBDs) should also be considered, especially in areas where people come into direct contact with these arthropods. This study aims to describe the etiology and epidemiology related to tick-borne agents in patients with AFI and the tick's natural infection by agents of TBD in the rural tropical Magdalena Medio region in Colombia, and explore the factors associated with the presence of Coxiella burnetii infection. We conduct a cohort study enrolling 271 patients with AFI to detect the bacteria of the genera Anaplasma, Ehrlichia, Coxiella, Rickettsia, Borrelia, and Francisella through molecular techniques, and additionally evaluate the presence of IgG antibodies with commercially available kits. We also conduct tick collection in the patient's households or workplaces for the molecular screening of the same bacterial genera. Seropositivity to IgG antibodies was obtained for all the bacteria analyzed, with Francisella being the most common at 39.5% (107/271), followed by R. rickettsii at 31.4% (85/271), Ehrlichia at 26.9% (73/271), R. typhi at 15.5% (42/271), Anaplasma at 14.4% (39/271), and Borrelia at 6.6% (18/271). However, these bacteria were not detected by the molecular techniques used. Coxiella burnetii infection was detected in 39.5% of the patients: 49.5% only by phase I and II IgG antibodies, 33.6% only by real-time PCR, and 16.8% had a concordant positive result for both techniques. A total of 191 adult ticks, 111 females and 80 males, were collected and identified as Rhipicephalus sanguineus s.l. and Rhipicephalus microplus. In the 169 adult ticks in which natural infection was evaluated, Ehrlichia spp. was detected in 21.3% (36/169), Coxiella spp. in 11.8% (20/169), and Anaplasma spp. in 4.7% (8/169). In conclusion, we identified the prior exposition to Francisella, Anaplasma, Ehrlichia, Rickettsia, Borrelia, and Coxiella in patients through serological tests. We also detected the infection of C. burnetii using molecular techniques. In the ticks, we identified bacteria of the genera Coxiella, Anaplasma, and Ehrlichia. These results suggest the importance of these zoonotic agents as possible causes of AFI in this region.

3.
VideoGIE ; 6(8): 344-346, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34401627

RESUMO

Video 1Endoscopic submucosal dissection (ESD) of large rectal lateral spreading tumors (LSTs) that extend to the dentate line with internal hemorrhoids is a challenging procedure because of the increased risk of bleeding from penetrating and hemorrhoidal vessels and the reduced visual field caused by the dilated venous packages and the narrow anal lumen.This video describes novel technical approaches to minimize the risk of intraoperative bleeding.The described approaches are indicated in large rectal LSTs that extend to the dentate line with large internal hemorrhoids. The described selective-vessel approach is also indicated in any vascularized superficial lesion amenable to endoscopic treatment.ESD was performed in the retroflex view using an Evis Exera II video processor, an H180 gastroscope, an ERBE ICC 200, and CO2 insufflation. As tools, IT-nano, needle knife, hook knife, hemostatic forceps, and a distal cap were used. The lifting solution was a mixture of normal saline, hyaluronic acid, epinephrine, and indigo carmine.A hemicircumferential superficial granular lateral spreading tumor was observed in the lower rectum. Indigo carmine dye spray facilitated the identification of the lesion's margin and demonstrated no ulcer, converging folds, or large nodules. After the submucosal (SM) injection, a shallow mucosal incision was made in the retroflex view using a conventional needle knife, followed by the circumferential incision at the proximal side using an IT-nano. The SM layer was dissected at a superficial level to avoid large SM vessels, thus preventing intraoperative bleeding and maintaining a clean surgical field. Small vessels were selectively coagulated mainly by using the small disc located at the back of the insulated tip as the SM later was superficially dissected. To facilitate precise coagulation, a stepwise dissection technique was used for larger vessels. After identification, the vessel was first exposed by dissecting the surrounding SM layer at the left and right sides using the long blade of IT-nano, with blunt dissection of the surrounding tissue at the vessels' posterior aspect using a Hook knife. Double-vessel sealing using a hemostatic forceps was performed both at the rectal and tumor sides. Lastly, the vessel was transected between sealed segments using the IT-nano, without major bleeding. The circumferential incision was completed at the left side and distally extended to the anal canal where large hemorrhoidal bundles were seen. A needle knife was used to complete the SM dissection and, here, the final cut. En bloc resection was successfully achieved without intraoperative bleeding.The en bloc resected specimen was 85 mm in size, and squamous epithelium of the anal canal was observed at the distal margin. Colonoscopy 5 months post-ESD revealed adequate healing, no stenosis and no hemorrhoids.Coagulation and hemostasia should be promptly carried out whenever inadvertent injury to large vessels and subsequent bleeding occurs during lateral exposure, posterior blunt dissection, double coagulation, and transection of vessels.Curative ESD can be achieved in large rectal LSTs that extend to the dentate line with large internal hemorrhoids. Strategies to minimize intraoperative bleeding during ESD should be considered and include the following:•An SM dissection from the proximal tumor margin in the retroflex view to circumvent contact with hemorrhoids.•A differential level of dissection to prevent inadvertent vessel injury-shallow first to avoid large SM vessels and deeper above the muscular layer closer to the dentate line to shut off blood supply by penetrating hemorrhoidal vessels.•Last but not least, a selective approach to vessels to reduce the risk of bleeding, with direct coagulation for small vessels and with lateral exposure, posterior blunt dissection, double-vessel sealing, and transection between sealed segments for larger vessels.

4.
Ann Behav Med ; 53(3): 211-222, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29746621

RESUMO

BACKGROUND: A well-established gender-differentiated association between acculturation and current smoking exists among Latino adults. There are far fewer studies on the potential influence of acculturation on smoking cessation, and extant findings are mixed. PURPOSE: Using a multidimensional measure of acculturation, the current study examined the independent and interactive associations of gender and acculturation with smoking cessation among Mexican American smokers engaged in a quit attempt. METHODS: Using a latent variable modeling approach to repeated measures analysis, the independent and interaction effects of acculturation in two cultural directions (American and Mexican) were examined for their prospective associations with smoking abstinence. Interactions of acculturation domains with gender were also examined. Acculturation was assessed at baseline and abstinence status was assessed at 3 and 26 weeks post-quit. RESULTS: The interaction of American and Mexican cultural identity was significantly associated with smoking abstinence, such that greater American cultural identity was positively associated with abstinence only among those with high Mexican cultural identity. The interaction of English proficiency with gender was significant such that English proficiency was positively associated with abstinence among men but not women. CONCLUSIONS: Findings in the cultural identity domain are consistent with a "benefits of biculturalism" perspective, and may be particularly relevant to the adoption of an American cultural orientation among persons with an already-strong heritage-culture orientation. Findings also replicate a gender-differentiated association between acculturation and cessation. Implications for treatment development and future research are discussed.


Assuntos
Aculturação , Americanos Mexicanos/psicologia , Abandono do Hábito de Fumar/etnologia , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estados Unidos
5.
J Ethn Subst Abuse ; 17(3): 303-323, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27436513

RESUMO

Few studies have examined the socio-cultural determinants of alcohol and drug misuse trajectories among adult Latinas. To assess the associations between socio-cultural determinants and alcohol and drug misuse, we used a longitudinal design to follow a sample of adult Latina mother-daughter-dyads (N = 267) for ten years, and collected four waves of data. They were adult Latinas of Caribbean, South and Central American descent. Specifically, this study investigated the effects of the following factors: (1) Individual Determinants (e.g., socioeconomic conditions, mental health, and medical status); (2) Cultural Determinants (e.g., acculturation to US culture); (3) Interpersonal Determinants (e.g., interpersonal support, relationship stress, mother-daughter attachment, intimate partner violence); (4) Community Determinants (e.g., neighborhood related stress); and (5) Institutional Determinants (e.g., religious involvement, involvement with the criminal justice system). Using hierarchical modeling, we found that taking prescribed medication on a regular basis for a physical problem, religious involvement, and mother-daughter attachment were negatively associated with drug misuse, while involvement in criminal activity was positively associated with drug misuse. Regarding alcohol misuse, results showed that age at arrival in the United States, number of years in the United States, and religious involvement were negatively associated with alcohol misuse, while involvement in criminal activity was positively associated with alcohol misuse. Based on our findings, explicit implications are provided for culturally relevant interventions.


Assuntos
Hispânico ou Latino/estatística & dados numéricos , Relações Mãe-Filho/etnologia , Religião e Psicologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Adulto , Idoso , Alcoolismo/etnologia , Região do Caribe/etnologia , América Central/etnologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , América do Sul/etnologia , Estados Unidos/etnologia , Adulto Jovem
6.
Rev Peru Med Exp Salud Publica ; 33(2): 321-7, 2016 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-27656933

RESUMO

Older adults comprise a heterogeneous population group that usually has a high disease burden, comorbidities, and, in many cases, subclinical conditions that compromise their health and quality of life. In addition to the physical component, the health conditions of elderly individuals are significantly influenced by cognitive and affective components, social and family factors such as abandonment, and functional factors including the ability to perform everyday activities. In response to this complex scenario, the comprehensive geriatric evaluation constitutes a multidimensional and interdisciplinary diagnostic tool that assesses the health of older adults in all of its complexity by considering the physical, mental, social/family, and functional needs to obtain full knowledge of older person's health status and creating a plan that consists of appropriate and individualized interventions that considers the preferences and values of older individuals and their families.


Assuntos
Avaliação Geriátrica , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Humanos
7.
Rev. peru. med. exp. salud publica ; 33(2): 321-327, abr.-jun. 2016. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-795394

RESUMO

RESUMEN Los adultos mayores conforman un grupo poblacional heterogéneo que, usualmente, presenta una gran carga de enfermedad, pluripatología y, en muchas ocasiones, condiciones subclínicas que comprometen su salud y calidad de vida. Además del componente físico, la salud de los adultos mayores está influenciada, de manera importante, por factores mentales, que incluyen componentes cognitivos y afectivos; factores sociofamiliares, como el abandono; y factores funcionales, como la capacidad para realizar las actividades cotidianas. En respuesta a este escenario complejo, la valoración geriátrica integral se constituye en una herramienta diagnóstica, multidimensional e interdisciplinaria, cuya característica es evaluar la salud del adulto mayor en toda su complejidad, es decir, toma en consideración los aspectos físicos, mentales, sociofamiliares y funcionales para tener un conocimiento completo del estado de salud de la persona mayor y, de esta manera, realizar un plan de trabajo con intervenciones apropiadas e individualizadas, tomando en cuenta sus preferencias, sus valores y los de la familia.


ABSTRACT Older adults comprise a heterogeneous population group that usually has a high disease burden, comorbidities, and, in many cases, subclinical conditions that compromise their health and quality of life. In addition to the physical component, the health conditions of elderly individuals are significantly influenced by cognitive and affective components, social and family factors such as abandonment, and functional factors including the ability to perform everyday activities. In response to this complex scenario, the comprehensive geriatric evaluation constitutes a multidimensional and interdisciplinary diagnostic tool that assesses the health of older adults in all of its complexity by considering the physical, mental, social/family, and functional needs to obtain full knowledge of older person's health status and creating a plan that consists of appropriate and individualized interventions that considers the preferences and values of older individuals and their families.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Humanos , Qualidade de Vida , Avaliação Geriátrica
8.
PLoS Negl Trop Dis ; 10(3): e0004528, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27002523

RESUMO

An estimated 2 million inhabitants are infected with Chagas disease in Mexico, with highest prevalence coinciding with highest demographic density in the southern half of the country. After vector-borne transmission, Trypanosoma cruzi is principally transmitted to humans via blood transfusion. Despite initiation of serological screening of blood donations or donors for T. cruzi since 1990 in most Latin American countries, Mexico only finally included mandatory serological screening nationwide in official Norms in 2012. Most recent regulatory changes and segmented blood services in Mexico may affect compliance of mandatory screening guidelines. The objective of this study was to calculate the incremental cost-effectiveness ratio for total compliance of current guidelines from both Mexican primary healthcare and regular salaried worker health service institutions: the Secretary of Health and the Mexican Institute for Social Security. We developed a bi-modular model to analyze compliance using a decision tree for the most common screening algorithms for each health institution, and a Markov transition model for the natural history of illness and care. The incremental cost effectiveness ratio based on life-years gained is US$ 383 for the Secretary of Health, while the cost for an additional life-year gained is US$ 463 for the Social Security Institute. The results of the present study suggest that due to incomplete compliance of Mexico's national legislation during 2013 and 2014, the MoH has failed to confirm 15,162 T. cruzi infections, has not prevented 2,347 avoidable infections, and has lost 333,483 life-years. Although there is a vast difference in T. cruzi prevalence between Bolivia and Mexico, Bolivia established mandatory blood screening for T.cruzi in 1996 and until 2002 detected and discarded 11,489 T. cruzi -infected blood units and prevented 2,879 potential infections with their transfusion blood screening program. In the first two years of Mexico's mandated program, the two primary institutions failed to prevent due to incomplete compliance more potential infections than those gained from the first five years of Bolivia's program. Full regulatory compliance should be clearly understood as mandatory for the sake of blood security, and its monitoring and analysis in Mexico should be part of the health authority's responsibility.


Assuntos
Doença de Chagas/sangue , Doença de Chagas/epidemiologia , Testes Sorológicos/economia , Trypanosoma cruzi/isolamento & purificação , Doadores de Sangue , Doença de Chagas/prevenção & controle , Análise Custo-Benefício , Tomada de Decisões , Custos de Cuidados de Saúde , Humanos , Cadeias de Markov , México/epidemiologia , Programas Nacionais de Saúde , Sensibilidade e Especificidade , Reação Transfusional
9.
J Youth Adolesc ; 45(3): 457-70, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26597783

RESUMO

The links between discrimination and adjustment in U.S. Latino/a immigrant adolescents is an important but understudied phenomenon. We aimed to investigate the longitudinal associations (across 1 year) among discrimination, prosocial behaviors, and depressive symptoms in U.S. Latino immigrant adolescents using two competing models: associations between discrimination and prosocial behaviors via depressive symptoms (mental health strain model), and associations between discrimination and depressive symptoms via prosocial behaviors (prosociality strain model). Participants were 302 Latino/a recent immigrant adolescents (53.3 % boys, M age = 14.51 years at Time 1, SD = .88 years) who completed measures of discrimination, depressive symptoms, and prosocial behaviors at 6-month intervals. The results provided support for both proposed models. The discussion examines the importance of prosocial behaviors in understanding adjustment and effects of discrimination among recently immigrated U.S. Latino adolescents.


Assuntos
Depressão/psicologia , Emigrantes e Imigrantes/psicologia , Hispânico ou Latino/psicologia , Comportamento Social , Discriminação Social/psicologia , Aculturação , Adolescente , Cuba/etnologia , Feminino , Humanos , Estudos Longitudinais , Masculino , México/etnologia , Modelos Psicológicos , Fatores Sexuais , Estados Unidos
10.
Rev. peru. med. exp. salud publica ; 32(4): 709-716, oct.-dic. 2015. tab
Artigo em Espanhol | LILACS, LIPECS, INS-PERU | ID: lil-790781

RESUMO

Determinar el perfil clínico, funcional y sociofamiliar de los adultos mayores de la comunidad en un distrito de Lima, Perú. Materiales y métodos. Estudio descriptivo de corte transversal de una muestra de 501 personas mayores de 60 años que viven en el distrito de San Martin de Porres. Se aplicó un cuestionario estructurado en el que se registraron variables clínicas, funcionales y sociofamiliares, se realizó una evaluación física para la evaluación de medidas basadas en la ejecución y se tomaron muestras séricas para estudio hematológico y bioquímico. Los datos se presentaron mediante estadísticas descriptivas como frecuencias y porcentajes para las variables categóricas así como medias y desviación estándar para las numéricas. Resultados. Se evaluaron un total de 501 adultos mayores. La media de la edad fue de 71,5 años (± 8,9 años), la enfermedad crónica más frecuente fue hipertensión arterial en 40,9%, seguido por las enfermedades reumatológicas con 36,9%; un 27,7% tuvo algún grado de dependencia parcial o total en las actividades de la vida diaria, 16,2% presentaron deterioro cognitivo, 8% vivían solos, 58,5% tuvieron riesgo o problema social. La autopercepción de la salud fue regular en el 61% y mala o muy mala en 16%. Conclusiones. Los adultos mayores de la comunidad de San Martín de Porres en Lima presentan frecuentes problemas de dependencia funcional, riesgo o problema social, enfermedades crónicas y una alta frecuencia de síndromes y problemas geriátricos...


To determine the clinical, functional and socio-familiar profile of seniors from a community in a district of Lima, Peru. Materials and methods. Descriptive cross-sectional study of a sample of 501 people aged 60 and over living in the San Martin de Porres district. We used a structured questionnaire in which clinical, functional and socio-familiar variables were recorded. A physical evaluation was carried out to assess performance based measures and serum samples were taken for hematological and biochemical examination. The data were presented with descriptive statistics such as frequencies and percentages for categorical variables and means and standard deviations for the numeric variables. Results. A total of 501 older adults were evaluated. The mean age was 71.5 years (±8.9 years). The most common chronic disease was arterial hypertension at 40.9%, followed by rheumatic diseases with 36.9%. 27.7% had some degree of partial or total dependence in activities of daily living, 16.2% had cognitive impairment, 8% lived alone, 58.5% had or were at risk of having a social problem.61% self-rated their health as normal, while 16% rated it as bad or very bad. Conclusions. Seniors in the community of San Martin de Porres in Lima have frequent problems of functional dependence, have or are at risk of social problems, chronic illness and a high frequency of geriatric syndromes and problems...


Assuntos
Humanos , Masculino , Feminino , Idoso , Nível de Saúde , Avaliação Geriátrica , Epidemiologia Descritiva , Estudos Transversais
11.
Rev. méd. hered ; 26(4): 222-229, oct.-dic.2015. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-781703

RESUMO

Describir el estado y las características de la investigación en Geriatría y Gerontología realizada en el Perú y su evolución en la última década. Material y métodos: Estudio descriptivo, bibliométrico de tesis y publicaciones en Geriatría y Gerontología realizadas a nivel nacional desde el 2002 al 2013. Se utilizó una metodología de búsqueda mediante el uso de palabras clave en base de datos de universidades, en REPEBIS, LILACS, SciELO y PubMed incluyendo las investigaciones que cumplían el rigor de un estudio científico. Resultados: Se identificaron 399 investigaciones, 104 (26%) de Gerontología y 295 (74%) de Geriatría. El 71% de los trabajos se realizó en la ciudad de Lima seguido por Arequipa (7%) y Trujillo (5%). La mayoría fueron descriptivos (88%), de corte transversal (77,2%) y realizados en escenarios hospitalarios (57,1%). El área social (15%) fue el tema gerontológico más estudiado y el de servicios geriátricos (7,5%) lo fue en el área geriátrica. El 28,6% de las investigaciones se publicaron en revistas biomédicas, de las cuales 82,5% fueron relativos al área de geriatría y 17,5% del área de gerontología (p=0,01) y fueron desarrollados en ámbitos de servicios de salud en 71,9% vs 28,1% en comunidad (p=0,006). Conclusiones: Las investigaciones en Geriatría y Gerontología en el Perú son en su mayoría descriptivas de corte transversal y del área de geriatría. En la última década hay un incremento en la publicación en revistas biomédicas...


To describe the status and characteristics of scientific research in Geriatrics and Gerontology performed in Peru and to evaluate its trend during the last decade. Methods: A descriptive study was carried-out in which a systematic search using specific keywords of investigations that followed rigorous scientific standards was performed in data bases including REPEBIS, LILACS, SciELO and PubMed. Results: 399 investigations were found; 104 (26%) in Gerontology and 295 (74%) in Geriatrics; 71% were performed in Lima followed by Arequipa (7%) and Trujillo (5%). Most of the studies were descriptive (88%); 77.2% of these studies were cross-sectional and 57.1% were carried-out in hospitals. Social issues were the most common topic covered: 15% in Gerontology and 7.5% in Geriatrics; 28.6% of the investigations were published in biomedical journals, of which 82.5% were in Geriatrics and 17.5% in Gerontology (p=0.01), and were carried-out more commonly in health care centers (71.9%) vs. in the community (28.1%), p=0.006. Conclusions: Scientific investigations in Geriatrics and Gerontology in Peru are mostly descriptive cross-sectional studies. There has been an increase in publications in biomedical journals during the last decade...


Assuntos
Humanos , Geriatria , Publicações Científicas e Técnicas , Epidemiologia Descritiva , Peru
12.
Rev Peru Med Exp Salud Publica ; 32(4): 709-16, 2015 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-26732919

RESUMO

OBJECTIVES: To determine the clinical, functional and socio-familiar profile of seniors from a community in a district of Lima, Peru. MATERIALS AND METHODS: Descriptive cross-sectional study of a sample of 501 people aged 60 and over living in the San Martin de Porres district. We used a structured questionnaire in which clinical, functional and socio-familiar variables were recorded. A physical evaluation was carried out to assess performance based measures and serum samples were taken for hematological and biochemical examination. The data were presented with descriptive statistics such as frequencies and percentages for categorical variables and means and standard deviations for the numeric variables. RESULTS: A total of 501 older adults were evaluated. The mean age was 71.5 years (±8.9 years). The most common chronic disease was arterial hypertension at 40.9%, followed by rheumatic diseases with 36.9%. 27.7% had some degree of partial or total dependence in activities of daily living, 16.2% had cognitive impairment, 8% lived alone, 58.5% had or were at risk of having a social problem.61% self-rated their health as normal, while 16% rated it as bad or very bad. CONCLUSIONS: Seniors in the community of San Martin de Porres in Lima have frequent problems of functional dependence, have or are at risk of social problems, chronic illness and a high frequency of geriatric syndromes and problems.


Assuntos
Atividades Cotidianas , Doença Crônica/epidemiologia , Características de Residência , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Peru/epidemiologia
13.
Int J Adv Couns ; 36(2): 136-149, 2014 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-24791033

RESUMO

This study examined associations of intragroup marginalization and cultural incongruity with acculturative stress and depressive symptoms among 155 undergraduate U.S. college students of Mexican heritage. Findings indicate that perceived interpersonal distancing by the family (intragroup marginalization) and perceived lack of cultural fit between the respondent and academic institution (cultural incongruity) had statistically significant direct and indirect effects on depressive symptoms via acculturative stress. Results also show that 39.7 % of the variance corresponding with depressive symptoms was accounted for by intragroup marginalization, cultural incongruity, acculturative stress, and other exogenous variables.

14.
PLoS Negl Trop Dis ; 8(4): e2776, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24743112

RESUMO

BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.


Assuntos
Antiprotozoários/economia , Antiprotozoários/uso terapêutico , Doença de Chagas/diagnóstico , Doença de Chagas/tratamento farmacológico , Prevenção Secundária/economia , Prevenção Secundária/métodos , Doença de Chagas/economia , Estudos de Coortes , Diagnóstico Precoce , Custos de Cuidados de Saúde , Humanos , México
15.
Cancer Epidemiol Biomarkers Prev ; 23(3): 402-8, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24609849

RESUMO

BACKGROUND: Biobanking is the collection of human biospecimens (tissues, blood, and body fluids) and their associated clinical and outcome data. Hispanics are less likely to provide biologic specimens for biobanking. The purpose of this study was to investigate the association of acculturation, nativity status, and years living in the United States with participation in biobanking among individuals of Mexican descent. METHODS: Participants were 19,212 adults of Mexican descent enrolled in an ongoing population-based cohort in Houston, TX. Participants were offered the opportunity to provide a blood, urine, or saliva sample for biobanking. Acculturation was assessed with the bidimensional acculturation scale for Hispanics and scores were categorized into "low acculturation," "bicultural," and "high-acculturation." RESULTS: After multivariable adjustment, we found an increased likelihood of participation in biobanking among individuals classified as "bicultural" as compared with "highly acculturated" individuals [OR, 1.58; 95% confidence intervals (CI), 1.10-2.26]. The associations of nativity status and years living in the United States with biobanking were not statistically significant. After stratifying by gender, the associations of acculturation, nativity status, and years living in the United States with biobanking were not statistically significant. CONCLUSION: Although individuals of Mexican descent who were "bicultural" were more likely to participate in biobanking than individuals who were "highly acculturated," the difference in rates of participation among acculturation categories was small. The high participation rate in biospecimen collection is likely due to extensive community-engaged research efforts. Future studies are warranted to understand individuals' participation in biobanking. IMPACT: Community-engaged research efforts may increase Hispanics' participation in biobanking. Cancer Epidemiol Biomarkers Prev; 23(3); 402-8. ©2014 AACR.


Assuntos
Aculturação , Bancos de Espécimes Biológicos/organização & administração , Americanos Mexicanos/psicologia , Adulto , Bancos de Espécimes Biológicos/tendências , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
16.
Drug Alcohol Depend ; 136: 143-8, 2014 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-24485880

RESUMO

BACKGROUND: Although studies have shown a cross-sectional link between discrimination and smoking, the prospective influence of discrimination on smoking cessation has yet to be evaluated. Thus, the purpose of the current study was to determine the influence of everyday and major discrimination on smoking cessation among Latinos making a quit attempt. METHODS: Participants were 190 Spanish speaking smokers of Mexican Heritage recruited from the Houston, TX metropolitan area who participated in the study between 2009 and 2012. Logistic regression analyses were conducted to evaluate the associations of everyday and major discrimination with smoking abstinence at 26 weeks post-quit. RESULTS: Most participants reported at least some everyday discrimination (64.4%), and at least one major discrimination event (56%) in their lifetimes. Race/ethnicity/nationality was the most commonly perceived reason for both everyday and major discrimination. Everyday discrimination was not associated with post-quit smoking status. However, experiencing a greater number of major discrimination events was associated with a reduced likelihood of achieving 7-day point prevalence smoking abstinence, OR=.51, p=.004, and continuous smoking abstinence, OR=.29, p=.018, at 26 weeks post-quit. CONCLUSIONS: Findings highlight the high frequency of exposure to discrimination among Latinos, and demonstrate the negative impact of major discrimination events on a smoking cessation attempt. Efforts are needed to attenuate the detrimental effects of major discrimination events on smoking cessation outcomes.


Assuntos
Hispânico ou Latino/psicologia , Preconceito/psicologia , Abandono do Hábito de Fumar/psicologia , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Idioma , Modelos Logísticos , Masculino , México/etnologia , Pessoa de Meia-Idade , Preconceito/estatística & dados numéricos , Prevalência , Estudos Prospectivos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fatores Socioeconômicos , Texas/epidemiologia , Tabagismo/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
17.
Drug Alcohol Depend ; 125 Suppl 1: S12-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22749681

RESUMO

INTRODUCTION: Existing research has documented high comorbid rates for injecting drug use (IDU) and social and health consequences including HIV infection, a condition that disproportionately affects U.S. Hispanic populations. Few studies have examined the specific associations between injecting transition risk among non-injecting heroin using (NIU) populations and mental health conditions. This study hypothesizes that injecting transition risk will be strongly associated with depression symptomatology controlling for age and gender among Mexican American NIUs. METHODS: Street-recruited NIUs (n=300) were administered structured interviews. The Mexican American sample was predominantly male (66%), unemployed (75%) with more than half experiencing incarceration in their lifetimes (58%). Depression was measured using the CES-D scale. Univariate and multivariate logistic regression analysis were employed to determine the associations between the dependent variable of heroin injecting transition risk and the key independent variables of depression symptomatology and other independent variables. RESULTS: Depression symptomatology was the strongest independent correlate of injecting transition risk. Those NIUs with high levels of depression symptomatology had more than three times the heroin injecting transition risk than those NIUs with low levels. Heroin use network influence was also found to be a strong correlate. Acculturation level was significantly associated with injecting transition risk. CONCLUSION: The comorbid condition of depression symptomatology and heroin use places Mexican American NIUs at elevated risk of contracting blood-borne pathogens such as HIV. Development of prevention and treatment strategies that target Hispanic non-injecting heroin users in socially disadvantaged communities should consider depression symptoms and develop interventions that build new social networks.


Assuntos
Depressão/etnologia , Dependência de Heroína/etnologia , Americanos Mexicanos/etnologia , Abuso de Substâncias por Via Intravenosa/etnologia , Estudos de Coortes , Depressão/complicações , Depressão/psicologia , Feminino , Seguimentos , Infecções por HIV/etnologia , Infecções por HIV/etiologia , Infecções por HIV/psicologia , Dependência de Heroína/psicologia , Humanos , Masculino , Americanos Mexicanos/psicologia , Estudos Prospectivos , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/etiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Adulto Jovem
18.
Rev. colomb. cancerol ; 16(2): 91-99, jun. 2012.
Artigo em Espanhol | LILACS | ID: lil-662993

RESUMO

Objetivos: Establecer la prevalencia y describir las características clínico-patológicas de las pacientes con cáncer de mama triple-negativo subtipo (basal-like y no basal-like) mediante técnicas de inmunohistoquímica que fueron atendidas en el Instituto Nacional de Cancerología (INC) y el Hospital San José (HSJ) durante el periodo 2006- 2008. Métodos: Se realizó un estudio descriptivo de corte transversal, en mujeres mayores de 17 años con diagnóstico histológico confirmado de adenocarcinoma de mama. Se excluyó a las pacientes cuyos bloques de parafina no se conservaron, o a quienes no se les pudieron realizar todos los marcadores inmunohistoquímicos requeridos por el estudio, y se procedió a realizar los marcadores de inmunohistoquímica considerados en el estudio (EFGR, CK5, CK6, S100, P65, CK 14). Se procesaron las muestras siguiendo las recomendaciones de la casa matriz. Se procedió a analizar la información con el programa estadístico Stata10. Resultados: Un total de 1922 casos de cáncer de mama invasor fueron diagnosticados en el periodo comprendido 2006-2008 de los cuales fueron identificados 154 casos de tumores triple negativos (RE negativo, RP negativo, HER-2 Negativo). De estos casos se obtuvo información completa de 84 casos. 50 (59,52%) casos corresponden al tipo basal-like, mientras que 34 (40,48%) corresponden a tumores no basal-like. Conclusiones: El presente estudio es el primero en Colombia que busca determinar mediante inmunohistoquímica la prevalencia del cáncer de mama triple-negativo de tipo basal-like en población colombiana; se halló así una prevalencia del 8,01%, porcentaje que se encuentra por debajo de lo reportado en la literatura mundial (11,9%-25%).


Objectives: To use immunohistochemistry to provide a description of and to ascertain the prevalence of clinical-pathological characteristics in patients with triple-negative (basal-like and non basal-like) subtype breast cancer treated at the National Cancer Institute (NCI) and the San José Hospital (SJH) from 2006 to 2008. Methods: A descriptive cross sectional study was carried out among women over 17 years of age with confirmed diagnosis of breast adenocarcinoma. Patients whose paraffin blocks were not preserved and those on whom it was not possible to carry out the entirety of the immunohistochemical markers requisite for this study were excluded before collection of the immunohistochemical markers considered essential for this study (EFGR, CK5, CK6, S100, P65, CK 14) was performed. Samples were processed according to manufacturer´s instructions; information was analyzed with Stata 10 software. Results: A total of 1,922 invasive breast cancer cases were diagnosed from 2006 to 2008, 154 of which were triple-negative (ER negative, PR negative, HER-2 negative). Complete information was obtained in 84 of these cases: 50 cases (59.52%) were basal-like and 34 cases (40.48%) were non basal-like tumors. Conclusions: This study, the first in Colombia which seeks to determine through immunohistochemistry the prevalence of triple-negative basal-like breast cancer in the Colombian population, found said tumor prevalence to be at 8.01%, which is below that reported in worldwide literature (11.9%-25%).


Assuntos
Humanos , Feminino , Adolescente , Adulto , Estudos de Coortes , Estudos Transversais , Estudos Epidemiológicos , Imuno-Histoquímica/classificação , Imuno-Histoquímica/métodos , Neoplasias da Mama/classificação , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Colômbia/epidemiologia
19.
Acta méd. peru ; 27(1): 8-11, ene.-mar. 2010. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-565491

RESUMO

Objetivo: Hallar la correlación del Test "Get Up and Go" con el Test de Tinetti. Material y método: El presente trabajo es un estudio de concordancia, de las pruebas antes mencionadas. La población estuvo conformada por adultos mayores, que acuden a la consulta externa del consultorio de geriatría del Hospital Nacional Cayetano Heredia. La muestra fue tomada mediante muestreo accidental, se tomó a los primeros 100 pacientes que acudieron al consultorio externo de geriatría durante el mes de marzo del 2005. Resultados: La edad media de los pacientes fue 75,2 +/- 7,46, el 31% refirió haber presentado una o más caídas en el ultimo año. La correlación entre ambas pruebas medida mediante el estadístico Kappa, fue de 0,81 con una significancia p < 0,001, para un punto de corte del "Get Up and Go" menor de 20 segundos. Conclusiones: Existe correlación entre una prueba compleja y amplia, el Test de Tinetti, y otra más sencilla y corta, el "Get Up and Go", elcual debe ser usado como la herramienta inicial para evaluar el riesgode caídas.


Objective: To find a correlation between the Get-Up-And-Go Test and the Tinetti test. Material and Method: This is a study that assessed the concordance of the afore mentioned tools. The population consisted in elderly persons attending the geriatrics outpatient clinic in Hospital Nacional Cayetano Heredia. The sample was taken using the accidental sampling method, and the first 100 patients attending the geriatrics out patient clinic during March 2005 were included. Results: Mean age of patients was 75.2 +/- 7.46 years, 31% declared they had one or more falls during the last year. The measured correlation between the two tests using Kappa statistics was 0.81 with p < 0.001, for a cutoff point for the Get-Up-And-Go test set in 20 seconds. Conclusions: The is a correlation between a complex method, the Tinetti test, and a simple and short method, the Get-Up-And-Go test, which may be used as an initial tool when assessing the risk for falls.


Assuntos
Humanos , Masculino , Feminino , Acidentes por Quedas , Idoso
20.
Rev. méd. hered ; 20(1): 16-21, ene.-mar. 2009. tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-537478

RESUMO

Objetivo: Determinar la frecuencia de casos de úlcera de presión y los factores asociados más importantes para su aparición en pacientes adultos mayores hospitalizados en el servicio de medicina de un hospital general. Material y métodos: Estudio prospectivo, observacional. Se estudiaron a todos los pacientes mayores de 60 años, hospitalizados en el servicio de medicina del Hospital Nacional Cayetano Heredia, entre diciembre de 2006 y abril de 2007. Se evaluaron diferentes variables demográficas, clínicas, así como diversos síndromes geriátricos; en dos grupos de pacientes, quienes desarrollaron úlcera de presión y los que no desarrollaron úlcera de presión. Se utilizó chi cuadrado y el análisis multivariado para determinar asociación estadística. Resultados: Se incluyeron 463 adultos mayores, la frecuencia de casos de úlcera de presión fue 11,4 por ciento. Las variables que estuvieron asociadas con el desarrollo de úlcera de presión, con una significancia estadística en el análisis univariado fueron: edad mayor de 70 años, dependencia parcial o total, deterioro cognitivo moderado o severo, incontinencia urinaria, malnutrición, riesgo moderado y alto para desarrollar úlcera de presión según escala de Norton, neumonía y accidentecerebrovascular como diagnósticos de ingreso, uso de catéter vesical, sujeción mecánica, dispositivos externos locales en zonas de prominencias óseas, la presencia de cuidador y el desarrollo de infección pulmonar intrahospitalaria. Luego del análisis multivariado solo: malnutrición (OR =6,87; IC 95 por ciento, 1,38-34,06 p=0,01) y sujeción mecánica (OR=8,09; IC 95 por ciento, 2,47-26,41 p=0,001) fueron los factores de riesgo. Conclusiones: La úlcera de presión es una condición frecuente en el adulto mayor hospitalizado. Los factores asociados a su aparición fueron malnutrición y sujeción mecánica.


Objective: To assess the frequency of pressure ulcers and its related factors in elderly patients admitted to the Medicine wards at a national hospital. Material and methods: Prospective and observational study. We evaluated patients older than 60 years of age who were admitted to Medical wards of the Hospital Nacional Cayetano Herediabetween December 2006 and April 2007. We assess clinical and demographic variables and geriatrics syndromes in two groups of elderly patients according with the presence of pressure ulcers or not. We performed chi-square and multivariate analyses for detecting statistic association. Results: We studied 463 elderly patients, and the frequency of pressure ulcers was 11.4 per cent. The following variables were associated with pressure ulcers: patients older than 70 years old, partial or total dependency, moderate and severe cognitive dysfunction, urine incontinence, malnutrition, moderate risk and higher risk according Norton scale, pneumonia and stroke as entry diagnosis, use of bladder catheter, physical restraints, use of pressure-reducing cushions and heel protectors, caregiver support and the presence of in-hospital pneumonia. In the multivariable analyses, only malnutrition (OR= 6.87; IC 95 per cent, 1.38-34.06, p=0.01) and physical restraints (OR=8.09; IC 95 percent, 2.47-26.41, p=0.001) were significant associated factors. Conclusions: Pressure ulcers are frequent in hospitalized elderly patients. The associated factors for pressureulcers were malnutrition and physical restraints.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Úlcera por Pressão , Estudos Longitudinais , Estudos Prospectivos , Estudos Observacionais como Assunto
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