3,434 research outputs found
Implementation tells us more beyond pooled estimates: Secondary analysis of a multicountry mhealth trial to reduce blood pressure
No full text©Rodrigo M Carrillo-Larco, Safia S Jiwani, Francisco Diez-Canseco, Rebecca Kanter, Andrea Beratarrechea, Vilma Irazola, Manuel Ramirez-Zea, Adolfo Rubinstein, Homero Martinez, J Jaime Miranda, GISMAL Group. Background: The uptake of an intervention aimed at improving health-related lifestyles may be influenced by the participant’s stage of readiness to change behaviors. Objective: We conducted secondary analysis of the Grupo de Investigación en Salud Móvil en América Latina (GISMAL) trial according to levels of uptake of intervention (dose-response) to explore outcomes by country, in order to verify the consistency of the trial’s pooled results, and by each participant’s stage of readiness to change a given lifestyle at baseline. The rationale for this secondary analysis is motivated by the original design of the GISMAL study that was independently powered for the primary outcome-blood pressure-for each country. Methods: We conducted a secondary analysis of a mobile health (mHealth) m
Using country-level variables to classify countries according to the number of confirmed COVID-19 cases: An unsupervised machine learning approach [version 2; peerreview: 1 approved, 1 approved with reservations]
No full textBackground: The COVID-19 pandemic has attracted the attention of researchers and clinicians whom have provided evidence about risk factors and clinical outcomes. Research on the COVID-19 pandemic benefiting from open-access data and machine learning algorithms is still scarce yet can produce relevant and pragmatic information. With country-level pre-COVID-19-pandemic variables, we aimed to cluster countries in groups with shared profiles of the COVID-19 pandemic. Methods: Unsupervised machine learning algorithms (k-means) were used to define data-driven clusters of countries; the algorithm was informed by disease prevalence estimates, metrics of air pollution, socio-economic status and health system coverage. Using the one-way ANOVA test, we compared the clusters in terms of number of confirmed COVID-19 cases, number of deaths, case fatality rate and order in which the country reported the first case. Results: The model to define the clusters was developed with 155 countries. The model with three principal component analysis parameters and five or six clusters showed the best ability to group countries in relevant sets. There was strong evidence that the model with five or six clusters could stratify countries according to the number of confirmed COVID-19 cases (p<0.001). However, the model could not stratify countries in terms of number of deaths or case fatality rate. Conclusions : A simple data-driven approach using available global information before the COVID-19 pandemic, seemed able to classify countries in terms of the number of confirmed COVID-19 cases. The model was not able to stratify countries based on COVID-19 mortality data
Multimorbidity and disability among Venezuelan migrants: a population-based survey in Peru
No full textBackground: The political and economic crisis in Venezuela has originated an unprecedented migration. As of November 2020, 1.04 million Venezuelans have moved to Peru. Understanding their health profile is needed to identify their needs, provide care and secure resources without affecting the healthcare of nationals. We quantified the burden of multimorbidity and disability in the Venezuelan population in Peru.
Methods: We analyzed the 2018 Survey of Venezuelan Population Living in Peru; population-based with random sampling survey in six cities in Peru. Participants were asked about the presence of 12 chronic conditions (self-reported); this information was grouped into 0, 1 and ≥2 conditions (i.e., multimorbidity). Disability was also ascertained with a self-reported questionnaire adapted from the short version of the Washington Group on Disability Statistics. Socioeconomic variables were analyzed as potential determinants. Variables were described with frequencies and 95% confidence interval (95% CI), compared with Chi2 test, and association estimates were derived with a Poisson regression reporting prevalence ratio and 95% CI. Results accounted for the complex survey design.
Results: The analysis included 7,554 migrants, mean age 31.8 (SD: 10.2), 46.6% were women, 31.7% migrated alone and 5.6% had refugee status. The prevalence of multimorbidity was 0.6% (95% CI: 0.4%-0.9%), and was often present in women (p<0.001), people ≥50 years (p<0.001) and those without recent job (p<0.001). The prevalence of disability was 2.0% (95% CI: 1.5%-2.7%), and was common among people ≥50 years (p<0.001) and those without recent job (p<0.001). Migration alone and refugee status were not associated with multimorbidity or disability.
Conclusion: The self-reported prevalence of multimorbidity and disability in Venezuelan migrants in Peru was low, and were not strongly influenced by migration status. While these results could suggest a healthy migrant effect, the healthcare system should be prepared to deliver acute and preventive care for these migrants, while also securing primary prevention to delay the onset of chronic conditions in this population
Urbanization, altitude and cardiovascular risk
No full textBackground:
There is limited information regarding the variation of the cardiovascular (CV) risk, that combines multiple risk factors in one metric, according to urbanization and altitude.
Objective:
To assess and disentangle the potential association between urbanization and altitude with absolute CV risk using Peruvian nationally-representative surveys.
Methods:
Pooled analysis of Peruvian Demographic Health Surveys (from 2014 to 2020), including subjects aged between 40 and 74 years, was conducted. The outcome of interest was the 10-year predicted absolute CV risk based on the non-laboratory version of the World Health Organization (WHO) and split into <10% and ≥10%. The exposures were urbanization (rural or urban) and altitude (<500 meters above the sea level [m.a.s.l.], between 500 and 2,499 m.a.s.l, between 2,500 and 3,499 m.a.s.l., and ≥3,500 m.a.s.l.). Crude and adjusted Poisson regression models were built to assess the associations of interest, reporting prevalence ratios (PR) and 95% confidence intervals (95% CI).
Results:
Data of 80,409 subjects, mean age 54.3 (SD: 8.8) and 42,640 (54.4%) females were analyzed. Regarding urbanization, 30,722 (25.4%) subjects were from rural areas, and 60.6% lives at <500 m.a.s.l., whereas only 9.3% lives at ≥3500 m.a.s.l. The 10-year predicted absolute CV risk mean was 4.5% (SD: 3.1), and 7.8% had a CV risk ≥10%. In multivariable model, urbanization, mainly rurality (PR=0.89; 95%CI: 0.81–0.97) and altitude (PR=0.82; 95%CI: 0.75–0.90 for those living between 2,500–3,490 m.a.s.l. and PR=0.68; 95%CI: 0.60–0.76 for those living ≥3,500 m.a.s.l) were factors independently associated with CV risk. Urbanization was an effect modifier of the association between altitude and CV risk with a greater effect in urban settings.
Conclusion
Urbanization, specifically rurality, and high-altitude, mainly ≥2,500 m.a.s.l., were factors independently associated with lower predicted CV risk
Diabetes mellitus tipo 2 en Perú: una revisión sistemática sobre la prevalencia e incidencia en población general
No full textObjetivos. Identificar estudios de prevalencia e incidencia de diabetes mellitus tipo 2 en población general adulta de Perú. Materiales y métodos. Se evaluaron estudios observacionales que incluyeron individuos de población general seleccionados aleatoriamente. La definición de diabetes debió incluir al menos un parámetro de laboratorio (p. ej. glucosa basal). Se revisó LILACS, SciELO, Scopus, Medline, Embase y Global Health, sin restricciones. El riesgo de sesgo se evaluó con la escala Newcastle-Ottawa. Resultados. La búsqueda identificó 909 resultados, adicionalmente se agregó un artículo de otra fuente. Luego de evaluar los resultados, se seleccionaron 20 artículos que representaron nueve estudios (n=16 585). Uno de los estudios fue de alcance nacional y otro seminacional (ENINBSC, 2004-05 y PERUDIAB, 2010-12); el primero reportó una prevalencia de 5,1% en sujetos ≥35 años, mientras que el segundo reportó 7,0% en sujetos ≥25 años. Otros estudios se enfocaron en poblaciones de una o varias ciudades del país, o en grupos poblacionales selectos, como el estudio PERU MIGRANT (2007-08) que reportó la prevalencia de diabetes en sujetos de zonas rurales (0,8%), en migrantes de zonas rurales a urbanas (2,8%), y en zonas urbanas (6,3%). Tres estudios realizaron seguimiento prospectivo, siendo uno de ellos el PERUDIAB: incidencia acumulada de 19,5 nuevos casos por 1000 personas al año. El riesgo de sesgo fue bajo en todos los estudios. Conclusiones. Estudios poblacionales señalan que la prevalencia de diabetes ha aumentado y se registran aproximadamente dos casos nuevos por cada cien personas al año. La evidencia aún es escasa en la selva y en poblaciones rurales
A divergence between underlying and final causes of death in selected conditions: an analysis of death registries in Peru.
No full textBACKGROUND: The underlying cause of death is used to study country and global mortality trends and profiles. The final cause of death could also inform the ultimately cause of death in individuals with underlying conditions. Whether there is a pattern between the underlying and final cause of death has not been explored using national death registries. We studied what final causes of death were most common among selected underlying causes using national death registries in Peru, 2015. METHODS: Underlying and final causes of death were classified according to their ICD-10 codes. Underlying causes included chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), diabetes, and selected cancers (cervix, breast, stomach, prostate, and lung). Final causes were categorized as: communicable, cardiovascular, and cancers. Descriptive statistics were used. RESULTS: A total of 77,065 death registries were analyzed; cases had a mean age of 69.4 (SD: 19.3) years at death and were mostly men (53.9%). When the underlying cause was HTN, the most frequent final cause was cardiovascular diseases (82.3%). For all the other underlying causes, the most frequent final cause was communicable diseases: COPD (86.4%), CKD (79.3%), cancer (76.5%), and diabetes (68.3%). CONCLUSIONS: In four selected underlying causes of death there was a divergence with respect to the final cause, suggesting there was a shift from non-communicable to communicable causes. Although efforts should be deployed to prevent underlying non-communicable diseases, potential communicable complications should not be neglected
Sexuality conceptions in students of public schools with sexuality education projects in Barranquilla, Colombia
No full textEl tema de la sexualidad en relación con la educación
ha sido profusamente trabajado, no solo en el contexto regional y nacional, sino en el mundo entero. Quizás ello se deba a que, por la forma como la vivimos, la
identificamos muchas veces como uno de los rasgos más
distintivos de nuestra especie. No obstante, el abordaje
desde una perspectiva más compleja y más certera de
la educación sexual se ha visto dificultado por la diversidad disciplinar y teórica desde las cuales se entiende
la sexualidad y los temas con ella relacionados (como,
pr ejemplo, la adolescencia, en tanto grupo objetivo primordial de los proyectos y programas), o la tendencia a
reducir la sexualidad al coito y a la genitalidad o a un
conjunto de informaciones estereotipadas, entre otras
razones.The topic of sexuality in relation to education has
been extensively worked not only in the regional and
national context, but in the world. Perhaps this is
so, because the way we live it, and often identified
it as one of the most distinctive features of our species. However, the approach from a more complex
and more accurate perspective of sexual education
has been hampered by the theoretical and discipline diversity from which sexuality and issues related
to it have been understood (eg, adolescence, usually
understood as primary objective of both projects and
programs), or the tendency to reduce sexuality to intercourse or set of stereotypical information, among
other reasons.Campis Carrillo, Rodrigo Mario-8d8df788-4082-4a26-ac91-0e626b0607e4-
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