Prevalencia de obesidad y factores de riesgo cardiovascular en estudiantes de ciencias de la salud - universidad del Quindío - 2013

ANTECEDENTES: En Colombia, reportes del año 2010 de la Encuesta Nacional de la Situación en Nutrición ENSIN 2010(2), muestran uno de cada dos colombianos, presentan un índice de masa corporal mayor al esperado (3) METODO: El presente estudio de corte transversal, determino la prevalencia de obesidad y otros factores de riesgo cardiovascular en una población de estudiantes de Ciencias de la Salud de una Universidad regional en el primer periodo académico del año 2013. El tamaño de muestra fue n=113 sujetos que corresponden 60,5% a la carrera de medicina y 39,95% a enfermería. Con el fin de conocer su comportamiento con respecto a hábitos y estilos de vida específicos como el consumo de alcohol, el consumo de tabaco y el sedentarismo, así como su asociación a eventos inflamatorios relacionados con la fisiopatología de los procesos de salud asociados al peso, por medio de instrumentos de medición clínica, antropométrica y sérica, determino un modelo estadístico propicio para entender el comportamiento de la obesidad y la enfermedad Cardiovascular RESULTADOS: La prevalencia estimada de sobrepeso y obesidad por Índice de Masa Corporal (IMC), fue del 27,7% (IC 95%: 19.9%,37.2%); por el perímetro abdominal (OBPABD) se encontró una prevalencia estimada del 27,4% (IC 95%: 19,9% – 36,4%), y la prevalencia con el Índice Cintura Cadera (OBICC) fue de 3,5% (IC 95%:1,3% – 9,3%). CONCLUSIONES: La presencia de hábitos no saludables y la presencia de sobrepeso y obesidad se considera que es necesario en primera instancia una valoración general de estado nutricional de los universitarios de las diferentes facultados y plantear estrategias preventivas ya que la literatura documenta los efectos de los hábitos no saludables sino además documenta los efectos de la prevención de la misma ya que en si se ha encontrado asociación para enfermedades cardiovasculares. Se propone que para obtener mayor información del comportamiento de los factores de riesgo cardiovasculares se deberían realizar estudios retrospectivos en el que intervengan las demás carreras de la universidad y poder evaluar la totalidad de población universitaria

Nivel de escolaridad y consumo de alcohol etílico, cannabinoides y solventes en Colombia año 2014

Introducción: El consumo de sustancias psicoactivas como problema de salud pública, debe ser abordado desde diferentes perspectivas. En la literatura se evidencia factores involucrados como, edad de inicio de consumo, información de riesgo, círculo social y antecedentes personales. Igualmente se ha mostrado la asociación con el deterioro de las capacidades de aprendizaje y la farmacodependencia. En este estudio se determinó la asociación del consumo de inhalantes, cannabis y etanol y el nivel de escolaridad alcanzado. Metodología: Estudio observacional transversal, cross sectional, de los casos reportados al sistema único de indicadores de consumo de sustancias psicoactivas en Colombia en 2014. Muestra 6804 casos. Se realizó análisis univariado y bivariado con valores de p, para significancia estadística. Resultados y discusión: Se identificó comportamiento epidemiológico similar, en concordancia con otros estudios, evidenciándose población entre los 15 y 35 años de edad (76,7%), predominantemente hombres (83,9%) y consumo principal de cannabis (43,9%) y alcohol (23,1%). Se determina asociación estadísticamente significativa entre el consumo de inhalantes, etanol y marihuana y la finalización incompleta de estudios de secundaria (p<0,005), el cannabis con asocio a culminación incompleta de estudios universitarios (p<0,005). Hay plausibilidad biológica y epidemiológica con los hallazgos del estudio y otros trabajos desarrollados con anterioridad.

Autocuidados e automedicação na temática da obstipação

Atualmente, consideram-se os autocuidados como a primeira forma de prevenção e tratamento de doenças. Através de alterações no estilo de vida e da automedicação é possível obter enormes benefícios, não só na saúde mas também na economia do próprio país. Para que estas medidas sejam eficazes e seguras, é essencial garantir a formação e informação da sociedade, sendo os profissionais de saúde os principais intervenientes neste processo. Assim, o farmacêutico deve intervir junto da população, não só na promoção da saúde, como também no incentivo ao uso racional dos medicamentos. São diversas as situações passíveis de automedicação e são igualmente vários os casos de utilização incorreta de medicamentos neste contexto. Assim, optou-se por destacar a automedicação na obstipação com recurso não só a Medidas Não Farmacológicas, como também à utilização de laxantes. A obstipação é um conjunto de sintomas associado a determinada causa. Fatores desencadeantes podem ser de origem patológica ou de origem comportamental, destacando-se o stress, polimedicação e hábitos de consumo. Os laxantes são normalmente utilizados no tratamento da obstipação, no entanto, temse conhecimento que podem ser indevidamente usados para outros fins, nomeadamente em contexto de distúrbios alimentares. A dependência destes medicamentos é elevada quando utilizados de forma incorreta, por tempo prolongado e em elevada frequência. Deste modo, o presente estudo tem como principais objetivos percecionar quais as possíveis causas da obstipação; avaliar a utilização de laxantes; identificar que tipo de intervenção é feita pelo farmacêutico nesta temática; avaliar qual o grau de conhecimento da sociedade relativamente à obstipação e ao uso de laxantes e elaborar o Protocolo de Intervenção Farmacêutica na obstipação. Trata-se de um estudo descritivo e transversal que se baseou na realização de um questionário de resposta fechada a utentes da Farmácia Damaia. Foram inquiridos 300 voluntários, de ambos os géneros, com idades compreendidas entre os 1-88 anos (45,15 ± 20,16 anos), após consentimento de participação. O questionário abordou diversas áreas, nomeadamente estilo de vida, rotinas e hábitos defecatórios e xvi utilização de laxantes. Os dados foram tratados no programa Microsoft Excel® 2007 e posteriormente analisados. Através do estudo foi possível percecionar que são várias as falhas existentes ao nível dos conhecimentos da população, nomeadamente em relação aos princípios básicos do funcionamento intestinal. Este estudo também demonstrou que existem lacunas nos conhecimentos acerca dos tipos de obstipação e na utilização de laxantes. Torna-se percetível que é fundamental o processo de instrução da população em relação a esta e outras temáticas relacionadas com a saúde. Assim, o farmacêutico deve tornar-se mais pró-ativo e intervir nesta área, para benefício de toda a sociedade.

Cross-sector surveys assessing perceptions of key stakeholders towards barriers, concerns and facilitators to the appropriate use of adaptive designs in confirmatory trials

Background Appropriately conducted adaptive designs (ADs) offer many potential advantages over conventional trials. They make better use of accruing data, potentially saving time, trial participants, and limited resources compared to conventional, fixed sample size designs. However, one can argue that ADs are not implemented as often as they should be, particularly in publicly funded confirmatory trials. This study explored barriers, concerns, and potential facilitators to the appropriate use of ADs in confirmatory trials among key stakeholders. Methods We conducted three cross-sectional, online parallel surveys between November 2014 and January 2015. The surveys were based upon findings drawn from in-depth interviews of key research stakeholders, predominantly in the UK, and targeted Clinical Trials Units (CTUs), public funders, and private sector organisations. Response rates were as follows: 30(55 %) UK CTUs, 17(68 %) private sector, and 86(41 %) public funders. A Rating Scale Model was used to rank barriers and concerns in order of perceived importance for prioritisation. Results Top-ranked barriers included the lack of bridge funding accessible to UK CTUs to support the design of ADs, limited practical implementation knowledge, preference for traditional mainstream designs, difficulties in marketing ADs to key stakeholders, time constraints to support ADs relative to competing priorities, lack of applied training, and insufficient access to case studies of undertaken ADs to facilitate practical learning and successful implementation. Associated practical complexities and inadequate data management infrastructure to support ADs were reported as more pronounced in the private sector. For funders of public research, the inadequate description of the rationale, scope, and decision-making criteria to guide the planned AD in grant proposals by researchers were all viewed as major obstacles. Conclusions There are still persistent and important perceptions of individual and organisational obstacles hampering the use of ADs in confirmatory trials research. Stakeholder perceptions about barriers are largely consistent across sectors, with a few exceptions that reflect differences in organisations’ funding structures, experiences and characterisation of study interventions. Most barriers appear connected to a lack of practical implementation knowledge and applied training, and limited access to case studies to facilitate practical learning. Keywords: Adaptive designs; flexible designs; barriers; surveys; confirmatory trials; Phase 3; clinical trials; early stopping; interim analyses

Young children learning about evaporation: a longitudinal perspective

This paper traces the learning pathways over a 4-year period of 12 children learning about evaporation. The findings show the complexity and dependence on context of children's understandings. Detailed transcripts for 2 children are used to demonstrate how understandings of phenomena are framed within a network of personal narratives of self that reflect children's different subjectivities as learners and school children, It is argued that the longitudinal methodology opens up a more complex and nuanced view of children's conceptual learning in school settings than is afforded by cross-sectional studies and that the focus on individuals over time compels a very different construction of the learner than is represented in mainstream conceptual-change literature. [ABSTRACT FROM AUTHOR]

Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples

Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n = 7898) and in the US states of Oregon (n = 15 224) and Maine (n = 16 245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12-17. Rates were lower (odds ratios 0.5-0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria.

A cross-national comparison of risk and protective factors for adolescent substance use : the United States and Australia

Purpose
To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused polices.

Methods
Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use.

Results
More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use.

Conclusions
Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.

Psychiatric disorders and unmet needs in Australian police cells

To determine the prevalence of current psychiatric disorders and unmet needs in a sample of police cell detainees in Victoria. A cross-sectional descriptive study was conducted, including data linkage with the Victoria Police database and the Victorian Psychiatric Case Register. In Melbourne, Australia, 150 detainees were recruited from two busy metropolitan police stations. Outcome measures included estimated rates of psychiatric disorders, using the Structured Clinical Interview for DSM-IV-TR, and individual needs, using the Camberwell Assessment of Need – Forensic Version. One quarter (n = 32, 25.4%) of detainees had a prior admission to a psychiatric hospital, and three quarters met current criteria for a diagnosable mental disorder. The most common disorders were substance dependence (n = 81, 54%) and mood disorders (n = 60, 40%). A third met diagnostic criteria for both a mental illness and a substance use disorder. The odds of being classified with mood (OR = 10.1), anxiety (OR = 2.2), psychotic (OR = 15.4) and substance use disorders (OR = 26.3) were all significantly higher in the current sample as compared with the general population. Detainees with a mental illness identified significantly more needs and significantly more unmet needs (e.g. psychological distress) than those who did not rate as having a current mental illness. There remains a pressing need to evaluate standardized screening tools for mental illnesses in police cells to provide timely access to assessment and treatment services. The need for functional interagency collaborations are highlighted and discussed.

Corneal markers of diabetic neuropathy

Diabetic neuropathy is a significant clinical problem that currently has no effective therapy, and in advanced cases, leads to foot ulceration and lower limb amputation. The accurate detection, characterization and quantification of this condition are important in order to define at-risk patients, anticipate deterioration, monitor progression, and assess new therapies. This review evaluates novel corneal methods of assessing diabetic neuropathy. Two new noninvasive corneal markers have emerged, and in cross-sectional studies have demonstrated their ability to stratify the severity of this disease. Corneal confocal microscopy allows quantification of corneal nerve parameters and noncontact corneal esthesiometry, the functional correlate of corneal structure, assesses the sensitivity of the cornea. Both these techniques are quick to perform, produce little or no discomfort for the patient, and are suitable for clinical settings. Each has advantages and disadvantages over traditional techniques for assessing diabetic neuropathy. Application of these new corneal markers for longitudinal evaluation of diabetic neuropathy has the potential to reduce dependence on more invasive, costly, and time-consuming assessments, such as skin biopsy.

A non-stationary panel data investigation of the unemployment–crime relationship

Many empirical studies of the economics of crime focus solely on the determinants thereof, and do not consider the dynamic and cross-sectional properties of their data. As a response to this, the current paper offers an in-depth analysis of this issue using data covering 21 Swedish counties from 1975 to 2010. The results suggest that the crimes considered are non-stationary, and that this cannot be attributed to county-specific disparities alone, but that there are also a small number of common stochastic trends to which groups of counties tend to revert. In an attempt to explain these common stochastic trends, we look for a long-run cointegrated relationship between unemployment and crime. Overall, the results do not support cointegration, and suggest that previous findings of a significant unemployment–crime relationship might be spurious.

Panicca: panic on cross-section averages

The cross-section average (CA) augmentation approach of Pesaran (2007) and Pesaran et al. (2013), and the principal components-based panel analysis of non-stationarity in idiosyncratic and common components (PANIC) of Bai and Ng (2004, 2010) are among the most popular “second-generation” approaches for cross-section correlated panels. One feature of these approaches is that they have different strengths and weaknesses. The purpose of the current paper is to develop PANICCA, a combined approach that exploits the strengths of both CA and PANIC.

Aggregate volatility risk and the cross-section of stock returns: Australian evidence

This study examines the relation between aggregate volatility risk and the cross-section of stock returns in Australia. We use a stock's sensitivity to innovations in the ASX200 implied volatility (VIX) as a proxy for aggregate volatility risk. Consistent with theoretical predictions, aggregate volatility risk is negatively related to the cross-section of stock returns only when market volatility is rising. The asymmetric volatility effect is persistent throughout the sample period and is robust after controlling for size, book-to-market, momentum, and liquidity issues. There is some evidence that aggregate volatility risk is a priced factor, especially in months with increasing market volatility.

Nonparametric tail risk, macroeconomics and stock returns: predictability and risk premia

This paper proposes a new novel to calculate tail risks incorporating risk-neutral information without dependence on options data. Proceeding via a non parametric approach we derive a stochastic discount factor that correctly price a chosen panel of stocks returns. With the assumption that states probabilities are homogeneous we back out the risk neutral distribution and calculate five primitive tail risk measures, all extracted from this risk neutral probability. The final measure is than set as the first principal component of the preliminary measures. Using six Fama-French size and book to market portfolios to calculate our tail risk, we find that it has significant predictive power when forecasting market returns one month ahead, aggregate U.S. consumption and GDP one quarter ahead and also macroeconomic activity indexes. Conditional Fama-Macbeth two-pass cross-sectional regressions reveal that our factor present a positive risk premium when controlling for traditional factors.

Integridade tissular de pacientes com úlceras venosas: um estudo baseado na Classificação dos Resultados de Enfermagem

The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

Dimensional analysis of burden in family caregivers of patients with obsessive-compulsive disorder

Aims: Obsessivecompulsive disorder (OCD) also generates emotional burden in the patient's family members, but no study has evaluated the specific dimensions of burden. The objectives were to evaluate the dimensions of the Zarit Burden Interview (ZBI) and possible correlates. Methods: This was a cross-sectional study involving 47 patients and 47 caregivers, using a sociodemographic questionnaire; the ZBI; the Self Reporting Questionnaire; the Family Accommodation Scale; and the YaleBrown ObsessiveCompulsive Scale. The ZBI factor analysis was conducted using Varimax Rotation. Results: Six factors were identified, explaining 74.2% of the total variance: factor 1, interference in the caregiver's personal life (36.6% of the variance); factor 2, perception of patient's dependence (10.8%); factor 3, feelings of irritation or intolerance (9.2%); factor 4, guilt (7.2%); factor 5, insecurity (5.6%); and factor 6, embarrassment (4.8%). The six ZBI factors were associated with greater OCD severity and with greater accommodation to the patient's symptoms, and factors 1, 2, 5 and 6 with caregiver's psychological morbidity. Caregiver's sex (female) was associated with factors 5 and 6, relationship with the patient (being a parent or son/daughter) with factor 5, higher educational level with factor 6, living with the patient with factor 3, worse self-evaluation of health with factors 1, 5 and 6, and occupational status (not working) with factors 1, 2, 5 and 6. Conclusion: The dimensions of burden identified indicate the most affected aspects of a caregiver's life and could guide the planning of more specific interventions. Thus, the caregiver could participate more effectively in the OCD patient's treatment, with a lower impact on his/her life.