[Patient-Related Factors Affecting Bowel Preparation Prior to Colonoscopy.] / Factores relacionados al paciente que afectan la limpieza del colon previo a la colonoscopia.

INTRODUCTION: Colorectal cancer is a major health problem worldwide because it is the third most common cancer and the third leading cause of cancer mortality in western countries. Screening for colorectal cancer in asymptomatic patients is crucialfor reducing the incidence and colonoscopy is one of the methods of choice. The ability of colonoscopy in detecting small lesions is clearly influenced by the quality of the colonic preparation. OBJECTIVES: To know which are the variablesrelating to the patient and the type ofpreparation that affect the quality of colonic cleansing. MATERIALS AND METHODS: It was designed a cross-sectional study. It was administered a questionnaire for the enrolled subjects to assess the presence offactors that could affect the quality of colonic cleansing. Then they underwent a colonoscopy. The different variables between subjects with adequate or inadequate colonic cleansing were compared. RESULTS: We evaluated 277 subjects. In multivariate analysis the only variables that showed significant differences are split dose [OR 0.45 (0.21 to 0.99)] and age [OR 1.02 (1-1.05)]. Obesity showed no significant differences in multivariate analysis [OR 1.84 (0.9-3.78)]. CONCLUSIONS: Age and split-dose were the only variables significantly associated with the quality of bowel preparation prior to colonoscopy. Not so constipation or the presence ofdiverticula, so these patients do not require special preparation regimes.

Prolonged Intestinal Transit Time and Its Relation with Capsule Endoscopy Diagnostic Yield.

BACKGROUND: Capsule endoscopy is a gold standard diagnostic method for small bowel lesions. There is scarce evidence regarding vari- ables that may increase the odds of identifying small bowel lesions with this endoscopic method. The aim of this work is to describe variables associated with a higher probability of finding small bowel lesions on capsule endoscopy. METHODS: Cross-sectional study was performed using our Department's adult patients' capsule endoscopy database. The presence of any small bowel mucosal lesion was registered. Other variables were examined: age, gender, reason for referral, quality of bowel cleans- ing, and intestinal transit time. These variables were compared between those patients showing at least 1 lesion versus those without lesions. Univariate and multivariate analysis was performed to determine variables significantly associated with the presence of bowel lesions. RESULTS: In total, 140 studies were analyzed; 90% were performed due to occult gastrointestinal bleeding. Median age was 69 years (60-75); 54.29% were males. Bowel cleansing was adequate in 94.29%; 68.57% showed at least 1 lesion. Non-significant difference was observed in terms of age between groups of comparison (70 [61-76] vs 63 [59-74], P = .07). No difference was found comparing bowel cleansing, gender, or reason for referral. Intestinal transit time was significantly longer among those patients with a bowel lesion (359 minutes [257-427] vs 279 minutes [200-333], P = .05). On multivariate analysis, age and intestinal time were significantly associ- ated with the presence of at least one small bowel lesion (odds ratio 1.02 [1-1.06] and 1.09 [1.03-1.12], respectively). CONCLUSION: Age and intestinal transit time were significantly associated with the presence of abnormal findings on capsule endoscopy.

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness.

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and cost-effectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and costeffectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation. (AU)

Efeitos de um Programa de Prevenção à Violência no Namoro / Effects of a Dating Violence Prevention Program / Efectos de un Programa de Prevención de la Violencia en el Noviazgo

Resumo Este estudo avaliou os efeitos de uma intervenção para prevenção à violência no namoro sobre intenções de enfrentamento a esse tipo de violência, dificuldades em regulação das emoções e endosso a normas tradicionais de papéis de gênero masculino. Participaram 45 adolescentes, alocados não randomicamente em um grupo experimental (N = 21) e um grupo controle (N = 24). A intervenção compreendeu nove sessões focadas em informações sobre violência no namoro, habilidades sociais, tomada de decisão, papéis de gênero, direitos sexuais e reprodutivos e empoderamento. Análises intra e entre grupos revelaram redução significativa em crenças que apoiam a restrição emocional como característica masculina no grupo experimental, ao passo que intenções de enfrentamento à violência no namoro e regulação emocional não sofreram mudanças significativas em nenhum dos grupos. Contudo, avaliações qualitativas evidenciaram a prática extrassessão de habilidades de autocontrole e expressão emocional, assertividade e empatia. Novos estudos, principalmente longitudinais, são recomendados para elucidar esses resultados.

Abstract This study evaluated the effects of a dating violence prevention intervention on intentions of coping with this type of violence, difficulties in regulating emotions and endorsement of traditional male gender norms. There were 45 adolescent participants, not randomly placed in an experimental group (N = 21) and a control group (N = 24). The intervention encompassed nine sessions focused on information about dating violence, social skills, decision making, sexual and reproductive rights, and empowerment. Analyses intra and between groups had shown significant reduction in beliefs that supported emotional restriction as a masculinity characteristic in the experimental group, whereas the intentions of coping with dating violence and emotional regulation had not suffered significant changes in any of the Groups. However, qualitative evaluations had evidenced the external practice of self-control and emotional expression skills, assertiveness and empathy. New studies, mainly longitudinal, are recommended to elucidate these results.

Resumen Este estudio evaluó los efectos de una intervención para la prevención a la violencia en el noviazgo sobre cómo hacer frente a tales intenciones de violencia, dificultades en la regulación de las emociones y aprobación de normas tradicionales de roles de género masculino. Participaron 45 adolescentes, no asignados no aleatoriamente en un grupo experimental (N = 21) y un grupo de control (N = 24). La intervención consistió en nueve sesiones que se centraron en información sobre violencia en el noviazgo, habilidades sociales, toma de decisiones, roles de género, derechos sexuales y reproductivos y en la potenciación. Análisis intra y entre grupos revelaron una reducción significativa en las creencias que apoyan la restricción emocional como característica masculina en el grupo experimental, mientras que las intenciones de enfrentamiento a la violencia en el noviazgo y la regulación emocional no sufrieron cambios significativos en ninguno de los grupos. Pese a eso, las evaluaciones cualitativas mostraron la práctica externa al período de las sesiones de habilidades de autocontrol y expresión emocional, asertividad y empatía. Son recomendados nuevos estudios, principalmente longitudinales, para esclarecer estos resultados.